Over the last month or so I’ve managed to drop the 15 extra pounds and the majority of the convincing second trimester pregnancy profile that I had cultivated during my post-op immobility and at the same time I’ve gotten stronger – both mentally and physically. In short, I’ve taken a more holistic approach to my knee rehab. The initial improvements in my knee have finally allowed it to become another working part of my daily life rather than the center of my every waking thought.
That said, there are things that I still cannot do. Simple things that are made all the more frustrating and concerning when I recall the published rehab schedules that I long ago made a conscious effort to ignore. I still have some degree of pain with every step and most of my shin feels oddly like it’s under the lingering effects of a low dose of Novocain. My physical limitations now all seem to center around an inability to put any significant amount of pressure through the knee, especially when it is bent past about 20 degrees. I still cannot quite walk down stairs. I cannot quite stand and pedal my bike. And I absolutely cannot run, jog, or otherwise motivate myself any faster than a normal walking pace. Attempting any of these activities results in an immediate line of pain up the front of my kneecap. Overall, the pain is improving somewhat, but only so slowly at this point that my progress in that particular area is not even noticeable unless I recall my condition over the course of the past few months.My range of motion is now reasonably good. In flexion I can typically get to within an inch or so of heel-butt contact. I’ve not worked on this post-op so what I have gained is just the natural result of the reduction in swelling and the improved flexibility of the muscles and connective tissues involved. Extension, on the other hand, was a long and painful struggle – one I took very seriously. Thankfully, my knee eventually conceded that particular battle and I now have essentially full (hyper-) extension nearly equal to the “good” leg.
“If you do too much, you’ll know it.” This simple excerpt from the book of wisdom was given to me at some point so early in the recovery process that I can’t even remember who said it. Regardless, credit to someone is well deserved as this bit of information turns out to be entirely true.On Day 95 I went out on the bike again. I’d done my first short ride on Day 90, and I’d been riding 30 minutes every night on the trainer for a few weeks so I figured it was time to try a slightly longer route. 18 miles this time, with a few mild hills thrown in. The ride was a success. In fact I felt so good afterwards that the next day I welcomed the chance at a short family walk through Mill Valley. We were a few blocks out when my 3-year old wore through a blister inside one of her shoes. No problem, I simply carried her piggy-back style on the return trip like any caring and physically capable father would do. Later that day a small group of extended family prepared for a hike up one of the many trails of Mt. Tam. Clearly it was expected that I would sit that trip out as I was given instructions on staying behind alone – “the TV is downstairs”, “help yourself to the kitchen”, that sort of thing. I surveyed the expedition team - a handful of healthy adults, a few young kids, including my wounded 3-year old, and one of the grandparents. I could certainly keep up with this group. And so I did, and with only a handful of sharply painful missteps and ill-executed strides. It felt so good to be out and active. I was becoming normal once again.
But as I woke the next morning I quickly realized that I had slightly overestimated my return to normalcy. I had trouble just putting enough pressure through my knee to stand. The new swelling was quite apparent and my range of motion was reduced by many degrees on both ends. Eventually I became stable on my feet again but for the next couple of days I walked with a renewed limp and pain levels that I had nearly forgotten ever existed. I had done too much and as I was promised, I knew it.
Since then I have been much more careful, and I’ve pretty well limited my knee-related physical rehab to bike riding and slow, controlled strength developing movements like the ones that can be had on a high quality leg press sled. Every Saturday morning I ride semi-leisurely for a couple of hours and then on Sunday mornings I hammer with everything I have through a 25.1 mile loop that includes a 3 mile out and back climb into a local canyon. I race against myself, against my own ability, and against the clock. And my average speeds have been steadily increasing every week at every checkpoint along the route. A few sections of the canyon road are as steep as I can possibly climb at this point and if I push hard enough in the return downhill I can sometimes hear the announcer voice of Bob Roll in my head as I slice through the French countryside ahead of the furiously chasing peloton. With an all out effort, my speed is limited at different points on the ride by either my knee or the conditioning of my cardio-vascular system. On my most recent ride the limiting factor was often the cardio – which in terms of my knee is a strange victory in itself.
