Post-Op Update – All Clear!

I saw my surgeon 3 weeks ago for my 7 month post-op visit. To me, best case scenario I was hoping for was that he would say I don’t need a follow up procedure and can go ahead and start drilling lightly again on the mats.

To recap: I dislocated my knee sideways while playing single leg x-guard – 4/17/2021. Freak accident. Tore my PCL, LCL, Popliteal tendon, and several other things (basically blew out the outside of my knee joint along with the PCL inside the joint, Dr could rotate my fibula behind the back of my knee). Tried for 8 months to rehab without surgery but no dice and had reconstruction surgery 12/16/2021 (my mom’s bday!). 4 screws, several donor ligaments, and a staple later I have a zombie terminator knee with a rad 8 inch scar up the side.

He did me one better! I have a full release to train again! His words: “I’m okay with you doing whatever you want to do for training, it’s not going to hurt it”. Since he works on pro football players and a good number of the Jiu Jitsu folks in town, I figure I can trust that and go for it! I will see him again one more time at the beginning of December for my 1 year post-op visit – that’s where he gives me a final check and then clears me to compete again.

What Does That Mean?

I still have to regain a lot of functionality. The reconstruction is solid but I still have some muscle fiber areas that don’t engage properly, and my range of motion is around 125 degrees flexion. The Dr said it would continue improving slowly over the next 6 months – and the more I move the better it will be for the joint recovery.

I have not been allowed to actively engage my hamstring muscles in almost a year and a half – so you should see my pathetic attempts at hamstring curls! I have a lot of work to do in the next 6 months to get myself back up to 100%. The strength will come back slowly so my primary focus is mobility and getting to where I can touch my heel to my butt comfortably again (kind of a necessary function for Jiu Jitsu). I’m slowly building endurance on my bicycle again as well.

My PT had me drop to 1 day a week after meeting with the surgeon. At my session last week, she told me that we are mainly working on strengthening now and she can trust me to know how to do that safely on my own. She sees no reason that I have to continue coming in for what is basically a personal training session, so I’m going to do 2 more sessions with her and then just work on it on my own.

Jiu Jitsu Training

As of right now I am still in limbo land for training locations (read my last few blog posts if you’re nosey enough to know why) but I like the direction things are moving. Thankfully I work in an office with several other people who train (including my boss). We have really nice roll out mats that I can use after hours and on weekends – so we’ve been hosting small group training sessions and people pop in randomly to drill or roll. I’m still teaching my Saturday open training session and have started drilling with that group as well.

It’s probably good for me since it forces me to ease back into it instead of going full throttle when my body isn’t used to it. That’s a recipe for winding up back in the Dr’s office with something else injured!

Return to Competition

I’ve got my eye on the AJP Tour Grand Slam events for next year! They are now holding two events back-to-back – Masters on day 1 and Pro on day 2. This means two good sized events for one trip! My must-do list is; London, Miami, and Tokyo – then circling back to the World Pro Championship in Abu Dhabi in November. I’ll try to fit in the Rio Grand Slam as well if possible.

I know my coach wants me to do the IBJJF Master Worlds and Pans, and if I can fit it into my travel schedule, I’ll plan to do Worlds as well. I’ll likely also do the IBJJF Nashville and Atlanta opens as they pop up (schedule permitting).

I get about 3 weeks of PTO (15 days) per year from my job. I’ll be doing most of these events quickly so I can save the PTO to linger longer in Japan and at the World Pro (may try to pop over to visit Israel from the UAE).

Altogether, I’m trying to be patient with the process. I still have a long way to go but at least the worst is over finally!

Still Kinda Broken – 5 Months Post-Op

Technically I am no longer broken, but it still feels like it at this stage.

I had my 5 month check up with my Doctor’s PA this past week. I expressed to him my frustrations at my rate of healing. I was hoping that I would be able to train lightly at this point, but I’m still rebuilding muscle tissue that hasn’t worked since my nerves were cut during surgery, and also range of motion has been extremely slow to improve. In fact I have not had much R.O.M. improvement over the past several weeks – hovering around 116 and 118 as my maximum flexion when pushed by my PT. It makes me feel like a failure, that I must be missing something, and wondering if this is just going to be as good as it gets.

He assured me that I am still on track for a complete recovery and return to the mats with zero restrictions. It’s just gonna be a slow process because of how much damage was done to my knee, the amount of extensive surgical repair it took, and the 6 weeks splinted to let it get really stiff. He said my bones are sitting in perfect alignment now within the joint and they are feeling super stable.

What is holding me back most right now is my range of motion. It was very intentional that we let it get stiff post-op because he knows the type of activity I do on a daily basis (he’s worked on a lot of bjj athletes as well as pro football athletes). We are riding the fine line of getting as much stability as possible in the repair before we loosen it up. It’s easier to loosen it up afterwards, whereas if it heals too loose, we would have to re-do the original surgery. We want my knee to last the next 60+ years and handle all the impact I plan to put it through.

I see the surgeon again in 6 weeks. At that point I will be in that 6-7 month post-op window when the new ligament grafts will be sufficiently healed and we can turn our attention more to the mobility issues. If I’m still not making much progress at that point (mobility wise), we will likely do another procedure in the surgical center to break up the scar tissue. It sounds scary but they assured me it’s nothing like the massive 3 hour long surgery I had in December – I’d be able to walk and bend my knee immediately after waking up. What’s nice is that I’ll have insurance coverage this time around – that first procedure was a little yikes!

