Return to Athleticism

[Nick Hunter]

Day 22

Am using more weight on the leg press, and nearly walking without a limp, though there is still tightness in the joint that makes that a challenge. I tried using the leg press that lets you lean on your back and slide down on your own bodyweight today.

After getting through a psychological hurdle on the sit-down leg press with a single leg where I pushed a light weight through a complete ROM, I ran into a painful feeling that closely resembles the tweaking that used to accompany my knee bailing for the last three years. This really pissed me off. I'm worried there's something that went unfixed.

[mark williams]

Hi Nick - glad to see you're making progress!

Keep an eye on that "feeling" you experienced but try not to over-analyse at this stage. This is very rich coming from me as when I was a week off crutches and was still having pains and the odd click I was convinced something had gone wrong etc etc... my knee feels "loose" - did he tighten things up enough?... why does it hurt so much, should it still be hurting like this?... why does it feel like it's going to lock?... etc etc.

The fact is, your knee will never be the same. FACT. Your knee will never feel the same again. ALSO FACT. You will, however, not notice the difference any more unless you really focus, after a certain point.


Give yourself a chance.

The healing processes that are going on right now are many, and don't just relate to the new ligament bedding in, or to the tendon repairing itself (after having it's middle third cut away!)
There are proprioception issues (nervous feedback from various mechanisms around the joint that help you with subconcious spacial awareness and balance), plus a lot of atrophy in all muscles around your leg, not just the quads (although you'll be hyper-aware of them after that butcher had his way with your tendon!).

The bottom-line is that you have a brand new leg that you are learning about all over again. How it works, what it will do, what it won't do - and while over the years full use of this leg has been a sub-concious affair, for the next few months it will be a concious one. This means you will feel sensations that previously, were so common-place your CNS didn't bother to make you aware of them. Ie; the torque in the knee when you twist on it - the shift in ground level as you walk etc.

What I'm trying to say (and making a long-winded hash of it!) is that it becomes very easy to over-analyse what you are feeling and worry yourself unnecessarily. Don't over-reach, do only what the physio says you can do - but do it hard!

Sounds like you're doing well to me mate.

Rock on - rugby awaits!!!

[Nick Hunter]

Can't wait, Mark. I miss it a lot. I will just meditate that this is only week 4 I just finished.

[Nick Hunter]

Well, progress? It's hard to tell.

Almost Week 7

There is still a lot of crunching and jump-skipping of my kneecap in the same general angle during extension. This causes some pain, and the knee also has sharp pain inside the joint while weight bearing (squatting, leg pressing) during any flexion or extension.

My surgeon is insisting that there is nothing else wrong with my knee besides the ACL they fixed. No plica, no cartilage damage. He says there may be some scar tissue causing the unsmooth tracking, and that my quad is not sufficiently recovered to control the kneecap well enough to bear weight without pain. He suggest doing my exercises anyway, even if I am knowingly compensating through motions in order to avoid pain. I am obsessed (naturally) with the notion that there is some sort of permanent damage to my knee that is going unrecognized, however.

Perhaps it is that everyone's track is different, but I would have thought I could stand up off the couch with equal unconscious force able to be applied through each leg by now.

My doctor also prescribed an anti-inflammatory to help the swelling, which is still present. However, after 4 days of use my gums were bleeding all day long and I was wiping coagulated blood out of my mouth in the mornings.

On another note, my NSCA CSCS materials came in the mail today.

I have completed and taken notes on Chapter 1.

[Nick Hunter]

5min on the bike

140lb Leg Press
1 set x a billion reps of various degrees of flexion


I noticed that if I squeezed my entire leg as hard as possible all the way through a rep, the knee cap didn't crunch or jump around nearly as much, or hurt nearly as much, and I could go down lower, (to about 90 degrees)... I was super psyched.

Then I walked back up the stairs and each step hurt like crap... what?

[Steven Low]

Is there imbalances in your leg? Medial-lateral or anterior posterior?

Tight muscles in the hip/ankles and/or limited mobility?

[Nick Hunter]

Steven,

I have had bone spurs in my ankles for somewhere in the neighborhood of 10 years. My ankles flex about 5 to 10 degrees past 90, and that's it. Consequently, my calves can't be but so loose. I believe my hamstrings are also somewhat tight, but I used to be quite strong in the back squat and deadlift. Idea?

[Steven Low]

Is the maltraction medial or laterally, or like into the bone kind of thing?

[Nick Hunter]

To make up for the lack in ROM from the ankle, the knee tracks inward into valgus as the ankle pronates.

[Steven Low]

Is this when it rubs in valgus, or when you try to track it properly straight?

I have nearly the same amount of ROM in my left ankle that you do due to an ankle injury I never rehabbed right. But I don't have any problems sprinting and such. You need to retrain correct movement patterns. More would be nice but not always possible.