So it’s been quite a few weeks since my last update and things were “ok”. The simplicity of it all is that it isn’t ok.
Physiotherapy has ground to halt and development of Range Of Motion (ROM) has completely stopped. There’s no magic number when it comes to flexion as there’s no major functional movements that require anything beyond 130 degrees. But, you need a straight leg and that has stopped short of 5 degrees.
Because of this, if you can’t straighten your leg you can’t load it and the medial thigh muscle can’t activate fully so muscles are not balanced, meaning the leg is noticeably smaller in musculature making all sorts of issues further up the kinetic chain (hips, lower back, neck).
Physio sessions have halted as there must be an obvious reason why I cannot develop my ROM and load my knee without a substantial amount of pain. At first, there was pain down the front of the shin-bone which I attributed to the plate and 9 screws that are fixed onto the front of my leg. There is also pain into the back of my femur and tibia/fibula (not muscular), and this pain is instantly stopping me from doing certain exercises.
My body is now starting to adapt round the injury (and pain) and I’m hobbling around the house and in the gym with my crutch which I should be well rid of by now. So much so that recent tests have identified that certain muscles in my leg aren’t activating at all because of the pain – not a conscious effort – this is my brain deciding this deactivation for me to avoid all related pain.
This pain and worry has resulted in organising a Private Consultation with my original surgeon. The difficulties and frustrations organising this with agreement of an insurance company trying to limit their payout has been challenging and although this consultation was agreed it did take more time than it should. Trying to look at the positive side of things – I’m grateful this has been organised privately as NHS waiting lists are very long – I could’ve been looking well into next year.
So, the consultation was organised at the surgeon’s “home hospital” some 70 miles away. This surgeon was the on-duty trauma surgeon at the time of my operation at my local hospital. Although I have no doubt of his ability, he is in fact a shoulder specialist! He was surprised to see me as he had discharged me a few months back and in his words “I would’ve expected you to be running by now”. He examined my knee, my gait and ordered a few x-rays there & then. Upon further examination it seems at the time of the incident a piece of the tibial bone has been shunted up into the actual knee joint. This would explain the pain I have been experiencing. He dismissed the pain down the front of the shin because of the plate and explained the associated pain because of this “bone-block” would be why I am in pain.
So from thinking I may need the Hardware Removed altogether because of the specific pain at the front of the shin I may only need keyhole surgery to “tidy up” the damage inside the joint.
He notated there & then to his secretary a request to see a knee specialist at my local hospital and a nerve conduction test to see if any nerves have been damaged/severed by the incident or by the surgery.
After a considerable amount of chasing, more than I should have, both appointments have been confirmed and I undertook the Nerve Conduction Tests at a local private clinic last Friday. Result: No major nerve issues although a small nerve at the side of my right leg was partially blocked. I was assured this nerve isn’t necessary for normal function and sometimes it’s used as a donor-nerve for other nerve repairs. Muscle functionality was also tested and it was noticed that parts of my hamstrings aren’t simply working – the doctors’ explanation “that’s because the pain is too intense so your brain doesn’t want to use it”.
The knee specialists’ consultation is tomorrow afternoon. It’s at this point he will say keyhole, hardware removal or full reconstruction. My anxieties about this are rising as I’m typing this blog as it does result in how I live my life moving forwards – I’ll just say “fingers crossed!” but I know it won’t be as simple as that 🙁
Hopefully, as it’s privately funded, this may take place in the very near future, again NHS waiting lists do not look too promising this side of 2021.
I’m continuing my training sessions as it’s abundantly obvious that my current state of fitness will help in the recovery of whatever surgery I need. I was training to get ready for 2022 but the recent problems have made me look at my “reality versus expectations” for the near future. On one end of the spectrum I could be race-ready just as I was that fateful day back in May or on the other end of the spectrum I could be looking at other things to do with my life rather than dedicate it to triathlon and cycling.
