One year ago today is when I tore my ACL. I was skiing in the backcountry. I was done for the day, left my party to head back to the trail head by myself (they continued to ski). I had a very awkward slow motion somersault with one leg/ski buried, so I think it was hyper-extension with some twisting in there that actually did it. If my boot and binding were above the snow it would have released. But not when buried. It was a very specific fall. Eventually we made contact through a series of text retries, and they helped me get out. It was an epic 3.5 hour exhausting ski out on one leg. Full story in The Accident tab above!
I wasn't swollen (visibly at least, leg did not bend well), I was not in pain as long as I didn't stand on the leg. I got to see the orthopedic surgeon the very next day. MRI was a few days later. Surgery was 16 days later. I updated the tendon research clinician in Australia and had a very reassuring (and quick) reply. I feel some progress finally. I can feel muscles fire when I do the leg press. I did TWO walks in the snow this weekend - something that would have made me couch bound for days before - but I just had some swelling, no extra lingering pain. (Note: not that it feels normal by any means!) I would say that something is working! The biggest reassurance is that my disruption in ACL rehab should not have any long term negative affect on my overall joint health as long as I get and stay strong and stay active!
0 Comments
Everyday, I question if this is the right track I am supposed to be on! Fingers crossed!
The "track" being whatever the Australian tendon clinician expert says (versus just doing things on my own like the physician assistant and first physical therapist said). Her diagnosis is much different from what every one else has said - which have been tendonitis, tendinopathy, Hoffa's fat pad impingement. Then again the treatments for those things have not been working for me. Her taping is the first thing to alleviate most of the front of the knee pain and indicates that it is not the tendon (didn't quite want to call it patellofemoral syndrome either), combine that with their cutting edge research (the Sports and Exercise Medicine Research Centre pumps out lots of published peer-reviewed articles), I hope she is the one who is right! I would love to know how long this plan will take, when will we move into quad stuff or when should I resume ACL rehab stuff and should it be with a physical therapist. Hopefully I can get these questions answered. I just worry about more quad atrophy. Here is her suggested rehab. Just three moves. I'll admit I add in some single leg balancing on a towel, single leg lifts with a 4 pound ankle weight and quad sets. She said I can do whatever cardio doesn't aggravate the knee, so that is walking, biking and elliptical right now. I try to do it as often as I can (or the knee allows) because it uses the quad. I go up stairs two at a time with the operative leg and I try to get out of a chair with only the operative leg so that quad stays alive. The random crying has subsided for now, so that is a relief. I'm not used to being so emotional. Feeling rather antsy, unsettled and distracted lately. Having bouts of crying uncontrollably about every other day too. I think as I get near my one year mark (both injury and surgery) feelings are getting a little intense. I'm super unhappy about my recovery progress this far out.
My limited capabilities really get to me on some days. Yes, of course I realize there are far worse situations out there, but I can't ride all day, everyday on gratitude highs. That waxes and wanes. The progress feels invisible most of the time. Walking on sidewalks and treadmills is getting really old. Not to mention my knee hurts. The tape is starting get really uncomfortable, but it's hurts more without the tape so I will keep taping. Today I will focus on the small wins!
Tonight is rehab night, where I will do my three SHORT rehab exercises given to me by the Australian tendon expert (I use the equipment at Planet Fitness). I will do 35 minutes of stationary bike too. I will walk outside midday because it's going to be nice out. I have no idea when I get to do more exercises. I feel like I need to be doing more, but she is the expert and her magical taping method worked - first thing to help my pain! So you can see why I want to do whatever she says. Wow, 11 months post ACL reconstruction as of yesterday. It's hard to believe I made it winter to winter and still have a long way go, but there is a very slow improvement. I'd say I'm still 35-40% of normal. I try to be grateful for a long list of things everyday, even if it's as simple as being grateful I can drive myself anywhere I want.
