My first blog post

I’ve created this blog after having reconstructive knee surgery as I thought it would be useful for people to know what to expect if they are going to have something similar. I found it really hard to find information before I had the surgery so hope this helps. I also have quite a lot of time on my hands as I’ll be on crutches for the next 10 weeks….

Here is a pic from the day I had it done.

IMG_3357

4 months on!

This is my first post for quite a while. This is a good thing as the main reason for blogging was to fill the time when I was immobile so it shows I’ve made some progress. I’m now also logging the time post op in months rather than days or weeks. It is a bit like referring to the age of your kids, I’m not quite sure when you decide to change the metric but I look forward to referring to referring to post op in years. FYI – my daughter is 14 months, my son is 4.

So what has happened in the 2 months since surgery. Here is a potted history: 

5 weeks –

This was the first week I’d left Warrington  in five weeks but unfortunately only to attended a conference in the equally ‘desirable’ Birmingham. I made a bit of a miscalculation as I thought I’d be weight bearing at the conference but I wasn’t so had to make do with hoping around everywhere – more work for the triceps. Not sure about the brace, shoe, trouser combo!


6 weeks

This was the day I’d been looking forward to the most post surgery.  Six weeks and one day since the operation and I was back in the same place seeing the physio and was allowed to put weight on my leg the first time – happy days. 

I’d slipped a few times during the first six weeks and put weight on my ‘blown knee’ and it felt weird to say the least as I got a really strange tingly and pins and needle like sensation right up my leg. Therefore I was a little apprehensive about putting weight on properly for the first time. Despite this it wasn’t that bad and I was able to put weight on my knee relatively quickly and progressed over the next two weeks to fully weight bear. 

8 weeks

I was finally cleared to ditch the brace for sleeping. Initially I was told I’d only need to sleep it in for 6 but my physio was twitchy about doing it too early to avoid damaging my MCL when I turned in the night. The brace didn’t bother me too much for sleeping but it was still a relief to get rid of it as it was another thing crossed off the list. I was also pretty much 100% weight bearing by this point too. 

At this point you really realise how important the physio is as you start to put more and more strain on your knee. How it feels is directly proportional to the frequency at which you do your exercises. As you become more active and transition back to ‘normal’ you find you have less time and don’t prioritise it as much but you do this at a detriment to the recovery. At 8 weeks this was a ‘standard’ night in….


I also started cycling on a turbo trainer at this point. This was hard work due to losing so much aerobic fitness and also my knee bend was not that good so I had to have the seat really high to minimise the pain. This has really helped though and I was able to lower the seat over a 2 to 3 week period to a normal level. 

9 weeks

I was cleared to only wear the brace for when moving around. It then turned into more of a toy round the house and something for my son to mess around with…


I was also cleared to drive which was a big step forward in terms of independence but possibly a step backwards in terms of road safety in the Warrington area…. (4min 30secs into my best men’s speech at the link below will testify to this). 

Driving also meant it was now a lot easier to get to work. I’d returned to working in the office 7 weeks post operation and was getting a lift in previously not driving now meant I didn’t have to rely on taxis to ferry me to physio etc. 

10 weeks – no more crutches. 

I was still hobbling a bit but could now get around without the crutches which made life a whole lot easier.  

11 weeks

By this time I was not wearing the brace except when outside the house. The physio didn’t give me the all clear to do this and it is one of the only ‘rules’ I’ve broken but I thought it was better to try and wean myself off in a familiar environment rather than just go cold turkey at 12 weeks. 

12 weeks

The physio ok’d me to get rid of the brace all together and it was time to ramp up the exercises. Thankfully a new gym has just opened round the corner from where I live and it is really quiet so I pretty much have free reign to use whatever equipment I need. Here is a pic of my first day. 


It was a big struggle the first time on the machines as 3 months of doing nothing had taken its toll. It was really good to start getting a sweat on again though and actually burning some energy. 

