Day 17

I’m told that somewhere along my journey back to health there will be a corner. And that this metaphorical corner, once turned, will mark the start of better days. Rehab will become easier. Pain will be minimized. Recovery will be accelerated. It is a belief in the existence of this corner that helps to motivate me, especially on those days when my own improvements are not readily evident.

As for my physical status, my resting pain is basically under control at this point but I am behind schedule on recovery. My range of motion was supposed to be 0-90 by the end of week 2. Now, well into week 3, I can barely reach zero in extension and I’m still max'd out at about 80 degrees of flexion. The unassisted walking (in reality, gross limping) that I had done late in the 1st week proved to be too much too early and actually ended up causing more pain and swelling. It turns out, the general rule in recovery is that walking is exclusively about form, not function. The goal is to walk with focused and exacting mechanics, even if accuracy requires crutches or other assistance. Hobbling awkwardly across the room without crutches may be emotionally rewarding but it's not physically beneficial.

It seems that there are two key interrelated elements involved in ACL surgery recovery – swelling and movement. The way they work together is that deliberate, controlled movement helps reduce swelling, and reduced swelling allows for more range of movement. Of course the converse is true as well. Swelling prevents range of movement and lack of movement prolongs swelling.

With regard to swelling, here’s another entirely unconfirmed medical theory based solely on my observation: it seems that there may be two types of swelling. The first is an immediate, fluid inflammation that is quite visible and increases when the knee is abused and held below the heart. This swelling can be greatly reduced by ice, elevation, and light, directional massage. The other category of swelling is a more solid, unyielding swelling of the bones and tissues. This swelling has a greater effect on stiffness and on limiting range of motion. It is this type of inflammation that seems to be somewhat improved by anti-inflammatory drugs and movement. And time. Lots of time.

This is our family room.

And, for now, my bedroom.

And my dining room.

And my rehab area.

And my office.

This is essentially where I have spent at least 20 hours of every day since I returned home after surgery. If I’m not in this very spot, I’m either at physical therapy, in the kitchen, or in the bathroom. These four locales have quite nearly made up the total of my existence over the past few weeks. I have been considering taking down the air-bed and getting back to real life – sleeping in the bedroom, eating at the dining table, working at a desk. But I don’t want to be wrong and then have to ask to have it all set up again. I guess the fact that I am even considering giving up my comfort zone is a promising sign.

I’ve been in physical therapy three days a week since surgery. For the most part it has been a steady struggle, but today I had a small breakthrough. With my leg very nearly reaching full extension, I stood up without crutches and slowly transferred my weight from my left side to equally balance myself over both feet. I could feel my right knee gradually settle into the type of centered, stable support that allows us to stand upright with relatively little effort. I slowly straightened my posture and looked directly ahead of me. I felt eight feet tall. I drifted into a vision of myself comfortably standing on the sidelines watching my daughter at her next soccer game. Standing solid like that on both feet was a minor, although much needed achievement. Shortly thereafter a man came into the PT clinic, his head held well forward on his rigid neck. He held a plastic cup into which he spit the accumulated saliva that he was apparently unable to swallow. His voice strained as he explained to the staff that he had been sitting up at home for nearly ten minutes at a time. By their responses it was clear that they were as pleased with his progress as they were impressed by his determination. And I was once again left with an adjusted perspective and a renewed appreciation for my own condition.

After physical therapy I returned home, cinched down the straps on my hinged leg brace, and with the prior approval of my physical therapist, I set off on a partial weight bearing walk around the block with my crutches and my two kids. There are ten houses on the inside of my block. The round trip took about 25 minutes. It was an exhausting trek but it was not unreasonably painful and I actually felt strong right up to the end. If I have a few more days like this one, I suspect I may be turning that corner I've been told about very soon.