Rehab: Weeks 19 - 27


March 17, 1998
The results of my second Cybex test last Friday look great. I am now at the minimum 70% strength across the board required to start the running program of my rehab, with one odd exception. As I almost expected, the high torque, low speed numbers shot up considerably as a result of the intensive weight training I put my left leg through, with the results (surprisingly) more than doubling over where they had been 10 weeks ago. But what I didn't expect was that the low torque, high speed results would drop off from last time, with the relative quad strength dropping by 18% and the relative ham strength dropping by 7%. But even though I'm below the 70% minimum for low torque, high speed quad strength, my PT, Jenny, has decided that those results (since they dropped from last time) are probably a fluke and has released me to start the running program.
Jenny is also going to let me gradually move from the first phase of the return to sports to the second phase. In addition, I'm also OK to start some more serious cycling, that is no more being stuck to the saddle. I can now stand on the pedals for hill-climbing and building speed. Finally, I'll be working out of phase one of the return and through phase two, and then, in a month or so, get set-up with an athletic trainer to begin working on the final steps toward a full return to sports.
At 18 weeks post-op as of today, I can't say how good it feels to finally be this close to calling myself recovered. It's been a long, hard road so far, and I'm certainly not kidding myself that the next few months aren't going to be equally tough. I'm ready, though. If anything, the last 5-1/2 months since I've injured myself have prepared me for this final push.
I know now that there's little I can't do, as long as I tell myself I can do it, and then never forget that fact. I've developed a sense of patience greater than I've ever known before, and learned, by one of the hardest ways possible, that good things truly do come to those who wait. And, most importantly, I've learned that at some point in everyone's life God sends something their way to test their faith and courage, and this, I believe, has been my test. I can only hope that I've passed, but deep down I know that I have, so far anyway. And I have no doubt whatsoever that I will pass the final part, too.

March 20, 1998

Yesterday, I went running for the first time in nearly six months. And I found out just how out of shape I am. I wasn't able to run more than two laps on a 170 meter indoor track. I wound up running two laps, walking two, running two more, then walking two. After stopping to stretch, I walked two more laps, and finished by running one lap.
Psychologically, it felt great. Physically, my knee felt strong and there wasn't any pain until I was nearly done with my last lap, then my knee started to feel sore, but it quickly went away when I did my cooldown stretching.
I know that this doesn't follow the running protocol set out by my rehab, but I thought that since I didn't run a half mile in one stretch, I should do a little more.

April 1, 1998

Boy oh boy, have I been a slacker in more ways than one. It's been way too long since I've updated this journal for one thing. But much, much worse I haven't been putting much effort into my rehab. I've only been doing the minimum to get by and haven't been running in at least a week. My academic advisor has been pushing me for a rough draft of my Master's thesis and that's been taking up most of my time the last week. Tomorrow I have to get back to the gym and spend some time on the running track as well as in the weight room. The only up side has been the fact that I've been doing a lot of walking and biking to get around lately.
And the whole issue of time comes up again for this summer. I'll be working a job tht requires 50 to 60 hours a week, plus being on call 24 hours a day. Somewhere in there I'm going to have to figure out how to squeeze in time to exercise. I'll probably have to get up early to work out and then try to squeeze in more work out time after I get done at the office in the afternoon and before I go back in the evening. I'm still not sure when I'll sleep.
The one thing, though, that my return to running has emphasized is just how out of shape I am. Not being able to do more than two laps on a 170 meter track is a bit of a downer. I think part of it is also that my leg is still relatively weak, compared to what it used to be.
The real downer, though, is how slow my progress has become. There's no noticable improvement anymore, especially not like it was in those first few weeks after surgery, when I could see changes even over the course of half an hour of rehab exercises. But the difficulty I have with running gives me something to measure myself against, and now I'm going back to my rehab with a whole new vengance.

