Just over 9 months after the screws went into my ankle, they came out.
I was supposed to be at the hospital for 9:40 with surgery slated for 11:10. We stopped off before I went in and voted in the Federal Election as I didn't want to risk being doped up after surgery and not being able to vote.
The worst part of the day was honestly the morning wait. I had been told that with my surgery time penciled in for 11:10, the porter would pick me up around 10:40. Yeah, try 12:40. The extra two hours of anticipatory nerves were not a thing I was looking for! A nurse friend of mine reassured me over text that they weren't going to cancel my surgery (my biggest fear! I wanted this over with!) and so I read some magazines and impatiently waited it out.
So I finally got wheeled up to the operating room and learned that my anesthetist plays hockey with the surgeon who did my ACL reconstruction. Small world, right? They wheel me into the (freezing!) operating theatre proper and within a few short minutes I was out. I came to at about 14:05 in recovery, which gives a pretty good idea of how short a surgery it was. Similar to my ACL surgery, I came to quite alert. Unlike my ACL, I didn't feel the need to cry for no reason, making this by far the easiest time I had coming out of anesthetic of my three surgeries this year. This is also evidenced by me being bumped back down to day surgery almost right away.
My nurse friend Nancy came to hang out with me and then take me home when they finally cut me loose. It was great to have her there as she got me two extra pieces of toast! Unlike my ACL, they also let me have two drinks. Either the Mis is less stingy with this stuff, or the Grey Nuns was just really, really convinced I was going to puke. Either way, toast was delicious.
As I was about to get discharged we had a length back and forth between me and the nurses about my limitations post-surgery. I had asked Dr. Toreson before surgery how this would affect my bench press training (I'm competing in a month) and he had told me no restrictions, let pain be my guide. The only thing he said to be sure to avoid was body contact (which is off limits right now anyways due to my ACL). Well, the nurses were like "oh god you're going to break your bone!!" and the literature they gave me said not to lift more than 10 pounds. They tried paging my surgeon for clarification but he had left for the day, so they made me promise that I would call him (which I did yesterday - bench training is a-ok).
I was surprised with how well I could walk. I had read some people's accounts of their hardware removal where they were on crutches or back in the boot; I walked out under my own power just like Dr. Toreson had said I would. Made it back home, got myself installed on the couch, and stayed there for most of the rest of the night.
I took yesterday off work but didn't really feel too worse for wear, so I mostly just watched TV. My partner was home from work early and I wanted out of the house, so I tagged along to the gym. I didn't work out really, but did a few sets of strict pull ups, kipping pull ups and dips. Hooray for upper body! Today I'm back at work and off pain meds. Other than feeling a little more tired than normal and the obvious reality of a bunch of staples in my leg, I'm feeling pretty good. Optimistic that the hardware removal will help with some of the residual swelling in my ankle and allow me a bit more range of motion. Squat time is coming!
Wednesday, October 21, 2015
Tuesday, July 14, 2015
Days 9-19
On Day 15 I had my second physio appointment, and my first with the physio that my surgeon wanted me to see. Overall I was happy with him - he ran the appointment efficiently, explaining each new exercise and then giving me enough time to complete it. Very seldom was kept waiting in between exercises, explained stuff well, seemed to be progressing me along.
New exercises for Week 3:
New exercises for Week 3:
- Bridge (3x5 progressing to 3x10 with a 5 second hold at the top)
- One-legged bridge (alternating legs)
- Swiss ball roll-ins (3x20)
- Swiss ball bridge (3x5 with a 5 second hold)
- Box air squat (3x5 progressing to 3x10; decrease height with success)
- VMO squat/wall squat (1x5 progressing to 3x15 with a 10 second hold)
- Air squat series (1x10 progressing to 3x10)
- toes straight forward
- toes straight out
- toes straight out with a toe raise out of the squat to the top
- lunge (one set with each leg forward)
- AM terminal extension with belt (1x5)
Roll ins seem to be helping with flexion, so that's good. The bridges are getting easier and have the added bonus of helping with glute engagement, which I suck at at the best of times. The one legged bridge, especially trying to bring my left leg into extension, is definitely a challenge.
With the exception of the VMO squat, which is not exceptionally difficult, all things squatting are demoralizing and frustrating. I seem to be improving, and I don't even necessarily think that I'm behind, but going through two straight injuries that eliminate your ability to squat functionally is awful mentally. I just want to be able to squat to parallel and not look like I'm trying to fold myself in half. It's embarrassing and frustrating.
I saw my surgeon on Friday (Day 16). I finally got the low-down on what went down during my surgery. As she expected, my knee was a mess when they went in there and there was a lot to clean up. Overall she was happy with how this went. My ACL was repaired using a hamstring graft. My bucket handle tear was indeed flipped and blocking the joint, rendering me locked. None of my torn parts were repairable and they took 2/3 of my medial meniscus. My medial compartment is my best one in terms of osteoarthritis, where I am a 2 on a scale that goes from 0-4. My lateral compartment was a 2-3, with a section observed at 40 flexion that was a 4. My anterior compartment was also a 3. The hope is that now that my knee is stabilized we can slow down the further degradation of the joint. She doesn't anticipate weightlifting putting undue stress and damage into it. Football is obviously another story. Overall she says that it shouldn't bother me arthritically for several years yet, and once it does my activities will be dictated by how I take pain. Not the greatest news, but no surprises basd on what my MRI had showed.
I'm still swollen, but less so than in the first two weeks. I have fallen off a little bit on my icing regime and should probably take some more care to be doing that. I think I may leave my cryo cuff at home from now on and emphasize icing from there. I don't think that I need to be icing while I'm at work anymore.
I got my fluid trainer set up last night so that I can happily bike away at home in addition to when I'm at the gym. I forgot to ask about the ski-erg at my last appointment so I'm going to make sure that's on the list for this week. I've seen pictures on instagram of another Sather patient able to use the rower, so I was going to ask about that as well. As of tonight I'm going to restart doing some upper body work as well so that I can try and get my routines back to some semblance of normal.
Not too sure what my goals are in terms of hitting them by my next physio appointment. I guess just general comfort and vague improvement in my squats so I feel less awful and incompetent. I am going to have to ask Ian what reasonable targets are in between my appointment on Thursday and whenever the next one will be as I am not a good judge and have proven to be a very harsh critic right now.
Friday, July 3, 2015
Post-Surgery - Days 6-8
Day 6
I slept better last night than previous nights which was probably a combination of being able to sleep on my side and it not being nearly as obnoxiously hot. I'm still not sleeping soundly through the night - I'm waking up every couple of hours. Normally I'm a really good sleeper, so I'm hoping this will pass soon. I'm feeling a bit foggy and tired during the day, which I'm sure is related to my quality of sleep. I could do without it though!
I'm off prescription meds entirely and taking ibuprofen instead. I have a bit of pain upon waking up when I first walk and the blood rushes into my leg but overall not too bad.
Day 7
I was convinced to head over to Commonwealth and hang out at our booth during the Women's World Cup. I did very little - I stood around for while chatting and then the rest was spent sitting with my leg up on a bucket. At halftime I ran a till with two friends pouring beer for me. Sketchiest part of the day was probably my brain fart when I decided to walk around the opposite side of the stadium to the one I normally walk - the one with a huge slope down and then up. I had the debate of "what is better - turning around and walking all the way around to the other way, or sucking it up and walking this?" I went with the latter and started moving very, very slowly downhill. About midway down a guy I know who drives carts in the stadium picked me up, called me an idiot for walking it, and took me to the booth.
When we got home I made up for lost time and iced every hour (well, every hour +20 counting the time I as using the ice). Other than feeling fatigued, I didn't feel any worse for wear for my adventures.
Day 8 - FIRST PHYSIO APPOINTMENT
The highlight of today was my first physio appointment. My friend Sharon was nice enough to drive me there as I wanted to at least ask about the safety of me returning to driving before I did it. My physio was pretty happy with my progress - I've hit the marks they wanted in terms of pretty much full extension and 100-110 degrees of flexion, so that was good. The biggest thing I need to work on is re-training my gait to include the component where you heel strike and are in extension - after having been locked for so long, I have modified into a bent knee walk that I do not want to keep long term. It's always interesting to have to think really hard about doing a motion that you take for granted. I pulled out both crutches to help brace me, and spent some time really emphasizing the extended position heel strike, keeping the quad engaged, and getting a proper stride.
Speaking of quads, we did a lot of quad activation work. We started with a lot of quad setting from progressively lower each set. My first one I had a fully rolled towel under my knee, then a half roll, then no roll. Then we did some work dorsiflexing the ankle against a towel to try and push into terminal knee extension. Then straight leg raises, which I definitely struggled with sans towel. The quad activation part, and trying to actively make sure that my knee stayed as extended as possible was definitely a challenge. This is a weird feeling as someone who has historically been very quad dominant, but the comeback has to start somewhere.
Still trying to work terminal extension, I also did some work standing with a theraband around my knee, and then pushing into extension. After that, I got cleared to ride the bike, which was super exciting. I can definitely see how the movement helps to loosen up the joint. The first couple revolutions were very difficult, but the pattern naturalized for me very quickly. The last thing we did were wall slides, and again it was the quad activation to go from the bottom (in flexion) back to the top that was the hardest part.
My next appointment is in a week, and I switch physios to the one that my surgeon wanted me to see (same clinic). They told me to continue really emphasizing my extension this week, and that he would expect me to be walking with a proper gait next week and that we would continue pushing to regain terminal knee extension. They also expect my flexion to continue improving; I feel like I'm being held back by my stitches more than anything. After I hit a certain point it just feels really tight against them. We'll see what happens.
NEW EXERCISES FOR THE WEEK:
I slept better last night than previous nights which was probably a combination of being able to sleep on my side and it not being nearly as obnoxiously hot. I'm still not sleeping soundly through the night - I'm waking up every couple of hours. Normally I'm a really good sleeper, so I'm hoping this will pass soon. I'm feeling a bit foggy and tired during the day, which I'm sure is related to my quality of sleep. I could do without it though!
I'm off prescription meds entirely and taking ibuprofen instead. I have a bit of pain upon waking up when I first walk and the blood rushes into my leg but overall not too bad.
Day 7
I was convinced to head over to Commonwealth and hang out at our booth during the Women's World Cup. I did very little - I stood around for while chatting and then the rest was spent sitting with my leg up on a bucket. At halftime I ran a till with two friends pouring beer for me. Sketchiest part of the day was probably my brain fart when I decided to walk around the opposite side of the stadium to the one I normally walk - the one with a huge slope down and then up. I had the debate of "what is better - turning around and walking all the way around to the other way, or sucking it up and walking this?" I went with the latter and started moving very, very slowly downhill. About midway down a guy I know who drives carts in the stadium picked me up, called me an idiot for walking it, and took me to the booth.
When we got home I made up for lost time and iced every hour (well, every hour +20 counting the time I as using the ice). Other than feeling fatigued, I didn't feel any worse for wear for my adventures.
Day 8 - FIRST PHYSIO APPOINTMENT
The highlight of today was my first physio appointment. My friend Sharon was nice enough to drive me there as I wanted to at least ask about the safety of me returning to driving before I did it. My physio was pretty happy with my progress - I've hit the marks they wanted in terms of pretty much full extension and 100-110 degrees of flexion, so that was good. The biggest thing I need to work on is re-training my gait to include the component where you heel strike and are in extension - after having been locked for so long, I have modified into a bent knee walk that I do not want to keep long term. It's always interesting to have to think really hard about doing a motion that you take for granted. I pulled out both crutches to help brace me, and spent some time really emphasizing the extended position heel strike, keeping the quad engaged, and getting a proper stride.
