Last weekend we took a trip to the desert for a long weekend in the sun. Temps ranged from 44-65F which was quite perfect. We brought our little awesome trailer and camped for free next to a river on BLM land. I love that trailer! It was a hiking trip, not many mountain bike trails near Capitol Reef National Park. I did 4 days of hiking all in all. One was a 5 mile hike that was pretty technical for me. I taped my knee up and used hiking poles, and I was able to "walk" normally without planning which foot has to go first. There were some serious rock stairs on the descent too! If the hike were flat and easy, then I would not tape up my knee. No flare ups, just a tad sore. Functional progress. Overall I'm 20.6 months post op from ACL reconstruction. I'm just over 9 months into the proximal muscle rehabilitation and taping with my DPT in Australia (yes she is still guiding me!). Lately I've been going about life without any taping or Ace wrap to the knee. The effects of detraining: Often I've wondered if I am 9 months into new rehab, why aren't I comparable to someone who is 9 months post surgery? Seems like it would make sense? Mick Hughes another great Australian physio recently shared a white paper "Prescription of training load in relation to loading and unloading phases of training." Basically it's a formula that can suggest how many weeks does it take to get back to full training levels before a break/rest/injury/illness. This is a great explanation of why at 9+ months post op, I'm not comparable to someone who is really 9 months post op. I had this huge long rest/break and it really does affect the overall outcome and time frame. It makes complete sense now! Not paying attention to training loads after a break can lead to injuries as well. This is how to safely resume load levels while minimizing injury risk. Out of curiosity I calculated what my modified weeks would be until I'm at full training levels. I'm assuming 50 weeks of inactivity pretty much at 0%. That includes the time just after injury. I had some weeks of rehab in there before things went off track, but I'm not counting them because it just wasn't a lot or very effective (and really painful!). The formula suggested I have 81 weeks before I am back to full training levels. That's about 18 months. I'm 9+ months in so far. I've actually said out loud that I feel like I'm only halfway through this strengthening phase judging by front of the knee pain and how functional I feel. I even asked Mick how long does it take to get PFPS under control he said if you had 11 months before meaningful rehab started then he said it "would be fair to say that it may take equal that time maybe even a little longer to get on top of things." Basically it is hard to actually put a real time frame on it. I understand that, no one can predict, but I like to use research to kind of give me a ball park. 18 months puts me at July 2019. Maybe that will be when I'm ready to start running/jumping/agility. Wow, if that is anywhere near reality, I'll take it! I'll have to make another post next summer! After reading this and looking back to my 3 week hiatus back when my dog passed away, I probably shouldn't have upped all my weights when I resumed rehab! If you have not reached out yet to me, I'd love to learn why you visit my journey!
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Holy moly, does this feel like forever or what!? Day 600 and this recovery is still front and center in my life. Knee logistics. Which shoes to wear, which pants can I do today. Do I wrap my knee or tape it up today or *gasp* go naked knee? How long will I have to stand at that party? I put all the hundred marker days in my Google calendar so I make sure I acknowledge it and celebrate it. This is something I feel pretty strongly about - especially if you have a fairly long recovery! Gotta celebrate all the milestones. Make up milestones if you want to. I chose to celebrate with an activity that I know I can do - mountain biking. Fancy drinks and nice meals help too! Let's face it. There is a lot I cannot do right now. But I won't go down that list today. I look back just 100 days ago - June 29 - and I can already see some changes. Back then my max mountain biking distance and mileage was about 12 miles and 2000 vertical feet. I did a 15 miler back then, and there was a flare up afterwards. Now I can do 20-27 miles without any extra soreness, and my vert is higher as well (so far I've hit 3500 feet). This is thanks to the amazing body and its ability to adapt over time! My rehab weights have also gone up. Below is a graph in percent change in my weights. Definitely progressed here, no declining despite several flare ups (I may have lowered weights in a flare up, but work my way back up slowly). I didn't know the hip cable machine had 1.5 pound increments! It was going to take me forever to move up 5 pounds, but thankfully I noticed someone moving this 1.5 pound weight. Ha! Seated adduction machine was added just a week before Day 500, so I started out kind of easy and just added 5 pounds every session, hence why it looks like a large increase. Hip thrusts had the next biggest improvement. These are a great hamstring/glute move. I am happy to see the leg extension weight has a 29% increase. This one isolates the top quad; the muscle that is most behind. The other improvement I notice is my stamina. I can do more and more often! Relatively speaking that is. As of mid September, I have been biking on the trainer at home 30 minutes every morning. It's not fast, but I use some resistance. A rehab day is often 3 hours: 30 minute trainer, 15 min elliptical (warmup), 2 hours of leg weights, 15 min of elliptical. 3 days a week. It's pretty time consuming! Then I bike or hike on off days. Weekend bike rides can be 2.5 - 4 hours long. While I'm not full of energy, I feel like I can do more activity now and more consecutive days.
So there are my improvements! It helps to really dissect things out like this. When you're in the day to day, it feels super stagnant. Progress can't really be measured week by week. Still waiting for a "good" knee day. I have a daily, very obvious sensation even if the pain isn't front and center. It's a mixture of patellofemoral pain (diffuse anterior knee pain), ACL reconstructed joint feeling (clicky, swollen, mechanical insides) and the bone plug they took from my kneecap and the patellar tendon (like a clothespin or vice grip is always attached to my knee). Some days it feels exactly the same as last year, other days I feel a slight improvement. Luckily I still have full range of motion and I don't generally feel any of it when I'm lying down. Photos from my 600th day celebration ride. I'm going to be a little sad when biking season is over in Northern Utah. I hope to fit in a few desert trips over the winter. |
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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