It's been a long Winter, and Spring can't come soon enough.
Physically things are coming along just great. I saw my PT today, and we did a bunch of testing comparing the involved leg against the good leg.
Involved. Funny term, involved. I've been involved with Karate for 3 years, my body's been involved with training, my time involved with playing music, being a decent husband, and raising a child, but I never considered just my knee involved with anything. Huh.
Testing consisted of a number of squat-and-reach exercises, such as standing on one foot while touching the floor as far out as possible at a 45° angle each way from the foot without falling. Another test was one-legged squats as low as possible.
Numbers look good, my operative knee is 85-90% as compared to the good knee. That means I can start a re-entry to running following protocol; basically it's walking with short periods of running, working up to progressively longer running periods without walking breaks.
Not that I've ever been much of a runner, but it's at least a change in routine, and one that will get me doing something moderately resembling recreational activity outside. Honestly, I miss the solitude that running early in the morning brings, and I look forward to it.
So, yeah, just over 7 weeks post-op and I'm running. Cool.
Emotionally things are a struggle this time. First time was a novelty, second time was routine at worst, but the third time is really weighing heavy on my mind. There are times when the depression and worry is tangible, like a yoke around my neck that I just can't remove.
There's an annoying, nagging voice in my head that won't stop wondering if I'm some kind of natural klutz. Another one argues that no, it's strictly a case of freak accidents--hardly predictable, not likely preventable except to quit Karate.
And then the people who hear about 'the third time,' and keep saying I need to find a safer hobby.
A hobby.
A hobby??? This is not a hobby, it's part of my way of life!
It's as much a hobby to me as someone going back to school to get a Masters or Doctorate is just a hobby.
Thanks for reading, and pardon my ranting and raving.
It's been a long Winter, and Spring can't come soon enough.
Showing posts with label physical therapy. Show all posts
Showing posts with label physical therapy. Show all posts
Thursday, March 4, 2010
Sunday, January 24, 2010
Bracing for reality
***I'm posting some arthroscopic pics near the end of this post, fair warning for queasy readers.
This time around has had an interesting start.
By the second day after surgery, the knee was bearing weight unusually well when compared to my first two ACL reconstructions. Thursday I got stitches out and did a round of physical therapy. Quads are firing well, straight leg raises are strong, about 70 degrees of flexion and a degree or two of hyper-extension. The slight hyper-extension is a most pleasant surprise, usually that doesn't come along until much later in the game.
I was approved to go without an immobilizer brace during passive activity, such as working at my desk or around home. I'm supposed to continue wearing it as a matter of security until this week's session when my gait will be re-evaluated.
Tomorrow I return to the real world, going back to work for the first time in 2 weeks. We have overlapping responsibilities in my department, so I have all confidence that my partners have provided due diligence in my absence. Hopefully I won't be drowning in backlogged work to do!
Truth be told, I've done just about everything I can around the house, got a few 'administrative' things out of the way after many long delays. I'm ready to get back into a routine, although it won't include Karate for somewhere around 14-16 weeks.
I plan to continue my bench-time tradition of watching sparring classes on Monday nights to help keep me connected with my fellow students, and help satisfy my craving for Fight Night. It helps to keep me focused on what I need to do, and the encouragement from my friends on a regular basis is truly a balm for the soul.
I have made the very difficult decision to stop sparring for a long time. Sparring is part of the curriculum, but for folks over 35 they will adjust requirements for black belt as necessary. I don't plan to give up sparring forever, but 3 major injuries requiring surgical work and 2 other injuries have cost me well over a year of time.
By many accounts I would be screening for black belt later this year, but reality says it'll be some time in 2011 at the soonest. I'm tired of the annual re-set of my training and want to remove the one activity most responsible for my injuries.
There are no guarantees in life, but I need to start stacking the odds more in my favor if I want to continue with Karate for the foreseeable future. I'm damned good at open hand and weapons forms, time to focus on those strengths. I'm not any more afraid of sparring than before, but I am concerned that my reflexes are telling me to move in ways that are dangerous.
1st time: I was falling backwards, torn ACL from trying to stop a fall.
Lesson: Just fall.
2nd time: I was landing from a powerful tornado kick, torn ACL from a planted foot on landing.
Lesson: Don't go overboard on fancy kicks when you're tired.
3rd time: I was ducking under a punch way too far, torn ACL from trying to explode upwards.
Lesson: Don't go overboard on moves you haven't drilled on.
I don't want any more of these lessons.
As promised, here's 2 pics:
This one is of the floater found while inspecting the meniscus. Looks like a tiny bit of meniscus that had torn loose, not a big deal.
Here's the ACL. It starts at the top left looking great, the rest is simply a shredded pile of silvery ligament spaghetti.
This time around has had an interesting start.
By the second day after surgery, the knee was bearing weight unusually well when compared to my first two ACL reconstructions. Thursday I got stitches out and did a round of physical therapy. Quads are firing well, straight leg raises are strong, about 70 degrees of flexion and a degree or two of hyper-extension. The slight hyper-extension is a most pleasant surprise, usually that doesn't come along until much later in the game.
I was approved to go without an immobilizer brace during passive activity, such as working at my desk or around home. I'm supposed to continue wearing it as a matter of security until this week's session when my gait will be re-evaluated.
Tomorrow I return to the real world, going back to work for the first time in 2 weeks. We have overlapping responsibilities in my department, so I have all confidence that my partners have provided due diligence in my absence. Hopefully I won't be drowning in backlogged work to do!
Truth be told, I've done just about everything I can around the house, got a few 'administrative' things out of the way after many long delays. I'm ready to get back into a routine, although it won't include Karate for somewhere around 14-16 weeks.
I plan to continue my bench-time tradition of watching sparring classes on Monday nights to help keep me connected with my fellow students, and help satisfy my craving for Fight Night. It helps to keep me focused on what I need to do, and the encouragement from my friends on a regular basis is truly a balm for the soul.
I have made the very difficult decision to stop sparring for a long time. Sparring is part of the curriculum, but for folks over 35
By many accounts I would be screening for black belt later this year, but reality says it'll be some time in 2011 at the soonest. I'm tired of the annual re-set of my training and want to remove the one activity most responsible for my injuries.
There are no guarantees in life, but I need to start stacking the odds more in my favor if I want to continue with Karate for the foreseeable future. I'm damned good at open hand and weapons forms, time to focus on those strengths. I'm not any more afraid of sparring than before, but I am concerned that my reflexes are telling me to move in ways that are dangerous.
1st time: I was falling backwards, torn ACL from trying to stop a fall.
Lesson: Just fall.
2nd time: I was landing from a powerful tornado kick, torn ACL from a planted foot on landing.
Lesson: Don't go overboard on fancy kicks when you're tired.
3rd time: I was ducking under a punch way too far, torn ACL from trying to explode upwards.
Lesson: Don't go overboard on moves you haven't drilled on.
I don't want any more of these lessons.
As promised, here's 2 pics:
This one is of the floater found while inspecting the meniscus. Looks like a tiny bit of meniscus that had torn loose, not a big deal.
Here's the ACL. It starts at the top left looking great, the rest is simply a shredded pile of silvery ligament spaghetti.
Saturday, January 16, 2010
Been There, Done That, Got The T-Shirt.
Hello, dear reader. It's been a while.
As I mentioned briefly on New Year's Eve, I re-tore the ACL in my right knee December 28th during sparring class. This is the knee that started all this business almost exactly 2 years ago.
I ducked under an opponents punch way too deep, with my right leg forward, and tried to explode upwards with a back fist while most of my body mass was still moving from right-to-left. I made it about 3/4ths of the way up, then my right knee bent sideways and I went down.
Last Monday, January 11th, I had an ACL revision done on the knee. The procedure is much the same as ACL reconstruction, except with a lot more prep work and bigger hardware. The prior ACL is removed and loose tissue cleaned up, and the old fixative screws are taken out. (I have my old screws as a token now.)
As with the prior 2 reconstructions, I opted for a femoral nerve block with a spinal block so I could observe the procedure. Good news is that the meniscus continues to be well anchored, with no signs of damage save for a tiny floater they caught doing laps in the saline on camera.
Again, like in December 2008, the spinal wore off a bit prematurely and I had major cramps in my lower back due to the position I was in on the table. Also, I began to feel the pins and needles in my right leg as the spinal wore off, and the tourniquet was removed. Yes, I could have opted for some sedation or pain killer, but I weighed the cost of $100 a pop against my short term discomfort--we have new insurance that would have me paying more out-of-pocket now--and I decided to save a buck or two.