April 3, 1998

The dim, flickering candle at the end of the tunnel is finally becoming a bright, blazing fire. At eight days shy of five months post-op, I challenged my knee today, and it came through with flying colors. It was anything but intentional, though.
When I was running at the gym I noticed that the b-ball courts were pretty much open on one side (the running track looks down on the courts). To make a long story short, I checked out a basketball and intended to just shoot around for a few minutes before hitting the weight room. Well, a few minutes turned into an hour, and involved a bit more than just shooting around. Once I got started, I just kept going a little farther and a little farther.
For the most part the bit more wasn't anything I'm not supposed to be doing as part of my return to sports rehab, the only real difference was that I included a basketball. OK ... so here it is: Side-to-side dribbling (similar to lateral shuffle), backward dribbling (back pedal), and running half court laps and dribbling (jog curves). But I also did a few things I probably shouldn't have (but only a little bit ... honestly). Things like pivot and shoot in the paint and a few short drives to the basket. But no jump shots or jumping up to rebound. I even had a little fun, tossing up about half a dozen half court shots and actually putting one through.
The bottom line is this: As I sit here tonight typing this, my entire body aches, with the exception of my knee. When I got done, my knee felt great! No soreness or pain, no stiffness, no weakness or buckling. It felt great afterward, I didn't even need to ice it. The best part, however, was that there were times out there on the court when I hardly even thought about my knee, and the knee felt strong and stable the whole time.
The other good news (great news!) of the day is that when I saw Dr. Mott this morning, he told me he wants me to go in for another Cybex test along with functional testing in four weeks and then see him two weeks after that. He said I'm probably about ready to graduate, that is be released for sports.
It's looks like I'm on my way into the home stretch. As Vince Lombardi was fond of saying, "Tomorrow, we start the big push." (Read Jerry Kramer's Instant Replay for a better understanding.)

April 10, 1998

After running at the gym today, I headed down to the basketball courts again, and shot around and did some dribbling drills, same as last week. Only this week I could feel the workout in my knee. There were some sudden, slightly sharp pains but nothing that made me stop for more than a few seconds. I was on the court for over an hour and felt totally free. Afterward, the knee felt OK, but once again the rest of me was pretty sore.

April 16, 1998

I set up what should hopefully be the last testing on my knee. I have an appointment to meet with an athletic trainer on May 4th for strength and functionality testing. At the same time I'll be working with her to set up exercise programs to carry me through the rest of my return to sports as well as the rest of my life. Then I meet with Doctor Mott on the 15th and that should be my "graduation" day, that is the day I get my release back into sports.
I was in the gym again doing a some weight work followed by a little running and stretching to cool down. I did the usual leg presses and ham curls, as well as a few laps of jogging and quite a few walking on the 170 meter indoor track.

April 17, 1998

Today I decided to forgo my usual Friday hoops and work in the weight room after running instead. I did 6 sets of 20 leg presses at 165 lbs., 4 sets of 15 ham curls (with the left leg doing about 2/3's of the work) and 2 sets of 20 hip abductions on each leg. I know it's not too smart to do weights two days in a row, but right now I have to squeeze in workouts whenever I can fit them into my schedule.

April 18, 1998

Biking today has taught me one thing above all else, my return to sports is going to be tougher than I thought. I can't ride on the road more than half an hour before my legs get sore and tired. It's going to take a lot of work to get my legs back into shape after a six month layoff.

April 22, 1998

I have to offer an apology for my journal not being available for so long, but it seems my ISP made some changes in its service and Internic (the organization that registers such things as IP's and URL's) took its own sweet time getting those changes recorded and logged. I have been writing entries all along, but I wasn't even able to log into my ISP's server to upload them, but now they are, and my journal is back.

May 1, 1998

Basketball today was more rewarding than ever. I started doing some pivoting and jumping. Everything felt great, even though my knee is a little stiff tonight, it doesn't hurt in the least. The rest of me hurts pretty bad, though. I guess that comes with the territory (in this case the territory being an hour on the b-ball court). I'm still not playing against anyone, and I think I'm going to wait till sometime in August or September before I get on any kind of court with other people. That may be a bit conservative, but I feel like I'd rather be safe than sorry.
The other big event is that Monday I'll be spending an hour-and-a-half with one of the athletic trainers in my clinic. She'll be testing my relative leg strength and functional abilities to see if I'm ready for a full release to sports. Be watching this site Tuesday morning, as I'll have my results posted by then. In addition to the training, she'll also be going over (what hopefully will be) my final exercise regimen for my return to sports. One of the major things I'll need to go over with her is a "compressed" exercise program for this summer. One that I can squeeze into a half hour in the morning before I head into the office where I'll be working, followed by another quick half hour in the evening before a grab a quick dinner and then head back to the office for a couple more hours of work. But, with a good program and some dedication, I should be back on the courts full-bore by this fall.

