Knee lessons: introduction
In Jan 2019, I tore my ACL skiing. I still remember how bizarre it felt. I twisted my knee a bit on a pretty mild fall, then I tried standing up, my knee gave out, and I fell again. There was no pain at all. I think I tried getting up one or two more times before I realized that I needed help and couldn’t make it down the mountain alone.
ACL injuries are super common, so I followed all the advice I was given by my doctor and proceeded to get an ACL reconstruction. For those that don’t know, an ACL reconstruction generally means that a surgeon will take a portion of tendon from elsewhere in your knee and use it to create a replacement ACL. Most young, athletic, disciplined people have a good outcome and go back to all or most of the activities they enjoyed prior to surgery within a year of having the surgery.
Unfortunately, a small percentage of people have bad outcomes from an ACL surgery, and I am one such person. It first became clear to me that something was wrong about five months after the initial surgery. I was in a group of people getting physical therapy after ACL surgeries, and, despite working just as hard if not harder than everyone else in my group, I was in much more pain, I had started to lose the ability to extend my knee properly, and my knee felt unstable. As I learned later, a ball of scar tissue called a “cyclops lesion” had formed in my knee. I had to have a follow-on surgery less than a year after the first surgery to get this lesion removed.
While frustrating, I will still hopeful, as the ACL graft itself was strong, and the surgeon told me that this was only going to set me back six months. But as I worked through the rehab, I kept experiencing pain in the front of my knee. I finally came to realize that I had not been getting the best care by my surgeon or physical therapist (PT), so I tried a few PTs before finding one I really liked. This new PT helped me get back to hiking and weight lifting for about a year, but then the pain in the front of my knee worsened, and it’s been hard to even keep up the hiking or weight lifting.
After speaking to several of the best knee surgeons in the US, I learned that I have a large, and growing, cartilage defect behind my patella that is the root cause of the pain and instability I feel in my knee. As I have already tried conservative management (i.e. lots of disciplined physical therapy) for 2+ years, all the surgeons I spoke to recommended a cartilage restoration surgery called MACI. The surgery is next week. I suppose this is why my knee is on my mind even more than it usually is. This is my final attempt to try normalizing my knee function. I don’t expect to ever run again or do any high impact activities or sports, but I would love to cycle and backpack again.
So here I am, almost 5 years after the injury, and I am in a worse position than if I didn’t have the ACL reconstruction in the first place. I’ve spent countless hours doing specialized exercises in the gym, reading about knee injuries, and interacting with others with complicated knee problems in real life and on forums. Despite all this effort, I cannot walk around the house without knee pain, and I’ve never been able to return to running or cycling, two activities I used to love.
I’d be lying if I said it hasn’t been difficult and frustrating dealing with this injury. But it has also taught me, and is still teaching me, some things about myself and about life. So I thought I would explore what I have learned in a series of blog posts. I’ll update the list below as I write them. Stay tuned!
Some future posts I am considering writing:
- How to get great medical care
- Data does not have all the answers
- How to rehab any overuse injury and prevent future injuries
- How to train like an athlete
- Don’t be cheap when quality matters
- Know when you are beaten
- Sometimes you are the statistic
- Loss taught me what I really valued