Day 379 - What a summer it was...

So it's been a long time since I last posted! I logged back in here to find I had three drafts going. The first was a vow, to me and all of you, that I would not spend a summer night inside. I was going to spend my free time outdoors. The second draft, from day 119, was official graduation from physiotherapy! I worked long and hard hours to the point where I was able to transition to actual workouts at the gym. The last draft I had saved was from day 201 and titled 'I did something crazy'. I did actually. I registered for three triathlons.

Let me start by saying I accomplished all of the above. I worked hard, overcame pain, fears and nerves, and I actually did what I said I would. Sometimes all it takes is a bit of motivation, and lots of hard work. I've never been someone to go back on my word. So when I set those goals, I stuck to them. The summer of my torn ACL I gained so much weight and became completely inactive apart from my pre-op physio. It was a very difficult time especially since I am usually super active in the summer. When this summer rolled around, me and my new ACL got right to it! I kicked off the season with the Ride for Heart in Toronto, where I rode 25km. Doesn't seem like a lot, but it was plenty for my knee. I also bought a season pass to the local parks in my area and spent the weekends there paddling. I had always told my sister we'd go SUPing, and we finally did! Later in the season I moved on to a few 50km bike rides and lots of shorter ones too.

The final push for me was completing my first triathlons. A few years ago I registered for my first triathlon, but being accident prone, broke my foot only a few weeks before the race. After I tore my ACL I thought I would officially never cross triathlon off my bucket list. BUT I DID! Lots of hours training (and I probably could have trained more), but I did it! They were no podium finishes, but I was there to do it for me, and prove I could finish. I have started planning out my next race season, 2017, with the hopes of also fundraising and raising awareness for those who live with heart disease. On top of having bad knees, I also live with heart disease. It makes working out one of my least favourite things to do. But now that I've been diagnosed and have the proper medicine, it makes it possible for me to get back into the gym.

So one very long post later, I wanted to say that after over a year since my ACL surgery my knee is feeling great and has allowed me to get back to doing all the things I love. I'll keep posting every now and again, but I think this blog will follow my road to finishing an Ironman Triathlon. Let's knock it off the bucket list...

Day 180

I really need to keep up with these posts! I am working on my knee everyday, sticking to my physio exercises and also adding in more at the gym. I hit the gym everyday because they have a Bosu ball there, which by the way is the best thing since sliced bread. I love it! You can do so many different things with it and it's a great tool to have for ACL/MCL recovery. 

My ACL recovery is going very well, the knee feels better with each day that passes. The MCL is still loose, and I can definitely feel it, but I am working on strengthening my inner thigh muscles to try and make lateral movements stronger. I wear my custom DonJoy for all my workouts  to keep my knee stable at all times.  

Below are a few of the exercises I have added to my physio program:

Bosu ball squats: 3 sets x 10 reps

Bosu lateral hops / Bosu T-hops: 3 sets x 10 reps

https://www.youtube.com/watch?v=kbhY5WWgki8

I've tried experimenting with a few other movements including lateral skating with the bosu, alternating legs, 3 sets x 10 reps on each side. This movement helps a lot with the muscles that you use when moving/pushing laterally. 

Now that the weather is nicer I've started to train outside as well. It feels good to be back on my bike! Threw some new handle bar tape on it. Blue, my fave, and matches the body too! 

Swimming and biking are becoming easier, and I can now add resistance and push through the pain. However running is still a no-go. I was hoping to compete in my first triathlon this year, but it's looking like I won't be ready for it by July. There is a later one in August as well, so i'll keep training for that! That has been my only goal so far, is to run! 

Until the next post,

Steph

Day 139 - Aches and Pains

Day 139, and not really any difference. Sticking to my regimen is hard and I don't have the right equipment at home to do my exercises. I want to start doing my regular workouts, but I am finding it tough.

Today I did my functional training as assigned to me by my PT. I am not quite ready to try running yet, but I did put some jump rope into my exercise today. There was stinging pain where the MCL connects to the shin, at the bottom of my scar. I hopped through the pain though. I will discuss with my PT and my surgeon to see why I still get sharp pain in that area only. The knee cap itself feels fine, but my quad isn't firing very well either.

