My ACL Injury: 3 1/2 Months Post Op DONE!

Hello Renrenspeakers! I hope all is well! It has been a little while since I’ve updated yall on the blog. I wanted to hold off a bit on sharing my milestones during recovery so that I had more to share with you! Time has been flying! Technically, it has been 15 weeks and 1 day since my ACL surgery, so a little over 3 and a half months now.

My first exciting piece of news is that I am back to work now on a restricted capacity! I started work last Monday, and so far, the transition has been different but overall good! My knee definitely is not the same, and I notice some minor swelling and puffiness at the end of my days due to prolonged standing and moving around my facility. But I am very blessed that my work has been accommodating in the fact that I have had short half days to ease my transitions to work, and very high level patients to work with so that I do not put myself at risk of injury.

Going back to work has been a bit nerve-racking, I will be honest. It feels good to physically be able to handle being on my feet, but psychologically, the lingering thought of what if there is risk of retear? is sometimes there. I am so used to being a busy bee, so especially at work, I have to remind myself that it is important to take seated breaks in between patients so that I can rest my knee and not overexert myself. It has also been eye-opening to be a therapist and a patient simultaneously. I relate to my patients even more in terms of having some kind of limitation. Overall, being back to work has reminded me that it is so important to listen to my patient’s strengths, challenges, limitations, and adapt my therapy sessions accordingly.

My second piece of exciting news is that I now have 73% quad symmetry on my surgical leg compared to my non-surgical leg! My PT reassessed my strength on Monday, and it has improved each time my strength has been assessed. I remember the earlier days when I barely hit 53%, so to see an improvement over time has been rewarding and makes me feel stronger and more confident. I now am able to do activities such as Bulgarian split squats, leg presses, kick backs, weighted wall sits, step ups, lunges, and deep squats. Yes, they are hard and a challenge, but each session gets more comfortable as I continue to progress with my exercises.

Lastly, I started some light plyometrics and the agility ladder! Mind you, this is very preliminary — no single leg hops or large jumps just yet. However, being able to even attempt pogo jumps continuously for a minute was very rewarding! It felt very different and slightly uncomfortable at first, which I largely attribute to the guarding of my knee. After initially trying the first time and actively trying to overcome my own psychological barrier, my confidence to attempt another trial of pogo jumps slowly increased. I am not running or anything yet, but I am hoping that with time and strength, this is possible sooner rather than later.

ACL recovery has been kicking my butt financially, as I have to rebuild my emergency fund now while playing catch up on my finances. All my financial goals for this year have been thrown out the window, lol. Though the financials of any medical injury or disability is scary and stressful, what gives me reassurance and peace is that physically my knee is transforming into a stronger, more functional knee every day that passes. Objective and subjective measures of my recovery have been a great indicator of all the work I’ve put in.

ACL recovery is quite tiring – physically, emotionally, and psychologically. I will not lie — sometimes I don’t want to exercise and go to the gym to work on strengthening. It can be exhausting thinking about my knee all of the time. I still struggle with trying to find the balance between working out my knee and resting. I do go home every day and ice, compress, and elevate religiously since my knee is typically begging for it at the end of my work day. I never want to overdue it, but sometimes it is inevitable. It has been a journey, but each day the goal is to get closer to my new normal as possible.

Peace and love,

Irene

My ACL Injury: 9 Weeks Post Op DONE!

Hello Renrenspeakers,

Happy September! We are finally in the fall months, and this is when the year begins to fly by. Speaking of flying by, my ACL recovery has been flying by! Today, I am officially 9 and a half weeks post surgery, can you believe it? I cannot. I am in the stage where recovery begins to feel…. long, admittedly.

I still feel very blessed that recovery has been smooth thus far. I honestly attribute it to being pretty active prior and taking my prehabilitation (prehab) very seriously before I had my surgery. If you don’t know what prehab is, essentially it is a proactive fitness practice intended to strengthen the body and improve physical function prior to having surgery or facing a huge physical demand. If you know me, I probably talked endlessly about it before ACL surgery (LOL). However, I did it for good reasons!

Remember, I said that recovery has been pretty smooth as a collective thus far. I didn’t necessarily say every single day was fine and dandy, however. About a week ago, I had a day in particular that stood out to me in which I did not have a “good” day. I attempted walking down a huge flight of stairs multiple times in that day to challenge myself, as going down the stairs currently is still pretty uncomfortable. I believe that very action made my knee very sore/achy the next day. It was a little worrisome because I haven’t had much discomfort and achiness like that since my early days of surgery. This was a great example of why people say “Listen to your body.” Even extending my knee that day felt very uncomfortable, which has not been my experience this late into recovery. That day, though I wanted to complete my home exercises, my body said otherwise. I was forced to go back to rudimentary practices of elevating with my wedge pillow and icing aggressively. It is sometimes crazy to realize how something as simple as rest can make a big difference! This instance solidified the lesson that sometimes less is more, and more is not necessarily what is best for my knee. The next day, I felt back to my baseline — not achy and ready to do those exercises without severe discomfort.

Since graduating from my ACL brace, progress has admittedly felt a little slower compared to the initial, rapid gains early on in ACL recovery. However, when I think about my range of motion for instance, I realize that actions such as getting out of the car even at 6 weeks is not something I have to consciously sequence and motor plan for anymore. I am able to get out with complete ease and like it never was a struggle in the first place.