13 weeks

This was my first set back. I’ve generally been ok with respect to leg extension and getting my bad leg to have similar hyperextension (about 5 degrees) to my good leg but have struggled with my bend. I got to 90 degrees quite quickly but then got stuck around 120 degrees. My normal physio was then off one week sick and the physio manager stepped in for my appointment at late notice. She then proceeded to berate me for my lack of progress and told me that I should be pushing harder (the complete opposite of what the surgeon and physio said the previous week). The testosterone then kicked in and I subsequently started to push my bend a lot harder. This was definitely not a good move as whilst doing this at the gym I felt a twinge as  I was pulling my heel to my bum. This lasted for a couple of days and I had to back off the exercises and was back to limping quite badly as I was getting shooting pains at the back of my knee. I then revisited my physio (the normal one this time) to get it checked out and he couldn’t see anything particularly untoward and advised to continue to take it easy as he suspected it might have been some issues with scar tissue or something just getting caught. Thankfully after another couple of days of scaling back the pain started to subside and I was able to start to progress again but it has taught me to not push too hard otherwise I could go backwards as quickly as I could go forwards. 

15 weeks

I was cleared to start to lift weights at this point and started to talk with the physio about what I need to do if I want to start to think about playing basketball again (hopefully Abi hasn’t read down this far). In terms of weight he is looking for me to lift 1.5 times my body weight on a leg with two legs and then try the same on one. For all you engineering geeks out there the premise is that when you land there is a dynamic amplification factor (gooogle it) which means this is effectively the load you are putting through your knee. Therefore to be able to safely land on one knee you need to be able to leg press this load. Given that I’ve done pretty much nothing on my bad knee since I injured it 10 months ago this wasn’t going to happen over night and at first I started at about half my body weight and have been building it up gradually. 

4 months

So where am I now? The good,

– 86kg on a leg press with two legs

– one legged squats

– biking

– no swelling

– no ‘hotness’

The bad

– still numb around my knee and the front of my lower leg

– it gets very stiff when sitting down for long periods (writing his on a plane won’t be doing it any favours)

– can’t kneel down

– feels very mechanical when walking

The ugly

– still bruised around my calf, and the front and back of the knee


but so far so good and I’m on the mend and still see improvement everyday and probably about half way towards being back to full fitness. 

Day 34: Surgeon appointment

I went to see the surgeon for the first time post op today. Following the surgery he was a bit sketchy as to what he had and hadn’t done so I was hoping to get a bit bit more info. 

Firstly he got me up on the bench and took the brace off so he could take a good luck at my knee. Before the appointment I had been on my feet quite a bit and with sitting in the car my knee had become quite bent and was not lieing flat. This was a bit of a red flag for the surgeon as he said the main thing to focus on between 4-6 weeks was to get the knee flat and stretch the ligaments to avoid permanently having a leg that couldn’t fully extend. Funnily enough this was contradictory to the advice from the physio who said the main aim was getting a 90 degree knee bend at 6 weeks – as I’ve said previously knees are far from an exact science and everyone seems to have a different opinion. 

The surgeon then took it upon himself to get my leg straight through brute force. He put one hand either side of my knee and put all his weight on it to force it straight. I thought the grafts were weakest in the first 12 weeks but he didn’t seem to care! He asked me if it hurt and where to which I simply replied “yes and everywhere!” 

Thankfully that was the last of the pain and we then had a chat about what he actually did and how it went. By all accounts it was pretty successful and everything got fixed as planned. There was a worry that the front of my knee around the kneecap and the meniscus was damaged but apart from a slight scuff on the kneecap that was all clear. Therefore the long term prognosis with respect to arthritis and a potential knee replacements is reasonably good as all the shock absorbers in my knee are still in tact – I didn’t broach playing basketball again…..

He also talked me through the pics they took with the camera. The pic below shows why I had to have a new MCL. 


The white line is effectively the MCL which is torn which leads to the knee opening up in the direction of the arrow. This leads to greater contact stresses between the tibia and fibia as the load is distributed over a smaller area and the potential for arthritis is increased. 