I've added some ball exercises as well. I now do a bridge into a hamstring curl on the exercise ball. I also do jackknives because I need to build up some core strength. It is extremely week since I haven't done any real exercise until now.

These are the only real updates I have right now.

Until the next post,
Steph

Day 136 - Cleared to run!

So I am officially at 4 months and 13 days post op. This week I worked with my PT and was able to go through my progress and protocol. A lot of my exercises are now focusing on my core and butt muscles which are weak. This includes bridges with my feet on an exercise ball and some other slower movements where the focus is to engage the muscles.

Going through the protocol, she said I could start jump rope again and straight line running. Not both on the same day, and only for a short amount of time. Now I just need to find a treadmill! The pool has definitely been helping my knee (and leg) feel better. It's light impact but works the muscles, so it feels nice and relaxed after my pool sessions. I'm hoping over the next few weeks, I can stick to my daily exercise and start seeing some good results. I can't remember the last time I had a proper workout, and as I approach the one year anniversary of my ACL tear, I am ready to kick it into high gear.

Until the next post,
Steph

Day 123

Today was my first day back in a pool in over a year. Even before tearing my MCL and ACL, I can't remember the last time I swam! I was cleared two weeks ago to start swimming so I hit the pool this morning for some lane swimming. I plan to swim three times a week (Sunday, Tuesday and Thursday), all lane swims. Some laps I use a flutter board and just focus on my leg mechanics, but most of them I do freestyle (front crawl) to keep track of my SWOLF.

Swimming is a great way to build muscle up again, with little resistance on my knee. It felt pretty good during swimming and even after. No pain to complain about. It's also a total body workout (my arms are dead!) so I'm glad I can finally get back to it. Running, I'm coming for you next!

Here's my stats. They're bad, but not so bad considering it's been over a year with no swimming!

I use the Polar V800 triathlon watch to keep track of all my training, including my physio routine. Can't wait for winter to be gone so I can test out the GPS on my bike (and eventually running)! You can find the watch here.

Till the next post,
Steph

Day 119: Feeling the Burn!

I am happy to say I have progressed to the next phase of my recovery!

Phase iii is outlined as:

1. May progress when the person has full ROM, no effusion or pain. Continue to normalize gait.
2. Goals of:
• Running with no pain or swelling, hopping without pain, swelling or giving way.
• Straight line Running, no cutting or pivoting.
• Lunges, sort cord or theraband, resisted hamstring curls.

I am super excited to have reached this phase, and I can say that I am feeling the burn! The "exercises" I had in the previous phases were to get back ROM and straightening, but now it feels like I am starting to strengthen my quads and hams. It's a great feeling which I haven't felt in my leg for almost a year now!

I have also been cleared to go to the pool, which is something I love. It's great for my leg, but also my arms and back too! Of course it's freestyle and flutter kicking only, no whip-kick. But I am okay with that. Me and the flutter board are going to become good friends in the coming months. Looking forward to testing out my Polar V800 in the pool too!

Below are my current exercises.

Right now my red theraband is my buddy, I take it everywhere, and try to sneak in my exercises with that where I can. Working full time definitely makes this physio process a lot harder! Dedication and motivation are key, otherwise it's an even longer road.  

I also setup a spreadsheet to keep track of these exercises, including the number of sets and reps. For this phase, strengthening and control, here is the table.

ACL Post Op Rehab - Phase III - February 18 (Strengthening and Control)
Bike: 30 minute warm up
AAROM Knee Extension w/ TENS: 10 minutes
AROM Flexion Prone Knee Bend: 10 reps x 5 sec hold
Step-up Forward: 2 sets x 10 reps w/ red band
Squats: 2 sets x 10 reps w/ red band
Leg press: 2 sets x 10 reps @ 113 lbs
Hamstring Curl: 2 sets x 10 reps @ 10 lbs
Clams: 2 sets x 10 reps (3 sec hold) w/ red band
Static Lunges: 2 sets x 10 reps
Bridging: 2 sets x 10 reps (3 sec hold) w/ heel raise
Sidesteps: 3 sets x 10 reps w/ red band
Lane Swimming: Front crawl / flutter kicks only, no whip-kick strokes

My goal now is to gain strength in my quads and loosen up the hamstring, which is super tight, through the above exercises. The pool should be a great way to do this, swim pass here I come! Once I get some strength and more control, I hope to progress to running by the time spring comes around!

