Swelling

... and just when I thought everything was peachy clean.

Last night my surgical knee had extra fluid in it. I'm not even sure when it got there as I didn't notice until I was about to hit some zzz's.

The past week:

Tuesday: Personal training - Worked entirely on jumping / plyometrics
Wednesday: Surgical Knee was sore going up / down stairs
Thursday: Personal training - various strengthening routines for quad / hamstrings
Friday: same soreness as Wednesday.
Sunday: Played high level ultimate frisbee game. Although knee was sore, no pain / instability / swelling after game
Monday: pain in knee when going up / down stairs. Most it's been since surgery. Although not unbearable, still unusual.
Monday-night: Noticed my knee has more fluid in it than normal (since surgery)

Currently, there's very little pain when going up/down stairs, no loss in range of motion, no instability. Just a little bit of extra fluid / puffyness.

After doing some research I think it might be overuse and/or scar tissue irritation. But either way, I'll be taking a break over the next 2 weeks and give it time to relax. It's also possible my patella isn't tracking 100%. If it doesn't get better, I'll see a doctor / physiotherapist in the new year.

8 months post op!

99.9999999% back to feeling normal! My ultimate game last Sunday made me realize how much I've forgotten that I injured my leg. Which is a good thing as we're playing a higher level of ultimate now.

Personal training continues twice a week (30 min sessions) until my two legs are equal. My surgical leg is currently 1/4 inch smaller than my good leg.

I've been doing warm-ups before each game and haven't pulled my hamstrings since.

Stuff that has improved over the past few months:

• still a large spot below the knee cap that is partially numb, but I'm slowly feeling it again.
• the catching problem doesn't happen anymore, although I can sometimes feel like it wants to catch. It's a lot less noticeable now.
  
• the tingling in the toes only happens when I wake up, no longer during the day and it's quite minor now.
• size difference between my two legs is only 1/4 inch now. (down from 1/2 inch)
  

Goals for the next month are:

• Don't be tearing no ACL!
• Keep my legs strong!
  

7 months Post Op

Over the past month since being given the go-ahead for sports, I've been playing 2 days of Ultimate a week + 2 days of personal training (30 mins of pure torture for my legs). Overall, the knee has constantly been improving, I have more confidence in my leg, and with the intense PT sessions my muscle strength is coming close to matching my good leg.

I managed to do a full field sprint without feeling like I'm using my right leg more than surgical left, although I'm nowhere near top speed. However, I ended up straining my good leg hamstring and partially straining my surgical leg hamstring. Note to self: warm up before the game. This one seems obvious but I totally forget to do it and it's extremely important.

The knee catching still happens every now and then but it's slowly slowly getting to the point where I don't remember it.

I've also noticed some muscle anomalies with my surgical leg. When sitting on the floor with my legs straight out in front of me, and raising both legs (while straight). I've noticed the middle quad muscle in my surgical leg is very pronounced, whereas the right leg has all muscles balanced. Hopefully this is nothing to worry about.

I still have skin numbness below the kneecap on the outer size and about the size of tennis ball. If it's getting better, I can barely notice. I've read that the nerves take a long long time to regenerate.

Over the next month, I'll be sticking with personal training 2 times a week to get the surgical leg equal to my good leg.

My goal for the next month is:

- Do a proper warm-up before each game!

Ditching the knee sleeve and playing too much

Over the past 7 days I've played Ultimate: 1 hour on Monday, 1 hour on Thursday, 3 hours on Saturday, 1.5 hours on Sunday and I'll be playing 1 hour tonight. I told myself not to do this, but when someone asks "Can you sub for Ultimate", I just can't say no. However, while playing, I'm fairly conservative. I'm barely breaking a sweat by the end of the game (although my legs do feel a bit tired). I'm still cautious when changing direction and going for a long sprint. It seems when whoever I'm guarding goes deep, I don't keep up. This wasn't the case before the injury, so over the next 2 months this is my goal: Do a full field length sprint and keep up with who I'm guarding.

I've also ditched the knee sleeve as it wouldn't protect me from tearing anything and it makes me aware of my weaker leg. Right now, treating my surgical leg different than my good leg is a bad idea as according to this study, I'm about 3 times as likely to tear my good leg than bad. (2.8% vs 1%). That study also showed there's no difference in re-injury if you return to sports at 5 months vs 9 months (assuming patellar tendon graft was used). Also this study showed (and every other study I've read) there was no statistical difference in the outcome of acl reconstruction if you wear a brace or a sleeve.

I played against a guy yesterday who was recovering from his second acl surgery (he's torn both legs). Since I do not want to go through this process against, I'll be sticking with Personal Trainer 2 times a week until I'm treating both legs equal.

Last Saturday I had the unfortunate experience of seeing a girl go down while playing ultimate and hear the words "I was running and then I heard a pop". Hopefully not a full ACL tear but it still makes me cringe and feel sorry for her. On the bright side, at least I know from experience it's not the end of her sports career!

So my goals over the next month or two will be:

- Get both legs equal in strength and usage!
- Full field length sprint
- Don't play so much Ultimate (this will be a tough one!)

Turning 30 and playing Ultimate Frisbee

Today was my first Ultimate Frisbee game in 13 months. It also coincides with my 30th birthday which was a nice birthday present!

Overall the knee felt fine. No soreness or swelling. And although I played a pretty relaxed offensive game, on defense I played fairly hard. It felt great to play again! I wore a knee sleeve just to remind me not to do anything stupid. I feel like I'm still using my right leg more than my left, so hopefully more personal training will help solve this imbalance, or perhaps it's just a confidence thing and I just have to become more comfortable with it. Either way, it's Ultimate season for me!

Houston we have liftoff!