The next one shows the difference between the front of my meniscus and the back and it is clear to see the difference!


All in all not too bad a result and I’m booked in to see the surgeon again in 4 weeks to check I can get my knee straight of my own accord. Between now and then I’ll be concentrating on doing as many exercises as possible to avoid him jumping on my knee again!

Day 27: Naked Knee – Dressings off

Im not going to lie I am very queesy when it comes to blood guts and anything of that ilk. For the birth of both our kids I stayed well away from the business end, even when the anaesthetist questioned my masculinity during the birth of our first child as I “hid” behind a screen during the C-section (FYI – clinical fact, knee surgery is more painful than pregnancy. The scar is big enough to pull a baby through and it took longer!). 

Therefore removing the dressings from my “wound” was not at the top of my to-do list as it meant it would be winking at me every time I lookeed down. Nevertheless I knew it was something I had to do as opening it up to the elements was the quickest way it was going to heal and eliminate the chance of infection as it scarred. Day 27 I’ve gone for it (4 days after the nurse said I should take it off) and as you can see it is not looking too bad – a lot less like Frankensteins head now!

Now the dressing is off it is strangely liberating as this was one of my last reservations associated directly with the surgery and now I feel that it is almost a chapter closed on this part of the recovery and now I can look forward to getting stuck into the rehab. 👊

Day 27: First stand up wee

So, 24 days post op and I made it to the pub for a few beers after work for the first time. The biggest dilemma I had was when I went to the toilet…. Any male knows that pub toilets are not a pretty place and sitting down in a cubicle is something to be avoided at all costs but when I hadn’t been to a urinal for over a month I had a decision to make. After a moment of indecision I decided to brave the stand up option and as ever someone was kind enough to catch the moment…. check out the concentration. 

Exercises: First 6 weeks

The first 6 weeks is pretty dull from an exercise point of view as it is all about letting the knee heel. The clips below show  about all I’ve been allowed to do so far. I started these the day after the op and although they were tough at first they’ve all got easier with time and hopefully hold me in good stead for post 6 weeks when I can put weight on start weight bearing. 

Straight leg raises,

Static quadriceps,

Passive knee bending – this is the most ‘painful’ as at first as it was really stiff and quite painful but as time as gone on it has eased and now I’m at 90 degrees. 

Patella mobilisation – this is probably the weirdest one as at first it is difficult to locate your kneecap as the knee is so swelled and the movement leads to a weird sensation around the scar. 

Calf stretches,

Day 24: Face like a knee

24 days after the operation and my knee is finally starting to look like a knee again or more like that guy from Mcfly’s face (google tells me his name is Tom Fletcher). Never has a man had a face that looked more like a knee!

Face_Like_a_Knee

In other news I’ve had it confirmed that one of the mums from nursery definitely hates me. She has always looked at me like a second class citizen every time I’ve dropped my son off in the morning. I managed to get out of the house at the weekend and went to a 4th birthday party which said mum also attended. I was pretty proud of myself as this was the first time I’d managed to get out of the house (apart from hospital visits) until I overheard her say loudly to the person next to her:

“oh my god, those crutches are such a death trap”.

What a cow, at a 4th birthday party there are a lot more dangerous things than my crutches tucked under a chair; she should take a look at her herself and if she cracked a smile once in a while she might be a bit happier – all she did was moan the whole time about not wanting to be there (unfortunately what I wanted to write here has been toned down as my wife said it was a bit harsh – it was funnier though).

The other half

There is no good time to rupture the ligaments in your knee but doing it when you have a 11 month old baby girl and a 3 year old boy isn’t ideal!

Once I found out from the surgeon I’d be none weight bearing for 6 weeks and then on crutches for another 6 weeks I was reticent about telling my wife as it probably wasn’t the news she was hoping for after initially I’d been told it was only going to be 2.  She wasn’t in the best of moods anyway as she was going back to work after a year of maternity leave and me being sofa bound and unable to help out was not going to improve things. Nevertheless it wasn’t like I could keep it a secret…


Thankfully we managed to get away for a week to Tenerife before my wife went back to work which was a bit of a ‘last supper’ before the operation.

