A little over four months ago, I began physical therapy to rehab my right knee after reconstructive ACL surgery. I’d had other orthopedic surgeries before, but this recovery effort was drastically different. I have learned a lot of important things during my ACL rehab journey. Things like patience, perseverance, resilience, and how to take control of my outcome. This is what I want to share with you.
Asking for help
For better or worse, I am fiercely independent. Sometimes to the point of obstinance. I hate asking for help. If I can do something by myself, I prefer to. Plus, over the years, I’ve mentally groomed myself to question the reliability of others. Maintaining my independence is the number one reason I stay fit and active.
So, when I hurt my knee, I immediately knew I’d lose my independence for a while. If I wanted to bathe, eat, make a cup of coffee, have clean clothes, or get to PT, I’d have to ask for help. Although necessary, it felt physically uncomfortable to ask, “Can you get me….?” Or “Can you help me…?”
In the beginning, asking for help was important. As time evolved, not asking for help was equally important. It became a milestone of improvement. The more I could do for myself, the better I was coming along.
You get out of rehab what you put into it
With my lack of independence in the balance, suffice it to say I was super motivated to maximize all my PT sessions. My right quad had shriveled up and no longer had any shape, and regaining strength was the key to recovery. What I didn’t know is how slow of a process that would be. I had to meet my body where it was and work with what it was ready to do. When it was ready, I had to be as well.
I attacked each PT rehab session with gusto. Never once did I tank a session. Never once did I quit when exercises were hard. And they were—a lot of times.
Had I not done any of those things, I wouldn’t be where I am. As a result of dogged determination, I’m doing well. I’m not ahead of schedule and not behind schedule, but I’m right where I should be.
Nutrition matters
In a previous blog article, I mentioned that while my surgeon sent me home with a whole list of stuff to help me physically heal my knee, there was nothing about how nutrition plays a part in recovery and rehabilitation. So, I’ve taken that upon myself. It’s not until recently that I’ve paid particular attention to the timing of my nutrition and how it’s actually helped me during each session.
I made sure I had a light meal or snack before each session that included protein and carbs. I made sure I had the same after each session. Protein helps build muscle; carbs give you energy. Having both before and after provided fuel and recovery.
On the days when I did not eat well, I did not perform as well. I still never tank a session, but I get tired much quicker. On the days that I did, I saw the rapid progression between sessions.
Hydration matters
Getting enough fluid before a PT rehab session is equally important as getting the right nutrition. I made sure to drink before each session, during BFR days, and after each session. When I don’t hydrate properly, either before PT or an exercise session in general, I fatigue quickly.
Fluid balance is essential for a whole host of reasons. When muscles are under strain – or contraction – during exercise, they need nutrients and oxygen to flow through them faster to remove waste (used up protein cells) and remove heat (sweat). This metabolic activity requires fluid.
Attitude matters
As soon as I heard my knee snap after I jumped off that rock on that hiking trip, I knew I’d be needing surgery. Only I didn’t know how long recovery would be until I saw Dr. Salvo. I’d had ortho surgery before and was back to good in about two months. When Dr. Salvo said nine, I couldn’t conceive of recovery and rehab being that long. Sure enough….
Regardless of how long it was going to take, it never occurred to me that not recovering completely was an option. I always knew that I would come out the other side completely healed and back to my normal self. I never thought ‘woe is me’ and succumbed to self-pity. The truth is I did this to myself, and I couldn’t undo it. I refuse to accept that the injury was the end of my life as I knew it. It was an inconvenience for sure. But not permanent, and not the end.
Attitude matters. In the early days of physical therapy, some of the simplest exercises were hard and humbling. Only once did I want to cry (which is something I never told anyone, BTW). For the moments when it felt like my body wanted to give up and give in, I doubled down and pushed through. You can either be your own biggest champion or your own biggest enemy.
You only cheat yourself
Different physical therapists and different physical therapy practices do things differently. Some follow a software script of rehab exercises for any given injury so that you do the same exercises each session until you gain some strength and move on to the next set. So long as the progression follows what the prescribing physician set out in terms of goals, you’re making progress.
This experience was different. Sarah, my PT, had me do different rehab exercises at every session. Yes, these would repeat over time, but it wasn’t like the workout routines I designed for myself and could then follow without further guidance or input.
The variety was good. And clearly, it’s worked. But what I mean by ‘you only cheat yourself’ is that Sarah isn’t standing next to me like a personal trainer, counting my reps and sets. That’s up to me to do. Sure, she shows me what to do and watches me to make sure my form is good, but then I’m on my own.
It’s up to me to make sure I do all the prescribed sets and reps and maintain my form. Shortcutting any one of those three only cheats me, not Sarah. She, the practice, and the insurance company get paid either way.
So, if I lose count, don’t do an exercise using the right form, or run out of time on the BFR before I’ve finished my reps, the only person that loses is me.
Rest matters
I was really surprised when one day Sarah mentioned that she’d been reading about how important rest is when weight training. As a PT/DPT, I figured she’d know how muscles respond to growth and recovery. Since I’m not a PT expert, I guess that isn’t what they focus on in their studies, much like my ortho didn’t focus on nutrition.
Rest matters between exercises. So, between each set of exercises, I would time my rest on my Fitbit. Twenty-seconds, thirty seconds, sometimes forty-five or a minute, depending on the exercise. It made a difference in how well I was able to complete the entire round of exercises.
You have to help yourself
It’s only been in the last couple of weeks that I’ve been more disciplined in going back to the gym. I had a weird mindset, mind-shift thing going on where I felt the groove of going to the gym slipping away. But after some think-time, I figured out what the issue was and put something in place that allowed me to get back on track.
It’s made a difference in how well and how quickly I’ve progressed in PT over the last couple of weeks. So, that’s what I mean when I say you have to help yourself. Active recovery from an injury shouldn’t only happen when you’re in PT. You have to work the process outside of PT too.
A recent test showed my quad strength is at 80% of my good leg. This is good. Actually, this is great. Everything I do outside of PT to rebuild my quad strength, such as riding a bike, walking, getting on the elliptical, and overall strength training, accelerates my recovery.
Final Words
My recovery is in my hands. And frankly, that goes for anyone who’s ever experienced an injury, hip replacement, knee replacement, or any kind of issue. You have to own your responsibility to your own body. Whatever results you want to see are the direct results of your efforts. Not your doctor, not your physical therapist.
Yeah, its’ gonna hurt. Decide what you want more. Play the long game. Endure the early struggle so you can reap the benefits in the long run.