- Can I play sports?
- "Yes"

Oh, what a sweet sweet word.

I didn't know what to expect going in. I figured it was a coin toss 50/50 chance of being allowed to play. I put my cards and effort on the table and had to hope for the best. After a 2 hour wait to see a random doctor in the clinic, he gave me the good news and congratulated me for graduating the 6 month mark. Tested out the ACL and said I'm clear to play. No brace and no restrictions. Just go easy on it at first. Also, try and even out the 2 legs in terms of muscle size. Out of the blue, the massive headache I had all morning suddenly disappeared.

I'll be sticking with personal training 1-2 days a week until both my legs are equal and who knows, maybe I'll stick with a personal trainer forever. I figure the stronger my leg / core muscles are the less risk of re-injury or injuring the right leg. Lesson learned: don't tear your ACL.

Now, to find an ultimate team to sub for...

6 months Post Op

Yesterday was my 6 month mark since surgery. It's very hard to believe it's been so long since the surgery, but even longer since the injury. In 2 days I'll visit the surgeon for the go ahead for sports!

Over the past 2 weeks I've been in Ireland and about 7 out of the 10 days I did 30 minute rehab exercises in the morning. I also did lots of walking and hiking up cliffs:


Overall, the knee felt good. I had to do my regular quad stretches to get rid of the knee catching. One interesting event which gave me a lot of confidence in my knee was when me and my girl Alice were running around a cliff, going up and down the rocky terrain. At the end she mentioned how I didn't have reservations about running and jumping on the rocks. It was a defining moment that I didn't think about my knee and worry I'd re-injure it.

I feel like I'm ready to play sports again, now I just need the doc's permission!

2 Days Left!

24th Week Post Op!

As I approach the final 2 weeks to Judgment Day I've started to exam my leg, comparing it to my good one. It's currently 1/2 inch smaller than my right, which isn't too shabby. Agility drills are approaching a normalcy that I'm quite proud of now. I've started to do a regular jump off the left leg and it's feeling quite normal. Walking, however, has some minor issues but overall nothing too serious. The fat pad still catches every now and then, but a quick quad stretch fixes it.

I'm heading to Ireland for 10 days and since I don't want to lose all the muscle I've gained I'll be doing 30 minute workouts every morning with a combination of the following exercises:

drop squats, one leg raise onto chair, one leg squat with other leg in front, one leg squat with other leg behind, various core exercises, jumping jacks, cross country skier, 5 plate lunge, hammie drop, squat jump onto bed, and calf raises.

Due to the fact that this is Ireland I'm going to and beer is cheap, I highly doubt I'll be doing this every morning, but this is the goal!

12 Days to go!

22nd Week Post Op

22 down, 4 more to go!

I saw my physio for probably the last time this week. I only have to come back in if I have questions. Right now all my workouts are done with my personal trainer twice a week, but I'll probably bump it up to 3 times a week to makeup for the lost physio session. My PT is a bit more charismatic than my physio... ie "Don't jump like an old lady, jump like you're athletic!". The sessions are very very intense and I find myself barely able to walk afterwords, but this is exactly what I'm looking for.

The past few weeks of PT have brought a lot more confidence in my leg. They've also brought a bit more tingling in my toes. I'm not sure if this is something to worry about or not. It doesn't affect my ability to move my toes or any part of my leg / foot. From internet research, the best guess is that the nerve is getting irritated by either the remaining swelling or inflamation.

1 year since injury

Today marks the one year anniversary since my injury and the last time I played a sport. Cutting hard one way, then slowing down, then doing a 270 while speeding up caused my knee to explode. I'm a very fast / agile guy and my specialty is stopping on a dime and changing directions quickly. I've been playing sports for years and every game I'm running / cutting hard so why did it happen that game as opposed to any other? I've come to conclude it was a multitude of factors:

1. Playing 4 nights a week - doesn't give your muscles time to heal up. The weaker your muscles are, the more strain is put on your ligaments.
2. Quad / Hamstring ratio strength - I never did any exercises (lunges) to build up my hammies. Hamstring's protect your ACL. I never built up the muscles around the knee either. I'm sure my quads were way too strong for my hamstrings.
   
3. Tight Hammies - I never did any stretching and when attemping to touch my toes I was about a 1 foot away from them.
4. Turf field + Gaia cleats - locks you into the ground. The gaia ultimate cleats I use are kind of like football cleats and they provide very good grip. However, the turf field I was on sort of locks you in, ie. there's no give. Someone I played with tore their ACL on that field too.
5. Age - I was 28 at the time. Apparently when you're 18 the ACL can handle 3000N of force, whereas when you're 30 it drops to anywhere in the low - mid 2000N's.

I've been trying to find a silver lining to this whole experience and all I can think of is that I can possibly prevent others from going through this. Yesterday at ultimate practice I showed my team the exercises I do and tried to explain how important lunges are. It's something really simple to do every morning to build up muscles to protect the knee!

5 months Post Op!

5 down, 1 to go!

It's hard to believe it's the final month! Due to me moving places this month I've started to slack on routines. Thankfully personal training started up last week with some intense workouts which has really helped me build confidence in my leg. Also my cardio seems to be fairly decent (according to my physio).

I've also started to actually run for the disc now instead of the usual rumping. Although it's not a full out sprint, I do try and push myself to catch the disc regardless of how far away it is. It feels great!

Size wise, my left leg is still slightly smaller and still has some inflammation. But overall, the muscles are looking much better! The fat pad catching problem is still around but a simple 20 second quad stretch gets rid of it.

My goals for the next month are the same as the last month: Get that left leg to be equal to the right and have equal confidence in both legs!

One month left!

20th week post op!

20 down, 6 more to go!

