Day 49 - One year later

So today marks one year since I originally injured my knee. What a difference a year makes. I've been through one rehab, relearned how to walk and run, reinjured my knee, been through a surgery and am now going through a second rehab.

While this rehab is definitely slower and tougher, it's better overall because the knee keeps improving. After the original injury, I still had the meniscus tear in there mucking things up, so that kept getting irritated and setting me back about as much as I went forward. I'm not out of the woods yet, but so far so good. And Tiger Woods, with his first victory this weekend since his surgery, keeps providing much needed inspiration that there's life after ACL reconstruction.

Day 48 - Knee song Monday

Thursday, Friday, Monday, who can keep track. And metaphysically speaking, is there really a difference? Ponder that question while you listen to this classic from Jeff Beck and Rod Stewart, Hangman's Knee. I think it's about a hangman who tears his ACL and can no longer perform his duties.*



* This may be less than true.

Day 47 - Beach knees

I did a lot of walking at the beach. My knee got a little sore, but it was a strange soreness because it sort of faded away rather fast. It's not like when my knee (where the cartilage was torn) would get sore before the surgery. That pain would just remain and even get worse. So I'm hoping the beach-walking was ultimately good for my knee. Maybe it had some sort of rehab effect.

Day 45 - Beach

I'll be here later today:



Actually, it'll probably look more like this:



So I'll be here:



Enjoying one of these:



All in the name of knee rehab, don't you know.

Day 44 - It's alive!

My new ACL is actually an achilles heel tendon from a very generous guy who agreed to donate his organs and other assorted tissues after he died (they use the achilles tendon because it's pretty tough and even after all the treatments it goes through to kill viruses and whatnot, it's still stronger than my original ACL). So this thing was technically dead at some point. And after all the treatments (irradiation and chemicals) and being stored, it had been kaput for quite some time. But now that it's in my knee, my body is now undergoing the process of making it come alive! It takes about a year, but my body will grow new blood vessels into it and essentially turn it into one of its own tissues. Pretty damn cool. Life after death.

And what a great gift from a stranger I'll never meet. So become an organ donor today. Who know who you might help.

Day 43 - So far, so good

I had my 6-week checkup today with my surgeon to make sure everything was healing properly. He came into the exam room, took one look at my knee and exclaimed, "Holy crap! I must've been drunk when I did this operation. What a disaster." Just kidding. He said everything looked great and I was right on track. The most important thing now is not to overdo it, he said, because my knee will start feeling better and capable of engaging in more strenuous activities, but the new ACL is still being incorporated into my bones, so I could wreck the whole thing if I push it too much.

Day 42 - What does it feel like to tear your ACL?

Sorry to those with a weak stomach, but I had to put this in here after reading this description of what it's like to tear your ACL on ESPN (but I did put in a picture of puppy to take away some of the sting, so if at any point you feel nauseous, just look at the puppy and you'll instantly feel better):

Typical symptoms include a "pop" felt in the knee, followed by immediate pain and swelling. The pain may be so severe that the player will feel nauseated and vomit. Sometimes players may have mild pain and swelling. Because of the range of symptoms, a physician should always evaluate the player

I didn't experience any of those, well, except for the pain. I didn't feel a pop. And the pain wasn't that severe that I thought I would vomit. But I knew something was immediately wrong before I even hit the ground. As the ACL (and probably the cartilage) tore, a white hot sensation shot through my brain as I was tumbling to the ground.

I had never felt anything like that before, so that was a pretty good indicator that something seriously bad had happened. I was in pretty intense pain, but I think it was more due to the concern that my knee was wrecked rather than sheer physical pain. I pounded the ground with my hand and said the "f" word repeatedly. I'm not sure why I did that, but it seemed like a good thing to do at the time. Maybe something to do with exercising the evil spirits or something. Plus, it distracted my brain from the pain.

But once I hobbled off to the side of the field, I laid around for probably 20-30 minutes or so, waiting for my girlfriend at the time to arrive and drive me to the hospital. The pain was bad, but not too severe. I was carrying on conversations and doing ok for the most part. And I did follow the ESPN recommendations above and had a doctor at the ER examine me. They took X-rays and did the standard tests for an ACL tear. The doc concluded that my ACL wasn't torn and that neither was my cartilage. She was wrong on both counts. But I was later seen by an orthopedist and a physical therapist, both of whom also did not think my ACL was torn. So either there's a lot of bad healthcare providers in this area, or I'm just one of the lucky ones whose knee remains stable even after an ACL tear. But apparently, it's not stable enough. Ok, back to the puppy.

