Second op successfully completed, 8 August 2005
This past week or so it's been hard work getting myself ready for the second operation on my knee. Not only did I have to get the swelling down and the movement and function back sufficiently for the surgeon to do his job, but psychologically you've got to get yourself ready to go into theatre again for a more serious procedure, only ten days after the initial op. I want to thank Sophie Dhenin, my physio at Scorpio Clinics in Virginia Water. As you'll learn during the course of this website report, I'm going to be seeing a lot of Sophie in the coming weeks and months. She's going to be on my case and giving me a pretty hard time, I imagine! But seriously, I really appreciate her help and advice at this crucial time.
As I said, this past week we've been working on trying to regain full movement with particular emphasis on extension – in other words, straightening the knee. This gets the quads (essentially, the muscles above the knee) working again, as they were seriously inhibited by the initial injury and the subsequent swelling.
Sophie had lots of tricks up her sleeve to achieve these goals, including something she calls 'passive mobilisation techniques' which I won't go into right now. It's pretty technical stuff. Also, I've been working up quite a sweat on a device called an ATM2, which is a piece of equipment devised in the US initially for spinal conditions. It turns out it's also very effective for other injuries, such as the one to my knee. In between these sessions at Sophie's clinic I've been busy doing loads of exercises at home, going to the gym and icing my knee at regular intervals.
All in all, I've been lucky enough to have more physio than perhaps most people would get in the same situation, so we were able to make quite significant progress in a relatively short period of time. For anyone who's been through this procedure – and there's a lot of you out there judging from the very kind messages we've received through the website – you'll know what's it's like. Not a lot of fun…but it's got to be done.
By the way, I just want to say thanks again to all of you out there who have taken the time and trouble to write to me. Honestly, I've been overwhelmed and touched by the sheer volume of support from fans all over the world.
Coming up this week...
Anyway, the hard work paid off and this Monday morning I went in for my second operation, the ACL reconstruction as described by my surgeon Andrew Unwin in last week's report. It is largely "keyhole" surgery and I'm told quite often you can get little hitches, but there was none of that and thankfully it went really well. I'm seeing Andrew later this evening and he'll be talking me through things in more detail. To be honest with you, I don't think I've ever been so nervous as I was in the few hours leading up to the operation – it made the first tee at The Masters seem like a piece of cake! I guess it's not surprising that I felt like that. I mean, it's the first time I've been under a general anaesthetic. First time I've ever had any kind of operation, really - apart from last week's, obviously. But that wasn't a major thing like this. Anyway, I'm glad it's over and that it went well. I want to thank everyone who was involved. It means a hell of a lot to have good people around you at a time like that.
One funny side to the story is that when I came round from the anaesthetic, apparently the first thing I said was, 'I'm playing in the Masters!' I was so groggy I don't remember that, but I'm told it's true!
There's really not much more for me to say at this stage, but I thought you might be interested to look at the sheet I've been given by Sophie this afternoon, which basically outlines my physical program for the post op rehabilitation. As you can see, I'm going to be a busy man!
Ernie, your initial objectives are these…
Minimise swelling (so you can work on your exercises).
Restore full movement.
Maintain and improve muscle recruitment.
For the first week at home you need to devote yourself to your knee!
To minimise swelling:
Ice your knee every hour.
Stay sitting or lying as much as possible with your leg elevated for the first week post-surgery. Do not spend time wandering around the house. You should be either doing your exercises or resting!
Keep tightening your quads – hold for 10 seconds and relax. This is whilst you are not doing your other exercises.
To restore full movement and improve muscle recruitment:
Do these exercises six times daily. In between exercise sessions spend at least 15 minutes with your knee stretched out straight and your heel resting on a rolled up towel so that the effects of gravity can help your knee to extend. You may mix them up to provide variety!
1. Static quads – x 20
Push back of knee firmly down into the bed, trying to brace knee into extension. Hold for five seconds then – keeping knee locked – pull your foot up towards you to lock the knee even more firmly into extension. Hold for five seconds. Relax.
2. Straight-leg raise – x 10 (progress as quickly as possible to x 20)
Same procedure to lock the knee - then lift the whole leg up 12 inches then slowly lower it, keeping it locked straight throughout.
3. Flexion – x 15
Bend knee as far as possible using your own muscles. Then wrap a towel around your shin or ankle and use it to pull your heel further up towards your buttock. Remember:
You are aiming to touch your heel to your buttock.
Use the yardstick to monitor your progress.
Once you can bring your heel to within 12 inches of your buttock, try to push flexion by kneeling and sitting back towards your heels.
You CANNOT damage anything by doing this.
4. Ankle pump - lots!
Lock the knee straight as in Exercise No. 1 and pump your ankle up and down still keeping the knee locked.
Thanks Sophie. I'll do as you say!
That's it for this week's report. I'll be sure to write again soon.
Bye for now.
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