Sunday, July 16, 2017

4 months



This month has been.... exponentially better than the previous few! I was limited with what I could do previously, as I had to be careful how much I used my left quad and leg. Otherwise, any over use (whether intentional or not), and the area where they took my tendon would flare up, swell, and overall the knee would just ache.

But it's as if my quad tendon somehow magically grew back right at the very end of 3/beginning of 4 months post op. I asked my surgeon how long it takes for the tendon to grow back afterwards, and he said he honestly wasn't sure, and it's different for everyone. I can certainly say it took a full 3 months for me. No more hollow feeling right above my knee cap, woo hoo! 😀

Looking somewhat normal!

I had another check in with my surgeon, and was cleared for hiking/running/14ers. So of course, I immediately go outside and play! It is great to be back out even if it takes a little more work than normal- and that's 100% ok with me! I do over analyze every single step, foot placement, and feeling in my knee while I'm out n about playing in the mountains. It was and still is 2x as hard mentally on all of my hikes/outings as opposed to before, given that extra focus and thought that goes into each and every step- it only takes one misstep! I've done some sketchy hikes for 4 months post op I'll admit, but that also required 2-3x more work(focus) than normal.

Careful pole placement before every step is critical!

'Don't push it!' I've heard countless times, and I listen every time. That's part of the reason why I wear my brace while I'm out and about. As a reminder. A brace will not stop an a full ACL tear- if that much pressure/twisting is on your leg, a brace is useless in stopping it. If there is a brace that is 100% guaranteed to prevent ACL tears... let me know! Im convinced though it does help keep my knee straight and encourages forward motion as opposed to sideways. It reminds me mentally to dial it back... what I need some (most) of the time..!

In the last month, all within 90-120 days post op:
- Skinned uphill at Arapahoe Basin, and hiked back to the area I hit the rock
- Hiked Torreys/Grays via Kelso Ridge
- Hiked/slept on Mt. Bierstadt
- Mountain biked at Green Mountain, near Winter Park, Buffalo Creek, Hartman Rocks, and Hidden Mesa
- Hiked Mt. Antero/ Cronin
- Hiked 13er Whale Peak
- Jumped in numerous alpine lakes
- Hiked up and around Rollins Pass
- Numerous short 2-3 mile runs on pavement

Always careful, but always enjoying every minute out
I thought for sure I had pushed it a little hard a few times and expected to wake up to a swollen knee requiring a few weeks of rest. But no none, not once. I can't explain it... It's like wait... I just had knee surgery! Nothing is really playing out how I thought it was going to go (in a good way..!). It did ache while camping at 14,000ft. There are odd pulls and pops. And it still hurts to wear jeans/tight pants, so I know it is still healing.


Where I'm assuming I clipped the rock! 


I could not go downhill without my poles... #1 post ACL op hiking necessity!

My knee cap definitely feels a little odd, given the bump you can see here!

Next up: work on slowly adding miles to my runs! I cannot wait to be able to go out on a 10-13 mile run... feel that runners high again! In the meantime... it's mountain biking and hiking!

Tuesday, June 6, 2017

3 Month Mark

I'm actually really sad posting this... this is version x2 of my original post. Don't trust command+Z on Blogger here apparently. I lost the whole post. My original had some thoughts from a few weeks ago, which was a super rough time for me. There's no way I can recreate those thoughts in which I wrote in that mindset. That mindset is long gone now. This is the worst feeling... much like closing a finished assignment without saving! 😓  

I suppose the abbreviated and shortened version will have to do...

Weeks 9, 10, 11 - my 'rough weeks'

I had been dreading the time of recovery when your knee feels fine and back to normal, but you simply cannot use it as normal... and that was this past month. I was in the 'red zone' as I call it- where the graft being used as the new ACL reaches it's weakest point and 'dies' before it begins to build strength again. Because of this, I told my PT I do not want to add in or try any new exercises until I was past the 12 weeks mark, and he agreed. 

