Shannon

On a somewhat related note, I will be moving up the January 10th anniversary contest drawing and announcement to February 3 since I'll be in the hospital for all of the 4th (the original month-end deadline).

I promise to create an easier to use contest entry form and provide some more info on future months' prizes. I didn't get many entries through the forum announcement alone, and only started really hearing from folks after sending out an abbreviated (and much overdue, as ever) Wild Texas Newsletter.

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- Shannon Moore
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Shannon

Hey gang, just a quick update. I am walking again, albeit with a hinged brace to protect my post-op knee. I walked 1 mile today on a paved walking/jogging trail in my parents' neighborhood...of course, it took me 38 minutes to walk that mile, but it's a start. I carried a crutch with me just in case, but didn't use it except on very steep portions or where the pavement's cracking (the trail's in a bit of disrepair).

I have physical therapy three times a week for the foreseeable future (think: 4 months, at least).

Just wanted to touch base and let everyone know I had rejoined the bipedal community!

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toejam

Good for you. Keep up the hard work and start planning a trip for motivation.

lost_but_found

Sounds like you are doing a great job of cautiously strengthening your knee! That is what a quick recovery is all about - just be careful not to over-do. Here's wishing for a quick and full recovery!!

vettech2112

You've definately given me confidence about my knee issues. My new insurance will be in effect in March and I'll be at the orthopedist soon thereafter else I will have to face the wrath of my lady love. I was afraid of what they might find but your quick recovery has made me a bit more willing to go face the music.

I agree that planning a hike might be good motivation for your speedy recovery.

Shannon

I have to admit I'm as surprised as anyone by how smoothly this has all gone. Youth is definitely a factor, but I also believe in the power of a positive attitude. My fellow knee rehabbers fall into two distinct groups -- those who, like me, come in to PT with a smile and upbeat attitude ready to face the challenges; and those who, either due to pain, personality or both, come in surly and negative about their progress, ("I'm a wimp." "My knee will never be the same." "It just hurts so bad I don't think I'll ever be able to ____.") Even though there are definitely moments one of those thoughts crosses my mind, they're squashed by a positive, goal-oriented focus: "I'm doing my best, and that's always good enough." "I couldn't do this exercise 2 weeks ago, and now look at me!" "I can't wait until I get to ____ again."

I take a pain pill before most of my PT sessions. At first, I thought it might not be wise as I could push my knee too hard, but it's worked out well. I only need 1/2 of a pill anyway, and soon I won't even need that. The soreness is becoming more of a deep muscle pain/ache, with only brief moments (during certain exercises) of sharp pain, generally where my meniscus was torn and cut out (partial) or on my knee cap where the patellar tendon piece was harvested to make my new ACL.

The ACL brace I wear is awesome. I can totally trust my knee when it's on -- it's what I should have been wearing prior to surgery, to prevent my knee from repeatedly giving out on me like it was. That might have saved my meniscus, though that's just an idle thought.

I sleep well at night and am back to normal duties. I go up and down our stairs at home as often as if I were not just 3 weeks post-op. Sure, I'm sore and feeling it by the end of the day, but it's progress. The only problem I have is going down the stairs I have to take them one at a time. I can't quite get my left leg to travel the full range it needs to take the stairs down as one would normally (alternating legs).

I posted a bit about the exercises I do in PT in my entry in today's knee journal: http://geekhabitat.com/200/day-17-to-be-continued/

I need to scan my exercise sheets (for the at home exercises I do daily) and post those. I'll do that soon. They're exercises you could do before surgery to strengthen your quads, hamstrings and calf muscles -- the stronger you go in to surgery, the less you have to work to rebuild after surgery and the better stabilized your knee will be (regardless of if you have any ligament tears).

If I can get you a PT recommendation, let me know. My physical therapists work with the SA Spurs and other athletes (soccer, baseball, etc.) and they may be able to recommend a physical therapist in your area.

