Week 5

Sometimes things just seem to come together.

One Saturday morning, the day after my post on how I was having doubts about returning to climbing, a copy of Climb Magazine arrived through my letter box. Inside was an article on climbing coaches on how they can help climbers develop.

One of the case studies featured was a lady called Dawn who had started using a climbing coach following knee surgery (following an injury sustained at an indoor boudlering wall- I would say snap, but that sounds a little inappropriate given the context). She talked about how , through coaching, she regained a lot of her confidence, as well as her physical skills. She said that she would definitely recommend coaching for anyone with issues with confidence, especially coming back from an injury.

I hadn't considered coaching before. I have seen people training with a coach at my local wall, but I am very self conscious and the idea of paying someone to watch me climb gave me sweaty palms. When I first started climbing I would find the room with the fewest people in and climb the problems there, and I never, ever climbed in the room in front of the reception. I know that in reality nobody is really paying any attention to what I'm doing, but that doesn't stop me from feeling self conscious and shy.

I will definitely consider giving coaching a go. In general I would say it isn't for me- I climbed because I enjoyed it and while getting better was satisfying, I was content to improve at a slower rate just by climbing a lot.

I hadn't really thought about coaching for confidence or psychologically getting over injury. I might try dipping my toe in the water and attending some of the free women's and improver classes held at my local wall to see if I would benefit from some instruction, or if its more stressful than helpful.

Week 4, part 2

Since I have started on some exercise that ultimately aims to smooth my return to climbing once all of my physical rehabilitation is complete (in about a year from now), it seems somewhat deceitful not to discuss an issue that has been playing on my mind for several months now; I'm not sure I want to return to climbing. (Not to mention this blog is meant to be about getting back to the wall).

Prior to my injury I was climbing 4-5 times a week, and I had just started to make trips outdoors (I had only been climbing for a little over a year when I was injured). I really loved climbing, and whilst I was nowhere near an advanced climber (a single v7 (indoors), after a good couple of weeks work is the hardest I have ever climbed) I had made quite a lot of progress in the latter part of the year (I started with hardly any upper body strength and it took me months to be able to climb even the simplest v0 over hangs). I was running a couple of times a week, trying some upper body, finger and core conditioning exercises and doing a lot of stretching to improve my climbing (I'm not tall, and not hugely strong, so my climbing was really based around my flexibility). Basically, a lot of my time revolved around climbing.

When I first had to stop climbing due to injury I missed it terribly. There were huge gaps in my schedule where climbing and climbing related activities used to be and I didn't know what to do with my time. However, as the months past that desperation to get back to the wall faded and I just got used to not climbing.

Now, I look at videos on youtube of the bouldering world cups, or see my friends trying problems and I wince at every drop knee, every fall. Instead of a really interesting or fun problem and great technical skill all I see are the many ways you could injure your knee. As much as I have learned to cope with being injured and it definitely isn't the end of the world, I really doubt I have the mental strength to go through what will in the end be about 18 months of rehab again.

I am starting to prepare myself for a return to climbing, building up my finger strength etc, so that I can decide much later down the rehab line if it is what I want to do. In some ways I know that this is stupid, my fall was very unlucky and I could do exactly the same injury slipping in the street, but at the moment I feel like I would psychologically hold myself back. I want to climb because I enjoyed it. If all I end up doing is thinking about my knee and the possibility of injury the fun will be well and truly zapped out of it.

There isn't a proper conclusion to this post because I haven't worked out what I want to do yet. Part of me thinks I won't know until a year from now when I try a problem again for the first time. I just wanted to share my doubts because I think there's more to injury rehabilitation that the physical.

Week 4

I have become a bit frustrated by the extremely slow rate of progress with my knee. I'm still using a crutch and in the past three weeks I have barely left the house save for a trip to the hospital and the doctor's surgery. This is in part because I can't get public transport anywhere unless I can be guaranteed a seat, and I can go anywhere in crowds because whilst walking in a straight line (with the aid of a crutch) is pretty easy I can't do any twisting to move out of anyone's way. I'm lucky that I can work from home so I don't have to take a huge amount of sick leave to cover this period.

I get over these frustrations and stop myself from slipping in to a low I have decided to slowly start trying to build up my finger strength. When I first injured myself I did try to maintain my upper body, core and finger strength, but after about six months when it became clear I wasn't going to be climbing any time soon my motivation disappeared and that all fell by the wayside.