Speaking of quads, we did a lot of quad activation work. We started with a lot of quad setting from progressively lower each set. My first one I had a fully rolled towel under my knee, then a half roll, then no roll. Then we did some work dorsiflexing the ankle against a towel to try and push into terminal knee extension. Then straight leg raises, which I definitely struggled with sans towel. The quad activation part, and trying to actively make sure that my knee stayed as extended as possible was definitely a challenge. This is a weird feeling as someone who has historically been very quad dominant, but the comeback has to start somewhere.
Still trying to work terminal extension, I also did some work standing with a theraband around my knee, and then pushing into extension. After that, I got cleared to ride the bike, which was super exciting. I can definitely see how the movement helps to loosen up the joint. The first couple revolutions were very difficult, but the pattern naturalized for me very quickly. The last thing we did were wall slides, and again it was the quad activation to go from the bottom (in flexion) back to the top that was the hardest part.
My next appointment is in a week, and I switch physios to the one that my surgeon wanted me to see (same clinic). They told me to continue really emphasizing my extension this week, and that he would expect me to be walking with a proper gait next week and that we would continue pushing to regain terminal knee extension. They also expect my flexion to continue improving; I feel like I'm being held back by my stitches more than anything. After I hit a certain point it just feels really tight against them. We'll see what happens.
NEW EXERCISES FOR THE WEEK:
- Wall slides (20-30 reps)
- Quad setting (20 reps x 5 second hold)
- Quads over roll (20 reps x 5 second hold
- Straight leg raise (15-20 reps x 5 second hold)
- Terminal extension (3 sets of 8-10 reps)
- Baby squats (3 sets of 8-10 reps)
My goal is to complete my exercises a minimum of 2x/day (lunchtime + evening). I'll also be riding the bike daily, starting at the recommended 5 minutes per time and progressing from there.
Monday, June 29, 2015
Post-Surgery - Day 5
Day 5 is the exciting day where my bandages got to come off. Which was a really good thing because they were half off by the time I got from the bedroom to the living room, and had fallen completely down to my ankle by the time I got to the kitchen to pick up a pair of scissors. I was pleasantly surprised by how small my incisions are - I've seen some pretty substantial sized ones in my trips down the #aclsurgery hashtag on instagram.
The biggest thing thus far today has been swelling above my knee. The irony of it is that this is how I was misdiagnosed repeatedly and played 4.5 years of hockey/football/strongman/etc. on no ACL and a couple meniscal tears. It seems like overnight this swelling increased a bit, and it looks super funky when I do my flexion exercises. I can also feel the tightness when I walk. Hoping to make it recede a little with today's icing regime, but we'll see how it plays out.
Pretty much confirmed today that I react to toradol in much the same way as T3 in that I become emotionally irrational far quicker than I should. Soooo...I'll be cutting out meds now and switching to advil, as I can't really afford to be crying over random problems when I go back to work. Sanity...important!
My pain levels aren't high by any means, but I do find I'm feeling things more than I was the first few days. It could be because I haven't been taking very many meds or it could just be general owie feelings. I notice it most when I stand up and the blood rushes back down into my leg.
Pretty sure I was past 90 flexion today, so that's great. I think my knee extension work is getting better as well. I think my gait is going to be the hardest for me to fix in terms of the extension you should hit to start a stride - I have six months of really bad gait patterns to undo.
The biggest thing thus far today has been swelling above my knee. The irony of it is that this is how I was misdiagnosed repeatedly and played 4.5 years of hockey/football/strongman/etc. on no ACL and a couple meniscal tears. It seems like overnight this swelling increased a bit, and it looks super funky when I do my flexion exercises. I can also feel the tightness when I walk. Hoping to make it recede a little with today's icing regime, but we'll see how it plays out.
Pretty much confirmed today that I react to toradol in much the same way as T3 in that I become emotionally irrational far quicker than I should. Soooo...I'll be cutting out meds now and switching to advil, as I can't really afford to be crying over random problems when I go back to work. Sanity...important!
My pain levels aren't high by any means, but I do find I'm feeling things more than I was the first few days. It could be because I haven't been taking very many meds or it could just be general owie feelings. I notice it most when I stand up and the blood rushes back down into my leg.
Pretty sure I was past 90 flexion today, so that's great. I think my knee extension work is getting better as well. I think my gait is going to be the hardest for me to fix in terms of the extension you should hit to start a stride - I have six months of really bad gait patterns to undo.
Sunday, June 28, 2015
Post-Surgery - Day 4
Today has been the first day I actually felt like I had something done. I woke up alert from my surgery, and have been pretty alert/no pain ever since. Today I have been ridiculously tired and have slept most of the day. Probably a good indication that I over-exerted myself yesterday.
Woke up and did my exercises. Flexion is definitely coming along, and I'm fairly sure that I'm past 90. Extension I think is coming, but it's harder to tell with these dressings still on how my knee is hanging. I get to take them off tomorrow, so I'll be able to get a better view.
Excitement of the morning was that things began moving again. Thank you world!
Iced my knee twice and fell asleep for a couple hours. Woke up, watched some TV, iced again, and followed tweets online about the football final from the other conference. I'd been feeling a bit achy, so when that game was done, I took a toradol and promptly fell back asleep for another couple hours.
It's really weird to me to look down at my feet and have my left ankle be bigger than my right. I don't think my swelling is excessive, but it's definitely present.
Looking forward to taking the dressings off tomorrow just because the big one keeps falling down/falling apart a bit. Part of me wants to see the incisions, etc. but part of me doesn't. Guess I better get used to them - they aren't going anywhere!
Saturday, June 27, 2015
Post Surgery - Day 3
Slept slightly better last night - still not sleeping through the night, but there were less wake-ups.
Got my exercises done; I think I'm still around 90 degrees, warming up to past 90.
Feeling pretty good, I made the decision that I was going to go out and watch my football team play for the conference championship. It's currently 30+ degrees in Edmonton so essentially I was making the decision to be outside for the vast majority of the day.
The team won so that was great to see, but I definitely paid for it in the form of some increased swelling through my knee. When I finally got home I iced every hour for 20-25 minutes x4 to try and help bring it back down, which I think I did. I was happy to note at bedtime when I did my exercises again that my mobility had not been impacted by my adventurous day.
No tramadol today; I had one toradol when I got him to try and help with inflammation. I made the decision not to take another one before bed because I was really hoping for things to "get moving" again and both medications have constipation as a side effect. I had the same problem after my ankle surgery and it resolved itself, but I wanted to help things along so I took some Restoralax before bed. Sorry for the pun, but this is the crappier side of surgery.
Got my exercises done; I think I'm still around 90 degrees, warming up to past 90.
Feeling pretty good, I made the decision that I was going to go out and watch my football team play for the conference championship. It's currently 30+ degrees in Edmonton so essentially I was making the decision to be outside for the vast majority of the day.
The team won so that was great to see, but I definitely paid for it in the form of some increased swelling through my knee. When I finally got home I iced every hour for 20-25 minutes x4 to try and help bring it back down, which I think I did. I was happy to note at bedtime when I did my exercises again that my mobility had not been impacted by my adventurous day.
No tramadol today; I had one toradol when I got him to try and help with inflammation. I made the decision not to take another one before bed because I was really hoping for things to "get moving" again and both medications have constipation as a side effect. I had the same problem after my ankle surgery and it resolved itself, but I wanted to help things along so I took some Restoralax before bed. Sorry for the pun, but this is the crappier side of surgery.
Friday, June 26, 2015
Post Surgery - Day 2
I didn't sleep super great. Not because of pain, but I just didn't sleep soundly (I normally sleep like a rock from the time I go to bed until the next morning). Every time I woke up I was thankfully still pretty groggy, so I was able to switch positions as much as is possible when you have to sleep on your back, and get back to sleep.
My pain levels have been really low and I really don't like the way the tramadol makes me feel, so I elected not to take any. Since the toradol is also an anti-inflammatory, I decided later in the day to still take that. Ok, but "I decided" I mean one of my friends got mad at me and gave me the stink-eye until I took it.
The cryo-cuff is awesome. The ice isn't quite lasting as long in the cooler as advertised, but it's also 30+ degrees right now and possibly warmer in my house. It's a cooler, not a miracle worker. I ran out of ice from the first bag in the morning, but my stink-eye-giving friend Sharon was nice enough to stop by in the afternoon with another one. I iced five times for 20-30 minutes each time (10, 1, 4, 7:30 and 10:30). I don't seem to have any of the bruising that I've seen on other people after their ACL surgery, so that's both welcome and interesting.
I did my exercises three times, with the exception of passive knee extension, which I did 5 times. Flipping over to do prone flexion is by far the worst. The actual flexion isn't that bad (I'm limited more by the spot where it gets super tight as opposed to painful) but trying to get in position to do it super sucks. I'm trying to flex harder on my knee extension work to really try and get to 0 (and past it). Hopefully it's coming. Extension is my huge focus.
Marlies helped me wash my hair, so now I no longer look like a super creepy grease monkey. I'm actually quite excited that on day five I'll be able to get my incisions wet, and because I'm not NWB like I was with the ankle, I can actually shower standing like a normal human!
My pain levels have been really low and I really don't like the way the tramadol makes me feel, so I elected not to take any. Since the toradol is also an anti-inflammatory, I decided later in the day to still take that. Ok, but "I decided" I mean one of my friends got mad at me and gave me the stink-eye until I took it.
The cryo-cuff is awesome. The ice isn't quite lasting as long in the cooler as advertised, but it's also 30+ degrees right now and possibly warmer in my house. It's a cooler, not a miracle worker. I ran out of ice from the first bag in the morning, but my stink-eye-giving friend Sharon was nice enough to stop by in the afternoon with another one. I iced five times for 20-30 minutes each time (10, 1, 4, 7:30 and 10:30). I don't seem to have any of the bruising that I've seen on other people after their ACL surgery, so that's both welcome and interesting.
I did my exercises three times, with the exception of passive knee extension, which I did 5 times. Flipping over to do prone flexion is by far the worst. The actual flexion isn't that bad (I'm limited more by the spot where it gets super tight as opposed to painful) but trying to get in position to do it super sucks. I'm trying to flex harder on my knee extension work to really try and get to 0 (and past it). Hopefully it's coming. Extension is my huge focus.
Marlies helped me wash my hair, so now I no longer look like a super creepy grease monkey. I'm actually quite excited that on day five I'll be able to get my incisions wet, and because I'm not NWB like I was with the ankle, I can actually shower standing like a normal human!
Thursday, June 25, 2015
Post-Surgery - Day 1
Today has been interesting as I've essentially been watching my leg and foot swell up a bit. I'm thinking that the colour may start coming out tomorrow. Pain is up a bit compared to yesterday, but it's nothing that I can't handle. I've taken a single tramadol (I'm allowed up to two per dose) three times - once in the morning, once after lunch, and once around dinner time. I'll probably take two when I go to bed, along with a ketorolac. The tramadol comes with a warning that it may cause drowsiness/dizziness, and I'm finding that to be accurate. I'll take a tramadol and then be playing on my phone or trying to catch up on some work on my laptop and find that the words start to spin a bit and I'm nodding off. So I'm not the most productive, but I didn't really expect to be immediately after surgery either.
