ACL SURGERY AT 50 ... MY JOURNEY FROM FALL TO FITNESS ...

This article could help someone ,especially in their fifties ( like me) with basic fitness  to give hope that " If I can do it , you too can ".
My pre-op fitness regime was yoga and pranayama which helped with my flexibility and mental agility. But my muscle strength is very average, which is the case with most non-sporty people over the age of forty. I chose to get my surgery done at  chennai  Sri Ramachandra sports centre for two reasons. One is, the chief surgeon, Dr Arumugam is my husband's friend and  very experienced in arthroscopic surgery. Other reason is, psychologically, I felt I was going to a wellness centre and not an illness center ( hospital ). To see sports people getting back to their form is  a great motivation for me.

What is ACL reconstruction surgery ?? ( in brief ):
Anterior cruciate ligament holds the thigh bone ( femur ) and the shin bone ( tibia) and helps in rotational motion of the knee. Surgery is the only longterm solution for complete  ACL tear. It is a two hour procedure where the  surgeon takes a graft ( for me it was from my hamstrings ), drills holes into the two bones ( femur and tibia) and fixes the graft with bio screws. Rehabilitation after ACL reconstruction surgery is a six to nine month journey. It is a typical sports injury and many players  have comeback to their sports in a year's time. Even for non players, getting back to routine functioning is not an issue. Even older patients with knee replacement surgery get back to routine in six weeks time and this is no exception.
The question is Do I want to get back to my previous level of fitness ?  If yes, then it is important to stay strong and follow doctor's guidelines consistently to regain full range of movements and strength .

As I am writing this,  I am pushing myself beyond my comfort zone. As an educationist, we motivate our students to set a goal for their exams and stay focused. And now, I am doing that to myself.

I KNOW I would miss my yoga
I KNOW I would miss my long walks
I KNOW I would miss my race with my cat isha ( I would skip a couple of steps as I run up the staircase to beat her!)
I KNOW I would miss my campus walks and talks with my teachers at both our schools.
I KNOW I would miss the priceless smiles of children as I glide through the corridors..

BUT I choose to inspire and stay inspired.

Pain is inevitable. Suffering is a choice. 

My first ten weeks after ACL reconstruction surgery , in brief . ( from my journal entry)

First week 

On March 18th, I marched into the sports centre with my walking stick, super confident that I would walk out comfortably in a day or two! Thanks to our skilled doctor and his team, I came out of general anaesthesia very smoothly. And then , the PAIN started ....First two days I had a lot of discomfort in spite of taking painkillers. Using the bed pan made me feel so helpless and vulnerable. Audio books helped to  keep my balance. On the second day my physiotherapist asked me to walk. I almost fainted when I stood up! Finally I managed and came home with long heavy braces. Pain killers and antibiotics were given for a week and I started to feel better. Started simple exercises too.

Second week

Doctor's review on tenth day went well as far as healing was concerned. But I could not do left lifts. Doctor told me firmly " you need to work harder else you'll  not be able to get back to doing things you enjoy ". That was the nail on my head and I resolved to do whatever it takes to get back to form. For me, the Pain of being sedentary was another issue. I have been a " hyperactive person all thro life (I cannot sit through movies unless I truly like the story line) and this could be the greatest punishment to  not walk....
But I chose not to dwell in my illness. I engaged a physio for home visit and managed to walk comfortably ( with braces) and started strengthening exercises with ankle weights.
I am finally strengthening my core muscles;  something that I was contemplating since I was forty,  but never got to do!
Life is nothing but a series of lessons for us to learn and grow. Lessons come gently at first. But when we don't listen, it drops a bomb.
And I got it.

Third week

I had fever for a couple of days and doctor said it could be because of exercise strain and knee soreness.  I feel sharp pain in the knee once in a while. And nights are a nightmare. Staying so long away from my work( though I was constantly connecting with our team online)has started to take its toll on my mind. And I decided to go once in while to school.The physical exertion due to lack of sleep and exercise is causing chronic tiredness. 

Fourth week

Feel elated that I can lift my foot with two kg ankle weights as expected in this week. Had an Aha moment when I learnt to transfer my body weight comfortably during single leg stand. My knees flexion is only  70 degrees and it is making me anxious. Why can't I achieve 90 degrees?
Looking at the brighter side of my injury, my left knee is actually doing me a lot of good. He is the " ring master" in my life now, making me flex and fret, taming my senses, forcibly getting me onto a better life style. In the past month I have lost 2 kgs, just by eating sensibly. My right leg is truly my "hero", supporting me without complaining. So I decided to start ankle weight strengthening for my hero aswell ( which many patients do not do and end up excessively straining the non-injured leg).

