My experience with tearing my ACL
I tore my ACL in April of 2018. This was my first major injury in my life (and hopefully the only ;)). I was playing in the finals of a volleyball tournament and landed on a single leg while rotating. Let’s just say physics won this time around. However, if I reflect back to how I was training at that point in my life, I was actually doing heavy strength training leading up to a potential powerlifting competition. And when I say heavy, I mean trying to truly progress my one rep maxes. This is not the training style that would be complimentary to a dynamic, multi-planar, explosive sport like volleyball. My muscles and tendons were already taxed from the week of heavy lifting, so thinking I could get away with playing a full day volleyball tournament at the week’s end was foolish. So, I learned my lesson the hard way.
Would it have happened even if I wasn’t training the way that I was? Possibly. But I do know that I was at a greater risk for injury considering how pre-fatigued my body was going into it. So, I initially thought my athletic career was over. ACL tears have been sensationalized to be “sport-ending, devastating injuries”. It is also assumed that surgery is the only route to fix it.
My symptoms were significant swelling, inability to straighten my knee, but once I was able to weight bear a week or two later I didn’t experience any laxity or instability as some folks do.
I got imaging done. My specific scenario was a full ACL tear to the left knee; grade 1 MCL strain, bone bruising and no meniscus damage.
I consulted the surgeon. But I also consulted my friends in the movement and healthcare fields. I wanted second and third and fourth opinions on how I should proceed. Recognizing that every practitioner has a bias in their respective disciplines, I took everyone’s advice with a grain of salt and weighed my options. After many lengthy discussions with Mike who knows the anatomy of the body better than I do with his RMT background, and talking to many other people who had incurred the same injury, it was clear to me that 99% of people (at least in my sample group) opt to get the surgery to repair the ACL either with a hamstring graft, a patellar tendon graft or a cadaver graft. None of these options excited me. You are essentially signing up for another injury to repair the current one. I knew I had been signed up for a lengthy rehab process regardless if I got surgery or not, it was really just a matter of figuring out if I felt like repairing it was necessary for me.
The 1% was my friend Dan. I remembered that he did not undergo surgery after his tear from martial arts. Dan and I were cut from the same cloth in terms of our professions and outlook on movement, so I trusted his perspective. After sitting down over coffee and hearing his story, I had another perspective. A beautiful, refreshing perspective. To potentially not get surgery and rehab my knee as it was. He was able to get himself back to 100% working order, doing all the movements and activities he enjoyed with no qualms. I knew he had worked hard and methodically at his rehab.
So I ultimately decided to keep myself on the surgery wait list, as I understood I may be on this list for upwards of 10 months! During which time, anyone who knows me knows I wasn’t just going to sit around twiddling my thumbs waiting for a call. I got right to work. I knew what I needed to do, so I didn’t work with any physiotherapist. Over the course of the next 9 months, this is what I did (timeline is rough estimate based on my memory since I didn’t actually write down what I did at the time):
Month 1 (the rest of April):
Iced and elevated every couple hours to get the swelling down
Attempted to bend and straighten my knee to the best of my ability
Foam rolled my leg muscles to prevent extra tension from building up (I wish I had had a theragun at that time)
Tons of stationary biking to encourage range of motion, increase blood flow and preserve cardiovascular health
Was on crutches for 1.5-2 weeks and then was able to weight bear and hobble around without them
I went back to work at the gym 1.5 weeks post-injury which in hindsight was probably too soon but I was determined. Plus it was the place I did the majority of my rehab at. It was a very motivating place for me to be for many hours of the day and I received a lot of encouragement from my friends, colleagues and gym members.
Wore a hard knee brace to commute to and from destinations as an extra precaution and honestly mostly for other people to visibly see I was injured and to not push me off the sidewalk haha, but took it off at the gym as it felt cumbersome and restrictive of my movement.
Months 2-4 (May-July):
Progressively worked on getting my range of motion back and began re-teaching myself to walk normally without compensation
My apartment was a second story walk up with 2 flights of stairs to navigate everyday so being able to walk up and down stairs was a high priority. My first goal was to be able to bend my knee and lift it high enough to place my foot on a step. At first, I was heavily hip hiking to compensate for my inability to do this. I still remember the day I successfully did it without leaning my body to the side. What an achievement it was I almost cried.
Fast forward to working on basic non-load bearing leg exercises (think band knee extensions, glute bridges, prone band hamstring curls…) and lots of stretching. All the while I thought, well this is an opportunity to get really strong in my upper body and work on mastering the muscle up. So I did, I did all the pull ups, bench press, shoulder press, dips, etc and was eventually able to do 5 strict ring muscle ups in a row (the most I’ve ever been able to do). It gave me something else to focus on besides the monotony of rehabbing my knee.
