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Platelet Rich Plasma Injection.

You can read a more official description here, but the short description is that they draw out your blood, spin in in a machine and make the plasma super concentrated with the parts that promote healing.

Super Blood

Okay, that’s just a name that I made up, but basically that’s what it is. The whole process takes about 40 minutes and I was able to walk out with just a couple of bandaids on my knee. Did it hurt? Well…. sort of. There was no numbing of the area except with a cold spray (I assume that is what the spray was for). I was calm enough to take a picture in the middle of the process. Doctor Jones said that it was the first time that someone had taken a picture during a PRP injection. All for journalism.

After effects…I could “feel” the needle’s trajectory for the rest of the night. It didn’t hurt….just was noticeable. Also my knee felt “full” like there was some pressure on in. Again, not painful, just odd.  I had spent most of the morning moving my home and the new location is on the 3rd floor. No elevator. Lot’s of stairs. After the injection, I did stop my moving activities as I read that activity should be reduced for 24 hours.  No more stairs and decided unpacking and resting would be best.

What are the downsides? Well, the PRP injection is not covered by insurance and is $600 out of pocket. That kinda hurts worse than the needle.  It’s worth it to heal as quickly as possible and get back to being active again.  Ok, back to running. I’m basically already doing most of what I’m wanting to do.

Other than that, Doctor Jones says that the knee feels good. Solid ACL feel. My next Ortho appointment is mid October. That’s 4 months out from the surgery and we will have the “when can I start running” conversation then.

I went to PT today excited that I was able to walk without crutches and with only a slight limp. I expected that my physical therapist John would probably not be happy that I was weaning off crutches as quickly as I had since our last session.

I was right. John was NOT happy. I am not getting the extension on my healing knee that I need to make a solid forward step. There is a slight bend in my knee when stepping forward which results in me having a little limp. The limp can quickly become habit and then I have that to fight against not just the physical recovery part. Soooo…..back to one crutch when I’m walking around. Most of the time. I’ve gotten a little taste of freedom and being able to hold things in my hands and walk from room to room. Walking from room to room carrying things is super important in normal life, but especially now. I am moving in 2 days and really am behind on packing.

I’m committed to working hard and working smart on this recovery, so I’ll take a step back and keep one crutch at hand until I can walk with a straight knee.

My physical therapist John has started weaning me off the crutches this week on Wed. 5 days into the weaning process and this is the progress

Day #1. Knee feels unstable while at PT. John has me doing this toe tap motion on a 6 inch tall box. Lift right leg, tap right toes on box, lift left leg up….WOOOOOOAAAAHHHH…that feels weird and unstable. Having to force myself to do it. John says that my brain is having to learn the new length of the ACL and knee structure. Makes total sense and that makes it easier to know that it’s my brain working through things. Still walking with 2 crutches using about 50% weigh on the recovering leg.

Day #2.  Today I’m carrying two crutches, but for “local” moving around, I am only using one. It’s a new set of motions and the crutch goes on the side with the healthy leg and moves forward with the recover leg. Logic is that if the crutch slips, all of the weigh is supported by the stronger knee. Good to know as it will rain for the rest of the week. Some slight discomfort, but nothing major.

I have an adjustable desk at work and have been raising it and standing often. Forcing myself to repeat those toe taps from yesterday over and over, hundreds of times. Lift foot, tap backpack. repeat.

Day 3 – Friday. Just carrying one crutch today. Making short steps to get coffee or to other side of room without any crutches. Excited that I got to teach yoga tonight without crutches. Small class of 3 students. It was super humid in there too. It felt amazing!

Day 4 – Saturday – Today I started my yoga teacher subbing at the YMCA. It was a beginner flow class at 8am and was a lot older crowd than I usually teach. Super fun and wasn’t heated. I was able to do limited demonstrations also.  Then I went to teach a gentle flow at noon in the hot studio. I love that heat….opens the body up so much! Walked around the day without crutches. Pretty serious limp though. My pelvis has a posterior tilt when stepping forward.. Basically the same mechanics I had after the injury and prior to surgery. Some swelling in the knee but no pain. Took a couple of ibuprofen and elevated it at night.

Day 5 – Sunday – Today life is busy. I’m packing the house to move next week and need to be mobile. Walking up stairs like a normal person today instead of single leg stepping it.

Morgan noticed my calves are different sizes….not sure if left is bigger because it’s stronger or if there is that much atrophy in my right already.  Hope that evens up soon.

I started my 5th week with the most excruciating pain in my knee since the incident itself. I wasn’t really doing anything challenging or strenuous in that moment, just sitting at my desk. It was really sharp and stabbing and seemed to be centered right where the torn cartilage and microfracture repair was located. It shook my confidence and for the first time since this process got started, I questioned my return to yoga, driving, work, and other activities so quickly. Let’s be honest, other than having to use a backpack for carrying things while on crutches, I haven’t let the surgery slow me down from life.  The same day of the sharp pain I had my weekly appointment with Jon at physical therapy and was worried what he would tell me. Will he tell me that I screwed soomething up and will have to have the microfracturing done again?