Day 41 - I tear, you tear, we all tear our ACL

We all know about Tiger Woods and Tom Brady, but what other professional athletes have torn their ACLs and returned to the field of battle? (Yeah, yeah, Brady hasn't returned yet, but New England has already traded away last year's starting QB, so it's a safe bet Brady will be back at the helm next season). The answer is a whole lot of guys.

Here's a partial list to get us started. I'll add more in future posts.

Philip Rivers, the quarterback from the San Diego Chargers, tore his right ACL in 2007 (and somehow played in the AFC championship game against Brady's Patriots before having surgery on his knee in the off-season). Rivers returned as the starter in 2008.

Donovan McNabb, the Philadelphia Eagles QB, tore his right ACL in 2006. He's since returned, even though the unappreciative Philly fans give him crap no matter how his knees are doing.

Carson Palmer, quarterback for the Cincinnati Bengals, has torn his ACL.

One-time Chicago Bears QB Rex Grossman tore his ACL, but returned the next season.

Patriots safety Rodney Harrison hit the trifecta in 2005, tearing three ligaments in his knee: ACL, PCL and MCL. He returned the next season.

Day 40 - Back in the saddle

Today, I rode my bike for the first time since the surgery. It was a leisurely 43 minutes, but not bad for the first time back. My knee felt OK for the most part, although there were a few twinges and odd feelings because it's a bit different riding a real bike versus the exercise bike in the gym I've been pedaling away on for the past couple of weeks.

I realized it'd been about 3 months since I've been on the bike because I didn't ride for about 2 months before the surgery. I could tell it'd been a while because at one point I thought I was flying and looked down at my spedometer and saw I was only doing about 18 m.p.h. That used to be slow for me.

I also learned why I'm not a bike mechanic. It took me hours and hours to set up my front derailleur and I thought I had finally gotten it right. But I quickly realized after setting out that something is definitely wrong because it doesn't shift properly. I have no idea what though. But the good news is that all my overhauled work held together and nothing fell apart or shot off the bike. And the knee feels OK and I seem to be walking normally now that I've gotten the glut. med. firing. So all in all, I'd consider this a success.

Day 39 - Gluteus vacation

I still have just a slight limp. My left leg does something that's just a bit different from how my right leg moves. I wasn't sure what it was, but my physical therapist said I have a weak gluteus medius (shown in red). This is a close cousin to the gluteus maximus, the big muscle that's also known as da' butt. The glut. med. is just in front of that and on the side of the hip. It helps control your pelvis as you walk and perform other movements. I think it got weak on me because I'd been putting more weight on my right side for a couple of months before the surgery and then continued that after the surgery. The glut. med. on my left side wasn't getting any work so it finally went on a permanent vacation. So I'm doing exercises to strengthen it.

I'm also still working on my VMO. In addition, my bursa on the inside of my knee is inflamed, possible due to my lazy glut. med. It's shown in this picture as the Pes anserinus bursa.


They don't show it on the photo, but the Pes anserinus is just next to what was the Zone of Ouch. That is still a tender region, but it's become more of a Zone of Please Be Gentle than anything else.

I need a vacation. To paraphrase H.L. Mencken, ACL reconstruction ain't for sissies.

Day 38 - Pasta for pets

This is where I'll be tomorrow:

Pasta for Pets
Annual spaghetti dinner and game night
March 21, 2009
Time: 6:00pm-9:00pm
Metropolitan Memorial United Methodist Church, 3401 Nebraska Avenue NW Washington DC 20016 (across from American University)

Mamma mia! You'll love our pasta and game night!
Come to our annual spaghetti dinner and game night to benefit the Love Fund! Tickets are $15 each ($50 for a four-pack)and be will available for purchase at the door or [ buy tickets online ]. Space is limited. Bring your big appetite and game face!

This event is sponsored by our friends at ProFeed, Alexandria Animal Hospital, Ledo Pizza, San Vito Ristorante, and Filomena Ristorante.

If you're in DC, you should go too. Spaghetti is always awesome. And the proceeds go towards covering the costs of emergency vet care for dogs and cats that otherwise couldn't afford it (c'mon, most of these dogs and cats can't hold down a job (that's what happens when you never wear pants), so they'll never be able to cover the bills themselves). So go and eat and feel the satisfaction of having done some good in the world. What's not to love?