Having initially injured my knee over 6 months ago I was keen to have the surgery as quickly as possible and was booked in for Sunday 2nd April (a week after getting back from holiday). This was an ideal date as my wife, after being back for only a week post maternity, was now off for Easter as she was a teacher.  This was a lifesaver as although I was in hospital for two nights, I couldn’t have coped for the first couple of days if she wasn’t about as it was so painful getting around on crutches I couldn’t really do anything for myself.

Once I got home it was obvious I was going to be a burden rather than a help.  I couldn’t get anything for myself, couldn’t take the kids to nursery or football or any of the other things I usually did. I couldn’t even enforce much authority from a static position on the sofa.  Thankfully my oldest son hasn’t quite realised quite how hollow my threats are yet and that if I tell him he can’t have another crisp/cracker/chocolate (or any other small food related item) there is not much I can do about it due to the time it takes me to get up onto my crutches.  Long may it stay this way…..

Easter couldn’t have come at a better time as 5 days of looking after me and the kids was starting to wear my wife out but there is one thing that will always make her happy (not me or family) – chocolate! Despite all the stuff going on my wife still managed to do a great job at the Easter bonnet competition and won first prize! Fin was very proud of himself as you can see!


It is now 19 day post op and my wife has started work again. I used to drop the kids off at nursery but that isn’t an option at the moment so she is having to do pretty much everything. After about 12 days I could get around on crutches a lot easier so I’ve been able to start doing basic stuff with my oldest son – cleaning his teeth, reading stories, putting him to bed, taking selfies.   I even wiped his bum a few days ago while balancing on one crutch (that is a secret between me and Fin though as I’ve told my wife I can’t do that at the moment and it is her job).  I can’t really do much with my daughter though as 10 month olds don’t really like to sitting on your knee and there is only so much time she’ll let me tickle her before she gets annoyed.


It sounds very cheesy but I don’t think I’m going to be able to say thank you enough for all the help my wife has given me since the op but as soon as I’m back on my feet I think I’ve got a lot of fathering to catch up on and she has a lot of sleeping to do!  It is also her birthday on Monday which again isn’t ideal – she has had a bit of a raw deal the last couple of years for birthdays as this time last year she was about 38 weeks pregnant. Better luck next year hopefully!

Day 20: 90 degrees

20 days post surgery and I’ve hit my first target of 90 degrees range of movement – the initial target was to make sure I was at this point at 6 weeks to ensure I could then get weaned off the brace so happy days.


I also braved it and went to work for the first time today.  I got minimal sympathy but managed it ok. I think I’m still going to heed my surgeons advice and work from home for the first 6 weeks or so to make sure I can keep my knee elevated and iced and ensure my recovery is as quick as possible.  There is no way that I’d keep up with my exercises if I was in work either.

I also found a good new function on my iPhone today where you can make videos from your timeline pretty easily – see below for day 1 to 20 including the minimal amount of fathering I’ve managed to do while being confined to the sofa.

 

Day 17: Staples out

This is the day I’ve been dreading as much as any other! It was time to head back to the hospital and get my staples out. I have to admit I’m not a fan of any kind of blood or gore and am the first to hide behind the sofa if anything comes on the TV.

Thankfully it was an 8.30 appointment so there was not much time to think about how bad is was going to be.  On entering the ward and getting up onto the bench I sounded out the nurse as to how much it was going to hurt.  She reassured me that each one being removed would be like a tiny pin prick and that only the ones that had gone a bit red would hurt.  It wasn’t just the removal of the staples that was freaking me out it was seeing the wound again in its full glory…. End of the day they weren’t going to remove themselves though and so she got stuck in and removed the dressings first.