Because the bone tunnel necessarily has to be enlarged, the replacement tendon and hardware are also larger. The original upper fixative screw was installed into the end of the femur 'from below,' essentially within the knee joint. This time, the screw was installed into the end of the femur from above, which meant my quads took a beating from being retracted while this somewhat gruesome business was conducted. I saw that bit from the arthroscope and realized that it's gonna sting like the dickens when the blocks wear off...
On a funny side note, Dr. K had some difficulty tightening this upper screw, losing his grip at one point and nearly knocking over some monitors and IV poles in the operating room! I suggested perhaps an impact wrench might not be a bad idea, but he replied that using motorized assistance tightening screws could result in over-torquing.
Once Dr. K was done and the other surgeons could take over closing things up, I reminded him of my request for a t-shirt from the clinic; I figure a guy is due something for his trouble after 3 operations! He not only made good on the promise, netting me a nice long sleeved Under Armor shirt with embroidered logo, he even put it in a gift bag with a birthday card and delivered it personally while I was in stage 1 recovery.
The card reads "Each year the wishes just get bigger and better!" with a note: That's 3 years in a row! Enough already! (Just kidding.)
So the first 36 hours post-op sucked as usual, peaking on Tuesday night when I had a major charlie horse in my thigh that felt like a dagger was stuck there! Fortunately a bit of Tylenol with Codeine took care of that and I could sleep peacefully. Since Wednesday I've taken nothing but Ibuprofen, a good thing and par for the course.
First PT session was Thursday. My prior PT clinic has closed its doors due to the recession, so I opted to do PT at the clinic where the surgery took place. There I met Ben, who will be my main PT this time around. I was encouraged by being able to toddle around the house with just a cane already, a very positive early milestone that the knee can bear weight well already.
Surprisingly my quads were firing quite well, and I could do straight leg lifts without too much difficulty. I even have a bit of hyper extension, already nearly equal to my good knee. Flexion is only at about 60 degrees while on my back, maybe 70-75 hanging over the edge with assistance from the good leg. The biggest stopper right now is the local knot of swelling to the outside of the quad, the result of insult to the tissue from installing the fixative screw.
Last night I was wide awake at 3am with a mild fever coming on. So on top of the typical post-operative pain, I had body aches as well, and lay awake for probably a good 2 hours trying to find a comfortable position. I should also mention, it's the first night back in my regular bed upstairs, and not on the totally comfy couch downstairs, so re-adjusting to sleeping on the mattress probably contributed to lower back cramps. Meh.
Well, tonight I'll be hanging out with Mrs. Shaft while G-Shaft goes to a schoolmate's birthday party for a few hours. We plan on tossing back a few Amaretto-Sour's while watching a movie and enjoying a new recipe for cold Thai peanut noodles.
More tomorrow, possibly pictures, and what the future holds for Paul "Hack Shaft" Pederson.
As I mentioned briefly on New Year's Eve, I re-tore the ACL in my right knee December 28th during sparring class. This is the knee that started all this business almost exactly 2 years ago.
I ducked under an opponents punch way too deep, with my right leg forward, and tried to explode upwards with a back fist while most of my body mass was still moving from right-to-left. I made it about 3/4ths of the way up, then my right knee bent sideways and I went down.
Last Monday, January 11th, I had an ACL revision done on the knee. The procedure is much the same as ACL reconstruction, except with a lot more prep work and bigger hardware. The prior ACL is removed and loose tissue cleaned up, and the old fixative screws are taken out. (I have my old screws as a token now.)
As with the prior 2 reconstructions, I opted for a femoral nerve block with a spinal block so I could observe the procedure. Good news is that the meniscus continues to be well anchored, with no signs of damage save for a tiny floater they caught doing laps in the saline on camera.
Again, like in December 2008, the spinal wore off a bit prematurely and I had major cramps in my lower back due to the position I was in on the table. Also, I began to feel the pins and needles in my right leg as the spinal wore off, and the tourniquet was removed. Yes, I could have opted for some sedation or pain killer, but I weighed the cost of $100 a pop against my short term discomfort--we have new insurance that would have me paying more out-of-pocket now--and I decided to save a buck or two.
Because the bone tunnel necessarily has to be enlarged, the replacement tendon and hardware are also larger. The original upper fixative screw was installed into the end of the femur 'from below,' essentially within the knee joint. This time, the screw was installed into the end of the femur from above, which meant my quads took a beating from being retracted while this somewhat gruesome business was conducted. I saw that bit from the arthroscope and realized that it's gonna sting like the dickens when the blocks wear off...
On a funny side note, Dr. K had some difficulty tightening this upper screw, losing his grip at one point and nearly knocking over some monitors and IV poles in the operating room! I suggested perhaps an impact wrench might not be a bad idea, but he replied that using motorized assistance tightening screws could result in over-torquing.
Once Dr. K was done and the other surgeons could take over closing things up, I reminded him of my request for a t-shirt from the clinic; I figure a guy is due something for his trouble after 3 operations! He not only made good on the promise, netting me a nice long sleeved Under Armor shirt with embroidered logo, he even put it in a gift bag with a birthday card and delivered it personally while I was in stage 1 recovery.
The card reads "Each year the wishes just get bigger and better!" with a note: That's 3 years in a row! Enough already! (Just kidding.)
So the first 36 hours post-op sucked as usual, peaking on Tuesday night when I had a major charlie horse in my thigh that felt like a dagger was stuck there! Fortunately a bit of Tylenol with Codeine took care of that and I could sleep peacefully. Since Wednesday I've taken nothing but Ibuprofen, a good thing and par for the course.
First PT session was Thursday. My prior PT clinic has closed its doors due to the recession, so I opted to do PT at the clinic where the surgery took place. There I met Ben, who will be my main PT this time around. I was encouraged by being able to toddle around the house with just a cane already, a very positive early milestone that the knee can bear weight well already.
Surprisingly my quads were firing quite well, and I could do straight leg lifts without too much difficulty. I even have a bit of hyper extension, already nearly equal to my good knee. Flexion is only at about 60 degrees while on my back, maybe 70-75 hanging over the edge with assistance from the good leg. The biggest stopper right now is the local knot of swelling to the outside of the quad, the result of insult to the tissue from installing the fixative screw.
Last night I was wide awake at 3am with a mild fever coming on. So on top of the typical post-operative pain, I had body aches as well, and lay awake for probably a good 2 hours trying to find a comfortable position. I should also mention, it's the first night back in my regular bed upstairs, and not on the totally comfy couch downstairs, so re-adjusting to sleeping on the mattress probably contributed to lower back cramps. Meh.
Well, tonight I'll be hanging out with Mrs. Shaft while G-Shaft goes to a schoolmate's birthday party for a few hours. We plan on tossing back a few Amaretto-Sour's while watching a movie and enjoying a new recipe for cold Thai peanut noodles.
More tomorrow, possibly pictures, and what the future holds for Paul "Hack Shaft" Pederson.
Friday, May 29, 2009
Freedom
I'm free...I'm free!
And freedom tastes of reality.
And freedom tastes of reality."I'm Free" from The Who's rock opera "Tommy"
1. Saw Dr. K this morning, restrictions are removed.
2. "Have a good life," he said.
3. Made a pact with him that we shall never meet again under these circumstances.
4. Got the above song stuck in my head.
5. Testing for my next belt tomorrow morning.
6. Sparring Monday night...
Thursday, March 19, 2009
Going Home...Again...and Lemonade
For the regular reader of this irregular poster, you'll notice the updated countdown clock.
After passing the mid-point of my 24 week rehab period, I made the decision to update the clock to reflect my return to Karate on Monday.
Am I crazy? No.
Just feeling fat, uninspired, and bored to tears.
The PT I currently do at home in many ways is more aggressive on my knee than perhaps 80% of my Karate activity. I may as well work out in the company of friends rather than in isolation!
Therefore I've decided to return--with certain restrictions until June 1st, the end of my 24-week "restricted" period.
Forms / Kata shouldn't be an issue, since they don't involve jumping or spinning kicks, and the few kicks that are present are with my non-operative leg.
I will make appropriate substitutions for the next 10 weeks:
- Instead of kicks with hard snaps, I do slow-count kicks, substituting a strength exercise for a power drill
- Kicks with my non-operative leg will be performed with the chamber action slowed down (which usually involves some degree of pivoting on the supporting leg)
- Spinning kicks? More slow-count kicks.