I'm trying to ice on a fairly regular schedule. Today I've done I believe four sessions (9am, 12pm, 3, 7) and I'm about to plunk the cryo-cuff on for another one. I've done two sets of exercises and again, will do one more before bed.
EXERCISES:
I'm trying to ice on a fairly regular schedule. Today I've done I believe four sessions (9am, 12pm, 3, 7) and I'm about to plunk the cryo-cuff on for another one. I've done two sets of exercises and again, will do one more before bed.
EXERCISES:
- Prone knee flexion (use non-operated leg for assistance; go until stretch, hold for 5s; lower slowly) x10
- Seated knee flexion/extension (use non-operated leg for assistance; extend until stretch, hold for 5s; flex until stretch, hold for 5s) x10
- Supine heel slides (slide heel of operated leg towards butt, hold for 5s) x10
- Isometrics (tense squad and butt, hold 5s; extend heel into bed, hold 5s) x10
- Ankle pumps (plantar and dorsiflexion) - I've been doing this every hour or so for about 10 reps to keep the blood flowing in my calf
- Passive knee extension ( heel up on a yoga block and letting the knee go into extension/hyperextension) x10 minutes
Wednesday, June 24, 2015
Surgery - Day Of
I was assigned the first surgery slot of the day, so we were up bright and early. Thankfully I live about five minutes away from the hospital where I was having it done, so we only had to leave at 6:20 to get there in plenty of time for my 6:30 arrival time. My surgery was booked for 7:45-9:30.
Pre-surgery was pretty chill - we went through all of my paperwork and then I got to write on my legs which one was being operated on and which was not. I was then transferred downstairs to the day surgery ward. Marlies came down with me, which was much appreciated. I spoke to my doctor, who re-emphasized that I'm going to have to work my ass off to get my extension back after being locked for six months. Game on. From there, Mar took my glasses and it was off to get cut open.
The anesthetic hit me fast and hard. They started my IV, I moved from the gurney to the operating table, I remember feeling a bit of burning through my hand, and then boom, I woke up in recovery. When I came to, I turned to the nurse and explained I wasn't in pain, wasn't sad, but was about to cry for no reason. She helpfully gave me some kleenex.
I felt a little bit nauseous but not too bad, and was alert enough that they bumped me back upstairs. From there I drifted in and out of sleep and really had no pain. I had several nurses come to visit and all were pretty impressed by my level of alertness. One didn't want to give me a second cup of gingerale, but I finally convinced her that yes I was thirsty and no, I wasn't going to vomit it up. Honestly, compared to how I felt after my ankle surgery (again not really in pain, but definitely a lot more drowsy) this was a walk in the park. I had to prove I could stand up and walk around without falling over or throwing up and passed that. After having been NWB for 7.5 weeks for my ankle, it was shocking to me how much weight I was able to put on my knee and how little it hurt.
Marlies came to pick me up and we stopped to pick up my medications (tramadol and ketorolac) and then headed home. The rest of the day was a mix of napping and watching Scrubs. My pain levels stayed really low - I took a tramadol sometime around 4:30 and then two before bed with one of the keterolacs. I didn't sleep super well, but that wasn't really pain related - I just really hate sleeping on my back.
Pre-surgery was pretty chill - we went through all of my paperwork and then I got to write on my legs which one was being operated on and which was not. I was then transferred downstairs to the day surgery ward. Marlies came down with me, which was much appreciated. I spoke to my doctor, who re-emphasized that I'm going to have to work my ass off to get my extension back after being locked for six months. Game on. From there, Mar took my glasses and it was off to get cut open.
The anesthetic hit me fast and hard. They started my IV, I moved from the gurney to the operating table, I remember feeling a bit of burning through my hand, and then boom, I woke up in recovery. When I came to, I turned to the nurse and explained I wasn't in pain, wasn't sad, but was about to cry for no reason. She helpfully gave me some kleenex.
I felt a little bit nauseous but not too bad, and was alert enough that they bumped me back upstairs. From there I drifted in and out of sleep and really had no pain. I had several nurses come to visit and all were pretty impressed by my level of alertness. One didn't want to give me a second cup of gingerale, but I finally convinced her that yes I was thirsty and no, I wasn't going to vomit it up. Honestly, compared to how I felt after my ankle surgery (again not really in pain, but definitely a lot more drowsy) this was a walk in the park. I had to prove I could stand up and walk around without falling over or throwing up and passed that. After having been NWB for 7.5 weeks for my ankle, it was shocking to me how much weight I was able to put on my knee and how little it hurt.
Marlies came to pick me up and we stopped to pick up my medications (tramadol and ketorolac) and then headed home. The rest of the day was a mix of napping and watching Scrubs. My pain levels stayed really low - I took a tramadol sometime around 4:30 and then two before bed with one of the keterolacs. I didn't sleep super well, but that wasn't really pain related - I just really hate sleeping on my back.
Wednesday, June 3, 2015
Three Weeks
I'm now three weeks away from surgery. I actually back-counted today, and the time from MRI to surgery is just over six weeks. My MRI requisition to MRI was just over three weeks. It may have taken a ridiculously long time for me to get a proper diagnosis, but things have moved pretty quickly since then.
April 17 - Requisition
May 10 - MRI
May 11 - Results
May 12 - Discuss Results (and get sad)
May 21 - Appointment with sports med Dr.
May 21 - Surgical consult
May 25 - Called with surgery date
May 26 - Boss okayed date, confirmed with surgeon's office
May 28 - "Learn to Crutch" at the hospital (aka - 95% of people don't read this pamphlet so we made an in-person session you have to attend instead)
There's nothing really left in the next couple weeks for me to do other than wait it out and try not to obsessively google everything I can about ACL reconstruction. Honestly my biggest question at this point is where on the pain scale this will fall in comparison to my ORIF surgery in January. Mainly because with my ankle, I then proceeded to work from home for almost two months, whereas with this I need to be back to work pretty quickly. Surgery is on a Wednesday, and Canada Day is the Wednesday after my surgery. Ideally I'm back at work on the 2nd after my physio appointment. I can probably get away with the 6th (the Monday) at the absolute latest, but I have to be back in the office that week. I have to be on site for a tournament that week-end (July 10-12) which is going to be interesting to say the least. My partner is coming along to act as my legs for the week-end and I will have to make sure I have a plan in place for icing/elevation. Thankfully if I can get through this crunch, I get two weeks before I have to be on site again and hopefully at a month post-surgery I'll be at least doing ok.
Since I've been told to do no lower body work between now and my surgery, I'm really trying to push with my upper body work. I'm doing a bench day based on 10/20/Life and then a shoulder day and a back day. I'm hoping to be able to do the majority of this program post-surgery as well; I'm going to have to run it by my physio though as the last thing I want to do is screw up my reconstructed knee. There's a couple exercises I think I'll have to modify further - I z-press on both back and shoulder day (one with a swiss bar) but I don't think I'll be sitting on the ground for this after surgery. Seated press should be a decent and doable substitute. I'll have to modify face pulls to do them seated as well, but that should be fine. I'm going to have to play around and see if cable rear delt raises are something that I can do from a seated position as well.
April 17 - Requisition
May 10 - MRI
May 11 - Results
May 12 - Discuss Results (and get sad)
May 21 - Appointment with sports med Dr.
May 21 - Surgical consult
May 25 - Called with surgery date
May 26 - Boss okayed date, confirmed with surgeon's office
May 28 - "Learn to Crutch" at the hospital (aka - 95% of people don't read this pamphlet so we made an in-person session you have to attend instead)
There's nothing really left in the next couple weeks for me to do other than wait it out and try not to obsessively google everything I can about ACL reconstruction. Honestly my biggest question at this point is where on the pain scale this will fall in comparison to my ORIF surgery in January. Mainly because with my ankle, I then proceeded to work from home for almost two months, whereas with this I need to be back to work pretty quickly. Surgery is on a Wednesday, and Canada Day is the Wednesday after my surgery. Ideally I'm back at work on the 2nd after my physio appointment. I can probably get away with the 6th (the Monday) at the absolute latest, but I have to be back in the office that week. I have to be on site for a tournament that week-end (July 10-12) which is going to be interesting to say the least. My partner is coming along to act as my legs for the week-end and I will have to make sure I have a plan in place for icing/elevation. Thankfully if I can get through this crunch, I get two weeks before I have to be on site again and hopefully at a month post-surgery I'll be at least doing ok.
Since I've been told to do no lower body work between now and my surgery, I'm really trying to push with my upper body work. I'm doing a bench day based on 10/20/Life and then a shoulder day and a back day. I'm hoping to be able to do the majority of this program post-surgery as well; I'm going to have to run it by my physio though as the last thing I want to do is screw up my reconstructed knee. There's a couple exercises I think I'll have to modify further - I z-press on both back and shoulder day (one with a swiss bar) but I don't think I'll be sitting on the ground for this after surgery. Seated press should be a decent and doable substitute. I'll have to modify face pulls to do them seated as well, but that should be fine. I'm going to have to play around and see if cable rear delt raises are something that I can do from a seated position as well.
Thursday, May 21, 2015
Impending Sugery
Quite possibly the only good thing to come out of today is that I am marked urgent for knee surgery and will hopefully get in within 1-2 months. Everything else was kind of depressing.
My knee is essentially a mess and that mess is a result of being misdiagnosed since 2011, which is the likely time I did tear my ACL. Since I've been working with an unstable knee since then, I've been progressively damaging it more and more, until we got to now. As she described it, I effectively have the knee of a 62-year old, not a 32-year old.
Given that I have been misdiagnosed by no less than three physios and one sports med doctor at three different clinics, you can imagine I'm not terribly impressed. Miles is literally the only one throughout this entire time that has raised ACL as a possibility.
The first doctor I saw today figures that the flap of my meniscus that is displaced (and preventing me from getting full extension) may actually be stabilizing my knee. So essentially I'm that episode of The Simpsons where Mr. Burns has every illness known to mankind and they are all jammed in that door frame. I was pretty frustrated after he told me he highly doubted I tore my ACL in November, but likely earlier, and I expressed my concerns with respect to getting surgery and being able to recover in time to try to make team Canada. Based on my history of misdiagnosis, my sporting needs, and the fact that my knee is locked, he told me he would try to accelerate my timeline. He actually managed to get me a surgical consult today, so that was I guess a second good thing.
The surgeon I wound up seeing was the one that my physio had recommended, and she was pretty solid. The concerns with my knee are (i) repairing what can be repaired; and (ii) trying to minimize the further progression of osteoarthritis in the joint. The bad thing is that I have some bone spurs and degradation on the lateral side, I have my meniscal tears on the medial side (given my two tears, my medial meniscus is likely to be fully removed) and then I have some anterior degradation because of my lack of ACL. Hence tricompartmental arthritis. She was telling me that long term to minimize its progression I may want to consider giving up high impact sports and heavy lifting...you know, everything I love.
So next step for me is to go get a physical signed off on, as apparently that's a requirement for surgery. And then hopefully I get a call within the next week with a date.
And then 12 months of recovery.