Jon listened and said that it was most likely just scar tissue starting to break up. Nothing to worry about and then like every other week, he proceeded to use some sort of rubbing compound and jab his fingers into where the incision points are. Breaking up that scar tissue hurts like torture also but the incision spots are barely noticeable at this point.

One of the exercises that he assigned is laying on my back, he attaches 10lb weights to my ankle and I do 2 sets of 10 leg lifts. Then I roll over and repeat laying on my front and then on both sides. The last side hurt and was the first time I had to quit anything i was asked to do. ugggg.

We also discussed the process of weaning of crutches on the 6 week mark. I thought it would be a line in the sand and then I was done with them, however he says that there will be a period of walking with 2 crutches then walking with 1 crutch….up to a couple of weeks. Again, uugggg.

Fast forward a few days and I forgot about the pain and start the “walking” with 2 crutches movement. No real weigh on the surgery leg, just moving the leg like it would normally during walking. Just getting it ready for the transition back to walking.

Well, it’s been a busy 3 weeks since my last update. There have been road trips and adventures galore! I’m pretty much as mobile as a person on 1 leg and crutches can hope to be. No issues moving around or getting through life. I’ve been seeing my Physical Therapist Jon for the past few weeks and he’s been doing a great job getting me to fire the muscles that I’ll need once the crutches go away. He is also a triathlete and understands my desire to get back out there.  I’ve picked a potential next 70.3, the Crystal Coast Half Booty tri in May of 2019. (https://fsseries.com/event/crystalcoasttri/). I’ll definitely post my training program once that gets started.

What else? Oh, my good friend Tanner gave me a great deal on a Wahoo Kickr snap. I’ve sourced all the connecting pieces to connect my laptop to the TV and get it ready for some zwift fun.

Went lap swimming once, did a 1000m set with no issues and am considering doing the parents relay at Morgan’s swim meet on Saturday. Definitely will have to post pictures if I do.

Been in the gym working on upper body, core, shoulders, and back about every other day. Been getting to yoga about 3x’s per week and it’s been nice to be in the room. Modify like a champ!

1 week and 5 days left on crutches and then I will have a Platelet rich injection into my knee. Hopefully that means I will be walking semi normal then.

Feeling hopeful!

Day 6 – I get to be active and sweat today!

GYM – I to the gym for some upper body and core work. I use the machines so that I don’t have to try to move weights around on crutches. I dropped the amount of weights I used down by 20% and added a 4th set instead.  Since most of the machines are sitting this works well. I usually just cross my right leg over my left ankle to avoid pressing into the floor.

Yoga – I took a 60 minute hot yoga vinyasa class today. My plan was to basically lie on the mat, maybe do some of the warm up breathing sequences and then stay in savasana basically until the end. Not at all what happened. I got a good solid practice in! There were A LOT of modifications that I had to do. I estimated that I completed about 80 percent of the class. There were some postures that simply didn’t have an appropriate modification that I felt safe using at this time. Definitely going to write a follow up post just on the Yoga modicatons and will probably explore hosting a workshop for knee injured student teaching these modifications.

It’s been almost a week since the last update. Let me catch you up….

Day 4 was just spend moving around Raleigh trying to do normal activities as much as possible. I stopped taking my prescription pain meds around noon and switched over to Ibuprofen. Easier on my stomach and I was feeling loopy. Also since there is so many people that I hear of that have had surgeries and then ended up addicted to the pain meds. Not a problem I want to have.

Day 5 – Today was my first PT appointment. It went well and I was given exercises designed to fire my glutes, hamstrings, quads, and calves. I’m still restricted from putting weight on my right leg. The PT described it like this.. the microfracturing process is like planting grass seeds. You dont want ride over the sprouts with a mower until they have taken root or else they will be scraped away. Same concept with the new tissue being formed from the bone marrow and blood that is setting up. He also cleared me to go to the gym and back to yoga as long as I don’t place weight on the right leg. Deal!

Today is the first day that I don’t have family staying with me to help out. It’s really not inconvenient at the moment, except trying to carry things from one room to another. In a moment of inspired frustration, I attached a bike water bottle cage to one of my crutches. Now I can get water and coffee from room to room a lot easier.

I can feel the leg recovering and the pain level has definitely dropped off. Only have taken 1 pain med this morning and hope to keep it down to just a couple total for the day. They tend to make me nauseous unless I am seriously hurting and I think the threshold for that has shifted.

Flexibility in my ankle is good and my knee bends slowly. Not trying to push it at this point just keeping the flexibility there. I’m definitely thinking I want to get in the hot yoga studio room this week even if I just lay there. Taking these meds and being sedentary has me feeling like I need to detoxify and sweat out something.

Also I finally pooped today for the first time since surgery. Sorry if it’s TMI, but apparently it’s a side effect of the meds. My usual diet is mostly clean and predominantly vegetarian so this usually isn’t a problem. Feeling a little more back to normal I guess.