Knee Song Friday

Thursday, Friday, who can keep track. A short song, but perfect for this blog. Wounded Knee by Yoriyos:

Day 36 - Bee's Dog's knees

In a previous post, I waxed poetic about how we all have bad knees, primarily due to our upright posture. But that was quite speciest of me because dogs have injury-prone knees too. In fact, a few years ago, my dog, Coltrane, tore the equivalent of her ACL. In dogs, its called a cranial cruciate ligament, but it's sometimes referred to as the ACL. Coltrane was facing the threat of the knife too, but she made a miraculous recovery the morning of the surgery. The vet put her under, but after testing her knee, he decided she didn't need the surgery because her knee was pretty solid. That was good news for both of us because I was fearful and nervous for her. You see, the procedure for repairing a torn ACL in dogs is a pretty brutal surgery. To give you a hint of how painful it is, the surgeons use this evil-looking torture device to slice off the top of the tibia:


Yikes! The sight of that may have been what scared Coltrane into rapid healing. The procedure, known as tibial plateau levelling osteotomy, consists of cutting the top of the tibia bone off, repositioning it so the knee functions better and using a plate and screw to hold it in place while it heals. The end result looks like this:


It's apparently a pretty successful procedure. But the thought of slicing off the top of the bone still makes me queasy. Of course, they drilled into mine, and I'm not sure that's any less painful.

Day 35 - Heartbeat goes boom boom boom

I rode the exercise bike yesterday. My knee felt pretty good, at least until I stopped, at which point, it was a bit stiff. I just can't seem to turn the corner with the swelling that's still in the knee. I'm probably expecting to recover faster than my body actually can, or at least that's what one of the physical therapists told me. She said at this point after the surgery, a lot of people are still working on just getting their full range of motion back and can't bend their knee enough to ride a bike. So at least I've got that going for me.

I also got my pulse up to 141 on the bike. That's the highest it's been since the surgery. At least as far as I know. I don't think I've done anything strenuous enough to raise it higher. Although there is one physical therapist who might've caused an even bigger spike in my pulse. Every time she walks by I get a sense of tachycardia and if I was a cartoon character, I might look something like this:


I don't know if that's good for my knee. But if it's bad, I don't want to be good.

Day 34 - Somebody should buy me this for St. Patrick's day

Get it in green or something. Or fill it with Guinness. But seriously, what a cool mug for somebody who's gone through knee surgery. I can't believe nobody has bought this for me already. Where's the love?

Day 33 - A movie and my knee

Last night, I saw the film, Two Lovers, the last movie Joaquin Phoenix says he will make, opting instead to become insane and pursue a career as a rapper. Spoiler alert: Stop reading here if you don't want to know how the movie ends. In the film, Joaquin Phoenix's character, Leonard, is in love with Gwyneth Paltrow's character, Michele. But she doesn't really love him and rejects him for another guy after the smitten Leonard has ACL reconstruction surgery. No, not really. I was just trying to somehow make this knee-related. She rejects Leonard after he buys her a diamond ring. He falls to pieces. Briefly. Then he quickly collects himself and --apparently adhering to the philosophy "when life gives you lemons, make lemonade" -- gives the ring to another girl he's been seeing but whom he doesn't really love. It's sad and discomforting, but understandable from Leonard's point of view because previously in his life, his fiancee had called off the marriage and he was so distressed he tried to commit suicide and was institutionalized. A cynical, pessimistic ending, or an uncomfortable dose of realism? It reminded me of the late David Foster Wallace's (shown below) two paragraph story A Radically Condensed History of Postindustrial Life:

When they were introduced, he made a witticism, hoping to be liked. She laughed extremely hard, hoping to be liked. Then each drove home alone, staring straight ahead, with the very same twist to their faces.

The man who'd introduced them didn't much like either of them, though he acted as if he did, anxious as he was to preserve good relations at all times. One never knew, after all, now did one now did one now did one.

Oh and there is a knee angle here. I walked to the theater --about a 15 minute stroll each way-- and my knee felt pretty good coming and going, about as good as its felt since the surgery. It's a little stiff today though. And so it goes.

Day 32 - Clem Snide and Heligoats and my knee. Oh my!

