1 Month, 27 Days

I had physiotherapy this Tuesday. We did some jogging again, but this time going for some 50-60 meters at a time. We also did some hopping from one foot to the other, side to side and forward and backward. Finally we did some reverse lunges, before going back inside. Back in the studio we did some squats to shoulder presses, then some deadlifts, both with 8 kg dumbbells. To finish, he had me do shallow single legged squats while holding an exercise ball between the knee of the opposite leg and the wall - quite difficult to coordinate everything while keeping the proper form.

He instructed me to include deadlifts in my gym work plus well as leg presses and leg extensions at the end of training sessions to really work the muscles and stimulate strengthening and growth. He also gave me a green light to increase the distances in my run/walk intervals and to adjust the dynamics as I feel suits me the best. In general, we are moving more and more toward self-guided training where he will just provide advice as an outside observer.

Yesterday I commuted to work by bike. It's very short, just 3 km one way, but it provided a more challenging dynamic than the previous weekend rides since I had to focus on the interaction with the traffic rather than on my interaction with the bike. Nevertheless, it felt good; I was able to relax and pedal without thinking with no complaints from the knee whatsoever. I was pushing harder than on the previous rides, naturally getting into a stronger rhythm. Judging from the sensations from the legs, I would have been able to forget I'm still in the very early stages of regaining my strength and endurance, but a quick check of the speedometer was quick to break that illusion. All in all, cycling feels good and I'm looking forward to increasing the mileage. I guess it's lucky the weather will be getting worse in the next months, so hopefully I won't be able to go too far too quickly.

Today I went to the gym. I warmed up for 12 minutes on the elliptical trainer, then did squats, leg press, leg extensions and some leg abductions, just to give those muscles some attention since all the others have been working a lot lately. I left deadlifts for the next session since the hamstrings still feel a bit fatigued from the PT session. Squats felt very good though, I was able to increase the weight to 25 kg.

I think I've approached the limit of how much the knee can take at this time. It feels a little sore now, the way it didn't last week. I'm icing it regularly and keeping an eye on it. Since the exercises are getting harder, I will be making longer rest breaks in between, and that will hopefully help to find the balance again.

1 Month, 23 Days

Time for another weekly update. I have been doing the jogging intervals daily and it's been going quite well. I've been able to slowly increase the internal distance while keeping the number of intervals at ten. I increase the distance based on feel for each interval - I start with a few 20-pace ones to warm up, and then I start extending them little by little. The longest one I've done so far has been full 40 paces.

I rode my own bike yesterday, for the first time since the surgery, and then once more today. It felt a bit strange for the first few minutes, but very good overall. I've had no pain from the left knee, riding both in and out of the saddle (very careful and deliberate in the second position though). Nevertheless, I'm keeping it short and easy at the moment: it's been a while and it's not just the legs that need to get used to cycling again, but the back, neck, shoulders, and the rest of the body. I did 4.5 km on the first ride and 7.5 km on the second, 17-18 km/h average.

First ride on my bike since the operation

Other than that, I'm also working harder in the gym. I'm increasing time on the elliptical trainer in the gym slowly, up to 10 minutes now, and I've added 2.5 kg to the bar for squats. It's not much, but I'm making progress.

Overall, the knee is proving to be functional, but I still feel occasional aches and pains. Standing in one spot or walking too slowly is the worst as the knee swells up noticeably, but ice and some rest helps in those cases. It sometimes complains on the first few steps after sitting for a while, buy it settles down when it warms up a little. I do still have to remind myself from time to time to keep pushing it out of the comfort zone, but so far it has taken everything I throw at it with few complaints.

1 Month, 2 Days

We went for a day trip with friends yesterday, and I spent most of the day on my feet. It was leisurely pace walking, but nevertheless the knee felt sensitive and a little sore by the end of the day. I applied ice and the diclofenac gel, and decided to skip the exercises - today was meant to be a rest day anyway, so I just moved it a day ahead.

Today it's still a little sensitive, but better. I didn't walk as much during the day and I didn't have any problems when doing the exercises this evening. I went harder with the exercises targeting the hip abductors and skipped some of those that involve loading the knee, just in case.

I haven't mentioned it before, but in the last couple of weeks I've really made it a point not to sleep on my left side, to avoid putting pressure on the operated area. It doesn't feel bad when I first lie on the left,  but I've come to the conclusion that most of the time when the knee was swollen in the morning, it was because I'd spent most of the night on the left side. I think I've now come to the point where I avoid that side even in my sleep, and the knee is no longer swollen when I wake up.

