A Familiar Challenge

Underlying Fear…

Every athlete has had that thought. You know, the one that creeps in from time to time as if the Devil is toying with you. It’s the thought of sustaining a serious injury while playing the sports we love. I didn’t become aware of this fear, specifically of the “ACL tear”; nor did I even really know what it meant until I was in high school. Every year that I was in high school, a senior on the girls basketball tore their ACL and were out for the season. Fortunately, I made it out of high school and community college avoiding the ACL plague that unfortunately hit many of my friends.

Post-School recreational sports

After 4 years of playing 3 sports year-round from volleyball to basketball to track and field followed by numerous team and individual sports camps over the summers and then an additional two years of basketball and one year of volleyball in community college, I felt I’d made it! I’d escaped the major injuries. Phew! I had suffered my fair share of sprained ankles none the less but nothing that kept me out too long. That was until a few more years down the road at the age of 26. I’d taken up pickup basketball at work with the guys, literally all men and then me. I’d play whenever my schedule allowed, sometimes early in the morning if I didn’t have a client or had a late cancellation, other times at lunch time when training hours were harder to come by and sometimes in the evening after work. I had played on a women’s rec league at my work but it didn’t last very long as we didn’t have enough women to create multiple teams so I was left with the option to either not play at all or to play in the men’s league, which was fine with me. It pushed me and I enjoyed the challenge.

One Tuesday night while playing pickup ball after work with the guys, I don’t even recall if we had 10 players, we may have only had 8. My buddy Kyle was giving me a hard time, as we often did talk smack to each other on the court. He said that I didn’t drive to the basket enough. I kept this in mind as I was playing of course, I felt I had been challenged so I had to show him I could drive it in too. It wasn’t that I couldn’t, it was more of a choice. Most of these guys were much bigger and stronger than I was so it was more about being smart.

I remember it fairly clearly after 13 years, I had a fast-break situation and was going one on one against one of the biggest dudes on the court, no joke he was 6’4 and probably 240 lbs and he’d wear these eye goggles that looked like tanning bed eye protection. Being that I had been hitting shots outside I think he thought I was going to stop and pull up rather than take it in against him; however I had been challenged to take it in more…so I did. The fact that he probably thought I was going to pull up and shoot it coupled with my determination to take it in hard; lead to a nice little collision and POP right at the free throw line. I fell to the ground sitting on my butt with both legs out in front of me and looked up in time to see my shot roll into the basket. I just sat there though, breathing and staring at my legs and registering that audible POP that I’m sure everyone on the court heard. It felt like I sat there for 5 minutes but it was literally probably 30 seconds. I hobbled off the court and took a seat on the bench next to Kyle. I said I was good, it just felt like I sprained my knee. It felt stiff and a tad numb. I even thought about going back in the game but decided against it and instead drove myself home. I took the next two days off and visited an Orthopedic Surgeon in Bellevue whom tested my knee and was 99.9% sure I had cleanly torn the ACL. I was devastated and in a bit of denial, angry. A statistic. It finally got me. Only 30% of ACL tears are from contact injuries, 70% are the result of your typical plant/cut mechanism or not landing properly from a jump etc. Sigh. I returned to work that Friday and had people asking me, “Didn’t you tear your ACL the other day?” Yep. You literally wouldn’t have even known, I was back to walking normally after 3 days. Five weeks later on March 14th I underwent a successful hamstring autograft in which they used my own tissue from my hamstring tendon to replace the ACL. On to recover I went…

13 years later…

The year is now 2019. I’ve had no issues with my reconstructed ACL. I was back to playing basketball at work after 5 months of rehabilitation which is very fast. I was careful though and listened to my body, I knew my limits. I was always good about this. From surgery early in 2006 through mid-2008 I mostly did my typical workouts of weight lifting 4-5 days a week and playing basketball, volleyball or racquetball or doing various cardio machines. At the end of 2008, I started training for my first NPC Figure Competition and eventually over the next 6 years went on to compete in a total of 9 competitions. It gave me something to train for and pushed me more so on the aspect of diet and nutrition. Between 2009 and 2014 I was going back and forth between training for competitions and also playing tackle football for the Seattle Mist. I started with the team at the end of 2009 and football quickly became my main focus as sports were my true love. Figure competitions only gave me a small taste of competing and challenged me in new ways but were totally different than actually playing a sport and using your athletic SKILLS to display your talents.

