This is the third 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 final post describes my experience going through surgery and the recovery process.
July 8th, 2015
This humid July morning I woke up feeling anxious and excited with a hint of nervousness. As I drove with my parents through the Manhattan traffic to the Hospital of Special Surgery I was cautiously optimistic. The proper discussions and due diligence with Dr. A and his staff were complete, which gave me an air of confidence. However all the preparation in the world couldn’t put me completely at ease, as there is always the chance something may go wrong.
Minor doubts aside, we arrive at HSS and head up to the general waiting room. At 10:00am the room is already packed, mixed with family members waiting for loved ones to come out of surgery and anxious patients such as myself sorting through pre-operation paperwork. HSS hummed like a well-oiled machine, and I was surprised at how efficiently the staff handled the crowded room. I was attended to almost immediately, and within minutes my paperwork was completed. Now all I had to do was wait for them to fit me with crutches and my brace, then I would be led to a private pre-op room where I was to relax and receive final screenings before surgery.
After waiting about ten minutes a young man in scrubs with an eastern European accent named Pavel brought into a back room to fit me for crutches. Pavel was calm and cool, and made a couple sarcastic comments to put me at ease. He adjusted the brand-new crutches to fit my height, which were an upgrade from the hand-me-down pair I used from my friend night I was injured. He then whipped out the Bledsoe knee brace, and it hit home that this thing would essentially be a part of my body for the foreseeable future. This brace was one of those full-length heavy-duty guys that have all kinds of straps, buckles and dials. Pavel explained the importance of setting the right adjustments now, as I would wake up from surgery with the brace already on. Better to make the correct adjustments now then after surgery. I’m pretty sure I let out an audible ‘gulp’, then paid extra attention to how he adjusted the settings, knowing full well I would have to do that many times.
After my brief session getting fitted, I waited another ten minutes before a nurse called me into my pre-op room. As I was entering the hallway from the waiting room towards the pre-op area, I bumped into Brook Lopez of the Brooklyn Nets. All 7’0” of him just chillin’ in front of the door waiting to be called in for an exam. In the split second we saw each other no words were exchanges, just eye contact and a simple head nod. He looked bored and seem ready to get out of there. I probably looked anxious and surprised to see a professional athlete.
My pre-op room was through the doors that Brook Lopez was guarding, first room on the left. It was a private room with a examination table, some medical equipment and a television to keep me occupied. A nurse inserted an IV into my wrist, and I was told to relax for a short while. My parents came in with me to make sure I settled in, and were able to hang out with me or most of my time there. They were even allowed to stay when a nurse would come to ask me some basic questions.
After about an hour of watching SportsCenter and chatting nervously my parents and nurses, the physicians assistant for HSS (not Dr. A’s PA) came in to confirm the operation that I would undergo. He read off a piece a paper, and in a very nonchalant manner said:
PA: “So, you’re here for your ACL, right?”
Me: “Um, no actually. It’s my MPFL.”
PA: “Oh, right right. I’m sorry, it does say that right here. MPFL allograft, with….
Me: “Wait, did you say allograft? I’m actually gonna be using my hamstring tendon.”
PA: “Yes, you’ll be using one from a cadaver though.”
Me: “No, that’s not right. Dr. A. and I agreed to the autograft, using my own body part.”
PA: “Hmm, alright. I’ll need to go confirm this with Dr. A.”
The PA went into the depths of the operating rooms, and emerged with the correct information confirming my procedural choice. He updating the paperwork within the system, and re-printed the documents for me to sign.
I learned a couple things from this interaction with the PA. The first is that preparation does wonders. If I hadn’t taken my time to do research on my own and meet with Dr. A. four separate times before heading into surgery, I may not have understood the mistake that was made. I’m so grateful that I caught the mistake before heading into the operation room, where I may have had a different operation than the one I intended. There is a chance the surgeon would have noticed the error, but he may not have been able to do anything about it. This leads me to lesson number two: don’t sign anything you don’t understand. This is true for anything really, but especially when you are cutting open your body. Even after the paperwork was updated I read through the procedure with a fine-toothed comb, making sure nothing was left to chance. My experience with HSS was tremendous, but this was the one hiccup in there operation. I don’t bring up this incident to brag, rather to note this as a cautionary tale. At then end of the day your are the only one looking out for yourself, so be sure to cover all your details, and make sure the hospital does as well.