She removed the first staple from where I had a graft and that wasn’t too bad.  I then just closed my eyes and gritted my teeth as she worked her way to the other graft site and then onto the main ‘event’.  After about 5 staples she did have to tell me to breath as not only was I gritting my teeth I was holding my breath and she advised that doing this any longer would lead to a lot more complications than just pain from the staples….  About 5 mins after she started they were all out – about 30 in total. Here it is after all the staples were removed:


Once she had finished I started to feel sick and I started to go a funny colour.  This was just me being wimp more than anything and the nurse told me to lie back and let some blood flow to my head while she opened the window to let in some fresh air.  She then took great pleasure in ringing upstairs and asking over the phone in a loud voice,

‘Can you get bring me down some water proof dressings, I’ve got a fainter and I don’t want to leave him’

I’ve been called a lot in my time but being called a fainter by a 50 year old women made me feel like a right pussy and I soon perked up.

Thankfully I still have to keep the wound covered up for about another week to keep it dry and then I’ll be able to get away with a tubigrip just to avoid my brace rubbing on the scar.

All in all it wasn’t as bad as I expected and I think I’d built it up to be more in my head.  Ultimately it is another thing ticked off the list and hopefully the chances of infection are now reduced as everything is starting to heal.

How I blew my knee

The initial injury started over 6 months ago. I had been on a stag over the August bank holiday in Berlin. I returned on the Monday and decided it would be a good idea to play in a pre season basketball game  on the Tuesday night to sweat of the excesses of the weekend. The game was against a bunch of keen under 18 national league kids. It all went wrong as quick as the first quarter when I jumped to grab a rebound and one of the opposition players decided it was a good idea to try and steal the ball while I was still in the air. He didn’t get the ball but succeeded in twisting my body so my legs were then up in the air and consequently I landed on the side of my foot with my left knee at 90 degrees. This put all the force through my knee and was the source of my initial injury. If you are one of those sick people who like to watch sporting injuries here are a couple for you — a lot worse than mine but both still play in the NBA today.

As I landed my first thought was that I’d broke my leg similar to the videos so I was relieved when my leg was still pointing in the right direction.  The pain was immense though and I was helped off the court In a bit of a state.

I couldn’t drive and was in shock sitting on the sidelines (feeling hot/cold and sick) and so I got my Dad to pick me up and take me to A&E. I finally got to see the doctor at around 2.00am (approximately 5 hours after it had happened) and he decided I’d got a ‘soft muscle tissue injury’. He dismissed any damage to the ACL based on the ‘hugely scientific diagnosis’ that I would be screaming a lot more if had torn my ACL. He did say that if it swelled up in the coming days I should go to my GP but I think this was a throw away comment to a certain extent as it was pretty obvious it would swell up given the injury I had.

I returned home satisfied that I hadn’t done anything serious but in the back of my mind I was not 100% convinced as I knew it was worse than anything I’d done previously. After a couple of day as the swelling got worse I decided to take the advice from A&E and visit my GP to get a second opinion. I also wanted to check that I’d be ok to get on a flight with so much swelling as I was going on holiday a few days later.

On entering the GP surgery it was obvious he was not interested from the outset. He dismissed the advice of A&E to see him if the knee swelled as he said this would always happen and was not an indicator of anything. I told him what happened and after minimal examination he agreed with A&E that it was a soft muscle tissue injury. He advised that within 4 weeks I should be able to walk on it again with no pain and that within 6-8 weeks I’d be fine to start running again.

I took his advice and did my own rehab as I saw fit (squats, yoga, jogging etc) to get to a place where I could return to normal exercise again. In the back of my head I kept  telling myself to ‘man-up’/’no pain no gain’ etc as I’d not done anything serious and that I should expect some pain getting back to full fitness. By 7 or 8 weeks (and as a reason to not watch strictly on a Saturday) I was able to run again reasonably fast:

https://www.strava.com/activities/752699296/embed/f341bbe51457bc22254aa77bcbee599f17415a6b

It hurt a bit but like I said above I expected that. After another couple of weeks I stepped it up again and after putting myself through my own fitness test I started playing football again.

https://www.strava.com/activities/755369104/embed/dcf94accad0cda641662aa9a42296102e1017139

I ‘only’ play in goal so I’m not continuously tackling but it is still a lot of twisting and turning. Generally playing wasn’t too uncomfortable except when I squatted right down but it was getting better on a week by week basis.