I have to admit I'm getting a little nervous that in 6 weeks my left leg won't be up to par. Unfortunately this weeks' new pair of shoes has given me extremely painful blisters on my feet that has left me limping around on both feet and unable to do my physio. Personal training started this week, however, all he ended up doing was manual therapy on me... which is somewhat disappointing. Apparently we'll be starting on muscle strengthening next week.

My physio has tossed around the word "proprioception" but I've never fully appreciated what it meant until I started juggling while standing one legged on the bosu ball. Normally, both my legs are fairly equal while standing on the bosu, but add juggling to the mix and it's completely different. I can balance a lot better on my right leg while juggling then my left. This is good news in one way: I can measure improvements in the propriocepters in my knee while doing this routine!

I've also crossed the 50 day mark, woohoo!

19th week post op!

19 down, 7 more to go!

The last week has been good to the knee. More agility exercises were given (figure 8's, S's) Everything feels normal and I have to say I'm quite happy that I'm still fairly agile. I'll be starting personal training next week to help speed up the recovery.

I've also noticed the large patch of numbness below the knee is slowing fading away. I can actually feel things on it now and although it's no where near normal, I'm happy that it's returning.

My physio was examining my knee today and the difference in muscle strength. Everything looks really good as I'm approaching the size of the other leg.

18th Week Post Op!

18 down, 8 more to go!

I've started back up into physio 2 days a week now as I'm now cleared to do the harder physio routines. Most of the exercises are about legs & core and jumping onto the bosu ball. I found all the exercises fairly easy so I'm hoping for tougher ones for the next session.

I may pickup a personal trainer for 1 day a week at a gym mainly for 2 reasons: a) I'm finding it's becoming more difficult to push myself on my own and b) the physio place I go to (Athletes' Care) doesn't have a big area to practice running / agility drills.

4 months in review!

4 months down, 2 to go!

I met with another random doctor today to go over my knee. The new ACL is great, flexion and extension are great. I mentioned the catching problem and she said to build up my muscles as there's a significant difference between my two legs. I also mentioned the pain in the back of my knee while fully flexing and her response was "It's nothing to worry about". Not exactly the answer I was looking for but oh well.

After looking over the surgical report that said I'd lost 50% of the lateral meniscus and the cracks in the cartilage she asked: "Are you planning on going back to Ultimate?". I responded with a resounding: "Oh Yeah!". "You're one of the diehards eh?". I have an appointment in 2 months with the actual surgeon who will either give me the green light to play again, or the red light backhand to the face. I've got a lot of work to do the next 2 months to get both legs equal in strength, but I'm up for the challenge!

The past month changes:

• Tingling in foot is now gone.
• Fat-Pad slightly catching every now and then, not as bothersome as it used to be
• Running is a lot more normal.
• One-legged hopping is better
• I can skip rope much more confidently now!

My goal for the next 2 months is having both legs equal in strength, balance, agility, and flexibility.

60 days left!!

16th - 17th week post op!

17 weeks down, 9 more to go!

I played another scrimmage of Ultimate frisbee again last night. It felt good running for the disk again even it was just a light jog. I'm also glad my throw is still fairly decent. However, the better my knee feels, the more reason I *shouldn't* play. So I'll have to go cold turkey the next 2 months and resist the temptations. If only there was the "patch" for Ultimate!

The past 2 weeks have been fairly consistent. The hamstring machine at the gym has finally been fixed and I'm happy to know my hammies didn't degrade over the past 3 weeks (in fact got stronger) even without using it. Apparently all of the other routines I do work the hammies just as much. The fat-pad knee catching problem still occurs every now and then, but it's not nearly as bad as it used to be. I've been working really hard on the foam roller and lots of stretches.

I meet the surgeon (or probably some random doctor) again on Tuesday which is coincidentally 4 months post op. It's also the time I can start doing cutting routines and high-level plyometrics. I'm looking forward to that!!

15 Weeks Post Op!

15 down, 11 more to go!

The past week had it's downs and ups!. Some important milestones were reached:

• I can touch my feet standing up for the first time in 29 years. I've never been flexible and was born with tight hamstrings (or at least, that's my excuse)
• I played ultimate frisbee last night. I know I shouldn't, but it was just a scrimmage and I made sure no hard cuts or jumps were made. I also did the "safety run" instead of regular runner since the ground wasn't exactly smooth.
• The fat pad catching problem is basically gone thanks to foam roller!

I should probably update the clock to say "until a *real* game of Ultimate Frisbee", but for now I'll just leave it.

Foam Roller

Say hello to my new best friend! I picked up one of these bad boys on the weekend and after 2 days of rolling, rolling, rolling, my two main issues are gone. I haven't had my fat pad catch or feel like it's in the way in over 3 days. It's amazing how something like that just goes away one day considering it was getting worse while walking.

Also, the pain I felt while walking that started last week is basically gone. I believe, after careful analysis, that the problem was with my IT band. Some IT band streches + roller dude and bamo, it's gone! It comes back a little bit after intense workouts but, with the roller, it doesn't last long.

My chiro-dude told me weeks ago that my quads were really tight and mentioned getting the roller. I should have taken his advice earlier!

14 weeks post op!

14 down, 12 more to go!

This week started off with some hardcore jumping and agility drills with no pain or swelling. However 2 days later I was barely able to walk normally due to the pain on the outside of my knee. From what I can guess, I overworked some muscle I haven't used in 10 months. I don't feel pain when: sitting, going up/down stairs, jumping, hopping, running, or doing lunges. It's specifically when I have full weight on my leg in full extension and then I bend slightly and quickly. It's been slowly getting better, but not 100% yet.

Last night I ran outside for the first time since the injury. It felt great, felt normal, and no pain. I'm inching closer to a full out sprint (2 more weeks to go for that!)