My knee is essentially a mess and that mess is a result of being misdiagnosed since 2011, which is the likely time I did tear my ACL. Since I've been working with an unstable knee since then, I've been progressively damaging it more and more, until we got to now. As she described it, I effectively have the knee of a 62-year old, not a 32-year old.
Given that I have been misdiagnosed by no less than three physios and one sports med doctor at three different clinics, you can imagine I'm not terribly impressed. Miles is literally the only one throughout this entire time that has raised ACL as a possibility.
The first doctor I saw today figures that the flap of my meniscus that is displaced (and preventing me from getting full extension) may actually be stabilizing my knee. So essentially I'm that episode of The Simpsons where Mr. Burns has every illness known to mankind and they are all jammed in that door frame. I was pretty frustrated after he told me he highly doubted I tore my ACL in November, but likely earlier, and I expressed my concerns with respect to getting surgery and being able to recover in time to try to make team Canada. Based on my history of misdiagnosis, my sporting needs, and the fact that my knee is locked, he told me he would try to accelerate my timeline. He actually managed to get me a surgical consult today, so that was I guess a second good thing.
The surgeon I wound up seeing was the one that my physio had recommended, and she was pretty solid. The concerns with my knee are (i) repairing what can be repaired; and (ii) trying to minimize the further progression of osteoarthritis in the joint. The bad thing is that I have some bone spurs and degradation on the lateral side, I have my meniscal tears on the medial side (given my two tears, my medial meniscus is likely to be fully removed) and then I have some anterior degradation because of my lack of ACL. Hence tricompartmental arthritis. She was telling me that long term to minimize its progression I may want to consider giving up high impact sports and heavy lifting...you know, everything I love.
So next step for me is to go get a physical signed off on, as apparently that's a requirement for surgery. And then hopefully I get a call within the next week with a date.
And then 12 months of recovery.
Wednesday, May 20, 2015
Limbo
Tomorrow is my referral appointment with a sports med doctor at the Glen Sather clinic. I'm hoping to get some answers to a few questions with respect to activity and ideally get a better picture of what kind of hoops I would need to jump through in order to try and make sure I don't have a six month waiting period before surgery. With a minimum six month recovery, I pretty much need to get surgery by October if I'm going to make a run at team Canada next year. I also need a better idea of knee timelines so I can figure out the timeline for getting my ankle hardware taken out.
Apparently they offer a functional strengthening and conditioning class for ACL patients - either pre-op or 4-6 weeks + post-op, but I'm unlikely to qualify as the requirements are full range of motion of the knee (I'm missing a significant degree of extension) and moderate effusion or less (my MRI put me at moderate to severe); so that's too bad. But I really need to know what I can do in the meantime. I'm in this awful no-man's land where I don't see the point of doing anything because (i) I'm somewhat worried about continuing to grind away my knee; and (ii) everything seems pointless because I'm just going to need to go through another recovery period.
Apparently they offer a functional strengthening and conditioning class for ACL patients - either pre-op or 4-6 weeks + post-op, but I'm unlikely to qualify as the requirements are full range of motion of the knee (I'm missing a significant degree of extension) and moderate effusion or less (my MRI put me at moderate to severe); so that's too bad. But I really need to know what I can do in the meantime. I'm in this awful no-man's land where I don't see the point of doing anything because (i) I'm somewhat worried about continuing to grind away my knee; and (ii) everything seems pointless because I'm just going to need to go through another recovery period.
Tuesday, May 12, 2015
Well, that's not great.
MRI results are back. As suspected, the actual outcome was not great, essentially one of the "worst cases" I was hoping not to hear.
ACL shows signs of complete tear ("less likely partial severe"). PCL intact. MCL unremarkable. LCL shows mild signs of chronic sprain mainly involving the proximal third of the ligament, but is well attached.
My medial meniscus has not one but two tears - bucket handle type tear with a meniscal flap subluxated medially and then a flp-type tear involving the meniscal body and anterior horn. My laterial meniscus is fine.
And then a 12x5x5mm intra-articular loose body is hanging out in my knee.
The summary version was "extensive medial meniscal tear as discussed with a bucket-handle type component and tricompartmental osteoarthritis. Chronic complete (less likely partial severe) ACL tear".
Given the sports that I do, it's highly unlikely I will get away without ACL surgery, which is unfortunate given that it carries a 6-12 month recovery with it. I had been hoping for a relatively minor meniscal problem that would require arthroscopic surgery and 4-6 weeks of recovery.
My physio says it's fairly remarkable that I've been able to play football given my injuries and says that if I'm able, I might as well keep doing it until I get surgery. I have a referral to the UofAs sports medicine clinic (it was set up before my MRI), so we'll see what happens with that now that I have my MRI results. My physio is also trying to help with setting me up with a surgical consult as quickly as possible.
So between now and surgery, whenever it may happen, I will just keep trying to strengthen my quads and hamstrings as much as possible to go into surgery as strong as possible. And you know, accept the reality that I am trying to regain my strength in the present for no actual short term pay-off. I won't be competing in either strongman or powerlifting this year. I am looking at competing bench-only in the fall, as I could likely take the record provincially. And by likely I mean "I bench the current record for multiple reps" but I'd like to be able to take it into the 200s. We'll see. I'm working on putting together a program where I bench 2x a week instead of just once, since it's the only lift I have not really hampered by injury.
ACL shows signs of complete tear ("less likely partial severe"). PCL intact. MCL unremarkable. LCL shows mild signs of chronic sprain mainly involving the proximal third of the ligament, but is well attached.
My medial meniscus has not one but two tears - bucket handle type tear with a meniscal flap subluxated medially and then a flp-type tear involving the meniscal body and anterior horn. My laterial meniscus is fine.
And then a 12x5x5mm intra-articular loose body is hanging out in my knee.
The summary version was "extensive medial meniscal tear as discussed with a bucket-handle type component and tricompartmental osteoarthritis. Chronic complete (less likely partial severe) ACL tear".
Given the sports that I do, it's highly unlikely I will get away without ACL surgery, which is unfortunate given that it carries a 6-12 month recovery with it. I had been hoping for a relatively minor meniscal problem that would require arthroscopic surgery and 4-6 weeks of recovery.
My physio says it's fairly remarkable that I've been able to play football given my injuries and says that if I'm able, I might as well keep doing it until I get surgery. I have a referral to the UofAs sports medicine clinic (it was set up before my MRI), so we'll see what happens with that now that I have my MRI results. My physio is also trying to help with setting me up with a surgical consult as quickly as possible.
So between now and surgery, whenever it may happen, I will just keep trying to strengthen my quads and hamstrings as much as possible to go into surgery as strong as possible. And you know, accept the reality that I am trying to regain my strength in the present for no actual short term pay-off. I won't be competing in either strongman or powerlifting this year. I am looking at competing bench-only in the fall, as I could likely take the record provincially. And by likely I mean "I bench the current record for multiple reps" but I'd like to be able to take it into the 200s. We'll see. I'm working on putting together a program where I bench 2x a week instead of just once, since it's the only lift I have not really hampered by injury.
Monday, May 11, 2015
MRI
Had my MRI yesterday. Panic was low, so that was positive. The worst was when they were positioning me in the machine, as I was waiting for them to be like "HAHA!" and shove me all the way in. I had to be positioned and then re-positioned, as my knee wasn't quite far enough in, and the second time I panicked. The techs were very nice ("it's ok! Open your eyes! I promise you're not all the way in") and the whole thing took about 20 minutes, so it wasn't terrible. If I ever need an MRI pelvis or higher though, there's going to be issues.
My results are back with my physio already and he wants to see me to discuss tomorrow at 9:30. So I essentially have 17 hours to worst-case scenario and panic. Part of me is happy that I'll know either way what's up, but part of me is pretty worried as obviously something came back as this is the first time he hasn't given me results via email (my ultrasound in November came back negative; my x-ray in mid-April confirmed that I was healing properly). I can think of a couple "worst cases" that I really don't want. I guess we'll see tomorrow.
My results are back with my physio already and he wants to see me to discuss tomorrow at 9:30. So I essentially have 17 hours to worst-case scenario and panic. Part of me is happy that I'll know either way what's up, but part of me is pretty worried as obviously something came back as this is the first time he hasn't given me results via email (my ultrasound in November came back negative; my x-ray in mid-April confirmed that I was healing properly). I can think of a couple "worst cases" that I really don't want. I guess we'll see tomorrow.
Monday, May 4, 2015
Still Going
After about five months of encouragement and prodding, Marlies is seeing the same person I am for meal planning/consulting. This is great on several levels, not least of which being that it makes it infinitely easier for me to follow my plan if she's on one as well. I can deal with the requests for McDriveThru easier than the chips/chocolate/etc. that populate the pantry. Or the "hey let's go out for dinner". Today has also been entertaining, as I'm getting a play-by-play of her eating like it's a job. The difference between me cutting and her trying to gain is about 1,200 calories a day. I packed her first four meals of the day last night and was like "ok, you need to look at this and kind of visualize eating it". I also told her to set alarms for her two "snacks" (her snacks have more calories than my meals!) because if she doesn't and falls behind on eating, she's going to puke trying to catch up.
This is the push I needed to get back on following my plan stringently. Rehabbing my ankle has been really draining mentally and my motivation hasn't been where it needs to be. I'm also really tired of GI distress brought on by eating more bread in particular, so yeah, bring the meal plan back on.
Steadily reloading on the ankle front. Our football jamboree took a hit this week-end when one of the teams that was supposed to come folded the day before. It left us with three teams, and somehow missing the abbreviated jamboree was easier to take. We are currently awaiting a revised schedule, which will hopefully arrive early this week (and be done properly). While annoying for everyone else, this has worked out really well for me as it gives me an extra week of rehab before we play. I've been more than a little trepidatious with respect to my ability to be able to be productive on a football field this week-end.
One of the biggest things I need to keep working on is getting over my fear of going to the ground. My bones are fully healed (and in the case of my fibula, medically enhanced) and I need to get over my injury mentally. The image of being on my knees and having a body go overtop of me is still very fresh in my mind, and I need to reinforce how statistically unlikely it is that it happens again with the same result. Marlies and I did a couple sessions this week-end where I would lay prone and she would fall onto me in various positions (injured leg up, down, etc.) and with varying intensity. She also kicked my leg at various points (stepping over, etc.). While this sounds ridiculous and probably humorous, it was really necessary for me. It went ok, and so I need to figure out the best way to progress to actual contact. One of my good friends is game for helping, but I think I need to start with someone smaller and progress upwards. It seems less daunting to be hit by a 100# person than one my size. ;)
Sitting in the bottom of a squat is getting better. I was able to power up a 95# snatch this week-end, so that made me happy. I need to fix my technique yet again so that I'm recruiting legs instead of just beasting it up, but I was happy that I was able to extend, get on my toes, and then re-bend to catch.
My biggest goal this week is to be able to do at least 5 straight single leg hops with proper take off and landing.
This is the push I needed to get back on following my plan stringently. Rehabbing my ankle has been really draining mentally and my motivation hasn't been where it needs to be. I'm also really tired of GI distress brought on by eating more bread in particular, so yeah, bring the meal plan back on.
Steadily reloading on the ankle front. Our football jamboree took a hit this week-end when one of the teams that was supposed to come folded the day before. It left us with three teams, and somehow missing the abbreviated jamboree was easier to take. We are currently awaiting a revised schedule, which will hopefully arrive early this week (and be done properly). While annoying for everyone else, this has worked out really well for me as it gives me an extra week of rehab before we play. I've been more than a little trepidatious with respect to my ability to be able to be productive on a football field this week-end.