I was left to sit in the pre-op room for another 20 minutes or so, relieved that everything was corrected but getting more anxious by the minute. The nurse shaved my right knee, and said Dr. A. would be stopping by to sign my right leg. She explained no other writing was allowed on the body, and his signature denoted which knee they would operate on. I found this interesting, as I heard stories from friends who actually wrote on their opposite leg, “WRONG ONE”. My Dad actually suggested that doing such a thing couldn’t hurt. However it was good to know HSS had their own way of doing things, which was just fine with me. As long as they operated on the right knee (gulp). Pun intended.
Dr. A. finally swung by to do a final check-in, and said it was almost time or surgery. He took out a sharpie and asked, “so, which knee are we operating on?” I could tell he was just going through procedure, so I responded with “my right knee”. As he signed his name on my right leg he confirmed my assumption that it was standard protocol to ask the patient to confirm which knee the operation was on. He also confirmed that the signature denotes which knee they will operate on, and he went on to describe the operation in a detailed but concise manner. He even used his fingers to benchmark how big each incision would be. True to form the conversation lasted no more than five minutes, but I now felt completely confident and ready to get this thing over with.
Around 2:00pm, July 8th
An even-keeled middle aged doctor then walked in, and introduced himself as the anesthesiologist. He calmly explained that once I was brought into the operating room I would be sedated, then given spinal anesthesia that allow for a nerve block and local anesthesia to occur. The nerve block would effect my entire lower body, meaning that when I awoke from surgery both of my legs would be numb. That would wear off after a while, but the local anesthetic would last roughly 24 hours. You would think all of this would make me nervous, but the smooth and confident nature at which the doctor explained this all to me truthfully put me at ease.
After this brief review of the anesthesia process, the anesthesiologist informed me the moment of truth was here. He helped guide me and my IV stand into the OR, where the team was making last minute preparations while blasting I Wanna Know by the R&B singer Joe. This came as a pleasant surprise, as I had expected a grim business-like room with serious medical assistants to be prepping my station. Instead I was received by a group of friendly nurses who were smiling and playing a relaxing, nostalgic throw-back. It was exactly what I needed. Although the excitement of the moment was palpable, any last bits of nerves were washed away.
I carefully laid down on the operating table, and was told to relax as they injected the anesthetic through my IV. They guided me to breath deep breaths and think happy thoughts as I started to feel sleepy. I did that for a about ten seconds, thinking of a calm wave washing along the shores of a beach. Like the wave in my mind I let the drowsiness wash over me, then I was out.
Around 6:00pm, July 8th…..let’s be honest, I don’t really know what time I awoke from surgery. It was a bit of a blurr. It may have be 5,6,7 … sometime in the evening
My next memory is me waking up in the post-op area with two nurses organizing something in front of me. I feel very sleepy and high from the medication, but extremely relaxed. Before I can even think I ask the nurse how the operation went, while reaching down to touch both of my thighs. I was told both of my legs would be numb, but my first thought was to see if they operated on the right leg. Right away my hand came in contact with the Bledsoe leg brace on my right leg, and I laid back fully relieved. I had complete faith in Dr. A. and his medical team, but I just needed to make sure. The nurse answered my question by saying the operation went very well, and was completed in only 58 minutes. Dr. A would be stopping by shortly to see how I was doing and brief me on the operation and next steps for recovery.
Once I looked around and got a better sense of my surroundings, I realized I was in a long hallway with patients who had just come out of surgery lined up in a row. I heard Dr. A. going down the line checking in on each patient, and realized what a machine this man was. He had a reputation for a strong work ethic and heavy patient load, as I witness from visiting him in his office four times prior to surgery. But I was now witnessing all the work he did this one day, and it was remarkable.
Dr. A finally stopped by my area, and asked how I was doing. He said he was pleasantly surprised at how smooth my operation went, and confirmed that it was only 58 minutes. Apparently this was very quick for a surgery this intricate. He said my body took very well to every stage of the surgery, and confirmed that he had to perform the lateral release, because that portion of the ligament was very tight. Going into the surgery it was understood that the lateral release would be something he would determine once inside my knee, but I had accepted this would probably be performed. When it was all said and done the surgery was a success, and he recommended that I stay overnight at HSS, which was also expected. This was to keep me comfortable while they monitor my pain levels, make sure I can walk with my brace on, and can adjust the dosage levels of my pain medications if necessary.
