But six weeks ago, I was cleared to start putting weight on my leg and to go back to physical therapy. At my first PT appointment, I set a goal for myself to be able to walk without crutches within two weeks. At the time it seemed easy (I had walked before… why would I not be able to walk again?). But I quickly realized that when you sit on a couch for six weeks and your leg is hanging off you like a piece of dead flesh, all the muscles (not just the ones you can see) atrophy. Not only that, the neural connections weaken and so neuromuscular control is greatly compromised. Long story short, I was able to take my first substantial crutch-free walk 16 days after that first PT session. And boy was it sweet: to walk across the bridge at sunset on a mild day, hands unencumbered and knee unbraced, to be able to enjoy the feeling of the ground beneath my legs. I knew there was a long way to go, but there was light at the end of the tunnel.
Since then, I’ve been going to PT once a week. Each time I am challenged to do more: more weights, more balance, and more neuromuscular control. The obvious limitation is that my meniscus root repair is still healing, which at this stage limits how aggressively PT is allowed to push me. I can walk very comfortably now but still have minor issues with my gait. For example, my left gluteus is still much weaker than my right, and so when I take a step on the left, my hip tends to swing out a little to the right, similar to the gait pattern caused by a stroke in the anterior cerebral artery. I also favor putting weight on my entire foot as opposed to just the heel (probably because it feels better to have the knee a little bent rather than locking it) and so my friends say that I walk as if I’m stepping through snow. I also can’t go down the stairs super normally yet, because bending my knee while putting weight on it is still a little painful, but every day is an improvement. And there are days now that I skimp a little on daily physical therapy exercises at home. But I do see day to day improvement, and I hope to start adding strength training and more intense workouts soon!
This morning I had my 3-month appointment with my surgeon. He tugged on my knee, checked my quad tone, looked at my flexion and extension, and proclaimed the physical exam “perfect.” He said I could now do strength and conditioning as tolerated, start swimming, and ask him about returning to running in a month. (!!!) Interestingly, he did mention some limitations that I hadn’t realized I would be under. For example, even when fully healed I should try not to exceed 30-35 miles of running a week. (Admittedly, I rarely run that much - but it’s a little sobering to realize that my meniscus will never allow me to train for a marathon.) He also advised me to load my knee past 90 degrees as little as possible (which means no deep squats, possibly ever). Finally, he said that he wants me to stick with higher-rep weight training, and that this is something he does too with the Bruins professional hockey players he takes care of.
I think the key is to realize that while things are way ahead of where they were 6 weeks ago, I still have a lot of work and improvement in front of me, and I can’t be satisfied with where my knee is at now. The main goal for me this year must be to return my knee to a point where I can trust it and where I have as few limitations as possible going forward.