Every Surgery is Different [2+ wks post-op]

I kept such close tabs on my recovery from the last surgery that it's hard not to go back to the blog and see if I'm "keeping up" with myself from last time.  When I'm "ahead" it's a good thing to have that comparison, but when I have unfamiliar feelings, pain or am not "on track", it can be very frustrating.

In the first week I felt a lot of improvement over the last surgery, but during the 2nd week it tapered off a little and I started to focus on my pain level and how much bend I was getting. There was a lot of aching when at rest and it constantly feels like the kneecap would catch, which kept me from improving my gait and working on things like going down stairs. More than either of those is the pain I'm feeling on the outside of my thigh, even just to the touch. Drew tried to explain that it might be coming from the bruising I have irritating some nerve endings and causing the sensitivity... I am not sure that's what he meant, but whatever is causing it, I think it's something that needs to run it's course.

There has been improvement now as I'm closer to 2.5 weeks. The general aching pain has subsided, but the thigh sensitivity is still present. I can stand/walk for longer periods of time and we've added some strengthening items to the PT exercises. Those exercises include angled squats (knee bending from 90 degree bend to straight), mini-squats on the Bosu and balancing on my surgical leg while throwing and catching a weighted ball. I feel strong in these exercises and have been doing them at home to stay on track.  Only once has Drew had to do a little "forced bending" at PT to work on my range of motion (ROM), but it was not nearly as bad as last time, and hopefully we can avoid it going forward!

One thing I have to remember is that I can't compare myself to myself... When I mention feeling "behind" to my physical therapist he stopped and (quite seriously) claimed that it doesn't matter that I've had the same surgeon, same procedure and same physical therapist... Every recovery is different and I just have to listen to my body and work on the rehab!

Photos from 7/30, 13 days post-op:



Yes, I'm trying to flex my right quad!

Working the bend, bruising starting to fade

Crazy bruising; waaaay more than last time

Unexpected Feelings (1.5 yrs Post-Op)

Generally I try to think positively about my knee. I've long since gotten back to most of my favorite activities (and most recently- indoor volleyball!) and being out and active gives me the impression that I'm 'all better' even if I openly admit that my surgical leg still has a smaller quad and some actions, such as jumping in place on one leg, feel decidedly different from one leg to the other.

In the last few weeks my surgical knee has been feeling... different. It seems to be a combination of feelings, not necessarily at once, that's had me mentioning to family and friends that it feels "funny". For example:

• In day-to-day motions my knee will suddenly feel tight like it's about to pop or crack to relieve the tight feeling. Sometimes it does pop or crack, other times I stop quickly enough where it feels like it got on the cusp of popping, but I change my motion to avoid it. The times that it does pop or crack is not painful, but slightly annoying.
• When sitting on a chair, with my legs straight out in front of me, I will apply a little pressure just below my patella (to the area where my graft was taken from). Keeping this pressure, I first flex my legs (straighten) and then start to bend them slightly (both legs at the same time). My surgical patella will sometimes feel like it's 'catching' or even 'grinding' as it slides up during the bend. I realize this is a very specific motion / feeling, but the engineer in me wants to put the knee in certain situations to see how it reacts compared to the non-surgical side!
• No matter how much I try to stretch, loosen, warm-up or manipulate my surgical knee, it seems to have a feeling like the pieces of the joint are not allowed to move as freely as the non-surgical knee. Imagine a non-surgical knee being surrounded by water whereas the surgical knee feels like it's moving through something thicker- like jello or pudding. Not painful, or even limiting, just... different.
• It's since gone away, but at one point when I would straighten and flex my surgical leg there seemed to be a popping noise at the BACK of my knee, towards the inside. I seem to recall this happening during rehab, and we attributed it to the swelling in the knee pushing parts of the joint out of place and hitting nearby veins/tendons/what-have-yous. So, either that was just a guess at the time, or perhaps there was some additional swelling in my knee recently to bring me back to that feeling. Either way, that particular popping/uncomfortable feeling has since passed.

