I feel like the first two sessions (which were definitely rough) were the feeling out sessions before we really got down to business today. We definitely went longer than the first two sessions, with a lot of work going down on both my ankle and my knee.
Ankle:
Measured at a relatively easy 3", with 3.5" almost achievable with some push. Lots of work on the fibula side - there were some particularly tough spots up by my knee, and then down by my malleolus, but this side was not nearly as bad. When we switched to my tibia side, it felt like being repeatedly jabbed in a bruise down by my malleolus and that side in general was more of a fight to get through.
Re-tested again with a tough but doable 3.5" and he thinks that this may just be the reality of my ankle. I feel like tension through the anterior of my ankle and at this point we may be looking at how my bones sit/healed/are as opposed to clearing up adhesions. I asked if 4" would be a cause for celebration and he said that it would be pretty hard for me to get there. In terms ideal movement, my doctor (and a lot of functional movement assessments) considers 5" is considered to be a pass. If I could get 4", I think I'd consider that a major victory. We'll see if continued focus on my Bulletproof Ankles programming makes any difference.
Knee:
Now here is where we are seeing some serious improvement. My initial test felt way less restricted, and was 6". This is an inch of improvement from where we started in session two, and the sensation of where I feel tension/restriction is starting to change. It's no longer just all back of the knee/hamstring area. I'm feeling it there (but way less), and actually starting to feel quad tightness. This is exciting.
He went grinding along my joint line again, which did not feel as bad as last week. There's some places over my medial meniscus that are more uncomfortable, but definitely better than last time. He then started in on some manual work on my quads, which again wasn't too bad. Then shit got real and he did instrument assisted release along my VMO and my rectus femoris. This was insane. First off, apparently muscle should feel smooth - mine felt like a rumble roller. Sweet grindy noise too. VMO was bad, but rectus femoris was worse. He did six passes over the one spot and it was the longest thirty seconds of my life. Purposeful pain though - I re-tested at 5" and barely felt any restriction in the back of my knee - it was way more in the quad, which is where I would expect it to be.
Next Session: Thursday. He said he may start moving into my left ankle and both my shins. I know how much I hate it when my RMT does my shins, so I'm sure this will be quite the treat.
Tuesday, June 7, 2016
Friday, June 3, 2016
Session Two
I went in to this one knowing a bit more of what to expect, so that was good. I was mainly curious to see if we would be going over the exact same parts, or if we would move to different ones. The answer was some of the same, some new, with the goals remaining the same (ankle dorsiflexion and knee flexion).
Ankle:
I tested at a 3" dorsiflexion to start and felt stiffness through the anterior and towards my tibia. He worked on my ankle A LOT. This time we did work up the fibia side (along my scar) continuing past it and up towards my knee. In terms of discomfort, there was much above my malleolus, then not nearly as much for the middle part, and then it increased again as we got closer to the knee. We also worked the tibial side this time, which let me tell you was loads of fun. He finished off doing some work on the anterior part of my ankle.
Re-test was a 3.5" but it was definitely a more challenging 3.5" than my first session and I definitely still felt stiff.
Knee:
Initial test on the knee was at 7", which was an inch and a half of improvement over session one. Thankfully he did not focus long on the lateral side of my knee, which has a nice bruise and was super tender. He did work along the joint line, some more on the medial side, some more on the quad tendon/vastus medialis, and then focused a lot of attention further up the leg. This was tight. Once again, work on my knee flexion hurt way, way more than work on my ankle.
Re-test was at 5.5". The cool thing about the re-testing too was that I stopped just feeling the discomfort along the back of my knee and actually started feeling tightness in my quad. This was pretty exciting!!
Bruising:
A little bit more than last time - mainly right above my knee, some dots up my quad, and some dots of bruising on the back of my calf.
Ankle:
I tested at a 3" dorsiflexion to start and felt stiffness through the anterior and towards my tibia. He worked on my ankle A LOT. This time we did work up the fibia side (along my scar) continuing past it and up towards my knee. In terms of discomfort, there was much above my malleolus, then not nearly as much for the middle part, and then it increased again as we got closer to the knee. We also worked the tibial side this time, which let me tell you was loads of fun. He finished off doing some work on the anterior part of my ankle.
Re-test was a 3.5" but it was definitely a more challenging 3.5" than my first session and I definitely still felt stiff.
Knee:
Initial test on the knee was at 7", which was an inch and a half of improvement over session one. Thankfully he did not focus long on the lateral side of my knee, which has a nice bruise and was super tender. He did work along the joint line, some more on the medial side, some more on the quad tendon/vastus medialis, and then focused a lot of attention further up the leg. This was tight. Once again, work on my knee flexion hurt way, way more than work on my ankle.
