Well, shit. I tore my ACL.
My injury recap falls into a few phases: an initial buckle/hyperextension, a feeling of dislocating my patella (knee cap), and immediate white hot pain. I was on the ground for a couple minutes before limping off for ice.
It was during a basketball game, and the injury itself is often referred to as a non-contact knee buckling incident, if you’re familiar with knee injury lingo.
I’ve played basketball my entire life, but on that day the same dribble-hesitation move I must have done thousands of times resulted in a very different outcome.
If you’d like, you can follow the ACL recovery podcast series, which begins here.
I visited my primary care doctor a week after the injury thinking it was (potentially) bad news. In my head I thought I’d partially torn or severely strained the lateral ligament, the LCL. Tender and swollen, it felt “off” and I still had a lot of pain and swelling.
As an athlete I knew in my gut something was wrong. During the buckling incident (which recalls as slow motion in my memory bank), it felt like the LCL rolled forward, if that makes sense. Almost an over-and-back feeling along the outside of the joint. This along with a slow grinding feeling (not a pop), which I thought was my patellar tendon getting hammered at the time.
An x-ray was ordered but it read all clear, and I had passed the ACL drawer tests in the office. But how could nothing be wrong? Bruising was now apparent along my LCL, as well as on the front and back of my knee. Yet my doctor said, “we aren’t too quick to order this given cost as most of the time symptoms improve over 2-4 weeks.”
About a week later (are you counting the weeks?) I told the office I wanted an MRI to know what was going on. That gut feeling was only getting bigger, and sure enough, one month after the injury it was confirmed that the ligament was completely torn.
On the surgical side—after a stressful week of PCP-to-insurance-to-ortho-office phone tag—I connected with the same doctor who worked on my brother’s ACL a handful of years ago. Once in his office, we ran through the MRI results where he (correctly and immediately) identified the issue with various manual tests, and so forth. In about 20 minutes time I was walking out with surgery as the next step.
In hindsight, I would suggest two very important things if you believe you’ve done real damage to your knee. First, never visit a PCP unless you have to solely for an immediate referral. Visit a specialist in knee injuries right away if you can.
Second, one may be guarding the knee after injury, along with persistent swelling, making it difficult to get a positive test on joint laxity. This is another reason to visit a doctor that sees and feels knees all day long. In my experience, visiting the PCP resulted in a lot of frustration and hassle actually getting to the surgeon I needed to speak with all along. I didn’t have the luxury of going right to an orthopaedic office, but highly advise it if you can.
If you’ve done this before, there’s an emotional side that’s hard to quantify or explain with this injury. For me, it’s ranged from being scared about the surgery itself, to knowing I’ll be in pain, to the recovery process that will come next.
I’m very familiar with pain in the knee after doing the damage—and the weeks of icing and hobbling around after that—but will this be even worse? I know “pain” on the bike and slowly gaining back ROM with knee injuries, so will this be more difficult? Everything I’ve read seems to indicate a sobering “yes.” Or at the very least, a “different pain.”
There was so much planned this spring and summer: long road cycling rides, backcountry hikes, travel. I feel like I’ve let people down, and surely I’ll feel let down in the months to come.
Physically, 5 weeks after injury and without current physical intervention (cycling and pre-op exercises), my right leg would have atrophied into a pole. It’s shocking how quickly muscle control and mass goes away. That’s been one of the hardest realities to visually accept. Related, pre-habilitation has consisted of a lot of band work and cycling to regain strength and flexion.
As I alluded to, my brother had the same injury this time of year a handful of years back. Memories of his experience are rushing back, and I wonder if I was supportive enough of him. I remember his pain and his struggle.
From much of what I’ve read, researched, and spoken with others about, this process is going to require a lot of support. Physical support during rehab, emotional support during the low points, and mental support as I begin to test the leg again.
For now, I’ll leave it at that. If you happen to be visiting after a knee injury, you may feel the same things. Sad, depressed, angry, uncertain. But know it’s all normal when this level of injury has occurred. I hope following this journal helps you in your own unique recovery process.
This will be the first of many “Injury” posts throughout my journey recovering from this injury. I’ve searched far and wide for a journal that shares that process on the web, and haven’t found too much luck—just a few posts here and there. I want to share my story, both for myself as a therapeutic process, but also for people (even just one person) who may find this helpful one day. If you’d like, begin the torn ACL recovery podcast here.