In order to provide some context as to when the injury occurred, what's happened since then, and where I'm at now, here's a brief timeline.
Day -1 (Fri, Feb. 24):
Woke up dog-early to road trip from Boston to southern Virginia for a college ultimate frisbee tournament.
Day 0 (Sat, Feb. 25) -- The injury:
In the first game of the tournament, I was loading on one leg to jump for the disc (kind of like a lay-up) when my opponent directly hit the side of my knee, causing it to snap sideways and produce the dreaded pop. After 15 or so seconds of panic I realized I could move the knee and was able to walk off the field. The athletic trainer on duty couldn't definitively say what was wrong. She told me to take the rest of the day off and maybe I could try playing the next day. There wasn't much swelling or loss of motion, so I was hopeful that it was just a bad bruise or something like that.
Day -1 (Fri, Feb. 24):
Woke up dog-early to road trip from Boston to southern Virginia for a college ultimate frisbee tournament.
Day 0 (Sat, Feb. 25) -- The injury:
In the first game of the tournament, I was loading on one leg to jump for the disc (kind of like a lay-up) when my opponent directly hit the side of my knee, causing it to snap sideways and produce the dreaded pop. After 15 or so seconds of panic I realized I could move the knee and was able to walk off the field. The athletic trainer on duty couldn't definitively say what was wrong. She told me to take the rest of the day off and maybe I could try playing the next day. There wasn't much swelling or loss of motion, so I was hopeful that it was just a bad bruise or something like that.
Day 1 (Sun, Feb. 26):
Woke up to a very swollen knee. The swelling caused my quad to shut down, which amplified the instability. I could walk, but very slowly. At the fields I borrowed crutches from the athletic trainer, so I could get around faster when I needed to.
Day 2 (Mon, Feb. 27):
While the rest of the team flew back to Boston, I drove to North Carolina to hang out with one of my best friends, Faith, who recently started med school there. Lucky for me I hurt my left knee so driving myself was fine.
I probably should have been using crutches at this point, but it didn't seem worth it to drop $50 for a pair at CVS when I knew I had some at home.
Woke up to a very swollen knee. The swelling caused my quad to shut down, which amplified the instability. I could walk, but very slowly. At the fields I borrowed crutches from the athletic trainer, so I could get around faster when I needed to.
Day 2 (Mon, Feb. 27):
While the rest of the team flew back to Boston, I drove to North Carolina to hang out with one of my best friends, Faith, who recently started med school there. Lucky for me I hurt my left knee so driving myself was fine.
I probably should have been using crutches at this point, but it didn't seem worth it to drop $50 for a pair at CVS when I knew I had some at home.
I considered going to an urgent care place to get it checked out, but decided against it because I assumed they would just take a bunch of money, take some x-rays, tell me it wasn't broken (which I knew), and tell me to RICE. I figured the damage has been done so it is what it is, and I wasn't in excruciating pain so it didn't seem like an emergency.
Day 3 (Tues, Feb. 28):
I had a blast hanging out with Faith! We didn't actually do much, but spent a lot of time catching up and goofing off. It was so encouraging to be able to pick up where we left off, and the visit was confirmation that this friendship will last through the distance.
Day 3 (Tues, Feb. 28):
I had a blast hanging out with Faith! We didn't actually do much, but spent a lot of time catching up and goofing off. It was so encouraging to be able to pick up where we left off, and the visit was confirmation that this friendship will last through the distance.
That night I drove to the airport to go back to Boston. Getting from the rental car drop-off area to the gate carrying my backpack and duffel bag was slow and scary, but fortunately the gate was right past security so I didn't actually have to walk very far.
Day 5 (Thurs, Mar. 2) -- First doctor's visit:
Was finally able to see the sports med doctor (I'll call him Dr. F), who also happens to be the team doctor who took care of us when I played soccer in undergrad. He's worked with me with several injuries, so we know each other fairly well and I have a lot of respect for him.
He examined my knee, performed all the typical tests, and said "I can read you pretty well by now, and I know you're worried about the A-word." (He actually said "the A-word," haha.) He was right. Anyone who has ever played cards with me knows I have no poker face. He had a suspicion that the ACL was torn, but couldn't say for sure because I had enough muscle guarding that the tests weren't effective.
Dr. F also took some x-rays to make sure that there were no fractures (which I already knew and wasn't concerned about).