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- Shannon Moore
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Shannon

Just a brief progress report -- I see my orthopedic surgeon for my 2 month post-op checkup on Friday, and my physical therapists said at 8 weeks post-op (which is what I am), I'm basically DONE! Graduated! That doesn't mean I'm 100%, by any means, but what it means is all the things that they do in PT are to regain normal flexion (bending ability of the knee) and extension (straightening the leg), rebuild wasted away muscles (happens after any orthopedic surgery) and teach the patient to use the "new knee" (which will feel different for quite awhile, even after its healed, since the ACL you're born with has the ability to communicate to the brain your joint's position and status and that's something that has to be relearned after ACL reconstruction.

I feel great and have for several weeks now! I have occasional twinges of pain, but nothing too severe -- actually about the same as what I dealt with prior to surgery (but that was ALL the time; now it's just when I do certain twisting movements which the knee's not quite ready for).

I'll let you all know when I'm "hike-able" again. I suspect my OS will say, "Go for it, just wear your brace and listen to your body!" I've walked 2.6 miles already today and am waiting for Justin to get home from work to walk another 2 miles with him. Walking's been my primary exercise outside of PT and at least in my case it's made all the difference in the world (mentally, as well as physically -- something proactive I can do to help the knee along and get outside.)

It'll be awhile before I can jump into backpacking with real weight on my back, but I will be camping ASAP (too bad I missed the brief but heavenly cool part of Texas springtime -- 86+ degrees today, grrrr...) and I'll be hiking as soon as I get the nod from my surgeon.

My PT won't entirely cease, it's just that it's now my responsibility rather than my therapists to guide me through exercises. They've been GREAT!!!! If you live in San Antonio, Austin, San Marcos, Corpus Christi or Mexico City, I highly recommend the physical therapy component of The Orthopedic Store. Superb staff (I've been going to the San Antonio Airport location, on Arion Pkwy in San Antonio), all the right equipment, good attitude (make you work, but work to have fun as you progress, too) and well worth the time. My surgeon prescribed me to them, so it was the luck of the draw, but if I ever had a loved one needing physical therapy (they don't just do knees -- there are hand, shoulder, neck, hip and back patients as well), I would definitely recommend them.

I'll post another update after I see my surgeon on Friday. I'll probably be jazzed because I think he'll clear me to walk on paved and level surfaces without my hinged brace now and that's been my mental waypoint for resuming hiking of any kind.

Thanks for the support gang. I had no idea I'd be this far along and feeling this good just 2 months post-op. I've worked hard in PT and listened hard, and I'm sure some of it's just luck/genetics, but whatever it is I have been thrilled with the outcome thus far.

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- Shannon Moore
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ploddinTod

Shannon,

I think you and Justin need to make plans right now for the weekend, hoping the OS gives you the go ahead. A cool front will be in place, so camping should be very pleasant. What would you do about hiking? Limit yourself to level, smooth and easy trails? Guess that rules out E-Rock.

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PloddinTod

Shannon

Funny you should mention Enchanted Rock. Guess who hiked both to the summit of Erock and the Echo Canyon Trail prior to surgery? I wore a cheapo neoprene wraparound brace on my knee, and was hurtin' pretty good, but I did it. When my MRI results came back and I realized I'd just hiked up Erock with a severed ACL and two meniscus tears, let's just say I was a little unnerved! Also went out on the Intercoastal Waterway in pretty good chop just days before my MRI...not a wise move -- I could barely walk on land, much less on a boat in choppy water!

I did .25 miles on rocky, uneven terrain Monday and .5 miles on the same today with some small hills thrown in (just a neighborhood area park -- the Leon Creek Greenbelt) and fared well. And walked another 2.25+ miles with Justin this evening. My OS appointment on Friday is in the afternoon, and we're probably flying to Tyler this weekend for a day trip (no hiking or park visiting, alas -- no time). But I'm booking a campsite ASAP even if it's midweek or Justin's out-of-town (he has a bunch of business trips coming up).

I don't think I'll be climbing up Trail 5A at Hill Country SNA on my first trip out, but in terms of miles I'm ready to put some good mileage on my new knee and she how she fares. I'll probably start off easy with the 6 mile loop I'm familiar with at Guadalupe River SP near my house -- mostly flat, with plenty of rocks and roots to retrain my left leg to respond when I say "LIFT" at a moment's notice. At this point in my rehab, muscle strength is key but so is something called "proprioception" -- regaining that connection between the brain and the joint. I figure the more miles, the more retraining the brain and joint get.

