This is the first post in a three-part series detailing my journey recovering from reconstructive knee surgery. In these long-form accounts I will dive into the genesis of my injury, the arduous process leading up to and recovering from surgery, and the grueling rehabilitation. This first post describes the full account of my injury.
On a hot summer night at Scalzi Park in my hometown of Stamford, CT, I decided to meet some friends to play pick-up dodgeball. You read that right, dodgeball, the elementary school gym class game that I hadn’t played in about ten years. Apparently I was after some serious street cred. The previous summer, the movie Dodgeball, A True Underdog Story came out in theaters, which revitalized the game as a summer hobby. The fad carried on, which explains why weeks after graduating from high school I was playing this grammar school playground game.
A couple of hours into playing I found myself jumping sideways in the air to dodge a ball, just like White Goodman avoiding a Peter Lafleur heater. As I hopped over the ball and watched it whiz underneath my legs, the last-minute nature of my sudden sideways leap caused me to land in an awkward manner. My right foot touched the ground first, with the outside edge of my foot hitting the pavement. Immediately I felt a pop-pop! in my knee, with the sensation of something snapping right to left very quickly. Intense heat shot directly throughout my knee, which was accompanied by intense pain. I experienced that clammy feeling you get when you are about to faint, and was pounding the pavement with my right first while screaming in agony. Safe to say it was the worst pain I’ve felt, and it came from playing fucking dodgeball! After a few people picked me up and sat me down in the passenger’s seat of our car, I distinctly remember my twin brother Bryan saying that he wished I didn’t scream like bitch, and that it was embarrassing.
I never had a serious knee injury prior to this, so I had no reference point to process what had just occurred. My thoughts immediately went towards ACL, although I was able to limp around and put pressure on it, so I didn’t really believe that is what gave out. The next morning I called our local pediatrician to explain what happened and get his professional advice on next steps. After explaining the jump, awkward landing, and that I felt (but didn’t hear) a couple pops that may have been my kneecap moving in and out, he pretty much suggested the standard R.I.C.E. treatment (rest, ice, compression, elevation). If that didn’t help than an x-ray and MRI could be in order, but he didn’t recommend that at this point. I was fine with that, and even went to a Yankees game later that day sporting an ace bandage and a slight limp. Little did I know this initial injury would change my athletic life forever.
Fall 2005 – Spring 2009
Heading into my first college semester at the University of Connecticut, I felt pretty much healed up and ready to go. I had full mobility, flexibility and strength in my knee. Truth be told it only took about a week or two after the dodgeball incident to feel better, and was prime and ready to start my college experience. I did notice a vein running down the middle of my kneecap that had not been there before, and my kneecap did seem to shift ever so slightly off to the right (lateral) side. This didn’t seem like too big of a deal, but in the back of my mind I knew something wasn’t quite right.
That first semester I played a ton of pick-up football and basketball, and did so with minimal to no pain. There were a few instances were I would feel my right kneecap slide in and out ever so slightly – playing football in the snow, making a cut on the basketball court, after lifting a heavy set of squats. But these instances occurred without the same torque as the initial injury, and was painless aside from the discomfort of feeling your joint slightly sliding out of place. Even as I joined the rugby team, this would happen in practice or a game, but I would continue to run, tackle, and perform the explosive movements necessary to play the sport. This may seem like a ton of instances, but it really only occurred 5-7 times over those four years, the majority taking places the first year and a half after the initial injury. These were also what I consider minor occurances, as I didn’t feel a pop or any shooting pain or fall to the ground in agony.
Years later I learned what occurred initially over the summer was a patellar subluxation. This is when your patella (kneecap) is pulled outside of a groove called the trochlea, which is essentially the dislocation of your kneecap. Once this happens once your ligaments are loosened up like a rubber band, increasing the probability of this occurring again. So while these “minor” occurrences in college didn’t cause any immediate pain, it was putting a strain on the health of the knee and the surrounding ligaments. While I was able to stay active and play competitive sports, in my heart of hearts I wondered if this was something I was going to deal with the rest of my life.
This summer I drove up to Saranac in updstate New York with some college teammates from UConn to play in the annual Can-Am 15’s rugby tournament. The tournament is a massive event, and the party scene is legendary. We had entered in the social division, so it is safe to say that the actual rugby playing was a secondary concern on this trip. The squad we entered was a motley team consisting of Middlesex Barbarians players combined with a few UConn alumni. Because of this I ended up playing inside center, a position I have played before, but doesn’t exactly fit my skill-set or body type.
