Run away Revovery!

After months of not running, two ACL surgeries, and months of recovery, I finally took that first step and left the other foot in the air. 

I have a team of doctors, physical therapists, and surgeons I've worked with from day 1 of the injury in July 2014 to now, and they all have different opinions. I have heard "you can't run yet" to "do whatever you want, safely". Thank goodness I have a degree in kinesiology and know my body well! While no one, me most of all, wants to see me reinjure my knee, we all want to see progress. I was stalling. So I took matters into my own hands and hoped years of muscle memory could help get me over this plateau. I started with walking. Then jogged 10 feet, then 100 feet, a week later I jogged a little farther. Each time my stride evened out and I felt less awkward. 

Today, I jogged a full mile without stopping. It was slow, but it is progress! I'm sticking to flat land, going straight, and icing and stretching and still lots of bike riding but I am doing it. My knee is actually feeling better for it too. I usually give 24-36 hours rest in between and I listen to my body, I'm not interested in pushing too many boundaries at once. Jogging lit up EVERY muscle and I've been resting like crazy too. 

I feel like so many of these blogs are full of while I can do this, I still CANT do ... So I wanted a completely positive one. The journey to a fully healed knee is still a long one but I am getting past pain and despair and back to trusting my muscles, strengthening them, and a better state of mind each day. Don't give up! I'm still in PT and I get massages regularly as well as dry needling. But progress is being made! 

I even signed up for a fun 5k in July :) 

Slow Progress is still Progress

I'm officially 6 weeks post from acl surgery #2. My knee definitely needs more, to around 125-130 degrees flexion and between 2-5 degrees extension. My life revolves around pt, stretching, strengthening, and hoping for nice weather. 

Some of the best helpers have been super long static stretches: I contort myself on the couch, grab a book, and keep that knee bent at least 10 minutes. I slowly uncurl, and then switch to extension. I do this everyday for 20-60 minutes. 

I might as well be Lance Armstrong for how much time I spend on the bike. Every day, without fail, at least 20 minutes. I've also incorporated the treadmill and elliptical back in as well. I do light strengthening exercises, and various stretches. 

I got a deep tissue massage. While it hurt like hell, it was worth it. I woke up the following morning and everything hurt BUT my knee. I'm also giving heat when I I wake up a try and I'm still icing as needed. 

I have a LONG way to go still, and until I can hit 135 degrees of flexion and 0 degrees extension actively- I'm not good enough. Dry needling has resumed and I have more deep tissue massages scheduled! I stretch 3+ times a day, and I'm still taking Valium at night to help the muscles relax. My knee joint doesn't hurt. It's the lateral hamstring tendon that's unhappy as well as surrounding muscles. Putting pressure or direct weight on my knee is tender, but daily scar tissue massage done by yours truly has significantly helped. I'm cleared to try jogging so I think that I might attempt that next week! 

Doing the child's pose stretch hurts but it's easy to gauge progress and allows you to use your arms to push back. Breathe! Go slow and allow gravity to help. 

A yoga rope, foam roller, and my cousin to help push me into a deeper stretch have definitely been a huge help towards recovery! 

Bending and reading! Can also be done while watching TV or relaxing. Bend every chance you get! 

Manual Manipulation and Debribement; Post op: 2 weeks

   So last blog, 2 days out, was a bad day. My first week out of surgery was pretty rough. It had to be. We had to keep that knee bending. Sorry for the lapse in updates, but the first week post op was pretty much a lot of the same.
   Week 1: work on ROM. Bend. Straighten. Scream. Breathe. Repeat. I slept, a lot. I spent a lot of time in my CPM machine. I ate a lot of really healthy, healing promoting foods. I got out of the house in small doses and I kept my spirits up. Huge thanks to Claire, my cousin and caretaker through this 2nd recovery. She has been the upbeat attitude I need most when I struggle with my knee and she is always willing (maybe more than willing) to lend a hand and force bend it when I was being a baby about it.

Claire took great care of me!

    I was off crutches after 2 days. We really just needed to make sure the nerve blocks wore off so I wouldn't tumble down. I was doing stairs pretty well and getting around quickly enough 3 days post op. I was not babying my knee this time around! This was also a much less invasive surgery. But, still surgery nonetheless. If I wasn't sleeping, eating, stretching, or at PT, I was icing. Ice is nice. Always. I stopped all pain killers after 4 days, and just went to ibuprofen for pain.

