Seeing the light at the end of the tunnel!
Sooooo I know it’s been a while, but I’ve have been crazy busy with personal events, physical therapy, starting work again, annnd riding bikes!! So yea so here are the updates: work has started again! Back to saving lives and trying to find my groove again. One thing I can say is when your surgeon gives you the option to take the full 3 months off from work, definitely take the entire time(if you can). My first few weeks back were harder than expected. My knee had to adjust to all the walking and being on my feet all day while at work. If you have a desk job this may be easier, however, I work in the ER. Walking and standing are huge parts of my day and put a lot of stress on my knee. I am kind of grateful because this actually showed me that that these are not good rest days. I used to use the days I work 12 hours shifts for rest days off the bicycle, but since my surgery, I now know how much walking I actually do. I referred to the pedometer on my phone and I actually walk on average 3 miles during one shift! I realize 3 miles is not a lot to some people however, when you’re trying to rest in between hard training days on the bike, or even for the recovery stages of ACL surgery, being on your feet all day is not exactly ideal. While at work, I often take small breaks to do the good old RICE method. Rest, Ice, Compression, and Elevation. These 4 little things have been godsends to my work day. Like I said, in the early stages of returning to work, my knee started swelling and that god awful pain on the medial (inside part) aspect of my knee started to flare up.
Good news though!!! Since the weather has become more tolerable for my knee I got permission to ride my bike outside! Yes! Yes! Yes !!!!! Riding outside on my bike has been a blessing. I even started doing some training. Initially I had to ride my bike with flat pedals, however, I have progressed over the last few weeks to riding clipped in. The reasons for the delay on the clipless pedals: tendonitis, tendonitis, quad strength, and tendonitis. So here are some words of wisdom: Ease into everything!!! Between going back to work, continuing PT, and having my soul returned back to me . . . I mean getting permission to ride, HA! I developed patellar tendonitis.
Patellar tendonitis is when the tendon that attaches the patella (knee cap) to the tibia (shin bone) gets inflamed. This is commonly caused by overuse and stress on the knee. Surprisingly, this is actually a pretty common overuse injury among cyclists, but is also a common complaint among people recovering from knee injuries in general. The continuous strain of regaining strength and muscle mass during PT aggravates this little tendon pretty bad, and produces a whhhhooole lot of pain. If any of you have had ACL surgery or have had tendonitis, you would agree with me that it is the the worst! Walking, running, jumping, and sitting hurts. Everything flares it up!!!! When I saw Dr. Nicholas back in February he adjusted my PT regimen. I was told no running at PT and no clipless pedals while riding. My PT, Chris, was already ahead of the game. We backed off running and jumping because Chris saw the signs and symptoms of the tendonitis developing early on. And trust me, I felt them! Ha ha! Chris also stressed resting more. Boy, was I glad I listened.
At PT we continued to work on strengthen exercises, balance, and core, but since a month has passed we slowly introduced running into the regimen again. Chris also started to incorporate cutting and more jumping activities. Some of these activities include broad jumping, lateral jumps/hops, and alternating hops. Right now the alternating hops and single leg hops off of an elevated step are the hardest because it isolates jumping off and landing on the surgical leg. Leg press, hamstring curls, lunges with weights are still done weekly, but my favorite exercise is now doing weighted squats on the bosu ball. This help you activate your core and intrinsic muscles which are crucial for balance on the bicycle. This also helps with power, strength, and muscle endurance. Another important exercise and test I have been doing at PT is the Cybex Machine. This might be one of the coolest parts of PT. The Cybex machine measures your hamstring and quadriceps muscle strength during flexion and extension. The physical therapist makes various adjustments to resistance and speed accordingly. The computer then calculates and quantifies the data so the physical therapist can analyze your specific deficits in comparison to your non surgical extremity. As you can see, I actually have a 15% quadricep deficit in my surgical leg in comparison to the healthy leg. This means I still have a little bit more work to do, but we are almost there! Progressssssss!! On the data sheet we can also see I have deficits in my non surgical leg. The reason we see this hamstring deficit in the left leg (non recent surgical leg) is because, as mentioned in the previous posts, I had ACL reconstruction with my hamstrings grafted a few years ago. Since then, I have had chronic weakness with flexion in that leg. Unfortunately, this is something I have been struggling with since that surgery. The Cybex machine also has exercise programs that helps train your fast twitch muscles and build power. Let me tell you . . . this crap is hard. You will definitely be sweating during this. Thankfully Lisa and Chris are like Mickey Goldmill from Rocky on occasions haha. They are always pushing me to reach the best numbers.
Soooo back to the bike talk . . . as mentioned before, I have also increased my riding time!!! I started focusing on endurance based miles and just enjoying riding again. Long easy rides with friends and relaxing on the bike has been so helpful. Sometimes we get caught up training for the race season so much that we forget what it’s like to just ride our bikes and have fun. Fortunately, dialing it back a bit has helped me just chill on the bike again. I also recently visited my parents in Florida and was fortune to get some solid base training in as well. I managed to get a solid 21 hour ride week in on the road aaaaannnnnnnd the XC bike!! I wasn’t allowed to do anything too crazy, but luckily Florida’s trails are flat and non technical. I almost felt as if my cross bike would have been more appropriate on them, but the xc was super fun!!! I definitely recommend the trails at Santos and Alva. They fun, fast, and fllllowwwy. The flat terrain also helps build fitness because you’re constantly pedaling. It's kind of like being on the trainer, but with a view and wind. Oh, and don’t be fooled. Just because Florida is flat doesn’t mean it’s always easy! That place has tons of wind which often leaves you riding in a head wind frequently. Occasionally you get lucky and get a sweet tail wind that makes you feel like you’re flying!
Side note: As much as I wanted to go all out, it was extremely hard to dial it back. That has actually been one of the things I have been struggling with lately. When you get permission to do something you often want to go to the max with it. As stated above, listen to your therapist and surgeon. Tendonitis sucks and obviously the number one concern is your ACL graft. The graft is usually at it’s weakest at 12 weeks so its curicial to develop the proper strength and recovery before advancing your activities. Depending on the graft and the person, some studies even say it can take up to a year to be fully recovered from ACL surgery. So the take home message is: listen to your therapist, be patient, take your time, and do the work. Every day you’re going to have to put the work in to regain your strength!! Rest included!
Some other updates! New sponsors for this year!!! Thank you Lazer Helmets, Honey Stinger, and Osmo Nutrition for helping me this year. I am pretty excited to represent your brand! Also, a special thanks to TRT Bicycles for always being my shop and at my backing call! Thank you to ESI Grips, Maxxis, and Fox for continuing to stand behind me this year as well. I am beyond grateful for all of you. Thank you to Center for Physical Therapy for also hooking me up when my health insurance did not come through as expected. You guys are a life saver and are all amazing!!
I’m hoping to get some solid training in to bounce back the second half of the XC race season and for cyclocross!! Fingers crossed I get the green light from the boss man (aka Dr. Nicholas) next week.
