Coming back after injury!

Thursday, May 16, 2013 at 11:18

TriathlonOz - Michelle

It's now just over 7 weeks since I injured my right knee (see previous blog) and the good news is I seem to be "fully" healed and can run, ride, and swim totally pain free and without limitation of movement.

A few people have asked me to document what I've been doing to get to this point so here's a run through:

At the hospital ED they took an x-ray to determine no broken bones and referred me to the Orthopedic specialist with the expectation of an MRI. Due to the extreme swelling, I had to wait at least 10 days before the scan could be done. During that time period I had crutches initially as I could not balance enough on the leg to walk without a limp. I found them incredibly debilitating - ok, I HATED them so I really tried to cope without the crutches as much as possible. I couldn't drive or do the grocery shopping and this made a huge impact on our family as I'm the taxi for all sorts of kids activities and school drop off/pick ups too but David stepped in and took over that load. I got so much work done (I work from home on my computer so applying the R.I.C.E principle was easy!). I was also very conscious about what I ate/drank during those first few weeks - and ate a huge amount of raw greens in every form possible, salads, green smoothies, etc. I also upped my dosage of Juice Plus supplements doing anything I could to rapidly improve my recovery.

My biggest fear was not being able to ride for my team in the Busselton Ironman 70.3 (11th May) but by the end of the first week when the last chance cancellation date for partial refund came around, I accepted defeat and pulled out. So damn you Busselton - that's twice now that I've been injured and not had a chance to improve my 2010 race time.

The hospital ED referral to the Orthopedic Trauma Clinic stated my injury as a suspected Anterior Cruciate Ligament tear. But it was only a guess because without an MRI it could be anything. Because I had no idea what sort of injury I had, the next 10 days wait was torture. The more I checked in with the Google-Doctor, the more confused I became about whether I should be keeping the leg immobile or whether I should be starting to do exercises to increase the range of movement.

I had a visit with a sports physio who confirmed I should be moving it, so I got some specific exercises from her to work on. The concern was the extent of muscle-wasting, which was already apparent by the 7th day post-injury. But by the time I got to the Orthopedic Trauma Clinic there had been a massive improvement in how I could use my leg and the registrar that did my injury assessment was quite amazed at the speed of my recovery at that point. I wasn't yet able to fully bend my knee and any sideways twisting from my ankle would hurt at the knee, and getting into bed was always painful, but I was walking without the crutches (slowly) but without a limp so I was given the green light to ditch the crutches. I was told that it was unlikely to be the ACL due to the recovery I'd already made, but the suggestion was that an MRI would most likely reveal a Medial Menisus tear - but I'd have to wait another 3 weeks.

I took that as really good news and knew that the more I could strengthen and use my leg before "surgery" if that's what was required, the better my chances of a quicker recovery.

So I wanted to start using my bike (stationary) to encourage the full range of movement in my leg which was still not bending fully. The internal swelling was restricting my knee from bending at the top of the pedal stroke and I had no strength or ability to twist at the ankle so I could not use my cleated bike shoes but with VERY VERY VERY slow pedalling in the easiest gear I was able to get my leg bending sufficiently to do a few minutes at a time. I read that if it hurt after exercise, that was ok provided I iced it and if the pain subsided within 2 hours - it did, so I kept that up for a while. I also went to my gym and used the recumbent bike that didn't bring my ankle up so high to my knee so the angle was better. Walking was still slow for a while too but I just kept it to small distance such as getting my daughter to school (1.5km round trip).

For those few weeks waiting for the MRI I cycled on my indoor trainer every 2nd day and eventually was doing quality training sessions of 60 minutes using all the gears. I kept pushing myself to ensure I was doing enough cardio because I was so scared of getting fat!! I'd also worked specifically on out-of-the-saddle stuff once I was ready as I was so concerned about the lack of quad strength. I was told that I could swim but I got that terrible cold/flu and it was wintery rainy weather for most of that 3 weeks so I didn't bother.

When my time finally came for the MRI I was able to walk briskly and had even managed to try running (a few hundred metres) and all felt good so I was feeling positive about avoiding surgery. At that point anyone who didn't want to do all the sorts of crazy activities I do would probably be happy to leave it at that, but there were still things I couldn't do that would be a problem for me the wanna-be-triathlete. I couldn't do any weight-bearing on bended legs - eg. squats, sitting cross-legged, kneeling, and definitely no yoga or ITB stretches etc. So I needed to know what was going on inside my knee.

The results of the MRI came a few days later and sure enough - no meniscus tear either! What I had was a BONE BRUISE on my kneecap!! What the....??
I didn't need the orthopedic surgeon to tell me that bone bruises are very painful, but I didn't like the prognosis - "will take many months to heal and because of your age, your knee might never be fully functional as it were before"! What??? No.... that can't be!&*#$%*

Back for MORE rehab exercises then... and lots more raw green vegies and smoothies... and get stuck into strength training to work those quads, glutes and abs for me!

So now it's been 7 weeks since the fall and I'm doing ok really. We bought a cat, I've got a new hairstyle hahah. Ok seriously now... my cycling is back to normal (just a bit slower than I'd like), and I went for my first swim yesterday and have started a little running and strength work. So I'm getting there and my knee is fine - just a bit too late to have done the Busselton Ironman 70.3 last weekend though. Soooooo disappointing.

Missing that race was a bummer. It would also have been my first race in my new age group 45-50. Wow, that is scary to put it up there in numbers like that when I've only just had my 45th birthday.

So next on the horizon is a family holiday in July and then another in August (both 4WDing and camping) so I'll just be trying to keep fit and get comfortable running small distances. I'll be thinking about events after August and would like to aim for one or more of the following events:

- Mountain Designs Adventure Race (Dwellingup) (1st Sept)
- Cape to Cape MTB(24th - 27th Oct)
- Augusta Adventure Race (3rd Nov)
- Mandurah Ironman 70.3 70.3 (10th Nov)

If I'm not ready for 1st Sept then I'll consider Cape to Cape & Mandurah as I don't think I could do both the Augusta AR and Mandurah one week apart. David and I are on the wait list for Augusta AR as a duo team so it would be one hell of a big day. Watch this space!
Some wish for it, others work for it!
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