- Jumping kicks? More slow-count kicks.
So basically between now and June, I'll be doing a ton of strength work, deep stances, careful pivots, and drill on learning my new weapon form with the bo staff.
Come June 1st, I'll be more than ready to get back to sparring!
I want to thank Black Belt Mama for the "When Life Hands You Lemons" award:
Like any good blog award, there are some rules:
Paying it forward, my nominee is a fellow Martial Artist, Bobspar.
Bob is a self-declared Middle-Aged Martial Artist, and the first blog I came across when seeking other Martial Artists with ACL tear stories. My own blog title is inspired from his attitude of not only embracing where he is in life, but also having begun his journey in the Martial Arts as a middle-aged person!
Bob found a particularly sour lemon to make lemonade--he was literally minutes away from completing his black belt exam when his knee decided to play a game of "Pop Goes The Weasel," tearing his ACL and delaying his black belt for over a year as a result. He is training hard for his test coming up this May, and I wish him the best of luck!
After passing the mid-point of my 24 week rehab period, I made the decision to update the clock to reflect my return to Karate on Monday.
Am I crazy? No.
Just feeling fat, uninspired, and bored to tears.
The PT I currently do at home in many ways is more aggressive on my knee than perhaps 80% of my Karate activity. I may as well work out in the company of friends rather than in isolation!
Therefore I've decided to return--with certain restrictions until June 1st, the end of my 24-week "restricted" period.
Forms / Kata shouldn't be an issue, since they don't involve jumping or spinning kicks, and the few kicks that are present are with my non-operative leg.
I will make appropriate substitutions for the next 10 weeks:
- Instead of kicks with hard snaps, I do slow-count kicks, substituting a strength exercise for a power drill
- Kicks with my non-operative leg will be performed with the chamber action slowed down (which usually involves some degree of pivoting on the supporting leg)
- Spinning kicks? More slow-count kicks.
- Jumping kicks? More slow-count kicks.
So basically between now and June, I'll be doing a ton of strength work, deep stances, careful pivots, and drill on learning my new weapon form with the bo staff.
Come June 1st, I'll be more than ready to get back to sparring!
I want to thank Black Belt Mama for the "When Life Hands You Lemons" award:
Like any good blog award, there are some rules:
- Post the logo on your blog.
- Nominate blogs that show great attitude or gratitude
- Link to the nominees within your blog post.
- Notify the recipients of the award by commenting on their blog.
- Share the love and link back to the person from whom you received your award.
Paying it forward, my nominee is a fellow Martial Artist, Bobspar.
Bob is a self-declared Middle-Aged Martial Artist, and the first blog I came across when seeking other Martial Artists with ACL tear stories. My own blog title is inspired from his attitude of not only embracing where he is in life, but also having begun his journey in the Martial Arts as a middle-aged person!
Bob found a particularly sour lemon to make lemonade--he was literally minutes away from completing his black belt exam when his knee decided to play a game of "Pop Goes The Weasel," tearing his ACL and delaying his black belt for over a year as a result. He is training hard for his test coming up this May, and I wish him the best of luck!
Friday, March 6, 2009
I've given up.
What??? Say it ain't so, Hack ol' buddy!
Big guy like you, strong like an ox, you say you've given up?
Yes, it's true. I'm done for a while, and giving up.
Giving up something for Lent, silly!
What, you read the title after hearing nothing from me for weeks and just assumed the worst? C'mon, gimme a bit of credit here!
As has often, but not always, been my practice in the past, I'm resisting nearly 7 weeks of temptation. This year I've given up alcohol (except Communion at church) and fried food--specifically hamburgers and anything deep-fried. Believe me, as casual as it sounds it truly is NOT an easy thing to do.
So why bother?
I don't consider myself a fundamentalist or terribly evangelical sort of person, but I do enjoy a good challenge. For those unfamiliar with the basic premise, before he faced his final series of challenges culminating in execution, Jesus spent 40 days fasting in the desert and facing temptation by Satan to give up his mission.
These 40 days are represented by the season of Lent, during which the Christian church asks its membership to sacrifice some practice from Ash Wednesday through Easter. Somehow giving up red meat and opting for Fillet-O-Fish for 6 or 7 Fridays in the Spring just doesn't resonate with me as true sacrifice.
Instead, I chose something I take for granted in my daily life, like the evening beer I drink while whipping up dinner, or the Wendy's I have after band practice on Wednesdays. Besides, I was putting on too much weight. Quoting Joni Mitchell, "You don't know what you've got 'til it's gone!"
Temptation? You bet. Worst temptation so far was Tuesday night. I cooked Beer Cheese Soup, where the recipe calls for one beer in the pot and one in the chef. Somehow it tasted different.
In conclusion of this topic I'd like to suggest to those of you who observe Lent to really think hard about what practice feels impossible to give up. Then DO IT. Believe me, after nearly 7 weeks, you will be a changed person.
This coming Monday the 9th marks my half-way point. 12 weeks since surgery, 12 more weeks until June 1st when (barring any complications) I will have no restrictions on activity.
I'm meeting with my Karate instructor Monday evening to review leg movements. I'm going to review the various stances and core movements with my PT next Friday.
I intend to return to Karate within a few weeks. There's no reason to do exercises in solitude at home when I can do them in the company of my peers! I'm running nearly 4 miles these days, and will add plyometric exercises shortly. Heck, some of those go beyond the boundaries of what we do at Karate!
My restrictions are fairly self-explanatory. Obviously I won't risk re-injury:
- No sparring (DUH!)
- No jumping kicks
- No turning kicks
- No snapping kicks (slow-count or slow-motion only)
But even with these restrictions, there's TONS that I can still accomplish.
I'm giving up on waiting.
Big guy like you, strong like an ox, you say you've given up?
Yes, it's true. I'm done for a while, and giving up.
Giving up something for Lent, silly!
What, you read the title after hearing nothing from me for weeks and just assumed the worst? C'mon, gimme a bit of credit here!
As has often, but not always, been my practice in the past, I'm resisting nearly 7 weeks of temptation. This year I've given up alcohol (except Communion at church) and fried food--specifically hamburgers and anything deep-fried. Believe me, as casual as it sounds it truly is NOT an easy thing to do.
So why bother?
I don't consider myself a fundamentalist or terribly evangelical sort of person, but I do enjoy a good challenge. For those unfamiliar with the basic premise, before he faced his final series of challenges culminating in execution, Jesus spent 40 days fasting in the desert and facing temptation by Satan to give up his mission.
These 40 days are represented by the season of Lent, during which the Christian church asks its membership to sacrifice some practice from Ash Wednesday through Easter. Somehow giving up red meat and opting for Fillet-O-Fish for 6 or 7 Fridays in the Spring just doesn't resonate with me as true sacrifice.
Instead, I chose something I take for granted in my daily life, like the evening beer I drink while whipping up dinner, or the Wendy's I have after band practice on Wednesdays. Besides, I was putting on too much weight. Quoting Joni Mitchell, "You don't know what you've got 'til it's gone!"
Temptation? You bet. Worst temptation so far was Tuesday night. I cooked Beer Cheese Soup, where the recipe calls for one beer in the pot and one in the chef. Somehow it tasted different.
In conclusion of this topic I'd like to suggest to those of you who observe Lent to really think hard about what practice feels impossible to give up. Then DO IT. Believe me, after nearly 7 weeks, you will be a changed person.
This coming Monday the 9th marks my half-way point. 12 weeks since surgery, 12 more weeks until June 1st when (barring any complications) I will have no restrictions on activity.
I'm meeting with my Karate instructor Monday evening to review leg movements. I'm going to review the various stances and core movements with my PT next Friday.
I intend to return to Karate within a few weeks. There's no reason to do exercises in solitude at home when I can do them in the company of my peers! I'm running nearly 4 miles these days, and will add plyometric exercises shortly. Heck, some of those go beyond the boundaries of what we do at Karate!
My restrictions are fairly self-explanatory. Obviously I won't risk re-injury:
- No sparring (DUH!)
- No jumping kicks
- No turning kicks
- No snapping kicks (slow-count or slow-motion only)
But even with these restrictions, there's TONS that I can still accomplish.
I'm giving up on waiting.
Wednesday, February 4, 2009
Old doc, new tricks
Thursday's visit with Dr. K went as expected. No surprises, and I'm cleared to begin running. Granted, in the chilly state I live in it's not been above freezing the entire month of January, and mornings are still dipping into the negative numbers even today. Combine that with a nasty cold I've been dealing with over a week, and I'm just not ready to head out for an early morning jog! I do promise to post some pictures when I do, however, since the mornings are so beautiful this time of year.