One of the biggest things I need to keep working on is getting over my fear of going to the ground. My bones are fully healed (and in the case of my fibula, medically enhanced) and I need to get over my injury mentally. The image of being on my knees and having a body go overtop of me is still very fresh in my mind, and I need to reinforce how statistically unlikely it is that it happens again with the same result. Marlies and I did a couple sessions this week-end where I would lay prone and she would fall onto me in various positions (injured leg up, down, etc.) and with varying intensity. She also kicked my leg at various points (stepping over, etc.). While this sounds ridiculous and probably humorous, it was really necessary for me. It went ok, and so I need to figure out the best way to progress to actual contact. One of my good friends is game for helping, but I think I need to start with someone smaller and progress upwards. It seems less daunting to be hit by a 100# person than one my size. ;)
Sitting in the bottom of a squat is getting better. I was able to power up a 95# snatch this week-end, so that made me happy. I need to fix my technique yet again so that I'm recruiting legs instead of just beasting it up, but I was happy that I was able to extend, get on my toes, and then re-bend to catch.
My biggest goal this week is to be able to do at least 5 straight single leg hops with proper take off and landing.
Wednesday, April 29, 2015
Just one of Those Days...
| Injury rehab is so emotionally draining, and this is by far the biggest one and the longest timeline I've had to battle with. I lost it last night because shit just wasn't going well at football practice. Any sort of resistance - be it hands or a push back - and I just couldn't hold a drive block to save my life. It's so humbling and frustrating and embarrassing - I used to be good at this sport and now I feel so far from where I was. Forget improving this season - I will be lucky if I am the same player I was last year. That is a difficult feeling to come to terms with and as the first game looms every closer (10 days today) the reality eats at me all the more. I'm about 50/50 to even play in that game and that 50% requires a whole lot of improvement to come in the next week as it relates to driving out off my toes. Some days I just get really tired of always being in some kind of pain. I'm transitioning more from joint-specific pain to stabilizer pain, which is good news in terms of making progress but sucks in terms of feeling general muscle fatigue all the time. I'm taking a forced rest day today because I need to let the muscles in my calf and foot simmer down. My foot sweats non-stop. It's kind of gross. If I have my socks off because I'm doing stabilization or mobilization or whatever, I leave sweat footprints in the carpet. Pretty hot, I know. I did back squat 135 for 5 last night - my depth (in oly shoes) was actually rock bottom, so that was cool. I noticed today that my talus is tracking way better and I am getting some calf strength back, such that I can get up on my toes both easier and higher than last week. So I mean, progress, just never the progress that I want. Skipping is truly terrible. I favour my left leg over my right and can't string together more than like five jumps. Embarrassing. Lateral hurdle jumps are better than forward, but neither are great. I can't successfully jump backwards over a 6" hurdle (which is a huge piss off). |
Monday, April 27, 2015
Squats! Squats! Squats!
I've been eyeing up my olympic weightlifting shoes for the last little while and wondering if they could push me over the edge in terms of being able to hold the bottom position of a squat. As we approach six months of injuries that have kept me from being able to do full squats (with my hamstring/meniscus/whatever injury in November, and then my ankle in January), my hips are definitely feeling it. Waiting on my ankle mobility to allow me to hold the bottom barefoot has become, IMO, counter-productive. With that in mind I threw them on and stuck the bottom of a squat. And then accumulated 10 minutes in the bottom. Which took...more than 10 minutes.
My hips, adductors and anterior shin were definitely the tightest, with the anterior shin being the one that surprised me (though it makes sense given my ankle injury and mobility issues). I've added the 10 minute squat accumulation to my goals for the week and I think it's really going to make a difference for me.
Having held the bottom of an air squat, the next big milestone to tick off the list was an actual, weighted squat. I started with a front squat with just the bar, and that worked out well enough. From there I went to back squat with a safety squat bar (side note: I am the only person at CFSP that uses the SSB...guys, you are missing out). I finished off with old reliable, the back squat. I didn't go heavy (stopped at 105), but it felt good. I'm happy with my positioning in the bottom, and I'm activating pretty well out of my bottom. And...I get to squat again!
Yesterday was day 99 post-injury, so I kind of wanted to do something pseudo-special to commemorate. I settled on my favorite CrossFit workout, Grace, which is 30 95-pound clean and jerks for time. My (incredibly old) PR was 3:10 and I finished it yesterday in 3:15. I hadn't actually done this WOD since 2011 and healthy I should easily be able to do this in 2:30 or so (my PR for 30 95-pound snatches is 2:55 and the snatch is a more challenging movement). But I was happy as (i) I had just finished press work immediately before doing the workout; and (ii) my ability to drive through my toes to push the bar overhead improved as the workout went on.
After we got home, I was watching hockey and trying to decide whether I was at a point where I should start trying to run again. My ankle felt pretty rough on Friday after football practice (I suspect the primary culprit was actually jumping ladders before football) and I was swollen both Friday and Saturday before returning to my normal swelling size on Sunday. I finally decided fuck it, and went downstairs to hit the treadmill and see where things were at. I started by doing a couple intervals at slower jogs (4mph, 4.5mph, 5mph, 5.5mph) at minute on/minute off, before getting to 6, which is pretty much your standard average everyday speed for a 5k. (6mph = essentially a 30 minute 5k). I did a minute on, sucked wind, and called Marlies downstairs to check how limpy I looked. She watched my next interval and said I looked pretty good (some favouring, but not enough to be like HOLY SHIT STOP), so with that I decided that it was time to buck up and start trying to get my legs back. It was very humbling to do Day 1 of a 5k program - which is 9 1:00 running intervals with 90 seconds walking in between) and have my legs be burning at the end of each interval. It's not like I've ever been the greatest runner to begin with, but this is a new low. :P But on the bright side - I completed all the intervals, my ankle didn't feel terrible, and I don't feel awful this morning.
My hips, adductors and anterior shin were definitely the tightest, with the anterior shin being the one that surprised me (though it makes sense given my ankle injury and mobility issues). I've added the 10 minute squat accumulation to my goals for the week and I think it's really going to make a difference for me.
Having held the bottom of an air squat, the next big milestone to tick off the list was an actual, weighted squat. I started with a front squat with just the bar, and that worked out well enough. From there I went to back squat with a safety squat bar (side note: I am the only person at CFSP that uses the SSB...guys, you are missing out). I finished off with old reliable, the back squat. I didn't go heavy (stopped at 105), but it felt good. I'm happy with my positioning in the bottom, and I'm activating pretty well out of my bottom. And...I get to squat again!
Yesterday was day 99 post-injury, so I kind of wanted to do something pseudo-special to commemorate. I settled on my favorite CrossFit workout, Grace, which is 30 95-pound clean and jerks for time. My (incredibly old) PR was 3:10 and I finished it yesterday in 3:15. I hadn't actually done this WOD since 2011 and healthy I should easily be able to do this in 2:30 or so (my PR for 30 95-pound snatches is 2:55 and the snatch is a more challenging movement). But I was happy as (i) I had just finished press work immediately before doing the workout; and (ii) my ability to drive through my toes to push the bar overhead improved as the workout went on.
After we got home, I was watching hockey and trying to decide whether I was at a point where I should start trying to run again. My ankle felt pretty rough on Friday after football practice (I suspect the primary culprit was actually jumping ladders before football) and I was swollen both Friday and Saturday before returning to my normal swelling size on Sunday. I finally decided fuck it, and went downstairs to hit the treadmill and see where things were at. I started by doing a couple intervals at slower jogs (4mph, 4.5mph, 5mph, 5.5mph) at minute on/minute off, before getting to 6, which is pretty much your standard average everyday speed for a 5k. (6mph = essentially a 30 minute 5k). I did a minute on, sucked wind, and called Marlies downstairs to check how limpy I looked. She watched my next interval and said I looked pretty good (some favouring, but not enough to be like HOLY SHIT STOP), so with that I decided that it was time to buck up and start trying to get my legs back. It was very humbling to do Day 1 of a 5k program - which is 9 1:00 running intervals with 90 seconds walking in between) and have my legs be burning at the end of each interval. It's not like I've ever been the greatest runner to begin with, but this is a new low. :P But on the bright side - I completed all the intervals, my ankle didn't feel terrible, and I don't feel awful this morning.
Wednesday, April 22, 2015
MRI Booked
Got a call this morning from my physio encouraging me to purchase a lottery ticket. My MRI requisition went in on April 17; they came back with a date of May 10th. Less than a month turnaround for an MRI is pretty damn good. So I guess I just keep my head down and focus on rehab between now and then and cross the playing bridge if the ankle allows it. I have my next follow up with my orthopedic surgeon on May 6th; it would be awesome if I felt ready to play by then.
I did a lot of mobilization work yesterday as an active rest day before football practice. I did 10 minutes in the bottom of a (banded) squat, with a good chunk of that time spent with a 25# plate on top of my knee/quad to help promote active dorsiflexion. Figuring some of my problems are also upstream with my hips in particular, I spent some time in a super frog, which was as unpleasant as I remembered it to be. Following that I spent some time in a middle split wall stretch, where I discovered that my adductors are pretty much so tight that they feel like bone. Awesome. That felt great. I was also in the zone and wearing noise canceling headphones and didn't notice when the crossfit class lined up to do sprints. They were nice (and a small class) and didn't use the fourth lane that was taken up by me. :)
Between yesterday and today I've compression flossed my left knee three times and having done so, have regained enough mobility that I can hit terminal knee extension. It's one of those things that makes me curious whether my problem is or isn't meniscal, but I guess I'll find that out in a few weeks. The whole area feels kind of weird though.
I worked through a few drills at football yesterday. I'm still very slow, which hurts my pride, but it's good to be building my confidence and getting the mechanics back. I did some ladders with the full team; I'm at maybe 50% of my healthy speed. People are supportive though, and happy to see me doing something. I worked the basics of locking up and drive blocking against limited (no) resistance and that went pretty well. Pass blocking I need to work on having a softer knee and driving through the toes. We did some lateral mirroring too, which went better than expected. It was probably my best lateral movement to date, which I credit to thinking more about what my partner was doing than about my ankle.
I did a lot of mobilization work yesterday as an active rest day before football practice. I did 10 minutes in the bottom of a (banded) squat, with a good chunk of that time spent with a 25# plate on top of my knee/quad to help promote active dorsiflexion. Figuring some of my problems are also upstream with my hips in particular, I spent some time in a super frog, which was as unpleasant as I remembered it to be. Following that I spent some time in a middle split wall stretch, where I discovered that my adductors are pretty much so tight that they feel like bone. Awesome. That felt great. I was also in the zone and wearing noise canceling headphones and didn't notice when the crossfit class lined up to do sprints. They were nice (and a small class) and didn't use the fourth lane that was taken up by me. :)
Between yesterday and today I've compression flossed my left knee three times and having done so, have regained enough mobility that I can hit terminal knee extension. It's one of those things that makes me curious whether my problem is or isn't meniscal, but I guess I'll find that out in a few weeks. The whole area feels kind of weird though.
