How do you 'get out there' when you are injured?

[icefest]

After injuring my knee yet again, I finally had an MRI which found I have a torn meniscus and ACL. Voltarin has been a good friend and physio is helping me rebuild the right muscles to improve stability. Going to speak to a surgeon in a few weeks...

I still really miss our pack walks but paddling has been a bit of a savior in getting us out there. We took the kids on a four-day canoe trip down the Glenelg River which was lots of fun and a bit of a glamping experience with everything that you can fit in a canoe - including the esky. The downside was that we didn't feel like all that remote and away from things because of all the people in fishing boats, speedboats/waterskiiers, and loads of other paddlers. The upside was we met some lovely people.

If you want to get away from the crowds on the glenelg, head north from the highest campsite (or if the river is up a bit, paddle down from casterton).

[DarrenM]

Never heard of the beef collagen Darren and I am too much of a sceptic make a useful comment on that but, despite my sceptism I gave a Combo of fish oil and glucosamine a try for my arthritis a few years ago and I have to say it woks.

For those who would suggest it is the placebo effect, who cares. Any relief is good relief which makes me a happy camper(cyclist, gardener, wookworker, fisherman, bread kneader et al)

Thanks Empty, I'm generally sceptical also but had heard from a reliable source that it helped improve some arthritis pain when using it for something else. It's not for my own use as I'm not that far down the track......yet.

[north-north-west]

Never heard of the beef collagen Darren and I am too much of a sceptic make a useful comment on that but, despite my scepticism I gave a Combo of fish oil and glucosamine a try for my arthritis a few years ago and I have to say it works.

Yep. Only been on the glucosamine/chondroitin supplements for about 6 months, but the improvement is massive. Wish I'd done it years ago.

[stry]

Never heard of the beef collagen Darren and I am too much of a sceptic make a useful comment on that but, despite my scepticism I gave a Combo of fish oil and glucosamine a try for my arthritis a few years ago and I have to say it works.

Yep. Only been on the glucosamine/chondroitin supplements for about 6 months, but the improvement is massive. Wish I'd done it years ago.

The vet injects my dog with some really good stuff (cartrophen). If I could get a similar improvement in myself to the improvement in the dog, I'd be pretty pleased.

[icefest]

Interesting stuff, pentosan polysulfate (Cartrophen), I'll be interested to see some long term studies.

DMAODs have a long way to go, and If the mechanism of pentosan polysulfate's action against OA becomes known it might lead to similar durg with a greater than 5% oral availability.

[Suz]

SimOz1, you have a quite similar injury to me (ACL tear), (mine was ACL, MCL and PCL but without a meniscal tear). So, from what the GP, surgeon and physios have all told me - you can do anything in a straight line! The ACL's weakness in your knee will become apparent when you stop and pivot on the affected leg. I don't know anything about the meniscus tho. I can't hike either for the risk of slipping - I've already had my surgery (1 month post op now) and have to wait for another 11mths to do any real hiking (well I'm gonna bug my surgeon about that when I next see him). BTW, you have a LONG recovery ahead of you. If you have private insurance YAY! because I waited 10 mths for my op thru medicare. So total time out from hiking = 2 years.

So straight line things you can do are e.g. bike riding and stuff that doesn't involve the knee like kayaking which you're already doing. It is good to have strong muscles around your knee to support the joint, so bike riding would be good for that. I didn't do anything for my year awaiting surgery (sat around and sulked because I couldn't play basketball), I have lost a lot of muscle and gained a lot of fat lol - but oh well.

RonK - I also get serious knee pain on descents and perhaps you and I have different problems but…I always thought the issue was with my degeneration in my knees (I have been wearing orthotics since I was 15 due to wear n tear on the cartilage causing bone on bone grinding). But apparently with 20 years of orthotics wearing these days my knees are very nice n healthy inside - surgeon told me my knee looked perfect inside apart from torn ACL and some meniscal bruising - both from the injury. My sports physio diagnosed my knee pain on descents as patello-femoral pain which is a treatable condition with strengthening exercises of the vastus medialis oblique (vmo) (i.e. inner quad muscle). I had all the tell-tale signs of the condition which I will work on fixing in conjunction with my ACL rehab. (The signs are basically - weak, underdeveloped vmo, a knee cap that doesn't sit flush on the knee when leg straightened - because the outer quad is pulling the knee cap away from the centre), tight ITB, hammies and calves and also flat footedness). I am yet to find out whether these exercises will help. Apart from that, descending REALLY slowly and using walking poles prevents flair up.

