At the end of the second week of recovery, I feel that I have built on the knee rehabilitation of week 1, and while the medium term commitment of this process is becoming – starkly – more clear, it is equally clear that every day brings overall improvement. Some high points of the last week include first session with the sports physio and first gym session. On the other side of that is easy knee-fatigue, continued ache and a greater appreciation for the rehab-hill to climb. These less positive elements are balanced, however, by an awareness that this is only a temporary situation, that the rehab is working and that, really, I am so fortunate to have access to keyhole ACL reconstruction, so any ‘first world problems’ should be kept firmly in perspective!
Wednesday was my first physiotherapy consultation with the same Physio I have worked with for MCL rehab and pre-op ACL rehab. My Physio was very happy with my progress and in her opinion I’m about 3 weeks ahead of the curve in terms of recovery; this is down to the heavy commitment to physio work before the operation. We worked through the next set of exercises to add to my daily regime and I was cleared for restricted gym duty. I started work on the stationary bicycle on Friday; Physio prescribes 10-15 minutes, 80-90 RPMs, focus on the push and pull to work hamstrings and quads and a 7 out of 10 level of exertion. I achieved this but it was extremely challenging as there is still swelling and stiffness and it is difficult to fire the hamstrings on the operated leg. While I thought I wasn’t going to be able to make it happen, after about 5-6 minutes of warm-up was able to work at the desired level and got a wee bit of a sweat around the hair line and some heart rate, but not a drippy crazy sweat or high level of exhaustion. Physio also advised to integrate upper body work on these sessions to help with motivation and so continued the one-legged press-ups from last week and brought in bicep curls (as of this week on 3 sets of 10 reps with 9 kilo dumbbells and hope to improve – I’m sure sounds majorly puny to some readers!). Felt so good to get into the gym and went out that evening so a fair bit of walking that day, which did lead to soreness through the night and the following day, but a lot less of an ache and more mobility after 48 hours, which seems to indicate that I’m not over doing it, but I am pushing it enough to get benefit. I am aiming for 3 days a week at the gym plus daily physio on a ‘little and often’ basis.
I’ve chosen to fund my own private physio. I was offered physio from the NHS and there are physios with BJJ experience available at my hospital. However, in my experience of various knee injuries over the last 4 years, I’ve come to understand that the NHS-perspective seems to be heavily biased towards ensuring a person can safely and happily carry out day-to-day tasks, rather than be prepared for activity and sport. I believe this is why my original orthopaedic advised me to avoid surgery as recommendations may be filtered through this bias which doesn’t really account for the more marginal lifestyle of the amateur athlete. My experience suggests that there is a sense in the NHS that one is either a professional athlete or not – ‘true’ as far as it goes – and there is less appreciation for the lifestyle of the amateur athlete, where physical activity is integral but not the entirety of life and work. This perspective perhaps reflects wider trends towards obesity and associated inactivity and over-eating. I am not criticising the NHS-perspective, but rather noting my observations based on my limited experience with a very small portion of the system, but it is clear from my own history that the lifestyle and physical expectations of the amateur athlete aren’t catered for within NHS protocols; unhappily, very active non-professional athletic people, are rather rare. Statistically, folks are either couch potatoes or professionals and it is entirely rational for the NHS to use this notion as a basis for its protocols (if that is in fact that case), but as my goals are to go beyond the ability to enjoy the day-to-day in comfort, incurring the expense of a private sports physio is a worthy priority.
While I am very happy with my progress and feel very positive about rehab and being on the other side of this process, it is frustrating to be out of BJJ and I am missing my team mates and the training a great deal. This has been compounded by the announcement of a Braulio Estima seminar at my club in December! I am pumped that Braulio is coming to Dartford BJJ and will be able to observe, but is just a bit of a bummer as am losing fitness, timing and missing out on this month’s Marc Walder seminar, so had a minor pity party this week and baked oatmeal raisin cookies and sorted out my autumn wardrobe. Hoping increased gym work will distract me from these less healthful coping mechanisms going forward.
- Wall sits – 3-5 reps, hold for 10-15 seconds, 3 times per day
- Bridge – 3-5 reps, hold for 10-15 seconds, 3 times per day
- Prone hamstring curl – 3-5 reps, 3 times per day
- Continue ‘little and often’ walking, icing and elevating leg
- 1st physio consultation
- 1st gym session – stationary bike
- Stiffness and ache still very prevalent, but moments when there is no ache
Every ACL op and recovery will be particular to the person. The thoughts and experiences recalled in this series of posts is in no way intended as medical advice or as a replacement for seeking medical attention for any injury. This information is presented merely as a record of one person’s experience with ACL operation and recovery.
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