Last Physio?

So today was my first physio in about 2.5 weeks. More exercises were added:

• Jumping up on-top of objects and jumping down (3-4 feet high). I also carry weight while doing it.
• Ladder shuffles? This basically entails a ladder on the ground and I run through it as quickly as I can. I can tell my left leg is slower than my right.
• Jumping onto bosu with one leg and than jumping off with that leg.

He also mentioned at this point I don't need to come back. Everything looks good and if I keep up with my exercises and keep pushing myself I should be fine. I have to add exercises I feel would simulate the sports I play.

He also said that I don't really have any restrictions at this point and mentioned that most acl tears are twisting ones, so I have to think about that while doing anything. I still have 3 months left till sports so I'll probably hold off on full blown sprints for another month. But one thing I can definitely do is jump for frisbees!

3 months in review! (13 weeks post op)

3 down, 3 to go!

The last month has had some setbacks and gains. Overall I can't tell that much difference between now and the last month. I think my knee looks about the same.

The good:

• Jogging again: after 2 weeks I'm almost feeling normal again.
• Skipping rope: I no longer double jump.
• Doing one legged squats without bosu has helped the fat pad catching problem
• Extension matches the other leg, while flexion is almost there
• Running up stairs.
  

The bad:

• kneecap fat pad is catching when I hyper-extend and then bend quickly.
• tingling in my middle toe.
• still have knee soreness / tiny bit of pain + inflammation.
  

The awesome:

• Only 3 more months to go!

I'd say my motivation dropped this month due to the small problems that have arisen. I guess I assumed everything would constantly get better but that doesn't seem to be the case. ACL rehab has it's ups and downs. Right now, I feel like I'm heading back into the "ups".

I can't wait for this next month to be over as then I'll be able to do the hardcore physio stuff: plyometrics, sprinting, and jumping.

Goals:

• Become very very comfortable doing one legged squats without the bosu (for some reason being on the bosu is easier for me) Hopefully this will get rid of the fatpad catching problem
  
• Become more comfortable with jogging. Right now I still have to think a lot while running.
  
• Get ready for the high-level physio coming in the next month.

12th week post op! tick tick tick

Finally broke the 100 day mark until sports! wheeee! It's hard to believe I only have 99 days left! In one week I'll be half done!

Over the past week I've started to jog, run up stairs, and skip rope. Other than that, not much new. I get the odd crack, snap, needle pain in and around my knee every now and then, but it's not too bad.

12 down, 14 more to go!

Jogging 101

On Saturday I attemped jogging for the first time since the injury (9? 10? months ago). It also coincides with the first time I have ever used a treadmill. Due to this last fact I had trouble *walking* on the treadmill at first. I'm more used to my body moving when I take a step forward, not some pad underneath me.

Anyway... after 10 minutes of walking and speed walking and building up confidence to run, eventually, with 2 hands on the bar in front of me, I started to jog. I put a lot of weight on the bar just to feel safe but I knew I had to eventually remove myself from the "training wheels" and go it at it freestyle. At first I was using my right leg a lot more than my left but eventually (through lots of self confidence building) I managed to equal them out and jog normally!! No pain or swelling afterwards so I can continue to jog indefnitely! Well, maybe not indefinitely. Right now jogging for me consists of 1 minute of jogging and 1 minute of speed walking, 10 minutes total.

I've also been running up stairs which feels great! Although my physio didn't say it was ok, I'll just assume it is!

11th Week Post Op

- "Can I jog yet? "

- "Yes."

Ahhhh, those are some sweet words. Although there is no treadmill at my physios', I will try jogging tomorrow at the gym. I'm restricted to soft surfaces for now and if it swells up afterwards I'll have to wait another week before trying again.

I've got some more intense hopping routines and the superman exercise: stand on one leg, and make body + other leg parallel to the ground. Superman is intense.

One thing that has cropped up in the past few weeks is the fat pad under my knee cap, also known as the infrapatellar fat pad. When I hyper extend and let my leg sit there for a bit, and then bend my knee quickly, I can feel that fat pad in the way, almost as if it is blocking my knee from bending. It is not painful at all. If I do it slowly it feels normal. Both the physio and chiro didn't have any good solutions but don't think it's too much of a concern. Building up leg muscles will hopefully solve the problem and I'll also be icing it in case it's inflammation.

10th Week Post Op!

I'm finally in the magical weeks (10-12) where the graft is stuck to the bone and won't come out and that means 2 weeks away till I start running again.

- Skipping rope has improved, but I need to take 2 hops before the rope goes all the way around. My knee starts to shake quite violently when it gets tired, so I can't do it for long.
- I'm up to 40 pounds on hamstring curls 3 sets of 10. I rarely feel that strain when I do them and if I do, it's minor.
- I've still got some inflammation of the bursa sacks (or whatever blob like pad is under the knee cap) which leads me to...
- I've decided I need more break days to let my leg rest and heal. Sometimes a week of daily exercises goes by and I wake up one morning with a sore leg / knee.

The next 2 weeks will be fairly boring. I'm counting down the days till I can run!

And on a side note, not relating to my leg, I've finally started to get the handle on throwing a long flick! woohoo!

9th Week Post Op

Another one bites the dust!

I have 3 more weeks until I can start running so I won't be seeing my physio until then. I finally overcame my mental barrier stopping me from the one legged hop! Physically, it was very easy, so my physio gave me a new exercise: Skipping Rope. Having never used this strange contraption, I was a little bit stumped on getting it all the way around. But after many trial and error episodes, I managed to skip rope! Every now and then the rope hits my head, but as my physio says "you'll improve your leg and improve on skipping rope!"