I was told they would be taking me down to the room where I would stay overnight, and assumed I would have to get transferred to a wheelchair. It didn’t even occur to me that my bed had wheels, and they would simply roll me to the elevator and put me on my merry way. My new home for the night was a couple floors down, room 6E. I was introduced to Brownson, who would be the nurse taking care of me throughout the night. He was a nice guy with a dry wit that kind of reminded me of the comedian Hannibal Buress.
The room was meant to be shared, and another patient was wheeled in shortly after me. My bed was next to the window, with only a curtain to my left separating me and my new roommate. I learned his name was Reuben from his talks with the nurse. We both had separate television sets to keep us occupied, and headphones we could use to listen to our shows. I do remember it being within the 9:00pm hour when I was finally all settled in, and switched on the Yankees game while I ate the dinner provided to me by the hospital. I don’t remember what it was, probably some sort of chicken, but it wasn’t that bad.
Brownson made sure I was comfortable, and showed me how to adjust the settings on my bed to move it up or down, and gave me a breathing apparatus that I had to blow into ten times per hour. He also gave me a “urinal”, which was a portable contraption that I would use to pee in whenever I needed to go. This is actually a lot harder than it seems. I had to essentially do my thing while laying on my back, with another person (and sometimes his nurse) in the room, with impeccable aim. The container was fairly large so I didn’t have to worry about overflow, but when I was done I had to hook it on to the side of my bed and wait for my nurse to come take it from me. Until then, I was accompanied by it at my bedside. It honestly didn’t bother me one bit, but thought you would all appreciate the graphic detail.
Speaking of cleaning, they were good about giving me fresh supplies of soap, water, and moist towelettes whenever I needed it. That night and again in the morning, they provided me with a “shower kit”, which was a tray of water, soap, and warm towels that I could use to wash myself. Again, not too glamorous, but to me it was great to be taken care of.
Aside from keeping me comfortable, the real reason I stayed overnight was to allow the hospital to monitor my pain. Every hour throughout the night, Brownson would come in to check on me and give me a dose of painkillers, along with stool softeners to help alleviate this eventual side-effect. In case I was in too much pain, my IV was hooked up to a “cocktail”, which was a morphine concoction that would increase my high even further. Despite my constant state of sleepiness, it was tough to get consistent sleep. My new surroundings, hourly check-ups, and the fact that I just had surgery all played a role in my lack of sleep. On a scale of 1 to 10, I would say my pain hovered around a 2. I was never really tempted to use the cocktail, but did press the button once to see what it felt like. It didn’t work, and I didn’t have the patience nor the care to tell Brownson. So I let it be for the rest of my duration at the hospital.
When I checked into my room I was provided with a continuous passive motion (CPM) machine, which would essential start the first phase of my rehabilitation. The CPM machine allows my knee to move in a controlled range of motion that increases over time, and has many benefits. Starting on this machine the day after surgery would help mange pain, reduce inflammation, and help increase range of motion quicker than if I had stayed in a hard cast for a few weeks. Dr. A. prescribed that I use the CPM machine for a half an hour three times day at 20 degrees, increases it five degrees if I showed progress after a few days.
Although I didn’t get consistent sleep, I woke up feeling relax and rested in the morning. I ate a healthy breakfast with tons of protein, which was not a big shift front my normal meathead diet. The nurses explained that I should eat a lot of protein over the next week or so, as it would be critical in helping everything in my knee heal faster. While eating breakfast I did my CPM exercises, and through on SportsCenter for some entertainment. I learned that New York Giants free-agent-to-be Defensive End Jason Pierre-Paul had a horrific fireworks accident on the 4th of July, which resulted in him losing portions of his right hand. Not only did this put his career in jeopardy, but this careless mistake would alter his life forever. I suddenly felt very lucky to be in the position I was in, sitting in a hospital bed be catered to after my knee had just been fixed. Although you shouldn’t feel too sorry for JPP. He ended up re-signing with the Giants, and while his comeback wasn’t terribly successful, he still has a job in the NFL. Plus, he’s still a millionaire.
