A Long Road

The Injury

October 16, 2014
Like every other taekwondo sparring class, I focused on anticipating (not reacting), on remembering it’s a game (not an actual fight) and on improving the techniques embedded in each drill. I trained hard enough that about forty-five minutes into the hour-long class, I was tired. After our Master demonstrated the next drill, I told my training partner that I was going to modify the exercise to be a little less demanding. I executed an easier version of the move 4, 5, then 6 times. My legs felt pretty good. My breathing had somewhat recovered. I was okay to do the actual prescribed drill.

Seconds later, my left leg rebounded off my partner’s chest guard and my right leg came up to throw the second kick of a double roundhouse. But as my left foot landed on the mat I heard (and felt) a loud “pop” in my left knee. Rather that take my full weight onto the knee joint, I opted to break fall, landing on my left side.

Despite the loud “pop”, my knee didn’t actually hurt, so after a few seconds I got back to my feet. My knee felt a little stiff, but I was able to walk without any pain. Rather than continue with sparring drills, I opted to observe the last few minutes of class from the sidelines, doing a bit of walking and some very light stretching.

As the next class started, I moved into the ready position to practice my forms. Turning to my left to execute a low block, I finally figured out what was wrong with my knee – it bent slightly backwards!!

October 17, 2014
Overnight, everything in and around my left knee joint swelled. It was so swollen and stiff that it wouldn’t bend much, so I had a hard time getting down the stairs. I called my physiotherapist and made an appointment for the next morning.

Diagnosis

October 18, 2014
After carefully listening to my description of what had happened and doing a range of motion and other diagnostic assessments, my physiotherapist diagnosed a Grade 2 ACL injury with posterior lateral corner involvement and possible meniscus damage (the only way to confirm meniscus involvement would be an MRI). Estimated time for rehabilitation and recovery = 12 weeks.

Rehabilitation

Physio

I learned that an important first step along the road to recovery is to retrain the muscles surrounding the injury to “fire” properly. The lower part of my quad muscle is of particular concern. Two sets of 30 repetitions is a boring, but necessary part of the daily routine.

My ACL rehabilitation started with some very basic exercises designed to get the muscles around my left knee firing properly again post-injury, starting with the lower quad area. Ice and rest helped with the swelling. I opened a new page in my notebook and drew a column for each prescribed exercise, deriving a small measure of satisfaction each time I ticked off an entire day’s set of exercises.

October 23, 2014
Exactly one week post injury I got a green light to go outside for a walk! After being trapped inside for several days, I was very happy to grab my camera and trek along the sidewalks in our neighbourhood, scouting for signs of autumn.

November 8, 2014
Approximately 3 weeks post injury I went “off sidewalk” for the first time. Mr. GeoK and I planned a walk in Canmore on a well-established trail, but as is so often the case with us, we ended up getting a little more adventurous. He had to lend a helping hand on a particularly steep stretch of the path. On the prescribed exercise front, there were more columns across another page in my journal and we added a wobble board and some resistance bands to the set of gear in our exercise room at home. I built up to 30 minutes/day on the recumbent exercise bike, with a fairly low resistance.

Around this time I realized two things:

  1. I needed to do the same exercises with my right leg that I was doing with my left, so that I wouldn’t return to taekwondo training with a strength imbalance; and
  2. With just a little more focus on cardio training, I might be able to return to taekwondo training in better than pre-injury condition.

So I added both of those things to my journal. I also continued to watch my calorie intake, to minimize the chance of post-injury weight gain.

Strength-training

A large ball, resistance bands, a wobble board (made by my physiotherapist) and our universal weight machine – all used in my strength training exercises.

Early December 2014
Approximately 6 weeks post injury I could shovel the driveway and walk across a snow-covered field without too much difficulty. I enlisted the help of our youngest son for a new strength-building exercise that involved throwing a ball back and forth while standing on one leg. My knee was feeling pretty good and I was ready to try out the exo-skeletal knee brace I borrowed from my sister-in-law (who had a full knee rebuild several years back).

December 9, 2014
Finally, 8 weeks post injury, I headed back to the dojang. I had talked over what I should and shouldn’t do with my physiotherapist and we came up with some strategies to modify most of the stepping and kicking techniques for the first few weeks back. The first class went well. I was amazed and impressed when I did a one-legged squat on my injured leg (with a partner for balance)! The second class started well enough. I did several patterns and then as I set up for kuemgang poomsae I made a mental note NOT to stomp during the pattern. And I remembered not to stomp – the first time. When the second left leg stomp came up in the pattern, kinesthetic memory overrode my good intentions and my left foot stomped hard on the mat. I bit my tongue to keep from swearing out loud, dropped out of the pattern and hobbled around, carefully controlling my breathing as the pain in my knee subsided to a throb. It was a small setback that required the reintroduction of ice and complete avoidance of kuemgang pattern for a couple of weeks!

December 20, 2014
I wore high heels for the first time since October and my knee was okay with it! Aside from the fact that I continued to wear a full knee brace to taekwondo, I reached the point that I no longer felt injured EXCEPT in two instances:

  1. Impact pain (from things like charging up the stairs 2 at a time); and
  2. Pain deep inside my knee when I had a lot of weight on my left leg and bent my knee acutely (such as bending down to compose a photograph, something I do more often than I realized before this injury).