May 4, 1998

My third Cybex test shows that the strength in my left and right legs are now starting to become more equal. These numbers are a big change from the numbers of my last test, but Amy, the athletic trainer I was working with, said that Cybex numbers can vary from test to test but that my results today are still very good. So, now I'm a lot more interested in things such as what I can do and what my endurance is like. My focus from here on is going to be on my overall functionality.
The other part of my time with the AT today was to take a look at where I am functionally, and from what she saw, things are looking pretty good. I also worked on the next phase of the return to sports progression. But more importantly, to figure out what and how I can squeeze a daily exercise program into 30 minutes a morning this summer, since my time is going to be so limited by the fact I'll be working so many hours. The bottom line is that the phase 3 part of the return should work out just fine and I should also be able to fit in 45 minutes or so of cycling in the evening before dinner and my second round at the office.
Finally, I also learned some very important lessons today. How to run, decelerate, jump, land and cut on the court to protect my knees in the future. For instance, on a turn, planting the outside foot farther out to cut and turn leaves the knee open to a greater chance of a torn ACL. The better way is to round the turn more, and plant the inside foot and pivot through the turn. This eliminates the sudden deceleration of planting the outside foot to make a sudden cut.
There was one thing, though, that I didn't want to hear. While I was icing down after being run through my exercise program, Amy told me to expect my knee to hurt and swell more often now that I'm getting into a more full-blown exercise routine. It is a bit of a relief, though, to hear that this is pretty typical and nothing to be too worried about. She said to remember that ice is my friend and be willing to use it whenever I need it.
Well, next stop is next week Friday (the 15th) when I see both Dr. Mott (my OS) and Jenny (my PT) for what will hopefully be my "graduation."

May 11, 1998

Six months post-op as of today. Nothing else to say, just wanted to make note of that fact.

May 15, 1998

Today was a big day! I saw my OS this morning and he told me everything is looking great. He was happy to hear that my knee isn't giving me any problems and doesn't hurt and isn't stiff, except occasionally (which doesn't concern me too much since it was stiff and sore from time to time before I injured it). He was also pleased with the results of my last Cybex test and said it looks as though the strength is coming back really nice. The bottom line is that he told me to come back in six weeks and that he'd most likely "graduate" me at that time (i.e. give me my full release).
Then a little later in the morning I saw my PT, and she cut me loose with the advice to stick with the advanced return to sport exercises. After asking how things were going and how my knee was feeling, and finding out Dr. Mott was also ready to cut me free, she said I could probably start to slowly work my way back into sports participation, as I feel both physically and psychologically able. The best feeling was Jenny telling me that I was one of their "real success stories."
Back in the "dark days" of November, right after my surgery, I never thought this day would come. I remember lying on the couch in pain, unable to bend my knee very much. For about a week every time I stood up there was a tremendous burning pain in my shin. I couldn't sleep at night. My quads, what little was left of them, were about the consistency of Jell-O. Being dependent on others to go places or for things as simple as having a glass of water with me while I was watching TV.
Today I still remember the progression of my rehabilitation and recovery, but it only seems like I do in snippets (the milestones are what pop up). I can remember being overjoyed at eight days post-op when I took my first shower. I can remember the disappointment of not doing very well on that first Cybex test at eight weeks post-op. I remember my first bike ride back in the first week of March, that was my first truly liberating experience. I remember coming back in mid-March and kicking the Cybex machine's butt. I can remember the sheer delight, the idiot's grin plastered across my face, when I took that first lap around the track back in March. I remember that first day back on the basketball court, when a few minutes of shooting around before hitting the weight room turned into an hour and resulted in all of me being stiff and sore except my knees.
But most of all I think I'll remember this day, because now I think back on the day of surgery, while lying in the recovery area, and remember thinking, "What the hell have I just gotten myself into?" Thinking that I was an out-of-shape weekend warrior in his middle thirties who should forget all this nonsense about getting my ACL reconstructed and just settle into a nice peaceful middle age. But then as I worked through my rehab I started setting goals for myself. I want to learn how to ski this winter, I want to learn how to sail next summer. And now, more than ever, I want to get back onto a volleyball court and prove to myself that I can still do it. That I'm not afraid of coming back.
Stayed tuned.


Rehab: Six Months Plus