3 Month Checkup: Stationary Bikes are your Perineum’s Worst Enemy

Well, it’s been 3 months since I’ve written anything on here, so I figure that now is as good a time as ever to add some new content to this thing. The main reason why I haven’t written anything is that, frankly, there hasn’t been anything interesting to write about. Months 1-3 of ACL rehab consist of very few things that aren’t mind-numbingly boring; the exercises are simple and boring*, the stretching is painful and boring, and the cardio is both mind-numbing and ass-numbing (lots and lots of biking.)

bikes suck

"Ouch! My ASS!!"

But if you do some simple math, you can figure out that 3 months is roughly equal to 12 weeks (3 months x ~4 weeks/month = ~12 weeks.)  The reason why 12 weeks is significant is because that is how long it takes for graft-to-bone healing. Basically, at 12 weeks you now have a real ligament, not just a piece of random sinew screwed into your bones. The reason why that is significant is because your rehab will change immensely after this 12 week milestone. For one thing, you will get to run again. This is both good and bad; on the one hand, you’ll be absolutely tickled pink to be able to get off that goddamn uncomfortable bike seat and onto a treadmill.

...and your perineum will thank you

For some, however, your joy will quickly turn to apprehension as you realize that your running mechanics are not exactly how you remember them. Actually, there’s a very good chance that you will feel like an uncoordinated loser your first time up on the treadmill. I was able to regain some semblance of a normal gait after a few jogging sessions, but that first day was pretty awkward.

The 12-week milestone comes with a lot of awkward firsts, including various agility drills and plyometrics. I had heard of people recovering from surgery having mental blocks about performing certain movements during their rehabilitation, and I thought that I probably wouldn’t be one of those people due to my perceived mental toughness. But it turns out I absolutely am one of those people, and landing after jumping is now a terrifying experience for me. One of the exercises that I do now is one where I jump from the floor onto a mini trampoline, then jump from the mini tramp back to the floor. Sticking the landing after jumping off the trampoline for the first time is one of the more nerve-wracking moments I’ve had since the beginning of rehab. I couldn’t see myself when I landed that first jump, but I know that I was cringing big-time, and I imagine that my facial expression greatly resembled Stevie Ray Vaughan’s “guitar face.”

guitar face

He can't even bear to look at how hard he's rocking

While these new agility drills bring an elevated level of peril to my workouts, it feels great to finally be making athletic moves again after an 11-month layoff. And not only making those moves, but actually feeling confident in my body’s ability to pull off those moves without crumpling awkwardly to the ground. I’m still a little apprehensive at times, but I’m starting to grow more and more comfortable with things like jumping and running every day, and I’m getting to the point where I can see the light at the end of the tunnel. The period between 3-4 months post-op is where many athletes make their largest strength gains, so I’m excited to see how far I can progress between now and January. Really the only limiting factor I have right now is some patellofemoral pain that I’m suffering, which leads me to my next point: don’t use a patellar graft.

The one piece of advice that I would give to those who are planning on having ACL surgery in the near future is to not use a patellar tendon graft. Why? Because it’s flat-out painful. Kneeling is near-impossible for me, and I experience pain right over top of my kneecap when doing most exercises (jogging is especially inflammatory.)

It hurts me to look at this

Pictured: my own personal hell

Not only is it painful, but it’s actually affecting my strength gains. For example, I can’t kick out as hard as my muscles will allow during knee extensions due the pain in my kneecap. Everything inside the knee is fine, but the graft site on the outside of the kneecap is so tender that it flares up every time I contract my quadriceps. Eccentric exercise, for some reason, is when it acts up the most. It will get better with time, but it’s certainly frustrating to be limited by it during the time when I’m supposed to be making the biggest strides strength-wise.

So to summarize: doing athletic stuff again is cool, patellofemoral pain sucks, and this:

Might as well be this:

Pitchfork : bike seat :: Tomato : tomahto

*I’ve never seen another YouTube video where a heavy metal soundtrack was so poorly-chosen and unfitting.

About Andrew Sacks

I'm a 27-year-old former college baseball player, currently working as a strength and conditioning coach in Baltimore, MD.
This entry was posted in Me, Physical therapy, Recovery and tagged , , , , , , , , . Bookmark the permalink.

10 Responses to 3 Month Checkup: Stationary Bikes are your Perineum’s Worst Enemy

  1. Christine says:

    Thanks so much for your awesome blog. I’m about to get ACL surgery in a week and have been reading blogs like crazy to learn about people’s experiences. Yours is the only one that both does not freak me out and does leave me laughing. Definitely laughter is the best medicine for pre-surgery anxiety. Hope you continue to post about your progress and keep at it!