Until the next post,

Steph

I Hit the Wall - Day 88

It's been a while since I've posted, yet again. Unfortunately the same laziness that caused me not to write has been contributing to me slacking on my physio too. I came down with a cold again, so didn't go to the gym all week! I was in a pretty low spot on Friday night as I at thinking about the fact that I've hit a wall in my training. The swelling and pain won't allow me to progress, and I am tired of seeing my atrophied quads. I have decided to push through the pain so I can progress to my next level of the protocol.


At the next level I will be able to start swimming and running again, two things I have been counting down the days to do. I think once I can get back into that, my knee will strengthen up pretty quickly. I have set a goal to get back to boxing and to be able to run. So that is what I am still working towards. The swelling is ever so slowly going down each day, although there is still one problem area. Range of motion is definitely much better. I am able to bend to almost full ROM, and straightening is almost at 0 degrees as well. Straight leg raises are going well, with very minimal pain so that is promising. Some photos on day 88.

I have set a goal to complete an Iron Girl Sprint distance triathlon on August 7th, 2016. This will motivate me to stick to my recovery plan and workout on a regular. I am also doing the Ride for Heart on June 5th, 2016. I am planning to do the 75km distance, but I will see what my knee can handle by then. Let the training begin! 

8 Weeks Post Op - Day 56

I just realized it's been quite a while since I posted an update! That's what happens when you have to go back to work full time. I also came down with a bad cold I can't shake, so I haven't made it into the gym yet.

Yesterday marked 8 weeks since my surgery, and today is day 56 of recovery. I saw my surgeon on Monday and he was very happy with my progress. He said my range of motion is at around 130 degrees flexion. Straightening is going well, I can definitely push to 0 degrees, but I need to keep working on it. The graft is healing well, and so is the MCL. Both are nice and strong. I am still in phase 2, but now doing some exercises to start regaining strength! He told me to do as much as I can on the stationary bike as well because it really gets the muscles going. He wants me to put the seat nice and high to get my going through my range, and getting full extension. I see my surgeon in March for my 6 month follow-up, and he's confident we can start discussing a gradual return to sport then. Working hard now to achieve that.

Here are the exercises I'm doing.

Massage Therapy

Massage therapy works wonders! I had a massage 3 days ago and my knee is feeling great! It could also be because I have been in bed for the last two days, suffering of an awful cold. But I did my physio exercises on Friday, and my ROM was way better than it was on Thursday. I was only getting to about 108 degrees flexion, and after the massage I'd say I was closer to between 115 and 120 degrees.


Massage therapy is the manipulation of the superficial and deep tissue in order to promote deep relaxation and release tension. It helps to soothe injured muscles and stimulate blood circulation.

Complementing physiotherapy with massage therapy is a great idea. My massage focused on the IT band, patellar tendon and hamstring areas. The first two were where my incisions are, since they were a bit lumpy under the surface. The massage helps break up any scar tissue under the surface. My hamstring, and the back of my leg in general, are very stiff so the massage definitely help loosen them up a bit. I'll be doing a massage once a week for the next few weeks.

Day 38 Post Op

I am now into week 6 of recovery, and I can honestly say things are going well! I worked with the athletic therapist this week, and she was the first person to check my patellar mobilization and how the scars are healing. She told me my progress is really good, and I need to keep working on my exercises at the level I am now. She showed me how to move the knee cap a bit, and where to massage the incision so scar tissue doesn't form. Scar tissue could limit ROM, so it's important to focus on this. I still don't have full ROM yet, but I am working on it. There is still some swelling that is present but I started getting massage therapy too, so hopefully it will clear out in the coming weeks.

I can FINALLY do a straight leg raise, and actually activate my quad. That could be a result of them zapping the shit out of my quad with the stim machine. I'm not kidding. I was acting like a baby from the pain, 35mA doesn't sound like a lot, but it is!

My previously goals were to drive my car and to walk straight. I can now do both! I am back to work now, so I try to get up and walk as much as possible. There is definitely a lot of pain when I go from sitting to standing, under the knee cap where the incision is. But as I continue to walk and straighten, the pain goes away. The goal I set now is to be able to walk down the stairs. I can only go one step at a time, but I need to work on building strength before I can progress to going down the stairs.