I think with the change in weather and also sports seasons, now would be a good time for me to reconsider a continuous 'rehab' plan for my knee. I've got a BOSU ball that's gathering dust, and don't spend nearly enough time stretching before my various sports. I think it would be wise for me to get out for a run and some PT-like exercises more often before Michigan's winter weather sets in and I'm forced to strictly indoor activities.

On a lighter note, whenever I'm in the middle of an activity, the knee doesn't pop (that I notice!) or have any continuous feelings of pain or soreness that limit me. Perhaps it's that I'm distracted with the sports, or that in the faster movements the knee is performing like it's been (re-)designed to!

Snow, Here I Come! [8+ Months Post-Op]

Things, thankfully, continue to remain 'normal' in respect to my surgical leg. We're nearing the end of the first indoor soccer season, and while I'm still a little nervous pre-game, I can tell there's improvement in my confidence of my knee, and I no longer hold my breath when someone's coming at me kind of hard, or if I get caught up in a play and think there's potential for knee injury. Starting to roll with the game more smoothly is yet another milestone.

Ultimate Frisbee has ended for the season (for some reason frozen ground is not ideal..!) so after the holidays I'll have to find something besides soccer 1 day/week to keep the knee moving and the muscles strong. Perhaps the BOSU will come in handy here.

All little update details aside, tonight I will be heading to northern Michigan to get back up on the snowboard which I haven't ridden since days before I tore my ACL last March 1!! I was so excited to dust off the 'ol board bag and load up on thermals and snow gear. I will take it easy to start (as the first few runs of every season feel like learning all over again!) but expect to feel nice and strong over the 2 days of boarding! One challenge I expect to face is any kneeling on the snow while strapped into the board. Having a stationary foot in respect to a large board is a challenge either way, and I want to be aware of my motions so I don't do any unnecessary twisting!

Until the next update... Happy Holidays to all!! :)

Back to Reality [7+ Months Post-Op]

Between the whirlwind weekends and evenings, and the shorter days which make me want to crawl into bed at 7pm, I'm sorry that I've been away from the blog so long... So here I am, reporting for blogging duty!

The fun news is that life is mostly back to normal, and now that I've a few more indoor soccer games under my belt (and yes, since you asked, I scored a goal last night! hehe) I see I am still timid, but getting a little better with each game in respect to my knee. Unrelated to my knee, I could definitely use some more skills when the ball is at my feet!

Ultimate frisbee is still going strong on most weekends, and that plus soccer is pretty much the sum of my activity. Although one exception was my halloween costume, which ironically is based on a SNL character whose signature move is lunging. I was more than proud to show off my 'Superstar' moves to anyone who asked! But halloween aside, I willingly admit that I have not been focusing on my knee like I should, and I hope to change that -- after Thanksgiving!

Day-to-day activities (including stairs) feel good, and even lunging or squatting while on the BOSU don't seem to induce any pain in my knee. The one movement I can think of which does bring on a twinge of pain is when I am standing on only my surgical leg and I do a one-legged hop. If the knee doesn't bend much, there is little to no pain. However, if I try to bend more to get lower to the ground and then push off and try to repeat this motion a few more times, there is definitely an uncomfortable feeling. I wonder if this is directly related to my patellar tendon (which is what was used to reconstruct my ACL)? I would guess yes.

Lastly, the 'popping' in the kneecap when going from straightened to slightly bent has been happening less and less with time. Typically when it DOES happen, it is just the once and I can't recreate the popping again right away. I think more muscle work on my quad would help eliminate this noise/feeling-- we shall see!

I'd like to say: I consider anyone who's been through, going through, or will be going through this whole ACL mess is a SUPERSTAR! :)

Typical Recovery Period? Check. [6 Months Post-Op]

6 months have passed since I went under Dr. Shapiro's knife, and I'm delighted to have this blog to go back and remember some of those specifics that are so easily forgotten as the 'light at the end of the tunnel' comes into view. I've now gotten back to try some of my fave sports (soccer, ultimate frisbee) which was my ultimate goal. Soon indoor soccer will start up, and perhaps I can even sub on some volleyball teams this winter... But more importantly, I've made it through the 'typical' 6 month recovery, and have reached some other goals:

• Walking without a limp
• Running (not rumping!)
• Reaching pre-surgical leg strength (using 1-leg press as a judge)
• Gaining most (but not all - yet!) of my quad muscle mass back
• I've got back my entire Range of Motion (ROM) with the exception of a little hyperextension (Dr. S said it's not necessary to get this back anyhow...)
• My balance and control is comparable to pre-surgery, just lacking a bit still
• For the most part, I have 'forgotten' about the knee and can enjoy my normal lifestyle!! Yippee!

