Week 16: Day 1

Christmas week: skipped PT on Friday, did nothing at all, but continued running.

On Wednesday, the PT introduced a squatting exercise, which seemed to put some pressure on that right knee... no pain, but definitely yet another thing that I need to get used to.

Running-wise, I did 7/3 on Tuesday and the knee felt good Wednesday morning, so I upped it to 8 minutes run and 2 minutes walk on Thursday. The knee felt a bit sore Friday, so Saturday I continued with 8/2 (treadmill, 10 min/mile pace, 0.5 incline). I could feel the knee while running Saturday and it was kinda sore on Sunday. So I am staying with 8/2 until my knee feels good the day after.

But yeah, Saturday marked 12.4 miles of running distance since my ACL tear (and heck, since a long time...).

Attached is the picture of my daily run distances since I got back into it, all 12.4 miles of it

:)

I've stopped consistently stretching on my non-PT days (only on running days), I keep forgetting or am too busy. I keep forgetting to ice the knee as well. I need to get back into these habits, at least keep my stretching going every day. Still, given that I do stretch 5 days a week (3 PT days + 2 running days, more like 6 now), it can't be that bad.

Week 15: Day 1

So yeah, Sunday finished up the first week of back to running! I managed to log 5.5 miles this week, or 7 miles including last Sunday. The Sunday run was three 7-minute intervals with 3-min walk breaks, at a 10 min/mile pace (treadmill and all).

Today, the knee felt a bit sore in the morning and there was some clicking, so the physical therapist advised me to hold it at 7-minute running intervals until the knee doesn't feel sore the day after.

My cardio is definitely not what it used to be, but I know that the only way is up!

During last week, I took on doing a balance and reach on a foam pad, which is considerably more difficult. Today, Monday, we switched to doing one-legged leg press, starting at 3 plates. 3.5 plates felt a little too hard on the knee and the release was kinda jerky. I think next time the 3.5 should feel OK.

At the hamstring curl machine, went up to 2.5 plates of weight and that felt just slightly difficult to finish. I could probably do 3 plates and barely finish, though we may stick with 2.5 plates one more time.

My quad control/leg control keeps getting better for doing the step-down exercise.

The Christmas week is coming up. I'm going to have to find a way to get a little PT in on Friday, the day of Christmas. Not sure if that will happen, but it would be nice if I get something done.

Week 14: Day 1

Two days ago, Friday, I visited the PT with the new script from the surgeon. The PT offered their own version of the "return to jog" program, which consists of going for 5 min walk, 5 min run half-hour sessions. Then progressively turning down the walking by 1 min and adding 1 min to running until there is no more walking for half an hour. This would put me at the same 9 miles a week milestone, so I decided to follow the PT's suggested protocol.

Sunday was a great day: did my first run. I followed the 5-min walk/run protocol and logged 1.5 miles, about half mile per a 5 minute run session. Total 2.3 miles distance. This was on a treadmill.

The first few strides felt weird! Also a few times my right knee buckled a little bit, but I held up just fine... those few times, it was a bit of an uncertainty after the strike: "can I hold it?" yes I can!

The 2nd and 3rd 5-min run sessions were more confident than the first one. I think the first one was "OMG am I really doing this?," followed by 5 minutes of thinking about it while walking and the rest were "yeah, we doin' this!"

So hells yeah. Tomorrow another 5-min walk and 5-min run! Then Thursday 4-min walk and 6-min run.

After the run, this evening I felt some soreness: inside thigh on the left leg, quads on the right leg, both calves and the right shin.

At today's PT, I stayed at 10 lbs ankle weights, but upped the leg press to 7.5 plates. The PT showed me a new exercise, where I do hamstring curls off a physioball, while raised in a bridge position. I also did 4-lb ankleweights on standing hamstring curls.

Week 13, Day 4: Orthopedic Surgeon Followup

Wednesday's PT was fine, stayed at the same weights for all exercises. The PT measured my strength and range of motion. I have full extension and 142 degrees of flexion. The hamstring strength is 4/5, not quite fully there.

Visited the Dr for a 3-month followup today! Told him about the tales of hamstring straining woes, to which he replied that incidents are bound to happen during such a long recovery period.

The ACL is intact and strong! The Dr tested the knee and did the pivot test. Everything checked out, so, hurray, my aftermarket ACL is still in business! Overall, he said my knee is looking great and I am right on schedule.

He said that the last bits of swelling will take some time to come down and he'd like to see that fluid gone. He said the incisions are as dark as they are going to get and are going to start fading in 3 months. He gave me a new script for exercises, saying that I need to start doing more weight training. I don't have the script handy, but it included lunges.

Also, I am now cleared for running! The objective is to start out slow. Start by walking for an hour. If that's OK, then an easy 1 mile, 1.5, 2, 2.5 and 3 miles, 3 times a week, every other day. So that puts me back to at least 9 miles a week, which is quite a good baseline to get back to! Next week will be the walk-an-hour week. Not sure I'm going to work running an easy 1 mile every other day into the Christmas week, but I'll try my best.

He also said that slight discomfort in the knee is OK, major pain is not. He said the knee won't feel "normal" until about a year out (and that's OK).

I asked him about my step down exercises being somewhat jerky and not having that smooth muscle control. He replied that I'll work through all of this with the physical therapy training.

Week 13, Day 1

2nd week of true hamstring strength building continues. The PT visit today increased the ankle weights from 9 lbs to 10 lbs. I also switched the bridging from my calves resting on the physioball to my feet resting on top of it. This way, my knees are bent a lot more and this makes bridging more difficult.

Finally, we also switched to a step-on and step-off kind of an exercise, which involves lowering my left foot off the front of the step, while bending the right knee. This is difficult to do smoothly and my muscles feel kinda "spasmy"/not smooth doing it. Same applies to stepping back off the step on the ground, where lowering my body weight off the step still causes me to crash on the last two inches of movement (and the movement is not that smooth either).

The Dr followup is Thursday, Dec 10th.

Next week was supposed to be the week that I resume running (the week after the dr followup). However, my hamstring strength has been delayed by two weeks due to injury and so I think that will delay my return to running as well.

Week 12: Going stronger

Hamstring strength resumed this week. 3 successful visits to the PT. The hamstring curl while standing up progressed from no weight, to a 2-lb weight, to a 3-lb weight. Bridging with my calves resting on the physioball.

Stayed at a 9-lb ankle weight for the leg raises, but moved up to a 7-plate leg press weight. At the last visit, moved back to the balance-and-reach exercises. Missed stretches Sunday, but managed to do them on all the other days.

Managed to get out to the gym for half an hour cardio Saturday and Sunday. Walked around a lot as well during the weekend, so the knee felt a bit sore from all the action.

Week 11: Hamstring still sad

Of course, pulling my hamstring at the end of week 10 spelled no hamstring strength for week 11. I visited PT on Monday and Wednesday, skipping all hamstring strength.

Unfortunately, I skipped my PT on Friday due to lack of good circumstances. I was visiting family for Thanksgiving and there was no good opportunity to do the strength exercises.

I've also been skipping out on stretches on the off days, so no stretches since Thursday. Boo.

Anyway, the hamstring seems to be recovering and I'm hoping to start the ham strength tomorrow night at the PT.

Week 10: Sad hamstring week

PT visit Monday had the usual strength increases for the quads. For ankle weights, I went up more than 1lb to 8lbs + shoes (from 7lbs no shoes).

So this was the weekend of hamstring strength, but because I sprained it three f'ing times last weekend, it was not meant to be.

Monday, we attempted hamstring exercise by standing up and flexing my knee by raising the heel up towards my butt. This hurt a little through the range of motion, but I did 3 sets of 15 anyway. Then we attempted bridging, which didn't hurt.

Wednesday at the PT the hamstring still hurt some, but I decided to do the exercises anyway. Thursday, I could feel my hamstring being tender all day long and Friday it was achy as well.

So at the PT Friday, I skipped hamstring altogether. My PT massaged my hamstring and ultrasounded it. She also gave me arnica gel to rub into my hamstring bruise.

Oh yeah, Monday, there was a big, nasty nasty bruise above my knee, near the hamstring violation site.

Friday, we decided to let the hamstring rest and try to be careful over the weekend.

So of course, what happens is that I ended up really pulling the hamstring AGAIN Saturday night, after stepping into a piece of poop on an uneven walkway. It really hurt.

This pisses me off because it means more hamstring strength training delays. I am guessing another week until it recovers.

And I have to try to be REALLY CAREFUL now, walk really deliberately and not wear those shoes that slip so easily in on wet pavement.

A sad hamstring week, here's to a Sunday of rest.

Week 9, days 4-7

Did some very intense elliptical Thursday, then all my scheduled PT strength exercises on Friday.

I have full flexion! Or at least 99% there. Wicked awesome!

Over the weekend, I skipped stretches both days. Boo on me. However, what's worse, is that I pulled my hamstring a total of 3 times, Saturday and Sunday. Damn. The last incident was just Sunday night, just as it began feeling better.

I hope that all this hamstring abuse won't delay my hamstring strength gains, though I think it probably will.

Having the hamstring be pulled was part of the excuse for skipping stretches on both days. I still could've done the calf stretches, but instead I wrote the whole thing off.

Well, let's see what the physical therapist says tomorrow.

Week 9: Day 3

Yesterday, did a pretty intense elliptical workout and the knee felt pretty much fine. Forgot to stretch though!

Today's PT was good. Same routine as Monday, except one-legged heel raises off the floor now. The right calf is definitely weaker, but no discomfort on the knee. On stepping down from the step, I am now trying not to "crash down" so much, but come down with more control. Still not descending entirely controlled though.

Week 9: day 1

Knee felt great over the weekend, but I skipped the stretches one day (too
busy). Alas skipped ice both days.

