Impending knee surgery... (what do I do in the meantime?)

J

jaykay

Professional
Hello,

I hv posted on this sub-forum quite a bit, mostly on knees since I have had menisectomy (meniscus cartilage) as well as ACL (anterior cruciate ligament) reconstruction on my rt knee and have attempted to share my experiences with all, both good and bad.

2 wks ago, I felt my left knee wobble while playing a league match but continued to play the match w/o much pain. The next day, my knee felt quite sore and a bit unstable. Being familiar with knee injuries, I immdtly set up an appointment with my orthopaedic doctor but had to wait for a wk because of the holiday (July 4th).

On meeting the doctor and upon manipulation of the knee, my doc was unsure whether it was an injury that required surgical intervention, or not. So he suggested an MRI. I had an MRI last wk and met the doc today for the results.

Meniscus cartilage was fine and so was the MCL and PCL. The MRI could not photograph the ACL either because it was broken or was not in location. The MRI report however said that 'the results are consistent with an ACL tear, and the injury appears to be chronic, as opposed to traumatic'; meaning that the ACL injury has progressed over a period of time from a partial tear to a full tear and it was not a single traumatic event that caused it to pop (as was the case in my rt knee several years ago).

So, it appears that I hv been cursed with knee injuries. Surgery, crutches, getting driven by the wife for physical therapy sessions, painful convalescence etc.etc., am really not looking forward to this.

Interesting factoid was that if a person sustains an ACL injury in 1 knee, the probability of sustaining an ACL injury in the other knee is rather high, apparently.

Now, I cannot schedule the injury immdtly since I'm starting a new assignment at work and cannot take 3-4 wks of downtime right away. So I need to push this surgery out for a few months at the very least.

This is a complete bummer - since this means that I cannot play the league or USTA for atleast 4-5 months after the surgery is done.

This is bitterly disappointing and unbelievably frustrating.

To put things into perspective, I'm a 4.0 and my court mobility is my strength.

In the meantime, the doc has said that since I have not suffered a traumatic injury that caused 'locking' or severe inflammation, I ought to continue light strengthening exercises on my knees. Perhaps some light tennis drills (limited or no competitive play) and swimming & cycling is recommended.

I hv no clue about biking (cycling). Any biking enthusiasts here who advise me whr to begin?

Thanx,
jaykay.
 
jaykay, sorry to hear about your injury. I, too, have had my right ACL repaired. Mine was repaired over eight years ago after being injured playing basketball. When I injured mine there was a loud pop so I knew I did something but it never swelled and never really hurt; similar to yours. I actually tore cartilage and stretched my acl in a previous injury and I think my acl finally just gave way. So I guess mine was chronic also?

My doctor suggested strengthening the muscles around it as much as I could before the surgery to try to minimize the atrophy afterwards.

I would ask your doctor what you could do as far as exercising or strengthening. It's been so long since I injured mine, I hate to offer any advice on exercises but I would say riding a bike would be a great exercise in the meantime.

I hope everything goes well with your surgery (if you have it). Keep us posted.

Oh yeah, be very nice to your wife beforehand. Like you said, she will have to drive you back and forth to the doctor, rehab, etc. for a few weeks.

Best of Luck.
 
jaykay said:
I hv no clue about biking (cycling). Any biking enthusiasts here who advise me whr to begin?
Click to expand...

Ok - I would normally have said "talk to your doctor", but given you have and all...

Speaking as a cyclist who has had two knee operations....

1. You want to avoid the classic mistake - whatever bike you get, put it in an EASY gear and spin your legs, using lots of easy gears, NOT grinding out big gears, which seems to be what most beginners do. Use the legs smoothly and at a reasonable pace, they won't wear out, you'll get some small leg workout & a good aerobic workout too, while not loading up your knee too much.

2. Assuming you don't have a bike, and are going to buy / beg / borrow / steal one :), you want to get a mountain bike in my opinion. They have more gears and an easier range of gears, much better for your knee.

3. Don't take the mountain bike mountain-biking! Save that until well after the operation. Pavements, roads, etc etc are what you should be aiming for. You can put maximum pressure in the tyres for road-work to allow it to roll smoothly.

4. Stay away from big hills wherever possible, again, bad for the knees.

5. Wear a helmet. Always. The number of people I've seen saved by them is just amazing!

Good luck, hope that helps...
 
You may also want to give the stationery bike a try; I credit that with saving my knees. Although my knee problems are probably not as serious as yours, I was diagnosed with patellar-femoral syndrome, and my knees felt as creaky and painful as those of an 85-year old man. I had trouble going up steps without sharp, shooting pains through my kneecaps.