My development lower-body is limited but I’m keen to keep pushing with my PT at each of these sessions. She’s been a welcome part to my training week and she pushes me and makes me do those exercises I choose not to do. As a PT earlier in my life, that’s exactly the point of having a PT so I trust her decisions and exercises as we both have a common goal – recovery. Upper body has been dumbed-down recently as I was starting to get quite big, after all, there has been no limitation in this area. I’m limiting upper body exercises to 2 sets but lower body has 3 sets (4 sets during PT sessions).
My swimming has been better, no doubt because of me being less-tired due to no running sessions. My speed has plateaued some 15 seconds per 100m faster than this time last year but the efficiency and subsequently my heart rate has got better. I’m sure my coach has some good sessions designed in the coming months to take that next step into increasing my speed some more.
Biking has been ok although limited to the musculature in my right leg, riding with 1.5 legs does have it’s limitations and I’m pretty knackered within the hour so turbo riding doing sessions between 30-60mins are the norm. From a psychological standpoint outdoor riding was always going to be stressful and I took my first ride outside as part of the Beccles Triathlon Club Ride a few weeks back. The strength in numbers and the low-key, low-stress riding with a statutory coffee-stop mid-ride was the best approach. In my own mind, each & every car coming in the other direction had the potential to veer-off and hit me head-on. Years of experience and riding on the open roads with no major incident paled into insignificance on this ride and the fear of injury and incident was very real. I will be starting psychology sessions on Friday of this week which will help me deal with these scenarios so I hope to be on the open road regularly very soon – operation pending.
If there’s something that teaches us during times of hardship and darkness is how you deal with it. The stigma attached with “not” being able to deal with things is still quite clear in society and a lot of people simply can’t quite deal with a friend having a hard time. They simply avoid the situation altogether which in-turn makes the sense of loneliness in their friend even more a reality. They know deep down that “that friend” won’t call them as they’re simply trying to survive each day and deal with the crap that life has given them – it’s a win/win scenario for that friend who said they’d be there for their mate. The fact they’re not made a choice to contact their friend is in fact a decision to avoid their friend. This is amplified a thousand times by someone sat at home with “four-wall syndrome”.
And there’s that friend who identifies that their friend is struggling, they’ve noticed they’re not as social, they’ve noticed they’re not around as much anymore. They know that they cannot do anything to fix it but will call, message or visit that person and just talk about day-to-day things. It’s not about fixing things, it’s about just demonstrating you’re there at arm’s reach knowing that the current state of mind of your friend means you might be at arm’s length. But nonetheless, you do it because it’s important to be there. I’d like to think I’m that person who would help a friend in need but I’m probably guilty of being that other friend too in the distant past – I’ve learnt to be better.
There’s a distinct difference between a friend and a friend, if you know what I mean.
It’s difficult to say this (I’ve deleted it and rewritten about 10 times so far) but the recent setbacks have pretty much stopped me in my tracks. My daily exercise routines were the only thing I had as a person. My mobility had been taken away from me. I felt as if I had nothing to offer – the “Nick” that everyone knew actually died back on 26th May. I closed the curtains, shut the world off and sat staring at the TV regardless of what program was on. I chose to avoid any social interaction and kept myself to myself. Even those close to me were shut off. I’m a fairly quiet person anyway so no-one would’ve noticed anything different anyway – right?
I don’t take this comment lightly but it’s quite clear that there is still a stigma about mental health. There’s countless campaigns saying “it’s good to talk about it” but the numbers are still on rise. Talking is the last thing that sufferers would want to do – it opens up all sorts of rabbit holes and all too often the result is more & more anxieties that remain unsolved.
I don’t know what the solution is, it’s different every time, but ignoring it and hoping it’ll go away is a wrong thing to do and trying to flex masculinity at a time like this only goes to show that some are not “aware” at all.
I guess this blog is me talking about it – therapy perhaps or just ranting (or both)?
I’ll just let you make your own mind up about that.
Let’s just get to the “knee-guy” consultation tomorrow – that’ll dictate the next few weeks mental state.