I am have completed 16 weeks of my new "proximal muscle rehabilitation" and this is really working. I am still pretty amazed at my strength gains and I'm not even doing squats or lunges still! I have no idea how long this should take, but I'm expecting a year of full rehab just to play it safe in my head!
The last two weekends and week has been pretty decent I must say! As in, what I had in mind for the day actually panned out and the knee didn't complain. I've done real trail hikes and real mountain bike rides, regular gym sessions. I am now at or above the weights that flared me up the first time around Day 77 and now it's Day 113 of new rehab. Took about 5 weeks of lowering many of those weights and then building slowly back up over time. First rule was to lessen the range of motion (but keep the weight), then if that still hurts/flares up - less the the range and weight. Yes it worked! Every week I feel stronger and stronger. One example, I almost had a crash on my bike. I was about to fall inward on a tight turn and I was able to hop and save myself with my operative leg and stop before crashing into a rock. That surely would have buckled my knee, but it worked and it didn't hurt after from that save! I still have not walked around with a naked knee yet. I generally wrap it with an Ace bandage wrap for daily life and biking/hiking. Not sure what the bandage is doing exactly. but it makes it feel better, like the only thing I feel is the bandage. Oddly tight pants do not give the same result. Taping still for the weight lifting. The other day while on a trail, I tried a little running uphill with poles. I am happy I was even able to attempt it! Not ready to run, just wanted to test things out. I really have to build a good structural base for sure so that I don't set off any other weird imbalances! Some local trail photos - spring in the mountains!
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Phew! Ok, I think I'm done with the two week pain train flare up. Overall, I handled it over all much better than my others (mentally speaking) except for two really painful days. I am back at the gym on my normal schedule, and slowly working up my weights on my operative leg again. FLARE UPS: This week I also Skyped with my physiotherapist. Overall she wanted to talk me about flare ups. In general, the knee is becoming more resilient so that these flare ups don't knock me down as before. I was able to still do some walking and gym stuff, not totally couch bound. Maybe a few days versus a full week like before. Over time the flare ups will be less as the knee is more load tolerant. If I never flared up, then the new rehab was too conservative. I could flare up again. Some pain is OK, just don't want it to limit daily function.
HYPERALGESIA: I described how the skin on the front of my knee is very sensitive, as in I can't even wear skinny jeans for a few weeks! Just too uncomfortable. (Thankfully I can wear stretchy pants to work.) She said that is the evolutionary part of the brain telling you to protect your knee because it's injured. It was a survival mechanism. Naturally that pain will lessen, the body wants to heal. Respect it, but tune it out too. RESUMING WEIGHTS: DPT also said when resuming back into weights, work back up a little slower this time around. Also, load is key here, so if I'm having a bad knee day, shortening the range of motion but keeping the load. Then if that is still too much, back off range AND weight. Range will come as I get stronger. I am doing that with most of the moves on the operative leg right now. GOALS! She encouraged me to make some short and long term goals. As in if I felt good right now, what would I be doing today. She said to get back into things within reason (YES waiting for mountain bike trails to dry up). The ACL itself is super strong, strength is what we're lacking. Long term goals would be what would I do if I felt outstanding. KNEE APP: Lastly, knee pain app! She authored a research paper on neuroplastic training and weight training. How augmenting weight training with audio and visual cues helps maximum weight training benefits with neuroplasticity. She turned the science into an app and I am testing it out! I will start it next week. There is some science she piloted with using a metronome while weight training which helps the brain really focus and reconnect those brain wires especially those with pain. Alright, going on day 13 of this stupid flare up. Pain is really hurting the mental game! I was doing so well mentally before this!
The pain gives me anxiety as well before going to the gym for rehab session (or just plain old planning out my day!). DPT's suggestion was to not stop going to the gym (as in don't rest fully), but to scale back the weights and the range of motion so that it doesn't hurt. Keep going all out on the good leg. Is going to the gym going to set off more pain and ruin my day or not? Should I go later in the day in case I ruin my day? How much should I lower my weights? Should I rest another day? I wasn't up for standing to cook dinner on Thursday, so we ordered pizza. The pain was enough to derail my plans on Sunday. Saturday, I did rehab in the morning with very low weights. Made it through the workout (slight kneecap twinge on the leg press though), felt OK enough to go to a party where I stood around a while, then afterwards did a very slow 3 mile hike which probably all set me off for Sunday. I was pretty sore and slow getting to the truck. Sunday, I had another party and had very high hopes of getting out on my mountain bike (did not ride our local trails all of 2017, but I did 5 rides in all since recovery on vacation). Alas the pain put an end to my plans. Instead I sat and folded laundry and sat in the garden and put leaves in a bucket for some fresh air. I was completely heartbroken that I hurt too much to even go for a short walk. I was in such a funk Sunday, really heard to get out of it. It was like what is the point of having any goals or plans with this stupid knee! This lead me to think of ways to prevent this heartbroken-ness when pain takes over my plans. Maybe I just need to NOT plan things AT ALL for now. Really, just day by day. Biking was on the brain for a few days, and I was getting really excited for it. Probably just thought about it too much. I spent the day (and days prior) giving myself pep talks. This is an hourly battle in my head people! Some tricks I use:
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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
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