I have read a lot about how to improve climbing you need to work on developing technique rather than strength. While I believe that this is true, 1. I can't work on technique now so it's strength or nothing, and 2. I think that these 'how to improve' guides are often written with men in mind. Since men build up their upper body strength faster than woman it is much easier for them to make huge gains through a bit of strength training ling before they have developed even basic technique than it is for a woman to get to this position. I'm also hoping that I will still have some of my technique left when I return to climbing (though at this point I don't feel like I remember anything). 

The first thing I have been using is a Powerball gyro (I say have been using, I have started to use it again today).  You circle your hand clockwise and counter clockwise working your forearm muscles, and depending on how you hold your arm, your supper arm muscles too. The faster you circle, the tighter you have to grip, so there is some grip work there too. I mainly just use this to warm up and get some blood flowing in to my arms because attempting any finger work (even fairly gentle stuff) without warming up first is just asking for a tendon strain.

I used to use this on my way to climbing for about 10 minutes on each arm (5 minutes clockwise, 5 minutes counter clockwise) so that after some dynamic stretches I was able to hop on the wall without tearing my tendons to shreds. I can't do 10 minutes at the moment, and since my knee meas I won't be climbing anytime soon there is very little point in pushing my fingers at the moment, so I'm doing 6 minutes (3 clockwise, 3 counter clockwise), and at a more gentle pace than before. I can feel my forearm and biceps working as I do it, which is quite nice in a way, it feels like I'm doing something.

The next thing I am using is the Gripmaster Pro medium tension. I also own the heavy tension, but after a couple of months of no finger work at all the medium tension is really all I can manage at the moment. I used to use my heavy tension grip once of twice a week prior to injury. I really only bought it so I had something to do on the bus to work, because i figured this was dead time otherwise. I'm not sure how effective it is, but I think it did help my open palm holds which makes finger injuries less likely.

This Grip master allows you to practice an open palm crimp type grip, and a pinch type grip. My pinch has also been quite weak so hopefully I'll be able to build it up a bit. I am alternating hands and grip styles and holding each grip for 12 seconds (12 because I like the number 12). I'm trying to do 4 repetitions of of the crimp, and 4 or the pinch on each hand.

My aim is to use this Gripmaster before moving on the the heavy tension model, and then on to a hang board before I return to climbing. The hang board is really the best way to practice grip strength, and the only way that I think I will be able to practice slopers (which I love).

In the coming weeks I want to add in some core and upper body strength and conditioning exercises. I think the core is especially important for climbing, so I'd like to be able to get that into good shape so that (hopefully) I don't just flop all over the place. I really can't wait to return to stretching. I think that will have to wait until at least 12 weeks post op when the graft is getting stronger, but it is something that I am really going to enjoy getting back to.

Week 3, part 2

So the last few days have been a bit of a regression.

I had the remains of my stitches removed last Thursday. However, I had a bit of a scab at the end of the incision where they took out the hamstring for the graft, and after this washed away it revealed some more remnants of stitches. These poking out of my skin have prevented the wound from fully closing over, and have become a little bit infected with a little reddening and some discharge.

I've been to see my local doctor, however she said that as the rest of the wound has healed and the operation was over 3 weeks ago, the chances of a proper infection setting in are small. As the stitches are meant to be soluble she predicted that they would eventually dissolve, or if they haven't by the next time I see the surgeon (3 weeks from yesterday) he could remove them. She thinks that tampering with it might just lead to greater problems.

My knee has become a little more swollen and tender and I am back to using two crutches, having reduced to one last week. I can bear weight on my leg, but it feels very bruised and it quite painful. My limp has also got worse. Going back to two crutches is a little bit frustrating since I was told that I wouldn't even need crutches at all two weeks post surgery, but there isn't much I can do about that. I thought that this might be due to the infection from the stitches, but the doctor says its more likely that I was just a bit too keen and did a little too much too soon.

In general the slow pace of recovery for the last few weeks has been a little frustrating. I knew it would be slow, but it doesn't really make it any less annoying.

Week 3

With all the dressing removed so begins 'scar watch' 2014...

To be honest I thought it was going to be much worse. The largest incision (where the graft was taken from the hamstring) is only an inch and a half or there abouts. I had visions of a 15cm line down the middle of my calf.