The taping still helps with daily function. I finally feel like I'm on a right track with my new rehab from a tendon research clinician from a sports and exercise medicine research center in Australia. We're getting my knee structures built up before I do much else. I guess she will help me until I have no pain and can resume normal ACL rehab in my town? I'm not positive. Trying to not get ahead of myself! At 11 months, I can jog a few painful steps. I can go up stairs two at a time (I think that is getting stronger). I don't have a fast response on my feet. I feel like I lack those reflex movements (although I was quick enough to help a mother at the store who's cart flipped forward with a baby in it!). Like when my old dog is slowly getting ready to fall (it's usually a slow mo thing), I cannot initiate that fast push off at all! I certainly cannot do any single leg forward hopping. Tripping and saving myself with the operative leg still hurts in the joint and my heart always skips a beat! I can get out of a chair with one leg with some concentration. I can't do a real full squat without pain. Uneven surfaces for hiking will cause flare ups so I avoid them for now. I can bike outside, but hills are tough and standing to pedal is pretty weak sauce and uncomfy on the knee, but I can do it and not have major pain consequences. Yesterday was a gym day. I added some weight to my standing calf raising move (went up to the next kettlebell size). It felt fine during, but I think after it caused my tibial screw area on the shin to become quite sore. Walking around the grocery store afterwards was pretty difficult. That lasted about 24 hours of not feeling great. The Australian tendon research clinician said I'm doing great, and that I could try the Smith machine, leg extension machine or squat rack for the seated calf raises (I was using weighted plates on my lap). Also I can start from flat foot on the ground (no need for a toe step). I asked about platelet rich plasma injections because my surgical team keeps pushing it (still not sure I'm going to ever return to them). She said it's not of use for what I have. She is very nice to be helping me, still blows my mind that she is willing to! I'm quickly coming up on my one year anniversary of the injury (January 29) and the surgery (February 14). I feel like I need to celebrate/honor/do something for the one year surgery mark. I have an idea (a few things will depend on whether it can happen - old doggie status, how the knee feels, the weather). It involves mountain biking on a mountainous desert island with free ranging buffalo. The trails are normally dry year round and it has some easy mountain biking I can do. I think that'd be a great day. Trails where I am are too icy and snowy for me to venture out on. If there weren't snow on the trails, I'd probably be out mountain biking right now. Of course I need some back up ideas in case that doesn't pan out. Flexibility is key! Knee Taping Update: I am one week into the taping / new PT experiment! So far so good!
I am amazed at how much this taping method has relieved the front of the knee pain! I usually leave it on for a couple days. I walked around one morning without it and was hurting pretty quickly. After today I will have four new PT sessions in. Walking down a slight downhill also is much better (but quad is weak). Squats are not yet OK feeling. I will update the physical therapist tomorrow, and see what my week 2 is going to look like! The Hypafix and Leukotape have arrived and I've taped up my knee as the tendon research expert has suggested (go to the Day 307 post to see how I found this person). This is a differential diagnosis test for patellofermoral joint pain syndrome. If the pain is relieved when taped, then IT'S NOT TENDON PAIN according to research. Knowing what is causing the pain seems pretty crucial for a treatment plan in my book. First photo is the example, second are the two tapes (they are not stretchy), last photo is my knee. I pretty much had INSTANT SUBSTANTIAL relief once the tape was on! Pain relief over the patellar tendon area when standing and walking. I can do standing calf raises and it doesn't hurt!!!!! I can see that I need to do it tighter as I should have more of a scrunched up knee. OK folks - this is pretty ground breaking! All this time, my surgical team (PT, MD, PA) have been calling this patellar tendonitis. This is a pretty common diagnosis term for those with anterior knee pain after BPTB grafts. It's always mentioned in published journal articles as patellar tendonitis too. One quote was less than 10% of BPTB patients get patellar tendonitis and it's usually short term 3-6 months out. Rarely did I see it mentioned lasting months 10 and beyond, or even what does one do if they have patellar tendonitis? This is what drove me to seek more information. I have always pestered my surtical team asking how can we really tell it's tendonitis? What if it's tendionpathy? I don't respond to any of the anti-inflammatory modalities they've thrown at me (which would usually work for tendonitis - aka inflamed), yet no one really wants to consider what else it may be! The next step is to change my rehab. Stop all my current exercises. The tendon expert has three exercises for me to start with all while wearing the tape:
Still waiting to learn more about what light cardio is allowed for this stage. I'm going to put my appointment with the research pain management center on hold for right now until I try out this new plan for a couple months.
And to think, I was instructed to NOT think/read/research about ACL problems for a length of time to see if that would help my pain. All this binge research came about at the end of a 5 week research hiatus, when I couldn't stand not learning! |
AuthorA 45 year old active female who tore her ACL in January 2017 (at the age of 40). Reconstructive surgery in February 2017 with bone-patellar tendon-bone autograft. Archives
November 2022
|