Today, Monday, went to the PT. Up to 7lbs on ankle weights and 5 plates on the leg press. Wobbly foam pad for the balancing and that was not that difficult. Managed a 30 second non-stop balance on the right leg at the end. Everything felt good.

My back to running date is early Dec. Seeing how I'm starting hamstring strength after 9 weeks, leaving only 3 weeks until running date. However the followup with my doc is a week off as well, so I may actually get 4 weeks of HM strength before running.

Week 8, days 4 and 5

Yesterday, rocked the elliptical at the gym for 15 minutes at a lighter-to-medium intensity and felt good. Topped it off with a 15-minute bike ride of higher intensity (180+ bpm heart rates again) and that felt fine. Did my stretches.

I was a bit surprised that the knee felt fine all the way through my 2nd elliptical outing. This means that I must've "conditioned it" or "broke it in" with the 10-min elliptical Wednesday. So basically, you gotta work it to get any results.

However, at the end of last night, did a bunch of standing around and walking. When I woke up this morning, my tibia felt more painful than the painless level that it has been at before. Still, it's a fairly slight increase in pain, so I'm not worried.

I've been doing more stairs, mostly the ones at home (avoiding stairs at work still). Coming down stairs is more difficult, as one might expect. It's not very smooth, I kinda "drop" onto the step, and so I need to work on it. Coming up the stairs feels fine/OK.

Today, I did some evening PT in my work gym. I ramped up my elliptical for 20 minutes at a lower intensity (heart rate 130-150bpm). A pair of 6lbs ankle weights made for one heavy gym bag. Did stepups, heel raises, balancing and stretches. Knee felt fine!

Week 8: day 3

Good PT visit today.

When I go to the PT, I either have my actual PT (with an MSPT degree) or her assistant work with me. They are both great and tend to agree on the same things. Today, my actual PT worked with me, for the first time since last doctor's visit. I mentioned that I was staying away from the elliptical until we begin hamstring strength. But she said that it's OK and I can start the elliptical at this point. I can keep doing it, as long as there's no pain, adding 5 minutes at a time.

So I did the elliptical for 10 minutes. At minute 2 or so, the knee felt a little bit painful, but it stayed at that same level through the whole thing, so I'm hoping that it will get "used" to this. I really want to be able to rock the elliptical full power soon.

I asked about stairs and she said that I should be navigating stairs normally, unless there's pain. Of course, I should limit the amount of stairs if I have a choice, so I'll still be choosing the elevator at work. However, at home, I should stop doing the one-legged stairs and do a normal ascent and descent.

When I got home, I attempted a normal ascent and it was alright (ascending feels weird, the right leg doesn't feel "full power" upon ascent). However, I was too afraid to attempt a descent.

The PT said that I should try to do things normally, such as stairs, because the longer I don't do things normally, the worse it will be to go back to normal.

She noticed I limped just a bit walking into the appointment, noting that I wasn't flexing my right knee enough on the right leg step off (I almost was keeping it locked straight). I walked around again, attempting to do it right and my walking was better. So I need to remember to keep that walking limp-free.

I stayed at 6lbs for ankle weights. The left leg is just barely able to finish those with the quads fatiguing, and the right leg had an easier time with the weights, with no quad fatigue felt. It's a bit strange, because my right leg is definitely not as beefy/muscular looking as the left leg, so I would have expected the quads to be strained less on the left leg.

Incision looks a bit red still but not any worse than Monday. So hopefully it's not an infection.

My flexion is kicking ass, I am down to three fingers butt-to-heel. (Or maybe even 2.5).

Week 8, day 2

Seems like the incision is less red overnight. Skipping the massaging, hoping the redness will go down. During the day, it felt like the jeans were rubbing against the incision, possibly irritating it. Almost felt like I should go back to wearing shorts.

Hopped on the bike for 20 minutes and did upper body workout, but didn't do the stretches last night. Forgot to do them after the workout in the gym and the hamstring didn't feel quite right when trying to stretch it last night, so I just went to bed as is.

Week 8, day 1

The sleeping has been good last week or so. I only sometimes wake up around 5-6 (instead of 4am) with a slight knee ache. Much improved experience overall!

PT visit today was good. I went to 5 plates on the leg press, but backed off to 4 in the beginning of the 2nd set, because I began getting some pain above the knee, at the bottom of the femur. It was slight and only on pushoff, but after I shifted to 4 plates, it went away. So I am staying at 4 plates for a bit.

Did 6lbs with ankle weights with both legs. My left hip may be sore tomorrow.. the left leg definitely forgot what it's like to lift these on a regular basis. Still managed all my 3x15 sets.

Did step-ups off a slightly taller step and they felt fine. The balancing with the eyes open is very good now on the right leg.

The PT noticed some increased redness around the hamstring incision site. Hoping it's not an infection. I am going to stop massaging it with the petroleum jelly cream for a few days to see if that changes anything. I also wiped down Aircast knee cuff, just in case some crap developed on it.

At home, coming down the stairs, I stumbled and pulled my right hamstring. Ow! Kinda sorta icing it now and hoping it'll heal itself overnight. I guess this is not a particularly terrible time to pull the hamstring (almost at the 8-week mark), but still not a good thing.

Week 7, days 6 and 7

The weekend was good. I did my stretches, but skipped the cardio, since I don't have a stationary bike I can use over the weekends (my roommate's bike is a reclining bike, not upright, and it is a hassle to use). I need to get a gym membership to do stuff on the weekends.

The knee felt good over the weekend. Still some aches and a throb of pain here and there, but pretty calm overall. Ibuprofen takes care of it all. The swelling seems to have gone down more right around the patella, with the most visible swelling just below the knee, above the hamstring graft site.

I went to two parties on Fri and Sat, mostly standing around and not a lot of sitting. I managed OK and the knee didn't act up too much. I have now developed a more pronounced click on certain knee movements and motions. Not so much during the walk, but more during a knee flex after some walking.

The muscle soreness from my first upperbody workout on Tuesday has finally faded over the weekend.

Week 7, days 4 and 5

Thursday was low-key. The knee felt good all day. I hit the gym and did 25 mins of cardio, including 5 minutes of high-intensity stuff that got my heart rate to 194bpm. It's been a while! The knee did feel a bit more painful after the intense cardio, so I think I ought to tone it down a bit.

Thursday did stretches before leaving work, after the bike.

Friday, hit the gym before leaving work. 25 min moderate intensity cardio (150-160bpm hr) on the stationary bike. Did all my strength exercises, including 5-lb SLRs on both legs. The left leg is not used to doing 5lb SLRs, so it's good I'm starting now, as it will take a bit to catch up with the right leg. Did balancing and step-us. Also calf raises. Pretty much everything I do at the PT except for the leg press. Stretched and went home.

Week 7, day 3

The knee is feeling good. I slept until 8am with no pain--amazing!

My roommate asked me if I wanted to go kart racing in mid-November. I checked with the surgeon and he replied "I do NOT think Kart racing is a good idea. Too high a chance of injury." Love the ability to get questions answered quickly by email from my surgeon.

Forgot about ibuprofen until 3pm this morning. Normally, after an 8am ibuprofen intake, the knee would remind me about itself by noontime. So yeah, these are all good signs.

PT tonight. Went well. Stayed at 5lb ankle weight, 4 plates on leg press. Step ups off a taller step now. Balancing was perfect for 3 sets of 30 seconds. After all that when I lied down for towel-assisted hamstring stretces, my right leg was shaking. Maybe the leg press and the straight leg raises did the
job?

The plan for off days is stretches and cardio. Friday is all weights, except the leg press, which I can't do at my work gym. Will also start SLRs and balancing on my left foot.

Week 7, day 2: Back in the gym for real

Slept alright, still woke up at 4:30pm with some knee ache and popped two ibu as usual. Then slept in until 8-8:30am (had a weird dream too...).

Knee was feeling good today. My walking is good most of the time--the limp is almost invisible. One of my coworkers commented that I wasn't limping anymore. As I walk though, especially after a little bit more walking, I feel a bit of a crunch/crack in my right knee as I step (feels that it's happening just below the knee). I wonder if it's the muscular imbalance or just the regular motions of the knee going thru the healing (scar tissue affecting tracking of things etc).

I decided to hit the gym proper today, attempting to get back to my upper body program. It was good, though very tiring! (especially after a looong day at work)

I jumped on the stationary bike and did it pretty intensely for 23 minutes. I turned up the resistance just a little and sped up my cadence. On this bike, 90rpm feels about normal, 80rpm leisurely. After doing about 90-95rpm for 12 minutes, I sustained about 100-105rpm for about 4-5 minutes, hitting a 180bpm heart rate. Then back to 90rpm for a few minutes and another 2 minutes of high intensity. I noticed that after this section, at about the 20 minute mark, my knee was a bit bothered and I could feel a little irritation/pain at the top of the tibia. So I cruised at a slower, 75-80bpm pace for another 3 minutes. It didn't feel quite right still, so I decided to get off the bike (hence the 23 minute session).

I then did some weights for the first time in a long time. I wasn't able to do quite the same weights I did before my ACL injury. For example, on a 45-degree wide-grip lat pulldown, I used to be able to do 3 sets of 12 of 122.5lbs. I attempted 120lbs today and did 12, 11 (with the last two weak) and 9. Same with biceps curls... Used to do 3x15 of 20lb weights, but opted for 15lbs today and did 12, 10 and 6 (so way weak there!).

At the end, I hopped on the stationary bike for another 5 minutes at a slow pace. I was wiped out from the exercise and maintaining a 75-80rpm pace with the lowest weight was still keeping my heart rate at 150-155bpm.

It's been months since my heart rate has seen 180bpm or any decent cardio exercise. If I can keep this up once or twice a week, I'll be happy. I'm sure I'm going to be hurting the day after tomorrow from delayed onset muscle soreness. My heart rate monitor logged a 1hr 13min workout with an average heart rate of 149bpm! Not too shabby!