Re-test was at 5.5". The cool thing about the re-testing too was that I stopped just feeling the discomfort along the back of my knee and actually started feeling tightness in my quad. This was pretty exciting!!
Bruising:
A little bit more than last time - mainly right above my knee, some dots up my quad, and some dots of bruising on the back of my calf.
Post-Session Feels:
My patella is cracking like crazy. It's not painful, but it is definitely loud. If I go from sitting in flexion for a little while and extend, it's essentially a guarantee for some noise.
Knee feels more mobile. I've felt a bit more discomfort in the back of my knee than normal, but it feels more like being able to move in a way I haven't for a long time as opposed to "bad pain".
Ankle has been a bit sore, but it's more usage sore as opposed to "wow I'm in pain from this" sore. It is absolutely nothing compared to December/January, when I would still limp from the pain in my ankle.
Session number three is booked for Tuesday.
Session One
I wasn't exactly sure what to expect out of my first appointment. I knew from googling whatever I might be able to find, and from friends' experience with Graston, as well as my own experiences even from massage, that it was going to be uncomfortable. But other than that, I wasn't too sure where he was going to be working or how long it may last.
Answer was about 15-20 minutes. The first session focused on two locations - my ankle to try and regain some dorsiflexion, and my knee, trying to regain some flexion.
Ankle:
Focus was on the lateral (fibial) side. This is the side where I had my plate and seven screws (thankfully removed last October). Overall it was not super pleasant, but the discomfort level wasn't off the charts.
Knee:
Whereas my ankle was all manual release, for my knee he brought in the instrument adhesion release. Essentially, a piece of metal stripped away at the lateral side of my knee which was way more uncomfortable than anything on the ankle had been. He moved a bit across the joint line and did a bit of work on the medial side as well and then proceeded to above my patella and hammered away at my quad tendon/vastus medialis. The last thing he did was a bit of work on my lateral quad - he said the two quads (so I'm assuming vastus lateralis and intermedius) were stuck together.
Test/Re-Test:
Initial test on my ankle was a difficult 3" dorsiflexion, with restriction in the anterior compartment. Re-test was a fairly easy 3.5", with far less feeling of restriction.
The day's test on my knee was initially 8.5" short of being able to touch my heel to my butt while laying supine. We finished at 6", which was pretty significant.
Bruising:
There was redness in my calf, but it was really no worse for wear:
Next Day Feels:
My ankle was stiff, but not painful. My knee was a bit of a different story. I started to have a lot of discomfort alone the posterior line of my knee when trying to move into extension. It was super weird. I wound up spending a lot of time doing knee extension work. I got a lot of relief from doing banded terminal knee extensions.
Answer was about 15-20 minutes. The first session focused on two locations - my ankle to try and regain some dorsiflexion, and my knee, trying to regain some flexion.
Ankle:
Focus was on the lateral (fibial) side. This is the side where I had my plate and seven screws (thankfully removed last October). Overall it was not super pleasant, but the discomfort level wasn't off the charts.
Knee:
Whereas my ankle was all manual release, for my knee he brought in the instrument adhesion release. Essentially, a piece of metal stripped away at the lateral side of my knee which was way more uncomfortable than anything on the ankle had been. He moved a bit across the joint line and did a bit of work on the medial side as well and then proceeded to above my patella and hammered away at my quad tendon/vastus medialis. The last thing he did was a bit of work on my lateral quad - he said the two quads (so I'm assuming vastus lateralis and intermedius) were stuck together.
Test/Re-Test:
Initial test on my ankle was a difficult 3" dorsiflexion, with restriction in the anterior compartment. Re-test was a fairly easy 3.5", with far less feeling of restriction.
The day's test on my knee was initially 8.5" short of being able to touch my heel to my butt while laying supine. We finished at 6", which was pretty significant.
Bruising:
There was redness in my calf, but it was really no worse for wear:
My quad tendon/vastus medialis/whatever started turning a bit purple about an hour after we finished:
The lateral side of my knee was much the same, and bruised a bit within an hour.
Next Day Feels:
My ankle was stiff, but not painful. My knee was a bit of a different story. I started to have a lot of discomfort alone the posterior line of my knee when trying to move into extension. It was super weird. I wound up spending a lot of time doing knee extension work. I got a lot of relief from doing banded terminal knee extensions.
