Kinda been on a 'bender

[Scrappy]

Hello Ladies! It's nice to see familiar names on T.E. It's been a rough couple of years but I'm happy to say life is smoothing out. I'm finally on the mend after 2 ACL's and a meniscus surgery, but finding myself lacking in motivation to get moving again. I've medicated the boredom and depression away with Vodka and have added a good 25 lbs to my frame. I would like to start jogging and cycling this spring but still deal with pain from scar tissue in the knee. Any advice on how to start jogging again again without pain?

Scrappy

[salsabike]

Scrappy, if it were me I'd go see a sports PT. If you're in Seattle, Real Rehab is a great place for that.

[Scrappy]

Thanks and Hello! I have been seeing a trainer to strengthen my legs but I'd really love to get back to at least a small amount of light walking/jogging. It's been 7+ months since the last operation, and the Dr. says I should be able to resume normal activities without pain..... grrrrrrr..

[Catrin]

Welcome back, and good luck with returning to activities! It does sound like a Sports PT might be a good option if you have access to one.

[OakLeaf]

To beat my favorite still-dead horse, how much work has your PT been doing on your foot strength and flexibility? Knees have nothing to support and align them except for what's above and below them in the kinetic chain ...

[colorisnt]

^That's a good point. I think people tend to forget the importance of their feet and ankles but in horses, it's usually the first place we are taught to look. Makes total sense to me but my sister is a runner and most PT's she has had for coming back from fractures, partial tears, chronic soreness, have ignored those feet. Until she found a good place, nothing seemed to get better. Turns out she was having issues with foot and ankle stability.

As for cycling, can you get on that first before the jogging? If you could get on the bike first, you might be able to lose some weight or at least transfer it to muscle which would help you when you go to run again. Not sure if that helps, though!

[ny biker]

Welcome back! I am not a medical person, but I do recall a lot of internal scar tissue when I had ankle surgery 20 years ago. Do you have full range of motion with your knee? If not, I think dealing with that might be the first step. In my case they were doing follow-up surgery 6 months later to remove a screw from my heel, and at the same time they broke through the scar tissue. I was asleep from sedation but it woke me up, because it involved pushing really hard on my foot.

Another thing I remember about that surgery was that it took a long time for all the pain to go away. It was a very slow, gradual process. Months after the surgery, it hurt to move my foot in certain ways and it was stiff and painful when I first woke up in the morning. About a year after the first operation, I realized that the daily pain and stiffness were gone. It was so gradual that I wasn't really aware of the improvement. I did still have pain when I turned my foot inward for several years after that, but eventually even that went away.

If you're cleared to resume normal activities and the doctor has told you that running is okay, I would try gradually working up to it. As Muirenn said, start with long walks. Maybe something like a couch-to-5k program would help.

p.s. One more thing about my ankle surgery experience -- all my friends thought that it should have healed much more quickly than it did, and they thought I was just a whiner when I was not able to be as active as they thought I should be months later. It was hard realizing that I could not rely on their support. But there are enough people here who have been through similar experiences and we are here for you, so feel free to lean on us if you need to. Good luck.

[Wahine]

Hello Ladies! It's nice to see familiar names on T.E. It's been a rough couple of years but I'm happy to say life is smoothing out. I'm finally on the mend after 2 ACL's and a meniscus surgery, but finding myself lacking in motivation to get moving again. I've medicated the boredom and depression away with Vodka and have added a good 25 lbs to my frame. I would like to start jogging and cycling this spring but still deal with pain from scar tissue in the knee. Any advice on how to start jogging again again without pain?

Scrappy

First off, my sympathies. I've been in the self-medicating with alcohol state myself a few times. It's a tough place to break out of.

The question you pose is actually a very complicated one. I'm working with a PT client of mine right now on a similar issue and we see each other once per week, workout together for 45 min where I look closely at her movement and prescribe exercises for her homework while closely monitoring and guiding her return to running program. There's no recipe for getting back into it. I can't give her a list of things to do over the next 12 weeks and have it work because we have to adjust her program every week to accommodate how her body is changing. I wish I had an easy answer for you, but there isn't one.

Here are a few things to think about though:
1) If you don't have your full knee ROM back, you need to keep working on that.
2) Basic running drills to improve form will get you headed towards running without running just yet.
3) If you can't skip, you can't really run.
4) You have a knee issue and yes, there are likely still structural things happening right at the knee itself, but you'll need to be working on hip strength and ankle and foot strength as was already mentioned above.
5) Ankling exercises are a good place to start. For eg this and this and this. There are a ton of examples of ankling exercise and running drills you can look up on youtube. Pick the ones that look like they are doable for you right now and try them out.
6) When you do start running/jogging you will have to start on a run/walk program and the transition between walking and running is the most stressful part of the activity in terms of physical forces on the knee. So when you start a run/jog interval, ramp it up slowly, hold 70% effort level for 30 seconds then coast down. Do not start and stop suddenly.

Meanwhile, walking with progression into more challenging terrain like steeper hiking, cycling or swimming may all be good options for cardio. Strength training in the form of a fast paced circuit of exercises is also a good way to build fitness and lean muscle, which will help with losing weight.

Here's another helpful link that might help you understand some of the issues involved in getting a knee rehab patient back into running.

[Catrin]

Foot and ankle surgery take a long recovery. It took me over 2 years to walk without thinking about it after my 2004 heel osteotomy (?) and ligament reconnection/repair. It is still a little inflexible but it is fine now. It took a LOT of work to get there and my surgeon wouldn't order PT.

There are a good number of ankle and foot related mobility work and other exercises that really help. People just don't get how long it takes who haven't been through it. Feet are complicated! Hang in there and listen to your body as you start to increase your activities.

[Wahine]

Just to clarify for everyone, Scrappy had knee surgery, not ankle or foot surgery. There has been reference to ankle exercises because they are also important after knee surgery as is hip work.

[Catrin]

Oops, sorry about that. I caught on the foot references and didn't read closely enough.

[Jacigh]

You might try riding a recumbent trike.. It is very kind on the joints.