Speaking of the swelling, I think the hematoma is really and truly gone and the red bump has disappeared. Left remaining is a general light swelling in the area that's most noticeable after I've spent done time on my feet, and that mostly disappears with rest and icing. But now that the swelling is mostly non-existent, a hard bump has become noticeable under the skin in the same area. I can't tell if it's some sort of deeper swelling, scar tissue, or something else; I'll see the doctor next week for a scheduled follow-up, so I'll ask him about it.

Day 20

Yesterday morning, a phone call woke me up quite early. I checked the incision scar habitually, and the swelling was the smallest I've seen it yet, it looked almost completely gone. This was not very surprising as I did ice it before bed the night before. I went back to sleep after the phone call, and when I got up later, the swelling was back to full size, about as big as I've ever seen it. Strange.

I realized I haven't taken any photos that show the swelling, so here's a couple that show what it looks like these days:

Leg flexed to around 90 degrees

Leg partially flexed, around 45 degrees from fully extended

The incision is almost completely healed. There is just one spot with a small scab remaining:

It looks bigger than it is - actual length is almost exactly 5 cm

Today it's been mostly business as usual. I'm descending stairs almost normally now, just a little hitch here and there. I had a nice walk, forty minutes at least, and it felt quite good. There weren't any big oscillations in the size of the hematoma during the day - even after the walk there was no noticeable increase in swelling. All in all, feeling better and better, looking forward to more physio exercises tomorrow.

Day 14 (2 Weeks)

Still improving, but still very slowly. It goes up and down during the day, so at times it feels like there hasn't been a change in a few days, and later it feels massively better. I guess it's also easy to forget that a particular move or position used to hurt before, once it no longer does. There are definitely no leaps and bounds though; it still hurts a little to go up stairs for example, and I still do the little hop-skip when descending them. The strange pulling feeling comes and goes too, so sometimes the most sensitive spot is there, while other times it's around the actual incision site.

Speaking of the incision site, the one thing that really hasn't changed much is the swelling/hematoma. It decreases a little with icing, but it comes back if I spend too much time on my feet, whether walking or standing in one place. I'm still icing it daily as it does feel better.

Physiotherapy starts Wednesday. The physiotherapist I planned to go to will be on vacation until the end of August, so I had to make an appointment with another physio I found at the same hospital where I did the surgery. My idea is to work on basic strength and coordination of the muscles around the knee in the following month, and then start the specific cycling and running work with the original physio once he comes back from vacation.

Day 12

I've removed the final bandage today. The incision hasn't healed completely yet, there's some scabbing and light bruising there. The picture is here for those interested, but I don't think it's presentable enough to be displayed directly in the post just yet.

I've been icing twice a day since the sutures were removed. The swelling/hematoma decreases noticeably after icing. It would probably have been a good idea to use the ice during the time the old thick bandage was off for showers.

There is a new sensation from the knee. I feel a distinctive longitudinal line of tension midway between the lateral epicondyle and the patella, like there is a thin band stretched there that gets tight when I bend the knee under load. Could be that they had cut the IT band away from the fascia along that line during the operation, or it could be some scar tissue. We'll see how it develops.

The functionality is still slowly improving, though maybe not as quickly as in the first week. It's good that I'm about to start physiotherapy soon, it should help to kick start the recovery and keep it on the right track so I don't develop bad patterns of movement.

Day 10

The stitches are finally out! That feels a bit better. I can't really tell what the scar looks like yet as I have a new adhesive bandage over it, not to be removed for two more days; luckily, I can shower with this one on.

In other news, the swelling around the incision is actually the hematoma doctor told me to expect - I thought a hematoma would include more visible bruising for some reason. I told the doctor I wasn't really icing it so far since the thick adhesive bandage on it make it really hard for the cold to actually reach the site. He urged me to start using ice regularly now. Other things to look forward to are:

• Start physiotherapy next week to rebuild the quads.
• Free to start swimming next Wednesday.
• Free to start cycling and/or running in six weeks, so beginning of September. I can do very short runs or rides before, but nothing longer than 20 minutes.

Otherwise, the knee is improving slowly. I'm walking up stairs almost normally now, though it still hurts a little. I'm also going down stairs facing forward (no longer sideways), but with a sort of a hop-skip on the left leg to avoid the painful eccentric contraction. Still doing glute and hamstring stretches daily, but I've given up on hip flexors and TFL, it seems to hurt more than it helps at this time.