This week I'll be focusing on ROM and straightening. I got to 1 degree, so almost fully straight!

The incision looks pretty good.

Progress and Problems

Today marks 30 days since my operation. I'm still having pain at the incision on my knee, but I have progressed fully to phase 2. My PT is happy with my ROM and straightening (when flat on the table). There is one issue that I am still working towards resolving, my straight leg raises. My PT has added some more exercises, and I think over time I will see a difference in my knee with these few extra exercises.








My Phase II exercises are as follows:

I was so happy that I was officially fully moved to Phase II, but there is one set back that I can't seem to get past. When my leg is on the table, I can straighten it and activate my quad to push it down to make it straighter. However, when I have to lift my leg off the table for a straight leg raise, there is still a 5 degree lag. I asked the PT why this is, and she said my quad isn't activating properly. I am also still walking with a slight limp, but I am trying to overcome that. I need to think about every single step I take. Am I leaning to far? Am I striking the ground with my heel? Am I keeping my hips square? I try and really focus as much as I can with every step I take. When I first get up from sitting with my knee bent, it's inevitable that I will limp for the first few steps as my knee gets used to straightening.

For the coming week, I will be working on that straight leg raise, and starting the exercises above to start the early rehab phase. I am hoping as I get some more strength back, the knee will feel better. It is so tight and stiff, like it wants to move, but it can't. I'm sure in a few weeks of doing my Phase II stuff, it will feel loads better.

4 weeks (28 days) Post Op - Road to Recovery

Today officially marks 4 weeks since my ACL reconstruction surgery. I think in terms of the protocol, I am on track with my recovery. I rode the bike at physio and actually went fast enough for the damn thing to turn on! I could feel every pedal stroke, but I rode for 10 minutes at a good pace. Small victories, but a victory none the less.

In terms of ROM, I can get about 120 flexion when I really push, and almost at 0 degrees straightening. I am working on straightening as often as I can, but I am also doing a lot of bending exercises to get the tendon to work more. I am still walking with a limp, but using the proper walking mechanics. Before my leg was straight as a board and I was limping even more. The pain is still ever present, well not pain but a weird feeling of tightness/stiffness. I don't really know how to explain it other than, I can feel my tendon working/engaging with every step or movement I make.

I got cleared for driving, but my PT told me to practice in a parking lot first. Makes sense since it's been a few weeks and I need to see how my knee reacts when I put pressure on the pedal and move between the gas and brake pedals.

Other than that, no real updates. My exercises are still the same: 1/4 wall squats, single leg stance, bending, straightening and some hip stuff. I try and do these 3 times a day, with a more intense session in the evening that also includes an arm workout. It feels good to sort of be back on my feet. I hope that with each day that passes now, my knee will start feeling more normal. I haven't been sleeping well so that is something I hope gets better soon too. Little gains each day, and week by week I am seeing improvement. I'm continuing down the road to recovery.

Benefits of Physiotherapy

I started physiotherapy a month after I tore my ACL and MCL, and I can't tell you how much it has helped. My legs never felt better and they helped me work out the tightness and strengthen my knees. I think that even if you don't have an injury, but maybe you don't feel 100%, definitely get in there for an assessment and see how a PT can help you.

Here is an excerpt from the Ontario Physiotherapy Association website:

Benefits of Physiotherapy

Physiotherapy can make a difference in an individual's ability to live an active, healthy lifestyle. For many seniors, disabled or chronically ill people, physiotherapy is the key to restoring and maintaining a level of physical function that permits independent living. Physiotherapy is one way to successfully push physical limitations to secure the Freedom to Function™.

Physiotherapy benefits include decreasing pain, improving joint mobility, increasing strength and coordination and improved cardiorespiratory function. Everyone can benefit from physiotherapy whether you are living with a chronic illness, recovering from a work injury or suffering after that weekend hockey game.

Physiotherapy increases your independence and gives you the Freedom to Function™ in your home, workplace or your favorite leisure activity. Physiotherapy offers a range of specialized services of benefit to patients with heart and lung disease, traumatic, workplace and athletic injuries, amputations, arthritic joints, stroke, brain injury, spinal cord and nerve injury, cancer and pre- and postsurgical needs.

For a more detailed look at the benefits of knee physiotherapy, hit this link.