To address the impact pain, my physiotherapist added several jumping exercises to the mix. As for the other, possibilities included a still-healing bone bruise and/or meniscus damage.

Arc-Trainer

Hard at work on the Arc Trainer.

January 5, 2015
Back in Calgary after winter break, I switched from the recumbent bike to the ARC trainer for the warm-up/cardio portion of my exercise program. Hill Interval training at Level 4 for 30 minutes was pretty easy, so the next time I went to Level 5 – also very do-able. But the first time I tried Level 6, I had to drop back to Level 5 part way through.

February 14, 2015
Mr. GeoK and I walked 20 km today and my knee came through just fine.

March 24, 2015
Today I heard the two words I’ve been hoping to hear since the start of 2015. My physiotherapist announced, “You’re fired!” We’ve been joking about this during my last few sessions and today was the day.

I will continue to do strength and impact exercises, but rotate leg exercises with core and upper body strength training. I’ve progressed to 45 minutes on the ARC trainer at Hill Interval Level 7 or 30 minutes at Hill Interval Level 8.

I continue to take a pass on sparring training at the dojang, but have progressed my taekwondo training to the point where I’m preparing for my next promotion test, coming up in June. I will continue to sport the exo-skeletal knee brace until I break from taekwondo over the summer and will probably wear it for a few weeks when I resume training in the fall.

I still feel some discomfort when there’s pressure or weight on my knee joint and I bend it as sharply as it will bend. There’s a little more “play” in my left knee than there is in my right, but for day-to-day activities, it’s in pretty good shape – I’d say 90 – 95% of what it was pre-injury. So I’m looking forward to resuming our hiking, biking and other adventures in the Canadian Rockies as weather and trail conditions permit.

Lessons Learned

Motivation
Once my knee was back to 75-80% of pre-injury “normal”, it was harder to stay motivated to train every day, especially to train to what I call “the edge” – i.e. hard enough to continue to recover ASAP without going so hard that recovery is set back. I found a few things helped:

  1. Charting progress – I started doing this from the first time I saw my physiotherapist. When I check off boxes across the page, I fell at least a small degree of control over the recovery process. And as some exercises dropped off and new ones were added, I could see the progress.
  2. Gamification of fitness – Yes, this is a thing. I’ve always been a bit competitive with myself (for example, I find myself thinking “I did 41 push ups without stopping last time I tried, so how many can I do this time?“). Over Christmas, I saw a couple of tweets about a walking challenge sponsored by Alberta Venture magazine and hosted on UWalk. Anyone who signed up got a year’s subscription to the magazine. Anyone who accumulated more steps than the magazine editor over the month of January received free admission to the Alberta Venture Fast Growth 50 conference. Anyhow, I signed up and then when I found out a fellow geocacher had also signed up, I got pretty competitive about it. Not only did steps walked or run count, but I could also log my hour-long taekwondo classes, which I perceived as “moderate” exercise. To take part in the challenge, I borrowed a pedometer from my local Calgary Public Library branch. Just as that challenge wound down, I invested in a FitBit so Mr. GeoK have an ongoing friendly competition to see who gets in the most steps each day. (And yes, I went to the conference.)
  3. Feeling good – The hard work that went into rehabilitating my knee injury has left me feeling better than ever. Pre-injury, I thought that 5 to 7 hours/wk of taekwondo was keeping me pretty fit. But once I started wearing a FitBit I learned that because taekwondo has just very short bursts of intense exercise, I wasn’t really getting any of the “bouts of 10 minutes or more” recommended by Canadian fitness guidelines. In fact, I log more active minutes walking to the library and back than I do in a taekwondo class (the walk includes walking down and climbing up about 20 flights of stairs). So now, on the days I don’t do taekwondo, I do a 30 – 45 minute cardio workout. And I’m more mindful of sustaining a certain level of effort at taekwondo so that I accumulate active minutes there, too. Finally, while I knew I should be doing resistance training, I wasn’t, and that’s now part of my fitness routine. I like feeling good.

Taekwondo is Still My “Thing”
When I took my first taekwondo class back in 2003, my main exercise over the seven preceding years was running around after my kids. So for the first six weeks of training, pretty much every muscle in my body was sore! Since then, I’ve come to love the mental and physical challenges of the sport; the fact that it incorporates balance, flexibility, strength and a bit of cardio training; the fact that it’s a family activity so that I can be active too (and not just drop my kids off and then go for coffee). Finally, I’ve made some great friends at the dojang and I missed them when I was unable to train for so many weeks.

Split Second Decisions Made Now Can Affect my Quality of Aging Forever!
The tenets of taekwondo include courtesy, integrity, perseverance, indomitable spirit and self-control. Back on October 16, in the war between indomitable spirit and self-control, indomitable spirit won out. This injury taught me “when it doubt, self-control has to rule”. I’m aiming for compressed morbidity, and that means training wisely. And being housebound for a week reminded me just how important getting out and about is to my happiness and sense of place in the world – another reason to train wisely.

Enough from me. Now that I’m transitioning from exercise for rehab to exercise for quality of aging, I’d appreciate any tips on motivation, progression or keeping it fun. Please leave a comment to share your best advice.

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2 thoughts on “A Long Road

  1. Pingback: Hiking Banff National Park – Saddleback Pass / Fairview Mountain | Out and About with the GeoKs

  2. Pingback: Hiking Banff National Park – Tunnel Mountain | Out and About with the GeoKs

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