Gruesome celebrity athlete injuries aside, around 10:00am I had a training session with Pavel, the PT I met from the day before. He would be teaching me how to walk with my brace and crutches. Since the brace was in a locked position, I was able to bear weight on my right leg immediately, as long as I used my crutches properly. Pavel took me into the hallway and taught me how to slowly put my right foot forward while leveraging the crutches, and made me do a couple laps around the reception area. He also showed me how to walk up and down a small wooden staircase. As I would learn over the course of the next several months, going up was actually fairly easy, because I could use my good leg to power up the stairs. It was going down that was a bitch. My constant state of drowsiness didn’t help, but I was able to ‘graduate’ from Pavel’s walking school. This meant that all I needed to do was prove to the nurses I can handle the pain, and they would call my parents to take me home.
My stay would last a bit longer for a couple reasons. One, my parent had lives of their own, and their schedules dictated that they wouldn’t be able to come pick me up until later in the afternoon. Two, the local anesthetic was due to wear off soon, and that would be the true test of my pain tolerance.
Sure enough, around 1:00pm the pain started to increase in intensity. In about a half hour, my pain level went from about a 2 to a 7. My knee was throbbing, and there was sharp pain all over. Later on at home my Mom would ask me what the pain feels like, and the best response I could provide was this – it feels like they drilled into my kneecap, which is exactly what they did to me. The ligaments were sore, the knee itself was swollen and tender to the touch. The CPM machine actually did help a bit with the pain, because it got my knee moving around and getting the blood flowing throughout the leg. But the worst pain occurred when it was just sitting still in the brace, unable to move at all. One of the nurses explained that there is always going to be some level of pain, it just depends on how much you can tolerate. They increased my painkiller dosage, and after a couple hours I finally was at the point where I could stand the pain. I let my parents know I was good to go, and took a short nap while I awaited their arrival.
Some time during that afternoon, my roommate Rueben was released. I learned from his conversations that he had back surgery, and briefly spoke with him when I was on my way back to my bed after my PT session with Pavel. He was a pretty young guy around my age, and seemed like a nice enough dude. Although we didn’t interact much, I was glad he was with his family and on his way home. After about an hour of peace and quite with the room to myself, they brought in a middle-aged patient, who was loud and obnoxious, and brought an entourage of family members into our small room. I was now getting anxious to get the hell out of there, and couldn’t wait to go home to my parents house in Connecticut, where I was schedule to spend the next couple weeks recovering.
My parents arrived around 4:30pm, and I ordered a dinner to go from the hospital. Even though I ordered it to go, I wolfed most of it down as I was getting ready to say goodbye to HSS. I caught the elevator down with my Mom, and Pavel happened to be on the elevator with us. He was surprised I was leaving so late, as I had done so well earlier in the day. I thank him for his help, then we went our separate ways. He really was a cool dude, and I appreciated his guidance throughout my stay at HSS. My Dad pulled the car around, and had a full pepperoni pizza, a Gatorade and a water waiting for me. I was still hungry and extremely thirsty, so this was about as good as it could have gotten for me at that moment. I lounged in the back of the car with my right leg laid across the back seat, stuffing my face with pizza as we drove the quick 45 minute drive to Stamford.
July 10th-July 18th, 2015
My parents had arranged for me to stay with them for the next week or so, which I was extremely grateful for. My set-up was on the pull-out couch in the living room, right in front of the T.V. and connected to the kitchen. The closest bathroom would be about 20 feet away, so aside from me entering the house when we arrived, there was no need at all for me to ever go up or down any stairs.
The first morning I woke up, my Mom asked me what I wanted. I ‘ordered’ two whole wheat pieces of toast with almond butter spread on each piece, a five egg omelet with tomatoes, cheese, peppers, and spinach, along with turkey bacon and assorted fruits. To my Mom’s credit, she made that same breakfast for me everyday at 6:30am, and I didn’t even have to ask. Even later in my stay when I wasn’t super hungry and didn’t need the extra protein as much, she had everything ready to go. It was awesome.
My parents both work at home in some capacity, so most of the time one of them would be there to prepare meals for me, and make sure I was taking my pain medication on schedule. We charted when I took each med and the dosage, because I wanted to get off of the meds as soon as possible. I knew I wouldn’t get hooked, but the sooner I got into my normal state of mind the quicker my overall recovery would be. The level of pampering was unreal, and I can’t thank my parents enough for it. They had a stand set up next to my bed so I didn’t have to go anywhere to get food. They literally delivered food, drinks, and medicine to my bedside. Amazing right?!