I forgot to do my stretches at the gym, but I did them at home before going to bed.

Week 7, day 1: less pain w00t!

Six weeks have passed. This is the best-feeling morning in the recent memory. Woke up at 7am with just a slight ache in the knee. Not even really painful. Iced it anyway, then got up to go to work.

So hopefully, this pain at top of tibia/around incision site is a thing of the past. Hurray healing.

The PT visit went well! The PT suggested to hold off the elliptical until I start hamstring strength in the middle of November. Leg press went well, no pain, and the balancing was fine for the first time (just a little pressure on the medial side, but no pain). The knee felt fine for the rest of the day after the icing.

I must have quite a bit of muscular imbalance in the right leg now, with the hamstring being very weak and the quad a bunch stronger.

Week 6, days 6 and 7

The pain went down a good amount this weekend. Saturday morning I woke up as late as 7am, though Sunday I still woke up at a middle-of-the-night 4:30am.

I am walking better and the top-of-tibia pain around the incision site was mostly not there. I am just getting some now as I am going to sleep, so I hope I didn't jinx it.

I did my stretches today and yesterday.

Attempted to go up a few steps with the other leg a few times throughout the weekend. Probably did something small like 15 steps during the whole weekend, spread out in chunks of 3-5.

Excited to go to the PT tomorrow with this reduced pain.

Week 6, day 5

First glorious full day without the brace today. Now, I have no excuse for not walking without a limp. I need to concentrate on walking right. I'm telling everyone to tell me I'm limping if I'm limping.

No PT today (down to 2 visits a week), but did strength exercises at the work gym today before leaving work:

* bike 20 min low resistance
* gentle heel raises
* 4.5 lb ankle weight no shoe straight leg and side leg raises
* heel-raises off a step w/ a calf stretch in between
* step-ups on a 4" step
* hamstring stretch w/ a towel

all strength exercises are 3 sets of 15 reps...

Went out at night today and the knee felt pretty good (though I did take 400mg ibuprofen some time ago). I think that top-of-tibia part is starting to heal.

Week 6, day 4: We may be hurtin', but we kickin ass!

Slept better than before, but still had to do a middle-of-the-night ibuprofen "shot". Leg felt less painful in the morning, though still not as painless as in the beginning of week 3.

THE BRACE IS GONE! OK, I am getting ahead of myself.

I had a followup appointment with my orthopedic surgeon today. The summary is that I am kicking ass and ahead of schedule. He said the pain levels will go up and down (good weeks and bad weeks) and this is just a part of the healing process.

I asked about the pain just above the incision site and he said that it's near where the screw enters. He said there are three things involved there: hamstring graft, screw and the tunnel. Any of these things could be hurting.

My knee looks good and the wounds look good. My flexion is great and he confirmed the full extension. He felt my quads (put your dirty mind away!) and said they were good.

The Dr suggested I massage the hamstring graft incision site with some cream. I need to find out what kind of cream to use.

He said that he can't test the graft at this point (too early). I asked about my concern with the CPM machine causing anterior translation of my tibia because my butt sank lower than the base of the CPM machine (during the first two weeks). He said that it wouldn't mess anything up, so not to worry.

The brace is off! Yay!!! The Dr did not allow me to burn it in a ritualistic fashion, in case I still need to wear it (if I'm feeling sore and need a gradual weaning off).

I asked about the knee buckling a little bit in the morning until I get out of the shower or walk around some more. He said that it's no big deal at all and reminded me that I just had major knee surgery.

I am now cleared for non-impact cardio, but I still have to wait until 11/14 (8 weeks post-surgery) before I can start hamstring strength.

When asked about using stairs, the Dr indicated that I can use them, but I should ramp them in (and all the other cardio) gradually. So don't do five flights of stairs on the way out. I will be incorporating some steps in gradually (though I may wait until my Monday PT appointment before I start playing with the stairs or other cardio).

I scheduled a followup for just after the return to running date (Dec 10). So this pushes my return to running date by a few days, but that's OK.

SO HELLS YEAH!

I did remember to get on the stationary bike for 15 minutes today before I left work. Did my stretches before bed.

Week 6, days 2 and 3: OW! continues

Monday night had poor sleep. Woke up in the middle of the night, popped 400mg ibu, iced the knee for 20 mins, did some patellar mobilization, then managed to fall asleep in an hour.

Last night had slightly better sleep, but basically the same pattern. I was able to fall back asleep sooner.

Tuesday I did stretches before bed. When doing the calf stretch on the right leg, it feels like I aggravate that hamstring graft spot a little bit. I still did two calf stretches, and tried to make them gentle.

I also noticed that Tuesday morning, I wasn't able to immediately get my full extension while walking. Also, the leg tended to want to give out, so I limped into the shower. Concerned with losing that full extension, I did a no-weight prone hang for 3 minutes. I also tried to extend the knee a bunch throughout the day. This seemed to do the trick, as this morning, I had full extension right away.

Tuesday and Monday I felt a little bit of soreness in my right glutes. This is probably due to an abnormal gait from the pain. I must be compensating for something. Same thing today, just not as strong. I am concentrating on having as normal gait as possible.

When I woke up this morning, I still had that painful spot right around the hamstring graft incision site. The knee itself felt fine. So today, most all the pain is top of that leg. I am popping 400mg every 4 hours pretty much on the clock. I think the knee felt better this morning than Tuesday morning, but this afternoon, it feels worse.

I wonder if I made it worse because I lifted some 35lb snow tires (one at a time) yesterday. I tried to do all the lifting (deadlift pose) with my left leg, but I may have inadvertently used my right foot. Maybe this aggravated the leg? Who knows...

The pain is pretty annoying at work this afternoon. It's about 4/10 or 5/10. I am sitting at my desk with the calf portion of the brace unbuttoned, to provide a bit of pressure relief.

Did I mention I hate this brace? I am inclined to burn it in a ritualistic fashion when it comes off.

The PT appointment this evening was good. The bike did not feel as painful as Monday and I was able to handle 4lb ankle weight plus the shoe. The flexion was measured as 135 degrees, but I have been doing very gentle heel slides, so it wasn't as much as I was able to coax before. Did step-ups and skipped the leg press. Step-ups aggravated the pain site just a touch on the comedown, but not too bad.

The PT wrote up a note for the appointment with my ortho tomorrow. Can't wait for that. When I get home, I need to come up with a list of questions for the doctor.

Week 6, day 1

5 weeks in, the countdown to losing the brace begins. Doctor's followup is scheduled for this Thursday.

Still had to take two more ibuprofen tablets in the middle of the night to go back to sleep.

It seems like the leg/knee is better. Better than Friday, for sure. As good as week 3 or 4? No. But I am hoping that I am on the downward slope as far as the pain goes.

Another PT appointment today. Skipped the leg press. Couldn't go as fast on the bike as I could a week ago, pushing faster and I could feel an increase in the pain at the top of tibia. The same spot was aggravated by quad sets: when I release the tensed muscles, I could feel a throb of pain below the knee. The PT decided to cut the quad sets out, since I am doing 4lb weights for my straight leg raises (with zero quad lag).

The step ups off a low 4" step were fine, just adding some stiffness to my knee. No pain though.

So the protocol for tomorrow at home is merely doing the stretches. Oh and some stationary bike, which I'm hoping to be able to do for 15 mins during work tomorrow.

Week 5, days 6 and 7

Tried to take it as easy as possible during the weekend. Skipped going to a party Saturday, stayed home instead. Spent most of the time on the couch or the bed without the brace on.

Lots of ibuprofen.

Decided to skip ALL exercises. Felt some pain in the shin on the release of a quad contraction, so decide to skip quad sets. Didn't want to do the stretches because that may irritate hamstrings (probably a dumb idea).

Sunday the leg seemed to get better, not nearly as bad in the shin anymore. Some clicking when flexing the leg, but that's not a big deal.

The pain is less in the shin and more in the knee itself now. Perhaps that's from lack of use of the knee. Should've done the stationary bike or something over the weekend at least.

Meh, the pain is annoying.

Week 5, days 4 and 5: Ow!

So yesterday Thursday (day 4), top of my tibia kept acting up. I did super-gentle heel slides ONCE. Took two ibuprofen overnight, before bed at 11pm. Woke up at 3am, feeling the pain. Decided to take two more ibu, but couldn't fall back asleep.

Today (Friday), went to the PT. The PT suggested taking it easy, so we skipped heel slides, step-ups and balancing. Unfortunately, I opted to do the leg presses anyway... unfortunately, because in the middle of the first set, I felt some pain at top of tibia when coming back down on the leg press (knee flexion at 10-15 deg), but I kept doing it anyway. After 3x15, my leg was not happy. Electronic TENS stimulation helped for pain management there, but it was still pretty intense. I went home at 3pm and took a sorely-needed nap.

I hope I didn't mess it up much worse with that leg press. Anyway, the plan is to take it wicked easy, no heel slides, only quad sets and stretches over the weekend. Also ice ice ice...

So yeah, the recovery was going fairly smoothly up to this point.

I think what's acting up here are the healing hamstring tendons, which attach at the top of the tibia (and fibula). It could just be the healing itself.

Week 5, day 3: Evening

After taking two ibu before going back to bed, I finally fell asleep by 6:30am. Decided to sleep in until 9:30 to let the leg heal and let myself rest. The leg felt good all morning until I got to work, and then it got a bit achy again.

Did ROM exercises at work at noon and then went to the PT at about 5:30pm.

I told my PT about the pain and she said not to worry. First of all, many people are in more pain 4 weeks post-op than me. I am also way ahead of the game on flexion. If I had only 90 degrees flexion after 4 weeks, then we'd be worried, but I have more flexion than most people at this point in time, and so that's not a worry for her. I think I have been overdoing the heel slides, pushing them to too high a point of discomfort and pain. The PT suggested that I take it really easy on the heel slides.