Steri strips and bandages off; 5 days post op

    Week 2: back to work! I can walk, without a limp! Which means my extension has improved greatly. My leg would get stiff as the day went on, but I kept on moving it. I woke up at 4am to use my CPM before work, crawled back into it after work, and again before bed on top of my manual stretching.
   My follow up with the surgeon was 10 days post op. My knee mechanics are good, it's my muscles having the trouble. I still have trouble with flexion but it gets better every day. I still have to take a muscle relaxer at night because I have mild tendonitis of the hamstring, and my muscles just don't relax otherwise. I take that, let it kick in, and stretch the hell out of it before I fall asleep.
   I was also cleared to start doing quad strengthening exercises. All in all, things are looking up! My knee still gets stiff at the end of the day but it feels like it wants to bend, where before the mere thought of bending my knee made me cringe.  No more CPM either!

They went in through my original ports; no extra scars!

Flexion in January vs. post op #2!

I can also now walk a mile faster than 20 minutes. Every time I walk, I cut my mile time down and I feel more stable. I also went back to yoga. I still have to modify a lot but hey, something is ALWAYS better than nothing! I still live off my foam roller, it's the best thing ever. I finally have hopes for this recovery!

Post Op Day 2: PT Nightmares

   When you mix exhaustion with pain and add a physical therapist into the mix, it's bound to end badly. But let's start with the good. 

   My calf pain is far less bad than yesterday. I can put slight weight on it, so I can get up and down stairs. Let me show you how I got up and down the stairs yesterday: 

Thank you tricep muscles! 

    I didn't sleep well, just due to general discomfort. I get an hour or so here and there at a time. Today PT was at 230 and it was pretty rough. I rode the bike, that felt ok. Then the bending started, and with the bending, the screaming and crying. I'm not much of a wimp but these surgeries have turned me into a complete little bitch. Working on my extension wasn't beautiful but nearly as bad as flexion. But by the end I could get myself to 120 degrees with a strap. 

   They're tossing some muscle relaxers into the mix to see if those help. I've been guarding my knee for so long, I have to retrain my brain and body to relax and trust it. I'm back at it again tomorrow morning, with orders to work on extension while icing and crank the CPM machine up to 120 degrees (I've been doing around 112, pass the pain pills). I'm also cleared for light stretching and sleeping sans immobilizer. I should be completely discharged of the immobilizer tomorrow morning! 

   Trying to stay hopeful, and ahead of the pain, so hopeful and high! 

How to force your knee into extension while icing! 

ACL manipulation and athrofibrosis Surgery

   So 4 months out from my ACL reconstruction and I needed a 2nd surgery. Why? Multiple reasons:

1. I still had a lot of stiffness. Think 85 year old woman stiffness upon waking. I'm 16. Not cool. 

2. My bones were forming funny since there's such little weight bearing force and I was setting myself up for pre arthritis. 

3. My flexion and extension STILL sucked regardless of daily exercises, dry needling at PT, constant stretching and quite a bit of screaming at PT. This resulted in a limp. 

   So they took me back under. Pre op was much in the same, I had a great care team at the University of Colorado Lone Tree Surgery Center. My PT, Evelyn Massey was there for my surgery and my surgeon, Dr. Armando Vidal, is pretty highly recommended. Having my pt there gave me a world of peace of mind. She knows my knee better than anyone in Denver. And she's a little bossy (in a good way!), so I had no doubt she would speak up and tell my surgeon "ok that's how far her knee can go so be gentle past there!". Bossy people love other bossy people. 

    So what did they do this second surgery? They went in through my portal holes and made one more small hole and scraped out the scar tissue build up that's been hindering my range of motion (ROM). They also cranked on my knee to bend and straighten it. It took just over an hour. I woke up about 30 minutes after, groggy with pain at about a 7 in the back of my knee where the nerve blocks didn't reach. My nurse immediately drugged me up and gave me pudding, tea, ice chips, and graham crackers till pain was at a 2. I left about 45 minutes after. 

