A knee knows

I tore the anterior cruciate ligament (ACL) in my left knee skiing at Mt. Wachusett in central Mass. on January 18, 2007. This is a common injury to weekend warriors like myself, so I thought others might like to know what happens once you've done something unfortunate like this to your body. Maybe you've injured yourself too, and feel like the game's over. However, you can return to your sport -- you just need to stay focused and do the work.

Here's where it started...



Friday, May 25, 2007

11 Weeks post-op

Saw my OS yesterday, who was very happy with my progress and with the solidity of the knee. He's mentioned a couple of times that the ultimate test of the knee's stability post-op would be to do the Lachman test on both knees eyes closed and, say, forgetting which knee was "involved" not be able to tell the difference between the two. He said yesterday on examination that I was very very close to that point. I think one key element of this would be getting the tension right during surgery, once the graft is installed. My understanding is the OS uses some kind of tensionometer to do this, but I have to think that experience, and the unique feel that an excellent OS can give this process are what make the difference between a mushy feel and a nice solid joint.

My OS is a nice guy, and you can tell he's very precise in how he does probably everything, from making coffee to tying the knot in his necktie. That's exactly what you want in a surgeon doing this kind of procedure.

However, as good as the knee feels, he wanted to caution me that I need to remain vigilant about as my PT would put it, "doing something stupid" that would cause the graft to fail. At this point, as good as it feels, I will only walk out onto a tennis court to sweep it; I won't even go out there with a racquet -- too tempting.

Monday, May 14, 2007

Nine weeks last Friday

After nine weeks post-op rehab, the news is good.

The technique I mentioned at six weeks post-op, of using a piece of pipe to break up scar tissue in my hamstring really made a huge difference. I haven't had a single hamstring tweak or pull since starting that process.

I'm now doing a series of exercises to strengthen my leg/knee, as follows:
  • One legged bridging: Lying on back, feet flat on floor. Raise and hold knee of non-involved leg to chest, raise pelvis, pushing off heel of involved leg, raising as high as possible. Four sets of 10.
  • Mini one-leg squats. Standing on platform on involved leg, with other leg hanging off platform, do four sets of 10 squats touching heel to floor.
  • Hip hiking: Standing on platform or step with non-involved leg hanging, tilt pelvis so heel touches, then raise pelvis on non-involved side as high as possible. Again, 4x10.
  • Forward reaches off step. Hands behind head, keeping back straight, from platform, extend non-involved leg over edge of platform and bend involved leg until heel touches floor. 4x10
  • Nose crushers: Stand with feet about 6-8 inches from wall. Keeping back straight, weight on involved leg, bend only at ankle and touch nose to wall, and return. 4x10.
Doing these 4x/week.

The knee is feeling excellent. No pain at all apart from some stiffness in the morning and after sitting for a while at my desk. A week ago or so, I took to wearing a neoprene knee brace just as a reminder so I wouldn't try to do something I shouldn't. Wearing it less now, but probably should continue -- it's a very good way to maintain awareness so I don't try to pivot on the knee or etc.

So, having passed the 8 week point, the graft should be starting to strengthen after declining in strength since the surgery for 8 weeks, as my OS explained it. By July, I'm going to really be itching to get out on the tennis court.

In the meantime, my shoulder is not really improving much if at all. I'm doing rotator cuff and other strengthening exercises every day and while the exercises seem to help the short term discomfort (it hurts at first and then feels better as I continue working out), I think it'll be a serious problem when I try to serve a tennis ball. I've got a call in to my OS asking him to approve an MRA for the shoulder, where they would inject some kind of dye into the joint before doing an MRI. Now and then at my son's Babe Ruth baseball games, where I've been coaching, I'll throw the ball a bit and there's always some pain. Seems like I'm OK if I'm throwing up to maybe 25 feet or so, but beyond that it can start feeling pretty bad. Normally, I really feel it the next day too. If there's any improvement, it's very very marginal. So I just don't get it.