I'm dying to camp and hike. Maybe I can convince Justin that I don't really need to tag along on the Tyler flight (truth be told, I'd already been working on him!) I need to celebrate, and what better way than in the great outdoors?!

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- Shannon Moore
Your Host @ WildTexas.com

munkee

It's great to hear that your recovery is going so well. I had Arthroscopic on my left knee about the same time that you did, around the beginning of Feb. I have been released to "do without pain" and some mild road cycling. I think you have the absolute right frame of mind for healthy recovery. DO YOUR EXERCISES! Yeah, sometimes it sux and hurts, but better for a short period of time now, than the rest of your life! You know at one point I read that the ACL on a womans knee is the most common female sports injury. I don't remember why exactly, but it happens alot. Well, congrats on a speedy recovery...

Shannon

Well, gee, you should've spoken up sooner -- we could've compared notes and traded flexion numbers in friendly competition! (What are you at, now? ) I have a knee journal I've been keeping since I first injured my knee -- http://geekhabitat.com/topics/wellness/knee-health/


Re: women and ACL tears --
Yep, women are 2 to 8 times more likely to tear their ACL than men. Wish I'd know that before, though I'm not sure what good it would have done me!

There have been a lot of studies about why women are incurring more ACL injuries than men. A lot of it seems to make sense, but it's hard to know which is the predominant reason.

Some of the research I've read indicates:

* Women's hamstrings are not as developed in relation to their quads as they are in men. Hamstrings are the primary support mechanism (second only to the ACL) of the knee. This is why rehabbing the hamstrings and quads is so important after ACL reconstruction, or for dealing with a partial ACL tear without surgical intervention. Oddly enough, I had a hamstring autograft, which means they took 4 strands of my own hamstring out and used it to form my new ACL. So my hammys are even weaker than they would be normally, although after 8 weeks of intensive PT I think they're getting better -- my quads are starting to come back in the post-op leg, and I can do hamstring curls better (faster/easier) than I could a couple weeks ago.

* Women tend to land poorly from jumps (hence the MUCH higher incidence of ACL injuries in the WNBA than the NBA). I don't know if this is due to body structure or sports training at an early age... nothing I've read really explains the "why" behind this one.

* A woman's wider pelvis creates a greater angle in relation to their lower leg, transferring more stress/strain on the ACL and makes proper landings all the more crucial. This is also true in pivoting sports (basketball, soccer, tennis).

* Women have a femoral notch that is not as wide as in men, and this notch is what the ACL passes through. A smaller notch equals a greater chance of tearing or severing the ACL. Of course, the perplexing thing is our ACL is also smaller, so shouldn't that be okay?

* Some studies have tried to correlate women's hormone levels (estrogen during ovulation) with their joints and ligaments growing softer and more lax and thus more susceptible to tears. Nothing conclusive, but some compelling circumstantial data, at any rate.

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- Shannon Moore
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munkee

Well, I was doing really well until I was in a hammock and it slipped a little and made me knee jerk my quad. Immediate and excrutiating pain. A quick call to the PT and she says I probably tore the scar tissue. She says it can be a good thing, but I beg to differ. I felt like I was set back about a week and a half. I go tomorrow so she can give me a reality on where I am.

Shannon

First Hike Post-Op (10 Weeks after ACL Reconstruction & Meniscus Repair):

Location: Guadalupe River SP Multi-Use Trail (All of Trail 1 & 2; avoided Trail 3)

First off, I did this without the 100% blessing of my OS -- he didn't tell me NOT to go hiking, but he'd have preferred I wait until I'm 4 months post op (16 weeks). I do so much walking on uneven, "iffy" pavement during my 2.5 to 5 mile walks every couple days that I've gained a comfort level with the knee that my OS can't have, since it's not attached to him.

I was very, very careful. Hiking boots, my hinged brace, and a walking staff for balance and stability particularly on declines/inclines.