In addition to the graft at it's weakest point, the area above my knee cap where they harvested the tendon was very sensitive to any use. It was a healing pain though- I know as a fact I did nothing to cause it the pain. If anything, I slacked in these weeks with exercises. 

These weeks were not just hard physically, but as with any injury, mentally as well. I had been putting on a facade. Heck I am still putting on one. Seeing my ski & trail running friends during this time was hard- being around them made me feel even more unlike myself behind my facade. Not to mention it was prime ski mountaineering season..! So I dealt with it by keeping to myself and staying home when I could. Because when I was home, either behind my laptop here or deep into a book, I could atleast assure myself that I was not bringing anyone else down. 😶


Week 12

I don't know what happened. It's like my quad tendon magically grew back over the last few weeks. All of the few exercises I was doing, I could now do twice as long without my quad bothering me.

If there is anything I'm confident in, it's my foot placement. Anything on two wheels now... I'm not so sure of yet (e.g. mountain biking..!). So I thought I'd try a hike:

Keeping it flat

More flat trail

At least this flat trail came with puppies :P

Not sore after all of these hikes. So I took it up a notch!

Stop one was Aspen with a short hike around Maroon lake, then the next day, hiked to a water fall as well as at the Great Sand Dunes National Park. I'd say this hike was about 6 miles RT.

So nice to 'summit' something

Then hiked ~4 miles on the CO trail the following day, with about 700 ft gain/loss. 

I woke up the morning after three days of hiking, unsure if I had pushed it too much... but was assured I did not when I felt nothing, it wasn't even stiff. 

To add to it- I returned for a PT session after about 3 weeks, now past the 'red zone',  and we added in some new exercises... I finally get to move laterally!

Sideways!


I've always loved this little exercise for some reason...



Well this post will have to do. Onto more outdoor adventures now that warmer weather is here and I'm cleared for some outside activities..!


Tuesday, May 9, 2017

2 months

Two month mark.... I've almost stopped tracking the time. It seems irrelevant and it's solely up to the knee as to whether I have the ok to keep working it or just simply need to chill. Which I've been having to do, alot recently. Definitely one of the reasons is because it's been super achy/sore... not in a bad way (haven't been pushing it at all). More of a healing-type ache.

Thankfully, classes pretty much took over this last month, so I really did have a reason to sit around and not be my feet much! My first month post op, I was almost completely focused on rehabbing my knee... this second month however I've been almost completely focused on school and finishing my undergraduate degree in accounting. I still go through all my strengthening exercises and to PT twice a week, but other than that, I haven't focused much else on it. I view this as a good thing though. I read a quote that stuck out to me (I can't seem to find it again!) and it went something along the lines of "Take is easy now during recovery and you'll get it all back, or push it too hard now... and you'll end up never getting it all back".

My workouts now consist of 10-20 minutes on the elliptical, stairmaster, or the rower, followed by 10-20 minutes of strength training (squats, lunges, leg press) and resistance band exercises. Any extra time goes to upper body and core... I'm certainly working on my pushups... alot! (pushups have always been hard for me so... perfect opportunity to change that!).

So. Many. Pushups

"Hey, um, did you have surgery on your knee or something?" I got asked while I was at Red Rocks 😅

Overall, the strength in my quad is coming back. Slowly but surely. My number one focus right now is strength. Work on getting the strength back (over time). The only thing that could possibly prohibit me from returning to the activities I love when I'm cleared (here in 6-9 months time) is my quad strength. My ROM is considered full (full flexion @ 135), but I still can't touch my heel to my butt yet!! You should try it... and then know that I would absolutely love to be able to do that :) Soon though I hope!