Some other items of note:

• There is still some numbness to the outside of where the incision was made, but seems to be reduced
• Kneeling (think: yoga) is an odd sensation (probably due to partial numbness) which I believe my mind tricks me into thinking is painful, but it really isn't too bad, just uncomfortable
• On days after lots of activity my NON-surgical leg is sometimes sore, suggesting I still overcompensate
• I typically don't feel a difference as I go down stairs anymore, but on the aforementioned 'sore' days, that old feeling creeps back in a little

I must admit, I've gotten a little lazy in my "workouts" and it doesn't help that I don't belong to a gym. I am hoping that returning to some sports and having my BOSU ball at home in these cold/dark evenings will keep me moving and hopefully motivate me to have some level of 'rehab' at home as winter sets in!

For Wendy (who 'rumped' for the first time yesterday at 5 weeks post-op!) and Bill, who went under the knife this morning -- Keep your eye on the prize! It will be worth it in the end!

For anyone else who finds or reads my blog- I hope it's useful and if you ever want to 'comment', I'm happy to give you my take on the "ACL Journey", or just hear how you're doing or about your experience!

My next goal still remains: Indoor soccer with my beloved Hooligans!!

Yoga, BOSU, and Kneeling [5.5 Months Post-Op]

It's a beautiful thing when you realize you're continuously 'forgetting' about your knee and any limitation you may have post-op. While I am still not at 100%, I have gotten back into most normal activities and feel confident doing just about any activity, with the exception of using my surgical leg for powerful 1-legged leaps... the power is yet to return!

One activity that has been a real confidence booster is Ultimate Frisbee. The constant changing of directions, quick sprints and sudden stops, and 'going long' for a scoring catch in the endzone remind me a lot of soccer or flag football (but with more running!) and I feel this is similar to a 'worst case' activity, yet I have very little hesitation! On top of that, there is no pain or soreness afterwards, which is key!

The yoga I am doing with Jen (today will be the 4th class) has been an eye opener mostly in the case of kneeling poses. When we lunge or stretch or sit in most positions, I do not feel a major difference from left to right. However when I have to put weight on my surgical knee (seeing as how I had a patellar tendon graft) it can become painful after a long period of time or even a short time if it's taking most of my weight at once. To help curb any kneeling pain, I use a foam pad beneath both knees whenever I can. One thing that makes me feel a *little* better is that Jen, an otherwise very healthy and active person, also thinks we are kneeling too much and it bothers her knees a little too... so maybe it's not just me!

One thing I have gotten away from is PT directed at just my left knee and surrounding muscles. When getting into a more active regimen (including running, UF, or BOSU DVD workouts) it's easy to forget to focus on the surgical leg. If it feels good, why keep the focus on one side? But I don't think this is the right approach, since just last night I was looking at the quad muscles from side to side and while it feels good in most activities, there is still a significant difference in muscle mass. This is where having a gym membership or personal trainer might come in handy (which I don't have), but also going back to the basics and doing exercises Drew left me with in our last meeting would probably help.

Finally, I am trying to do the BOSU a little more now that weather is starting to cool down and the local HS track is rarely available with school is back in session. The DVDs are some good direction for working up a sweat and getting some jumping and squatting in, but I definitely need to research some more exercises which will target my knee. I am open to suggestions!

We're creeping up on the indoor soccer season (late October, I believe) but I hope to get out with a ball and work some more soccer-like movements into my routine so I am a little more confident as I hit the turf later this month!

In just 9 days I will be at the 6 month mark. My, how time flies!