I still have residue from the dressing on my knee, but my knee and shin are still very tender so I can't do any scrubbing to remove it. I also can't rub any ointment into the skin as it feels like I'm pummeling a very purple bruise (sadly I know this from experience). This means that the attempts to reduce the scarring will have to wait for now. They should probably wait anyway because the largest incision isn't quite fully healed yet. The stitches are soluble and the surgeon remove the remnants at my last appointment, however I seem to still have a few bits poking out. I'm hoping that they will just dissolve on their own. If not I'll mention them when I'm back with the surgeon in a few weeks time.

I'm still icing my knee and keeping it elevated as much as possible because it is still quite swollen (though nowhere near as bad as the initial injury, and going down far quicker). I don't really have that swollen fluid/ leaking fluid feeling in my knee anymore, which is nice.

I still haven't received my referral to physiotherapy, however I'm not too bothered by this at the moment because I think I'm fairly limited until the swelling reduces properly anyway. I'm still using a crutch and moving with a pronounced limp. I don't know if the two are connected, but it rained quite heavily yesterday and my knee felt very stiff which made my limp even worse.

Week 2, part 2

Today I went for a review with the surgeon. It was the first time I had really been outside the house (excluding the garden) in a week and a half. For some reason walking on the pavement outside seemed a lot harder than walking around the house. I think crossing the road it was hard not to feel like you wanted to rush, especially when holding up traffic, and my knee felt a little battered after the short walk from the car to the hospital.

I was using one crutch but might consider using two outside the house at the moment, not least so people give me a wider berth because I  cannot twist to change direction AT ALL. The surgeon said that after about six weeks I should be limp free.

I had my dressing removed by the surgeon and the last of the soluble stitches cut out. I was told by the surgeon that I wouldn't require any further dressing, at which point my knee promptly started bleeding again. I've got some more dressing again, but I've been told to take it off after a couple of days.

I've decided not to post any photos of my leg sans dressing because it looks a little gory, but I will begin 'scar watch 2014' just as soon as I start applying the bio oil.

I'm taking painkillers twice a day at the moment. When I wake up in the morning the front and aide of my knee and down the front of my shin bone feels like a curious mix between battered and bruised, and suffering from that stinging feeling that you get after you have been cut.

I'm having an xray of my knee and another follow up in four weeks time, and I've been referred back to physiotherapy, so hopefully I can start making some progress soon. I am still struggling with bending my leg, not least because I feel the skin in very tender and pulling.

Week 2

Over the weekend my leg became really swollen. It was pretty painful and I don't think the hot weather helped. I have one ankle and one definite cankle.

 Left foot

The right foot for comparision.

I've been a bit more conscientious about that elevation part of the P-R-I-C-E principles to try and help some of he fluid to drain. It's helped a bit but there is still a fair bit of swelling. The internet says that this can last for up to 3 months.

Also during the weekend I slipped sitting down (I misjudged the height of the chair). This gave me a sharp pain in my hamstring and I've noticed a reduction in my range of movement as well as additional soreness at the back of my thigh. I'm continuing with my physio stretches, but being even more gentle than usual until the soreness subsides.

Day 4

Today I have slept, a lot. My leg seems to cause me more pain at night which makes sleeping difficult. Also, I normally roll around to try and get comfortable, and sleep on my side a lot, which I can't do at the moment (I'll lying flat on my back- sort of sardine style).

I've had a few moments today where I've felt something inside my knee 'pull' a little- it's a very sharp pain and sometimes it feels like the knee gives way a little bit. I don't know if this is because the swelling in my leg has started to go down and now that the 'padding' is disappearing there is more room for the knee to wobble? It might also be because I've become slightly less cautious on my crutches.

I can feel the fluid starting to drain from my leg, which is an odd sensation. It feels like I have liquid running down my shin from my knee (as an open wound leaking blood might feel), but you can't see anything on the surface. When this started happening after my initial injury I would actually stop when I was walking so that I could pull up my trouser leg and check I wasn't bleeding everywhere.

My doctor's note keeps me off work for another week. I have to admit that I thought that this operation would mean I couldn't walk, but that I could just use the sitting time to practice my Portuguese and really get better at the language. As it turns out as well as being largely immobile I feel pretty rubbish a lot of the time and I also feel exhausted a lot even though I'm hardly doing anything so the time isn't really being used very productively.