Along with the CPM machine, I was given a Game Ready ice machine, which was the exact same brand the Fusion crews uses at PT. Along with my exercises, I would ice 30 minutes three time per day as well. The initial machine I received was broken, and because of that they allowed me to keep the device for an extra week. They were great with bringing a replacement the same day we figured out it was broken, which was a huge plus. This machine was a godsend, and really helped deal with the swelling. The machine also contracted while it iced, which aided the effect even more.
I probably could have made better use of my time at home, but I pretty much binge watched T.V. This included watching shows suchs as 7 Days in Hell, the fictional tennis documentary featuring Andy Samberg and Kit Harrington; the first season of True Detective, half of season 2 and season 3 of House of Cards, The Dark Knight for probably the 100th time, Wimbledon, the MLB All-Star Game, Home Run Derby, and Celebrity game (yes, all three); and the ESPY Awards. As great of a show as True Detective was, it was probably a little too dark for me to be watching in my state of mind. It also “made” me watch season two of the show a couple weeks later, which was pretty bad and a complete waste of time. But I digress.
A few friends stopped by to visit me, which was pretty awesome. A few brought me food, and stayed to chat about their pwn previous injuries, work situations, and to just shoot the shit. I received encouraging texts and tweets from other friends, and I appreciated all of the support wholeheartedly. Colleagues from work even sent me a gift basket filled with snacks, which I didn’t expect at all. My rugby team was hosting our annual tournament, Hell Gate 7’s, during my first Saturday home. It was pretty hard not being out there to play or even watch, but it turned out to be one of the hottest days of the summer. To be honest I was fine laying my ass down in the comfortable air conditioning while my parents prepared food for me all day.
I was able to get off the pain meds after about six days, and increased my range of motion on the CPM machine to 30 degrees. I also was told the take the big bandages off my knee after three days, and leave the small ones covering my stitches in tact. This was a big mental hurdle for me that turned out to be nothing I should have worried about at all. Even thought my knee was extremely swollen, the three incisions didn’t look too bad at all. They were pretty much exactly how Dr. A. had described them, and it felt good to free my knee of the dirty bandages and let it breath a little bit.
My stay at home in Stamford did wonders for me, and I don’t know what I would have done without the help of my parents. I initially thought that I could make it alone in my New York City apartment, but now I realize how difficult that would have been. I can’t thank them enough for taking care of me during those first couple of weeks, as I know it set my rehabilitation off on the right track.
July 24th, 2015
Today I was due to get my stitches removed in the morning, and begin my official PT at Fusion in the afternoon. I was nervous about getting the stitches out, because this was the first time I would see my bare knee since surgery.
It ended up being a super simple process. The nurse removed the small bandages covering the wounds, and asked me if I wanted to take a quick look. I leaned forward for a second or two, and was amazed at how clean everything looked. There were a couple long blue stitches sticking out of each cut, but it looked nothing like the Frankenstein zipper I was expecting. I could also tell how well everything was healing up. Dr. A. walked in, and we had a casual conversation while the nurse removed my stitches. I was again taken aback by how painless that was. I had expected a shoe-lace through the hole type of feel, but it was more like she was lightly pinching my wounds. The nurse finished removing the stiches while Dr. A. gave me the green light to graduate from the CPM machine to actual physical therapy, and we booked a follow-up appointment for September.
My first session of PT was pretty uneventful, but it was important to me because it signified the first step toward my recovery. I was going into it expecting extreme pain, and mentally braced for a brutal six to nine months. Based on what I had been told prior to surgery, I could expect about six months of therapy, and a full year until I really feel like myself again. I did my best not to put a timetable on this, and just focused on my PT for three days a week.
I was again being treated by Brian, the same Doctor of Physical Therapy who treated me prior to surgery. He definitely took it easy on me my first time out, getting a feel for my knee and allowing me to get used to the routine. The standard procedure was to spend the first 20 minutes with Brian while he massaged my the scar tissue in my knee, essentially breaking it down manually. I was instructed to do this on my own throughout the day as well, because the more I did it the faster I would heal. He would also stretch my knee and leg by extending and bending it as far as I could. This was taking the foundation I built using the CPM machine to another level.