I went on the bike because the doctor told me to avoid jogging or using the stairmaster (which was previously my preferred aerobic exercise). I rode the bike for 40 to 60 minutes a day 5 to 6x per week at a medium to medium-high tension. One day, a few weeks into this regimin, I noticed that the pain in my knees had completely disappeared. It was amazing. Even a few hours of tennis did not bring it back.

Now, if I miss more than two days in a row of riding, I sometimes feel a pinch here and there, so I have to continue-but not a bad deal, though-trading a couple hours a week on the bike for lousy knee pain. Not saying this will work for your very different condition, but you might want to give it a try since your doctor has given you the go ahead to do light exercise.

Also, if you're the least bit overweight, get rid of the extra pounds; it does wonders for your knees (and back).
 
I will second the suggestion that you get a mountain bike, and ride it on the pavement. Make sure you get it fitted properly, because having the saddle be too low or too high can make your symptoms worse. Being either too far back or too far forward can be uncomfortable too.

Three things to absolutely invest in: a helmet, a good set of gloves, and a set of cycling shorts. Yeah, the lycra is not the most flattering thing, and when you first wear them (do not wear your underwear underneath your cycling shorts), it feels like you have a diaper on, but the comfort is well worth it.

OrangeOne is spot on with his advice to spin the pedals and not grind a big gear. Try to keep your cadence in the 85-95 range at first, and as you get some time on the bike, you'll find it easier to keep it between 90-95, which is kind of a sweet spot in terms of cadence.

As far as the bike itself, I don't know if you have a Performance shop near you, but they're having a blowout sale on some older bikes and you can find a really decent bike for about $500. This is really about the level where you get high quality components and frame that will last and work smoothly.

Good luck!
 
Thanks Phil - I'll keep this in mind. I'm a 33 yr old male, 5'11, 160lbs. Am not overweight.

MidlifeCrisis - I daresay your advice on the cycling shorts is HIGHLY DISCOURAGING. I seriously think I'll forego the cycling shorts unless you can give me a good reason. The bit about 'being in the sweet spot of cadence' went totally over my head. You may have as well spoken in Cantonese/Latin. Care to elaborate?

Addl follow-up questions: Why are you guys recommending a mountain bike (to be ridden on pavement)? Not that I have a difference of opinion, but I'd just like to understand the rationale behind it.

Also, I was thinking a crappy bike from Wal-Mart would be, say, $100. Extrapolating upwards for a better bike that I'll get fitted from a bike pro-shop, I was thinking of budgeting about $250 (helmet, gloves extra). Do I really need to spend $500? {= that's like [3 good tennis racquets + lead tape + good strings + overgrips] worth of money}
 
As always, thanks Marius. This is a wealth of information that I'll peruse through in detail later during the day.

Thnx again.
 
jaykay said:
Hello,

I hv posted on this sub-forum quite a bit, mostly on knees since I have had menisectomy (meniscus cartilage) as well as ACL (anterior cruciate ligament) reconstruction on my rt knee and have attempted to share my experiences with all, both good and bad.

2 wks ago, I felt my left knee wobble while playing a league match but continued to play the match w/o much pain. The next day, my knee felt quite sore and a bit unstable. Being familiar with knee injuries, I immdtly set up an appointment with my orthopaedic doctor but had to wait for a wk because of the holiday (July 4th).

On meeting the doctor and upon manipulation of the knee, my doc was unsure whether it was an injury that required surgical intervention, or not. So he suggested an MRI. I had an MRI last wk and met the doc today for the results.

Meniscus cartilage was fine and so was the MCL and PCL. The MRI could not photograph the ACL either because it was broken or was not in location. The MRI report however said that 'the results are consistent with an ACL tear, and the injury appears to be chronic, as opposed to traumatic'; meaning that the ACL injury has progressed over a period of time from a partial tear to a full tear and it was not a single traumatic event that caused it to pop (as was the case in my rt knee several years ago).

So, it appears that I hv been cursed with knee injuries. Surgery, crutches, getting driven by the wife for physical therapy sessions, painful convalescence etc.etc., am really not looking forward to this.

Interesting factoid was that if a person sustains an ACL injury in 1 knee, the probability of sustaining an ACL injury in the other knee is rather high, apparently.

Now, I cannot schedule the injury immdtly since I'm starting a new assignment at work and cannot take 3-4 wks of downtime right away. So I need to push this surgery out for a few months at the very least.

This is a complete bummer - since this means that I cannot play the league or USTA for atleast 4-5 months after the surgery is done.

This is bitterly disappointing and unbelievably frustrating.

To put things into perspective, I'm a 4.0 and my court mobility is my strength.