Assessment
Hips. This is where my back starts to round:
Knee flexion. My left (ACL) is straight up awful, but my right isn't optimal either (ie. also fails):
And finally, there's my knee extension and just how my left leg sits while I'm laying down, compared to my right:
So my three-pronged diagnosis of my immobile lower body was adhesion, nerve entrapment and degeneration. None of these things surprised me as the whole point of me coming was adhesion, I've felt the pins and needles/burning of the nerve issues, and many an ortho has told me about degeneration, making my goal to degenerate less over the next many years.
Having been assessed, it was now time to book my first treatment, which I scheduled for the next day. No sense wasting time getting this show on the road.
Strength Imbalances, Mobility and Adhesion Release
Having broken my ankle and had my ACL reconstructed and having that go along with already not being the most mobile person in the world before both those issues came about, it would probably be an understatement to say that there are some serious holes in my mobility game. Coming out of my year of surgery, I have started to take proper form, mobility, recovery, etc. a lot more seriously, instead of just going HAM all the time and dealing with the (often painful) consequences afterwards.
Despite my efforts to clean up the imbalances in strength between my right and left legs, I had been starting to see some favoring of my right leg creeping into my squat videos. Some days worse than others, certainly worse with multiple reps. The other major problem that I've actually been trying to deal with via the ostrich-head-in-the-sand approach was my complete inability to squat properly without the help of oly lifters. Deep down I've known that this was a dumb decision, but after a year and a half of rehab, I really just wanted to feel "normal" and do powerlifting training for realsies instead of feeling like a permanent bench-only candidate.
My back issues have catalyzed me jumping full on into this corrective programming, but originally I committed toes in. I heard about Performance Care first through a friend, but then again on a podcast that I respect a lot. Two points of recommendation was enough to get me on their website checking things out and I decided that hey, it couldn't hurt to try.
As I was going through their week one baseline testing, one of their "tips of the day" emails sent fear and trepidation shooting through my body. "You should be doing these without belts, knee sleeves and lifters". Belt, ok whatever - I'm fine with beltless work. But knee sleeves and, most importantly, lifters? Oh geez.
So I did the rest of my testing in my inov8s. And then started my week two workouts in them as well. Knee sleeves I've been doing my best not to wear, but on days where my knee feels a little sad, I've been rocking the single rehband. For this week's (W3) front squats I actually went with SBDs as I decided with my back feeling wonky, I wasn't willing to go naked knees too. Progress, not perfection.
What I quickly noticed (well, re-noticed - I already knew this from knee-hab) was that air squatting or back squatting in inov8s was an exercise in instability. Essentially, I became this creaky, unstable creature doing something vaguely resembling a squat. Given that my hips were on fire, I felt they were part of the problem, but wanting to know more I posted a video on the Bulletproof Facebook group asking for the designers' perspective. What they immediately noticed was my ankle mobility - or lack thereof. Not all that surprising considering my history. But what they suggested was different than the mobility/physical therapy road that I've been on for the last 18 months or so. What he suggested was that I go see a guy about adhesion release.
So I check out the website and decide to give them a call. I was initially a bit skeptical as the first thing the receptionist tells me is the price for the initial visit (higher - not surprising, assessments typically are) and that there is no treatment on first visit. I've been to a lot of assessments, but this is the first time I was getting told that there would be no treatment. Here is the part I actually super respect - she got the doctor to call me, and he explained the what and why behind that. The fact that he took the time to call and explain it to me was what pushed me on board, and I booked an assessment for the next day.
Despite my efforts to clean up the imbalances in strength between my right and left legs, I had been starting to see some favoring of my right leg creeping into my squat videos. Some days worse than others, certainly worse with multiple reps. The other major problem that I've actually been trying to deal with via the ostrich-head-in-the-sand approach was my complete inability to squat properly without the help of oly lifters. Deep down I've known that this was a dumb decision, but after a year and a half of rehab, I really just wanted to feel "normal" and do powerlifting training for realsies instead of feeling like a permanent bench-only candidate.
My back issues have catalyzed me jumping full on into this corrective programming, but originally I committed toes in. I heard about Performance Care first through a friend, but then again on a podcast that I respect a lot. Two points of recommendation was enough to get me on their website checking things out and I decided that hey, it couldn't hurt to try.
As I was going through their week one baseline testing, one of their "tips of the day" emails sent fear and trepidation shooting through my body. "You should be doing these without belts, knee sleeves and lifters". Belt, ok whatever - I'm fine with beltless work. But knee sleeves and, most importantly, lifters? Oh geez.