I think it was the third or fourth session of PT where I realized how painful this process really was. Brian lifted my knee in the air and bent it, and essentially letting it drop so that gravity would allow my knee to bend as far as it naturally could. This gave me flashbacks to the night my injury occurred, and was the worst pain I felt since that moment. My stomach dropped, and I felt that faint clammy sensation wash over my body. After 10-15 agonizing seconds it was over, but a new threshold was broken. For at least the first month or two, this would be my 20 minutes of hell for three days every week.
After being treated by Brian, I would perform as series of stretches and exercises to built strength and range of motion. The exercises were the same initial stretches I had performed prior to surgery: the series of hip raises, a seated hamstring stretch, thigh contractions, body-weight shifts, and a couple exercises geared towards increasing the range of motion in my knee.
The first day I attempted to the a simple leg raise laying on my back was one of the most frustrating things ever. I focused all my energy on trying to move my leg up six inches in the air, and it wouldn’t budge. I performed the leg lift with my left leg with so much ease, and I couldn’t get my right leg to move at all. It was an odd feeling not to be able to execute this simple movement. Discouraged, I went to my next PT session determined to get this right. One of the trainers observed me attempt my leg raise, and gave me a couple cues to focus on. He said that I should use my hip as the lever to activate the movement, while contracting my thigh to keep my leg straight. My thigh muscle was still extremely atrophied, so I kept my brace on to aid in keeping my leg straight. With his advice I was able to do the leg lift, while writhing in pain every rep. It was a mini epiphany – I needed to embrace the pain.
During these first critical months, my willingness to just take the pain would determine not only how fast I recovered, but how well I recovered. This may seem extreme, but my livelihood later in life depended on my ability to commit myself to taking 20 minutes of pain each day. There was no point in getting surgery if I wasn’t going to rehabilitate myself properly, and now that called for me taking the pain. It didn’t matter that I breathed like I was giving birth while Brian cranked my leg and forced my knee to new limits three times a week. It didn’t matter that I just wanted to come home, crack a beer and watch T.V. after work. Every day I needed to keep pushing the limit, taking one more step further toward recovery. Even if that meant suffering for a few seconds at a time. I had committed to repairing my knee, so I might as well do it right.
Some days it was tough, especially when I thought I didn’t improve from my previous PT session. Brain was hard on me, but he could tell I was putting in the effort. I slowly started to see the fruits of my labor, and as the range of motion stretches got more complex, the more painful it seemed to get. One Friday after a PT session I hobbled to the bar to have a few beers with some Village Lions, and ended up chatting with an Old Boy named Steve Raia, who had been through his share of surgeries. He probably doesn’t even remember this conversation, but he told me that one of the most satisfying yet painful day would be when you can stretch far enough that your heel touchese your ass while you are laying on your stomach. It seemed like I was a long way away from doing that, but about a month later Brian had worked me to the point where I felt my heel to my butt. It was a milestone of sorts, and signified that all the pain I was enduring was leading me down the right path.
Labor Day weekend was a turning point, as it was the first time I was comfortable enough to walk without my brace. A few weeks after starting PT I ditched one of my crutches, and used only one crutch for support. After that there was another two or three weeks of walking only with the brace. I will say, walking around with a large brace on your leg did feel like I was part of a brotherhood. I would get nods from random people on the street, and pats on the back letting me know that they have been there. I had several conversations in buses, trains and cabs, with everyone related their experiences to me. I made a few observations from all of these interactions.
For the most part, people are generally nice. Even in a city as cutthroat as New York, 98% of the time people would get up to give me a seat when I needed it. That other 2% is always going to exist, and there is nothing I can do to control them anyway. Second, everybody and there mother thinks ACL or meniscus tears are the only injuries you can have. I touched upon this in an earlier post, but it really was apparent when I was walking around with my brace. I’d hear, “hey bro, ACL?” “Aw man, I blew my ACL out too”. It didn’t bother me too much, sometimes I would just smile and nod. If people wanted to know they would take the time to find out. Third, everyone wanted to give me there opinion on how to rehab, or how bad it was, or how easy it was. At this point I was way beyond taking what other people said with a grain of salt. It was really just interesting to hear how unique the human body reacts for different people.
When I finally did take off the brace for good, it was odd walking without it. I had to really focus every step to make sure I was walking with the correct form, and not cheating myself into bad habits. I also had to walk very gingerly, to brace myself for unexpected movements. All the literal and figurative armor had been stripped from me, so people were no longer as nice to me on the trains and sidewalks. This was tough, because I was definitely nowhere near 100%, although to a stranger I seemed fine. It took me a while but I eventually got more comfortable out in public, especially as I started to progress with my exercises.