Day 6 (Fri, Mar. 3) -- MRI and physical therapy:
Got an MRI in the morning. I know most people hate the noise and claustrophobic environment of MRIs, but I actually find them oddly relaxing. It was nice to sneak in some mini-naps while the magic magnets created 3d images of what I would later find out was the remnants of my ACL.
I have already been doing PT for my shoulder (which I had repaired a year ago), so it was pretty easy to sneak in a session for my knee in lieu of the appointment I already had for the shoulder that day. After this injury, I'm pretty sure my therapist wants me to burrito myself in bubble wrap every time I step onto a field from now on. But hey, she should be happy, I'm keeping them in business. Boy, was this the most painful PT session I have ever had! I went in with only about a 45 degree range of motion, which was apparently not acceptable. So she had me lay on my back, told me to take a deep breath (side note: not a reassuring thing to say to someone), and forced it to bend farther. She might as well have been trained in martial arts, because she had me writhing around on the table nearly screaming "mercy."
As painful as PT was that day, I did leave the office with a significantly improved ROM. Probably more importantly, though, that experience taught me that it in this instance it was okay to push through the pain in order to regain function.
Day 5 (Thurs, Mar. 2) -- First doctor's visit:
Was finally able to see the sports med doctor (I'll call him Dr. F), who also happens to be the team doctor who took care of us when I played soccer in undergrad. He's worked with me with several injuries, so we know each other fairly well and I have a lot of respect for him.
He examined my knee, performed all the typical tests, and said "I can read you pretty well by now, and I know you're worried about the A-word." (He actually said "the A-word," haha.) He was right. Anyone who has ever played cards with me knows I have no poker face. He had a suspicion that the ACL was torn, but couldn't say for sure because I had enough muscle guarding that the tests weren't effective.
Dr. F also took some x-rays to make sure that there were no fractures (which I already knew and wasn't concerned about).
Day 6 (Fri, Mar. 3) -- MRI and physical therapy:
Got an MRI in the morning. I know most people hate the noise and claustrophobic environment of MRIs, but I actually find them oddly relaxing. It was nice to sneak in some mini-naps while the magic magnets created 3d images of what I would later find out was the remnants of my ACL.
I have already been doing PT for my shoulder (which I had repaired a year ago), so it was pretty easy to sneak in a session for my knee in lieu of the appointment I already had for the shoulder that day. After this injury, I'm pretty sure my therapist wants me to burrito myself in bubble wrap every time I step onto a field from now on. But hey, she should be happy, I'm keeping them in business. Boy, was this the most painful PT session I have ever had! I went in with only about a 45 degree range of motion, which was apparently not acceptable. So she had me lay on my back, told me to take a deep breath (side note: not a reassuring thing to say to someone), and forced it to bend farther. She might as well have been trained in martial arts, because she had me writhing around on the table nearly screaming "mercy."
As painful as PT was that day, I did leave the office with a significantly improved ROM. Probably more importantly, though, that experience taught me that it in this instance it was okay to push through the pain in order to regain function.
Day 7 (Sat, Mar. 4):
The PT experience the day before inspired me to attack rehab pretty aggressively. I spent about 3 hours practicing walking back and forth along the hall in our apartment until I reached as normal of a gait as I could manage. I also started doing some hamstring, quad, and hip strengthening. My goals were to (1) Walk as normally as possible, and (2) Get to the point where I could commute to/from work on my bike again.
The PT experience the day before inspired me to attack rehab pretty aggressively. I spent about 3 hours practicing walking back and forth along the hall in our apartment until I reached as normal of a gait as I could manage. I also started doing some hamstring, quad, and hip strengthening. My goals were to (1) Walk as normally as possible, and (2) Get to the point where I could commute to/from work on my bike again.
Day 10 (Tues, Mar. 7) -- MRI Results:
By this time I could walk almost normally and straighten my knee almost all the way. I was beginning to wonder if maybe my knee was okay after all! The several-day interim between the MRI and results was excruciating: hoping with all my might that everything was fine, while at the same time knowing in my gut that all was probably not fine. I just wanted to know, so I could move on mentally!
In the afternoon I finally had the anxiously-awaited appointment with Dr. F to find out my fate. Alas, my knee was definitely not fine. Here's the list of injuries from the report:
We set an appointment and surgery date with Dr. S, the surgeon who would piece my knee back together.