I also mentioned that the doc said my leg needs more hyper extension, but my physio thinks it looks fine and it's probably tight hamstrings. So my focus will also be on my flexibility over the next few weeks.

My leg has been aching more in the morning when I wake up, but I assume this is due to the more strenuous exercises I put it through. I've also had dreams about running, so maybe I'm sleep running!

17 More weeks to go!

2 Months in Review

Today I met with the surgeeeeoo.... doctor to go over my knee. Everytime I visit the fracture clinic I see a different doctor. My surgeon didn't show up as it was a pretty basic examination. This doctor tested the acl and checked out the knee. Diagnosis: grrreeeaaat! I do, however, need to work on hyperextension to match my other leg. He mentioned that I can expect to return to competitive sports at the 6 month post op mark which lifted my spirits up!

Accomplishments since the last month:

• Almost full flexion, minus a couple of degrees
• Walking is normal
• small hops on the one leg
• bumped up the weights on hamstring curls to 30 lbs for 3 sets of 10
• the inner quad is working properly and is looking better every day.

Goals for the next month:

• match my good leg for extension and flexion.
• start light jogging
• hop on the one leg with more confidence
• build up more quad / hamstring / core strength
• protect the graft

2 months down, 4 more to go! woohoo!

8 Weeks Post Op!

It's hard to believe it's been almost 2 months since surgery. Time is definitely flying now! I've been hitting the gym 6-7 times a week and sometimes twice a day, mainly for the bike, but also for:

Hammies!

I think my hamstring muscles are playing games with me. I originally thought doing 3 sets of 10 with 10 lbs weights on the hamstring curl machine was tough. But I decided to move up anyway and bumped it up to 15 lbs. 15 lbs felt the exact same as 10 lbs. So I bumped it up to 20 lbs and felt the exact same toughness as it did with 10/15 lbs. I could still do 3 sets of 10. My hamstrings didn't feel sore the next day either. So it appears my hammies are pretending to be weak when in reality they aren't. It still feels like I'm straining them a bit, but apparently that's ok!

Since it's the 8 week mark, according to my acl rehab protocol, I should be trying to light jog. But the first step in jogging is hopping on the one foot. I'm still slightly timid on doing this as I'm terrified of ripping/stretching/crunching/snapping/breaking my new acl. But after some slow warmups (on the trampoline and glider) I finally managed to hop from one position to another!

18 more weeks to go!

7 Weeks Post Op!

Another week down, 19 more to go!

Nothing much new from last week. I've added side lunges with a body twist and forward lunges with the body twist to my workout. The side lunges really, really worked my hamstrings / groin area and as such, walking around is very sore at the moment.

I continue to hit the gym almost every day for 30 min on the bike. I've bumped up my resistance quite a bit now. I've also hit 70 pounds one legged on the quad glider and I finally did 3 sets of 10 with 10 pound weights on the hamstring curls. No Hamstring snapping either!

Physio is only once a week now until the 10-12 week mark where I can start running / jumping again. The rest is in my hands (or legs)!

6 Weeks Post Op in Review

Another week down!

I had my last chiropractor session for a few weeks. He says everything looks good. I have almost full flexion and full extension. One thing he mentioned was my inner quad (vastus medalus). It doesn't look like it's "firing" properly until fully warmed up. So I've been focusing on that muscle before every workout.

Physio continues 1-2 times a week. I've been told to push myself harder which I'm glad to do. The Scar tissue under the skin has gotten smaller but it's still there. I have 2 bumps outside the kneecap which I massage daily. I can also now religiously do 15 one-legged quarter squats on the bosu ball without falling over. My leg is usually shaking at the end, but it's worth it! I have one issue with the bosu lunge. I can do it easily if I send my injured leg forward, but sending my non-injured leg forward causes my left leg to shake. This might be a result of weak hamstrings which leads to...

I did hit one roadblock which I finally overcame: Hamstring Curls. I can do them with no weight, but I tried the curl machine at the gym and 10 pounds was too much! Considering before surgery I was up to 80+ pounds per leg, 3 sets of 8 I was a little shocked. However, this is somewhat expected as they did take parts of the hamstring tendon to redo my acl. There's no pain, but it feels like I'm about to "pull" the hamstring muscle when I do them. So on Wednesday I decided to bite the bullet and give it my best and just deal with a strained hamstring if it occurs. Booya! After 3 sets of 6 of the 10 pound weight I was fine! Each curl felt like my hamstring was about to snap but it didn't. It's great that I can finally use this machine and see actual progress over the next few weeks / months.

Although swelling is almost a minimum, I still have inflammation of the bursa sacks around my knee. Not completely unexpected but I was hoping both knees would look the same around this time (minus the muscle diff).

White men can't jump.

Nothing could be more true at the moment! Today my physio had me attempt a one legged hop. Up and Down. I stood on the peg leg and tried to bring myself to jump... but I couldn't do it. It's been 8 months since my last leap off that leg, 8 months since my last soar through the air. It's not the strength I'm lacking, its the confidence. I love jumping, but mentally, I'm not ready yet. This is the first exercise Mark gave me that I just wasn't able to do. So I had to use the old man's jumper: The Trampoline. At first I couldn't get any height, but eventually I started to get a little and became a bit more comfortable. Then he had me hit the glider for push offs. This I was a lot more comfortable with, but also made me tire quite quickly.

As Bob would say: Baby Steps.

5 weeks Post Op

Another week bites the dust!

My physio added lunges onto the bosu ball to my workout regiment which scares me a little as my acl protocol from the surgeon says "No Full Lunges". Maybe it's not a full lunge since it's partially on the bosu. I'm also allowed to do the squat slider at the gym.