We won the first match, partially because the team we were playing had partied super hard the night before. I’ll admit I didn’t play my best rugby, dropping balls, missing tackles, and having poor timing in general. I was clearly playing not to get injured, which is always a recipe for disaster. I actually heard the words of my Connecticut Yankees teammates rattling through my brain – “Have fun up in Saranac Tubs, just don’t get hurt. We need you for our season!”.
In the second half of the second game, we were playing a tougher opponent and were losing. While getting up from a tackle to defend the ensuing ruck close to our own try line, I felt a familiar feeling as I turn to face to offense – pop-pop! I immediately went down and grabbed my right knee. It was the same intense pain and heat. Same clammy feeling, same fist-pounding into the turf. Only the pain was twice as bad as it was in 2005. A few teammates and the tournament trainers helped me to the back of the end zone and off the field, then left me to limp on my own to where our team was situated on the sideline. As I was limping along, I passed one of our rival teams from my league competition with the CT Yankees – Danbury. The last thing I wanted was for them to see me beat up, but they were on top of the hill and I was right there in the open. I felt like they were snipers ready to take me out. A couple of the guys who knew me from our battles on the field asked me what happened and wished me well, and I thanked them for their support. Also there is a bit of foreshadowing here for later on in the story.
With my playing days done for the weekend, I grabbed the best pain medication a rugger can find on the sideline – an ice-cold brewski. I was still able to put a little pressure on my right leg, but I did have a noticeable limp and had to walk on my heel. The rest of the weekend deserves its own blog post, but I spent it watching friends finish up their games, taking care of a female rugger friend of mine who ended up breaking her ankle (cripples gotta stick together), and sleeping on the most uncomfortable chair in the kitchen of a random house. Oh yea, and I got “iced” 4 times on the ride home the next day. While sitting in the same seat. For six hours. With Smirnoff Ices I myself had bought. Yup, that actually happened.
In the aftermath, I didn’t consult a doctor at all, nor did I do any kind of rehab. I simply took a month off from any kind of rugby, cardio, or lower body weightlifting activities. I told people I thought I sprained my MCL, as I still wasn’t quite sure what was going on down their. When the fall season rolled around, I felt good and was ready to go. If I worked to strengthen my thigh muscles, I hoped this would be the last time I would have to deal with this. This was not a smart assumption on my part.
November 2nd was our last game of the season for the CT Yankees, against our in-state arch rivals, Danbury. We didn’t have the best of seasons that year particular year, but we badly wanted to play spoiler to make Danbury’s road to the playoffs more difficult. They had beaten us badly earlier in the season, and revenge was on all of our minds.
We started off the game strong, with something to prove. The hits were hard and physical, as they always were when our two teams faced off. I was definitely not playing to avoid injury, and was fully embracing the moment. It was my teammate Pat’s birthday, and I distinctly remember him running a perfect unders line off my quick tap to burst through the defense and score a try. I can’t remember if that gave us the lead or not, but it was certainly a close game.
The start of the second half was our downfall, as Danbury began to wear us down and separate themselves from us. About 15 minutes to go in the half, I make a tackle on one of their bigger guys, then pop up and attempt to poach the ball. In a similar movement to what happened in Saranac, the now very familiar pop-pop! felling reared its ugly head. This time the pain was 10 times worse than before, and my knee immediately showed a black and blue discoloration on the left side of my kneecap. The referee kneeled down next to me, and I grabbed his arms as I writhed in pain and screamed like I was giving birth. One of our coaches/old boys/Chairmen of the Board, Old Randy, ran over to check on me along with a few other teammates. I remember one of them pointing at the discolored part of my knee and saying “you see that Tubs, there goes your ligament”. They tried to carry me off by lifting me by both legs, but my stubborn pride made them put me down and I limped off while holding their shoulders.
This time I knew I had to see a doctor, no question about it. I saw an orthopedic surgeon who was a friend of the family, and a very smart and accomplished doctor. He also is one of the nicest human beings you will ever come across. After my initial x-ray and consultation, he suggested I get an MRI, and gave me crutches to use for two weeks. I could limp around, but the crutches definitely came in handy. When I sat down with him to review the MRI results, he basically said I didn’t have anything to worry about. He said the black and blue mark was probably the result of a bone bruise, and that I maybe had a slight ACL strain, although that appeared to be intact. When I reviewed my injury history and asked if I would continue to be susceptible to this injury, he said no, and that I should be able to make a “full” recovery. Maybe some PT was in order, but generally I should be fine.