Having been through all this before, I had some fun with Dr. K and the medical student working with him. As I sat on the table with my legs dangling down, he asked "OK, which knee are we looking at today?" I told him to guess. "Well, they both look the same," he quipped.
I replied, "If you can't tell, then you must have done a pretty good job!" as I pointed to the left knee. Truth be told, they did look very similar in terms of minimized scarring. The only real give-away would be the slightly shorter patch of hair around the left knee and shin, still growing back from being shaved.
He demonstrated good surgical results to the student with a cursory Lachmann test and a pivot-shift test that months ago would have insulted the MCL sprain accompanying my torn ACL. We also chatted about the mechanics and root cause of injury to each knee, making for really rich conversation between surgeon, patient, and student.
At my 6-week appointment last year, I was asked if I had any more questions. "Sure," I said, "Am I going to be able to play drums??"
A puzzled Dr. K: "Well, I certainly don't see any reason you couldn't."
Me: "Great! 'Cause I can't play them at all!"
(insert rim shot: ba-dum bum)
This year: "Am I going to be able to pilot a plane?"
A year wiser Dr. K: "Could you do it before?"
See, you can teach an old Doc new tricks!
Having been through all this before, I had some fun with Dr. K and the medical student working with him. As I sat on the table with my legs dangling down, he asked "OK, which knee are we looking at today?" I told him to guess. "Well, they both look the same," he quipped.
I replied, "If you can't tell, then you must have done a pretty good job!" as I pointed to the left knee. Truth be told, they did look very similar in terms of minimized scarring. The only real give-away would be the slightly shorter patch of hair around the left knee and shin, still growing back from being shaved.
He demonstrated good surgical results to the student with a cursory Lachmann test and a pivot-shift test that months ago would have insulted the MCL sprain accompanying my torn ACL. We also chatted about the mechanics and root cause of injury to each knee, making for really rich conversation between surgeon, patient, and student.
At my 6-week appointment last year, I was asked if I had any more questions. "Sure," I said, "Am I going to be able to play drums??"
A puzzled Dr. K: "Well, I certainly don't see any reason you couldn't."
Me: "Great! 'Cause I can't play them at all!"
(insert rim shot: ba-dum bum)
This year: "Am I going to be able to pilot a plane?"
A year wiser Dr. K: "Could you do it before?"
See, you can teach an old Doc new tricks!
Tuesday, January 27, 2009
One down, four to go
Monday was my 6 week mark. This represents being 1/4 done with the 24 week protocol!
I celebrated today by forgetting my appointment to check in with Dr. K, and re-scheduled it for Thursday morning after my PT session.
Today's report: 30 reps @ 4 pounds, 32 sit-ups and push-ups. Numbers keep going up as the days go down!!!
I celebrated today by forgetting my appointment to check in with Dr. K, and re-scheduled it for Thursday morning after my PT session.
Today's report: 30 reps @ 4 pounds, 32 sit-ups and push-ups. Numbers keep going up as the days go down!!!
Thursday, January 15, 2009
Equality.
This morning's PT report:
- Flexion at 138°, full extension.
- Approved for slow-count kicks with the operative leg only, supporting on the non-operative leg. Cool!
- Step-down exercises are assigned to work further on strength and smoothness of transition when walking down stairs.
My last measured flexion in the other knee was 138°, so they both seem to be about the same. Further flexion is limited simply by my physiology, at least until I can kneel and sit on my feet!
Using 2lb. ankle weights for straight leg exercises (raises, abduction, adduction, standing hamstring curls). I can do about 20 reps without a pause, working up to 30 solid reps before increasing weight. By the end of the program, the goal is 10 pounds, 30 reps.
My non-operative leg is no stronger than my operative one, so I'm making an effort during PT to emphasize both legs equally.
For those who don't know what they are, slow-count kicks are an excellent exercise for strengthening your hip flexors. Their purpose is to enable greater height and control of kicks.
You begin in a fighting stance, then kick in 4 steps.
This example is for round kicks:
1. Pick up your kicking leg in its chambered position.
2. Slowly extend it out.
3. Slowly swing it just across that centerline.
4. Slowly swing it back.
5. Repeat 3 and 4 until your leg drops like a lead weight.
6. Re-chamber the kicking leg.
7. Put your kicking leg down (if it hasn't dropped of its own accord!)
8. Switch your stance and repeat with the other leg.
They are murder to do at first, but I've grown to enjoy slow-count kicks. When you begin, start on a wall or with a barre to grab, gradually progress to doing them without holding anything for support. Your hip flexors will be crying for mercy, so watch those first steps when you're done! If you do them for a while and they start to feel too easy, try adding ankle weights. Even 1/2lb. at the end of your leg is a huge challenge.
Kicking high takes two things: flexibility and strength. Leaning the torso way back does very little for improving kick height if you don't have strength, and slow-count kicks are probably the best exercise I know of to develop that strength. Enjoy trying them out--I know I will!
- Flexion at 138°, full extension.
- Approved for slow-count kicks with the operative leg only, supporting on the non-operative leg. Cool!
- Step-down exercises are assigned to work further on strength and smoothness of transition when walking down stairs.
My last measured flexion in the other knee was 138°, so they both seem to be about the same. Further flexion is limited simply by my physiology, at least until I can kneel and sit on my feet!
Using 2lb. ankle weights for straight leg exercises (raises, abduction, adduction, standing hamstring curls). I can do about 20 reps without a pause, working up to 30 solid reps before increasing weight. By the end of the program, the goal is 10 pounds, 30 reps.
My non-operative leg is no stronger than my operative one, so I'm making an effort during PT to emphasize both legs equally.
For those who don't know what they are, slow-count kicks are an excellent exercise for strengthening your hip flexors. Their purpose is to enable greater height and control of kicks.
You begin in a fighting stance, then kick in 4 steps.
This example is for round kicks:
1. Pick up your kicking leg in its chambered position.
2. Slowly extend it out.
3. Slowly swing it just across that centerline.
4. Slowly swing it back.
5. Repeat 3 and 4 until your leg drops like a lead weight.
6. Re-chamber the kicking leg.
7. Put your kicking leg down (if it hasn't dropped of its own accord!)
8. Switch your stance and repeat with the other leg.
They are murder to do at first, but I've grown to enjoy slow-count kicks. When you begin, start on a wall or with a barre to grab, gradually progress to doing them without holding anything for support. Your hip flexors will be crying for mercy, so watch those first steps when you're done! If you do them for a while and they start to feel too easy, try adding ankle weights. Even 1/2lb. at the end of your leg is a huge challenge.
Kicking high takes two things: flexibility and strength. Leaning the torso way back does very little for improving kick height if you don't have strength, and slow-count kicks are probably the best exercise I know of to develop that strength. Enjoy trying them out--I know I will!
Thursday, January 8, 2009
The 30's: Arriving and Leaving
Tomorrow I enter my 40's.
Today my PT confirmed that I've entered my 30's, so to speak...I have 133° of flexion in my knee!
That gives me a great feeling of accomplishment, especially in light of being just over 3 weeks out of surgery. By comparison, I was at 126° at this point with my right knee.
My final ROM in the right knee settled in at about 138° of flexion, -10° extension, so hearing my left knee is "in the hood" is quite exciting.
My extension still needs work, as I'm not quite into negative (hyper extension) numbers, but that mostly comes with time. I plan on prone leg extensions to push that issue. You lay on a bed face down, dangle the leg out with your knee at the edge of the bed and allow gravity to gently stretch things out into a slight hyper extension.
Taking stairs going up has become quite easy, but I'm still a bit unstable bending the operative knee going down. I'm fine until the last inch or two before my other foot lands, so I need some more strength work in that part of my range. I expect massive improvement when I begin squats in the next week or two.
I'm hoping my nighttime leg cramps go away soon. Other than ibuprofen--which is eventually gonna wear a hole in my stomach if I'm not careful--the practical solution has been a combination of a hot water bottle applied to the thigh and a large pillow between the knees.
The pillow keeps stress off of my sprained MCL, which I'm still nursing while in rehab for the ACL. Padding between the knees gives Mrs. Shaft a better night's sleep; I can sleep on my side comfortably and avoid waking her with snoring!