After 8 years of playing football in 4 different countries and 17+ different cities, winning 2 US Legends Cup Championships and 1 in Canada, I retired from playing in September of 2017. It still boggles my mind that I somehow managed to make it through my entire football career in my 30’s without a serious injury. The most serious injury I did have was a grade II sprain of my MCL on my reconstructed ACL knee. The injury looked gnarly and I was even scared I had re-torn my ACL and possibly done more damage, however; the MRI showed my graft was still “THICK and BEAUTIFUL” in the words of Dr. Scranton. My MCL on the other hand had undergone some serious stretch as noted in the photo progression below. I had some limitations for practices over the following two weeks but still suited up for our game in Vegas however did not get to play which was a smart call by my Coach. The only other physical ailments that I dealt with throughout football was plantar fasciitis, TWICE; once when I first started playing football in 2009 at the age of 29 and again in 2015 once my custom orthotics wore out, oops! (Side note: I would never wish plantar fasciitis on my worst enemy, it’s NO JOKE). In addition to that, there was the occasional ankle sprain, calf strain, Achilles tendinitis, swelling of the knee, groin pulls, hip pointer, deep quad bruise etc. This just goes with the territory of the sport and definitely with the VOLUME of training we would do on any given weekend.

Life after sports, part 2…

After a solid year of being retired from competitive sports, I made my way back to basketball and began playing regularly on the women’s rec team I had played for beginning a decade prior. I mostly played during my off-season from football as our Coach didn’t want us doing any other extra-curricular sports during our season; which make total sense and I was very good at respecting this request as I certainly did not want to sustain an injury that would keep me from playing football. I also found my way back to football; this time on the coaching side of things.

Premonition…

Monday nights returned to being my regular basketball night. Our women’s rec team always played on Monday nights the whole ten years I’d been a part of it. This season was different for me though as I had finally successfully recruited one of my former football teammates and one of my best friends to play on our team for the spring season. Having a true friend on the team made it new and exciting since we had never played hoops together. I was excited to see how our football skills translated back to basketball. Basketball was both of our sports growing up until we both found football in our 30’s. Having Lala on the team provided us an opportunity to see each other more regularly now that we were retired from football and Lala had recently become a very busy first time Mom!

After a handful of weeks I started to feel like I was getting my lungs back in shape, getting my BURST back on the court, rekindling that inner and outer aggression to the basket, my shots were becoming more consistent. I felt like I could run with some of the young 20-somethings and that in itself motivated me immensely.

Monday, May 20th, as I was driving to Bellevue for our 9:15 PM game like I would any other Monday, a thought crossed my mind. Looking back, it wasn’t just A THOUGHT, it was a VERY SPECIFIC thought. These general thoughts would cross through my mind from time to time as I’m sure every athlete has these thoughts seep in occasionally and you just learn to dismiss them very quickly because living in fear of what could happen is no way to live. I’m not a worrier, never have been. I am not an anxious or fearful person I live in the moment and try to always keep a positive outlook no matter what. That night while driving I had the specific thought of, “What if I injure my leg tonight and I can’t drive myself home:” Would my son have to drive all the way to Bellevue to pick me up? Could I drive myself home? I quickly dismissed the thought and distracted myself with some other though. The reason it is very specific to me is because this refers to not being able to use my RIGHT leg to drive. Even after injuring my left knee back in 2006, I was able to drive myself home because I had an automatic transmission and didn’t have to use my left leg. A right leg injury would be a different story, so I thought.