I worked through a few drills at football yesterday. I'm still very slow, which hurts my pride, but it's good to be building my confidence and getting the mechanics back. I did some ladders with the full team; I'm at maybe 50% of my healthy speed. People are supportive though, and happy to see me doing something. I worked the basics of locking up and drive blocking against limited (no) resistance and that went pretty well. Pass blocking I need to work on having a softer knee and driving through the toes. We did some lateral mirroring too, which went better than expected. It was probably my best lateral movement to date, which I credit to thinking more about what my partner was doing than about my ankle.
Monday, April 20, 2015
Three Months...
It occurred to me yesterday when we were on the way back from Calgary that three months has officially come and gone as of Friday. Ironically, I rang that day in finding out that I probably have medial meniscal damage in my left knee and need an MRI/possibly surgery. We'll see what happens there, but it wasn't the outcome I was expecting when I agreed to a consult for injection therapy on my supposed chronic hamstring problem. I'm just going to stay the course in terms of rehabbing my ankle and cross the meniscus bridge when I'm actually clear to play. I'm mostly annoyed that I had an ultrasound done in November about this that was negative for any meniscus damage and we've been treating as a hamstring problem ever since. Part of me is also at least slightly concerned because I'm pretty sure this started a few years ago during the CrossFit Open and I've just continued to make my meniscus worse. I also really don't want to play another season on a crazy swollen left leg like I did in 2013.
Other than the intense emotional breakdown that I had when they told me I probably had a meniscus tear and probably need to get it fixed, three months was relatively uneventful. I'm doing some work with a sled to try and encourage greater dorsiflexion and confidence forcefully coming up on my toes. I did a modified CrossFit workout on Friday as well that pretty much beat the crap out of me. My engine is that of a small lawnmower right now, apparently. :P
I had the bright idea to do one-legged single skips on Saturday instead of double unders in a workout. It went fine in the moment, but my calf has been so freaking tight since! Smart plan, that one was. I also jogged a 400m with Marlies to finish off the workout and that went ok. I made sure that she came along because I needed her to watch my gait as I went. I was slow as molasses, but my gait was good.
Ankle goals for this week:
1. Walking lunges
2. Single leg heel raises
3. Dorsiflexion work - sled + compression flossing
4. Running mechanics
5. Lateral movement
6. SQUAT
Other than the intense emotional breakdown that I had when they told me I probably had a meniscus tear and probably need to get it fixed, three months was relatively uneventful. I'm doing some work with a sled to try and encourage greater dorsiflexion and confidence forcefully coming up on my toes. I did a modified CrossFit workout on Friday as well that pretty much beat the crap out of me. My engine is that of a small lawnmower right now, apparently. :P
I had the bright idea to do one-legged single skips on Saturday instead of double unders in a workout. It went fine in the moment, but my calf has been so freaking tight since! Smart plan, that one was. I also jogged a 400m with Marlies to finish off the workout and that went ok. I made sure that she came along because I needed her to watch my gait as I went. I was slow as molasses, but my gait was good.
Ankle goals for this week:
1. Walking lunges
2. Single leg heel raises
3. Dorsiflexion work - sled + compression flossing
4. Running mechanics
5. Lateral movement
6. SQUAT
Wednesday, April 15, 2015
So, Let's Start With the Theraband...
The differences between my two physios are really quite significant. If I were an outside party just observing, I'd find it kind of fascinating, as it's somewhat representative of the clientele they most frequently deal with, but living it, I often just find it annoying.
The more annoying of my two physios also has a student. While I have nothing against either of them personally, every time that student tells me to start with the theraband I want to smack her. Unlike a large percentage of their patients, I am doing my exercises. In fact, I do them multiple times a day. I have therabands attached to the table in my office. I have a wobble board in my office. Hell, I have measurements taped to the ground so that I can do the dorsiflexion lunge test and gauge my progress. I digress, but seriously, fuck your therabands. I am not fucking up my theraband exercises, and you're not even watching how I do them anyways, so why are we running through these in my appointment?
If we aren't gauging my progress or adding a progression to the equation, don't make me do these stupid exercises at my appointments. You are unnecessarily adding time to my appointments and driving me insane.
Thankfully this week she didn't try to get me to move my toes more forward as I attempted squats. I WILL NEVER SQUAT TOES FORWARD; IT'S NOT HAPPENING. I just looked up videos from my last squat cycle healthy and my toes are in fact even more out than I thought (and I'm in weightlifting shoes, which lift your heels/take some of the need for dorsiflexion away). I'm all for improving my movement patterns, but how about we start with a goal of getting me back to the movement patterns I had previously...
Anyways, in happier news, I was in the clinic before my workout last night (they are attached to my gym, so I stop by most days to warm up my ankle on the wobble board and with some bosu work) and Laurie (who owns both clinics, used to treat me, and is someone I will often ask questions to) was like "oh, I called an ortho surgeon to ask him about you. Come talk to me, I have some context and answers". So that was great. She has downgraded me picking up a 465 yoke on the week-end from "OMG WTF" to "ok, it's not the end of the world, but it's not a movement you really need to be doing right now, so please save us all the stress for a little bit longer". At least she no longer believes I'll break my hardware (something Marlies has been saying from day one. She does failure analysis on metals for a living and is quite confident in the load bearing abilities of my seven screws and plate). So at least this batch of anxiety producing garbage can be laid to rest.
I heard back from Miles, my other physio today as well reference my progress and next steps. He is going to send me for another x-ray. Having past 12 weeks, I should have a hard callus on my break site. I am hoping, if everything looks good on x-ray, I could potentially get cleared to start doing some controlled contact drills. I'd mainly like to start working on drive blocking with a friend I trust and/or Marlies; I'd also like to try hitting our tackling dummy.
The three criteria for me returning to play from my first physio were:
1. Full mobility
2. Full strength
3. X-ray that shows I am ok to take contact.
Miles has said he would be happy with 90% mobility and 80% strength, as he anticipates my mobility and bony integrity will be back sooner than the strength will. In terms of mobility, I've been measured at 16/20 degrees of dorsiflexion and 33/50 degrees of plantarflexion. I am going to get Miles to re-measure tomorrow since we didn't measure last week, but my other physio said I didn't have a change over the last week (which was frustrating). I think the last couple degrees of dorsi are blocked by swelling still, but I'm not sure with plantar.
My five goals for this week:
1. lunges - have improved substantially. Last week when introduced, I was struggling with balance and arch mobility, such that it was hard to get into a lunge with my right foot back. Last night I was competently doing walking lunges in sets of 10.
2. single leg heel raises - not there yet, but improving. My double leg I can do freestanding now, with a 10 second hold on each rep at the top. Balance is still a bit wonky at the top. Single leg I'm up to two reps of starting at the top of a two leg, transitioning to single while holding on to something and slowly lowering, followed by 5-10 reps of single leg as high as I can go.
3. strengthen foot - rolling on the beastie ball while at work and at least 3x30 seconds of foot stretches.
4. lateral movement - steadily improving. I've been upgraded to "at least as fast as our slowest player" on the ladder.
5. free squat - improving. still can't hold in the bottom.
The more annoying of my two physios also has a student. While I have nothing against either of them personally, every time that student tells me to start with the theraband I want to smack her. Unlike a large percentage of their patients, I am doing my exercises. In fact, I do them multiple times a day. I have therabands attached to the table in my office. I have a wobble board in my office. Hell, I have measurements taped to the ground so that I can do the dorsiflexion lunge test and gauge my progress. I digress, but seriously, fuck your therabands. I am not fucking up my theraband exercises, and you're not even watching how I do them anyways, so why are we running through these in my appointment?
If we aren't gauging my progress or adding a progression to the equation, don't make me do these stupid exercises at my appointments. You are unnecessarily adding time to my appointments and driving me insane.
Thankfully this week she didn't try to get me to move my toes more forward as I attempted squats. I WILL NEVER SQUAT TOES FORWARD; IT'S NOT HAPPENING. I just looked up videos from my last squat cycle healthy and my toes are in fact even more out than I thought (and I'm in weightlifting shoes, which lift your heels/take some of the need for dorsiflexion away). I'm all for improving my movement patterns, but how about we start with a goal of getting me back to the movement patterns I had previously...
Anyways, in happier news, I was in the clinic before my workout last night (they are attached to my gym, so I stop by most days to warm up my ankle on the wobble board and with some bosu work) and Laurie (who owns both clinics, used to treat me, and is someone I will often ask questions to) was like "oh, I called an ortho surgeon to ask him about you. Come talk to me, I have some context and answers". So that was great. She has downgraded me picking up a 465 yoke on the week-end from "OMG WTF" to "ok, it's not the end of the world, but it's not a movement you really need to be doing right now, so please save us all the stress for a little bit longer". At least she no longer believes I'll break my hardware (something Marlies has been saying from day one. She does failure analysis on metals for a living and is quite confident in the load bearing abilities of my seven screws and plate). So at least this batch of anxiety producing garbage can be laid to rest.
I heard back from Miles, my other physio today as well reference my progress and next steps. He is going to send me for another x-ray. Having past 12 weeks, I should have a hard callus on my break site. I am hoping, if everything looks good on x-ray, I could potentially get cleared to start doing some controlled contact drills. I'd mainly like to start working on drive blocking with a friend I trust and/or Marlies; I'd also like to try hitting our tackling dummy.
The three criteria for me returning to play from my first physio were:
1. Full mobility
2. Full strength
3. X-ray that shows I am ok to take contact.
Miles has said he would be happy with 90% mobility and 80% strength, as he anticipates my mobility and bony integrity will be back sooner than the strength will. In terms of mobility, I've been measured at 16/20 degrees of dorsiflexion and 33/50 degrees of plantarflexion. I am going to get Miles to re-measure tomorrow since we didn't measure last week, but my other physio said I didn't have a change over the last week (which was frustrating). I think the last couple degrees of dorsi are blocked by swelling still, but I'm not sure with plantar.
My five goals for this week:
1. lunges - have improved substantially. Last week when introduced, I was struggling with balance and arch mobility, such that it was hard to get into a lunge with my right foot back. Last night I was competently doing walking lunges in sets of 10.
2. single leg heel raises - not there yet, but improving. My double leg I can do freestanding now, with a 10 second hold on each rep at the top. Balance is still a bit wonky at the top. Single leg I'm up to two reps of starting at the top of a two leg, transitioning to single while holding on to something and slowly lowering, followed by 5-10 reps of single leg as high as I can go.
3. strengthen foot - rolling on the beastie ball while at work and at least 3x30 seconds of foot stretches.
4. lateral movement - steadily improving. I've been upgraded to "at least as fast as our slowest player" on the ladder.
5. free squat - improving. still can't hold in the bottom.
Tuesday, April 14, 2015
But Does it REALLY Matter?
One of my physios asked me today if it "really matters" if I'm back this season. Considering she plays high level soccer and we are in a similar age bracket, I was kind of surprised it came out of her mouth.
Football season is just over two months (May 2-July 5). This year it is slightly extended due to Nationals (July 28-August 2), but that's it. As a team we start practicing in February in the gym and then April outside (obviously I haven't been able to practice...I've gotten to watch every damn one). So two months of playing, three months of practicing (two of which are boring gym shit), and SEVEN MONTHS OF WAITING. That is the life cycle of a football year. So yeah, having gone through seven months of waiting and three months of injury, with an impending two month season before another seven months of waiting begins, it does "really matter" to me if I play this season. Beyond the fact that I'm trying to get noticed for Team Canada, let's also factor in the fact that I am 32. I only have so many good years left as a player. So yeah, it does "really matter" to me that I make the most out of them.
