Wednesday, June 11, 2008

What did I just do to my knee?

On Friday, June 6, 2008 I tore my ACL while playing basketball. After getting my results from my doctor a week later – after the MRI and some physical assessments – I decided to write a blog to detail my progress. This blog will serve as a document for any other person who tears an ACL and wants a first-hand account of what to expect.

Some background: I’m a personal trainer. I’ve been doing this for about 8 years now – 4 at Washington Sports Clubs and 4 with my own gym, Balance Gym. Somehow I fell into post-rehab work – getting people back from MCL tears and sprains, ACL tears, meniscus tears, low back pain, herniated discs, broken wrists, etc. Right now I have a client, Zoe, who tore her ACL a year ago and had her surgery with Dr. D. She also rehabbed with Chris. I started training her a week before I tore my ACL. So I’ve been doing balance and core stability work for years. It’s not like I’m a de-conditioned person carrying extra weight. In fact, since I returned from my trip, I’ve been training like mad.

First, the incident: It was another regular Friday night at the gym, playing 3 on 3. I drove to the paint, went for a jump-stop and upon landing, felt my knee go side-to-side, giving out on me and then I fell to the ground. I didn’t hear the “pop” that is common with ACL tears, but looking back, I did feel a slight pop. Knowing what it could be I iced my knee throughout the night. The next morning I knew I was in trouble. I couldn’t straighten my knee and it was pretty swollen. The swelling, I would learn later, is from a vein/artery/blood vessel that runs through the ACL and ruptures when the ACL tears. This fills the knee with blood, hence the swelling. Fearing the worst, I called Chris, the Physical Therapist that my gym has a referral reciprocity agreement with. He came by in the afternoon, did some assessments and determined that my MCL was still intact. The ACL? He couldn’t tell.

It was still swollen and wasn’t getting any better. Sunday was spent hobbling around. In fact, I took the scooter out for a drive around all the monuments – I figured since I can’t walk, I might as well scoot.

On Monday I headed in to Chris’ office to get the knee checked out. He gave me ice and heat therapy, electric stimulation and had me contract my quad 20 times in a minute while a machine measured my progress. My quad wasn’t firing off – shut down, basically. On Tuesday, I saw Chris again and then saw the orthopedic surgeon that he works with, Dr. D. Dr. D performed another physical assessment – which didn’t give him any conclusive evidence of a tear. So he scheduled me for an MRI on Wednesday. The MRI took about 20 minutes – they took 5 series of photos from all angles – I know this from looking at the photos. I looked at the MRI photos, but I couldn’t see more than my PCL. The rest I wasn’t so sure about.

My next appointment with Dr. D was Friday morning at 8 – D Day for my ACL. I didn’t have a good feeling going into the appointment. My knee was still swollen, I couldn’t straighten or bend it all the way – I knew it was fucked (a very scientific term, by the way). Dr. D confirmed my fears – he said, “Do you want to bad news or the good news?” I replied, “I know it’s torn.” He said, “Ok, here’s what’s next” and then began to outline my choices.

So Dr. D gave me the low-down. My ACL had to be reconstructed (as compared to repairing it, which can't be done). This would be done through surgery – my ACL would be reconstructed with a graft of a bone-ligament-bone piece into the 2 bones that the ACL connects to – the femur and the tibia. The graft options are the patellar tendon or the hamstring tendon. The patellar is the first choice since its similar in length to the ACL (isn’t our Creator creative?). And this graft could come from me or a cadaver, and by cadaver I mean a dead guy. Hopefully this dead guy had good knees. So that’s my first decision. I’ve been researching the pros and cons of each. There are plenty of sites detailing these, so I will sum up. If I choose to use my own patellar tendon, they will slice open my knee and take 1/3 of my patellar tendon out. They will also take a piece of bone from the femur and tibia (shin bone). The pros: it’s my own tissue. The cons: It’s basically 2 surgeries – one to cut the front of my knee and the other to reconstruct the ACL. I could also experience discomfort kneeling in the knee since it would have been cut open. The cadaver? The pros: it’s only one surgery. I won’t experience front knee pain. The cons: it’s dead tissue that my body could reject. Some report that it’s not as stable.

So I’ve been asking around to get other opinions and find out other people's experiences who have also torn an ACL and undergone surgery. Sophie, Eric, Erica, and Holly all had cadaverous replacements and they seem to be happy with them. Sophie and Eric recently had them done; Erica had hers done about a year ago. Eric’s surgeon works with DC United, so he’s got professional athletes to repair. Not sure if that’s a good thing, though. Professional athletes need to get on the field quickly, so maybe the “fast” option is taken so that they can play while still under contract. I am thinking more long-term; I want to able to be active forever, not just the next three years!

So, more research today. I am also going to get into the psychological part that I dealing with. I am also going to outline the training I will do both before and after surgery,

The other thing I have to deal with is the psychological part of surgery. I am very active, both in my personal life and my business life.

Here’s what I am told is the time frame: Now to July 10, rehab the knee – building up the muscle and getting back range of motion. I am told that from research, this will speed the recovery of surgery. July 10 - Surgery. Then rehab...

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