I've made quite a lit of progress with my knee bend, which is good to see, but my knee still feels really tight and stiff (except for those occasional wobbles). I don't know if some of it is the plasters that I have covering the incisions pulling, but it feels like my skin might burst open if I bend my leg any further.

Day 3

Last night I had a pain in the back of my ankle that I can only describe as akin to being stabbed with a searing hot poker. I'm not really sure what was going on there- I guess that it has something to do with the hamstring graft, but I wasn't really expecting pain not in my knee.

I have been trying to get an appointment with my GP to discuss my return to work, and to ask a few questions about the pain and the swelling. I would feel a lot happier if I could just check with a medical professional that what is happening with my leg is within normal limits and there isn't anything to be worried about. I haven't been able to get an appointment with a doctor and I've been told the next available appointment is the 1st of July, which is pretty useless. The literature that I was given from the hospital says that you will be visited by a nurse to change your bandages and check up on you, but I was told I would need to change my own bandages because I guess budget pressures have dispensed with that service. It's a bit of shame, just for the purpose of being reassured if nothing else, and maybe spotting the person who is experiencing problems once every so often, but well, that's how it is.

I know that it has only been a few days since the surgery, but it is hard not to get frustrated with everything being so slow. Everything takes a really long time at the moment- getting up, getting around, and everything seems to take a lot more effort that usual, not least because I'm having to consciously secure my balance all the time.

I've continued with the physio but I'm yet to see improvement (I know it's been a couple of days since I started), but I'm hoping that this is one of those things that is slow at first and then really picks up the pace.

To stop myself from getting too down in the dumps I've spent a little time sat in the garden sun until it got cloudy because the summer doesn't seem to have properly arrived despite it being LATE JUNE.

Day 2

Today I have started to do a lot more icing of my knee- 20 minutes every 2 hours. My leg feels quite swollen, it has a squishy full of liquid feeling. This (so my hospital literature tells me) is normal and can stay for up to 3 months. Excessive movement and exercise can aggravate it, so there has to be a balance between helping the liquid drain and the swelling go down, and doing physio to try and build up the leg muscle and develop strength and control in the leg.

I'm still taking pain killers and feeling quite nauseous. I'm only eating plain food at the moment and I'm having to eat fairly regularly as I seem to feel worse when I have longer gaps between food. The ibuprofen I'm taking should hopefully help with the swelling as well as the pain. I'm also taking something paracetamol based- so nothing all that strong, but it is doing the job.

I've started the very basic physio exercises that I was given prior to leaving the hospital. I'm doing quite well gently pushing my leg straight- it's not there yet, but it's pretty good. After the initial injury it took months and months to get my leg fully straight again.

However, I'm really struggling with bending my knee. I'm trying to do heel slider exercises where I sit on the floor and pull my heel in towards my butt, bending the knee, but I can barely get anywhere.
The worst thing about hardly being able to bend my knee at the moment is that getting dressed is really hard and involves a lot of lying down shuffling to get my shorts over my knee.

Since I'm not going to see the doctor until next week I'm reluctant to push anything so I may be going a bit too slow, but I'd rather that than doing too much and damaging the graft.

I've started to put some weight through my leg, but using both two crutches so in reality most of my weight is going through my good leg and my arms. I don't feel very confident standing on my operated leg, but I think that some of that might well be psychological rather than due to physical instability in the knee. I can't walk properly because of the lack of full extension and bending in my leg, so I'm really only standing on the ball of my foot, but I guess it's some progress.

Day 1

I still have very little feeling in my operated leg meaning that I'm still hopping on crutches rather than walking. I'm also still having problems with low blood pressure and dizzy, nauseous spells. To avoid any falls it means that I am getting up as little as possible.

My leg has been twitching an awful not, which combined with the limited feeling in the leg gives a strange zombie leg sensation. I am wondering if some of the lack of feeling is due to the elevation and compression bandage, because my left foot looks a tad more purple in comparison to my right.

Over night I slept with my leg slightly elevated and as straight as I could get it (swelling and bandages mean its about 160 degrees rather than 180. I've already got pretty good range of movement, but it's hard to tell what my limits are because of the numbness I have in my leg. I'm doing very small amounts of physio, gently trying to bend and straighten my leg. I've been told that it is essential that I do these exercises with my foot on the floor because having my foot off the floor can stretch the graft. The graft at this point is getting weaker and doesn't have a blood supply so I need to take this easy because my nightmare would be to damage the graft now and be left with a wobbly knee for the rest of my life.

