Weeks 1- 3.
At the start of August 2022 whilst out on a short recovery run, I pulled up with a sudden and sharp pain in my left knee. In January 2023 a complex tear to my left medial meniscus was confirmed. At that stage the surgeon advised that no intervention was required as there had been a degree of recovery. with rehabilitation I was returning to a reasonable and increasing level of activity.
Things progressed well and at the start of June I was just fit enough to complete a 60k ultra run. My knee was rock solid during the run. It was strong and there was no hint of pain. Sadly, a week later my pain returned and I found myself unable to run more than a few miles.
In August the surgeon decided that it was time to intervene.
This is my first ‘rehab diary’ post covering three weeks post-surgery.
Surgery
On September 28th, I went into hospital for day surgery. An arthroscopy (keyhole surgical procedure) was performed under general anaesthetic to do a partial meniscectomy on my left medial meniscus.
A partial meniscectomy is a procedure used to treat meniscal tears, which involves removing as little of the damaged part of the meniscus as possible. The surgeon will also smooth the edges of the tear to avoid any fraying which can cause further issues.
A brief update from my surgeon after the procedure confirmed that it was a straightforward removal of a flap/fold of tissue.
There was no reaction or ill effects from the anaesthetic and a couple of hours after the surgery I was up, mobile and being taken through my rehab exercises by the physiotherapist. After this I was discharged and sent home with some spare dressings, tubi-grip and pain relief. I had arrived at the hospital at 7:00 am; the anaesthetic was administered at 9:55 am; I was out of recovery and back in my room by 11:15 am; and I was home by 3:30 pm.
Recovery
I experienced virtually no pain post-surgery and only required a couple of doses of basic pain relief (paracetamol and ibuprofen) over the following two days.
The day after surgery I removed the thick bandage and replaced it with tubi-grip which was to be worn for the first week during the daytime only. I removed the wound dressings after a week and the steri-strips used to close the tiny incisions gradually came off over the following days.
I have continued to be mainly pain free experiencing only occasional discomfort. This is expected and it is not uncommon for this to be at the site of the original pre-operative pain.
Rehab
Runners are not known for restraint. We often do not take the time to recovery from injuries and push too-hard-too-soon. I have to confess that in years gone by I have been guilty of that, although I have become wiser as I have got older.
The physiotherapist’s first words were; ‘I hear you are an ultra-runner’ followed by, these exercises will seem very easy compared to what you are used to. I can confirm they were very tame. When I left, I was given strict instructions. Do not exceed the prescribed rehab. Could I walk each day? Yes, short distances. Life walking, no hills no rough paths. The hill ban was going to be tricky as where we live is not flat. Could I use the exercise bike? No, wait until your 3-week physio check.
I was given a set of four exercises: ten repetitions five times a day:
Hip & Knee Flexion lying flat
Static Quadricep activation lying flat
Straight leg raises lying flat
Active assisted knee flexion seated
Stairs were to be taken a step at a time leading with my good leg going up and leading with ‘bad’ leg on the way down. After ten days I was able to go up and down the stairs normally.
I quickly established my rehab routine with the exercises and a daily walk. The walks extended from trips to the local shops and round the block to tackling my first short hill a week post-surgery. Hills and slopes were definitely more of a challenge that required caution especially going down. I realised that sensibility and patience was going to be required and hills were to be rationed challenge. After two and a half weeks I was able to comfortably, albeit slowly, walk three miles with some undulation.
It has also been important for me to try and maintain some level of core and strength work too. I decided to enhance my rehab regimen. It took a bit of creative, out of the box thinking but I was able to draw up both an upper body strength and an abdominal/core programme to do alongside the rehab exercises. I re-established my pre-surgery routine two sessions of each programme a week.
I have felt my knee gradually strengthening, but have listened to my body sensing when to push, but, importantly, knowing to ease back if on the verge of over-doing things.
And there we have a remarkably smooth and well behaved three weeks of recovery and rehab. Much to everyone’s surprise and contrary to expectation I have exercised restraint. Getting sensible in my old age?
The expectation is that this will allow me to return to long distance running. To give me the longevity and consistency that I want. I am not going to jeopardise this opportunity by being foolhardy and impatient. And let’s face it; I have paid for the privilege and am not about to flush a lot of money down the toilet.