I took his word for it, and spent the next four months recovering. I mostly rested for the first two, and spent the next two doing self-prescribed physical therapy exercises. These exercises focused on my hips, VMO muscle, and hamstring flexibility. They helped tremendously, and I came back to the pitch in time to tour Ireland with the CT Yankees, another story for another time.
April 2nd, 2015
As I type these words, it has been exactly a year to the date of the occurrence that finally snapped the rubber band that was my medial patellofemoral ligament. I had moved on to play rugby for the Village Lions, and team based in New York City. At 27 I wasn’t old, but definitely no spring chicken. To say that I thought those knee injuries were behind me would be a lie. As bad as it sounds, there would usually be a point during every game where in the back of my mind the thought of I hope this isn’t the day I get injured would creep in to my head. It would only last a split-second and for the most part wouldn’t effect my play at all, but the fact that I had that in my subconscious did not sit well with me. The vein through my kneecap I first noticed ten years ago after playing dodgeball was still apparent, and my knee still seemed oddly out of position.
Last year this date fell on a Thursday, and our D2 team was gearing up for a playoff run. The previous Saturday we lost a highly competitive match to rival Old Blue, and were using this bye week mainly to recover but stay crisp. It was a chilly evening with lots of wind, and during training I found myself doing a lot of standing around and passing, as scrumhalfs are known to do every so often throughout practice. Our head coach wasn’t there on this night, so our de facto D3 coach/player/old boy Aardvark took the lead at this particular training. Aardvark had us working on some practical tacking drills, and as I witnessed my teammates going through and hitting each other, I got the urge to take part in the action. The thought actually crossed my mind of staying put as not to risk injury, but my will to participate and hit someone took over, so I called my teammate Jack over to switch with me so I can participate in the drill.
I jump in the drill on offense cold and stiff, but anxious for action. I ran an average line that I wasn’t too happy with, then hopped over to the defensive side of the drill. Eager to make up for my mediocrity, I line up the guy who would be getting the ball, and visualized the shoulder I will be leading with while reminding myself to get low in the tackle. I ran up, braced my body for the impact, tried to get low in my stance, then… pop-pop!
As I lay on the ground with my knee ballooning by the second, hot pain shooting through my joint, and fist pounding the hard turf, I knew this was it. This was surgery. It had to be. I’ve neglected the process and may have been too naive to see this coming, but I also sensed it was right around the corner. My teammates knew it too. Shit, the womens team practicing on the other side of the feel probably knew it from the way I was screaming. I sat the rest of practice laying on the bench, cold, lonely and distraught. Many thoughts ran through my mind:
What ligament is it exactly? ACL? MCL? Meniscus? Something else? Is my kneecap always going to keep popping out? What is the pain so excruciating underneath my kneecap? How long will the recovery time be? Which doctor should I see? What hospital? It’s going to suck getting around NYC on crutches. Crap, I have to go in to work tomorrow to get my laptop…
My friend Jack got an old team trainer on the phone, Jeff. He did the best he could to assess what may have happened, and to calm me down and get me to rest it in the proper position right away. After practice was over, I was helped off the field and given a ride back to the East Village by my teammates Fuzzy and Pat, who went out of their way to drive me to my place. Luckily Jack lived around the corner and had an ACL procedure a couple of years back, so he ran home to grab me his crutches and some ice as I crawled up to my second floor apartment one step at a time. As we ordered pizza and drank beer, we talked about the road ahead and what I had in store. It was hitting me all at once, and although I was upset and concerned I appreciated the help I was already receiving. Teammates going out of their way to ensure my well-being, and a flood of texts keeping my spirits high.
I actually did go into work the next morning, which happened to be Good Friday. I sat at my desk with my feet propped up in an empty office, popping Advil like M&M’s. 2:30pm rolled around and I finally had enough. My knee was throbbing and I needed to get home. I hailed a Uber from my office in Jersey City to the East Village, and about $50 later I was back on my couch, contemplating the year to come.
The commitment to my comeback had just began.
– John Tublin