Little Miss Lucky

Happy St. Pat’s day to all from “Little Miss Lucky”–that’s me moments after my surgery.

Thanks to massive pain killers and nerve blocks, I don’t really remember most of it. I remember waking up to graham crackers and ginger ale and the nurse directing me to eat the crackers. I just wanted to fall back asleep. My leg was numb, but I could feel the bulky weight of my new reality. Maybe if I could go back to sleep, I could magically awaken to a fully rehabbed and strong ACL? Not the case. That was too much to think about. As the anesthesia slowly wore off, my surgeon came in the room. I felt like I needed to ask him so much, but was first concerned with how I was going to get into my car and leave the hospital; I couldn’t bare to think of life beyond that. Then he said,”Well, the worst part is over. It all gets better from here.”

He was and is right. Once you make the surgical decision to reconstruct your knee, every day from that point on gets better and the only thing you have to do is progress. I know, this sounds contrary to what most of the rest of this blog says. Rehab is not easy, but the great thing is that you have the opportunity each day to “rebuild” your knee and the rest of your body. You become more conscious of movements, body mechanics and proper form. You never take a moment you can move for granted again. Most people will never see life–or their bodies–from that angle. So complain as we do, the whole ACL experience makes us better athletes –and people in the end. Lucky us 🙂

The title quote belongs to my therapist. In PT we’ve been focusing intensely on strengthening the gluts–never gets old.
It’s all about getting the butt in shape so it will pull your body into better alignment and prevent further injury.
The butt is easier than you think to whip into shape, at least for the knee-supportive-strengthening purposes. Start with stairs and sitting/standing–two activities will do multiple times throughout the day. Since so much of rehab is a head game, and retraining your thinking about how your muscles work, get yourself to think that using your butt muscles is the ONLY way to pull yourself up from a seat and up a flight of stairs. So squeeze, pull and repeat. Try to consciously think about it for one whole day. If your butt isn’t sore by the end of the day, then try harder 🙂

It sounds simple, but you want to focus on retraining your “head,” which will trickle into every exercise, movement and sport you do.

A long, but informational video on Glute Strengthening and Theory from Posture Exercises blog.

Recently while leaving a PT appointment, I found one of their general business cards for their office, the San Francisco Sport and Spine Physical Therapy.

It struck me because it was very clever and filled with great tips, but it also struck me because I just complied my “10 Golden Rules of ACL Rehab Therapy.” Very timely. I was also surprised that three of their tips overlapped mine. Great people must rehab alike 🙂

This is what the front of the card looks like:

The back of the card reads:

“Tips for Saving Your Knees”

Don’t lock them.

Wear good shoes.

Run on grass or asphalt. Avoid concrete.

Sqaut like you are sitting: stick your butt out.

Stretch your legs, not your back.

Ramp up running or lifting in steps, not leaps.

Support your arches.

If it hurts, don’t do it. Ask for help.

If it hurts anyway, call us.

Help out a fellow reader! Please comment if you have any experience with this ACL subject matter.

Jaime, who recently commented on the ACL Happy Hour post, wrote:

“I am a ski patroller in the East and was skiing moguls and made a cut turn and heard the biggest POP you could imagine. My ACL was torn and along with it came a piece of my tibia which is displaced, and a torn meniscus. I have surgery next week and depending on how big the bone piece is the surgeon will either fix my meniscus, take out the bone fragment, clean it up, rehab me and then do the ACL reconstruction as a separate surgery… ORR if the bone fragment is too big to be removed he will pin it and suture it back, and then repair my ACL, meniscus and clean it all up in one surgery. Unfortunately, the second option will likely leave me with a very difficult recovery of motion.

So, I too am really nervous about the surgery and getting back to skiing. I never really thought I would have an injury like this, especially as a patroller. If this is still active, I would appreciate if anyone has had the displaced tibial bone piece I would appreciate information on the recovery for this!”

