Speed Bumps

Last month I wrote about my return to yoga. I was settling into my practice and was making quick progress from week to week, albeit that physical progress was just regaining basic mobility that I had let slide these last few years. Still, it was quite enjoyable, and I looked forward to each new class as an opportunity to do something that I could not do the week before. Of course, not all progress is linear and some days I could stand on one leg easily and maybe the next class I could not if my life depended on it. But each week there was a clear improvement over the previous, I and find this kind of noticeable improvement enjoyable. In my last article I discussed how father time changes your physical capacity and specifically some things are not as bendy as they used to be. The foreshadowing was real! During a regular workout in WOD class three weeks ago, I had an unfortunate mishap when trying to land a burpee box jump. In practice as a coach, I direct my thirty-five and older clients to step-ups instead of box jumps when they are programmed in a conditioning workout. This is because fatigue could affect your ability to land safely. For reasons to be obvious, I do not like the risk/reward ratio of box jumping while fatigued. Box jumps when done fresh have lots of benefits and are low risk. But high fatigue changes everything. On this fateful day, I even had a little conversation with myself during the workout about switching from jumps to step-ups. But since I was almost done, and since I am obviously special and an exception to my own rules, I decided to push through. On one of the jumps near the end of the workout my left foot did not make it onto the box and instead of landing on two feet, I landed in a deep one leg squat on my right leg on top of the box. As my right leg worked to control my bodyweight while rapidly descending a felt three pops and my quad tendon detach from its normal place on the kneecap. I rolled forward off the box and onto the floor immediately aware of my situation and new reality. Next came a quick self-assessment. Can I extend my left knee? Nope. Luckily, the tendon junctions really do not have pain receptors, so I was not in a significant amount of pain. Coach James walked over to check on me, thinking I had just taken a standard spill of the box and started asking me questions, such as, “are you ok?” As my heart rate was still 170+ from the workout and breathing was still biologic priority numero uno, I said something to the extent of, “I am fine, but I am not OK. I have just torn my quad tendon.” Then I pointed to the divot in my thigh above my knee where parts were missing. Surprised, he started asking some more questions and I replied: “You’re going to have to give me a minute.” The class was finishing the workout, and most had not noticed my little hiccup in the back of the room. From their perspective, I was just lying there panting like many of us after a hard workout. Someone eventually handed me my phone and I texted the good news to my wife so she could come get me (since you need your right leg to drive), and then Lisa and Liz, and finally a text to my favorite Orthopod and my preferred Surgeon.

Yes, I have both a sports orthopod and an orthopedic surgeon who specializes in knees on speed dial. Both my daughter and my wife have had their ACLs repaired in the past two years (basketball and skiing respectively). So, the docs at Sports Medicine Associates of San Antonio know me and my family well. Unfortunately, it was not buy two knee surgeries, get one free, and I could not give them a higher recommendation.

The next morning, I was in orthopod extraordinaire Dr. Stephens’ Office getting examined and then in an MRI by lunchtime. By that afternoon, the MRI showed a 60% tear of the quad tendon and tore all the quadricep muscles (there are four) except the rectus femoris. I did not completely rupture the quad tendon, so the muscles had not retracted up the leg and did not tear the reticulum on each side of the knee, so my kneecap was still in place and not moving around. There was a chance that the tendon would heal on its own, but considering what I ask my legs to do, the surgeon recommended having it repaired and I agreed. I had surgery with Dr. Glebus to repair the tendon a week later. Going in we expected a 45-minute procedure but once he got in there, the damage was more extensive than originally expected and it took about two hours to complete.

Recovery timeline:

Two weeks later (this past week) I had my first surgical follow-up. Good news, I am ahead of schedule on both mobility and strength. Physical therapy starts this week in earnest. Standard timeline for the physical repair to take is 8-12 weeks, so hard PT but no heavy loading until after that. Functional recovery will obviously be slow and continuous, but it is estimated 1 year until I am back 100%. I will beat that timeline as those rules are based on Muggles, but there are certain benchmarks and timetables for this stuff to heal properly and not get reinjured.

The negatives:

 My fitness was the best it had been in a long time. In ramping up for the Dallas HYROX in November, my running was the best it has been in a long time. Weight training was going well and loads were increasing steadily. Yoga was going great too; my flexibility was improving weekly.

 I cannot drive until they let me out of my brace which I hope to be four weeks post op. Until then, my wife is driving Ms. Daisy around and after three weeks of this I can tell you that she is pleased. Due to my size, it is also hard to fit into any except the largest vehicles since my leg is locked straight in a brace. This makes getting to class challenging as my driver is a terribly busy hard working modern career super woman.

The positives:

 Every setback is an opportunity. Going through the rehab process is a great chance to learn about modern rehab techniques and technology. My last semi- significant injury was a meniscus tear and then repair to my left knee in 2021 (injured throwing the Highland Games hammer). But this was a 15-minute procedure which I rehabbed myself and was back squatting two weeks post-surgery. This current injury is more serious, and I will have to be more patient. This is a fantastic learning opportunity.

 I was able to weight bear on the injured leg immediately. We were able to immobilize the knee in one of our left-over knee braces from the girls’ ACL repairs, and I never needed crutches. I was able to walk gingerly and Frankenstein style around the house, even surprising the home health nurse and doctor at my follow up.

 Surgery was on Thursday, it was moderately painful on Friday, and then no real pain on Saturday. I did my first workout, and upper body lift on Sunday. The plan is to jump back into the WOD class this week as my personal chauffeur can fit into her busy schedule.

One of my big frustrations with our clients is how easily they let little things interrupt their training and their progress. Certainly, life gets in the way. But when it comes to injuries, you train what can be trained. The beauty of our strength classes is that our coaches can be substitute, regress, lateralize, or progress any exercise or movement based upon your needs. Hopefully, I can demonstrate that via this process. I can certainly understand that injuries are frustrating and entirely unenjoyable. But if you are going to be athletic and active then they will happen at some point in life. People hurt themselves all the time doing the smallest things. The running joke amongst those of us past forty is that we seem to hurt ourselves in our sleep. But do not turn these speed bumps into mountains and make it worse by de-training. The key is to make smarter choices than me when choosing exercises (which is why we have the level method) and remember your ego is not your Amigo. I certainly ignored common sense in this case. If you take enough classes with me, you will hear me say to our newer athletes, “don’t let today’s workout ruin tomorrows.” The results that we want to accumulate from hundreds and thousands of training sessions done over a prolonged period of time. I made a poor decision that made that outcome more challenging, but I am certainly not going to make two poor decisions and sit on the couch for the next three months. If you are interested in seeing how the return to play process shakes out, you can follow along on our blog and I’ll do my best to document how I do it in class, how my rehab with the professionals goes, and the extra work I do at home.

See you in class soon! -Steve