My Comeback Continues... [5 Months Post-Op]

Towards the end of last week, my BOSU ball arrived!! I didn't get a chance to check it out until yesterday, and even then I chose to do what looked like the easiest of the included DVD workouts because I wanted to start out simple. So I promptly popped in the 'Long and Lean' DVD, and it was a lot of yoga-type poses (but, incorporating the BOSU, of course) and I was delighted to see that once I got past the awkwardness of doing the DVD for the first time, none of the poses created additional pain or strain through my knee! This included lunging poses where the BOSU was bubble-side-up and the forward (bent) leg was on the bubble. And now, a day later, I feel it more in my back and abs than my knee, which must mean in a left-to-right comparison, my legs are getting back to even!

The BOSU wasn't enough for the day though, as I have gotten pick-up ultimate frisbee back on the radar and we had a group planning to meet at 4pm. Eric and I have gone and thrown around a little, but that never prepares you for the stop-and-go running of a true pick-up game. So prior to getting started I strapped on my cleats and did some jogging on the field to remind my body of the ground conditions and being in cleats instead of runners. I also spent extra time stretching my legs out and doing some side-to-side jumping to imitate a quick change in direction. Besides the butterflies in my belly, I felt prepared to give it a try.

Originally I thought I'd have everyone huddled up and be making a blanket statement of 'take it easy on me!' but since we're not that hardcore (and, maybe the opportunity didn't really present itself) we just kind of got the game going and slowly but surely I reacclimated to the game and the feeling of being out on the field and active again. As soon as I started to feel comfy, the enjoyment really came for me... As out of shape as I might be for the sprinting aspect of the game, the knee held up amazingly and there hasn't even been any soreness since! There were a few plays where I became a little timid and avoided jumping up against other people for a free frisbee, but I will probably avoid major contact like that until I feel closer to 100%.

And my latest accomplishment on my 5 month anniversary from surgery, is that I've started a yoga class with my friend Jen! We chose a beginner level class we've taken before to try to get back into practice, and I am looking forward to the first session tonight where I can continue to monitor the progress in my knee and work on balance, strength, flexibility and relaxation! I am bringing along a foam pad to provide extra padding to my patellar tendon area during various kneeling poses, but aside from that I feel I have my entire range of motion (ROM) back, and hope there won't be many poses where I even feel a difference from side to side!

Namaste!

I Bit the (BOSU) Bullet... [20.5 Weeks Post-Op]

Time to step it up a notch.

The money I would have been spending on PT should be going towards a gym membership or equipment or something along those lines, but I just hadn't pulled the trigger... until now! I decided a BOSU ball would be a good purchase since I'd used it before in PT, and my therapist, Drew, also confirmed it's a good tool for rehab. Not to mention, it helped to get rave reviews from fellow blogger, Andrew, and also my friend Chris who has done some of his pre-med work with ACL rehabers. And BOSU isn't just good for balance and PT, but there are tons of exercises to be done on it which help all kinds of muscle groups. My arms and abs should be very, very afraid...

My dilemma was to decide if I should buy the consumer model or the commercial model. For about the same price I could get consumer +4 DVDs, or commercial +1 DVD. (See the difference HERE). In the end, I went with the consumer one, because while I'm all about getting a more 'durable' product, I will never put it through the use that a gym would if it was used for daily classes, etc. I hope I don't regret this decision!

How I Broke Up With PT [4 Months Post-Op]

Tomorrow I will be 4 months post-op. If you're an avid reader (or, recap HERE) you'll know my Doctor gave me the impression I only had a 4 month recovery (or, perhaps he meant 4 months of PT?…). I was skeptical then, and now that I'm here, I still know I'm not at 100%, but I'm doing what I can to get there.

Over the weekend I got yet another medical bill, and while I am blessed to be insured, I'm also blessed with a mathematical mind. Is what I'm paying for in PT really worth it anymore? Before I used to tell myself that having someone guide me, albeit 1x per week, was worth any cost to know I'm on track. However, the last month or so was very hands-off for Drew, and even regarding equipment use- aside from the 1-leg press and a BOSU ball here and there, most everything I can do at home. So, I approached Drew yesterday as I came into PT, asking "Is it OK if this is my last visit?" Drew gave me a long look and asked, "Are you breaking up with me?!"