Months 5-8 (August-December):
By this point I restored a good amount of range of motion and a good handle on bodyweight and light strength exercises. I began to focus on slowly building muscle back into my quads, glutes and hamstrings. I understood that the ACL’s main function was proprioception - in other words, helping you stabilize your knee in space and preventing your tibia from moving too far forward or internally rotating at your knee joint. So I knew without repairing this structure, I may experience some feelings of decreased stability when doing things like single legged exercises.
During this time period, I was able to jog for the first time on a treadmill. To say I was over the moon is an understatement. Historically I never loved running, in fact I would usually avoid it at all costs. But when it was taking away from me, all I wanted to do was run like the wind. This was a monumental day and I vowed to never take running for granted again.
Next I worked on decelerating my body going downhill which places considerable demand on the knees. In September, we planned a trip to Strathcona Provincial Park where we hiked Baby Bedwell Creek - a 7 km out and back hike with 520m of elevation. Basically a straight ascent to get to our campsite, meaning a long descent on the way out. It was challenging but I took it slow as my lungs needed work and I also took my time on the downhill portion hiking back out. I did not wear a knee brace on this hike as again I felt it too cumbersome.
In the early months I had completely written off being able to snowboard that winter. But as the months went by and I was progressively feeling stronger and more capable, I decided it might be possible. So I bought a longboard in hopes of trying to hop on a board and see how I felt cruising an empty parking lot as sort of a training tool. It was very scary at first. (Don’t worry I wore a helmet :p)
Come December, we went up island to Mount Washington and I rode the bunny hill and a couple green runs. I was like a kid on Christmas day. Laughing hysterically and uncontrollably going down the hill.
Months 9-10 (January, February):
In January (or the end of December I can’t quite remember), I finally received a call saying they could book my surgery date. I had kept myself on the list as a safety net in case my rehab didn’t go as I’d planned. I was in such good shape I knew in that moment that I needed to decline. I took myself off the list, knowing that it would always be an option should I change my mind in the future. I felt relieved and proud at how far I’d come.
The final test was to get back on the horse and play volleyball again. I was nervous naturally, as this was the activity that originally caused my injury. But, I took it baby steps at a time like I’d done with everything else up to this point. Knowing that this was a goal of mine, I had been incorporating volleyball-specific movements in the gym in a controlled environment. I proved to myself that I could land safely on two legs, and then one leg at a time. I could move laterally, forward and backward and change directions relatively quickly and proficiently. I went to an indoor practice with a women’s team where I did not jump. I stayed on the ground and sussed out how I felt reacting to the ball. It felt amazing. I took it easy and avoided diving for a while.
In February (almost a year after the initial injury), I was able to play beach volleyball with my friends. I was in my happy place again. So happy I definitely cried. The sand was forgiving on my joints and I felt good diving around for balls. Jumping felt hard and I felt slow, but that would come back with time.
Some people think that the rehab process would be complete at this point. But I knew that this would be something I’d have to keep up with and nurture for the rest of my life. I was absolutely determined not to experience something this devastating again. So, my rehab turned to preventative mode. I was dedicated and committed to keeping the tissues around the knee strong and mobile. I still had work to do to match my right and left legs in terms of strength and power output.
Another milestone worth mentioning that will hopefully provide hope and inspiration for others going through this process is that I was able to complete the multi-day hike on the West Coast Trail in September 2019 (a year and half after the initial injury). This is a 75km rugged, unforgiving hike along the west coast of Vancouver Island. It was the ultimate test of endurance to see if all the work I’d put in worked.
My personal exercise regime changed quite a bit and I learned a lot going through it. I learned to train more specifically for my activities of choice and also lean into finding and working on my weaknesses, instead of simply the things I’m already good at. In my case, I love heavy strength work, so it meant I would park that for a bit since I already had a good base of strength and incorporate more plyometrics, more explosive and more endurance exercises. I learned that working on absolute strength was not necessary for me to enjoy life. I learned that I am not superhuman and I need to respect what my body needs to perform it’s best in the things I love to do.
I’m lucky that it happened at that point in my life. With 8 years of coaching experience and an accumulated knowledge of biomechanics, anatomy and physiology, I was more prepared to deal with this than if I had been in my younger years. I’m grateful that I experienced that long rehab process as it’s made me more empathetic and given me a greater understanding when working with clients who are in the rehab process, regardless of their injury.
So, if you’re going through something similar, my message to you is stay the course, work on baby steps and know that through the good days and bad, you will heal.