Since I'm going into the 6th week, this is where the actual graft is at its weakest. Worrying about if the graft is going to pull out is secondary to it stretching. So I'll be avoiding the step downs except during my physio and do my best not to over strain it with activities.

I've had some pain in my hamstring below the knee on the outer side, almost to where it connects to the fibula. Acupuncture really helps but it does come back the next day. My physio thinks it's from not walking 100% perfect. Due to the fact it's no where near where they took the graft from or where they drilled, I don't think it's something to worry about.

Couple of important milestones were reached this week: I'm below 150 days left till Ultimate! and I did 15 one-legged mini squats on the bosu ball without using the wall!

Dude, where's my quad?

Here's a picture of both legs with muscles fully flexed. The quad in my right leg is quite noticable whereas good old stumpy on the left is lacking.



This was taken at 1 month post op. I've got a good amount of muscle building to do over the next few months, but I'm up for the challenge!

The real one month!

Today was the real one month since my surgery!

Here's some other blogs worth reading!:

Adam's Blog - Tore his ACL playing basketball (Currently 2 years post op)
Summer's Blog - Tore her ACL playing flag football (Currently 3 weeks post op)

1 Month Down, 5 more to go!!

Ok maybe in 2 days it will be one month, but it has been 4 weeks and I'm too excited to knock off 1 month till I can play Ultimate again.

My progress has been great. I'm back in full force for bending (120+ degrees) and I still have full extension. I've been taking it easier on the physio as per Mark's instructions. My leg strength and balance is very good. Walking is *almost* normal. I still have some swelling above the kneecap but with the reduced workouts that should go down soon enough. My left quads are quite significantly smaller than my right. But that's ok, more work for me! I get the odd aches and pains every now and then but they seem to disappear within a day. The bruising has fully disappeared too, although I still have a small scab on the bigger incision .

While in physio this week another girl had an acl reconstruction surgery a week after mine. She went to the same surgeon (Dr. Theodoropoulos) . She was told to use crutches and the immobilizer for 2 weeks after her surgery and then after that she was allowed to ditch one or the other. She was also told to bend her knee right away. (I was told no knee bending for 10 days, but could ditch the crutches as soon as possible, and after 10 days could ditch the immobilizer). So it looks like the surgeon tailors the rehab (specifically the first few weeks) to each individual instead of just a common rehab. I always thought everyone gets the same rehab but I'm definitely glad I had mine, even though I had to spend extra effort bending, I'm happy I could ditch that horrible immobilizer right away!

I've also discovered I'm starting to hate acupuncture. I know it's good for breaking up the scar tissue and, with the electric stimulation, helping rekindle the muscles. Originally I didn't mind it but having it done 3 times a week is starting to get on my nerves (especially when the needle goes right in a nerve). I so loathe those dreaded words: "I'll get the acupuncture"

My goals for the next month are:

• protect the graft (be careful going downstairs or ramps, no jogging)
• get rid of all swelling + scar tissue (30 min on the bike each day should help this, plus reduce the # of workouts)
• more quad strength without causing more swelling (more Intense workouts but do them less often)
• Strengthen the hammies
• Loosen up the knee (30 min bike every day)
• Maintain my balance, ( I don't think it can get better, but keep it top knotch)

And the most important goal: Increase positivity!

Things I've learned

With plenty of time on my hands, I've done a *lot* of web surfing gathering information on everything about acl, meniscus, surgery, and recovery. I had the quadrupled hamstring graft for my surgery. They took parts of 2 of my hamstring tendons and looped them 4 times over. The outcome is about the same as the patellar tendon graft but it takes longer to heal.

The initial period of the bone healing overtop of the graft is the most critical point in the recovery. A Patella graft takes about 6-8 weeks to heal, whereas the hamstring takes 10-12 weeks. The only reason the the graft stays in the bone tunnels are the fixation devices used. My surgeon used an endobutton for the femur, and bioabsorbable screw for the tibia. This fixation method can withstand about ~ 612 N of force before it'll come lose.

So, of course, I ask myself, what activities put a lot of force on the ACL? Well it turns out going down stairs or going down a ramp can put up to 445 N of force on the new ACL. Going up stairs only 67 N. Walking can reach around a load of around 169N. Jogging is around 630N. Doing a leg extensions with weights is probably the worst, which is why no acl rehab program does them. So basically, I have to be very careful going down stairs and ramps.

I also found out the amount of force required to break a native acl, patellar graft and hamstring graft:

Native ACL: 2160N
Patellar Graft: 2977N
Quadrupled Hamstring Graft: 4140N

However during the revascularization phase, the new ACL will go as low as 50% of the strength of the native ACL. (about 1050N). It can take up to 6 - 12 months before it gains about 80% of it's original strength). So the new graft after a year is about 50 - 100% stronger than the native ACL.

Most of this information was found here (warning: they have all the information regarding the animals they used for testing: monkeys, dogs, rabbits):

ACL Research

And for the amount of force the grafts can withstand and the amount of force on the ACL when doing various activities (plus lots of other info) was found on google books:

ACL Info

Here's another blog who details the ACL life timelime:

Adam's Blog

Take it easy!

So it appears I've worked a little too hard on my knee on Saturday as it was very sore on Sunday. My Physio said to go easy on it the next few days then ramp it up again. I've decided to take a break from the one legged squats on the bosu ball since that's by far the most strenuous, and I'll leave out the stair climbing. I have to continue to work on massaging the scar tissue as that's the biggest bottleneck right now.

I also got a chance to throw around the disc on Sunday which was nice! My flick hasn't deteriorated much which is comforting.

3 Weeks in Review

My knee is shaping up quite nicely! Although still stiff at times I've achieved a lot goals. My physio says I'm ahead of the curve and I only need to see him once a week now.