I’m almost nine months post-op to the day. Over the months–the pre-op, op and post-op altogether–I’ve gained valuable fro insight from my blog readers, fellow ACL survivors, my surgeon, physical therapists, co-workers and perfect strangers who noticed my brace, crutches or limp and were kind enough to share their words of advice.

So I’ve managed to save all the advice from all of these people over the last few months. And I encourage you to add anything that’s helped you along the way, as well.

10. “Do something every day.” -my physical therapist in San Fran

Whether it’s leg lifts, clams, stretches or intense cardio, it’s important to do something towards progressing your recovery every day. We all don’t have all the time in the world, but we have to do what we can to make recovery a priority. No matter how small the #of reps. It’s better than nothing.

9. “Invest in good running shoes.” -my cousin, the triathlete

If you have a good pair, you know they make a world of a difference. Have your PT evaluate your gait and help you determine if you need running shoes for stability or motion control.

8. “The hamstrings are most important for stability.” -my San Fran ortho dr.

Make them strong–really strong. They will help compensate for a less-than-optimal knee.

7. “Don’t let your knees go over your toes!” -my Jillian, the trainer from “Biggest Loser” (she yells @ me when I do her “30-day Shred” workout video)

No matter what the lunge, stretch or squat may be, it’s important to keep yourself aligned to prevent injury and pain!

6. “Work your core.” my Chicago PT

Same thing with the hamstrings, you gotta work your core to keep you stable and strong and prevent any other injuries.

5. “Clams are your best friends.” -My San Fran PT

They strengthen your glutes and work that IT band. Two major, major factors in determining your rehab success back to normal activity.

4. “It it’s too painful, stop.” -My surgeon’s nurse

3. “Some weeks are better than others.” -My surgeon

Sometimes you feel you can run a marathon and sometimes you hobble home from the gym, either way, you have to accept that this is how life will play out from now on. But, because of this experience, you are more cautious of your activities and more grateful for the opportunity to move your body every way you can.

2. “Performing less exercises with good form is better than doing a lot of reps in bad form.” My Chicago PT

Have your PT assess how you are performing the exercises. Practice makes perfect, but the practice has to be perfect form. It’s better to focus on the biomechanics of doing the exercises correctly than trying to do the most reps you can. Once the form is proper, then you can do all the reps you like.

1. “P-A-T-I-E-N-C-E.” My mom

No one said it’d be easy. Before you physically go into this process, you have to mentally prep yourself for the time it’s going to take and the time you will have to devote to getting yourself back to “normal.” Just remember we are all different. We are heal at different times. And we all return to sports at different times. The text book recovery for ACL reconstruction is 6-8 months. But you and your knee are unique like everyone else. Don’t let the textbook tell you when you feel like yourself, and take your time. It’s better to be fully prepared to compete, then rush into anything and risk further injury, or a re-injury.

Brace Yourself

Today I am getting fitted for brace that I will (or should) use for playing sports from here until about a year on out. Some people wear them longer, some wear them less. It’s whatever you feel most comfortable doing. Some people wear them for years as a preventitive measure. My doctor said it more or less serves as a “reminder” that you have a weaker knee.

Leading up to today, the only thing I knew about braces is that they are bulky, expensive and, well bulky. A lot of people get a customized brace which can range from $-$. Yikes! (No one said this injury was cheap.) You can also buy braces “off the shelves.” You can do this through knee brace industry experts, like Don Joy, or from your friendly corner store, like CVS. I will say it right now–I do NOT reccommend buying a post-op brace at CVS, especially for your initial return to full-contact sports. I’m simply stating that you can buy braces there. Maybe at some point down the road when you are well past surgery and just need a little brace to help you out, but even then, that’s your personal call.

Anyway, I’m measured, fitted and ordered for my new brace. I’ll let you know the damages when I find out.

What are your thoughts on braces? How often do you use them? Do you find them helpful?

Not every post has to be medically aligned or directly dealing with personal experience. How about something out of the ordinary for once?

I saw these silk-screened stockings today on Marc Zacharoff”s “We Love Viral” blog. When it comes to all the ways we’re required to dress our knees (i.e. bandages), think outside of the brace.