As much as I wish I could be happy about my situation all the time, truth is, I'm not. My happiness comes from being able to physically and mentally push myself for hours up in the mountains. Maybe thats a good thing, maybe thats a bad thing. Maybe I should view mountains 'as a privilege that can be taken away from you at any moment. So enjoy them while you can'. Which in some cases is true... but there are ways in which you can enjoy the outdoors no matter your physical capabilities as well. So really it can't be taken away... the way you enjoy it just might change. I didn't realize just how much of a direct path to happiness my physical fitness provided... but in hind sight, I did. I just have alot more time to think about it now! Don't worry though... I'll be fine, I think 😛  one more month until I'm (hopefully) cleared to cycle outside... that'll be a game changer.

My focus has significantly changed though since accepting that both running and of course, skiing, will be out for a while... onto other fitness challenges and goals (in addition to rehabbing the knee...), atleast for the rest of the year!




Tuesday, April 11, 2017

Week 4 - One Month!

One month down...5 more to go..! Well, really more like 11 to go, but I'll start that countdown after 6 months on September 14th 😋

There's seems to be a pattern- A couple days of low, followed by a couple days of high per week. I gave my knee a pretty good workout on Tuesday (day 21), and overall it did really well. It was a combination of the stairmaster, bike, elliptical, modified squats/lunges, ROM (135 degrees) and stretching/foam rolling. It didn't feel sore, but did let me know to take it easy the next few days by being really tight and stiff feeling afterwards. It felt as if someone had taken my tibia and femur and pulled them in opposite directions to make all of the tendons tight in my knee, then left it for a few days. Add it to the list of things-never-felt-before! I continued to work on ROM and easy quad exercises and it loosened back up just fine by Friday (day 24).

To add to the things-never-felt-before list, my swelling went down even more (yay!) throughout the weekend (day 24-26), however I think because of this I was able to feel things and use muscles/tendons that I had previously been protected by the swelling. My PT assured the popping and new feelings were all ok. I will though, be happy to squat again without feeling my kneecap popping..!
Can kind of make out my knee cap..!



For a visual of the popping in my knee, just what you wanted to see right? :P 

Week 4 milestones:

- Able to walk downstairs no handrails (day 26). Quad control/muscle is definitely coming back..!

- Walking normally with no limp

-Reached 140 degrees in flexion (day 27)

-New Exercises: wobble board and bosu ball for balancing.


With 150 degrees being my max flexion, I'm very happy with 140..!


This injury has definitely 'messed' with me mentally (as I would imagine any major surgery like so would do). For example, I tend to have alot of light dreams right before I wake up, and I remember in one, I was in a situation where I needed to run for some reason, and I said aloud to the other people running 'Sorry guys I can't keep up because I can not run!!' 🙈  Another habit that I've formed is picking up my leg for any lateral turn. I would imagine sometimes I look like a solider when I make any sharp turns because I just (out of mentally telling myself no lateral movements) pick up my leg kind of high and pivot on my right foot as if I'm marching 😅  Oh and I'll also occasionally just be walking along when a step with my left foot goes a little higher than normal, but then I continue on walking normal. Always catches me off guard! My brain and left knee evidently still need to work on their communication with each other 😛

Wall squats with an exercise ball


This is my active ROM (how much you are able to bend by yourself without help from a towel or wall to bend it for you.) Bent my right to compare!

Still a bump/swelling next to my lower incision
Overall I've surprised myself with how well I am doing, but as I keep telling myself, this isn't the hard part yet..! 


Tuesday, April 4, 2017

Week Three

This whole thing is going so fast, really. I can't believe it's already been 21 days. Maybe it goes fast at first and then slows down.... I suppose I'll find out. Funny enough, I've been way busier now here after surgery than I was before!

Week 3 post ACL surgery is definitely the 'back to normal' week, or so it proved to be for me. The first two weeks, your knee pretty much consumes your life, and you make arrangements around your knee. Now, not so much. I make my knee work with me and my plans..! I'm finding myself back to normal in alot of ways. Parking where I normally park, sitting at my desk (when I do... I actually stood for 4 hours straight one day!) with knees bent how normal people sit at their desk, getting in and out of my car normally instead of lugging my left leg up after my right, and showering without having to transform my leg into a sauna by wrapping it with plastic wrap before. But most of all... I'm back to my normal routine of planning workouts into my day. 