As I increased my range of motion, the level of difficulty on my exercises increased as well. My hips and thighs were slowly getting stronger, which allowed me to step things up a notch. I progressed to doing box squats, which was a huge deal for me. This was a basic athletic movement, but it felt great to do finally be doing something somewhat athletic. The first time I did wall sits, my knee was so tight I thought it was going to explode. But I would get through those 30 seconds, and eventually increase them to 45, then a minute. Each time I did a wall sit, one thing ran through my mind – take the pain.
One of the hardest things I had to overcome was learning how to ride a bike. Initially I wasn’t able to pedal all the way around, so I would go as far as I can forwards, then backwards, each time pushing my limit to see how far I could go. I cannot emphasize how painful this was. One day I peddled back to the point where I realized I can actually make it over the hump to pedal a full revolution. On this particular rep I was at the point of no return, and screamed out a bit as I pushed through a wall of pain to successfully execute a full pedal. David, one of the other PTs, chuckled a bit as he watched proudly. Yet another big milestone accomplished. For the next few weeks I would have to warm myself up for a few minutes on the bike before attempting to pedal for real, mentally and physically prepping for the pain. I forced myself to go through that pain on the bike before I got to Brain stretching me, with the thinking that his torture would be easier to take if I had already broken that initial threshold. For the most part that was true, but it didn’t make it any easier to take.
My follow-up appointment with Dr. A. was in the beginning of September, where he would evaluate how well I healed and was progressing with PT. After examining my knee for a couple minutes, he said the ligament was pretty much healed, and now it was all about continuing to build strength. My range of motion was beyond 90 degrees, which was a great sign. He recommended I step up my PT another notch, and that I could even start swimming and biking to build more muscle. Encouraged, I joined the 14th street YMCA, bought some cheap goggles and a swim cap, and on September 12th I had my first workout outside of PT in over six months. I swam 20 laps and rode the bike for 20 minutes, which was a huge accomplishment. It definitely wasn’t pretty and I’m no Michael Phelps, but it was a big deal for me. Once or twice a week for the next two months I would join the Grannys of the East Village and swim in the YMCA pool. Sometimes an old lady had to pass me because I wouldn’t be moving fast enough, or I would drift to the right as my leg would lag and not be as powerful as my left. But I started to get the hang of it, and was glad to be building muscle and getting some much needed cardio in as well.
November 3rd, 2015
This date marked my last visit with Dr. A. He liked how everything was progressing, and gave me the full go ahead to ramp up my PT, under the guidance of Fusion of course. He said he did not need to schedule a follow-up moving forward, unless I felt the need to do so on my own. We shook hands and I thanked him for fixing my knee, and he thanked me for being a good patient.
With that boost of confidence, my PT really started to intensify. I had moved on to plyometrics to begin the process of increasing my power, speed, and agility. These included exercises such as toe taps, step-ups, skaters on a TRX machine, and leg presses on a resistance sled. Plyometrics also allowed me to get used to impact, which would test my strength and help break down the scar tissue even further. By this phase of my recovery it was no longer about simply taking the pain. It was more about listening to my body. This is where I could lose focus and discipline, risking injury by attempting to progress faster than I should. I wanted to be as conservative as possible, moving on the the next exercise only when I received the official go-ahead from someone at Fusion. They provide the supervision and cues I needed to make sure I was performing each exercise correctly, so I wanted to master each movement as much as possible before attempting it on my own.
By December I had advanced to run on the Alter-G treadmill at Fusion, which was an anti-gravity chamber that helped ease the impact on your body while re-training you how to run. It kind of feels like floating a bit at first, but you can adjust the settings to decrease the amount of air pressure is in the chamber. I started off running ten minutes at a very slow pace at 75% of my body wieght, and increased the length of time I would run each week while simultaneously decreasing the air pressure within the chamber. After six weeks, I was able to run for 20 minutes, in addition to a 2 minute warm-up and cool-down. After eight weeks, I had pushed my limit enough on the Alter-G to graduate to running on a normal treadmill.
February – March, 2016
Shortly after running my first ten minutes on a normal treadmill, I had officially graduated from physical therapy at Fusion. But my work was far from over. I still didn’t feel comfortable enough performing the types of lifts and exercises I knew would get me in shape to return to rugby, which meant I needed to do sports performance training.