In December I then decided it was time to return to playing basketball – a big mistake. I’d now had 3 and a half months off which was a lot longer than the 6-8 weeks that the doctor had recommended and I’d been playing football so I thought I’d be fine. This was not the case and the first time I jumped and had to land on my left knee on its own it just gave way underneath me and I had to stop. Unlike the first time there was no twisting or eccentric loading (word for the engineers there) and it was just a normal landing. The pain was nowhere near as bad as the first time but I knew it would lead to a few more weeks on the sidelines.

At first I told myself that it was me coming back to early and that I hadn’t done enough exercises to get the strength back in my knee before playing again. As the weeks went by I knew this wasn’t the case. This time I did the same kind of exercises to rehab my but also started doing quite a few Joe Wicks HIIT sessions but I just had no stability in my knee so was all over the place doing any kind of dip or squat exercises.

In February I therefore decided it was time to go back to the GP and get his thoughts. I saw a different one this time and his attitude and outlook was totally different. He took a very proactive approach and was looking to get to the root of the problem from the outset. He did a series of tests (Lachman, valgus etc) and within literally a couple of minutes he was able to conclude that the ACL was torn. To a certain extent this was a relief as it confirmed the severity of the injury which I had always suspected.

I was then sent to see an orthopaedic consultant who confirmed the GPs suspicions on the ACL but also suspected that I had torn my meniscus. He said that it was likely that my ACL was torn initially and I then damaged my meniscus when I returned to playing basketball.

I then went for an MRI to confirm the above. The worst bit about the MRI was that I had to go to Man City’s ground to have it done; I’ve had enough bad news delivered from that place for a lifetime, I didn’t need anymore.

Anyway, to cut a long story short (this post is already epic) the above was correct but the ACL was actually ruptured and not just torn, there was damage to the MCL plus there were a few other bits and bobs from previous injuries that had never been diagnosed. The orthopaedic consultant advised that I could have physio to try and build the muscles up around my knee but ultimately if I wanted to return to playing contact sport with any kind of twisting and turning then surgery was the answer.

So on to see the surgeon…. the surgeon agreed with the orthopaedic consultant but due to the extent of the damage to the MCL, this would also need fixing too which meant it wasn’t just going to be key hole and there would have to be a large incision down the side of my knee. So that was that and 2 weeks ago I had the surgery – you can see how it went in my other posts.

I’ve always been one of those people that has avoided googling things to try and find out more because I feel there is so much ‘fake news’ around (maybe Trump is right) and you can misdiagnose and scare yourself very easily. I’ve also previously taken the opinion that you should trust the professionals that are paid to do their job and not go in with preconceived ideas as that is what I’d hope people do when they come to me for advice (I design offshore platforms for fires and explosions). In this instance I would have been in a much better place if I’d have done a bit of research regarding ACL injuries before seeing the GP for the first time. How I did my ACL is pretty much the ‘dictionary definition’ of how it happens and I felt the pop in my knee as expected.  If I’d have been a bit stronger in the initial consultation with my GP and challenged him a bit more then I feel the injury would have been diagnosed and I would never returned to running, football or basketball so quickly which ultimately made everything worse. I also never realised how ‘easily’ or quickly your body can recover from an ACL injury as I always thought it would be months after seeing sportsman doing similar injuries not the TV.

Ultimately I hold A&E and the GP partly responsible for not diagnosing the injury in the first place.  The consultants and physios I’ve seen agree that it should have been picked up but these things happen and it is now all about getting back to full fitness.

Sorry this has been a bit of an epic and congratulations if you’ve got down to the end of this post…..