Milestones for week 3:
- Up and down stairs, multiple times a day. Going up is great- I've actually hopped on the stairmaster a few times at the gym for 10 minutes at a time. I can go down stairs with alternating steps, but still need to hold onto the handrails to help support some of the weight.

- Full pedal stroke on a stationary bike- this one was most exciting. 120 degrees of flexion is needed before being able to cycle which I reached in 2 weeks and 1 day. I absolutely love using the bike to work on bending my knee. 

Working on getting the pedal all the way around- was hard in this pic
After a few days of working on it. Super easy now!

-No more steri strips! I took a shower without wrapping my leg up, and the water I think helped a few peel off. From what I could see and feel underneath, the incisions were sealed. My body has always seemed great with healing up very well and fast. At PT we peeled off the rest since I think we both wanted to see! 😅  and yep sure enough they were closed. Ok. I said it before, but now I reallyyy don't have anything else left holding me together! 

Clean knee! I'm working on accepting where the scars will be since the perfectionist in me wants them to be perfectly symmetrical and straight ha! :P 
-Reached 125 degrees of flexion. Certainly need to work here. Mentally, I had this goal of reaching 120, which I reached, so I felt 'free' so to say to work on other stuff. I definitely have seen more improvements in muscle strength than ROM this week. I keep meaning to measure my flexion of my right leg to see what my max degree of flexion should be. I'll mention that in next week's blog when I remember to ask my PT this week!

My heel had slipped a little here so not showing my full flexion, but this is how we measure flexion, with this nifty tool

- New PT exercises. Modified lunges, single leg press, body weight squats, resistance bands, and rowing machine. 


I've easily had a few days where I spent a good 2 hours at the gym this week, just going through all the exercises, foam rolling, and stretching. I have yet to over do it, haven't had an achy/painful knee afterward any of my 'workouts', and hopefully I can keep it that way. My quad atrophy is quite apparent, but honestly, I'm in no hurry to get back to where I was. I will eventually yes, over the 6 months, however, it's not the muscle you are working to get back, it's waiting on the new ACL to strengthen and ends to fuse to the bone. 

I wanted to show this perspective because it shows how you can barely see my right knee over my right quad, if at all. And, well, you can completely see my left knee. 😛  Crazy.

Staying positive has been easy this week, how can you not be happy by seeing so much improvement each week, let alone each day? However, there have been a few low moments. Not as many as before, but I have a feeling they will creep in every once and a while, like they did once this week. While at the gym, I was working on bending my knee. Simple exercise. Bend knee as much as you can, hold, bend a little more, hold, then release. But all of the sudden, it's like you get hit with all of these thoughts about comparing your workout now to what you 'used' to be able to do. If you haven't felt it, it's kind of hard to explain. Like a rush of negative thoughts over you, and you can't block them out there's so many coming in at once. I had alot of these the first few weeks both pre and post op, but they are certainly dying down now to only a few per week. I see why you come out of this recovery stronger than before since in my case, the biggest change for me I've noticed has been mental...way more than it has been physical. 

I am still not quite walking normal... still have a bit of an off gait. But I'm hoping this next week will help with that!

Tuesday, March 28, 2017

Week Two

When people ask 'how's the knee doing?', I find myself answering something like "Oh doing great. Could always be better, but it all depends on how you look at it." In some ways I'm where I expected to be two weeks post op, and others not so much. But I'm ok with that, as every knee is different and there's no one recovery timeline that will be 100% customized to you.