Fifth week 

Set out on my journey to Chennai by car for my month end review. A few minutes into the drive, though the windows were raised, a golden yellow butterfly had managed to slip through and I saw her seated on my pillow( which coincidentally was the same colour !) Seems to me that she is bringing blessings from the universe with a message "soon you will fly. Just fly  high in your spirits now" .
During review, my doctor advised removal of braces and asked me to walk. As I set my foot forward, a sense of fear and freedom overwhelmed me. I felt good though I was feeling butterflies in my belly! I kept requesting my doctor for some light knee braces for psychological support. Another fall was unimaginable for me. To my shock, he  decided to put me on a rehabilitation regime for five days at their centre itself. So I went for an hour everyday to my physiotherapist, who boosted my confidence.On the CPM machine my knee was flexing to 120 degrees. Shr said It's my mind that's holding back in pain. Started to walk comfortably without braces and on the fifth day I told my doctor " I don't need braces " . And we drove back home. A few days later, my husband jokingly asked my doctor " what marks would you give her for her progress?" . To my shock he said 50%. Just couldn't sleep that night. What more should I do to get better? How do I learn to handle the pain? I was always a topper in school and anything below 90% is unacceptable for me. My heart goes out to some of my classmates who would say " I worked hard. But still got less marks" . I am one like them today. How do I improve my skill to perform better?
As an educationist I feel,  the role of a teacher is  only to facilitate learning. The student has to study. I have to flex my knees. There is no shortcut.  Some extra notes and classes can help. But the student has to stay motivated and stay focused. The 120 degree knee flexion target is to be achieved before I go for my second month review. I also needed some gait training to walk without limp, which I managed to do by the end of the week.

sixth week 

Back home, I am religiously doing my exercises, one hour by myself ( stretches and ankle weights) and one hour with my physiotherapist in the morning. Again at night I do my stretches and weight training for an hour.  Still it's a slow steady process. I still wake up at 2 am almost everyday with pain in my knee. Though it's bearable, it's disturbing my sleep pattern. I am walking normally and even climbing stairs ( one step at a time) . Functionally, I am back to work. But very conscious of my eating habits. Try to finish my dinner by 6 pm . And stay on intermittent fast till 8 am the next morning. I start my day with fresh sprouted ragi porridge ( with milk , sugar and some protein powder ) . I.have reduced my rice intake greatly. Feel lighter and healthier. 

Seventh week 

Started on 2 kg ankle weights and my knee dosent hurt so much during flexing. Passively I have reached 110 degrees but active flexion is still close to 100 degrees only.
I have largely reduced my carbohydrate intake and I am eating only half of what I used to consume before surgery.  But I am exercising twice as much. And feel energetic ( but for the sleep issues, I would be very fine).
The food industry, in the name of nutrition is loading our fragile system and leading to life style diseases.  Everytime my physiotherapist  takes the goniometer to measure the flexion of  my knees, I have butterflies in my stomach. And when she says it's only 5 degree improvement,  " just not enough", I feel dejected. I have been working hard. What went wrong?
Its like the paper distribution after examination. When the teacher rebukes the student for scoring poor marks, the poor child wonders why he failed. He might have done his best. And the results are not enough. How many teachers take the effort to give positive feedback for self correction?

Thank god I have touched 100 degrees active flexion( and 110 degrees passive). I still have a long way to go . More so because my other leg is 140 degrees passive, thanks to my regular vajrasanam posture during my pranayama. If I think of the road ahead, it could be frustrating. So I have decided to take my journey one step at a time.


Eighth week 

Feeling greater confidence and control on flat surface.
I am able to walk longer.  Felt absolute joy to sit down with legs stretched out, to play veena. . Had an online session with my hospital physiotherapist. She was appreciative of my progress.  Has asked me to start squats, climb stair climb etc . Progressed to 3 kg ankle weights. Knee is now actively flexing at 110 degrees.passive is 115 degrees.  Functionally, this is enough. REACHED ENOUGH  for regular activities. But my target is to move on and not stop here. I
am not going to stop till I achieve the flexion  of my other leg ,and strengthen both legs beyond what it was before the fall.
Our body is the vehicle. Can't let it rust. Have miles to go before I sleep.....

Ninth week

There is a sense of well being now. Regined confidence.I am walking more and pain in the foot has reduced . Night time pain is still there especially when I turn or apply weight on my injured knee.

Tenth week after surgery

I am now able to do " single leg stand"  for few seconds with my injured leg. Still not achieved the desired target but I am happy that I am progressing. Went for my review and doctor was visibly appreciative. How much it matters for a student to get a pat on the back. Your student need not be a top scorer, it's enough if he is hardworking. The world needs first benchers and last benchers as well.
Fortunately, I moved from being a last bencher to first bencher in two months. But WHAT IF I could not ??
I salute and draw inspiration from paraplegics and people with degenerative diseases who live life bravely with all limitations. 

There are times when life does not give us choices. It is make or break. Such times are an opportunity to build resilience within us. We emerge stronger and fly like a butterfly that has struggled out of the cocoon by its own effort .
It's not just about life. It's about the QUALITY of life that we CHOOSE to lead, which matters.
Physical and mental well being is very crucial to success in any profession.  And, I feel, success is about balance in life. How can there be a balance when our body does not cooperate with us? For me, holidays are always with nature. Trekking/ hiking  in the wilderness
refreshes my body and soul. I start my day  looking at my trek photo in my mobile screensaver and motivate myself to do all that it takes to get back to my treks.

I NOW KNOW
My legs would get stronger than what they were before my surgery. That's what every challenge does to us. It helps us to grow stronger and wiser .
Let me end with Eckhart Tole's words
" Don't react to a bad situation. Merge with the situation instead and the solution will arise from the challenge"