I have been thinking that, since I now have full extension, I might as well get my flexion ASAP. I just need to relax and be gentle to my knee. So, gentle heel slides from now on. Hopefully this means the knee will calm down.

Attempted leg press with weight plates set to "4" (whatever actual weight that is), which felt easy, but trying to be careful with the motions not to upset the knee. I felt myself pushing most of the weight with the left foot, instead of using both feet equally. I guess this kind of thing will take a while to work out.

Taking two ibuprofen right before bed again today. Iced my knee before bed as well. Let's hope for a good night's sleep.

Week 5, day 3: a painful night

A painful night. Woke up around with throbbing/ache (pain scale about 5/10) around the tibia, despite taking two ibuprofen before bed. Finally got up around 5:40am, popped two ibu and went to ice the knee and write this blog entry. Alarm is set for 2 hrs for now, but I'm not sure how fast I will fall asleep.

Week 5, day 2: insurance fun

Knee still more painful and sensitive around incision site. Took one ibuprofen 4 hrs before bed, then another 2 hrs before, then another right before bed (figured the first one was "expired" by then). Slept well, but could feel it in the morning when I woke up.

Did a set of ROM exercises when I got home, but forgot to hop on the stationary bike at work. Need to NOT forget to do that. Still need to do another set of ROM exercises and the stretches before bed. Not sure if I'll do that just yet.

Got a bill from the hospital for the MRI, $1550, and the X-Ray, $122. Both services were supposed to be covered entirely by insurance and the MRI was not given until pre-approval. The note on the bill says "insurance denied." I hope it's some silly little error and not the start of some immense battle with the insurance co.

Week 5, day 1

Slept well for most of the night and then the ibuprofen must've worn off (and then I decided to straighten the leg a few times while half-awake and that didn't help things).

PT session today. Flexion is continuously improving, though the PT said not to worry about the flexion. I was worried for a moment when I only improved 1 degree over a week, but I have definitely made gains over the weekend and at the PT session today, so my flexion is coming surely and not even that slowly.

Attempted balancing again. This time, standing up perfectly straight was not painful, but leaning in to the left caused some pain on the medial side. Just a little pain at first, so I actually completed 3 30-second balancing acts, but towards the end of the 3rd, that pain increased and I think I probably overdid it. It's definitely a lot better than last week, so I'm sure one more week and I should be balancing pain free.

New exercise today: step-ups on a 4" step. No pain doing this one, though the knee felt a bit stiffer (perhaps a reaction to the balancing, who knows) towards the end of the 3 sets of 10 reps. So will continue doing this exercise going forward.

We did 3lbs of weight on the straight leg raises and it was just the right amount of weight. The muscles that get fatigued at the end though are not my quads, but the inside of my hips. I guess we gotta get those muscles back before we can start stressing the quads.

Week 4, day 7

Took it mostly easy today, except for walking about a half-mile in the morning. Did all the exercises for the day, even tried an 8-lb prone hang in the morning. I'll have to ask my PT whether I should still be doing prone hangs, as I didn't do any on Saturday (since I have full extension--I guess, looking to be validated?)

The knee felt better today and by staying at home at my computer, I spent less time in the brace. I slept well last night with two ibuprofens, so going to repeat the same tonight.

It seems that flexion keeps getting better. Just a little over a hand's width between the heel and my butt now.

Week 4, day 6

Knee is acting up. Didn't take any ibuprofen before bed and had a hard time sleeping with the aching knee. There seems to be some inflammation around the hamstring incision site and the top/medial arthroscopic incision site.

Went to a wedding today (no dancing!) and had the brace on under the suit. I don't know if it was twisted underneath, but the knee became pretty uncomfortable over time (sitting at a table with my knee flexed at 90 deg). I got home and couldn't wait to get the brace off and have the knee "relax."

I popped two ibuprofens (200mg each), did ROM exercises and stretches, then iced the knee for half an hour. I'm hoping it'll feel better.

The plan is to do another set of ROM before bed (with gentle heel slides), ice again and take it easy tomorrow.

Week 4, day 5

Knee felt inflamed and hot this morning, even though I iced twice before sleep. Achy today, not walking quite as normal.

Went to the PT: flexion up by 1 degree to 136, less than what I hoped. It felt like I made more progress than that with flexion. Oh well.

Going out for a few drinks to a bar tonight, so most likely going to skip the second set of ROM exercises before bed. I will be tired when I get
back and I want to give my knee a bit of a break. This is the first time I'd be skipping a set of exercises--not a good thing to start.

Week 4, day 4

ROM at work in the afternoon, the usual in the evening. ROM, stretches. 5-min prone hang with a 6lb ankle weight felt a touch too easy, so going to try 8lbs next time around.

Did a 15-minute stationary bike session before leaving work. Everything felt good. Walking keeps getting better, just a touch of limping, sometimes even none. I almost walk better when I don't think about trying to walk properly.

The flexion keeps getting better. A bit more aching in the knee today, I definitely was popping that ibuprofen every 4 hours throughout the day today.

The brace is less bothersome, as the hamstring incision site is no longer painful/irritating. I tighten the top of the calf portion of the brace quite tightly with no pain.

Week 4, day 3

Did ROM exercises at lunch today, then another visit to the PT in the evening. The knee was feeling good this morning.

The knee flexion is doing ever so better, probably better than 135, though we didn't measure. The PT confirmed full extension visually.

Attempted balancing on my right leg at the PT, but felt pressure and some pain on medial side of the knee, so we aborted those. Too early then.

Still no hamstring strength exercises until 11/14, though the PT will ping the Dr about straight leg raises on my stomach, as those work the glutes more.

Used a 2lb ankle weight for straight leg raises and side leg raises. Straight leg raises produced a burn in the hip, on the inside, and some burn in my hip on the outside with side leg raises... so staying with 2lbs for the next visit.

Week 4, day 2: Strer-strips removed and a bruising journey

Took off all the steri-strips tonight! Some of them were just barely hanging on the incision sites, holding on to a little bit of hair, so I just said F it and took them off.

First impression is that the arthroscopic incision sites are barely visible. Given how much dried up blood and "goo" there was on the steri-strips, I expected 4x4mm scab. Instead, it's just a tiny strip, like a little cut.

The only nasty looking thing is the hamstring graft incision, about 1.5" long. That scar will definitely stay with me for a while.

Here's a little photo series between my bruised leg and the not-so-bruised leg and the latest steri-strips-removed leg.

So, bruising and steri-strips after removal:

Week 1, day 6: lots of bruising:



Week 2, day 5: a lot of the bruising has faded:



Week 3, day 7: steri-strips barely hanging on:



Week 4, day 2: steri-strips removed:



Side view, the side arthroscopic cut is probably the most visible one:

Week 4, day 2

Decided to drive the Miata in to work today!

The tricky part is ingress and egress without twisting my right foot.

It's not too bad to plop into it, but getting out is quite tricky. The car is wicked low to the ground and the driver's compartment foot space is small. This makes swinging both feet out AND getting up pretty tricky. Thankfully, the steering wheel being there helps getting on my feet.

It was very nice to drive the convertible top-down though. It was 50 deg in the morning and I went for a lunchtime drive in 65 degree and sunny weather. Not too many days left in New England for this.

Did 15 minutes on the stationary bike at work in the afternoon. Knee felt fine, except for about minute 12, where it felt a bit irriated. Then I did my ROM exercises and stretches at home and walked around a mall for a while. I think this inflamed my knee somewhat, as it felt achy at night. I haven't been taking any ibuprofen today, so I took some before bed. I did ROM exercises, then iced the knee and went to bed.

Only one 5-min prone hang today, in the afternoon. I used 5lb weights and it didn't feel quite heavy enough (it was much more bearable). So that means that I'm getting my full extension, or at least I'm very close to it. I am going to try 6lb or 8lb ankle weights Friday.

Week 4, day 1

Waking in the morning, the knee feels stiff and doesn't quite want to extend all the way or flex much. First steps until after out the shower are limpy.

Everything seems to work better today though! Did a set of ROM exercises at work at noon, before the PT at 5:45pm.

Good progress at the PT! Switched to 1lb ankle weights. Straight leg raises on my back with 1lb seem to generate muscle burn inside my hips instead of on the quads. (I guess that's normal, everything coming back into action...) The side leg raises definitely took a little effort to finish on the last set.

Also, 135 degree flexion! w00t w00t!

And, best of all, it seems I now have full extension! We didn't measure it, but it sure looks that way (and feels that way).

I asked the PT to evaluate my walk, as I still have a touch of a limp. Of course, I walked almost perfect in front of her. It seems that I'm not letting my right leg flex enough (maybe no confidence in it holding?). I tried flexing the knee more and it was better. I had a better gait for the rest of the day. Some times I didn't even think about it and just seemed to walk right! The key is to get to that state all the time.

Week 3, day 7

Another quiet weekend day. Did ROM + prone hangs two times, plus stretches and no-weight straight leg raises.

The marked improvement in flexion is sticking. We'll see how much flexion I gained over the weekend. Also did some patellar mobilization--not sure if it really helps, but can't hurt.

In the morning, walked about 3/4 mile to a diner. The walk was not quite right, still some limp at the end of the flexion. The knee felt a bit tender afterwards. Still trying hard to walk normal.

Week 3, day 6

A quiet day at home. Walking around home doesn't make it that easy to concentrate on the correct gait, as the distances are very short and there aren't more than 3-5 step straights.

Turned in the Game Ready machine today, switching to the CryoCuff for my nightly icing.

Exercises:

Morning: ROM and a 5-min prone hang
Evening: ROM, straight leg lifts on my back, stretches, 3-min prone hang (these have all been with a 5lb ankle weight, but I couldn't keep going for 2 more minutes this evening)

After these ROM exercises, it becomes kinda tender/painful to fully extend the leg while standing. A bit weird. That goes away over time (15-30 mins) though.

