My first Blog Post: The 6 stages of an ACL injury.

Someone once said to me that, “when you witness an athlete get injured, and see the tears pouring down their face during major TV sports coverage, it's not due to the pain. It’s due to the disappointment and impending challenges they will face after the injury.” These challenges include: physical challenges with recovery, not being able to complete everyday lifestyle activities, post op pain, and most of all, the emotional stressor of possibly having their athletic career stripped from them in matter of seconds.

Unfortunately, I have had the privilege to experience this on 3 separate occasions minus the TV coverage. I have torn my ACL 3 times now; twice in my left knee and recently my right knee.

I can basically sum up 6 stages of emotions with my experiences:

Stage 1: The Injury
Stage 2: The Oh shit, this really just happened! Here comes the pain
Stage 3: Depression
Stage 4: Stop feeling sorry for yourself and accept help from others
Stage 5: The Surgery
Stage 6: The Long Haul

Stage 1: The Injury:

Description: You’re faced with a short intense burst of pain and shock that it just happened. You're body is overloaded with adrenaline making the pain not even an issue. Your mind does not even recognize the future emotional roller coaster ride you're about to experience.

My experiences: Stage one for me was a little different each time I tore my ACL. It was different because the knowledge base I’ve acquired over the years of being a medical provider, and let’s face it, you kind of know what to expect if you’ve had the same injury 3 times.

The first time was about 6 years ago and was filled with a lot of firsts. It was my first time at Diablo, the first year I really got involved with racing and riding mountain bikes, and the first time riding with new guy friends from one of the local bike shops. My technical skills were limited however, at the time, I felt really fit and just excited to be there. I also felt pressured to keep up, ride the harder trails (that I was not good enough to be riding in the first place) with the guys, and not slow anyone down. We went down one feature trail where the guys were slowly creating a farther gap between us. I remember being blown away with the speed these guys were descending the mountain. They were clearing table tops, hucking jumps, and railing berms at speeds I was not comfortable committing to at that time. Then it happened. I went off one of the wooden ramps, fell 5 feet coming off the bike, and crashed with my knees taking the majority of the impact. The sudden intense sharp, aching, pain of my ACL ripping off my tibia, went off like a grenade in my knee. I held my knee close to my chest, fought back the tears for the few seconds while the grenade continued to explode. I rocked back an forth like one of those soccer players you see on TV after another player just took them out during the game. Then the pain slowly subsided. By the time the pain stopped, my friends realized I was not with them, and finally came back. They helped me up and then I attempted my first step. Big mistake. My knee felt like a noodle and gave out immediately. I realized I wasunable to regain balance and was unable to ambulate. At that time I realized something was wrong . . . Stage 2.

Stage 2: The Oh shit, this really just happened! Here comes the pain:

This is the part where the adrenaline wears off. The overwhelming emotions of sadness and shock consumes you because that treaded ACL injury you hear ruining people’s athletic careers in fact, just happened to you. Yes, you. Like the nice slap in the face you just accepted into your life isn’t bad enough, that thing called pain comes back with a vengeance.

My experiences: The thought of a ligamentous tear was in the back of my mind when it first happened, due to the instability of my knee. I've seen and treated a bunch of patients in the past with this injury, but I remained in denial. I refused it happened to me. Who injures their ACL while riding bikes anyway, right? Well, even though it’s not the most common injury in cycling, I later learned I was predisposed for this lovely injury due to genetics and being female. . . which will get into in a later blog post. After going to the orthopedic surgeon days later, I got my MRI results, and became another statistic. The MRI confirmed I tore my ACL.

The second time I tore my ACL, was kind of a mix between Stage 1 and Stage 2. Due to the second ACL tear following my reconstructive surgery, I did not experience the same intense pain. Your native ACL receives nerve fibers that are branches from the tibia nerve. When the ligament is injured, they are disrupted on the initial tear causing pain. After having a graft done, you really don't experience that intense pain because the nerves are gone unless, it’s accompanied by bone injury. It’s more of a sudden pop. With that being said, I immediately knew I re-tore my ACL. I was 2 weeks out after being cleared to ride again and being discharged from PT. I was greeted by the familiar instability while walking again. The devastation had a quicker onset because I knew I had to have revision surgery, go through the gruesome 6 months of rehab that I just finished, and to do it all over again.

The third time, which happened a month ago yesterday, was much more devastating. I just bought a new bike, just completed my first full year in Elite/Professional Class for cross country, was looking forward to the upcoming cyclocross season, and was feeling awesome again. I say again because of the side note mentioned below.

Side note: This past year was extremely challenging for me. I started my first full year racing in Elite Class at the Sea Otter Classic battling a severe episode of vertigo (which I was nearly sent to the hospital for treatment). The middle of the season was also paused because I sustained a grade 3 concussion. I had a bad crash after practicing the drop at the Julbo Eastern Grind PRO XCT MTN Bike Race in Vermont. I was diagnosed with a severe grade 3 concussion at The University of Vermont Medical Center after being knocked out unconscious for 25 minutes. I also have no memory of about 2-3 hours of my life. Not only did this scare the life out of me, it absolutely crushed me emotionally. Not only was I not able to race the following day, but I was forced to skip nationals, stay off the bike for two weeks, and my face was a hot mess. This was suppose to a big year for me.

So where was I? Right, the feeling awesome part. Well lets just say that came to an abrupt halt when my knee gave out yet again. This time it was my right knee. I was riding downhill at Mountain Creek on my amazing new Trek Slash having a blast with friends. The fun stopped when I didn't see the small drop in the inside part of trail coming around a sharp turn. I put my foot out to prevent me from crashing and boom! There was that grenade feeling again, followed by the instability as mentioned with Stage 1. I knew I tore my ACL the second it happened however, this time I was oddly more calm during Stage 1. I knew I tore my ACL, but I kind of just said it out loud like it was a matter of fact statement. I was not even upset. Thank you, adrenaline.