Week two observations:

- I'd say after day 6 was when I really noticed that not just my knee, but my whole body was tired and sore. It's quite the core workout getting in and out of bed (it's like doing V sits multiple times a day!), and my upper body got its fair share of work as well given the crutches, getting in and out of the car, using the handrails going up and down stairs, etc. Who needs P90x? 😆

-I realized that rest days are necessary for your muscles during recovery (well that seems like a no brainer now that I type it out and read it like that... 😋  ). This is quite the oxymoron as you might be thinking hey but you are already resting all the time... when really it is just like any other training regime. Your weak quad/leg can only do so much so fast, and building back quad strength takes time, even though you want to get it back as soon as possible and work on it hard every day. Working on ROM is another story however, but when it comes to the quads, the same basics to gaining muscle apply. Stretching, foam rolling, etc. all still comes into play no matter how much or little quad muscle you have at a given time.


My circle of PT exercises I do multiple times a day- Side leg raises, hamstring leg raises, straight leg raises and inner leg raises.

-As I mentioned above, ROM (range of motion, aka flexion of the knee) is a new concept to me, and I'm finding out you can't treat it like a muscle. I've never in my life had to work on getting back a basic physical movement before, so I was not sure exactly how much to actually push it/work on it. Thankfully, between a friend on her third ACL recovery (who had 90% ROM in her week two!) and my PT, I was able to clarify just how much is ok to do... which btw was alot more than I was doing. With the stitches out, I feel so much more confident with flexing my knee. I went from 90 degrees flexion to 110 degrees (see this pic for ROM knee measurement). But working on my flexion brought back a little swelling, which in turn decreased my stability in my knee. A brace here helped me alot. Wearing a brace post op is all personal opinion, as it can have hindering effects (e.g. mentally thinking that knee is weaker because it's in a big brace, so you end up using that knee/quad less). I really didn't want to pull a crutch back out, so I decided to use my brace in this situation... and it's definitely doing a good job. Felt it catch my knee a few steps so glad to be wearing it now. And it honestly reminds and helps me from being too ambitious (instead of not using it enough)! Once the swelling goes down though and stabalizer muscles are able to wake up, I probably won't wear it then.

These pictures are 10 minutes apart- the picture on the bottom is before and top is after. This is from spending just a few minutes bending past and enduring a few moments in the "uncomfortable but not painful" zone, then releasing. Quite the difference, and it certainly is almost all mental. And yes, I changed pants and rooms between the two pictures as well :P 

Post working on ROM and icing... not a very happy knee!

Towel bends
Looking forward to what week 3 holds :)

Thursday, March 23, 2017

Post Op Appointment, Day 9


Had my post-op appointment today and all went really well! Took x-rays, went over my images from the surgery, and also got the stitches out. I asked about how much I can do and about pushing it too much, because knowing me I am more likely to do too much too fast, than not enough. “It’ll tell you. Just listen to your knee.” She said. Which makes sense- it’s also pretty much how I base my training: If it feels good, push it a little. If it’s feeling sore/tired/swollen, slow it down and rest. I was given a compression sock to wear in place of the wrap followed by the statement “If it can’t swell, it won’t swell” and I was on my way. Didn’t have anything out of the normal to talk about and I’m well aware of my ‘homework’ between now and my follow up appointment with my surgeon Dr. Vidal in 4 weeks.

I also left my crutches at home this morning, as I felt confident in my quad control and the crutches were proving to be more of a hassle than help. So 8 days was the magic number 😊

I feel so ‘free’ so to say now with no crutches or stitches… nothing ‘holding me together’! Well.. except for the big screw in my tibia! 😳

Today was also the first time I really felt a sense of joy/happiness since the surgery. Yes I was in a good mood with positive thoughts and such, but that alone doesn’t mean that you are truly happy inside. It was a small sensation of the feeling you get after working hard and achieving something- much like reaching a summit or crossing a finish line or... successfully getting through the first few hurdles of post ACL surgery 😛


The screw is for double fixation, I believe is what she called it. Basically it is to pull the graft/new ACL tighter.






Side View




No stitches finally!

video