In the meantime, the doc has said that since I have not suffered a traumatic injury that caused 'locking' or severe inflammation, I ought to continue light strengthening exercises on my knees. Perhaps some light tennis drills (limited or no competitive play) and swimming & cycling is recommended.

I hv no clue about biking (cycling). Any biking enthusiasts here who advise me whr to begin?

Thanx,
jaykay.
Click to expand...

hi jaykay,

I've experienced a knee problem which is not as serious as yours but it put me out for 6 months. It was in the middle part of my knee under the knee-cap. They said it was inflamation but turned out to be something torn. As like yourself my strength is my movement, since a serious back injury that i was told would never heal : movement is not my strong point just now, although im getting my movement back toghether.

During the time I was out I was taking many pain killers, applying hot water, ice packs, cushioning etc. I know how being out for 6 months is very frustrating having to go through it two times. I never set foot on the courts for the full 6 months and glad i didnt.

As my knee got about 20% better I decided to bring out the old cycling machine I had at the time, which proved the world of good. It helped keep my knee active while not hurting it, The doctor said it would help put things in place and get things back to normal. as for the pain - there was a little bit of pain for the first week but it got alot better. So this is something I'd advise.

I also wore a knee strap which helped alot, I didnt think a little bit of material would help much but it did for some reason.

As for "what to do while out of tennis" I'd look to cycle or get one of those cycling machines. Stay out of physical activity apartfrom, maybe, working on your upper body to keep you relatively active. Eat healthily and maintain a reasonably good diet.

When i first got back to the courts It was the best feeling in the world for me.

Good luck on getting back to the courts jaykay
 
jaykay said:
MidlifeCrisis - I daresay your advice on the cycling shorts is HIGHLY DISCOURAGING. I seriously think I'll forego the cycling shorts unless you can give me a good reason.
Click to expand...

Hehe - I'm going to reply to some of this (even though they were questions to Midlife and others. Hope no-one minds.

Lycra? Skip it. It's advantageous for people who get a little into the sport, and I don't ride without lycra or at least the padding, but for a beginner / rec-rider, you'll live. You're thin, so chafing shouldn't be much of an issue, too.

If you start riding enough to start feeling overall uncomfortable in the whole crotch area (sore afterwards, bad crease lines from underwear, etc etc) - then think about it. The biggest benefit of the lycra is the soft-pad sewn in anyways - and you'll find dozens of manafacturers who make "normal-looking" shorts with that soft-pad sewn in too. I can go into more detail here if required, but for now, skip the lycra.

[Unfortunately, the lycra-image is one that scares people away from cycling. (Disclosure: In the real world, I organise cycling events and one of my sponsors for these events makes non-lycra clothing with comfort-pads sewn in, etc. They also make lycra-gear, and even *they* don't understand why so many people, especially rec-riders, go for the lycra! I don't feel bad about mentioning any of this here because I haven't named the company).]

The bit about 'being in the sweet spot of cadence' went totally over my head. You may have as well spoken in Cantonese/Latin. Care to elaborate?
Click to expand...

Around 90 to 100rpm rotation speed of the legs (otherwise known as cadence) has been found by many people to be the optimum speed to pedal to be able to ride anything above a few miles through to a hundreds miles - it's the level where you work your lungs more (which can work all day) and your legs less (which can't, if they're being worked hard).

That said, this speed is for people who get "clipped" shoes & pedals, something that you may not get up front. You may get close to this speed if you use the "tie-in pedals" that may come with your bike, but most people hate using these!. Advice for people who don't clip or tie-in is just to spin easily, not grind it out. If you get "clipped" shoes & pedals (where the shoes have a cleat and clip into a pedal), then actual speeds, and higher speeds like those, become more relevant. Most people would find 90-100 rpm very hard to hold without clipping-in.

Addl follow-up questions: Why are you guys recommending a mountain bike (to be ridden on pavement)? Not that I have a difference of opinion, but I'd just like to understand the rationale behind it.
Click to expand...

Read my first post again - it's all about the number of gears and the range they cover. Road bikes, as a rule, come with fewer gears and harder gears, and although this can be changed should you desire, it's still a different range to those on a Mountain-bike.

Also, bang-for-buck, mountain-bikes are much cheaper than road bikes!

Also, I was thinking a crappy bike from Wal-Mart would be, say, $100. Extrapolating upwards for a better bike that I'll get fitted from a bike pro-shop, I was thinking of budgeting about $250 (helmet, gloves extra). Do I really need to spend $500? {= that's like [3 good tennis racquets + lead tape + good strings + overgrips] worth of money}
Click to expand...
[/QUOTE]

You're in the US, yeah? I'm in Australia, and things here are usually about double the price of the US (which is partially the exchange rate and then also the smaller market and smaller buying power here).