We did some L-to-R comparison of lunging, jumping, balancing on each leg individually, as well as measured circumference at my knee, lower and mid thigh. Here's how I see my progress as of today:
Strength ~ 90%: For instance, I can 1-leg press pre-surgical weight, but it's still a little shaky. Which brings us to...
Control ~55%: It is still difficult to absorb the impact when jumping and landing on my surgical leg. Controlling the motion of something like a 1-leg squat is very difficult and borderline painful to do as I work into deeper bending. I think toning the muscle around my knee as I get it back will help improve this.
Mass ~85%: I still have mass to regain in my L quad, but even the mass I do have is not as solid as my R leg. I know this will come in time, but as trainers have told me along the way, I have further to go than most people based on the large size of my non-surgical quad!
Endurance ~95%: I might be guessing high, but if my knee were miraculously healed tomorrow, I think my endurance would be pretty good. Although I might take that down to 90% or so when I think of playing the full duration of a soccer game with minimal subs, or the continuous sprints of ultimate frisbee.

Now that I'm PT-free I can consider my options (what unattached girl wouldn't?!). Buy some equipment for home exercise, like a BOSU ball? Or spring for a gym membership to have equipment at my disposal? Or go to some open swims at a local pool for some 'low impact' jumping to work on control? I know I can always call Drew for questions, pointers, or help… plus he provided me with a few pages of exercises to keep working on. Any way I work it, I'm pretty confident I can do this on my own now.

Sorry, PT… It's not you, it's me. ;)

Celebrate Your Independence! [11.5 Wks Post-Op]

Happy 4th of July!

I am sorry to bore you, but happy to say, there haven't been many blog updates because there hasn't been anything out of the ordinary that seemed worth posting. I see this as a good thing though, because while maybe I'm not breaking major boundaries, I don't seem to be hitting any walls either! Progress seems slow, but steady...

The big items recently still involve jumping. Jumping rope for 3x3min intervals... Jumping onto and off of the Bosu Ball (bubble side up)... Starting with weight on one leg, the other resting up on a step, and while jumping into the air, switching both legs at the same time, landing on the opposite leg.... (This last one we pushed to do 30 times in 30 seconds -- I was definitely getting a cardio workout then!).

With PT visits only 1x per week, we tend to fill the time with lots of exercises, but I have to be sure to do items on my own during the other days of the week. I could be a little more religious with these, but I don't feel I'm falling behind by much, if at all. I recommend finding a workout buddy to take with you to the track or jump rope with you-- You'll see the exercises you've been doing will wear out even a non-surgical buddy! :)

On that note, I feel like each day is getting closer to 'normal' (with the exception of muscle mass from surgical to R leg) and it's wonderful to be getting back the independence I've been working so hard to regain! For instance, yesterday I ran just short of 2 miles on pavement, and while it was tiring and left me a little sore-kneed, it's progress!

Jumping for Joy (Literally!) [~10 Wks Post-Op/ 3rd Follow-up]

This afternoon I spent about 1 hour waiting (and, oh yeah, got another set of identical x-rays taken...) for my 'ol pal, Dr. Jeff Shapiro. As I waited, I tried to think of intelligent questions I should be asking at 2+ months out, but since there's no squeaky wheel, nothing really came to mind. So, when he finally made his grand entrance and we exchanged our how-do-you-do's, he surprised me with this:

Dr. S: "Two down, two to go!"
Summer: [Obviously confused] "What?"
Dr. S: "Well, you're at two months, and only two more to go!"
Summer: [Still obviously confused] "Oh, um, for recovery? Or..?"
Dr. S: "Yeah!"
Summer: [Yep, still confused] "I thought it was more like 6 months... No?"
Dr. S: "Nope!"

Playing back this conversation now still makes me chuckle, because even though he clearly stated it was a 4 month recovery (total), I still don't really believe it. I mean, PT has been going well and all, and aside from some muscle I need to get back in my surgical quad, I'm feeling pretty confident so far. However, when I've had it in my head that all my fave activities are off-limits for 6 months, it's hard to change that placeholder in my head from mid-October to mid-August. Plus, a big fear of mine is coming back too early and not being back to 100%. But if I can't trust my doctor's word, who do I listen to??