Does it really matter? Yes. It matters.
When I plan out my lifting cycles, I have certain goals that I am looking to attain. I may not hit them exactly, but you stick the carrot out there, you plan the process, and you see what happens. Here I'm going to deload, here I'm going to hit a max, you plan all of this stuff out. You can't guarantee the destination, but you map your path out. I was trying to explain this today - ok, maybe I don't hit the goal of playing on May 9th (because you can't guarantee the destination) but I don't feel like I have a mapped out path right now and it is driving me insane. I need to know what the next little milestone is, what the steps are to getting to where I need to be. Am I 50% there? More? Less? I just can't do this "oh hey, enjoy the journey" type set up. I'll embrace the journey (because I have to), but I need it quantified. It's just the type of person I am.
Football season is just over two months (May 2-July 5). This year it is slightly extended due to Nationals (July 28-August 2), but that's it. As a team we start practicing in February in the gym and then April outside (obviously I haven't been able to practice...I've gotten to watch every damn one). So two months of playing, three months of practicing (two of which are boring gym shit), and SEVEN MONTHS OF WAITING. That is the life cycle of a football year. So yeah, having gone through seven months of waiting and three months of injury, with an impending two month season before another seven months of waiting begins, it does "really matter" to me if I play this season. Beyond the fact that I'm trying to get noticed for Team Canada, let's also factor in the fact that I am 32. I only have so many good years left as a player. So yeah, it does "really matter" to me that I make the most out of them.
Does it really matter? Yes. It matters.
When I plan out my lifting cycles, I have certain goals that I am looking to attain. I may not hit them exactly, but you stick the carrot out there, you plan the process, and you see what happens. Here I'm going to deload, here I'm going to hit a max, you plan all of this stuff out. You can't guarantee the destination, but you map your path out. I was trying to explain this today - ok, maybe I don't hit the goal of playing on May 9th (because you can't guarantee the destination) but I don't feel like I have a mapped out path right now and it is driving me insane. I need to know what the next little milestone is, what the steps are to getting to where I need to be. Am I 50% there? More? Less? I just can't do this "oh hey, enjoy the journey" type set up. I'll embrace the journey (because I have to), but I need it quantified. It's just the type of person I am.
Sunday, April 12, 2015
12 Weeks
Today marks 12 weeks post-injury (tomorrow is 12 post-surgery). I had asked my physio to help me set a lofty but achievable goal for me starting to run again and he had given me 12 weeks. So this week has been marked by a trepidatious determination to try and make it happen.
Made it happen. Got up to 4.7 for a couple one minute segments after doing a couple pieces at 4.0 earlier in the day.
I'm close to being able to hold an air squat in the bottom without losing my balance.
I box squatted 75-85-95-105-115x5 on Friday. I'm on the road to fixing my knees collapsing in. My body positioning is improving.
I can competently get up on my toes when on two feet. One foot is improving but I still need a wall brace.
I can walk up stairs properly. Down is getting closer.
Lunges are improving. My issue is more in my foot with my arch and extensors than having any issues with my ankle. The stretch in them is unreal particularly with my right leg back. With walking lunges I feel it on the tibia side on push off. I will nail these next week.
Worked on lateral walking and walking backwards this week. My push off is getting better.
Looking to be able to put more force into the ground. Continuing to push the running will help.
Made it happen. Got up to 4.7 for a couple one minute segments after doing a couple pieces at 4.0 earlier in the day.
I'm close to being able to hold an air squat in the bottom without losing my balance.
I box squatted 75-85-95-105-115x5 on Friday. I'm on the road to fixing my knees collapsing in. My body positioning is improving.
I can competently get up on my toes when on two feet. One foot is improving but I still need a wall brace.
I can walk up stairs properly. Down is getting closer.
Lunges are improving. My issue is more in my foot with my arch and extensors than having any issues with my ankle. The stretch in them is unreal particularly with my right leg back. With walking lunges I feel it on the tibia side on push off. I will nail these next week.
Worked on lateral walking and walking backwards this week. My push off is getting better.
Looking to be able to put more force into the ground. Continuing to push the running will help.
Thursday, April 2, 2015
Day 75
Well, it's been a while since I posted an update. Which is problematic, because stuff has actually happened!
Cleared to bear weight on March 11th. The most annoying part was probably when the surgeon asked me if I had already started physio - no, you hadn't cleared me. Had you done so, I would have gladly started earlier. Oh well - he was very happy with my x-rays and said the fibula fracture (which I had plated/pinned) wasn't really even visible anymore. He also said that my hardware, which we initially hoped would just happily live on inside me, will most likely drive me nuts and need to come out, as I just don't have a lot of fat around my ankles and I do a lot of sports where I will likely rub against my screws. So we will cross that bridge when we get there, but I may get that removed down the road.
I moved from two crutches to one crutch a few hours after we left the hospital because dammit, it was time to get started on learning how to walk again. Balance was a definite issue, as was atrophy in a variety of places but in particular the stabilizing muscles in my foot. My arch had fallen and it was a really weird sensation to walk and feel like my entire foot was on the ground (it felt that way because it was...).
The 12th was my first physio appointment, and I went with "my guy" (Miles), as I wanted to get things started off on the right foot before having to see someone else for my seven free appointments through Alberta Health (break some bones and have surgery, they give you some freebies to get you moving again, apparently). Mobility in the joint tested pretty well considering the severity of my injury. I started "skateboarding" on the treadmill - essentially my good leg on the side rails and my broken one on the treadmill, working through proper range of motion. This was painful, but very helpful in terms of re-learning movement patterns.
The 13th Marlies and I headed down to Calgary for my work. I was sitting without my foot elevated for a good portion of the week-end, and man, the swelling in my foot/ankle/calf at the end of the day was outrageous. The amount of pitting that I had (essentially, poke your swelling and see how big a dent you can make/how long it takes to go away) was hilarious and gross all at once. The 15th, while I was shuttling stuff back and forth in the soccer centre for medal ceremonies, was when I ditched my second crutch once and for all. WHAT A FEELING. Hobbling in the boot is frustrating in its own right, but it gave me BOTH HANDS FREE! This was amazing.
The 16th was when I decided I was going to try driving. I wandered out to my car, switched from boot to shoe, and gave it a shot around the block. Felt that I had more than enough mobility to safely maneuver a car on city streets, and declared myself a motorist once more. This was great, because it took away needing to coordinate rides so I could get to physio, a thing I was dreading. The 16th was also the day that I decided I was going to deadlift something. I worked my way up incrementally and then stopped at 225, a weight that is still quite light for me. I had no pain, and actually felt really happy because I was finally able to do some semblance of something I love. This deadlift would become a point of contention between me and my other physio (Christina), and remains one of the reasons that I am waiting out my seven appointments with her so that I can go back to Miles full time.
Between the 16th and the 20th I tried to spend as much of my indoor time as possible out of the boot. Scary outside world was still inside the boot. I was hobbling my way around out of the boot at Senior Provincials on Sunday and started to have a lot of fatigue related pain. Trying to be smart about things, I went back into my boot for some support. I did still have to walk around a lot over the week-end (especially on Sunday) and definitely felt it.
I took my boot off once I was done at Provincials on the 23rd and shoved it in the back of the truck. I haven't been back in it since. This is going pretty well. Mobility and strength are improving. On the 26th, Miles suggested some compression to help deal with my swelling. I picked up a cheap (this is a relative term - they were $40 socks) pair of 20-25mmHg socks to see if they made a difference. I was secretly hoping they wouldn't, because $. Having tested what my foot/leg look like after a day in an ankle sock vs. a day in a compression sock, I have to say that the difference is quite substantial. So for the foreseeable future I am rocking a highly fashionable look of one ankle sock and one compression. It looks most awesome when I'm at the gym in shorts.
My appointment on the 26th was also when I put Miles on the spot and asked him for a lofty yet somewhat achievable goal for me beginning to run again. He told me three months/end of week 12. I will be 12 weeks post-injury on April 12th. My goal is to hit at least 4.0mph on the treadmill by that day. Based on that, I've been adding 0.2mph to my speed during each of my daily treadmill sessions. This slow progression seems to be working thus far - last night I hit 2.4. If I can add 0.2 until I hit 3.0 (which would be Saturday), then I can go up 0.1 some days and 0.2 others until I get there. We'll see what happens.
My appointment on the 31st was the worst. My appointments with Christina go so differently than with Miles. Miles normally has me on the treadmill to start (10-15 minutes) and then some rocker board and wobble board. Then we do some joint mobilization, followed by some needling of my calf (and then my left hamstring, since we are still finishing up treatment for that injury, too). Then I get stim applied to my ankle (which is always fun because I have nerve damage from my surgery, so if they line the pads up in the right spots I can jack the machine up all the way and still feel nothing) and finish with ultrasound. We'll speak frankly about issues that I'm having (currently achilles pain) and what needs to be pushed through versus what might be bad. I feel like we are on the same page and like I am getting somewhere and that we are being as aggressive as possible to get there.
Christina I start with some joint mobilization. Then I go on the bike for 10-15. Then I do all the exercises that I do at home, which seems like a waste of time, SINCE I DO THEM AT HOME. If things go exceptionally well, we maybe add an exercise, which I then have to demo for a student. Then there some stim and some ultrasound. These appointments take close to two hours (Miles I'm there about 90) and I feel like I get half as much out of them. The worst part of Tuesday, though, was when the student said "well you look pretty active, you've probably squatted before?" COME ON LADY. Because she's a student, too, she's less inclined to modify treatment based on the needs of the individual patient and more one size fits all. I have never squatted toes forward, and I will never squat toes forward. I am not built in a fashion to accommodate this, and despite what Kelly Starrett says in his mobility books, not everyone is going to squat this way. But anyways, trying to get me to not toe out while I recover from a major injury, when it's not something I would do when I'm healthy, really just not working for me. Both Miles and my third physio (Laurie, who owns the clinic where both Miles and Christina work) have said to just squat toes out. When I explained to Laurie what's been going ton with my squat in general, she told me that I was working through it properly (band assisted free squats to counter-balance pitching forward and then box squatting).
Anyways, I've made the decision that since my time in physio is going to last at least seven weeks anyways, I'm just going to see Christina once a week, and then Miles for my other appointment. That was I can minimize my frustration and not have feelings that I'm not progressing like I could be.
My goal by the end of March was to sub-22 my 5k row. I did some high rep benching on Friday and then again on Sunday, so my pecs and triceps were a little fried so I delayed until the 31st and gave myself one crack it. Happy to say that goal is smashed - my 5k was 21:42. It's essentially just over a 2:10 500m pace (that would be a 21:40 5k). I'm going to have to get down to a 2:05 500m pace to get sub-21, so that's going to be fun. Not a bad goal to try and achieve though. Can't hurt in terms of trying to get my legs back.
I squatted for the first time post-injury yesterday. I box squatted 65# (box was three 45s and a 10). My glutes need to re-learn how to fire, but overall it was too bad. Honestly, in terms of restoring some of the ROM to my ankle joint, it was probably one of the most effective things that I've done. My treadmill session last night was my best one yet - well, after I got over some initial pain on my tibia side. Sometimes I just have to work through pain pockets around either of my fracture sites and then they go away. Pretty sure it has to do with swelling and scar tissue.