I'd be recommending you go to a bike shop (your thought of avoiding Wal-Mart is a great move!) and, if you were here, spend about $400 *aussie* on a "decent first bike", maybe $500 aussie at the extreme.

Therefore, I'd think $US 200-250 would be fine at a US bike shop. The cheapest bike from any decent brand (things like Giant, Trek, Specialised, Avanti, Norco, Merida, etc etc) should be around that point in the states. $US 500 is way too much for a first bike in my opinion, if you do get hooked then go spend that (or more) in a year or two!

Hope that helps - happy to answer more if required, always happy to help someone get into cycling :)
 
I just wanted to post a quick update on my knee injury, for whomsoever is interested.

I DID play tennis y.day. Played a with a <3.5 dude who was just ok. I lost in 3 (ordinarily, I'd hv crushed him). I played an overly cautious game and refused to run down any dropshot or lob. Under normal circumstances, my court speed is my strength.

The good news is that I was able to play WITHOUT any further injury or pain happening.

Thus, light tennis drills are possible, which is most heartening.

I shall continue to be cautious, limit my competitive singles play, continue to practise the game and perhaps play more doubles.

IF YOU HAVE SUFFERED A TRAUMATIC KNEE INJURY, pls don't do this.
 
Hi jaykay -

I'm not an expert on this stuff, seems like the more I know, the deeper I dig, the less certain I am. I CAN tell you for certain what I would have done differently with my period of time both before and after my knee surgery.

1. I would have been building muscle right up to before the surgery. This is a big topic, and I hestitate to get into specifics, but I for one had no idea how fast muscle can atrophy if not used. I was in a cast for only two weeks after my surgery and lost 2 cm of quad muscle above my knee. 1 cm is considered significant. This has lead to my kneecap wandering off to the side rather than centered on the trochlear groove as it should. Certain excersises can be very detrimental to your situation, and this should be done under the guidance of a qualified PT. The cycling and swimming are good ways to retain what you've got, but probably wont add the kind of muscle you would need to keep your knee lined up properly. I know this is not your issue now. I'm only mentioning it because it wasn't my issue either, until post surgery atrophy made it my issue. There are many excersises you can do (step downs, clam shells, quadsets ) that are good builders but don't but lots of stress on the knee joint. Stay away from seated machine leg extensions. I've asked many specialists what are excersises to avoid, and they've all mentioned this one is bad news for virtually all people, healthy or not.

2. Get your Physical Therapy all lined up ahead of time. I mean ALL lined up.

3. Find Somebody you can trust. If you are happy with who you have stick with that. Don't go shopping for physical thearpy after your surgery. Do your hunting and screening now if needed.

4. Make sure they handle staffing and appointments, so that you get the same therapist everytime. Relationship is important. Do They have specialist for your condidtion? What days and how many days is that person available?

5. If you have the slightest thought that you are not being attended to properly, trust your gut. Don't be afraid to swithch to a new company or location. I got a really bad start on my post op pt, swithched to a new place, but wish I had trusted my instincts and done it sooner.

6. Know exactly the earliest date you can start therapy. Be there on that date. Too late and you have scar tissue and muscle loss to battle.

7. Ask what equipment you will be coming home with post op. I scored an ice water irrigation system that routed under my cast and out to a portable ice chest. That was a real life saver. You need to keep swelling down, and a cast gets really hot and uncomfortable.


[..]....................


I feel a little sheepish giving you advice, as I'm fully aware this is coming to you filtered through my unique, narrow, personal experiences, but that's all I've got to speak from right now. Your last post states you got to play a little with minimal pain. That's way cool. I for one understand what a big deal that is.

PS. Before they give you the happy gas on the table, while you are still awake and able to speak coherrently, ask them to shave your leg throughly, and completely. They tend to shave only the small area they need to just to do the surgery then bandage up way more real estate than needed. Pulling the tape/leg hair off two weeks later was the most painful part of the whole deal. I have a new found level respect for my wife who makes appointments for bikini waxes, and actually shows up. That's real bravery.

Take care, best wishes to you.
-Jack
 
You must log in or register to reply here.

Similar threads

F
ACL and Meniscus repair without surgery
Replies
33
Views
3K
mmk
mmk
TENNIS_IS_FUN
I'm having surgery because of a torn ACL...
Replies
39
Views
6K
ratm355
R
T
Repair ACL 26 yrs after injury?
Replies
8
Views
1K
KHSOLO
K
S
Knee Brace
Replies
5
Views
1K
djkahn86
djkahn86
J
Complications with meniscal cartilage repair...
Replies
2
Views
797
jaykay
J
Back
Top