I seem to be on a string lately with concerts. Maybe the music is helping my knee heal (if it's good enough for stroke patients, it's good enough for me). Last night, I saw Clem Snide. I first stumbled upon this band when I was in grad school at the Medical College of Virginia many, many moons ago, and I've been a fan ever since. There's something both sad and beautiful and brilliant about their music that speaks to me. They look like this:


Heligoats, which consists of one guy, Chris Otepka, was the opening act. I'd never heard Chris, but I liked his songs. And apparently so did NPR. You can learn more about him and hear one of his songs for free here.

And as a bonus, here's a Clem Snide song:

Day 31 - The 9 circles of Hell

I went to see Dante's The Divine Comedy last night. As you may know, it's the story of a man's journey through the 9 circles of hell. Oddly enough, in this modern interpretation, the 7th circle was recovering from ACL reconstruction. Just kidding. It was the 8th.

In this picture, Dante and his lover Beatrice see God as a point of light surrounded by angels. Or are they inside a knee peering at the light from an arthroscope, which is about to operate?

Day 30 - Thank Zeus I have health insurance

Holy Cow! ACL surgery is vastly more expensive than I thought. I received my health insurance statement on the billing for my ACL surgery and it is staggering. My surgeon's charges amounted to $10,455.00. The center where I had the surgery billed $17,293.00. The anesthesiologist, who probably should've earned 10 times this amount because I didn't feel a thing, charged $1,328.05 for his services. The grand total comes out to $29,076.05. I have no idea how these guys stay in business though, because my health insurance only doled out $4,694.98. Under the terms of my insurance, I had to put in another $470, but even with that addition, that means the providers only got about 16% of their total bill.

And there's still the physical therapy appointments (twice a week for the next few months) and the follow-up office visits to the surgeon.

If I didn't have health insurance, I wouldn't be able to afford this. So I guess I'd just have to try to find this guy and see if he'd give me a deal on the cost of the surgery:


Or I'd just have to limp around on one leg for the rest of my life. Anybody for universal health care coverage?

Day 29 - Knee song Thursday: Knee deep

This is a perfect song for the kickoff of Knee Song Thursday: George Clinton and the Funkadelic's (Not Just) Knee Deep:



The song almost compels you to dance. Unfortunately, I can't dance. Yet. But maybe the heat of the beat will provide inspiration to my knee to heal up so it can dance.

P.S. Despite the title, the song really has nothing to do with knees, so pay no attention to the lyrics.

Day 28 - A return to darts

I returned to darts tonight for the first time since my surgery. I kind of sucked. I'd like to blame it on my recovering knee, but I sucked before the operation, so, uh, I guess the suckage is all me. I won a couple of games, so I wasn't complete crap, but overall my team lost. The knee felt OK though. I also learned about a cool bar in Silver Spring, Md., that sells top-notch darts. I plan to pick up some better darts soon because eventually my knee is going to heal and I'll have nothing to blame my total lack of dart skillz on.

Day 27 - Maybe ready for prime time?

Yesterday, I thought my knee might not be in any shape for any activity just yet. But it felt ok today, and my physical therapist told me to give it a spin on an exercise bike at the gym. She says a lot of odd things, but I decided to trust her on this one. I just got back from 20 boringly, slow minutes on the exercise bike set on the lowest level possible (so easy, a clinically dead corpse might be able to manage a few pedal strokes). My knee feels ok. There were some moments of sharp twinges while I was pedaling, but those went away. If it's still in good shape tomorrow, I might go for another spin in a couple of days.

Day 26 - Not ready for prime time

I tried to resume working out today. It was just upper body stuff, so I didn't think it'd affect my knee too much. But I guess it somehow did because my knee feels a bit stuff now. I'll see how it's doing in the morning, but I may have to forego working out for another couple of weeks or at least go with regimens that don't aggravate my knee. I think returning to the bike may be another week or two off as well. There's still a lot of swelling from the surgery and until that settles down, I think the repetitive motion of pedaling would just keep it irritated and delay my recovery. So it goes.

I've traced the main problem with my knee to two key areas shown here in this photo:


It's hard to tell but there's a lot of swelling in these areas as well as a big knotty lump. The worst one is the one on the left. When I straighten my leg, it's about the size of a golf ball. Here's a couple of photos of it:




Kind of gnarly. But it doesn't actually hurt that much. However, all the swelling is interfering with my biomechanics. So I wish it would shrink up and disappear.