The weather around here is hovering near zero degrees, with forecasts into the negative double-digits next week. Boy I sure hope it warms up a bit before I start running!!! I'm looking forward to Robert Frost moments.
Happy Thursday, everyone!
Today my PT confirmed that I've entered my 30's, so to speak...I have 133° of flexion in my knee!
That gives me a great feeling of accomplishment, especially in light of being just over 3 weeks out of surgery. By comparison, I was at 126° at this point with my right knee.
My final ROM in the right knee settled in at about 138° of flexion, -10° extension, so hearing my left knee is "in the hood" is quite exciting.
My extension still needs work, as I'm not quite into negative (hyper extension) numbers, but that mostly comes with time. I plan on prone leg extensions to push that issue. You lay on a bed face down, dangle the leg out with your knee at the edge of the bed and allow gravity to gently stretch things out into a slight hyper extension.
Taking stairs going up has become quite easy, but I'm still a bit unstable bending the operative knee going down. I'm fine until the last inch or two before my other foot lands, so I need some more strength work in that part of my range. I expect massive improvement when I begin squats in the next week or two.
I'm hoping my nighttime leg cramps go away soon. Other than ibuprofen--which is eventually gonna wear a hole in my stomach if I'm not careful--the practical solution has been a combination of a hot water bottle applied to the thigh and a large pillow between the knees.
The pillow keeps stress off of my sprained MCL, which I'm still nursing while in rehab for the ACL. Padding between the knees gives Mrs. Shaft a better night's sleep; I can sleep on my side comfortably and avoid waking her with snoring!
The weather around here is hovering near zero degrees, with forecasts into the negative double-digits next week. Boy I sure hope it warms up a bit before I start running!!! I'm looking forward to Robert Frost moments.
Happy Thursday, everyone!
Tuesday, January 6, 2009
Phase Won.
My rehab program is in 4 phases:
I. 0-4 weeks: Range of Motion. Goal: ROM of 0-120° and walking without a limp.
II. 4-6 weeks: Strength, balance, and proprioception. Goal: Unrestricted walking, including stairs.
III. 7-12 weeks: Power, speed, and more strength. Goal: Begin return to running program.
IV. 13-24 weeks: Function, agility, hopping, sport specific drills. Goal: Complete rehabilitation.
Sunday marked the end of week 3. My last PT visit had me at -3° to + 116° ROM, which seems far ahead of my prior rehab! I've been taking stairs leading with the operative leg going up now, but we're waiting on leading with the good leg going down until I demonstrate more control.
The busyness of the holidays has kept my mind occupied, and these first 3 weeks have simply flown by. Here's the basics of where I'm at currently:
- ROM: Objectively I'd say I'm well into 120°+ of flex, and extension isn't hardly uncomfortable at all.
- Swelling: I have dimples around my kneecap again!
- Scarring: Scars are healing up nicely, just one persistent site that's still rather swollen but not painful. My PT is having me massage the scars to keep them from bonding to the underlying tissue.
- Mobility: Haven't used a cane since the first week.
- Bruising: The last traces of pooled fluid in my foot have faded to nearly nothing now.
- Walking: I still catch myself in a conservative gait, working on lengthening my stride.
- Strength: Strapping on 2 lbs. of ankle weights for straight leg lifts currently.
Since swelling has gone down, my other ligaments have taken the opportunity to get some exercise of the knee-cracking variety. Things are still a bit tender in that area, so I'm careful whenever getting up from sitting for long periods. I still get these wicked charlie horse cramps in my thigh in the evening, but ibuprofen usually takes care of those. If they continue much past about week 6, I'll get them investigated in case there's funny business with nerves in my back.
I'm two days into my resolution for sit-ups and push-ups, hoping it's a good habit that will develop over the next few weeks. Can't wait to start running in another 3 weeks, which is odd since I'm not normally much of a runner to begin with--but it always manages to fire me up for the day.
Black Belt Mama is heading in tomorrow morning for some corrective surgery on a protruding sheath from the interference screw installed in her shin. Keep her in your thoughts that her healing will be quick and devoid of any PT requirements!
Thursday is the next check-in with my PT. Friday is my 40th birthday. I expect great things from both.
I. 0-4 weeks: Range of Motion. Goal: ROM of 0-120° and walking without a limp.
II. 4-6 weeks: Strength, balance, and proprioception. Goal: Unrestricted walking, including stairs.
III. 7-12 weeks: Power, speed, and more strength. Goal: Begin return to running program.
IV. 13-24 weeks: Function, agility, hopping, sport specific drills. Goal: Complete rehabilitation.
Sunday marked the end of week 3. My last PT visit had me at -3° to + 116° ROM, which seems far ahead of my prior rehab! I've been taking stairs leading with the operative leg going up now, but we're waiting on leading with the good leg going down until I demonstrate more control.
The busyness of the holidays has kept my mind occupied, and these first 3 weeks have simply flown by. Here's the basics of where I'm at currently:
- ROM: Objectively I'd say I'm well into 120°+ of flex, and extension isn't hardly uncomfortable at all.
- Swelling: I have dimples around my kneecap again!
- Scarring: Scars are healing up nicely, just one persistent site that's still rather swollen but not painful. My PT is having me massage the scars to keep them from bonding to the underlying tissue.
- Mobility: Haven't used a cane since the first week.
- Bruising: The last traces of pooled fluid in my foot have faded to nearly nothing now.
- Walking: I still catch myself in a conservative gait, working on lengthening my stride.
- Strength: Strapping on 2 lbs. of ankle weights for straight leg lifts currently.
Since swelling has gone down, my other ligaments have taken the opportunity to get some exercise of the knee-cracking variety. Things are still a bit tender in that area, so I'm careful whenever getting up from sitting for long periods. I still get these wicked charlie horse cramps in my thigh in the evening, but ibuprofen usually takes care of those. If they continue much past about week 6, I'll get them investigated in case there's funny business with nerves in my back.
I'm two days into my resolution for sit-ups and push-ups, hoping it's a good habit that will develop over the next few weeks. Can't wait to start running in another 3 weeks, which is odd since I'm not normally much of a runner to begin with--but it always manages to fire me up for the day.
Black Belt Mama is heading in tomorrow morning for some corrective surgery on a protruding sheath from the interference screw installed in her shin. Keep her in your thoughts that her healing will be quick and devoid of any PT requirements!
Thursday is the next check-in with my PT. Friday is my 40th birthday. I expect great things from both.
Saturday, December 27, 2008
Love
My wife loves my knee.
She said as much this week.
Well, she loves the rest of me, too, but my operative knee in particular comes in handy for Christmas shopping since it nets me a handicapped parking pass.
Notable milestones:
- 110° of flexion, -3° extension, and straight leg lifts with no noticeable lag.
- Beyond weight-bearing and walking without a limp, I was actually able to balance on the operative leg on a mini trampoline at PT!
- Stitches are out.
- Immobilizer brace and cane are gone. Amen.
Only noticeable ongoing issues are my leg coloring up (normal, but rather gruesome looking) and mild cramping in my quads. I'm strictly on Ibuprofen, and should be weaning off that soon.
This year we added a Wii to the household. With the addition of the Wii Fit, I hope to work a lot on balance as I work on strength and flexibility throughout my rehab.
As I reflect on the events of my 39th year, I realize that I am approaching 40 with 3 people and 4 screws inside me.
My resolution this year is simple; Start daily push-ups and sit-ups January 1st, adding more each week. Starting at 10 of each daily, in addition to my PT regimen, and add 1 each day. By my anticipated return date in 20 weeks, I should be at around 150 daily. Wish me luck!
What's your fitness resolution this year?
She said as much this week.
Well, she loves the rest of me, too, but my operative knee in particular comes in handy for Christmas shopping since it nets me a handicapped parking pass.
Notable milestones:
- 110° of flexion, -3° extension, and straight leg lifts with no noticeable lag.
- Beyond weight-bearing and walking without a limp, I was actually able to balance on the operative leg on a mini trampoline at PT!
- Stitches are out.
- Immobilizer brace and cane are gone. Amen.
Only noticeable ongoing issues are my leg coloring up (normal, but rather gruesome looking) and mild cramping in my quads. I'm strictly on Ibuprofen, and should be weaning off that soon.
This year we added a Wii to the household. With the addition of the Wii Fit, I hope to work a lot on balance as I work on strength and flexibility throughout my rehab.
As I reflect on the events of my 39th year, I realize that I am approaching 40 with 3 people and 4 screws inside me.