It didn’t occur to me until after the injury that I had somehow had a premonition about this happening. Almost in the same fashion as in 2006, I had a fast-break opportunity, no one had been heckling me this time; maybe just my own inner competitive self taunting myself to be aggressive, not back down and to beat this younger chick to the basket. I had 3 defenders around me as I burst down the left side of the court determined to either make the lay-in or at least get fouled in the process and take the free-throws. Just as in life, sometimes we have to make a split decision, there is no processing the decision, you just simply do it or don’t do it. As I approached the basket sensing there were at least three defenders around me, one that I could sense on my right, and two behind me. I decided I was going to jump-stop, head fake and go up for the shot and try to draw the foul. We all were moving so fast with such aggression to the hoop that I didn’t think they’d be able to control their momentum and they’d foul me even if they didn’t intend to. Just as I jump-stopped, almost simultaneously to when my feet hit the ground, the girl behind me shoved me to prevent me from getting the shot off. I felt my right knee hyper-extend as it jolted from back to front. CRUNCH. I stepped forward out of bounds under the basket as I heard all my teammates yelling FOUL!!! I put both my hand on my knees, bent over…assessing, analyzing once again. Deja-vu, almost. I didn’t make the shot and I was still on my feet, thankfully. The defenders rushed off to the other end of the court until a whistle was finally blown as I tapped out and limped to our bench taking a few deep breathes. Someone ran to get me some ice and returned with one of those lunch box tiny ice blocks, it’s all they could find as the training room was locked. I laughed but took it gratefully and rubbed it on my outer shin where I was feeling as though the joint got jammed and those muscles were on lock-down. There were only a few minutes left in the game but we were down 5 points to a very competition and young team. I wanted to beat them so bad but knew that I could not return. We had one other sub that night but we couldn’t overcome the deficit and lost, we played a great game though and hung with a team probably averaging 12 years younger than most of us. My teammates and the score keeper were all very nice and kept checking in on me. I assured them I just thought I had hyper-extended it. I’m not a dramatic person and I’ve been told I have a high pain threshold but how do you even gauge that? I’ve seen many people tear their ACLs over the years and I will say most have had fairly dramatic reactions. The only reason I say this is that as I put my sandals back on and limped to my car to drive myself home 35 minutes, I don’t think one person on my team thought I’d done anything serious. Heck, I wasn’t even sure I had, until the next morning.

Round 2

As I drove home and hobbled up two flights of stairs to my bedroom, my knee definitely felt a bit weak and loose. I wrapped it with ice and went to bed and didn’t even think to take some anti-inflammatory meds. My self-assessment at this point in time was that maybe there was a 10% chance that I did something serious. I didn’t hear a POP, just a crunch. That’s not as bad as the first injury, right? The next morning gave me my answer when I tried to get up and I could barely weight-bear. My self-assessment skyrocketed to 90-100% certainty that I’d done something pretty serious. My knee was extremely stiff and only mildly swollen. I knew. This was all too familiar. A flashback to 2006, two days off work, confirmed injury, returned to work as if nothing had happened only to have surgery follow. Time to make that call.

Luckily my Mom was staying next door with my Grandma while my Aunt was away in California for my cousin’s college graduation. I called her that morning and said I did something to my knee last night in our game and asked if she could take me to our team’s Physical Therapy center in Everett as the Head Trainer just happened to be there that morning training a new Therapist. My Mom happily agreed to drive me to my appointment, shaking her head at me as I limped begrudgingly to get in her car. The Athletic Trainer unofficially confirmed my worst nightmare, even though I’d already succumbed to the notion, I had completely torn my ACL and possibly my lateral meniscus as well. Here we go again. I fought my eyes as they were attempting to well with tears, not because I was in pain but because I knew the road ahead of me was long and not a fun one, especially being that I was 13 years older and I feared recovery would take forever. I quickly turned that emotion off, maybe redirected it is a better word. I remembered back to my first injury and how motivated I became and how I worked my butt off before surgery to prepare and remembered how quickly I was able to get back on the court because of that work ethic and attitude. This is the approach I would take for this challenge as well, it was no different.