[Pika]

I used to work for an NRL team.

The stuff they used to patch me up with was amazing.

I may have felt like a pin cushion, but the results!

Collagen, blood injections, cortisone etc.

I miss that stuff.

[GPSGuided]

I used to work for an NRL team.
The stuff they used to patch me up with was amazing.
...
Collagen, blood injections, cortisone etc.

The objective there is to get you back on the field and make money, not necessarily aiming for a long term cure. So be careful! Cortisone can make people feel euphoric though hopefully not in the doses you received. It's also a very powerful anti-inflammatory and can mask many underlying issues. So don't be too happy and wanting repeats.

Pentosan polysulfate doesn't sound too practical for human application. Strange the Wiki entry on human clinical trials didn't mention outcomes. Suspect it's being managed by interested parties.

[sim1oz]

Hi Suz, there are definitely a lot of similarities in our knee condition and limitations - you described it to a tee - anything that is straight is fine. I'm doing lots of leg work and pilates with my physio to build up my VMO (never heard of it until a few months ago), glutes, quads, and some other muscles I never knew about. My patella seems to be sitting nicely now, and all the swelling is finally gone after 3 months

I'm seeing the surgeon next week so I'll know exactly what I am in for and the timing. When I saw the orthopod he said 9 months recovery.... I just keep holding on to the dream that my knee will be FIXED and I can get back to proper walking again. I used to walk everyday, near home or out bush, and I am really missing it.

I'm fine to give up running and basketball. I'm enjoying the kayaking and am trying to persuade my other half that we should get some packrafts. I've been riding on a stationary bike every day but haven't got round to fixing up my normal bike to go for a ride. I need to give it a good 'service'. But I really miss my walks...

[JohnStrider]

My knee can sometimes hurt a little after hiking, but not sure if it's temporary or it's my body telling me that it doesn't like what I'm doing.

Would I be better off seeing a physio first or getting an MRI/X-ray to see what the go is?

[GPSGuided]

JohnStrider, suggest you see a health specialist first if you are so concerned, be it your GP or a physio. MRI/X-Ray may supplement the clinical diagnosis but it's not the sole mode to a diagnosis.

[Suz]

Hey JohnS, you'd have to get referred by your GP for diagnostic imaging anyway…so there is no choice but to see your GP first. Or just go and see a physio (get people to recommend good ones in your area - they are not all of the same quality) and see what they have to say.

Sim1oz, well you're working hard now which is good Yup 9mths post op waiting time til activity is middle ground, if you have the same surgical technique as me your graft will not reach full strength til 1 yr post op. I had the hamstring tendon autograft - there is also a patella version - your surgeon will decide which to do. There are also allograft versions where they take bits from dead people! If you have the hamstring version you have to be careful of your hamstring tendon post-op for about 10 weeks til it recovers. And also you need to start your physio pretty much straight away post-op (your physio has probably already told you this tho). Gotta be able to get that leg fully straightened within a week, they will hammer that into you.

[JohnStrider]

Cheers for the suggestion, folks

[Drew]

I'm seeing the surgeon next week so I'll know exactly what I am in for and the timing. When I saw the orthopod he said 9 months recovery.... I just keep holding on to the dream that my knee will be FIXED and I can get back to proper walking again. I used to walk everyday, near home or out bush, and I am really missing it.

Sim1oz - as I said to Suz in another thread the other day, I did my first post-ACL reco overnight hike in late August 2013 after mid April 2013 surgery. It might not be the same for you, but there's hope for some walking sooner than 9 months post-op!

[sim1oz]

Suz, I will find out on Wednesday but hamstring tendon autograft is what has been mentioned so far. I'll keep working hard. Now that I am doing exercises very targeted to specific muscles it is quite fascinating to see them visibly change and also feel the difference in the degree of control I have over activating particular muscles.

Drew, thank you for offering some hope!!! Where did you walk? I'm trying to think of somewhere 'gentle' for me to start back, so ideas are welcome. Most of my usual places are probably too intense. How quickly did you move from overnight to multiple night walks? I still haven't done the GOW so perhaps that's a nice way of easing back in after a few overnighters.

[GPSGuided]

My stomach turns every time I hear of people trying to push their 'return date' based on others' anecdotal experiences. Just remember, healing of human tissue is a continuum and there's no sudden transition point from weak to strong. Excessive early load may undo all the prior treatments and may require redo surgery, when it's always messy with much poorer outcome. Be patient and wait for professional advice and ease back gently.