Lofty goal is to play football in 37 days. We'll see what happens.
Cleared to bear weight on March 11th. The most annoying part was probably when the surgeon asked me if I had already started physio - no, you hadn't cleared me. Had you done so, I would have gladly started earlier. Oh well - he was very happy with my x-rays and said the fibula fracture (which I had plated/pinned) wasn't really even visible anymore. He also said that my hardware, which we initially hoped would just happily live on inside me, will most likely drive me nuts and need to come out, as I just don't have a lot of fat around my ankles and I do a lot of sports where I will likely rub against my screws. So we will cross that bridge when we get there, but I may get that removed down the road.
I moved from two crutches to one crutch a few hours after we left the hospital because dammit, it was time to get started on learning how to walk again. Balance was a definite issue, as was atrophy in a variety of places but in particular the stabilizing muscles in my foot. My arch had fallen and it was a really weird sensation to walk and feel like my entire foot was on the ground (it felt that way because it was...).
The 12th was my first physio appointment, and I went with "my guy" (Miles), as I wanted to get things started off on the right foot before having to see someone else for my seven free appointments through Alberta Health (break some bones and have surgery, they give you some freebies to get you moving again, apparently). Mobility in the joint tested pretty well considering the severity of my injury. I started "skateboarding" on the treadmill - essentially my good leg on the side rails and my broken one on the treadmill, working through proper range of motion. This was painful, but very helpful in terms of re-learning movement patterns.
The 13th Marlies and I headed down to Calgary for my work. I was sitting without my foot elevated for a good portion of the week-end, and man, the swelling in my foot/ankle/calf at the end of the day was outrageous. The amount of pitting that I had (essentially, poke your swelling and see how big a dent you can make/how long it takes to go away) was hilarious and gross all at once. The 15th, while I was shuttling stuff back and forth in the soccer centre for medal ceremonies, was when I ditched my second crutch once and for all. WHAT A FEELING. Hobbling in the boot is frustrating in its own right, but it gave me BOTH HANDS FREE! This was amazing.
The 16th was when I decided I was going to try driving. I wandered out to my car, switched from boot to shoe, and gave it a shot around the block. Felt that I had more than enough mobility to safely maneuver a car on city streets, and declared myself a motorist once more. This was great, because it took away needing to coordinate rides so I could get to physio, a thing I was dreading. The 16th was also the day that I decided I was going to deadlift something. I worked my way up incrementally and then stopped at 225, a weight that is still quite light for me. I had no pain, and actually felt really happy because I was finally able to do some semblance of something I love. This deadlift would become a point of contention between me and my other physio (Christina), and remains one of the reasons that I am waiting out my seven appointments with her so that I can go back to Miles full time.
Between the 16th and the 20th I tried to spend as much of my indoor time as possible out of the boot. Scary outside world was still inside the boot. I was hobbling my way around out of the boot at Senior Provincials on Sunday and started to have a lot of fatigue related pain. Trying to be smart about things, I went back into my boot for some support. I did still have to walk around a lot over the week-end (especially on Sunday) and definitely felt it.
I took my boot off once I was done at Provincials on the 23rd and shoved it in the back of the truck. I haven't been back in it since. This is going pretty well. Mobility and strength are improving. On the 26th, Miles suggested some compression to help deal with my swelling. I picked up a cheap (this is a relative term - they were $40 socks) pair of 20-25mmHg socks to see if they made a difference. I was secretly hoping they wouldn't, because $. Having tested what my foot/leg look like after a day in an ankle sock vs. a day in a compression sock, I have to say that the difference is quite substantial. So for the foreseeable future I am rocking a highly fashionable look of one ankle sock and one compression. It looks most awesome when I'm at the gym in shorts.
My appointment on the 26th was also when I put Miles on the spot and asked him for a lofty yet somewhat achievable goal for me beginning to run again. He told me three months/end of week 12. I will be 12 weeks post-injury on April 12th. My goal is to hit at least 4.0mph on the treadmill by that day. Based on that, I've been adding 0.2mph to my speed during each of my daily treadmill sessions. This slow progression seems to be working thus far - last night I hit 2.4. If I can add 0.2 until I hit 3.0 (which would be Saturday), then I can go up 0.1 some days and 0.2 others until I get there. We'll see what happens.
My appointment on the 31st was the worst. My appointments with Christina go so differently than with Miles. Miles normally has me on the treadmill to start (10-15 minutes) and then some rocker board and wobble board. Then we do some joint mobilization, followed by some needling of my calf (and then my left hamstring, since we are still finishing up treatment for that injury, too). Then I get stim applied to my ankle (which is always fun because I have nerve damage from my surgery, so if they line the pads up in the right spots I can jack the machine up all the way and still feel nothing) and finish with ultrasound. We'll speak frankly about issues that I'm having (currently achilles pain) and what needs to be pushed through versus what might be bad. I feel like we are on the same page and like I am getting somewhere and that we are being as aggressive as possible to get there.
Christina I start with some joint mobilization. Then I go on the bike for 10-15. Then I do all the exercises that I do at home, which seems like a waste of time, SINCE I DO THEM AT HOME. If things go exceptionally well, we maybe add an exercise, which I then have to demo for a student. Then there some stim and some ultrasound. These appointments take close to two hours (Miles I'm there about 90) and I feel like I get half as much out of them. The worst part of Tuesday, though, was when the student said "well you look pretty active, you've probably squatted before?" COME ON LADY. Because she's a student, too, she's less inclined to modify treatment based on the needs of the individual patient and more one size fits all. I have never squatted toes forward, and I will never squat toes forward. I am not built in a fashion to accommodate this, and despite what Kelly Starrett says in his mobility books, not everyone is going to squat this way. But anyways, trying to get me to not toe out while I recover from a major injury, when it's not something I would do when I'm healthy, really just not working for me. Both Miles and my third physio (Laurie, who owns the clinic where both Miles and Christina work) have said to just squat toes out. When I explained to Laurie what's been going ton with my squat in general, she told me that I was working through it properly (band assisted free squats to counter-balance pitching forward and then box squatting).
Anyways, I've made the decision that since my time in physio is going to last at least seven weeks anyways, I'm just going to see Christina once a week, and then Miles for my other appointment. That was I can minimize my frustration and not have feelings that I'm not progressing like I could be.
My goal by the end of March was to sub-22 my 5k row. I did some high rep benching on Friday and then again on Sunday, so my pecs and triceps were a little fried so I delayed until the 31st and gave myself one crack it. Happy to say that goal is smashed - my 5k was 21:42. It's essentially just over a 2:10 500m pace (that would be a 21:40 5k). I'm going to have to get down to a 2:05 500m pace to get sub-21, so that's going to be fun. Not a bad goal to try and achieve though. Can't hurt in terms of trying to get my legs back.
I squatted for the first time post-injury yesterday. I box squatted 65# (box was three 45s and a 10). My glutes need to re-learn how to fire, but overall it was too bad. Honestly, in terms of restoring some of the ROM to my ankle joint, it was probably one of the most effective things that I've done. My treadmill session last night was my best one yet - well, after I got over some initial pain on my tibia side. Sometimes I just have to work through pain pockets around either of my fracture sites and then they go away. Pretty sure it has to do with swelling and scar tissue.
Lofty goal is to play football in 37 days. We'll see what happens.
Saturday, February 28, 2015
Today is Day 41
I can see why most people who blog about their ankle injuries don't have much between their first surgeon's follow up and the second one. You hit this no man's land where you've seen a good amount of progress and there's just not that much else to do other than count down until your next follow up when you actually get cleared to start physio.
My dorsiflexion is still improving - I'm able to get past neutral now, which is great to see. Plantarflexion is also improving but the difference between my left and my right is still quite pronounced. My circles clockwise and counter-clockwise are going pretty well. Inversion and eversion are still the ones with the most minimal mobility, which isn't that surprising. There's a very tight spot on the medial side when I try for eversion. It's just below where my incision is, so I'm wondering if it's part of the ligament that I had repaired. It's part of a bigger section of swelling right around the incision that I'm trying to work on. The area around my lateral incision feels way less weird, although just below my malleolus I'm pretty sure I can feel a screw. Judging by my x-ray, it would be a spot that makes sense, as it's the edge of the plate as well as the end of one of the screws point upwards.
I've taken to sitting on the floor for a while every day as I discovered that my left leg (where I injured my hamstring in November) has still not regained range of motion and in particular, my quad won't naturally shut off when I have my legs extended in front of me. I also still can't hit terminal knee extension (with your legs in front of you, when you flex the quad, you should be able to get your heel off the ground). I can flex my quad now, which is an improvement from before and if I help things along by actively trying to raise my heel, I can have some success, but it doesn't come without pain. On the right, I can hold terminal knee extension with no problems; whereas on the left it causes some solid discomfort. It's also not the most pleasant thing to come out of just basic extension - as I sit on the floor, my leg relaxes such that my quad turns off, but when I come out of extension and back into flexion it's super stiff and annoying. My hope is that by the time I'm coming back from the ankle, the hamstring will also be happyish.
I did 8k in 1,000m intervals on the ski-erg a couple days ago. That was fun. I've been very, very curious about my heart rate while ski-erging and I've been wanting to pick up a new HRM/strap for a while now, so I grabbed a Schosche Rhythm+ from MEC today. The strap goes on your forearm instead of around your chest. So yay, new toy to play with.
I'm inching closer to single-digit days before my follow up. Ugh, it can't come soon enough. Just let me start physio!
My dorsiflexion is still improving - I'm able to get past neutral now, which is great to see. Plantarflexion is also improving but the difference between my left and my right is still quite pronounced. My circles clockwise and counter-clockwise are going pretty well. Inversion and eversion are still the ones with the most minimal mobility, which isn't that surprising. There's a very tight spot on the medial side when I try for eversion. It's just below where my incision is, so I'm wondering if it's part of the ligament that I had repaired. It's part of a bigger section of swelling right around the incision that I'm trying to work on. The area around my lateral incision feels way less weird, although just below my malleolus I'm pretty sure I can feel a screw. Judging by my x-ray, it would be a spot that makes sense, as it's the edge of the plate as well as the end of one of the screws point upwards.
I've taken to sitting on the floor for a while every day as I discovered that my left leg (where I injured my hamstring in November) has still not regained range of motion and in particular, my quad won't naturally shut off when I have my legs extended in front of me. I also still can't hit terminal knee extension (with your legs in front of you, when you flex the quad, you should be able to get your heel off the ground). I can flex my quad now, which is an improvement from before and if I help things along by actively trying to raise my heel, I can have some success, but it doesn't come without pain. On the right, I can hold terminal knee extension with no problems; whereas on the left it causes some solid discomfort. It's also not the most pleasant thing to come out of just basic extension - as I sit on the floor, my leg relaxes such that my quad turns off, but when I come out of extension and back into flexion it's super stiff and annoying. My hope is that by the time I'm coming back from the ankle, the hamstring will also be happyish.
I did 8k in 1,000m intervals on the ski-erg a couple days ago. That was fun. I've been very, very curious about my heart rate while ski-erging and I've been wanting to pick up a new HRM/strap for a while now, so I grabbed a Schosche Rhythm+ from MEC today. The strap goes on your forearm instead of around your chest. So yay, new toy to play with.
I'm inching closer to single-digit days before my follow up. Ugh, it can't come soon enough. Just let me start physio!
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