It feels like I made good progress tonight with flexion. At the end of the heel slides, my heel was ever so closer to my butt. Let's see if this improved range holds up tomorrow. Before the heel slides, I did some patellar mobilization, focusing on the forward/backward motion. I hope that helped.

Week 3, day 5: I can drive!

At the physical therapy, the therapist watched me walk in my brace without crutches. She approved of the gait--it had just a touch of limp, but seemed OK. Some of the limp felt like it was caused by the pressure of the brace.

So I am now cleared to walk without crutches! I am going to leave one crutch in the car, just in case, if I go to a mall or some crowded place, such that people wouldn't bump into me.

And best of all, I can drive!!

I drove home from work. It was so great to drive again. I have to be a little careful, trying to pivot the foot less and shift it between pedals more. Trying to heel'n'toe downshift less. Still, it's very great to be able to drive again. I really missed it.

Feels like my quads are firing more when I do static quads. So that's a good sign.

Did ROM exercises and a 5-minute prone hang at night before bed.

Week 3, day 4

Still using one crutch, even though I can probably manage without. Trying to pay more attention to turning today and trying not to twist at all on my right foot. I think I didn't pay as much attention to that since Monday, but I hope I didn't mess anything up (I didn't think I twisted far at all, but I was twisting more than I am now).

Tomorrow at the PT, we are going to re-evaluate my walking and see if I can be cleared to walk crutchless. Yesterday, the PT was suggesting using one crutch as a publicly-visible "I'm injured" marker. That makes a lot of sense. I think that when I am walking without a crutch, I may still grab one crutch if I'm going somewhere with a bunch of people.

Afternoon:

Did ROM exercises at work before lunch.

Evening:

Hopped on the stationary bike at work for 10 mins before leaving.

Did ROM exercises, straight leg raises and stretches. Prone hangs for 5 minutes with 5lb ankle weight. (unpleasant!)

Week 3, day 3

Walking seems to be better. I can walk without a crutch decent enough, I think, but still using one crutch to try to make sure the gait is normal.

Woke up with the knee feeling stiff, which makes the first bunch of steps of the day have an awkward gait (knee not extending all the way).

2nd PT visit went well. Was able to do the stationary bike, flexion up to 121 degrees. Extension *feels* like it's almost there, but it isn't. It's better than the original visit for sure.

Did range-of-motion exercises (heel slides and the towel-assisted terminal knee extensions) before bed. Also did a prone hangs for about 5-6 mins with a 5lbs ankle weight! Didn't feel too brutal, so things must be improving.

Week 3, day 2

Slept poorly!

I think the knee got inflamed from all the exercises and the walking. Even though I iced it before bed, I woke up in the middle of the night with the knee aching and not feeling comfortable. It felt warmer than the other knee (inflammation) and I couldn't get in a comfortable position to fall asleep. I popped an ibuprofen. Not sure if that helped, because I only feel asleep some 2 hours later.

Hope this won't happen again tonight.

On the bright side, showered standing up like a normal person!

Needing to use only one crutch is a big boon, as it frees a hand to carry stuff. This is essential (coffee and water at work, stuff at home).

Night update:

Did all the exercises, once after work and range-of-motion exercises 2nd time before bed. Prone hangs with a 2.5 lbs ankle weight at the end of the night.

Week 3, day 1: Evening

The PT assigned the following exercises to be done on a daily basis:

* static quads (5 sec hold), 30 reps, 2x day
* towel-assisted terminal knee extension (10 sec hold, see *A below), 10 reps, 2x day
* active-assisted heel slides (10 sec hold), 10 reps, 2-3x day
* straight leg raises, no weight, 3 sets of 15 reps, 1x day
* side leg raises, no weight, 3 sets of 15 reps, 1x day
* heel raises, 3 sets of 15 reps, 1x a day
* calf stretches, gently (twice, 30 second holds for all stretches)
* towel-assisted hamstring stretches (see *B below), gently
* prone hangs (to straighten), no weight now, but 3-5 lbs later, 3-5 minutes, 2x day

I did all of these before bed! (Obviously, things that are 2x day I did only once)

Let's hope I can follow this schedule every day.

The PT said to do strength (leg raises) every day until we start adding ankle weights, at which point the strength exercises will be done every other day.

Time to ice the knee and hit the hay!

... p.s.:

detail on exercises:

*A - sit on the floor, leg straight, place a towel or belt around the foot. Pull the foot towards myself, lifting it slightly, while pushing the knee down like a quad set.

*B - lay on my back, leg straight, place a towel or belt around the foot. Raise the leg, keeping it straight, pulling towel to assist until a stretch is felt.

Week 3, day 1: First PT appointment

First visit to my PT today. Things are looking good. Still some good strength in quads and hips. Hamstring ain't half bad either. Hurray pre-habilitation! The quad lag that worried me is just a little and is small enough that we are starting on straight leg raises right away. Apparently, the lag is not due to lack of strength, but more due to swelling/fluid interfering with muscle activation and that fluid also getting in the way of movement.

Cold extension 4 deg, flexion 103.

I tried walking with one crutch in the office and did pretty well! So gonna use one crutch for two days (until next PT appointment), while trying to make sure I have proper gait. I was actually able to do some walking with no crutches, but I have a limp. The one crutch makes a huge difference. Gotta concentrate on keeping the knee straight, hitting with the heel and toeing-off with my toes.

The plan is to re-evaluate my walking Wednesday and see if I can go to no crutches. If not Wednesday, then hopefully Friday.

Going to keep going to the PT three times a week for the next two weeks. Then we'll scale it down if things are looking good.

Exercises for home include heel slides, towel-assisted knee straightening/quad set, straight leg raises, side leg raises, heel raises, prone hangs. Also light hamstring stretches and light calf stretches.

The electrical muscle stimulation and ice at the end of the PT visit was brutal. OK, I turned it up to a brutal level, and had to turn it down a few notches. Between the pain/discomfort of extending the knee (my heel was propped up) and the electro-stim intensity, it was not a comfortable last 10 minutes. However, it is all good for me!

Week 3, day 1: Morning

Woke up, waiting for a ride to work.

Starting to put weight on the right foot and it feels weird! Clearly, weaning off crutches won't be instant here. Going to start with two today, putting more weight on the foot. My leg feels like it will give out easy. The first couple of steps felt strange on the foot.

At work, keeping my heel propped up on a little heater pad, or top of a neighbor's computer, trying to keep the knee in extension as much as I can tolerate.

Week 2, day 7: Evening

Last day of CPM. Got about good 4 hours in it today.

Exercises:

2x knee straightening, going to try to get one more set in before bed (like I did last night).
Some quad sets, maybe 10-15 reps, but they just don't feel strong.

I've been more or less dropping the ball on the quad sets. I hope that the PT will check my form and give me specific instructions (how many sets and reps per day). That will make it easier to follow.

So, first day of PT tomorrow, looking forward to it! Also re-learning how to walk starts tomorrow.

Night update: did one more knee straightening set, then did about 5 mins worth of prone hangs. Damn those hurt too. Couldn't do a whole 5 min hang in one go, and this is without any weight on the ankle.

Week 2, day 6: Evening

Slept much better without the brace! Hurray comfort.

Got outside again today, got driven around in my Miata by my friend. Incidentally, he also did the car justice and we experienced some nice G's. My crutches didn't fly out, so that's cool too!

Occasional ache comes and goes in the knee. About to risk it by going to a friend-of-a-friend's party in Somerville. I bet money the apartment will be on the stairs of the 3rd floor of a narrow, steep staircase with no railings. Still, I'm just going to try to be really careful.

Exercises:

Did two 2x of knee extension (sit down, straighten out leg, push knee/thigh down). 10 seconds each. This exercise works much better on the flat floor than the couch (too much room for error). I got the bottom of my knee to start feeling the carpet, so I definitely made a degree or two improvement tonight.

Oh by the way, DAMN it's painful to do! I tried to push it down to a pain threshold, the kind where I swear out loud. I almost got a tear in my eye going by the 9th rep. But hey, I got a few degrees out of looks like, hope it stays that way.

I also attempted another set of quad sets, but I think I may be doing them wrong. Am I supposed to put a towel under the knee to have something to push against? I think so, I'll look it up later.

Bad news: maybe due to the extra extension, I now have noticeable quad lag! OMG weak! Looking at it, it's gotta be about 5-7 degrees. I think it's because I have added several degrees extension, and probably because my quads keep getting weaker anyway.

It's really weird to have quad lag that's so noticeable! I sit there and it's like I can't do anything about that. I tighten the quads, but it's not enough.

Physical therapy cat says:


Hoping I can get another set of knee straightening and quad setting in before bed.

Also, my right leg is noticeably thinner than the left leg. It looks weird.

Week 2, day 5: Doctor Followup

Today was the first follow-up with my orthopedic surgeon.

He said that my knee is looking great. The steri-strips are going to fall off on their own and the stitches are buried deep inside and will not need to be taken out. He did mention earlier that the steri-strips can get wet, but I am going to stop wrapping my knee in saran wrap.

I asked the burning questions: when am I going off crutches and when am I driving?

So, I am getting off the crutches starting Monday, using the protocol of two crutches, then one crutch then zero until I can walk without crutches.

I cannot drive until I cannot walk without crutches. The time to learn to walk again is anywhere from 1 to 2 weeks, so I am looking at one more week of not driving (boo!).

I must work on getting terminal knee extension. Towel under heel and all that good stuff. Prone hangs. I'm gonna get this baby straight.

The surgeon showed me intraoperative pictures. I am going to post those later. Those were cool! All my meniscuses are clean as a whistle. I can see the new ACL.

I'm only now wearing the brace while walking and not during sleep! Hurray! Sleep without brace FTMFW.

Physical therapy starts Monday. The doctor wrote a script for the PT, which includes no hamstring strength until Nov 14th.