My resolution this year is simple; Start daily push-ups and sit-ups January 1st, adding more each week. Starting at 10 of each daily, in addition to my PT regimen, and add 1 each day. By my anticipated return date in 20 weeks, I should be at around 150 daily. Wish me luck!
What's your fitness resolution this year?
Wednesday, December 17, 2008
Hack Shaft II: The Clone (Pictures!)
Welcome to the sequel.
Unlike many movie series, my second ACL reconstruction experience so far has exceeded expectations. Here's a few comparisons:
- Initial injury. No swelling vs. puffing up like a balloon. My ACL had somehow managed to fold over itself immediately after rupture, effectively choking off any hemorrhagic blood flow and preventing swelling. What a miracle and a blessing, it saved me from Pre-Op PT to restore Range Of Motion.
- Locating the femoral nerve. Got it the right away vs. needing a few minutes (and hitting some raw nerves in the knee joint.)
- Lower sedation levels. The spinal block injection didn't bother me any more than the prick from insertion of the I.V. catheter; last time they knocked me out for about 15 minutes. Since I was far less sedated, I was able to experience the whole surgical procedure without memory holes. Yes, I'm one of those sadists who watched his own surgery...Again!
- No nausea from pain meds. Since Vicodin made me constantly nauseous, I raised the issue this time. We ended up with good ol' Tylenol 3 (Tylenol + Codeine) and it worked like a charm. Vicodin and its analogs are powerful Codeine synthetics, and my pain threshold just didn't justify the side effects. I remembered tolerating Tylenol 3 in the past, so we combined that product with 800 mg doses of Ibuprofen and I was much more satisfied with the results. As of this morning I'm strictly on Ibuprofen since I had no significant pain when I woke up.
Some things weren't as positive. The spinal block began wearing off as they were closing up; last time it didn't begin wearing off until I was in Stage II recovery hanging out with Mrs. Shaft.
It didn't cause problems with any surgery-related pain since the femoral block was still active, but my posture on the table made things uncomfortable at that point.
My operative leg was strapped to an immobilizer board, and the end of it was digging into my left butt cheek. My right leg was dangling unsupported over the edge of the table at perhaps mid-thigh position.
The resulting dead (rapidly becoming live) weight pulled my lower back into an increasingly uncomfortable arch and began tweaking my lower back something fierce! I tolerated it to a point, and when it seemed like closure was still gonna take a bit I brought it to the attention of my nurse anesthetist. Since lumbar support wasn't available, and raising my torso to a higher angle just exaggerated the discomfort, I ended up with a shot of some narcotic (under protest.)
I felt it was overkill, and when the first dose didn't settle my lower back I got another. That settled things down, but made me a bit more woozy in recovery than I cared for. Leave it to an anesthetist to conclude the solution to any pain is more drugs.
My advice for anyone reading this and preparing for surgery: If you're awake, get lumbar support in place if possible!! My conclusion is they probably couldn't place anything there since it was the injection site for my spinal block, and perhaps they needed to watch it or something.
Once closing up was done, my cryo-cuff was installed as well as the immobilizer brace I'd brought in for re-use. This time, however, they installed a compression wrap along the length of my leg, rather than just gauze to hold dressings in place. Unfortunately this resulted in a lot of insulation between cryo-cuff and my knee, so it was pretty much ineffective until dressings were changed the following day and a few layers removed.
This morning was the 48-hour mark and so I removed the dressings to shower up. Things look pretty much as expected, but my leg as a whole seemed much more swollen than last time. I assume removing the compression wrap probably induced that, as well as a lack of proper cooling for the knee the day before.
The only thing out of the ordinary was a nickel-sized blister at the end of some of the steri-strips on my shin. I contacted a nurse at the clinic, and the conclusion is it was most likely the result of unusual rubbing at that spot. I trimmed back the steri-strips to better expose the blister, then padded the site with some larger gauze to protect it until it either drains or the fluid is re-absorbed. Fluid in it was clear, so I'm not too concerned unless it bursts and creates an opening for infection. Just something to watch over the next few days.
As for getting around, I'm on a cane at home already and crutches in public (for speed), so am able to bear weight well. Couldn't do a straight leg raise at PT yesterday, so I'm working on quad sets and assisted raises using my non-operative leg along with passive extension while icing and such. My numbers are +10° extension (should ultimately be around -10°) to about +75° flexion.
I got a looong way to go, baby!
For the gruesome of yousome, here's before and after pics of the ACL:
Unlike many movie series, my second ACL reconstruction experience so far has exceeded expectations. Here's a few comparisons:
- Initial injury. No swelling vs. puffing up like a balloon. My ACL had somehow managed to fold over itself immediately after rupture, effectively choking off any hemorrhagic blood flow and preventing swelling. What a miracle and a blessing, it saved me from Pre-Op PT to restore Range Of Motion.
- Locating the femoral nerve. Got it the right away vs. needing a few minutes (and hitting some raw nerves in the knee joint.)
- Lower sedation levels. The spinal block injection didn't bother me any more than the prick from insertion of the I.V. catheter; last time they knocked me out for about 15 minutes. Since I was far less sedated, I was able to experience the whole surgical procedure without memory holes. Yes, I'm one of those sadists who watched his own surgery...Again!
- No nausea from pain meds. Since Vicodin made me constantly nauseous, I raised the issue this time. We ended up with good ol' Tylenol 3 (Tylenol + Codeine) and it worked like a charm. Vicodin and its analogs are powerful Codeine synthetics, and my pain threshold just didn't justify the side effects. I remembered tolerating Tylenol 3 in the past, so we combined that product with 800 mg doses of Ibuprofen and I was much more satisfied with the results. As of this morning I'm strictly on Ibuprofen since I had no significant pain when I woke up.
Some things weren't as positive. The spinal block began wearing off as they were closing up; last time it didn't begin wearing off until I was in Stage II recovery hanging out with Mrs. Shaft.
It didn't cause problems with any surgery-related pain since the femoral block was still active, but my posture on the table made things uncomfortable at that point.
My operative leg was strapped to an immobilizer board, and the end of it was digging into my left butt cheek. My right leg was dangling unsupported over the edge of the table at perhaps mid-thigh position.
The resulting dead (rapidly becoming live) weight pulled my lower back into an increasingly uncomfortable arch and began tweaking my lower back something fierce! I tolerated it to a point, and when it seemed like closure was still gonna take a bit I brought it to the attention of my nurse anesthetist. Since lumbar support wasn't available, and raising my torso to a higher angle just exaggerated the discomfort, I ended up with a shot of some narcotic (under protest.)
I felt it was overkill, and when the first dose didn't settle my lower back I got another. That settled things down, but made me a bit more woozy in recovery than I cared for. Leave it to an anesthetist to conclude the solution to any pain is more drugs.
My advice for anyone reading this and preparing for surgery: If you're awake, get lumbar support in place if possible!! My conclusion is they probably couldn't place anything there since it was the injection site for my spinal block, and perhaps they needed to watch it or something.
Once closing up was done, my cryo-cuff was installed as well as the immobilizer brace I'd brought in for re-use. This time, however, they installed a compression wrap along the length of my leg, rather than just gauze to hold dressings in place. Unfortunately this resulted in a lot of insulation between cryo-cuff and my knee, so it was pretty much ineffective until dressings were changed the following day and a few layers removed.
This morning was the 48-hour mark and so I removed the dressings to shower up. Things look pretty much as expected, but my leg as a whole seemed much more swollen than last time. I assume removing the compression wrap probably induced that, as well as a lack of proper cooling for the knee the day before.
The only thing out of the ordinary was a nickel-sized blister at the end of some of the steri-strips on my shin. I contacted a nurse at the clinic, and the conclusion is it was most likely the result of unusual rubbing at that spot. I trimmed back the steri-strips to better expose the blister, then padded the site with some larger gauze to protect it until it either drains or the fluid is re-absorbed. Fluid in it was clear, so I'm not too concerned unless it bursts and creates an opening for infection. Just something to watch over the next few days.
As for getting around, I'm on a cane at home already and crutches in public (for speed), so am able to bear weight well. Couldn't do a straight leg raise at PT yesterday, so I'm working on quad sets and assisted raises using my non-operative leg along with passive extension while icing and such. My numbers are +10° extension (should ultimately be around -10°) to about +75° flexion.
I got a looong way to go, baby!