Day 11 (Wed, Mar. 8):
I bought a basic knee sleeve from a local running store, and wow! I always thought those sleeves looked useless, but the compression does wonders for swelling and stability. Since then the sleeve has been my best friend. It drastically decreased my limp and allowed me to walk faster.
I started on the stationary bike (with no resistance). It was pretty painful and stiff at first, but felt pretty good after 10 minutes or so!
Day 12 (Thurs, Mar. 9): Juggling:
I recorded this video a few minutes after discovering that I could juggle a soccer ball:
By this time I could walk almost normally and straighten my knee almost all the way. I was beginning to wonder if maybe my knee was okay after all! The several-day interim between the MRI and results was excruciating: hoping with all my might that everything was fine, while at the same time knowing in my gut that all was probably not fine. I just wanted to know, so I could move on mentally!
In the afternoon I finally had the anxiously-awaited appointment with Dr. F to find out my fate. Alas, my knee was definitely not fine. Here's the list of injuries from the report:
- Completely torn ACL
- Torn medial and lateral menisci
- Grade 1 sprains of MCL and LCL
- Grade 2 strain of gastric muscle (calf?) and popliteus muscle (never heard of this, but google says it's a small muscle in the back of the knee)
- Bone contusions in tibia and femur (where the bones crashed into each other, I assume)
- Joint effusion (swelling) -- duh!
We set an appointment and surgery date with Dr. S, the surgeon who would piece my knee back together.
Day 11 (Wed, Mar. 8):
I bought a basic knee sleeve from a local running store, and wow! I always thought those sleeves looked useless, but the compression does wonders for swelling and stability. Since then the sleeve has been my best friend. It drastically decreased my limp and allowed me to walk faster.
I started on the stationary bike (with no resistance). It was pretty painful and stiff at first, but felt pretty good after 10 minutes or so!
Day 12 (Thurs, Mar. 9): Juggling:
I recorded this video a few minutes after discovering that I could juggle a soccer ball:
Though my knee was still too unstable to do any tricks (yes of course I tried), it was still a huge relief to realize I could juggle again. It made me feel a little more like myself. That night I went to the gym and spent about 30 minutes doing basic juggling,
I also tried the elliptical at very light resistance and ramp, and almost broke a sweat.
Being able to do these somewhat normal things was such a mental boost in the midst of a rough week of coming to terms with the reality of the injury.
Day 16 (Mon, Mar. 13):
4.5 miles in 40 minutes on the elliptical, with decent resistance. This was one of the first real workouts, and it felt so great to be huffing and puffing on that machine that I used to hate. After this, I ended up doing an elliptical workout pretty much every day until surgery to try to maintain some cardio fitness.
Day 19 (Thurs, Mar. 16) -- Back to bike commuting:
I finally felt like my knee was stable enough and had enough range of motion to try biking on the road. I cleared this with my PT first, who helped me come up with a strategy for safely biking in traffic (e.g. walk up hills, don't put full weight on left leg while accelerating from a stop). There were still some painful and unstable instances like initially pushing off from the ground. But even though it was painful, once I was in traffic I felt totally comfortable and in control, so it was plenty safe.
Being able to ride a real bike again was a significant milestone for me because it provided physical, mental, and logistical freedom. It cut my time spent getting from place to place in quarter and made me much more mobile.
Day 24: (Tues, Mar. 21) -- Pre-op with Dr. S:
During every interaction I've had with any kind of medical professional since this injury (athletic trainer, sports med doctor, physical therapist, and now surgeon), they have all performed the same series of tests on my knee. The point of each of these tests is to either (a) reproduce instability, or (b) reproduce pain. It's pretty disturbing to watch and feel someone manipulate your bones into directions they definitely shouldn't be able to move. If the MRI wasn't enough, Dr. S was definitely convinced that my ACL was torn after he had the chance to twist and pull on my knee!
I also tried the elliptical at very light resistance and ramp, and almost broke a sweat.
Being able to do these somewhat normal things was such a mental boost in the midst of a rough week of coming to terms with the reality of the injury.
Day 16 (Mon, Mar. 13):
4.5 miles in 40 minutes on the elliptical, with decent resistance. This was one of the first real workouts, and it felt so great to be huffing and puffing on that machine that I used to hate. After this, I ended up doing an elliptical workout pretty much every day until surgery to try to maintain some cardio fitness.