This week, my PT did some objective testing to assess symmetry and restoration of range of motion with my surgical leg. As an OT, I love this stuff because I live for objective, factual evidence in addition to subjective reporting to measure my improvement. First, my quad strength was assessed via the Limb Symmetry Index. Essentially, with the use of a pull-type dynamometer, I first kicked my nonsurgical leg progressively with as much force as I could before fatiguing. Then, I did the same with my surgical leg. My nonsurgical leg yielded 119 lbs of force, whereas my surgical leg generated 54 lbs of force. As you can see, that is a huge difference, lol. Basically, my surgical leg has about 45% of symmetrical strength compared to my nonsurgical leg, which is very expected given the timeline of my ACL recovery thus far. However, I have a LONG way to go. Focus at this stage of my recovery has been pretty much progressive overload of my knee to ensure that it can handle increased strength over time. Moreover, I have started more isolated single leg strengthening exercises such as single leg presses and assisted lunges. My quads are pretty shaky depending on how hard I go, but that is okay! It is expected, and I personally like the shakiness because it tells me that those muscle fibers are working their hardest to get me better!

I also have to share that my active range of motion is getting closer to being fully restored!! I am at 130 degrees of active knee flexion, which is close to my active knee flexion of 138 degrees on my nonsurgical leg. Exercises that have helped force this a bit have been wall slides and sitting on my yoga ball basically flexing as much as I can before I achieve absolute maximal discomfort. Another thought that reigns true is that consistency is truly key. It may get boring and mundane sometimes, but honestly, the actions that are repetitive and mundane do the job.

Overall, I am pretty happy about how my progress has been. Sure, do I wish I could run for the heck of it or jump right now? Heck YEAH I do! I do miss being able to do intense cardio now that it is something I am currently unable to do. However, I am also very thankful that I can walk with some speed, I can drive my car again, and I can handle some load on my knee, even if it isn’t at my prior level of function. I am looking forward to when I can resume my actual job, as it does require those functional actions such as bending and squatting daily. Finding the balance between rest and pushing myself is a constant dance — but one I am slowly starting to figure out. I am hopeful to seeing where my AROM and quad strength land at the 3 month mark. 🙂

*note — peep that this is my first picture without my brace on, yay!

Peace and love,

Irene

My ACL Injury: 6 Weeks Post Op DONE!

Hello Renrenspeakers! Happy Wednesday! Today marks 6 whole weeks and one day post my ACL surgery. This is a huge milestone for me because this means that my brace comes off and a little more of my independence is restored, whoohoo! I had my follow up appointment today, and so far everything is healing well according to my surgeon. I did not have a long appointment, but overall the surgeon assessed my range of motion, reviewed my scars, and gave me the green light to no longer wear my ACL brace.

6 weeks have flown by, to be quite honest with yall. I remember not being able to flex my knee at all to now having 115 degrees of active flexion at my last PT session. I am super close to restoring functional flexion ROM, and I can tell that a lot of progress has been made based on my ability to sit comfortably in a chair or complete rotations with my under the desk mini bike. I even have some hyperextension back! Swelling in my knee is so much more calm and I can see very slight knee definition returning (though my knee is oddly pointy, lol). I even went to the gym for the first time yesterday since my surgery and never have I been grateful for the ability to gym, haha.

I also want to share that I am now able to DRIVE again! It is funny because I typically am not the most excited about driving myself in general, but when the ability to drive is taken away, it makes me much more appreciative and grateful for that skill. I started with driving small distances around my neighborhood and to my local store earlier this week, but today was the official day in which I drove on the freeway for a long distance in order to make it to my appointment. It felt really freeing to drive, as a huge part of my independence was returned. Of course, I am so thankful for the support of my wonderful community who has assisted me with driving around to the store, PT, etc. However, knowing that my capability has been restored is so nice, I must admit.

Another milestone I have achieved by this time is that I can actually use the recumbent bike – mind you, very slowly and with very minimal to no resistance, but still. To be quite honest, I was never a huge cycler, but cycling in general has been paramount in assisting me with my ROM and breaking up scar tissue. I feel a huge difference in mobility when I start off my day pedaling for a few minutes on the bike since I’ve been waking up with my right knee naturally more stiff. Who knows, I might become a biker at this rate, lol.

Though I am super grateful that recovery has been a pretty positive experience thus far, I do want to share that I am constantly reminded that this is a LONGGGGG journey. I felt it before, but though my knee feels much better than it did before, I still cannot do a lot of activities and movements that I am used to executing such as dancing, kneeling, criss crossing, and jumping. My quad is still significantly weak and atrophied compared to my left leg, and without the brace, my knee feels like it is so fragile and exposed. I will probably wear my brace outside of my home for comfort at least for a little while until I get used to the feeling of walking without it again completely. The healing process is a bit deceptive actually because the 6-12 week stage of ACL recovery actually tends to be the most dangerous time due to the graft being at its weakest point since it is undergoing ligamentization, which is the process in which my new ACL (part of my quad tendon) starts to turn into a ligament. Thus, retear rates can be higher during this stage because the false sense of physical confidence in the knee makes people attempt activities the knee and overall leg is just not ready for yet. Therefore, it is a little discouraging to realize that even if I am pain free, I cannot run nor jump just yet. Again, I only want to do this surgery once and never again so it is soooo crucial I am careful, maybe even more careful than I was before. As an occupational therapist who is now on the patient side of care, this has been a very eye-opening experience.

In this next phase of recovery, I am excited to start building my quad strength back, continue to reduce swelling, normalize my gait, and overcome any mental barriers that might make recovery challenging at some points! Cheers to 6 weeks post ACL recovery!

Peace and love,

Irene