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:

• 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.  

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:

• 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.