Day 25 - Ani DiFranco saves my knee

I went to see Ani DiFranco tonight at the 9:30 club. It was a great day in DC. It was 75 degrees at one point and everything seemed to be going great. Really great. And Ani's concert was the cherry on top of an incredible chocolate sundae. What a great show. For whatever reason, she has a huge lesbian/bisexual following. So by going to see her in concert, I think that technically makes me a lesbian or a bisexual women. I just like her music. But whatever. I like lesbians and bisexual women too. And anyway, there are much worse things I could be.

Here's a photo of Ani. My iphone's camera is no good at long-range shots, so you'll just have to trust me that she's the yellowish blob in the center of the photo:


But more importantly for the ACL angle of this blog, I continued my beer experiment. There's a lot of steps at the 9:30 club and my knee felt awesome. Very little pain, if any. At this point in the trial, I must attribute the knee improvement to beer's anti-inflammatory properties. Of course, there's no way I could ever prove this scientifically, but emotionally, I feel beer has been essential to my recovery. And that's good enough for me.

Chad Stokes opened up for Ani. Here's a photo of him. Again, you'll just have to trust me that he's the blob in the center of the photo:

Day 24 - Beer success?

In yesterday's post, I committed to testing the anti-inflammatory effects of beer. The results are in. The experiment was a complete success. For the first time since the surgery, I'm comfortably walking down stairs today. This is a major breakthrough because up until now there was sharp pain in my knee when going down stairs. So I think we can declare this proof of the wonderful healing power of beer.

Of course, my knee's improvement could just be due to time. And the rehab exercises I've been doing. Or the physical therapy sessions. Or the estim machine. Etc., etc., etc.

But without beer, I'm sure those things would not have been nearly as helpful. I'll have to keep testing it just to be certain.

Day 23 - So if not ice, then how about beer?

So in the last post, we learned that ice doesn't really do much for soft tissue injuries. So then what's a guy with a swollen knee to do? How about a nice pint of beer?

Say huh?

No, really. A pint of beer. Ok, I admit that it sounds stupid at first, but it turns out that it's not so far-fetched at all. Scientists in Austria at the Innsbruck Medical University (I've been to Innsbruck, it's a nice town) showed a few years ago that beer has anti-inflammatory effects. Dr. Dietmar Fuchs (I hope his last name is not pronounced how I think it's pronounced or I may have to move my blog to the adult section), who led the research, said this: "On the basis of our new findings, beer must be added to the list of beverages with potentially anti-inflammatory components."

So what is Fuchs talking about? Well, it turns out that beer inhibits interferon-gamma, a chemical in your body that plays a prominent role in inflammatory responses. Now the research only used beer extracts and not actual beer, but I'm willing to be the clinical guinea pig and put this to the test with real live beer, all in the name of science, don't you know.

But what beer should I choose? Ah, I think I've got just the right one. The aptly named, Hop Stoopid, is perfect for this experiment. No, that's not a misspelling. You can see here from this photo that is how they spell it on the label:


You may wonder what it means. But I think I know. It's very hoppy and high in alcohol and after you drink it, you feel stupid. But --and this is the important part-- you also feel less inflamed. I'll report back later to let you know how this experiment turned out. I expect significantly less swelling in my knee, or at least the perceived feeling of less swelling.

I should note that Fuchs and his buddies made a point of saying that non-alcoholic beer should also deliver the same anti-inflammatory properties. But I'm pretty sure they were just kidding around.

Day 22 - Ice is nice?

My knee still has swelling, which is pretty normal this stage of the game. My physical therapist tells me icing will help reduce the swelling. But this is what they said about using the cryocuff after the surgery and there's no good evidence that makes much of a difference. So what about icing at this late date?

Several studies have looked at the effect of icing on soft tissue injuries. The verdict seems to be that ice doesn't do much. This review study from 2008 concluded: "There is insufficient evidence to suggest that cryotherapy improves clinical outcome in the management of soft tissue injuries." Another review study from 2004 came to pretty much the same conclusion.

I've also heard that to get deep tissues to a cold enough temperature to having any real reduction in swelling would require leaving the ice on the skin so long that it would actually do damage. And even then, you might not be able to achieve low enough temperatures in the deeper tissues.

So I think it's safe to say that ice is a bit of an old wives' tale. It might help reduce pain, which can be a good thing, but it doesn't seem to provide much, if any, reduction in swelling. So if ice is no longer needed for treating injuries, what can we do with all the extra? Maybe these guys would like to have it:

Day 21 - Does the stimulator actually work?