    What's different about this recovery? Well for one I have a CPM machine, which is a constant passive motion machine. It cradles my leg and passively moves it through a preset ROM so scar tissue is prevented from building up and stiffness is decreased. It's not as bad as it looks, and I know it's for the best. I'm in here 8 hours a day, everyday, for 2-3 weeks. 

I still have an ice machine of course so I'm pretty much attached to one machine or another or at PT all day. I should get discharged out of my immobilizer today, rather than being kept in it for weeks. 

    I started PT yesterday, a mere 4 hours post op just for more mobilization. My knee bent to 121 degrees and I got to 2 degrees extension- much better! Today may be a little worse with no nerve block but I'll power through like I always do. 

    My muscles haven't been stretched that far in FOUR months, so yesterday my calf was super tight and sore. Ankle pumps and water is your best friend for this. 

The unraveling: 

Doesn't look nearly as monstrous as my first post op unraveling! I'm on crutches again at least through today and then weight bearing as tolerated. This week should be... Interesting. But I'm over the scary part and back to square 1 with recovery! 

2 weeks until surgery #2!

   Some people heal miraculously, some do not. I had a great surgeon, a great physical therapy team, and I used all my sports medicine knowledge to rehab myself too. I was the perfect patient! I moved to Denver and started dry needling to be more aggressive towards the scar tissue.

Dry needling with stim to activate my VMO: 

 It helped, but not quite enough. My new surgeon out here has decided I need another surgery to manually manipulate my knee into flexion and take out some scar tissue. 

   I'm nervous but also hoping this 2nd surgery does me good. I have a lot of stiffness in my knee, especially in the morning. I hobble around until it wakes up! I only have 104 degrees of flexion and I'm still 3 degrees in extension, which is enough to affect your gait. So I walk with a limp some days. NOT HOT FOR A 26 YEAR OLD! 

    I still cannot run and I'm almost 15 weeks out. I should be much better than I am, but I'm not and its frustrating beyond belief but I keep on keeping on! 

I go to the gym everyday to ride the bike and I can do the elliptical now also. I've gotten back into yoga, I modify many poses but it gives me a sense of accomplishment. I foam roll, I stretch, I yell through physical therapy.

Doing yoga last week. Yes this was hard, but putting my life on hold wasn't working for me. I had to at least try, and I succeeded! Yoga has helped my knee quite a bit actually! 

   Every body is different, so take your recovery at your pace, research, get opinions! No slacking! If you have questions or concerns bring them up and get answers. Take your health into your own hands. 

11 Weeks Post-Op

   Just a heads up; the knee has become it's own entity. It runs the life. So don't be surprised if I refer to it in the 3rd person!
   We have a few new things that have happened since my last blog. My flexion is now to 103 degrees, painfully. BUT I can get to 95 degrees myself. Extension is only lacking about 3 degrees. As of right now, I don't have to go back under for manual cranking and manipulation. I may have to get scar tissue scoped in 3 more months, but that's still up in the air. Physical therapy has gotten slightly better. The bending still hurts, I still scream but I stopped crying through it! I also get to do a few more exercises which I am always happy for! I'm still icing and using compression, and doing daily stretches but I went ahead and made this crazy decision to move across the country last week! My cousin and I drove 1,700 miles to Colorado!
   While PT is on standby since I was getting here, and then had to acquire new insurance and doctor appointments, I have been vigilant about at least stretching. I was kinesiotaped before I left to give me a little extra help too! The kinesiotape helped "wake up" my quads to remind them to fully extend. Don't mind all the bruising- we also started foam rolling and using pressure point rolling therapy. Hurts so good!

The kinesiotape stayed on for quite a while too! Ask your physical therapist if they think it could help you too.
   Today was the first day in 6 days that I was back on the bike, and it felt good. I don't think I've lost any range of motion, but I'm interested to get a second opinion on how my recovery is going. I love my original doctors, but they just weren't willing to make this move with me. I'm looking into trying new things (Dry Needling and Acupuncture) and am remaining hopeful that I'll have a full recovery soon!

Thanks to my 3rd flood apartment, I do a lot more stairs and can even start to get down the stairs like an adult! I have to hold on to the rails and I'm going slow, but I'm getting places!

I can touch my foot! Stretchhhhh!