For the gruesome of yousome, here's before and after pics of the ACL:
The tip of the probe is in front of the Posterior Cruciate Ligament, the ACL's partner. "Cruciate" refers to the crossing of the two ligaments working in concert to hold the shin in proper position relative to the thigh. The lower end of the ACL took some bone with it when it ruptured, and somehow folded over itself choking off blood flow that would have otherwise caused massive post-injury swelling.
Welcome the PCL (top-left to bottom-right) and it's new ACL partner (bottom-left to top-right.) May they perform their duet perfectly in concert until the day I die.
Welcome the PCL (top-left to bottom-right) and it's new ACL partner (bottom-left to top-right.) May they perform their duet perfectly in concert until the day I die.
In closing this post, I want to take a moment to thank two anonymous people for their decision to be organ donors. Since my replacement ACL's are both allografts, (harvested from cadavers) I give my most heartfelt thanks to them both for checking that box on their state ID or driver's license forms. I hope you both enjoy the ride as I cruise into my 40's next month and continue my journey to black belt and beyond.
Monday, November 24, 2008
Time, and time again.
The date and time are set, the countdown reset.
December 15th, 8:30 am.
Saw Dr. K on Friday, he confirmed it is a complete ACL tear, and is just as baffled as I am as to the lack of swelling. He mentioned that sometimes it's the result of chronic ACL wear, but he saw no indication of that. Guess I'll just count my blessings I didn't have to go through the whole swelling-reduction program prior to surgery!
No indication of Meniscus damage, and signs of an MCL sprain which will resolve itself without surgical intervention.
As I head for my repeat, it's a reminder of all the things I had to do last time. Pre-op physical. PT appointments. Follow-up appointments. Work scheduling. Short-term disability. Allograft decision.
On.
And On.
And yes, I will be watching surgery again. That was cool the first time, gotta catch the sequel!
I will pack and gift wrap my uniforms and equipment this weekend. It was a ritual I used before, and one worth repeating. It symbolizes the pain of putting away my Karate for a while, with the promise of rebirth, restoration, and renewal in 27 weeks.
Happy Thanksgiving, all!
December 15th, 8:30 am.
Saw Dr. K on Friday, he confirmed it is a complete ACL tear, and is just as baffled as I am as to the lack of swelling. He mentioned that sometimes it's the result of chronic ACL wear, but he saw no indication of that. Guess I'll just count my blessings I didn't have to go through the whole swelling-reduction program prior to surgery!
No indication of Meniscus damage, and signs of an MCL sprain which will resolve itself without surgical intervention.
As I head for my repeat, it's a reminder of all the things I had to do last time. Pre-op physical. PT appointments. Follow-up appointments. Work scheduling. Short-term disability. Allograft decision.
On.
And On.
And yes, I will be watching surgery again. That was cool the first time, gotta catch the sequel!
I will pack and gift wrap my uniforms and equipment this weekend. It was a ritual I used before, and one worth repeating. It symbolizes the pain of putting away my Karate for a while, with the promise of rebirth, restoration, and renewal in 27 weeks.
Happy Thanksgiving, all!
Friday, June 6, 2008
Surgeon's Report: 3 Lovely Words
I had my final visit with Dr. K this morning.
His exact words:
WELCOME TO GRADUATION!
No more restrictions--even if I played football, he'd have OK'ed me for full contact.
The sky doesn't get any bluer, nor the light any greener than that. AMEN.
His exact words:
WELCOME TO GRADUATION!
No more restrictions--even if I played football, he'd have OK'ed me for full contact.
The sky doesn't get any bluer, nor the light any greener than that. AMEN.
Tuesday, June 3, 2008
Everybody hurts sometimes
So. My first report since returning to karate.
I gotta say, things are going fantastic!
I am resigned to non-contact exercise until I speak with Dr. K Friday morning, but that doesn't mean I can't have fun!
My first class last Friday with new students and lower belts went well. We worked on punches and elbow strikes a ton, with no leg movement save for shifting weight and proper hip rotation to put force into any given strike.
Saturday morning was an all-belt class, and in deference to my non-contact status, we worked with X-Ray paper. It makes effective targets, is durable, and offers a great snapping sound when you smack it! That class incorporated not just round kicks and hook kicks, but combinations and spin kicks as well. I proceeded cautiously, and by the end of class my knee gave no signs of trouble whatsoever delivering moderate effort kicks. It handled being the support leg on spin kicks just fine.
Monday I opted again for a lower belt class in lieu of sparring, which occurs immediately after class. Black Belt Lindsay brought birthday treats of killer cake and homemade ice cream, and we worked our stances.
Tonight's class was form work, and we ironed the wrinkles out of the middle section of the form where there's some odd front-back-front stance moves that challenge your thinking a bit! Class finished with body pad kicks, and I took that time to do my favorite slow-count kick drills. I'm impressed that most of my flexibility remained after slacking off of stretches the past 6 months.
So there's the first report since returning, folks.
Everything is far better than expected, and I'm much more relaxed since getting back into the swing of things. As my PT pointed out, I have some good experiences to use as feedback Friday morning when I meet with Dr. K.
And the knee? Haven't given it a second thought except to remember the all-important post-workout ice down. Truth be told, my knee is the one part of my body that isn't sore, and that's a good thing.
To quote R.E.M., "Everybody hurts, sometimes..."
I gotta say, things are going fantastic!
I am resigned to non-contact exercise until I speak with Dr. K Friday morning, but that doesn't mean I can't have fun!
My first class last Friday with new students and lower belts went well. We worked on punches and elbow strikes a ton, with no leg movement save for shifting weight and proper hip rotation to put force into any given strike.
Saturday morning was an all-belt class, and in deference to my non-contact status, we worked with X-Ray paper. It makes effective targets, is durable, and offers a great snapping sound when you smack it! That class incorporated not just round kicks and hook kicks, but combinations and spin kicks as well. I proceeded cautiously, and by the end of class my knee gave no signs of trouble whatsoever delivering moderate effort kicks. It handled being the support leg on spin kicks just fine.
Monday I opted again for a lower belt class in lieu of sparring, which occurs immediately after class. Black Belt Lindsay brought birthday treats of killer cake and homemade ice cream, and we worked our stances.
Tonight's class was form work, and we ironed the wrinkles out of the middle section of the form where there's some odd front-back-front stance moves that challenge your thinking a bit! Class finished with body pad kicks, and I took that time to do my favorite slow-count kick drills. I'm impressed that most of my flexibility remained after slacking off of stretches the past 6 months.
So there's the first report since returning, folks.
Everything is far better than expected, and I'm much more relaxed since getting back into the swing of things. As my PT pointed out, I have some good experiences to use as feedback Friday morning when I meet with Dr. K.
And the knee? Haven't given it a second thought except to remember the all-important post-workout ice down. Truth be told, my knee is the one part of my body that isn't sore, and that's a good thing.
To quote R.E.M., "Everybody hurts, sometimes..."
Friday, May 30, 2008
To Be Continued...
Ever watch a great show, only to be smacked by a To Be Continued... credit at the end?
Well, here's another one.
I thought my appointment was at 9, turns out it was at 8:30! And of course, the surgeon was leaving early today, so no possibility to wait for an opening later on. Now I'm scheduled to see him next Friday at 10:30...
AAAUGH!
Well, here's my deal. I'm already OK to work on my own with moderate tempo Karate per my PT. I will return to the mat tonight, with a self-imposed limitation of moderate tempo, non-contact kicking until I see Dr. K next Friday.
At this point I've just got to be out there with my peers, and I find no risk in doing what I'm already approved to do.
I'll just be doing it in uniform.
***UPDATE***
I spoke with my PT this afternoon, and she agrees with my limitations until I see Dr. K. That is, moderate tempo, non-contact activity on the operative leg. It's the same training I've been doing, just in a different venue and with friends. Yay!!!
Well, here's another one.
I thought my appointment was at 9, turns out it was at 8:30! And of course, the surgeon was leaving early today, so no possibility to wait for an opening later on. Now I'm scheduled to see him next Friday at 10:30...
AAAUGH!
Well, here's my deal. I'm already OK to work on my own with moderate tempo Karate per my PT. I will return to the mat tonight, with a self-imposed limitation of moderate tempo, non-contact kicking until I see Dr. K next Friday.
At this point I've just got to be out there with my peers, and I find no risk in doing what I'm already approved to do.
I'll just be doing it in uniform.
***UPDATE***
I spoke with my PT this afternoon, and she agrees with my limitations until I see Dr. K. That is, moderate tempo, non-contact activity on the operative leg. It's the same training I've been doing, just in a different venue and with friends. Yay!!!
