I am 21 weeks into the new rehab. Overall, I'm 15.5 months post ACL recon (started the new rehab at month 11). I have been regularly mountain biking the past 6 weeks which has been pure joy. I even bought a fancy new mountain bike to commemorate my 42nd birthday AND well, I deserve a damn ACL present. I bought a 2018 Giant Stance 1 and this thing is awesome. Lighter for a full-suspension bike, under $2000, climbs well. Very happy with it! I picked it up the day before my birthday so I was able to bike on my actual birthday which I wanted. I even did quite a burly ride last weekend that really put my endurance and strength to the test. Quite pleased that I could do it! I am still aware everyday with every step that my knee is not there yet, rather the quad is not strong enough yet which affects the front of the knee. I'd say I'm 60% of normal maybe? Definitely is improving as I gain strength. I haven't had a true flare up since April 1, so that is almost 2 months now. I still tape up for weights and I still wear the Ace bandage for most of daily life. KNEE SCORE UPDATES! Time for updated knee scores. Last scores were from 2 months ago. Before that was in December before I started new rehab over. We have some improvements! Lysholm (100 max) - Score is 80! OK that seems kind of high, but then when you look at the question "I have marked pain in my knee during or after walking more than 1 mile (10)" or "Intermittent or slight pain in knee after vigorous activities (15)" there isn't much in between. What is vigorous? Is this 1 mile of walking flat or rocky? Nothing between walking and vigorous like moderate? I can kind of power hike uphill with poles, I can bike fast/climb steep hills, but I couldn't run or play soccer or anything. If I tried to run a mile I'd surely be hurting. I went with 15.
IKDC (100 max) - Yes! What probably bumped it up the most was my change of activity level. Before I'd answer "Light activities like walking, housework or yard work" as my max level, but now I'm more of "Moderate activities like moderate physical work, running or jogging." While I'm not running or jogging, I do think I am mountain biking and hiking moderately so I changed it to this. Also squatting is getting better, not that it's part of my work out yet.
Kajula - I don't have a pre-rehab score, but I do have two scores now. Improvement in just 75 days! I don't really limp much, pain overall is improving, atrophy is still there but muscle is building.
KOOS Score - KOOS has a more detailed calculation, but in general this questionnaire addresses five categories: Pain, Symptoms, Functional Daily Living, Sports/Recreation, and Quality of Life. Overall everything has improved, but pain category (but still there) and QoL like worrying about your knee health improved the most. In another post, I'll talk about how I will know I'm ready for running, agility and landings. Still need a few more months of strength building!
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Just chugging along with rehab. Usually three days a week. No real significant pain. Most days I still wear Ace bandage wrap, a few times I went with naked knee. I have been mountain biking and hiking on weekends. Mid week hikes are kind of hard to fit in with life and caring for my aging dog. It's OK, that is just the chapter of life we are in now. I haven't really had good sleep in a long time because of caring for my dog, so overall energy is kind of low - like all the time. Still I'm getting in maybe 10+ hours of kneehab a week.
I went on a group mountain bike ride on May 5 which was International Women's Mountain Bike Day. It was the first time I rode with other people since my surgery. I was kind of nervous, and thought if I had to drop out then the group can go on without me and no one is upset I flaked out. I have to say I was pretty good (3rd in the conga line) and I already did another ride that morning! That was a nice little motivational boost for my mental game. I did leave early, but only because the starting and stopping was taking FOREVER and I felt like I was wasting my time. Luckily I already got that ride in earlier. Anyway, a group of that size wasn't my cup of tea anyway. This summer or fall I hope to complete a hiking goal of 5 miles round trip with over 1400 feet elevation gain. Why so specific? It will get me to the location of my injury site where I tore my ACL while backcountry skiing. I think it will be a significant milestone for the first time in my recovery to be physically able to get there. I am not ready yet. Haven't hiked over 4 miles yet, definitely not that much vert. Overall, the strength gains are going much slower now that the weights are getting heavy to me. I'm still progressing though. Also no major pain flare ups in a while so that is good! I have no idea how long it will be until I'm ready for running, agility, and pain free. One physio guessed another 2-3 months, but I've read 6-12 months in papers for patellofemoral pain, so that's another 2-8 months going by that. I told myself 12 months - be patient - it could be a while. Just one month ago I was in a huge painful flare up. Now here I am mountain biking every weekend. I'd go after work if time permitted too. I did two rides back to back this weekend! That is a first. I must say the past 3 weekends, everything I asked my knee to do, it held up. Biking, hiking, rehab, gardening, errands, cooking. This does not mean it was pain free or normal feeling, it means it didn't slow me down or prevent me from doing something I had planed, etc. This is really a wonderful thing! I am wearing the Ace bandage less and less too. Another great indicator. Strong quads = less anterior knee pain. I just finished 17 weeks of my new and improved rehab with the DPT at the sports and exercise medicine research center, and recovery day 442 overall since surgery. The leg extension machine has been added to my routine - both isometric single leg holds (5 x 45 sec) and also isotonic 4 sets of 6 reps for each leg (using a metronome to ensure time under tension - 3 seconds up, 4 seconds down and for neuroplastic training). I'm only at 15 pounds right now with my operative leg, but BOY this is really going to get the quad going I can tell even after just one week of the new exercise! Very exciting! I was in contact with another Australian physio who referred me to an excellent criteria based ACL rehab protocol called the Melbourne Return to Sport Score. It's patient friendly and really filled in the blanks for me as far as my overall game plan. It has 5 phases of ACL rehabilitation and they are all goal based rather than time based. So many protocols out there go by time which we all know doesn't work for everyone. You must meet all the criteria, including passing physical tests which are outlined in the PDF, before moving on to the next phase. To return to sport, they have a multifaceted scoring system. I'm in phase 2 working towards "regaining most single leg balance, regaining most muscle strength, single leg squat with good technique and alignment" as the most important goals. The PDF has a list of each phase's tests in detail, but the ones that I know I will not be able to do right now (to move on to Phase 3) are:
That last one, that's like 210 pounds unless I loose some weight really fast! Currently at 95 pounds with 6 reps with the operative leg. The Australian physio said my next phase would be the running, agility, landings portion and I'd need the help of a strength and conditioning coach or an athletic trainer (opposed to a physio). Currently figuring out where I will do that, or just continue on with the original DPT I am working with, but I now she is very busy and in high demand. My nephews are coming to visit me for a week long trip in 5 weeks' time. I'm hoping I can get much stronger so I can do the fun activities I have planned. Also worried about my old dog - not sure if she will still be with us or not by the time they visit; just taking it day by day - as with everything. She require a good amount of care too.
I can count on two hands the number of total mountain bike rides I've had since surgery (that is 8 rides so far on real trails), but it's going to be year of the mountain bike I can tell. A few photos from some rides in my beautiful state! |
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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