So I did the rest of my testing in my inov8s. And then started my week two workouts in them as well. Knee sleeves I've been doing my best not to wear, but on days where my knee feels a little sad, I've been rocking the single rehband. For this week's (W3) front squats I actually went with SBDs as I decided with my back feeling wonky, I wasn't willing to go naked knees too. Progress, not perfection.
What I quickly noticed (well, re-noticed - I already knew this from knee-hab) was that air squatting or back squatting in inov8s was an exercise in instability. Essentially, I became this creaky, unstable creature doing something vaguely resembling a squat. Given that my hips were on fire, I felt they were part of the problem, but wanting to know more I posted a video on the Bulletproof Facebook group asking for the designers' perspective. What they immediately noticed was my ankle mobility - or lack thereof. Not all that surprising considering my history. But what they suggested was different than the mobility/physical therapy road that I've been on for the last 18 months or so. What he suggested was that I go see a guy about adhesion release.
So I check out the website and decide to give them a call. I was initially a bit skeptical as the first thing the receptionist tells me is the price for the initial visit (higher - not surprising, assessments typically are) and that there is no treatment on first visit. I've been to a lot of assessments, but this is the first time I was getting told that there would be no treatment. Here is the part I actually super respect - she got the doctor to call me, and he explained the what and why behind that. The fact that he took the time to call and explain it to me was what pushed me on board, and I booked an assessment for the next day.
Banking Too Much on Things Going Well and Pushing Them Over the Edge Into Not Well
So my training since my last competition has been going pretty well. I competed near the start of April, and did not go in feeling particularly confident in my abilities - most specifically in my squat. It became pretty evident to me during my peaking weeks before the meet that things were not going to go like I had hoped - I failed at what I had been looking to take as a second attempt during my last heavy week of training, so that sucked. To make a long story short, I finished with 105/80/160 for a 345 total. This was good enough to qualify me for Regionals, but 20kg short of my national total. I knew going in I would need a near-perfect day to get it and I didn't. Not going to lie and say I wasn't disappointed, but dealing with disappointment is also part of the game. There's also quite a lot of 2016 left for me to nail down that total so hey, live to fight another day.
I took the week after my meet off as a deload. The week after that I was off on a semi-vacation and a set of work meetings, so it was also a pseudo deload. The only work I did in those two weeks was three squat sessions to kick off a three-week higher volume program. One day involved 3x10, one 5x5 and the other 8x3. I had run this back in November when I was finally getting back to squatting and saw a ton of improvement, which was the motivation in me wanting to run it again. I re-integrated the other two lifts in week three post-competition when I got back to Edmonton, starting on a four week block of the Stinn System. I modified the squats in the first two weeks of that block to allow me to finish out the volume cycle.
I came out of the volume feeling great; my first workout back into the Stinn cycle I easily hit a double at 97 and then proceeded to singles at 100, 103 and 107 (more than my meet), all beltless. Great start. A week after that, I went for a single at 110 belted (my failed third at the meet) and then a new PR of 112.5 and hit that too.
It's at this point I made a series of poor decisions.
Poor Decision The First - I went to football practice. This wasn't necessarily a super poor decision in and of itself. I wanted to see how my knee would react and this allowed me to do so. The poor decision was less doing football practice and more what came afterwards. The answer to how my knee would react was "by swelling, a lot". Two days later I sat on a bus for 11ish hours going to/from a football game to watch from the sidelines, which also didn't do much that was great in terms of getting swelling out of the joint.
Poor Decision The Second - As I was perusing videos I had previously uploaded to Facebook, I discovered one of me squatting 215 for 9 and the little hamster in my brain starts spinning on its wheel. This is now five days after I've gone to football practice and the swelling has not resolved itself. I squat 215 for 10. Beltless.
Poor Decision The Third - Thursdays are supposed to be my rest day, but I'm doing some baseline mobility and strength testing for a program that I want to run. It calls for a 10RM sumo deadlift. Thinking that I won't be able to do that much for a 10RM, I decide to go for it on my rest day. I undershoot my 10RM twice, meaning I do three sets of deadlifts (225, 255 and 270). I'm not going to lie - this actually felt really damn good. I was thinking "wow, when I re-test my 1RMs things are going to be sa-weet!"
Poor Decision The Fourth - Friday when I go in for my workout, things are starting to break down. My depth (which is normally never an issue for me) is creeping up for squats and my deadlifts feel heavy as fuck (go figure, considering how many loads I have blown this week). I figure I'll be "smart" and in addition to my Saturday rest day, I'll take one Sunday as well and that should fix everything.
