Weeks 3 – 6
The second instalment of my rehab diary covers the period between from my three-week physio check-in to my post-op check with the surgeon.
Week 3 Physio Check-in
I drove to my three-week physio appointment which was my first time driving post-surgery. My knee was fine but was at its limit of tolerance as I arrived home. It did not enjoy the twisting and clutch work involved with reversing into and parking in our narrow cul-de-sac street. (Maybe, I should just learn to trust sensors and camera). Anyway, I decided to hold back with the driving for another week or so.
The physio was pleased with my progress. In addition to walking, I was given the go ahead to start using the exercise bike with low resistance and initially for just ten minutes four times a day. I discovered that was quite ambitious when I lasted all of five minutes on my first attempt. The physio continued to counsel caution with hills when walking.
Further exercises were added to my rehab repertoire:
- Clam shells
- Heel raises
- Back and side leg swings
- Shallow squats
Having got over the initial shock of how little I could comfortably do on the bike (and not jeopardise the healing and recovery) I established some structure and routine around my rehab and set up was was best described as a light training programme.
I continued with the rehab exercise three to four times daily and and relevant days incorporated them into my on-going twice weekly core and upper body strength sessions. I combined walking and cycling and did various combinations of: two bike sessions and a walk, 3 bike sessions and no walk, walking only.
Writing this I realise that this was a significant uplift which is why at the end of week four my knee started to hurt. I totted up what I had done in my training log; a combined (walking and cycle) total of forty-seven miles over the week. Muppet! With each individual session being light it was, as I proved, all too easy to lose sight of the cumulative effort.
The discomfort in my knee drew me up short and anxiety, even a touch of panic, set in. Had I done any damage? Had I jeopardised my recovery? There was a battle between my emotional and logical brain. Logic said it was unlikely that I had done anything other that overwork it.
I reeled the activity back and spent the next week (week 5) focusing on rest and the rehab exercises. My knee eased and at the end of the week I did a couple of gentle short walks before trying a session on the bike. All was fine: no damage done. Thank goodness. That was indeed a lesson learned.
I concluded that frequent, short and easy sessions were actually not the right approach. As my post-op appointment was only a week away I would await the outcome of that and then re-assess how I would approach my on-going rehab and return to training.
Week 6 Post-op Appointment
Monday 6th November, my post-op appointment with the surgeon. A big day!
My knee had settled down after my over exertion so, I felt that it would be OK to try driving again and so drove to my appointment. I found that my knee was less sensitive and coped well with the mechanics of the drive.
I was excited and keen to speak with the surgeon to get the detail of what he had found and done. He walked me through the photos he had taken inside my knee. As he had predicted there had been a flap of the meniscus that had folded in. It was, he said, a very satisfying surgery to do. He also said more than once that that type of fold was a ‘very sore one’.
That did prompt me to think about how I had perceived the pain over the previous year.
Had it been very sore? At times; certainly when it first happened. There had been times when it was barely perceptible and others more so. Also, as I said to the surgeon, it was only after the surgery that I realised there had been a constant sensation of there being something there: a sense of pressure or friction.
He confirmed that overall, my knee was in pretty good condition. There was a little wear on the back of my patella as he would expect with a runner. My lateral meniscus was a little uneven too, but again there were no concerns or alarm bells. Finally, he pointed out that the bone surfaces are as smooth as the proverbial baby’s bottom. It would seem that I am reaping the rewards for my diligence with strength and cross training. The surgeon concluded that there was no reason why I couldn’t make a return to running if I desired.
It could take another six to eight weeks to settle down further and I was to be aware of the scar tissue especially the little pea sized lump directly below the incision points when kneeling. I had already found that one: ouch!
The surgeon discharged me with a smile and a shake of the hand.
Week 6 Physio check-in
Different physio, different location and within walking distance meaning I could kill two birds with one stone. See the physio and do my daily walk. I do like a bit of efficiency.
This will be short and sweet a bit like the appointment.
We had a chat about how the rehab had been going and what the surgeon had said the previous day then it was out to the gym.
Deep squats, single leg squats, jumping, hopping and step-ups and it was a case of all systems go. I was discharged and signed off to make a gentle return to running and a structured training regimen. There were caveats. No running downhill, start with a few gentle jogging intervals when out for a walk, take care with load and effort when doing strength training.
Whilst this was what I had hoped to hear I was still a little surprised not to mention nervous: rather like when he had asked me to hop and jump. I found that it was quite a lot process and it did take a couple of days to build up the courage to test the legs, and more importantly my knee.
More about this in my next post.