mickc
Recovering from Injury
I hate being Injured
I have to start by saying I'm no medical professional so everything I write is about my personal experience and whilst it works for me it may not work for others, really any serious injury and you should consult your doctor.
So, Unfortunately, I'm currently on the side-line frustratingly injured. It couldn’t have happened at a worse time for me. Not only is Autumn, my favourite season of the year to capture those biking pictures, but I've been committed to running, improving my fitness and I've started Taekwondo with the kids, which I’m really enjoying at the moment.
Maybe all the exercise has played a part in flaring up an old injury.
You see, through my teens and early twenties I played a lot of team sports, particularly football, basketball, and cricket. I loved playing all of them. That was until at 23 I was playing football for a local team when someone played the ball through for me, I twisted to start sprinting after it and my left foot got stuck in the ground somehow, my knee twisted, and I heard a massive rip as my posterior cruciate ligament snapped. I tried a number of times to comeback to football but found the same issue, when my leg was fully extended with my weight on it my femur (thigh bone) would slip slightly behind my knee as the there was no ligament to stop it. In hindsight I could’ve had an operation, but I decided not to as I found I could do the majority of sports apart from football. I could run, play squash, play basketball, play cricket and still bike. Basically because I never had to fully extend my leg with these sports, coupled with keeping my hamstring and calves strong, my knee has been stable. In fact, since I did the injury, I’ve only had it impact me once, when I was playing with the kids on grass and I stepped into a rut in the ground that I didn’t see, it hyper extended my leg and caused it to swell. It knocked my out for a week or so. Other times it has affected me has been when I have had accidents on my bike, injured some other body part and it has subsequently caused swelling in my knee.
This time was even less dramatic. I was simply out for a walk, in fact heading to school to pick up my daughter, when I felt and heard my knee click. It instantly sent a pain in my knee and caused me to limp. By the time I was home I could hardly walk and my knee had doubled in size. The next day was a none walking day, I struggled to stand up, walk, get up and down stairs. It was a painful day or two.
So, what did I do? Here are my tips on the road to a quicker recovery. As I say I’m no professional but can offer my view based on my own experience.
First thing is first. For the first 48 hours I follow the R.I.C.E concept, and that’s with most injuries that cause swelling just like my knee has. R is for ‘Rest’, take a load off and I didn’t use the knee at all unless necessary . I is for ‘Ice’, to reduce the blood flow to the knee, reduce the pain and reduce the swelling, I applied regular ice packs to the knee, well when I say ice packs I find a pack of frozen peas the best. They mould around the injured part and don’t allow you to leave them on to long because they melt quick. C is for ‘compression’, when I wasn’t applying cold, I wore an elasticated bandage to compress the area, again to reduce the swelling. E is for ‘elevation’, alongside rest I tried to make sure I kept the knee elevated, so basically higher than the heart. In addition I took ibuprofen to assist with the swelling. That was stage 1 the first 48 hours.
Stage 2 really begins when the swelling has stopped and the aim is to try to disperse and reduce the swelling, whilst starting to get a little bit of comfortable movement in the joint. It’s not the time yet to put any weight on the joint as it needs to heal. The first step I do is to introduce some heat to the joint to help the blood flow and get rid of the cells that have protected and started healing the injury. I start by replacing one of the ice packs out of every four with a heat pack. If it causes pain then the injury isn’t ready for heat yet. However if it is ok do one in four heat, then when the swelling has reduced a bit try two in four with heat, moving to three in four until the swelling has nearly gone and you don’t need ice anymore. For me this lasted about 4 days before the swelling had reduced significantly. In parallel, I tried to get a little movement in the knee or joint. If any movement is painful I don’t do this, but at some point there will be a range of movement that doesn’t cause any pain. I try to move my leg through the range as often as is comfortable without over doing it. I follow three of my own rules here, any pain and I stop, no weight should be used, and don’t push the range of movement into the pain zone, it’s got to be pain free movement. Once I have a full range of movement in the knee and the swelling has gone it’s onto stage 3, the rehabilitation.
The aim of stage 3 is strengthening the knee slowly to get back to full fitness. The key here is not to rush it and think you can run (literally) before you can walk. Through experience I’ve thought my knee is ready, done a run and knocked recovery back by a week. So, based on that it’s important to do some exercise but not put any weight on yet. I have found the best thing to start with is a stationary bike. I put the setting on the lowest it can be and then pedal steadily. This keeps the knee moving whilst putting a little pressure on it. If it feels good after a few times and there is no pain, I start increasing the resistance slightly. Once I’m working on a decent resistance, I then introduce a little bit of weight off the bike. For me it’s critical I strengthen the hamstring (muscle at the back of the thigh) and the calf (muscle at the back of the shin), as it stabilises my knee. So out comes the ankle weights. These are literally sacks of sand that you can strap to the ankle to add weight. I then lay of my front or stand on my good leg and do sets of leg curls, lifting the foot to my backside, working the hamstring. If all is going well the next bit is my favourite. It’s time to get the bike out and go for a gentle ride outside. This can be the make-or-break moment as you are moving your whole-body weight with your leg so take it steady.
In parallel it’s key to do some balance workon the leg. As far as I’m aware there are a number of small twitch muscles fibres and nerves around the knee. These can be damaged through the injury, so they need to be re-aligned for the brain to make small adjustments as you walk. This can be critical, for example you are walking along, and you walk into a small bump or hole on the floor. The brain picks this up and the small fibres automatically adjust so it doesn’t damage or affect the knee. This is done without you doing any thinking, it’s an automatic response. If these aren’t primed, then the injury could return. It’s simple to do, I hold onto a chair and balance on the injured leg. I move around slightly so the knee has to adjust. Ideally next would be to use a balance board to continue, but as most people don’t have one, I try to think of things I can stand on that will require a little balance. In the past I’ve balanced with one leg on bundled up socks, washing piles, the edge of the stairs, essentially anything soft that will require the smallest adjustments to balance on. Once the bike and balancing has progressed well, I then up the mileage on the bike and start doing some walks of up to a mile, before trying to run.
The final road to rehabilitation is to start runningagain. This is like being a new runner again, I start with easy interval activities of walking for 100 metres and jogging for 50 metres. Then I increase the amount of runninguntil I can run a mile without any issue. Again, the key thing here is if there is any pain to stop, return to the bike or back to seek medical advice. When, I’ve done this rehabilitation process if at any stage the results aren’t happening or there is still pain then I would be straight to see a medical professional to be checked out. Luckily for me this is an old injury I have experience with so know how it feels as I’m progressing through rehabilitation. I know when to stop, when to slow down or speed up. Any different injury, the principals can be applied, but if I haven’t experienced the injury previously, I get checked out by a professional first. If I don’t get any physio as a result, I follow these principles.
I’m currently about two weeks into my injury so am on the stationary bike and I plan to do my first steady bike outside this weekend. Fingers crossed the progression continues and I’m back to fitness in a few weeks so I can appreciate some of the Autumn beauty.
For more of my short videos click below:
