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ACL - Conservative Management

In December last year I was feeling pretty good. I had quit my very stressful full time job and was working school hours at an enjoyable, fairly easy job. My household was back on track, specifically the housework and the kids. I was also going to focus more on my fitness and health, get back to running, do some more basketball training. Actually, I was going to do everything I had always wanted, but never had the time for. I was ambitious.

Then the absolute unimaginable happened. In my basketball semifinal, we were losing. I became, for the first time since I can remember, grossly competitive. Very unlike me. But even more unlike me, I got aggressive. Going up for a rebound, which logic suggests I should always get given my size and ability to jump, players of the opposite team surrounded me. I landed, grappling for the ball. It was mine! They pushed, round went my body, but my foot was on the ground. Next thing, there’s a crunch, and my knee joint is dislocating slightly, the bones grinding together.

The shock hit me before anything else. I cried out, falling to the ground.

And there was pain. So much pain. I’ve done 3 natural births, broken bones and kidney stones. This was up there.

I literally couldn’t walk, or straighten my leg.

The doctor suggested a meniscus tear and an MRI. I was dubious about the seriousness of the injury. I always think I’m overreacting to things, I hate the medical industry. I take an x-ray and agree to come back if it doesn't get better. I go back. Nothing is better. He can’t even do a movement test to check for ACL. My knee is swollen and I am miserable.

I go for an MRI. Now I’m scared because things aren’t getting better. I can sort of walk, the crutches help but are annoying. I return to the doctor and the conversation goes like this.

‘Is your knee feeling any better?’, this is the doctor.

‘Not really’, I admit, scared shitless about my MRI results.

Doctor actually laughs, ‘Well. It’s not going to get any better’

He proceeds to tell me, with laughter, that usually people demand an MRI for small sprains. He said I’m his first patient who declined an MRI and literally has the more serious injury. I take this as a compliment for my pain tolerance. Sort of.

So it’s not good. He tells me I need surgery. I nearly cry. I take the referral and leave feeling awful. My running career is over. I literally need running in my life.

3 months later I finally get to see my surgeon and he convinces me to not have the surgery. I’m astonished. For two months I've been literally waiting for surgery. He explains that by building strength in my hamstring, and doing a lot of physio, I can create enough stability to live a very normal active life without my ACL.

I’m pretty happy about this. Surgery scared the hell out of me, and the all the physio and recovery. But this is a still a choice. I want, no I need, to run. I tend to be depressive and binge eat. Running keeps me sane and healthy. I feel alive when I run. I feel like I can win at life when I run.

My physio is ecstatic at my decision to prolong the surgery. She seems excited at the prospect of getting me back to running. She is literally the most encouraging person in my ACL journey. She calls me a coper. She's done that a few times. But I’m still scared about making the wrong decision. What if in a few months my knee gives way and I do more damage? And that pain. I don’t want anymore pain. But the surgery is also so daunting.

So I do what any respecting millennial would do. I listen to a podcast. I never knew there were physio podcasts. But there are. And specific ACL podcasts. I listen to these. Apparently there’s an Irish academic who specializes in ACL recovery. It’s fascinating. ACL injuries are so freakin common and I’d never heard of them before. It surprises me how many people who know about this injury. ‘Oh you’ve done your ACL. Your knee will never be the same’. Some people I could throttle.

So after my extensive research and expert advice, I’ve opted for conservative recovery. Mostly out of fear of surgery… but also because I trust my physio. I trust her more than the surgeon and the doctor and the podcasts. She knows ACLs. I only wish there were more examples out there of conservative recoveries. The general advice sounds like it’s surgery. Even my doctor said this without a second thought.

Yesterday I ran 4km, in under 6min/km. This is huge for me. Tomorrow I run 4.5km. Next week, 5km. I feel good. My leg is so strong. I do strengthening most nights. Squats, leg raises, balancing, hopping. So many boring strength exercises. I bought an exercise bike. I still can’t cross my legs like a school kid, but I nearly have full movement back.

I’m feeling good. And strong. Which is huge. I still get scared. I still watch my step with an eagle-eye, terrified of that potential one second lack of judgment that could see me in the operating theatre having a knee reconstruction.

Oh, I also played beach cricket, went surfing, can swim nearly 2km freestyle and I can cycle. I think I’ll go for a triathlon, work my way up to a half marathon. No more basketball, footy, touch, netball etc. But that’s ok. If I can run. I’ll stay sane.

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