During my last official weeks of PT I had started to do some agility work, which involved shuttle drills on cones, speed latter work, and other reactionary agility drills. This gave me huge confidence, and it felt great to show myself that I was able to move quickly, cut and execute short jumps. However I also could feel the lack of explosion and overall weakness I still had. I decided to start personal training John, one of the sports performance specialists at Fusion. John had seen me right after I got in injured back in April all the way through my surgery and rehabilitation. He knew my injury history and where I was at physically, and tons of experience training clients for specific sports. Equally as important, I knew he would push me to my limit while keeping an eye on my health. This trust factor was a huge deal – I could have signed up for personal training at any gym, or done cross-fit, or kept to my own routine. But none of that would have had the watchful eye of a specialist who knew exactly what I had been through, and what it would take to make me a better athlete.
John devised a basic workout program for me to do on my own throughout the week. Everything we worked on would be geared towards building me up to be a better athlete than I was prior to my injury. We would work on improving core strength, developing speed and explosiveness, and getting more meat around my legs as well as my upper body.
First we started with the basics – a 10-15 minute dynamic warm-up routine that would get my heart rate up and blood flowing throughout the body. Then we would jump into a circuit of some sort, usually combining a leg lift with a complimentary upper body lift, or a series of jumping exercises with a drill that focused on explosive running. Basically each day had a theme – power and strength, or explosiveness and agility. I would tailor my workouts throughout the week based on the hour I spent with John, alternative between power and speed days.
Although I was now able to run on a treadmill, John worked with me to correct my form so that I would run in a safe but athletically efficient. If I did something wrong, he always knew the right cue to get me back on track. This was true for running, jumping and lifting – everything was about being compact and crisp while remaining smooth and fluid throughout.
At first the sheer impact on my knee was very tough. Exercises such as power skips were hard to get used to, as I lacked the explosiveness to get in the air, but also the stability to land comfortably. After about a month and a half of building more muscle in my leg, I finally started to seeing improvements in my jumping and landing. In addition to the more advanced running I had been doing, this was the final step I needed to test my ability on the practice field.
March 31st, 2016
A year ago this week was when my injury occurred, and this was when I decided to make my return to the practice field. It felt great to be back out running around on the pitch, although my rugby skills were particularly rusty. I participated in all the non-contact drills, and did a little fitness as well. I felt myself fatigue towards the end of practice, but overall it was an uneventful training session. This was a good thing. I had made it through without any tweaks, and knew exactly where I stood and what I needed to work on.
The next couple months I made it to as many training sessions as I could, increasing my workload each time. I was still staying out of most contact, but was able to play touch and bump around a bit. The key for me was to take my time warming up, no matter what. I knew all to well that a major injury can occur at anytime, and I wasn’t willing to take any risks.
The only hiccups that I had was as my knee would fatigued over the course of working out, and I would feel my leg give out a big. This was a sign to take it easy, and I didn’t want to push myself and risk losing form, which could leave to another injury. I still struggle with that to this day, but it occurs less frequently. Time, more practice, and more muscle will be the antidote for that ailment.
I had no plans of playing in the spring, but it was important that I provided myself with a benchmark to measure. It was great to be back having a run with the guys, and getting my competitive juices flowing once again. Most importantly I gained a ton of confidence in myself, and knew that I had approached this process the right way. At least it was the right way for my body, and not a timetable set up by someone else.
July 8th, 2016
Typing these words and reflecting on this past year is a bit surreal to me. I have grown so much, and learned the true meaning of patience. But at the same time I realize there is nothing unique about my situation. During my time at Fusion, pre and post surgery, I have seen at least 10 teammates join me to rehabilitate themselves as well. Some of them had relatively minor injuries, while others had setbacks way worse than mine. If anything this experience has humbled me, and allowed me to appreciate what I have – a healthy body, loving friends and family, and the opportunity to achieve whatever I put my mind to.
Tomorrow I make my return to rugby at Hell Gate 7’s, hosted by my Village Lions. This is my comeback, but the journey won’t be complete. There is still more work to do, and I have plenty of room to get better. But this isn’t even about rugby. It’s about making sure that I can still live an active lifestyle 10, 20 years from now. Applying the lessons learned from this year and living them out will be the real challenge.
Thanks for following my story, I hope you enjoyed it.
– John Tublin