Wednesday, March 28, 2012

Who needs an ACL?

In all of my years of running, I have really never been injured.  Oh sure, there was the IT band issue when I tried to run my first marathon in 1991, and there was the plantar fasciitis that I fended off in 1998, but other than that and many twisted ankles, I have never stopped running for an injury.  And for everything except the IT band, all of my “injuries” didn’t stop me from running for more than a day or two.  This all changed on March 9 at 3:15pm, MT.

Darin coming off the first jump at Big Sky
March 9

My son, Nathan, daughter, Amy, and the three Willett kids (Joe, Emma, and John), and I are standing at the start of three massive jumps on the slopes at the Big Sky ski resort.  The boys and I have been doing these jumps all week, and we have less than an hour left in our week of skiing.  As we are standing there, Nathan says, “John you are up first this time.”  Before John can start though, I say, “Why can’t I be the director?” i.e., why can’t I go first this time?  I say this in jest, but Nathan says, “Okay, dad, go ahead.”  Now these jumps are rather big (see picture), but there is the bailout option in between each jump.  Usually I just do the first one, but I have done the first two a few times, and all three only once.  Only Nathan typically does all three.  The rest of us are just standing in his shadow, literally.  So, I drop into the first jump, hit the ramp, and fly into the air.  I maintain decent control in the air, but as my skis are landing on the snow, I hear the “pop” from my right knee.  The knee goes unstable, and I make the wise choice to bail out of trying to hold the landing.  On the ground, I realize immediately that my knee is not good.  It hurts for one, but the sound I heard was unmistakable.  I hadn’t heard that sound before, but it is exactly what I have read about from many other athletes.  If someone asked me right then what was wrong, I would have guessed that it was my ACL that gave way.

My first attempt to stand back up on my skis lasted about two seconds, and then I was back down on the snow.  My right knee is very unstable, and it hurts to put any weight on it.  The ski photographer nearby asks me if I need her to call ski patrol for me.  The thought of being strapped onto a sled and dragged to the clinic is enough to motivate me to try getting up again.  This time I only put weight on my left ski, and I manage to slide down the hill on just my left ski.  After taking my skis off, I find myself on the ground once again, but then I find that if I keep my right knee mostly bent, I can sort of hobble along.  I get myself to the room where Martha very quickly sizes me up and declares she is going to take me to the clinic.  I can’t argue with the need to go to the clinic so I get out of my ski gear somehow and into a pair of jeans.

At the clinic, the staff and doctor all look at my knee and guess that it is my left knee since it looks larger than my right.  I guess my knee hasn’t swollen any yet.  The doctor x-rays it to make certain nothing else is wrong, gives me a heavy-duty brace, and says I probably torn my ACL.  The brace allows me to walk with a nice limp, but no crutches are needed.  This allows me to get home on the plane the next day, although I did get extra attention from the security personnel.

March 26

It is now 17 days since the knee “popped.”  I have regained most of my range of motion in the right knee.  I can straighten it to a few degrees short of fully straight, and I can bend it about 120 degrees.  So, there is still range to be regained, but progress and healing is occurring.  Three days ago, I switched from the stationary bike to road walking.  I wasn’t sure how long or far I should or could go, but I went out and “blitzed” three miles in 47:30—less than 16 minutes per mile.  I was pleasantly surprised as I was expecting around 20 minutes per mile.  The next day, I walked three miles in 46:30.

This morning, I saw the orthopaedic surgeon to review the results of my MRI that I had last week.  Dr. Cheatham started by showing me the PCL, then the LCL, and lateral meniscus—they all looked great.  I was really excited to see I hadn’t hurt at least one of the menisci.  Then he showed me the medial meniscus, and it looked perfect.  He showed me the MCL and pointed to a little bit of strain that it appears to have received, but nothing that won’t heal up quickly on its own—definitely not a tear or anything.  Finally, he showed me the spot in the center of the knee where there is usually the ACL; however, there wasn’t much of anything in there.  He said he was sorry to be the bearer of bad news, but overall the news was very good.  I had managed to completely explode my ACL without any significant damage to anything else in the knee.  (This is unusual.)  We then discussed the wide range of options, including doing nothing, before finally I settled on using the middle third of my patella tendon to reconstruct the ACL.  My surgery is scheduled for April 13.  Please keep me and Dr. Cheatham in your prayers.  Before leaving, I ask the doctor about playing golf and light running.  (I knew better than to ask about playing ice hockey.)  He said he would hold off on golf due to the twisting involved, but then he looked at me like the crazy ultra runner that I am, and finally said that he guessed straight running on a smooth surface would be okay.

I came home from the doctor, ate lunch, did a couple hours of work, and then laced up the running shoes!  How far would I be able to run?  Better question, how far should I run?  Will the knee hurt?  If so, how much will it hurt?  How much pain should I tolerate?  With doubts (and a little fear) I walked the 400 or so feet to the end of our driveway.  I let a car pass, and then positioned myself on the left side of the road.  Here goes nothing.  I pushed start on my watch and lurched forward into a sort of shuffle.  After about 400 yards, I realized clenching my neck, shoulders, and hands wouldn’t keep my knee aligned, so I started to relax.  The amazing part is that there was no pain in the knee.  The muscles around my knee were firing away, but overall everything worked.  I hit the mile mark in 8:56, and decided to turn back to home—two miles would be enough today.  I finished in 17:27, and the elation I felt was huge.  This run confirmed everything the MRI showed.  There is no ACL, so I can run straight, but otherwise, the knee is intact.

I know there will be some difficult challenges ahead, both in the prehab before the surgery and the rehab after the surgery, but I am in good shape at this point.

Never stop running,
Darin