[Bluegum Mic]

Yes Sim and Suz. I too have completely ruptured ACL, MCL and PCL (no damage to meniscus). I did a 3 dayer up in the snowies 6 months post op but was walking locally on the GNW from 3 months. Everyone is going to heal differently but be diligent with your post op rehab. My reconstructed knee feels better these days than the other. The only thing it doesn't like is a straight lateral movement. The LCL never really healed but thankfully it just doesn't affect me often. Good luck ladies

[Suz]

Bluegum Mic, how did your knee actually feel after those 3 days in the snowies? Shame about the LCL - did you smash up all 4 ligaments at once?

I'm going to get on the GNW and walk little bits as soon as I'm allowed - it looks like quite a bit of it is fire traily - so nice and safe. One of my other physios said today that my planned 2 week hike 5mths post op is actually a good idea as it gives me something to work towards! YAY! So now it's 2 Yeas and 2 Nays from my 4 physios (it's funny how they are all different…even on whether particular exercises are helpful or not to my rehab). Anyhow, hopeful news on hiking the Kungsleden today and I'll see what El Cirujano has to say in a few weeks.

Sim1oz, I was thinking about our injury the other day, and you know what conclusion I came to? We need a team song. Here it is:
Silverchair - Straight Lines. Note here, the 2nd half of the chorus:

"Waking up strong in the morning
Walking in a straight line
Lately I'm a desperate believer
But walking in a straight line"

[Bluegum Mic]

It felt fine Suz. I get the occaisional problem with pes anserine bursitis on really long days (20+kms) but aside from that the knee is fine. As for how I did it. Skiing injury (first in 18 years of skiing so I'm pretty lucky there). My ski caught a rock on its back edge which twisted my ski inwards..my momentum was forward= knee dislocated out sideways. You should have seen how buckled the binding was.
Its exactly what I did. I set a goal to be up Kosi on foot in six months and back on the slopes within twelve. The latter was nerve wracking but I did it =D

[sim1oz]

@GPSGuided, I do understand what you are saying and will ultimately follow my physio and doctors advice, it's just nice to hear about walking again post-op. I want a FULL RECOVERY so if I have to wait longer I will, I've waited a long time already...

[GPSGuided]

Fully understand your eagerness and frustration. Here's hope that all will work out for you. Just make sure it's all done sensibly and not over do it. Ligaments and tendons take a long time to recover.

[Suz]

It felt fine Suz. I get the occaisional problem with pes anserine bursitis on really long days (20+kms) but aside from that the knee is fine. As for how I did it. Skiing injury (first in 18 years of skiing so I'm pretty lucky there). My ski caught a rock on its back edge which twisted my ski inwards..my momentum was forward= knee dislocated out sideways. You should have seen how buckled the binding was.
Its exactly what I did. I set a goal to be up Kosi on foot in six months and back on the slopes within twelve. The latter was nerve wracking but I did it =D

Ooh nasty and unlucky was to do it. Good recovery tho

Good to know about your exp. after 3 days hiking. I will try to avoid doing long days if I go to Sweden to prevent inflammation build up. Just mosey along and enjoy the view and bear the extra food weight. I also don't wanna risk getting 'tired' as that increases the risk of a slip. I am a bit obsessed with seeing the Rapa Valley and I'll be soo close, I hope my surgeon says it's okay!

[sim1oz]

had my knee reconstruction and meniscus trimmed a week ago. Planned a two week trip to NZ (routeburn, kepler, milford, kayaking) for next Feb/March as something to look forward to, keep me sticking to the rehab schedule and then train back to packwalking fitness. But this week i am seeking to keep sane by watching outdoor vids and reading blogs so everyone PLEASE POST now would be a great time to write up some of those trip reports - they will be appreciated x1000000

[Suz]

ha ha! I got really into 'hiking movies' right after my surgery - I was obsessed for about a month. I recommend some of the films on this list: http://www.backpacker.com/view/photos/c ... or-movies/

Anyhow, good luck with recovery.

[sim1oz]

Thanks! I am off crutches and diligently following my rehab schedule. I'm even managing to get some good wall squats done each day. I've booked a tramping holiday for NZ next year to give me something to look forward to. I have a tendency to jump back straight into things so I am waiting until my physio gives the ok to do more, as she is probably a better judge than I am, but it is still so frustrating. She is a bushwalker and paddler so I do trust her judgement. Off to watch another 'hiking movie'!