Hiked 4.2 miles (forgot my GPS, but I'm familiar with the hiking trail and the route I took -- see my trip report from a hike last year prior to my knee injury.) I'd forgotten how ROCKY the trail is, so that slowed me up considerably and made the hike rather boring -- I've never stared at the GROUND so much on a hike in my life. But it was better than tweaking the knee in any way and doing what we all fear most -- ruining the graft I've worked so hard to protect and build muscles around since February 4th (incidentally, today is exactly 10 weeks to the day of my surgery.)

I had some twinges of pain in the post-op knee, but mostly due to bumping the toes of my hiking boot against a rock -- sending vibrations up through the leg. That, and I no longer wear the brace for daily activities and walking (OS cleared me off it at 8 weeks post-op), so I'm not as used to the feeling of the brace pressing directly on my shin scar and wire-threading hole on the lateral side of my leg/knee. Those don't like HARD pressure on them, and that's what the brace does, depending on how the leg muscles are contracting at a given moment.

I had planned to potentially hike all 6 miles of the trail I'm familiar with, but it was better to quit while I was ahead. Moderate swelling after the hike, but actually less than I anticipated. No pain in the knee several hours now after the hike -- my shins (both legs) and feet (both legs) are what's grousing right now. My post-op leg's hamstrings and quads complained a little during the hike, particularly on uphill sections (not a massive grade, but more than these legs have seen in 16+ weeks, since my injury curtailed my hiking long before surgery came along.) But the muscles are fine after a short 1 mile walk on relatively flat plavement after the hike.

ONE TIP FOR HIKERS:
I was a dummy and never did my exercise walking while wearing my hiking boots (Vasque Sundowner Women's GORE-TEX leather boots -- can you tell I *love* them!?) The added weight, coupled with the completely different feel of them (high-top leather boots vs. my walking shoes) made the first 1-1.5 miles even more challenging because it seemed difficult to lift up the post-op leg sufficiently to get clearance over rocks and tree roots (a little scary, and the cause of my 2 or 3 toe hits against rocks on the post-op foot).

So, I'd advise folks who are cleared to resume hiking or backpacking start wearing their boots (and, if a backpacker, after some boot-wearing walks, your pack as well -- with a moderate load). That'll get your muscles, knee and brain back into the proper behaviors and is safer than just setting off down the trail for the first time in the boots, like I did today.

I didn't carry ANY extra weight (my usual camera gear and CamelBak water pack stayed at home), and my pace was way off my pre-injury norms... and I was rather bored because I was being SO CAREFUL I really couldn't appreciate the scenery unless I was stopped, and spent the whole time staring at rocks, roots and dirt to plan every footfall. So I think ultimately the OS is right -- really getting back to hiking like I enjoy isn't going to come until 14 or 16 weeks post-op, like he said, but at least I know my impressions on how the knee and leg is doing are accurate.

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- Shannon Moore
Your Host @ WildTexas.com

ploddinTod

Hey, Shannon, I like your new avatar. But you should have some sort of wrap on that knee signifying that you're on the mend.

BTW, good job on all that hard work invovled with your rehab. :yes:

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PloddinTod

Shannon

Grin! If I hadn't been "attacked" by the metal support on a recliner recently, I'd actually be braceless and wrapless by now (17 weeks post-op, as of Friday). Unfortunately, I knocked the knee but good last Wednesday -- hard enough to break the skin right over my healed shin incision -- so I'm back in my hinged brace for awhile yet. Justin emailed me that some friends of his from work want to have us join them on a hike up Enchanted Rock on Saturday. I've tentatively OK'd, although I think I'll probably be a straggler behind the group since the knee's just not back to it's pre-recliner attack status.

No permanent damage, but plenty of new bruising and soreness. Unfortunately, surgery can't cure genetic klutziness.

PS: Avatar was drawn by my brother, Thomas Wakefield Blackburn IV. (We like long names in my family; grandfather, Thomas Wakefield Blackburn II, wrote the lyrics to the "Ballad of Davy Crockett", as I've mentioned before.)

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- Shannon Moore
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