Over the next two days I had an X-ray and an MRI to confirm the trainer’s initial diagnosis although I had to wait until the following Tuesday for the official results. After both exams my husband I had already planned a long weekend away for Memorial Day and I didn’t plan on letting this “minor” setback stop us from going and enjoying a relaxing weekend away. While driving home from our trip Tuesday afternoon, my phone rang, it was the Orthopedic Surgeon, Dr. Lee; who also worked with the Seattle Mist as well as many other local sports teams and even previously the Oakland Raiders. He confirmed what we already thought, only with more news. I had a complete tear of the ACL, a radial tear of the lateral meniscus, a chondral defect on the medial tibia and a bone bruise, WOW. My husband said he could tell by my reaction on the phone that it wasn’t good. I was just shocked I had done all that from one shove. Kudos to that girl, I told you she was an aggressive little bugger. 🙂

Decisions, decisions…

I went in to my appointment with my surgeon with a pretty clear idea that I would elect to do another hamstring autograft, the same surgery I did in 2006. I had really great results with it and obviously it was all I really had to compare to. I came out of the appointment that afternoon completely confused and questioning myself and my decision. Luckily, this wasn’t the appointment in which I needed to make that final decision. The purpose of the appointment was to go over all of my options, ask any questions that I might have of the doctor etc and then take some time to make a decision before scheduling.

It had only been 13 years since my last injury but it was amazing some of the information that he shared with me as far as what the current trends were in this type of reconstructive surgery. Like before, you still had the option of using your own tissues, either using a graft from your hamstring or patellar tendon or you could use a cadaver allograft of either patellar tendon, hamstring tendon and now even Achilles tendon (which he didn’t mention the latter as it’s newer and there hasn’t been enough research done on it yet to show that it’s a worthwhile and sustainable graft). He explained to me that with a patellar tendon graft I could and probably would have on-going pressure/pain on the front of my knee, especially with kneeling. This wasn’t particularly appealing to me as I tend to kneel a lot in my line of work as a Personal Trainer. I’m often on the floor next to my clients as they do core work or if I’m spotting them on a bench. A hamstring graft he mentioned were great although they offer the toughest rehab as you do additionally have to rehab your hamstring since you are removing part of your tendon to retrieve the graft. You also have to anchor the graft to the bone with a staple and a screw whereas with the patellar tendon allograft they are able to remove a piece of the bone to use as an anchor to your own bone, making for less drilling.

In the end, I ended up going with my gut and with what I knew as I had already gone through it once. I elected to do the hamstring autograft, using my own tissues to repair the ACL. As for the lateral meniscus, that was going to be a game time decision. Dr. Lee explained to me that depending on the type of tear, the repair would determine my length of recovery. If the tear occurred along the seam, so to speak, they would be able to pin it back to itself which requires more healing time which meant potentially 4-6 weeks non-weight bearing in order for that meniscus to heal. If the tear was a radial or flap tear which sort of goes against the grain of the tissue, they could simply shave off that flap of loose tissue (menisectomy) which requires less recovery time and maybe only a week on crutches. Lucky for me, he was able to remove a chunk of the meniscus and I was able to weight-bear lightly the same day I had surgery.

Recovery couldn’t have gone much better the first few days. My husband took Wednesday through Friday off to be home and tend to my every need, knowing full well that my stubborn self was at least going to try to do everything on my own. Day one was a lot of time in bed relaxing and rotating between my compression sleeves on my calves and ice on my knee. I was able to get around just fine with my crutches and the pain meds were still doing their job. I knew that waking up the next morning that things would change and boy, was I right! The nerve block had worn off and I hadn’t had any pain medication since I went to bed. Wow, flashbacks to 2006 again. Again, another day consisting of rotating between ice, heat, compression sleeves and pain medication. Day three my parents were coming down to hang out for a bit and take my son back with them to celebrate my nephew’s 18th birthday. I ditched the crutches that morning and felt completely content to limp around with my locked-straight leg in my heavy, clunky knee brace. Stairs took some patience as I had to take two steps for every stair. I eventually got where I needed to and I had to remind myself constantly that there was NO HURRY. I’m so used to operating at a fast pace at everything I do so this was a great reminder to slow down and relex, at least a little.