I asked the doctor which tendons he took. He said he took the semitendinosus and gracilis tendons. He said since it's the tendons and not muscle, they will regenerate and I will have full strength of my hamstrings back. w00t!

I asked the doctor about what I felt was the poor fitment of the brace. He said that I should cut off one of the tightening straps that's right over the incision and just use the large tightening straps. Also, he explained that the function of the brace is three-fold: 1) to protect me in case of a fall, 2) to signal to others that I'm injured (VERY interesting! Didn't think of this!), and 3) to make it awkward to move around, to force me to be more careful. I can understand point #3: basically, while the brace is on, I know I should be careful not to twist or do anything stupid that may jeopardize the ACL.

One thing that he mentioned is that because the ACL surgery has advanced so much and is now less painful, people are inclined to try to be more active than they can be. Hence, the one function of the brace to remind me that I am still healing.

I only should continue the CPM machine use until Monday (I'll see if I can get it picked up Monday night).

The icing regimen is just once a day, after physical therapy or before going to sleep.

So!

I am a bit disappointed that I can't drive for another week. I hope it only takes one week (or less!) for me to learn to walk.

Time to get that knee extension back. Terminal knee extension exercises (towel under heel, push knee down) 10 repititions of count to 10, 3 times a day.

Week 2, day 5: Morning

Slept right thru my alarm. Oops! Slept decently well. Had the top strap of the calf portion looser on the brace, so it could move around up and down, rubbing less against my incision site.

Going to see the Dr soon! Will post details on what happened in the followup visit.

Week 2, day 4: Afternoon

Couldn't sleep worth anything. Readjusted the brace three times at 5am, made a bathroom trip. Between everything, that seemed to work and slept until 10am.

Accidentally put weight on the ACL leg AGAIN today. Twice, once was just a bit more than touchdown weight, so not too bad, but 2nd time was like a good amount of weight. Not full body weight, but probably a good half. Crap. Hope that doesn't mess anything up.

Week 2, day 3

Another quiet day in the CPM machine.

The knee seems to be less swollen and there's less bruising. The inflamed hot spot to the left of the kneecap is not hot anymore, just barely warmer. Feeling some random aches inside though. Popping a 200mg ibuprofen every 4-6 hours.

Icing nowhere near as frequently now, just like about 2-3 times in the morning, maybe another 1-2 times after. Forgot to do my quad sets earlier today, will do those soon.

My right thing really is looking considerably skinnier. It's really weird. I haven't seen it so skinny since before college.

Week 2, day 2: Evening

My sister came over to visit this afternoon. I suggested we go somewhere, because I've been inside the house since the surgery and I needed to get the heck out. I was starting to get sick of spending all this time on my couch.

It was real nice to go outside! F this couch! It was warm and cloudy out. Fitting into the passenger seat was no problem, as I have about 90-95 deg flexion easy now. I moved the seat all the way back and that gave me enough room to flex the leg in.

We drove up to pick up my dry cleaning (been hanging out there for 2 weeks now) and grab some dinner with some beers.

Speaking of beer, I had my first post-op beer Sunday, after I decided to stop taking Percocet. It was a Weyerbacher Slam Dunkel. I followed that up with a Victory Prima Pils. Mmm mmm delicious!

Crutching around for a short distance was fine, from car to restaurant and such--seemed easy enough. However, I did have a stumble where I put more than touch-down bearing weight on my right foot! I lost my balance a little getting out of the car and put about quarter weight or something like that on the right leg. It was certainly not full weight, but it was more than touch down as well. I hope that didn't mess anything up. This is the only such incident so far. I was more careful after that. (And this was before the beers too!)

We decided to take a stroll down the nearby mall, to kill some time before a movie. So I ambulated over a half mile on crutches. Holy arm workout! I'm going to be feeling *sore* tomorrow! I sweat easy and so I had a wet shirt by the time we got to the other end of the mall. My shoulders were certainly not used to this either and my arms were yelling "wtf are you doing buddy?!" And I still had to make my way back! After that, I wasn't feeling a movie.

We decided to go to Starbucks instead and just relax, so my sister took an initiative (as usual) to take some pictures of my sweaty self. So here I am, after over a half mile of crutching:





Yeah, I sweated a lot:



We saw a funny label on one of the machines:



I can't imagine doing 6 weeks of non-weight bearing, as is the case in many knee surgeries that require meniscus-related procedures. I have 3 more days before the follow-up with the surgeon, where I will hopefully get to drop my crutches.

Finally, my sister mentioned an interesting tidbit that happened in the pre-operation room on the day of the surgery. When the surgeon walked in, I had a list of questions prepared to ask. This was moments before I got the "six pack of beer" IV injection and was carted off. I was told that I'd have the opportunity to ask the Dr questions before the operation, so this was it. According to my sister, when the surgeon saw me clutching a paper with a list of questions, he gave one of the nurses a "here we go, what's he got here?" kinda look. As in "can you believe he has a list there" type of look. Just a funny tidbit.

Week 2, day 2: Morning

Slept better yet. Seemed to have found a better position for the brace. When I am up and crutching around, however, the foam still rubs on top of the incision. Unpleasant!

Can't wait to get off the crutches! I really hope that with the Friday's visit to the orthopedic surgeon, I'll be cleared to wean off them. I do feel car-ready (even now), as I have full ankle control and I have enough flex, it seems, to punch the brake pedal and blip the throttle on downshifts. I noticed that the car-unreadiness that I felt before was after a 30 min icing session, where some of my calf was ice cold and not quite ready for flexing.

No painkillers last night either, only took two Motrins before bed. Pain level was low, so hurray. Still got pretty brutal looking bruising on the knee. As long as that's normal, I don't care, it's just not pretty to look at.

Week 2, day 1

It's been a week since surgery. The swelling has come down a good amount and the knee feels better overall. Of course, compared to my left knee, the right knee is still pretty darn swollen.

Last night was the first night without Percocet. I had a hard time falling asleep, I felt hyper/not tired. This was probably due to me sleeping in until 11:30am on Sunday. I can't seem to get the brace on just quite right. The edge of the upper portion of the calf sleeve is right around an incision site, and so it has the potential to rub right against it. I woke up in the middle of the night with my hamstring sore at the top of the tibia. I rolled over a few times and the soreness seemed to move into the upper portion of the hamstrings. The knee was throbbing. I would say about 5/10 pain scale between everything. The brace felt awkward.

I got up at 7am and took two 200mg Advils with a bunch of water. At about 7:30, the pain seemed to sort itself out and it was much more tolerable. I then felt around the hinges of the ACL brace and they seemed to be a good half-inch below the knee hinge point. I looked at the brace and it slid down over the course of the night. I realigned the brace, this time going a bit higher on the calf (still trying to center the brace hinge with the knee). I tightened the calf straps much more. It seemed less painful to do that now (again, because there is that incision site under the top strap of the calf) and I tried to spread the tightening force by making the main wrap-around foam part as tight as I could (before tightening it more with the strap). This seemed to do the trick. I went back to sleep and woke up at 10:30am, much better slept. I ignored my 9am alarm. Working from home today, but I can afford to sleep in.

So technically, last night could argue for not dropping Percs. However, I'll try one more night, with a more careful brace fitment, and some ibuprofen before bed. Let's see what happens.

Quads.

So the quads on the right side are noticeably smaller. I wrote earlier that I had 0 quad lag, but I think that's wishful thinking. I must have around 1-2 degrees quad lag (nothing major like 10 degrees though1), as the heel definitely lags a touch when I fit the leg. I think it has actually gotten a touch worse since Saturday, but that could just be my imagination.

I read this interesting article that basically states that muscle atrophy and failure of voluntary muscle activation explains 85% loss of the quadriceps strength. Specifically, "[analysis] revealed that failure of voluntary activation contributed nearly twice as much as atrophy did to the loss of quadriceps strength."

So basically, my muscles are there, they are not just being activated.

Week 1, day 7

Woke up with the knee feeling better than ever, flexed itself more easily with less stiffness. Still took a Perc overnight, debating dropping that entirely now.

Another day of ice and CPM.

Week 1, day 6: Morning

Slept better than most night I'd say, though not as careful with the foot propping up on a pillow or the sleeping position otherwise. Had some fluid swelling mostly on the bottom left side of the knee, closer to the thigh.

No significant pain while sleeping, though the top of the brace is right against the 1.5"-long hamstring incision, so it's creating some friction pressure/discomfort there. I think that's the biggest source of pain (and that's more like burning/irritation, rather than pain). At least it's rubbing against the steri-strips and not the wound itself.

Took the Motrin ibuprofen (200mg), that should be OK getting me through the day.

Into the ice machine and CPM machine!

Also, all the bruising on the knee is really coming through becoming quite visible now! Looks like someone bludgeoned my knee.

I can see why driving is unadvised for a while. Tapping my foot to the music in the CPM machine is not quite as controlled as it needs to be. Whoa definitely weird! (This seemed easier to do yesterday though?)

Week 1, day 5: Evening

Pain management: feeling pretty good. No narcotics all day today, only took a Percocet just now before bed (just in case something starts throbbing in the middle of the night). Took a Motrin in the morning and the evening and that took off a little ache in the knee.

Been icing with Game Ready pretty much all day (about 10 hrs each day since the surgery). Been following the medium pressure 30 min ice, 30 min off cycle. Definitely notice a decrease in swelling after the first icing session of the day.

5-10 minutes after icing, I can feel the swollen areas get warm to touch. By 30 minutes, they feel pretty hot. That's kinda weird, but that also explains why cryotherapy helps. Yesterday my hot areas (towards the center of the body, left of the patella) seemed to get hot quicker after icing than today. Hopefully, this means that the swelling is going down.

Spent about 8-9 hours in the CPM today (lost count). It took a touch more effort/pain to hit 110 deg on the CPM today (and I'm not sure if it actually went all the way there... but it was 100+), maybe because I haven't been setting it to 110 for a few days now and also because the Percocet wore off.

