The first thing I say to people about tearing my ACL is “I don’t generally recommend it.”
On a lovely fall day in October 2015, I and some girlfriends went to an apple picking farm for some wholesome fun. This particular farm has a jumping pillow: a huge inflated rubber pillow affixed to the ground that kids and adults can jump on. It is surprisingly springy, more like a trampoline than a bounce house, and is lots of fun. Until and unless you are jumping and land wrong and your knee goes “pop!” and everything changes.
Although we haven’t been posting very much here on Tiny Fix lately, rest assured that your squad is still out there riding. I was riding my bike to work every day, rain or shine. I had plans to keep riding through the winter, as I do most years. I was also regularly running 5Ks and was signed up to do the Hot Chocolate race in late October.
Tearing my ACL was a huge blow to my ego, my identity, and my day-to-day life. I had to travel to a work conference four days after my injury, so with only a ¯\_(ツ)_/¯ diagnosis from urgent care and an off-the-shelf brace, I flew to Salt Lake City and worked a conference for five days. Looking out the hotel window at the mountains in the distance, and knowing that I couldn’t explore them with my free time before my flight home, was the first taste of the next several sad months of my life.
After my official diagnosis (and discovering I am terrified of MRIs and need hella valium to successfully complete one), my orthopedist recommended 6-8 weeks of physical therapy. Because my preferred activities of cycling and running don’t require a ton of side-to-side stability (“you can run a marathon without an ACL,” according to my doctor), it was possible that physical therapy would have been enough to get me back to where I was before the injury. And should we determine that surgery was needed, this “pre-hab” would lead to better outcomes post-surgery.
All I knew was I wanted to get back on my bike.
Unfortunately, at the 8 week mark, I was still experiencing moments of instability and didn’t feel confident attempting to run or ride my bike. So, it was on to surgery, replacing my missing ACL with the patellar tendon from a tissue donor (cadaver), and a much longer 6+ months recovery. While in the long term, surgery will lead to a stronger and more stable knee, in the short term it is a very traumatic event that requires extensive physical therapy to recover from; it’s way worse than the initial injury. You literally have to teach your muscles how to fire again, while your bones heal from having screws drilled into them.
It has officially been 6 ½ months since my surgery, and while I am finally approaching my previous levels of activity, I am not at 100% yet. According to my physical therapist and others who have been through this, it could be a year or more before I stop thinking about my knee all the time and things are fully back to normal. I still limp down stairs.
While I could ramble on and on about my experiences and how they related to cycling, I will distill it down into a few bike-related things I learned about having knee surgery:
Cycling is a huge part of recovery. The good thing about being a cyclist is that the motion of pedalling is critical to recovery from knee surgery. Early in the process, it’s all about range and fluidity of motion. Pedalling, first on a device called a Camo Ped, and later on stationary bikes, began literally one day after my surgery. Man, that first day trying to pedal on the Camo Ped was awful. There was a good amount of pain but more so I could feel the extra fluid in my knee squishing back and forth with each stroke. Ew. But starting with my first week at physical therapy I was gingerly pedalling on a stationary bike. We started with the seat too high, at first, because I couldn’t bend my knee enough to bring the pedal around, eventually lowering it as my range of motion improved.
Long term PT is exhausting and without motivation it can be tempting to ease up on it. Writing about those first few weeks of recovery just now felt so strange, because it seems like a lifetime ago. It was only six months, but when you’re in the midst of it, it feels like forever. Progress comes in jumps and starts, with frustrating periods of plateau in between. Knowing that the sooner I could get on my bike, the sooner I would be able to stop riding my crowded, stinky, frustrating city bus to and from the office, was a major motivator in those down times.
I took my ability to be active and to get around Chicago for granted. I live on the 4th floor of a walk-up apartment building. My bus drops me off on the lower level of Michigan Avenue, and getting into my building from the loading dock isn’t always possible. No one fucking shovels their sidewalks. People on the bus or train don’t want to give up their seats. Despite all of our attempts to make this city accessible, there are large swaths of it that just aren’t. As cyclists, we know what it’s like to encounter and have to travel through infrastructure that is less than ideal or outright hostile to us. This experience made me realize much more viscerally how that is a thousand times worse for people who are less ambulatory.
People ride their bikes like assholes. Oh my god, now that I’m back on my bike commuting to work every day, I am experiencing Chicago cycling culture with fresh eyes. SLOW THE FUCK DOWN, PEOPLE. And if you can’t slow down, please say “on your left” when you pass. I can’t control those of you that jump red lights at 6-way intersections or lane split between a city bus and a cement truck, much as I would like to. But please, if you do one thing, be more respectful of people riding slower than you for whatever reason: give notice before you pass, and make sure you have the room to do so.