Friday, May 23, 2008
Final week, and it's killing me!
One more week.
I'm dying here, folks, I really am. This week is going to feel as long as the prior 5 or so months unless I keep myself busy!
I'll admit, I have totally slacked off lately. However, I think I have the reason pinned down.
As I mentioned in my last post, I used to train for Triathlons, but the solitary nature of the training just wasn't my bag anymore.
Helloooo???
I'm training in solitude again!!! Geez, no wonder I'm going ape-shit.
I'm grateful for the long weekend and shortened work week. I'm finally getting a handle on some new responsibilities at work, and not stressing out nearly as much.
I plan to attend the evening class Friday, normally for beginning adults. At this time of year, however, it's sparsely attended if at all. I thought it'd be good to go for a gentle test drive during a quieter class. One of the younger students has been keeping tabs on me and is pledged to be at that class when I return.
I ran into one of our black belts at the store late Monday night (adult sparring night), and he shared how 'intense' sparring has gotten. They're even trying tag-team matches! Depending on my surgeon's opinion, I think I'll take the same tack that Bobspar did, and work sparring strictly on an upper-body basis until I've worked the knee a while in core classes.
My ultimate goal? To finish a sparring class injury-free. See, I've only ever made it to two classes; The first one, I rolled my ankle, aggravating an existing sprain that wasn't properly braced. The second one, I popped my ACL.
Besides running up to 4 miles, jumping rope, and doing some nutso hopping exercises, I have been doing moderate karate, primarily forms and my favorite slow-count kicks. There's a summer goals program that I look forward to, since it involves committing to and documenting additional aerobic exercise outside of class, push-ups and sit-ups. This much I can handle in solitude, given regular core classes to work out 'socially.'
I'm not going to go crazy when I'm back to karate, really I'm not.
But I am willing to learn how...
I'm dying here, folks, I really am. This week is going to feel as long as the prior 5 or so months unless I keep myself busy!
I'll admit, I have totally slacked off lately. However, I think I have the reason pinned down.
As I mentioned in my last post, I used to train for Triathlons, but the solitary nature of the training just wasn't my bag anymore.
Helloooo???
I'm training in solitude again!!! Geez, no wonder I'm going ape-shit.
I'm grateful for the long weekend and shortened work week. I'm finally getting a handle on some new responsibilities at work, and not stressing out nearly as much.
I plan to attend the evening class Friday, normally for beginning adults. At this time of year, however, it's sparsely attended if at all. I thought it'd be good to go for a gentle test drive during a quieter class. One of the younger students has been keeping tabs on me and is pledged to be at that class when I return.
I ran into one of our black belts at the store late Monday night (adult sparring night), and he shared how 'intense' sparring has gotten. They're even trying tag-team matches! Depending on my surgeon's opinion, I think I'll take the same tack that Bobspar did, and work sparring strictly on an upper-body basis until I've worked the knee a while in core classes.
My ultimate goal? To finish a sparring class injury-free. See, I've only ever made it to two classes; The first one, I rolled my ankle, aggravating an existing sprain that wasn't properly braced. The second one, I popped my ACL.
Besides running up to 4 miles, jumping rope, and doing some nutso hopping exercises, I have been doing moderate karate, primarily forms and my favorite slow-count kicks. There's a summer goals program that I look forward to, since it involves committing to and documenting additional aerobic exercise outside of class, push-ups and sit-ups. This much I can handle in solitude, given regular core classes to work out 'socially.'
I'm not going to go crazy when I'm back to karate, really I'm not.
But I am willing to learn how...
Thursday, May 8, 2008
Three weeks: A Genesis Story
In the beginning, there was Tri.
The Tri was with me
I was in the Tri
It was, you know, good.
It began with one Sister.
Then two.
Then three and four joined in, and numbers swelled to 9 of us doing Triathlons.
Crazy, good-natured, trash-talking, family relationship-building fun. That's 6 siblings, a brother-in-law, mid 70's mother, and a blind friend who is still inspiring to watch in competition.
While I no longer compete, training did establish comfort and familiarity with the core Triathlon elements of swimming, biking, and running.
While biking, I would watch my odometer and note mileposts to use for gaging distances when I was running. This morning I reached one of those well-used mileposts, the one marking a turn-around point 1.5 miles from my house.
I made 3 miles today...And it was good.
The Tri was with me
I was in the Tri
It was, you know, good.
It began with one Sister.
Then two.
Then three and four joined in, and numbers swelled to 9 of us doing Triathlons.
Crazy, good-natured, trash-talking, family relationship-building fun. That's 6 siblings, a brother-in-law, mid 70's mother, and a blind friend who is still inspiring to watch in competition.
While I no longer compete, training did establish comfort and familiarity with the core Triathlon elements of swimming, biking, and running.
While biking, I would watch my odometer and note mileposts to use for gaging distances when I was running. This morning I reached one of those well-used mileposts, the one marking a turn-around point 1.5 miles from my house.
I made 3 miles today...And it was good.
Friday, May 2, 2008
Four weeks to go:Time for some numbers.
I had it in my head that a 6 month rehab program = 26 weeks. From my surgery on January 2nd, this works out to July 2nd.
However...the rehab program is actually 24 weeks, or June 18th!
I'm going with my PT's opinion and my gut at this time (and it's still pretty sizable), that my visit with Dr. K on the 30th will result in my returning to Karate. Updated my countdown to reflect this.
I am exhausted this week. I'm trying to wrap up mixing my band's CD so we can publish it this month (www.oceansmusic.net), and only get time late at night at the rehearsal studio. Combine that with the early morning regimen to prepare for returning to Karate at the end of the month, and I'm burning the candle at both ends!
To fit everything in, I created two alternating day schedules, with a lighter "rest" day on Sunday.
M-W-F: Running and Karate
- Run 20 minutes, increasing to 30 by month end.
- 15 minutes of figure-8 running, starting long and wide, shrinking to sharp turns by month end
- 5 minutes of backwards running uphill, increasing as I'm able
- 15-20 minutes of slow tempo Karate form, stance marches, slow-count kicks, increasing to moderate tempo by month end
T-Th-Sa: Jump, Hop, Strength and Balance
- 5 minutes of jump rope, working up to 10 minutes by month end (great for sparring footwork endurance)
- 20 minutes of hop exercises: box, diagonal, straight line, zig-zag line, working up to one-leg by month end
- Strength exercises working up to 10 lbs. of ankle weight, various squats, hamstring curls, planks, core, pushups and situps
- Closed eye balance and stances with G-Shaft gently pushing or pulling to challenge proprioception
Sunday: Light 20 minute jog with extensive stretching
It's aggressive, but I truly want to stage a decent comeback. So far I've got no unusual pain or aches from all this stuff. I also have it written out so I don't have to think so hard in the morning!
Time to shop for cross-trainers...
However...the rehab program is actually 24 weeks, or June 18th!
I'm going with my PT's opinion and my gut at this time (and it's still pretty sizable), that my visit with Dr. K on the 30th will result in my returning to Karate. Updated my countdown to reflect this.
I am exhausted this week. I'm trying to wrap up mixing my band's CD so we can publish it this month (www.oceansmusic.net), and only get time late at night at the rehearsal studio. Combine that with the early morning regimen to prepare for returning to Karate at the end of the month, and I'm burning the candle at both ends!
To fit everything in, I created two alternating day schedules, with a lighter "rest" day on Sunday.
M-W-F: Running and Karate
- Run 20 minutes, increasing to 30 by month end.
- 15 minutes of figure-8 running, starting long and wide, shrinking to sharp turns by month end
- 5 minutes of backwards running uphill, increasing as I'm able
- 15-20 minutes of slow tempo Karate form, stance marches, slow-count kicks, increasing to moderate tempo by month end
T-Th-Sa: Jump, Hop, Strength and Balance
- 5 minutes of jump rope, working up to 10 minutes by month end (great for sparring footwork endurance)
- 20 minutes of hop exercises: box, diagonal, straight line, zig-zag line, working up to one-leg by month end
- Strength exercises working up to 10 lbs. of ankle weight, various squats, hamstring curls, planks, core, pushups and situps
- Closed eye balance and stances with G-Shaft gently pushing or pulling to challenge proprioception
Sunday: Light 20 minute jog with extensive stretching
It's aggressive, but I truly want to stage a decent comeback. So far I've got no unusual pain or aches from all this stuff. I also have it written out so I don't have to think so hard in the morning!
Time to shop for cross-trainers...
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