The rest of the 5 minutes (if that!) with Dr. S was uneventful- Range of motion is "great", swelling is minimal, and I have no complaints of pain... "See you in a month!"

So- I am resisting the urge to be completely ecstatic and drunk with happiness about this 2 month shave off my 'return'. Why? Well... while I feel I'm a positive person, I want to remain realistic and, perhaps, a little on the 'safe' side. We'll see how things work out, but I guess I'll limit myself to just a sip of this delight cocktail for now!

In the event I'd like to celebrate by jumping up and down - well, now I have been advised by my physical therapist to go on ahead and do it! Today in PT, among other things (see my ACL calendar), I started jumping. It's really a strange experience to try a simple motion like that, which I've avoided for the last two months, but is so elementary. Like everything else, I started with a little hesitation, but once I realized my knee wasn't giving out on me and there wasn't even a pang of pain, I became a 3x30 rep jumping bean! PT also brought on more Bosu Ball fun too...!

So, between the good news from the Doc and trying new things in PT, today was a great day! Not to mention, by next week I'll only be at PT once a week (currently at 2/week)! Booyah!

PT Routine Shake-Up [8 Wk 2 Day Post-Op]

I passed my 8 week mark on Tuesday and am cruising to 2 months post-op this weekend, on June 14. On Monday I went to PT and pretty much did my whole routine without any pointers, new exercises or even manipulation/ stretching by Drew, my therapist. Even though I did some treadmill time and feel my strides are becoming more even, I was disappointed at the lack of personal attention and was glad that I’d gone down to 2 visits / week. However in yesterday’s PT, Drew decided to mix it up for me, and it felt good to try new challenges, even if it left me whipped afterwards!

First, we skipped the 10 minute warm-up on the bike, since initially this was used to help get back range of motion and in later weeks, loosen up the knee w/o putting too much weight on it. Instead, I did 8 minutes on the Elliptical (Drew said to be sure I was a little tired and breaking a sweat when done), and after some calf and hamstring stretches, it was over to the treadmill. There I did 15 mins of alternating between speed walking and a run. I am gaining lots of confidence here and am sure I could have run longer, but didn’t know what else was in store for me.

The most entertaining, by far, was using the Bosu Ball, which is basically an inflated exercise ball, sliced in half with a hard plastic board across the flat. I had to stand on the flat part, meaning the half-sphere was towards the ground, and I had to balance on it, or risk falling off! I have never used a Bosu Ball, so I was very cautious. At first I thought the goal was simply to stand and balance, but then we added squats, which would mean having to distribute my weight evenly across both legs. I looked kind of like THIS, but kept my hands out in front of me for more balance. My surgical leg was a little shaky, and this was intensified by the Bosu Ball, making it even more difficult!

30 squats later (and, a careful dismount of this potentially dangerous piece of equipment), my surgical leg was ready for solid ground again!

I thought I’d be sorer today because I felt like we really pushed it (and, mixed it up, finally!) but perhaps the soreness will be another day behind. Or, maybe I’m further along than I thought, and ready for some more challenging tasks!

Other items of note:

• With the exception of an anti-inflammatory now and again, I haven’t had to pop pills for pain much since about mid-May (1 month post-op)
• The skin to the outer side of my vertical incision is still a giant numb spot, maybe 2/3 the size of my palm
• While I’m still able to ‘forget’ about my knee sometimes, I have noticed an aching feeling that comes about sometimes just when sitting
• More often I am able to get in and out of my car by pivoting on my L leg, instead of getting in or out of the car with both feet on the ground first
• I take the stairs up and down to my 2nd floor desk whenever I can, and going up remains pretty even while going down still requires some strengthening to even it out
• I can walk w/o limping, but if I’ve done a lot of activity or walking in any given day, my limp creeps back to a quite obvious favoring by days end
• I touched my butt with my heel! While standing I was able to grab my ankle and (with my foot slightly pointed/ while wearing tennies) was able to bend my knee so far as to feel my shoe hit my butt! (I even showed an assistant at PT just so someone else could share my glory!)
  
  What’s wrong with getting excited about the little things? :)