Well, like mentioned before, that wonderful thing called adrenaline eventually wears off. This time it was when I was driving home (sorry I didn't listen to you Cory). I initially didn't feel the need to go to the hospital, because I really didn't have pain unless I attempted to walk. I just told myself, “ so, I just won't walk untilI get home. I can drive home and deal with this later.” And lets face it, it was my third time around. I’ve seen this a bunch of times now treating patients in the ER too. I was an ACL veteran right? I remember telling myself,"I had a positive Lachman's and and anterior drawer test at Mountain Creek. I know my ACL is torn. Why the hell should I go to the ER? It’s going to be a waste of time.” Then my knee started to throb, but this pain was unlike the very first time I initially tore my ACL. The pain was much more intense this time. I felt every single bump in the road that my car hit, any movement of my knee, and the pressure of pushing down the gas pedal exacerbated the pain. At this point I have not straightened my knee out. I already know what you're thinking. Yes, I was stupid for driving home. I called my brother and asked him to bring me to my job, the ER.

Side note: Going to the hospital was an experience it self. Thank you Jack, Mark, Elyse, Amanda, Mike, Beth Ann, Adam, and everyone else at work. You guys were amazing. The excruciating pain of my two friends/co-workers straightening my knee out was horrible, but I wouldn't have picked anyone else to do it. I was blessed to have my friends and brother, Jason, by my side. Also thank you to the pharmaceutical companies for creating IV Toradol. That stuff is awesome haha. The anticipation of getting an MRI days later to see the additional damage, wasn’t exactly ideal. I wanted the answer right, then, and there. Don’t forget we are in Stage 2. Here comes the rush of emotions. I called my Mom and the words came out of my mouth,“Mom, I tore my A—.” I couldn't even initially finish the sentence. The tears of sadness and realization consumed me. My cycling career was over. . . so I thought.

Well here comes Stage 3.

Stage 3: Depression:

This is the stage where you realize that you're no longer able to participate in activities that you love to do. Life stops. You lose motivation and quit.

My experiences: the first time wasn't as bad because I really didn't expect what was coming. I didn't believe how crappy it was to recover from this injury and thought it wasn't going to be as big of a deal. The first and second times also didn't have a big impact on me because at that time, I also wasn't taking cycling too seriously. Racing and riding was just a new hobby. I was more upset with the inconvenience of not being able to complete everyday lifestyle activities as easy. Going to the store, taking care of my dog, and doing house chores were once simple tasks. Now they were difficult challenges.

I think this time was was more devastating because not only was I faced with a third surgery and the inconveniences mentioned before, I realized that everything I worked towards the last three years to get to the elite level was crushed. I also have a more complicated ACL injury this time around. I have significant bone bruising with microfractures of my tibia plateau and femur, sprained every ligament in my knee, and even managed to sprain my IT band. The pain was more intense and I walked with crutches for about week. I was also forced to take several days off of work. Calling out of work was never a thing. This was my first time missing work due to an injury, ever. Not only was I freaking out about my job, I was unable do the things I love the most: hike with my dog and ride my bike. Those things are my stress relievers. They're critical with keeping my sanity and provide happiness. They were yet again, removed. As some of you may have seen, I posted a dramatic post on Facebook stating I was selling all my mountain bikes and quitting racing. I even went through with posting my bicycles for sale on Facebook and Craigslist. On most days following the injury, I had zero motivation to do anything. I even lost interest in eating. And if you know me well enough, that's completely uncharacteristic of me. I love food. HA! All I wanted to do was sleep, and sleep more. Lucky for me I had amazing friends, family members, and people from the cycling community reach out to help me. Even my dog was even a motivational factor. They all helped me reach Stage 4.

Stage 4: Stop feeling sorry for yourself and accept help from others:

This is the stage where you kick Depression's ass. You stop feeling sorry for yourself. You realize you have amazing friends and family members that want to help you through rough times. You realize the end of the world has not come knocking on your door just yet, and things aren't that bad. You remember all the sick people in the world. There are people suffering way more than you. They have long term terminal illnesses, life threatening injuries, and permanent life alternating injuries. Get over yourself, things are going to be okay.

My experiences: I'm only going to elaborate on Stage 4 of the third and current ACL injury. The reasons are, this first blog post is becoming way too long, and I really want to focus on what I learned this time around. I do want to thank Amanda, “Twin,” for taking me grocery shopping when I couldn't walk after my ER visit. Also, thanks for documenting me riding the scooter in Hannaford! That was definitely a classic. Bill, thank you for taking Jake, my dog, to the Catskills. He definitely needed to burn up the pent up energy while I could not walk that week. Chris, thanks for coming with me to the doctors appointments and help keeping my spirits up. You guys rock.

The remainder of my blog posts will be focused on the help I got to reach Stage 4, ACL pre-op rehabilitation, my surgery which is scheduled on Friday, October 13, 2017 (yes, I picked that day LOL), and my experiences with post-op rehabilitation.

Intermittently I will be posting educational blog posts about the ACL topics such as: how I chose my graft, the research I did to do so, and what I learned along the way.

My goal is to share my experiences with other people who may be going through ACL reconstruction, other traumatic injury recovery, or people who are just simply interested in hearing my personal experiences with recovery and getting back into the race scene stronger than last time. This is also going to give me something to do while I'm stuck at home on the couch. HA! Thanks for reading along this far. I look forward to telling you about stages 4, 5, and 6 here on out.