There seems to be a fair amount of evidence showing that the muscle stimulator, or estimulator, does help strengthen muscles that have become weak. In a review in the Sports Injury Bulletin, Owen Anderson wrote this:

"[S]tudy after study has confirmed that the right kinds of electrical stimulation can keep muscles relatively sound, even when they are not being stimulated by the nervous system or engaging in any real activity."

That's pretty cool. But give us a real world example we can understand, Owen. Oh wait, he did. And helpfully it was related to an ACL sprain. Not a tear, but close enough for government work:

"In one of the earliest published studies on the effects of high-intensity electrical stimulation on the maintenance of size and strength in immobilised muscles, researchers electrically stimulated the quads and hamstrings on a daily basis for three weeks in the immobilised leg of an athlete wearing a lower-extremity cast as a result of Grade-II medial-collateral and anterior-cruciate ligament sprains in his knee (2). On the day the cast was removed, the girth of the athletes thigh was increased, suggesting that muscle hypertrophy had occurred, instead of the usual cast-associated atrophy. In addition, single-leg, vertical-leap height was 92% as great in the immobilised leg following cast removal, compared with the uninjured leg, and the athlete was able to immediately return to competition."

Sounds great. So another week of this estim machine and maybe I'll look like this:


Wait, wha?!

Actually, that won't happen. Read the rest of Owen's article for the full details, but basically while the estim will help bulk up weak muscles, it isn't going to work any steroid-like miracles. Thank Zeus.

On an unrelated note, according to the three lovely ladies that penned this piece about the applications of physics in physical therapy for the University of North Carolina, estim is also used in vet medicine. An excuse to work in a shot of my dog, Darwin:

Day 20 - A shocking development

To help my VMO learn how fire again, my physical therapist hooked me up to this machine. It's a muscle stimulator. They apply pads to my muscles and crank up the current. I contract when the current fires.


My leg muscles have seemed to have developed a way of contracting without firing the VMO so much due to my ACL/cartilage injury, so the idea is to help sync my brain impulses with the VMO contraction. It seems to be helping. I had the first treatment last night and my knee definitely felt better walking today.

After the physical therapy sessions, they again hook my leg up to the muscle stimulator, but the current is lower this time and just provides sort of a tingling feeling. No muscle contraction. They use four electrode pads around my knee, instead of just the 2 they use for stimulating the VMO. The setup looks like this:


The idea is to help block some of the pain in my knee. I think that seems to help too. My knee usually feels a little less painful for a day or two after a session.

Day 19 - Stripping

I removed the steri-strips today. The scars from the surgical incisions don't look as bad as I thought they would. I haven't yet washed my leg since removing the strips so you can see the outline of where they once were. Here's one side of my knee:


And the other:


They're still kind of itchy and sore and there's a lump of scar tissue under a couple of them. But overall, not all that noticeable. The one incision that I feared was going to be really gnarly was the "zone of ouch" culprit below my knee just because when the sutures were still in, it looked like they had pinched up a lot of skin and done kind of a rough job on it. But I guess they knew what they were doing, because it's turned out pretty good. Here's a close-up:



Not sure you can tell from that photo just where the incision was, but that's exactly the point.

Day 18 - VMO steals the show

As I mentioned in my last post, my VMO is weak. So I've spent a lot of time doing VMO strengthening exercises, one of which looks like this:


And from the side:


We'll see how well this all pays off when I have physical therapy on Monday.

Day 17 - Busted flat in Baton Rouge

Well, I wasn't exactly in Baton Rouge, but I did feel busted flat. I saw Kris Kristofferson in concert tonight ("Busted flat in Baton Rouge" is a line from his song Me and Bobby Mcgee), which required climbing up and down a lot of stairs. My vastus medialis obliquus (VMO) is weak and my knee is still a bit stiff, so climbing stairs ain't my forte just yet.


As you can tell from the pic, the VMO is a big muscle on the inside of your thigh. My VMO on my left knee is noticeably smaller than the one on the right, which is not uncommon after an ACL tear. The VMO helps control how your knee cap tracks and is also, as I'm finding out, pretty essential to going down stairs. So I'm now doing rehab exercises to get it back into shape.

But I made it through the night and limped on home. Hopefully tomorrow my VMO will be just a little stronger and stair-climbing will be just a little easier.