Day 19 (Thurs, Mar. 16) -- Back to bike commuting:
I finally felt like my knee was stable enough and had enough range of motion to try biking on the road. I cleared this with my PT first, who helped me come up with a strategy for safely biking in traffic (e.g. walk up hills, don't put full weight on left leg while accelerating from a stop). There were still some painful and unstable instances like initially pushing off from the ground. But even though it was painful, once I was in traffic I felt totally comfortable and in control, so it was plenty safe.
Being able to ride a real bike again was a significant milestone for me because it provided physical, mental, and logistical freedom. It cut my time spent getting from place to place in quarter and made me much more mobile.
Day 24: (Tues, Mar. 21) -- Pre-op with Dr. S:
During every interaction I've had with any kind of medical professional since this injury (athletic trainer, sports med doctor, physical therapist, and now surgeon), they have all performed the same series of tests on my knee. The point of each of these tests is to either (a) reproduce instability, or (b) reproduce pain. It's pretty disturbing to watch and feel someone manipulate your bones into directions they definitely shouldn't be able to move. If the MRI wasn't enough, Dr. S was definitely convinced that my ACL was torn after he had the chance to twist and pull on my knee!
The most important order of business during this appointment was to decide which graft to use. The most common options are hamstring tendon and patellar tendon. They are both great options, but based on the literature and articles I had read before the appointment, I had loosely decided to go with the patellar tendon. Dr. S confirmed that that was what he would recommend for me.
Dr. S also gave me the low-down on what to expect with the meniscus tears, which were too large to heal on their own. Basically, there was potential that I would be on crutches for 6 weeks with the knee locked straight, based on what he would have to do to the menisci. However, he wouldn't know until he was actually inside the knee, which meant that I would have to go into surgery not knowing the recovery timeline.
Day 26 (Thurs, Mar. 23) -- Day before surgery:
Here is where I was at right before surgery:
They don't let you eat or drink at all after midnight before surgery, so in order to combat grumpy hangry-ness as much as possible, I had a feast at 11:55pm. I don't remember what I ate, but I know I savored it.
Day 27 (Fri, Mar. 24) -- Surgery day!:
I'll probably outline the day of surgery in more detail in a later post, but I have a new ACL, yay! Dr. S said he ended up using my quadricep tendon as a graft because he measured my patellar tendon on the MRI and it was too short. I was a little bummed about that (quads are super important right!?), but I trust that it was the best decision. He was able to repair the medial meniscus, but the lateral meniscus tear turned out to be larger and more "complex" than expected, so he had to remove ~60% of that one.
Dr. S also gave me the low-down on what to expect with the meniscus tears, which were too large to heal on their own. Basically, there was potential that I would be on crutches for 6 weeks with the knee locked straight, based on what he would have to do to the menisci. However, he wouldn't know until he was actually inside the knee, which meant that I would have to go into surgery not knowing the recovery timeline.
Day 26 (Thurs, Mar. 23) -- Day before surgery:
Here is where I was at right before surgery:
- I could walk 95% normal and mostly effortlessly
- Stairs (up and down) were fine
- Biking around the city felt mostly normal
- Elliptical workouts same as pre-injury
- I could jog around 200m (but with pain)
- 90 degree squats with 25lb weight (but straightening out from the squat was stiff and mildly painful)
- 40lb single leg hamstring curls
- Single leg balancing 75% normal
- Single and double leg juggling felt great
- Flexion within 20 degrees of good leg
- Extension wasn't completely straight due to the meniscus piece lodged in the joint
- I still had at least one painful buckling instability episode every day
They don't let you eat or drink at all after midnight before surgery, so in order to combat grumpy hangry-ness as much as possible, I had a feast at 11:55pm. I don't remember what I ate, but I know I savored it.
Day 27 (Fri, Mar. 24) -- Surgery day!:
I'll probably outline the day of surgery in more detail in a later post, but I have a new ACL, yay! Dr. S said he ended up using my quadricep tendon as a graft because he measured my patellar tendon on the MRI and it was too short. I was a little bummed about that (quads are super important right!?), but I trust that it was the best decision. He was able to repair the medial meniscus, but the lateral meniscus tear turned out to be larger and more "complex" than expected, so he had to remove ~60% of that one.