Status:

• Knee flexion to 115+ degrees
• Can ride a bike now without grunting every revolution
• One legged Bosu Ball balance for minutes without falling
  
• Easily climb up stairs, going down.. not so easy
• Calf raises are a piece of cake
• Walking is getting to semi-normal. Because of the tightness it's still not smooth to bend the knee
• I can ditch the leg raises (my least favorite exercise)
  

Goals + New Exercises:

• 120+ degrees flexion
• Break down more of the scar tissue
• partial squats while doing one legged bosu ball balance (very tough!)
• Calf raises on stairs
• Hamstring curls
• Walk Normal
• Walk down Stairs normally without pain.
  

Now that the weather is finally warming up I should be able to go for longer walks. I still tire pretty quickly but that should change once I hit the bike more.

Chirowhat?

So today was chiropractor day. As many people have questioned "what the hell is he going to do?", I took the liberty of visiting him to find out. He is technically a sports chiropractor and was recommended to me by the surgeon.

It turns out he doesn't do any back breaking stuff on me, just tons of pressure and knee bending + acupuncture to help bend the knee. He worked on my knee for about 40 minutes. Overall he was very knowledgeable and explained why / how to get the scar tissue to break up so that I can have more freedom bending. I also checked out his skill set on the website and it's very similar to my physios except he has a chiropractor degree. So technically, the visit didn't involve any chiropractor stuff at all. He also plays Ultimate Frisbee which was cool! He got my knee to 100 degrees flexion and it's definitely not as tight as it was before!

This morning I had a dream I was chasing a disc and I jumped up to catch it. As I caught it I woke up. Ohhh what a tease! But only 164 days and I can play again!... although I've decided (along with the advice of the chiro dude) I won't be playing 4 nights a week.

Booya!

Andrew is at 90 degrees flexion after only 6 days! ... although it's still quite tight. I've also started on the hamstring strengthening, which gets strained very quickly.

2 Weeks in Review

It's hard to believe it's been 2 weeks since the surgery. It's nice to know I'm on the road to recover rather than just prepping for surgery. I'm currently behind schedule with the progress of my knee due to being told not to bend my knee for 10 days after surgery. I should never have been told this but it's water under the bridge now.

Status:

• I've gone from a 30 degrees bend to 60 degrees in 3 days due to extensive bending while programming.
• I have full extension
  
• I'm currently able to step up stairs (albeit, very slowing) but going down stairs is very difficult at this time.
• My legs feel like they've retained a fair amount of muscle which is great.
• The glider is fairly easy with 3 bands (lying down quad squats).
• I can do lots one legged calf raises.
• Balance is fairly decent: I can last for minutes without help while doing a one legged balance on an unstable pad.
• My hamstring is currently the weak part. It gets pulled fairly often, but this is normal considering 2 of my hamstring tendons are now inside my knee pretending to be an ACL.
• Walking is not normal at this time due to having to force my knee to bend.
• I haven't felt pain in awhile, but I still take ibuprofen,aspirin, tylenol a couple of times a day to help with the soreness and reduce some of the inflammation
  
• Sleeping is almost normal again. My body enjoys waking up at 4am for silly reasons.
  

Goals:

My exercises, 3 times a day, are: squats, calf raises, hip raises, leg raises, one legged balance, quad crunches, glutes extensions. Plus the usual non stop bending of my knee to catch up. My goal is to get to 90+ degrees bending within the week

At this point my moral is fairly high, although at times it's hard not to think about the lost meniscus + cartilage cracks which will eventually lead to osteoarthritis. When I get back into sports I'll have to decide between 2 options: Reduce the number of nights a week I play or face the consequences of pain in the knee in 5 years.

Regardless of the downsides, positivity is my best option at this point. How to remain positive? Watching ultimate frisbee videos of course! This college team to have recorded all their tournaments and packaged all the highlights into one video.

11th Day Post Op + Meet the Surgeon

Met with the surgeon today and he went over the details of the surgery, also had my stitches removed.

60% of my lateral meniscus was removed. It was apparently a bucket handle tear, which must have worsened since the MRI was taken. There's some cracks in the cartilage of the lateral side too (near where the impaction fracture occurred). In his own words: "Don't worry about it now, you'll be playing Ultimate Frisbee in no time, but you'll hate me when you're 60"

I also received the protocol for rehab, which mentions bending the knee right after surgery. Still not sure why they told me not to bend the knee... grr. Oh well, I had lots of practice bending my knee after the initial injury, I should twice as good / more experienced this time!

And on the bright side, there's no real restrictions for the next month, just no running / jumping. I don't have to wear the brace anymore (woohoo!) and can bend as much as I can. I've also been referred to a chiropractor to help with the bending.

9th Day Post Op

Shin pain has slowly been creeping downwards, but it's minor pain now. I no longer fear getting up.

I went for 2 20-30 minute walks today with just the brace. I'm slow, but I'm getting quicker! My knee swelled up quite nicely after each walk. I can also do the 2 sets of 10 leg lifts 3 times a day with ease now.

2 more days till I get the stitches / staples out!

8th Day Post Op

The pain in the shin has dwindled down quite a bit. Massaging, ibuprofen, and walking around seemed to have helped it out. I've noticed my leg size has shrunk a bit as the brace slowly fell down to my shin while walking.

Unfortunately the cryo-cuff died last night... I'll miss that cold touch on my knee during my sleep. Although I had the best sleep ever last night (possibly due to the lack of noise from the cryo-cuff).

1 week!

1 week down, 25 more to go!

I've managed to reduce the shin pain by massaging it while I stand up. This seems to help quite a bit. I've also ditched the brace most of the time as I just rely on crutches. (The brace makes the shin feel much worse). Overall I'd say the shin pain has gone down a little bit. I don't have any intense / unbearable moments of pain anymore.