Poor Decision the Fifth - So I've blown my load a few times over-exerting myself. I've also started integrating this imbalance/mobility work into my programming - because obviously by doing so that's going to fix my problems. At this point, I also start running a peak cycle because I want to re-test my numbers on my ACL surgery anniversary. To make a longs story short, this was a bad idea. I lasted a week.
Thankfully it doesn't seem like my back is too bad from all of this. I've progressed from unable to roll over in bed, put on socks, or get my shoes on, to being able to do all those things again. I tried some light squats tonight with no ill effects. Same goes for a light dead. I have learned enough from the above to not be like "woo, hop back on the peaking program and let's continue as planned". I've quickly realized that the strength imbalance/mobility stuff is taking way more out of me than I thought it would and that if I want to see some true improvement from it, I need to focus on long game, and drop the heavy weights for the short term. So I'm going to come up with something different but difficult and fulfilling to do on my surgery anniversary and give myself the opportunity to re-test later, when I'm more ready.
I took the week after my meet off as a deload. The week after that I was off on a semi-vacation and a set of work meetings, so it was also a pseudo deload. The only work I did in those two weeks was three squat sessions to kick off a three-week higher volume program. One day involved 3x10, one 5x5 and the other 8x3. I had run this back in November when I was finally getting back to squatting and saw a ton of improvement, which was the motivation in me wanting to run it again. I re-integrated the other two lifts in week three post-competition when I got back to Edmonton, starting on a four week block of the Stinn System. I modified the squats in the first two weeks of that block to allow me to finish out the volume cycle.
I came out of the volume feeling great; my first workout back into the Stinn cycle I easily hit a double at 97 and then proceeded to singles at 100, 103 and 107 (more than my meet), all beltless. Great start. A week after that, I went for a single at 110 belted (my failed third at the meet) and then a new PR of 112.5 and hit that too.
It's at this point I made a series of poor decisions.
Poor Decision The First - I went to football practice. This wasn't necessarily a super poor decision in and of itself. I wanted to see how my knee would react and this allowed me to do so. The poor decision was less doing football practice and more what came afterwards. The answer to how my knee would react was "by swelling, a lot". Two days later I sat on a bus for 11ish hours going to/from a football game to watch from the sidelines, which also didn't do much that was great in terms of getting swelling out of the joint.
Poor Decision The Second - As I was perusing videos I had previously uploaded to Facebook, I discovered one of me squatting 215 for 9 and the little hamster in my brain starts spinning on its wheel. This is now five days after I've gone to football practice and the swelling has not resolved itself. I squat 215 for 10. Beltless.
Poor Decision The Third - Thursdays are supposed to be my rest day, but I'm doing some baseline mobility and strength testing for a program that I want to run. It calls for a 10RM sumo deadlift. Thinking that I won't be able to do that much for a 10RM, I decide to go for it on my rest day. I undershoot my 10RM twice, meaning I do three sets of deadlifts (225, 255 and 270). I'm not going to lie - this actually felt really damn good. I was thinking "wow, when I re-test my 1RMs things are going to be sa-weet!"
Poor Decision The Fourth - Friday when I go in for my workout, things are starting to break down. My depth (which is normally never an issue for me) is creeping up for squats and my deadlifts feel heavy as fuck (go figure, considering how many loads I have blown this week). I figure I'll be "smart" and in addition to my Saturday rest day, I'll take one Sunday as well and that should fix everything.
Poor Decision the Fifth - So I've blown my load a few times over-exerting myself. I've also started integrating this imbalance/mobility work into my programming - because obviously by doing so that's going to fix my problems. At this point, I also start running a peak cycle because I want to re-test my numbers on my ACL surgery anniversary. To make a longs story short, this was a bad idea. I lasted a week.
Thankfully it doesn't seem like my back is too bad from all of this. I've progressed from unable to roll over in bed, put on socks, or get my shoes on, to being able to do all those things again. I tried some light squats tonight with no ill effects. Same goes for a light dead. I have learned enough from the above to not be like "woo, hop back on the peaking program and let's continue as planned". I've quickly realized that the strength imbalance/mobility stuff is taking way more out of me than I thought it would and that if I want to see some true improvement from it, I need to focus on long game, and drop the heavy weights for the short term. So I'm going to come up with something different but difficult and fulfilling to do on my surgery anniversary and give myself the opportunity to re-test later, when I'm more ready.
Wednesday, October 21, 2015
Hardware Removal
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!
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!
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.
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