    • andrewsacks says:

      Thanks very much! I find the whole process much easier to deal with if you can just find little things to laugh about while you’re going through it. Good luck with your surgery. I think you’ll be surprised by how quickly the ordeal goes by.

  2. uriahdude says:

    Day 2 after knee surgery and I’m glad I found this site because it’s the first time I’ve had a good laugh! Very good stuff. Seriously,you should write more often; knee rehab or otherwise.Too funny! Thanx for the laugh.

  3. KV says:

    Finally someone with my wacko sense of humor during what is unfortunately, a very real “un-funE” injury and recovery. You are a talented writer, and should seriously consider a career change! I’m two weeks post accident, whereby I, a very active, athletic, and normally graceful type of bi-ped, fell off a household step ladder that was obviously teetering on a rock in the driveway whilst loading umm… adult beverage ( beer) in the ole fishin boat for a well deserved fishing trip. (I must mention, I had not consumed one drop of afore mentioned adult beverage before accident) Well, the ladder went one way, my knee went another, and somehow my body didn’t know which direction to go, so it landed directly on my bony buttocks on the rocks. Well ok, I didn’t break neck on boat… thank God, (as I had neck fused in 06) .. and ummm. Ok,.. arms not broke, hands not broke, butt… nope,… not broke, but oh my holy *&%$ my knee! What the hell happened to my knee? Well,… yes, the ACL saw fit to just to fold up like a cheap lawn chair. Now the funE part. I drug myself into the house, iced it for an hour, and went fishing for 9 hours anyway. Survived the trip ok, and had convinced myself (even though I heard the “pop”, and pain that took my breath away) that I just “sprained” the darn thing, UNTIL next morning when I woke to find a rather a large grapefruit where my knee used to be, and could hardly walk.. so off to my Ortho God, who has already repaired both knees, shoulder twice, and wrist once, and knows more about me than my relatives. He proceeded to drain 15cc’s of blood from my now elephant sized appendage, sped me to MRI which confirmed “dead ACL” which essentially rolled up like a shade, and a badly bruised femur. I’m now hobbling with brace, (enuff of the damn crutches) and am awaiting surgery. I’m reading all I can about what to expect. The only part of your blog that made me cringe, instead of giggle, was knowing that bicycle torture will be part of therapy.. I dread that more than anything. I no longer have a butt, as it has somehow “melted” down the back of my legs, leaving me with “flatty fanny syndrome”, so having a bicyclular enema is not something I’m looking forward to, and having had both knees previously scoped and repaired (lateral release and meniscus repair) I know the pain of the bike. But, (pardon the pun) I guess its a necessary evil. Anyway, I sure appreciated your writing, and hope you to continue to keep up with it. Good luck with the recovery process!

  4. Stephanie says:

    Haha, I had to take a moment and stop reading. I got to the jumping on and off of a trampoline and I was done. That terrifies me to the bone! I went to a rehab center in 2007 when this first happened and they were doing tests and asked me to walk backwards. I felt like I couldn’t find the floor and I swear my nerves went crazy and my eyes started watering. The most I have ever had to do on a trampoline at any of the physio centers they have sent me to in the last 4 years… IS to stand on one leg at a time for 30 seconds. Haha. Treadmills frighten me too but I have used them.

    Squats are tedious, boring and painful. I am not looking forward to those beginning again.

    In my defense, I have not been able to run in four years. So I am a little apprehensive to try anything that involves jumping on and off of things and tracks that move from under you (and then of course your leg would give out) haha.

    Surprisingly enough, after reading some of your blogs (and another I found) instead of getting more nervous (which would have been hard to do) I am calming down quite a bit.

    Sooo thanks! haha.

  5. michelle reid says:

    just had knee surgery yesterday, Holy Hell! Pain! I’m scared. I am a mother of 2 and I have to use crutches. Geez! But this morning I actually laughed out loud (scared my husband) while I was reading our blog. Thanks

  6. Sandy says:

    Do still have patella-femoral pain? Just curious. I have to get scar tissue removed from my knees. Funny blog!!!!

    • Andrew Sacks says:

      Sandy, I do not have any patellofemoral pain to speak of anymore, thank goodness. The only thing I have problems with is kneeling on surfaces like concrete, but I guess that’s not really unusual.

  7. Mike says:

    Just had my right knee ACL repaired and meniscus tear cleaned up. Used a cadaver ACL. What am I in for? Well reading this blog gives me some idea. Nerve blocker just now wearing off, so I am starting to feel the real pain now.

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