On the fifth night after surgery as I was getting into bed, I couldn’t shake this deep achy feeling in my calf. It’s one thing to expect knee pain where they cut into my knee, drilled the bone and anchored a graft with staple and a screw. I even expected to have tight muscles in my quads, hamstrings, glutes/hips and maybe even calf. This calf ache was different though. It wasn’t muscular, it was relentless and nothing relieved it. I did my nightly routine of taking my pain meds, wrapping my knee for stability while sleeping and then added a heating pad wrapped around my calf to try to rid it of this deep, throbbing and heavy ache. I had a very restless nights sleep, no position seemed to alleviate the calf ache. I’d all but dismissed the knee pain as I was accustomed to it but I couldn’t shake the ache. By time I woke up in the morning and got out of bed, it felt as if I had torn my calf muscle in the night, but how? I got up only to realize as I tried to push off my right foot, it felt like my calf was going to either tear or explode. I couldn’t walk on it. Back to crutches, damnit. I made my way down to the couch, set up my compression sleeves and ice, settled in with my coffee, phone and TV and decided to send a text to my doctor regarding the calf pain. I mentioned that I knew blood clots were a risk but at what point should I go in with a real concern. He text me back and said he’d call in 30 minutes when his office opened. He called and said he could set up an ultrasound if I was really concerned or he could have his nurse call later in the afternoon as I needed to set up my post-op appointment anyways. I said I would continue doing what I was doing to see if the pain would subside and if it continued I would tell the nurse when she called. The nurse didn’t call until around 4:30PM and as my pain had not subsided at all, she was able to get me in to Swedish Hospital for an ultrasound at 6:30PM. Thank God!

My Aunt, who lives next door; was able to drive me up to the hospital for my appointment. A young man came out to meet me and lead us back to an odd side room where he performed an ultrasound on my legs and abdomen. He started on my surgery leg and within about five minutes he proclaimed, “yep, there it is.” Right where I suspected in my right calf. It was a squeezing, throbbing, achy pain as if someone had placed a blood pressure cuff around my calf and pumped it to max pressure then just left it. Just standing with no weight on my right leg was THE WORST pain, it was as if the blood was accumulating in my calf and didn’t have the strength or the pathway to be pushed up above my knee so it just sat there in my calf, pulsating and throbbing, wanting to circulate somewhere else but couldn’t. It was like blowing up a balloon to the point you know it’s about to pop and you get more and more nervous with each additional breathe that it’s gonna blow anytime! I wanted to take a pin and pop it and alleviate the pressure. These were just some of the thoughts I had when the pain was at it’s worst. He checked my left leg and my abdomen to be sure there weren’t others along the same path. All was clear thankfully. He also said he could tell this was a newly formed clot based on the how bright it was on the ultrasound.

I spoke with an on-call doctor that night from the hospital who was in touch with my surgeon, they agreed to immediately put me on a strong blood thinner to prevent the creation of any new clots and it would also help dissolve any parts of the current clot if they were to break off and travel anywhere. I’ll be on the blood thinner for 3 months in total and I can exercise and travel and do all the things with no restrictions. The only thing I came to find out I needed to change was my birth control pill. Yaz is known as one of the WORST birth control pills related to blood clots and I’m almost certain that it is the sole reason I got a clot in the first place. I’m off Yaz now and will soon be switching to something without estrogen. Bottom line is I’m glad I listened to my intuition and got my leg checked out as blood clots can be deadly if not dealt with in time. The blood thinners began working incredibly fast and I had relief within hours of taking my first dose.

My knee rehab is back on track and going extremely well. I was cleared of crutches and the brace within the first week after surgery which is very fast and I couldn’t be more happy with my progress. I’m extremely grateful for all of the support I’ve had along the way, from my husband and son tending to me daily as I let them, to my parents for checking in constantly, two different Aunts for driving me to appointments, a few friends for stopping by to visit and bring food and flowers and of course the incredible staff at Edmonds Orthopedic Center and Swedish Hospital for fixing me up right! Thanks for reading about my journey!

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