Today I could have a shower, but had to keep my leg dry, which leg to some creative work with a plastic bag and a roll of duct tape. Despite my best efforts my leg under the bag did get a little damp and I had to let my plasters air dry before I put on my tube grip. I hope that my soluble stitches didn't get too wet and haven't dissolved ahead of time (it's meant to take 10-14 days).

Because the plasters aren't being removed yet I haven't had sight of my scar yet. I have the type of skin that scars really easily, and the scars take FOREVER to fade (as evidenced by my good leg showing marks from my trip to Font almost a year ago). I've already got some Bio Oil on standby to try and reduce the scarring, but I'll have to wait for the wound to close before I can start applying it. I haven't had the success with Bio Oil and scar fading that some people seem to have, but I figure I haven't really got anything to lose.

Day 0

So today was the day.

 Pre surgery

 Post surgery

I had a 4 strand hamstring graft from my left left to replace my left knee ACL. My menisci couldn't be repaired (which I think is pretty common), so both menisci were trimmed and my bone has shaved to fit (I assume this is to reduce the bone on bone crunching, but to be honest when I saw the doctor post op I was still pretty out of it so these questions didn't get asked). Hopefully I'll find out some more at my 10 day follow up. My MCL has been left to sort itself out, and my PCL wasn't in bad nick so that has been left as is.

I've been told surgery went well, I'll take their word for it. I went into theatre and the last thing I remember was the surgeon telling me he was going to listen to jazz while he worked. I love jazz so I took it as a good sign.

The only hiccup was that post surgery my blood pressure plummeted to 75 over 50, meaning I was pretty dizzy for a long time post surgery and my physio (learning to use the crutches, and how to get up and down the stairs) had to be delayed.

My knee if still bandaged, and 12 hours post surgery my leg is still numb. The numbness means that I have no stability so I'm hopping on my good leg using crutches, but I hope to start walking using the crutches tomorrow. Hopping up and down the stairs is a little scary. I nearly fell during my practice. The possibility of damaging my graft is playing heavily on my mind, so I'm taking things slow and will be sleeping on the sofa tonight to avoid the stairs to my bedroom.

Tomorrow I start with basic physiotherapy- the aim for this week is full range of movement, work on strength will come after that.

I feel a little Rear Window, but I've got the world cup to keep me company and I haven't seen anything that looks like a murder out of the window yet.

An introduction of sorts

My name is Irene and I have an injured left knee.

In September whilst trying a slab  route during a bouldering session I slipped and fell, catching my foot in a jug belonging to a different route set on the same wall. This caused my knee to twist as I fell, leading to a pretty sickening crunching sound and an inability to put any weight on my left leg.

After the swelling (and there was A LOT of swelling) had gone down an MRI showed that I had completely ruptured the anterior cruciate ligament, strained the medial cruciate ligament and torn the meniscus. I don’t do things by halves.

Prior to my injury I was pretty active. I ran middle distance, did a lot of stretching, and a bit of swimming, but my main sport was climbing (specifically bouldering). I would describe myself and a super keen amateur- I really just want to do something I enjoy, but to push myself to do it as well as I can.

Since the injury I’ve been doing physio (a whole lot of squats) and waiting for surgery. I have regained full range of movement in my knee and can once again touch my toes, but I can’t do much in the way of really stretching my legs without ‘popping’ my knee out of place.

I also can’t crouch down onto my heels, and a butterfly stretch is ridiculously painful.

Despite the increasing strength I have in my leg muscles I have some clicking and catching as if something is stuck in the cogs and occasional wobbles in my knee. I also have a bruised feeling on the inside of my knee whenever I walk further than the shortest of distances.

In addition, I don’t have a huge amount of stability and I still am not able to do anything involving jumping and/ or twisting.

Tomorrow is the day I have surgery. I’m fairly apprehensive since I’ve not had surgery before and I’m not great with hospitals, needles, or any of that medical stuff (passing out having my blood taken as part of the pre-surgery assessment was probably not the best start).

I’m hoping to document my path back to being able to climb again.