So I’m hoping that towards the end of the year I’ll be freed to train again. Right now I am not even allowed to swing a kettlebell – although I was recently cleared to ride my bicycle again and am increasing load bearing exercises in twice weekly physical therapy. Comeback is coming – and I’ll know I earned it!

12 Weeks Post Knee Surgery

I dislocated my knee during a light sparring round April 17th, 2021. I didn’t let my partner know how bad it was because it was a freak accident and didn’t want him to feel badly. Thankfully I was able to quickly get in with one of the top Sports Orthopedic Surgeons in the area. He specializes in high impact athletes (16 years working for an NFL team) so I knew if anyone could get me back on the mats it would be him!

My diagnosis was a torn and frayed PCL (opposite of the ACL), torn LCL, several tendons torn, and basically the entire outside of my knee was mush (posterolateral corner/PLC). I have underlying hypermobility and joint instability (It’s a degenerative condition), so the Dr said it was difficult to tell how much of the instability was caused by the damage, and how much was just my normal baseline. (He said my “good” knee felt like a bad knee – but it is functional for me). He wanted to opt for more conservative treatment at first. “I have enough people to do surgery on. I don’t want to put you through surgery if I don’t have to.” I appreciated that approach since I do not have health insurance and would have to pay out of pocket for any expenses.

I did twice a week physical therapy, with regular check ins with the doctor. The idea was that we would let it heal and stabilize on its own as much as possible. When I plateaued that is where we would decide how functional I was. I hit the plateau early November and was able to walk around with a brace on, but my bones were shifting too much for me to be able to train safely. We scheduled surgery for December 16 (after I got back from coaching students at Worlds).

Surgery day was fun. I was actually a lot calmer than I thought I would be and looking forward to a nice nap. I was the doctor’s first surgery of the day – and must have really thrown off his schedule because it took him three hours to put my knee back together (his surgeries are usually about an hour). He said it was like trying to stabilize jello. I now have a few donor grafts and several screws holding my joints together, they also gave me a round of PRP in order to help speed healing. He had to drill through my bones 5 times in order to anchor everything. He had to get “very aggressive” and as a result they had to put me under very deep anesthesia; it took me 3 hours to properly wake up afterwards. He was however very pleased with the surgical outcome and confident it would heal strong and be more stable than my other knee.

The first week was super rough. They gave me opioid pain meds for 10 days, but I switched to Tylenol after the first few days. It was hard enough to get up to use the bathroom without dissociative drugs in my system. The anesthesiologist took me seriously when I told them I metabolize nerve blocks quickly so he must have given me an extra special dose – I couldn’t feel my lower leg for the entire first week. It’s probably a good thing based on all the work that the dr did.

I spent my first few weeks post-op with my leg locked out in a splint 24/7. I was allowed to be weight bearing “as tolerated” but until I regained sensation in my foot, I kept that to a minimum. I was on an ice sleeve machine for 5 out of every 6 hours and sleeping with my leg elevated to keep swelling to a minimum. Physical Therapy started the week after surgery right after I finished my first post-op visit where they removed my stitches and half of my staples (there were 39 total staples holding the side of my knee closed, the other half were removed a week later). Physical therapy at this point mostly focused on controlling swelling, isotonic muscle work, and passive prone mobility (bending my knee while I was face down).

At my 3 week checkup, I told the doctor that I had managed to complete a 300-hour game on my Nintendo switch (The Witcher), and he told his PA “Let’s get this girl moving”. He gave the PT clearance to start unlocking the hinge on my brace so I could start bending my knee while walking and pushing my range of motion more. He told me I could be as weight bearing as I was comfortable to do, so I found I could stand for a few seconds with my weight evenly distributed. I also got to remove the steri strips that were on my smaller incisions. The larger one (about the size of my hand from wrist to fingertips) I had to keep taped up a bit longer.

At the 7 week mark I hit a wall for range of motion. For the PCL ligament, they had to keep my leg locked out straight for the first 6 weeks because in that position there is no pressure on the new ligament. This enables all the bone grafts to start healing and the ligament to stabilize in its new home a little bit. The more the knee bends, the more pressure it puts on the ligament. Only time I was allowed to have my knee bent was twice a week under the direct supervision and application of my physical therapist. So now that it was anchored, we had to start stretching it out more aggressively. 90 degrees is what you need to sit in a chair with your feet flat on the floor. I was stalled out at 35 degrees and crying/sweating buckets when the PT would push to stretch it more. We were way behind schedule, so my PT called the dr’s office and they put me on a steroid pack for 6 days. With that we were able to get past the hurdle to 50 degrees. It’s very useful that my PT clinic is connected with my dr’s office, and they can share notes back and forth in the same system.

Since then, range of motion has still been a game of slow improvements. I see the doctor again tomorrow for my 12 week follow up and I know they were hoping I would be past 90 degrees by now but I’m barely passing 75 right now. I may be looking at another steroid pack, or possibly some injections. We shall see what the doctor says tomorrow!

On the positive side, I’ve been walking with a much more even gate. Doing light leg press exercises, single leg balances, and even walking across the floor without my brace on at PT. My hope for tomorrow’s appointment is that the doctor will okay me to get rid of this massive post-op brace and switch to my smaller custom brace for walking around. I plan to ask if he still thinks I have a chance of being able to safely compete at the World Pro tournament in November. Before surgery he said absolutely yes, but I know he had to do a lot more work in my knee than initially anticipated.

Here’s hoping!