Did three sets of static quads (12 reps each, holding about 10 seconds) throughout the day. Also followed up with a bit of a straight leg raise, while locking the knee out. So it's kinda like a static quad, but with a bit of a raise of the heel. It does take some effort to lock the knee, but it happens, and I think I should be good for proper straight leg raises now. It seems that by now I have very little to no "quad lag".

Feel a little lazy just icing and CPMing and quad settings all day long. Could I be doing more? Should I be doing more? If nothing else, I am at least definitely following the Dr's orders. The follow-up visit is in a week, Sep 25.

Week 1, day 5: Morning

Woke up with the knee feeling better/less swollen than most days so far. Slept better. Took only one Perc for the night. This morning, going to skip Percs and see whether the pain kicks in. Took a Motrin IB as a substitute.

I managed to take a decent shower with some saran wrap around the brace and a Home Depot 5-gal bucket as a shower seat. It was a complicated orchestration of steps, but seems like it should do the job fine for now.

One benefit of the 5-gal bucket is that, unlike a proper shower chair, it moves around the tub some, which compensates for the fixed showerhead.

Week 1, day 4: Afternoon

In between the 30-minute ice cycles with the ice machine, I attempted to do some quad sets against a heel propped on the side of the couch. I guess this would be the real quad sets, trying to get that heel lifted up, attempting to keep the knee locked. They are hard! I did a set of 15 earlier and then another set just now, and I barely have enough strength to keep that knee locked.

Going to spend another 8+ hours in the CPM today, but today going to do more quad sets. I realized that tightening the quad muscle on the CPM machine at the 0 position is not quite the same as doing a proper quad set with the knee fully extended.

I can definitely feel the hamstring graft when I mistakenly bend a bit too far forward and cause a hamstring stretch. Ow!

The knee is looking a touch less swollen now, and the surgical incision sites look not quite so gross in daylight.

Will attempt to consume fewer Percs today. Will attempt two in the morning and two before bed. Yesterday, I did two morning, one afternoon and two before bed.

Week 1, day 4: Morning and outer dressing removal

Woke up feeling better this morning, the knee didn't feel quite as swollen. Went downstairs for another day of CPM and ice.

Last night, took off the outside dressing, leaving only the steri-strips. It looks gross. Before, sock removed, dressing removed (the longer incision on the top of the photo is the hamstring graft site), a side-view of the removed dressing.

Week 1, day 3: Afternoon

After the morning Percs, breakfast and plenty of icing really helped out the comfort of the knee. Feeling much better than when I woke up.

Strapped in the CPM machine for a good 6 hours today, trying to do quad sets as the machine comes down. Probably doing about 8-10 static quads per hour or two.

I get to take off the outer dressing today. I expect the result to look well nasty.

Week 1, day 3: Morning

Slept so-so. Went to bed at 1:30, woke up at 6:30 for a bathroom break, then got up at about 8:30. Was sleeping on my left side with a pillow in between, trying to keep the swollen knee elevated above the heart.

The brace feels strange. Perhaps it's the swelling and it's pushing down on the knee a bit too much, but it just doesn't feel that comfortable or freely-mobile.

Woke up with more swelling (not measured, just by feel) and more stiffness this morning. Back in the CPM machine now and icing.

Popped another two Percs. I think I still need them, but yesterday I at least managed a 10mg less dose (only took it 3 times yesterday).

Hope the swelling goes down soon.

Pre-surgery: physical therapy pre-hab

When I found out I had a torn ACL, a week after the injury, I began attending physical therapy, 1.5 weeks after the injury, for the duration of 2.5 weeks before the surgery.

A friend of mine had an ACL tear and he alerted me of the importance of pre-surgery PT. His surgeon said he didn't have to do anything in particular leading up to the surgery and said that it was OK to wait two months. Over that time, his tendons and ligaments tensed up from the lack of the range of motion (the bundled-up torn ACL restricting that motion). After the surgery, my friend's physical therapist had to spend 1.5 months forcibly stretching out his knee. He was also on crutches for longer than necessary.

I e-mailed my surgeon the same day I found out it was an ACL tear, asking about the pre-hab. My surgeon agreed that pre-hab would be great and quickly forwarded a script to the PT office that I've been going to.

When I got the 2nd opinion on my ACL tear surgery, it was from a highly-recommended surgeon. This surgeon immediately told me that getting the full knee extension back as soon as possible was important (pre-surgery).

In the light of this information, it strikes me that the surgeon that my hapless two-months-of-no-PT friend had is not that good of a surgeon. So now you know folks, do pre-habiliation PT before your surgery.

As far as my own pre-hab physical therapy goes, I've already been attending an excellent local PT office for an running overuse knee injury. So, I've actually ended up having a good amount of quad strength built up as a result of doing the PT for that. This already put me in a favorable position for recovery.

We worked on getting my knee flexion and extension back. I started with 107 degrees flexion on my first visit and ended up with full flexion (something like 147 deg) in several days of doing heel slide exercises. I also recovered a bunch of knee extension via towel pulls and hanging my knee off the bed with ankle weights on it. I almost got to zero extension (perhaps bits of ACL still in there preventing from me being able to fully lock my knee).

I also was surprised to find that, post-tear, I lost some quad strength. At first, it took me some effort to do 2-lbs straight leg lifts, whereas I was up to 7-8 lbs pre-injury. I could also definitely feel my left leg having much more quad strength than my injured right leg. I progressed back up to 6 lbs in 2.5 weeks. I also performed balancing exercises, ball squats and a bunch of other good stuff.

I hope that all of this pre-hab poised me for a quick recovery. F that, I want a phenomenal recovery. I got a stronger-than-stock ACL now, and I am coming back stronger than ever!

Recovery schedule

These are the recovery milestones we are shooting for. Obviously, subject to change based on PT results and doctor eval, but everything goes well, we are looking at:

2009
Sep 28 (2 weeks) Off crutches: also start PT. 
Oct 26 (6 weeks) Back to the gym: stationary bike, elliptical, weights, etc.
Dec 7 (12 weeks) Running.

2010
Mar 1 (24 weeks) Back to sport: full recovery.

Week 1, day 2: Evening

Spending my 8th hour in the CPM and the ice machine. Family came over to visit from 11am until 6:30. Stuffed with delicious food.

The surgeon called to follow up. I gave him a rundown of everything I've been doing. He said that the CPM is just to keep the knee moving and doesn't really need to go past 90 degrees. So the script is to ice, CPM and quad until I see the doctor in about 10 days.

Restocked on ice and threw some water bottles in the freezer. Looking to keep the icing to the max and keeping the CPM going.

So, life on the couch, with the laptop. I'm definitely going to need to work from home next week, maybe even start earlier than I planned, since the boredom is probably going to get the best of me.

On the bright side, I have several friends dropping by for lunch and dinner over the next 10 days!

Week 1, day 2: Morning after surgery

Woke up, too early, but with no pain, really. Managed to sleep the whole night on my left side, with a pillow between my legs to ensure that the right knee stayed elevated above the heart.

I got a call from the hospital recovery staff nurse this morning. I told her I have no pain (so the Percs must be working) and she suggested to stay on a regular Percocet schedule for today. No other problems.

As I'm laying in my bed with my knee propped up, I am experiencing a little pain/some discomfort as the knee extends.

Waiting for the Dr's call. Going to make my way downstairs soon and get into the CPM.

Week 1, day 1: Rehab

When I got home around 5pm, I strapped myself into the CPM machine and had my sister help me get the Game Ready system going, with the articulated knee wrap. I put the ice machine on medium pressure and that seemed comfortable enough.

I did CPM for about 5 hours. I was able to quickly get to 60 and 80 degrees flexion. I left it at that, while letting the Game Ready ice/compress for 30 minutes and then take a break for 30 minutes.

I got to 110 degrees flexion without pain, and it seemed as though I didn't have to force it. Of course, this is a CPM machine on my couch, so a heel slide may tell a different story. My surgeon said that my hamstring will be sore, making the heel slides a little tricky.

I spent 5 hours in the CPM machine, though the dr only recommended 2-4 hrs. I was icing/compressing half the time (30 min on / 30 min off cycle). At some point I realized that I should be doing quad sets (static quads) on the 0 position of the CPM machine, while pushing the middle my kneecap down a bit. So I would do one quad set a minute or so. I ended up doing only about 30-40, but I hope that it will make a difference.

I popped a Percocet at 7pm and then again at midnight, before bed.

However, I then stayed up and used the Game Ready straight knee wrap to ice/compress for another 2 hours (same 30 min cycle). I also realized that I haven't been doing anything to get knee extension, so I ended up resting the heel (and heel/calf) on a pillow. This also kept it elevated above the heart. I had to alternate between a heel and a heel/calf because heel-support only was getting a touch too painful at times.

I attempted straight leg raises, and they seemed to be OK! I had the straight knee ice wrap on, granted, and haven't attempted that in a brace, but I did 3 sets of 15 and it seemed alright. I could feel my quad working a bit.

4 minutes until the Game Ready shuts off and then I'm going to sleep in the brace only. I could've slept in the Game Ready (but I don't know if I would've fallen alseep), but I think the safety of the post-op brace is worth not having the knee iced for the duration of my sleep.

The knee is still swollen, but I feel like I am making good progress on the day of the surgery. My surgeon calls tomorrow and we'll see if I'm on the right track.

Week 1, day 1: Surgery

The surgery went great! My sister is the best and helped me out immensely today and yesterday. She also took a bunch of pictures of me, so I could embarrass myself in front of all the Internets. I also have a newfound appreciation for all the medical staff. Big ups!

About 1.5 hrs before the scheduled surgery time (of 11am), I was called into the pre-op room and asked to change into a gown and put on these nifty non-slip socks. I've come to appreciate these socks on crutches.