I took a 20 min walk around the block with Alice today. I used the crutches but tried to put full weight on the leg. There wasn't any pain, but my knee did swell up a little bit.

6th Day Post Op

Well the shin pain is now extremely strong when going from a sitting position to standing. Putting weight on the foot after standing doesn't really change the pain much. Having the brace on makes it a lot worse. From what I've read this is normal, however, I'm more hesitant to stand up now and have relegated to crawling around most of the time. I'm still sticking to the extra strength Tylenol instead of the pain killers. I finally realized I should be icing the part that hurts. Maybe it'll make a difference. Hopefully this pain will go away soon so I can venture outside more!

5th Day Post-Op

Today was physiotherapist day. He threw out my slacker routine of just quad crunches and gave me 4 extra ones: leg raises, calf extensions, hip raises, and knee bending. He found it odd that the instructions I received didn't mention bending my knee. Either way, bending will occur!

Sleep wasn't very good last night, 2am 3am, 5am, 7am wake ups. I felt pain in the back of my knee for the first time. It went away after some massaging.

4th Day Post Op

Slept from midnight till 5am this morning, which is the best sleep I've had in awhile. Took my first shower on my own today. It's a long process of taking all the wrappings / bandages off, showering, and putting them all back on.

As for the knee, It's about the same as yesterday, painful when I first stand up, but after time I can walk around without the pain. I can already feel myself loathing the brace and then I realize it's quite a few weeks till I can ditch it.

Tonight was extremely painful when standing up and walking around was slightly painful. I suppose all the walking I've been doing has been too much!

3rd day post op

I stopped taking the pain meds yesterday and just relied on some extra strength Tylenol. So far I feel a lot better waking up this morning and there's no more nausea. The knee still needs the ice packs and although it's painful to stand on it initially, it usually subsides and I can walk around (with crutches)

I'm also practicing walking without crutches and just the brace, I go about a snails pace, but I'm hoping to hit 1meter / hour by tomorrow.

The doctor also confirmed I shouldn't be bending my leg until 7-10 days after surgery so that the sutures won't break.

2nd day post-op

Slept a little better last night, I've slowly weaned myself off the painkillers, I'm currently 6 hours and no pills... Hopefully I'll be able to eat better as my appetite has slowly gone downhill. I've also taken off the large bandage covering my knee and checked out the incisions. Quite gross!

1st Day Post Op

I hardly slept at all last night as the nerve block and anesthetic slowly wore off. However the cryocuff + pain killers helped. My leg has feeling again and standing up no longer makes me sick. The pain killers make me very drowsy. I'm able to eat more foods now which is good as my stomach has been whining non-stop.

I have my post op exercises / instructions to do. However, it doesn't mention anything about bending my knee, which I find a little odd. Most of the blogs / post-op rehab I've read consists of bending your knee asap.

My brand new ACL!

I was up at 5:45am to get to the hospital at 7. Surgery was at 9. I met 5 different people before surgery: the surgeon, the doc, the nurse, the anesthesiologist and his assistant. I had a nerve block and lots of drugs. At one point I kept looking at the air duct, and I thought it was moving and couldn't stop staring at it. After that I woke up in the recovery room. I had quite a bit of pain under my leg so apparently they might have missed the back side of my leg for the nerve block. They gave me some morphine and I was good. I was still pretty drowsy after waking up and had some issues standing up as I would start sweating heavily and felt very nauseous. Once I lied down again I was fine. Because of this I didn't leave the hospital until 3:30.

Because of the nerve block I couldn't feel the front half of my leg, which was kinda weird. My mom, being a physiotherapist, was able to hook me up with a cryo cuff! which has made icing a lot easier (although I didn't feel the cold at this time)

My girl Alice has been great at taking care of me and hooking me up with food! Although it's tough to eat at times.

All systems go!

I've received a call from the hospital with instructions on what to do / not do before tomorrow. Looks like everything is an "ok to launch!". No midnight snacking and no morning tequila shots!

My leg is feeling pretty good. It's hard to believe it's been 7 months since the injury. I've lost some enthusiasm over the past month or so, but now that the day has come I can feel it creeping back.

Breaking News!

I just received a call from the surgeon. Apparently new research has shown that the ACL is a myth and doesn't exist hence why it didn't show up on my MRI. Woohoo! But apparently they still need to remove part of my hamstring because "We planned to take it out, so let's take it out" so I'll still require surgery and the 6 months of rehab. Doh!

Here's the article debunking the acl myth: ACL Enlightenment provides relief to millions of injured athletes who tore nothing

9 Days to go!

9 days to go and I can feel my knee's anticipation! It'll be somewhat sad to go back into using crutches again, not being able to bend my knee fully, icing my knee again... but at least this will be the last time (hopefully!).

And I was so close to touching my toes, maybe an inch away. Currently up to 200 lbs on the quad slider (10 times 3 sets), and 75 lbs for hamstring curls (10,7,7 reps)

My pre-op physical had a funny diagnosis: Healthy ACL tear. I suppose he meant "Healthy minus the ACL tear"

Party #2

April 3rd is my surgery date, which means I'll hopefully be playing Ultimate Frisbee again Oct 3rd.

Although I'll miss playing in the summer, at least by June I should be walking normally again and can still enjoy the warm weather (and possibly do my physio outside)

Surgeon

Met with the surgeon today. Waiting time for surgery is 3-4 months. However, since I'm considered a "healthy" individual, I've been put on the cancellation list.

On the plus side, he said it's only a 6 month recovery period after surgery before I can play ultimate again.

The squeaky wheel gets the grease

So after many phone calls I'll be meeting the surgeon on Jan 27th. Hopefully surgery won't be too long after that.