After signing some more papers, the pre-op person (not a nurse? maybe a nurse?) called up an anesthesiologist. This was me, waiting:



The pre-op person explained to me the entire process. IV, signing papers, talking to the anesthesiologist team, talking to the doctor, the "two glasses of wine" relaxing injection, the operation and then the two phases of recovery.

After a little while in the pre-op room, I did begin getting nervous and was looking forward to the "two glasses of wine." When the time came to inject that, the anesthesiologist joked that it was more like a six-pack of beer. (We then joked about what kind of beer it would be.) This stuff worked pretty well and pretty much instantly gave me that "happy yay!!!" feeling. Thumbs up!

I have great veins, as per the anesthesiologist. Hence, she used a 16 gauge needle, in my hand. Damn, 16 gauge is the gauge of speaker wire! (that I often run here and there)

A rep from an orthotics company came over and fit my knee brace to me. It's a Bledsoe OR Post-Op Knee Brace. It's a pretty nifty brace in that it has pretty simple controls for extension and knee flexion limits, as well as a locking mechanism.

This picture shows a touch much leg, so close your eyes, lest you be blinded by the pasty whiteness:



Of course, I had to test drive it:



An assistant to the surgeon came out, for some Q&A. This was when the correct knee was marked and I ended upt having to ask the surgeon whether they mark the correct knee.



Having had only 5-6 hours of sleep, the tiredness began hitting me, but I was ready to rock:



The "six pack of beer" injection took place, my the surgeon, the rest of the team and the interns observing the surgery all gathered round. They carted my jolly self off to the op room.

I remember helping them transferring myself over on the operating table, complying with a "move just a bit over" request and then, bam, I was out.

Post-operation, I woke up in the recovery room, phase I, my knee sore and hurting a darn good amount. Even though there was a tube inserted down my throat, but my throat wasn't (and still isn't) sore.

The surgeon gave me two Percocets (the painkiller prescribed to me) and then gave me an IV painkiller. The pain didn't seem to be coming down sufficiently fast over 15 minutes, so a little more painkiller was administered over IV. This seemed to do the trick enough to make the pain closer to tolerable.

I was then discharged into recovery room II. At this point, the pain became tolerable. I had my CryoCuff ice machine on and the nurse refreshed the water. My sister was called back in and the taking of the photos resumed. Horns up!



I brought my own crutches (the ones I got with the ER visit) and the nurse in the recovery room went over the crutching with me. Even though I've already done some crutching a month ago, this time it is ever so important not to put weight on the right leg (against the doctor's orders).

The nurse was very helpful in readjusting the crutches and showing me proper sitting down and getting up technique.



To finish it off on a grosser note, here's an artsy shot with some blood in the IV tube:



After this was removed, I was wheel chaired out to my awesome yellow hatchback and my sister drove me home, while blasting my favorite tunes. It was a beautiful 75 degree day out.

In the waiting room pre-surgery

Waiting at the Shapiro Clinical Center of the Beth Israel Deaconess Medical Center. Actually feeling nervous now. T minus 2 hours.

TV is showing Regis and Kelly--it feels like anesthesia for your brain.

Planning on asking the doctor a bunch of questions, mostly about rehab, but also about whether they will mark the correct knee. I bet he will be pleased with that question.

The night before the surgery

The surgery is tomorrow at 11am. My room is cleaned, with lots more space for crutching. My sister is helping me out immensely, especially tomorrow, driving me back from the surgery and helping me set up my daytime continuous passive motion (CPM) machine and ice machine setup.

I'm feeling a touch nervous, maybe a touch anxious, but the anxiety hasn't really hit me yet. I think I will be plenty sleepy tomorrow, as I'm getting less than 6 hrs of sleep before. This may be a good thing for anesthesia, though it probably makes no difference.

I decided to start the drink-nothing eat-nothing protocol just a little bit earlier, at 9:30pm, instead of midnight, just in case.

My sister will pick me up in my yellow Protege5. That is nice, because I love that car and it's one of those familiar things that will feel like home right away. I'm going to set up a favorite album ready to play for the way back. In a way, I am looking forward to getting into that car and sailing away home, to good music.

I don't know how I'll react to the pain (and how much pain there will be). Will I be cranky? I hope not.

Oh yeah, and paid a little too much for a 60-capsule set of 50mg Colace. Given that you're supposed to take 1-3 capsules daily, 60 count is definitely overkill. (Though I just jinxed it).

Surgery selection

My surgery is on Monday September 14th.

I opted for the hamstring autograft. My orthopedic surgeon did not have a strong preference in the type of the graft, but did note that the hamstring graft (vs an allograft) tends to be stronger. Another doctor (I went to a 2nd surgeon for a 2nd opinion) mentioned that hamstrings tend to have a slightly higher success rate in young people. (I am almost 27).

Another factor was that the hamstring will retain 95% of its strength. This is difficult to distinguish, I'm sure, and I should be able to train the hamstring to have essentially equal strength (I doubt I will ever reach full strength capacity in either of my hamstrings anyway).

I will be going under general anesthesia, which I've done once earlier this year for wisdom tooth removal. I'm not sure whether they are going to give me Vicodin or Percocet for painkillers, but I need to remember to buy some over-the-counter laxatives just in case.

Machinery Delivered

Today, I accepted the delivery of the Continuous Passive Motion machine, which is going to move my knee for me for some 6-8 hours of day (supposedly, haven't received the instructions yet). The rental of this machine is covered entirely by my insurance.





I also opted for a higher-end ice/compression machine, Game Ready. This was delivered as well this morning. It will cost me $250 for 3 week rental (4 weeks if needed), but the PT likes it, and so I'm willing to pay that, if not at least for the increased level of comfort.

MRI Imagery

The MRI imagery revealed a full tear. Shown below is the sagittal view of the knee, PD and T2 imaging. Click on the image for a full size.

Otherwise, there is a bit of a meniscus tear, but nothing to worry about. Everything else looks clean.



After getting these images, I spent hours searching the web and comparing these to pictures of normal ACLs.

Other images in my MRI also show impact spots, where one bone moved and struck the other bone during the tear. The bone seems to have travelled unbelievably far, but that's what the doctors believe happened.

The MRI viewer is cool in that it also shows 3D views, made out of the image slices. I couldn't get too much useful info out of those, but I am also not an orthopedic surgeon.

The diagnosis

Oh so anxious! What is going on? What did I tear? Torn meniscus? MCL? ACL?

I scheduled an appointment with my orthopedist in Brookline for Tuesday, 7:30am, 3 days after the injury. The ortho felt up the knee and said that I probably tore something, ordering an MRI. I ended up scheduling the MRI for Thursday morning (not as early as I wanted). I was hoping it'd be early enough to get the results by Friday afternoon. Unfortunately, the doctor was out Friday and I only got the word of the results Monday morning.

My mind messed with me in the MRI machine, making it difficult to lie still. At first, it is easy enough. 10-15 minutes into it, I was getting little muscle twitches and realizing that I just tightened some muscles. Still, a cool experience. The MRI machine made lots of weird noises, which, no doubt, would make a cool song.

Monday morning I got an e-mail note from the doctor stating that it's an ACL tear. I scheduled an appointment, earliest available was Thursday, to discuss the results. My anxiety has now come down and I could now begin to prepare mentally.

At the Thursday appointment, the doctor went over the MRI results and discussed the surgical option and its recovery timeframes.

An ACL is torn

I have a full tear of the anterior cruciate ligament in my right knee.

So what kind of glorious, intense activity led to the tear? Was I injured playing basketball? No. Soccer? No. Any kind of sport? No. Kicking puppies? No.

Alas, the moment of un-glory was the dancefloor at a friend's wedding on one Saturday night, August 15th. After tolerating a typically mediocre wedding dance selection and spending most of my time chatting with people, I decided seize the night and dance for at least a little bit. When else do I get to get down wearing a suit? Almost never.

The DJ, by this time, has switched to tolerable top-4o hiphop. I stepped out to "Get Low" by Flo-Rida ("and then she hit the floor"). Alright, not feeling it that much, but at least it's a strong beat with a little syncopation. One or two more songs of the same, and then the DJ dropped the "Rockafeller Skank" by Fatboy Slim ("Funk Soul Brother check it out now"). A-ha, that's my tune right there! Big beat breaks, groovy basslines, time to get down.

Turns out, this was my undoing. I was into it, doing some toprock moves, switching both my feet back and forth simultaneously. At some point, I remember landing on both my feet, my left foot behind me, my right foot ahead of me. As I landed, I felt a snap.

The snap was in my right knee; I felt the top part of my leg move, while the bottom part stayed in place. It was really strange. My first thought was: "that's not supposed to happen! Something just broke!"

I attempted to continue dancing, but the right leg felt strange and I couldn't push off it easily, it felt like it was giving way. There was no instant pain, only that "something ain't right" feeling. There was no instant swelling.

I told the groom "I think I just tore something!" He said: "Go big or go home!" Fair enough--I went big, then had to go home.

I drove home, with my knee feeling achy. I limped a little into my bed and woke up the next day with the knee swollen a bit. I was unable to flex my knee past 90 degrees without pain. I also couldn't extend it straight. Something was wrong.

To go to the local ER, I attempted to get into my Miata, but was unable to flex the knee enough to get the right leg inside the cabin. (Later, I figured out that I could've just moved the seat back). Thankfully, I was able to get in into my Protege5 (an econobox hatchback) and was able to drive myself to the ER.

Hobble was the name of the game. I was afraid to set my foot flat (as that would imply greater knee extension), so I kept the right foot on my toes. This definitely worked my right calf.

I remember hobbling around from registration to triage to the doctor. Every time, the nurse offered a wheel chair and I refused, saying "I'll just hobble around." The nurse replied with "we can fix your knee, but we can't fix your pride."

I was given a knee immobilizer and crutches. I spent the rest of Sunday icing the knee and staying off the right leg.