Day 29 - Day 35

I called the doctor on Day 28, frustrated that the swelling hadn't gone down.  Many people had had knee surgery, and did not have this long a recovery.  A nurse listened to my concerns, then called later to say that the doctor wanted me to "chill out", and avoid even usage of the stationary bike.  So, from that day until my one-month follow-up, leg exercises were out of the picture.  The nurse did mention that I could continue to ice my leg and use anti-inflammatories.

So, I have done just that, but haven't seen much progress.  With the snapshots in hand, you can be the judge.

Day 29:

On Day 29, I awoke with slight aching below my knee.  It went away in a few minutes as I was getting dressed and didn't return.

Day 31:

Day 33:

Day 35:

I'm not sure how soon this go away, but the swelling's persistence is discouraging.

Day 22 - Day 28

During this time of recovery I tried as much as possible to incorporate some leg conditioning each day.  On leg days, I would use a low-resistance one-legged leg press for strength development on the right (operated) leg.

In terms of flexion, I could bring my legs to about 150-160 degrees, but when I was at the gym I couldn't grab my ankle and stretch the quadriceps muscles due to the swelling.

On Day 22, you can see that the calf muscles in both legs are of similar size, as calf exercises could still be done without restriction:

The increase in leg exercise intensity did help regain strength, but also prevented the swelling from going down.

On Day 24, I tried doing body weight squats with an exercise ball between me and a wall.  I could hear fluid move around in the operated knee and a "squishy sound" in my left knee.

I noticed as I walked the halls at work that I didn't shuffle my feet as much, particularly in the those first few steps upon rising from my desk.

At home, I noticed that I can get out of bed directly, with the right (operated) knee extending as fast as the other).

On Day 25, the knee feels slightly more swollen than the morning before.  On Day 26, co-workers notice a limp as I walk about the halls.  When I awake, there is not any pain, but

On Day 28, you can see that the swelling below the knee is the same or worse than a week previous:

Frustrated by that progress, I called the doctor's office.

Day 14 - 21

Recovery two to three weeks after surgery had greater mobility but a maddening persistence of the swelling below my knee.  The big victory during this time was getting dressed; I no longer had the urge to brace my hand against a wall or tub as I put on a pair of jeans or shorts.

On Day 15, you can see that I am unable completely straighten my leg.  At the time, I credited this to the swelling around the incisions below the knee.

When seated at a desk for more than 20 minutes, I had difficulty getting up quickly, and there was a stiffness to the right knee that was uncomfortable.  After a few steps away, this stiff sensation would dissipate.

On Day 16, you can see that swelling above the knee is still there, and there is visible atrophy in the quadriceps muscle (compared to the left leg, not shown):

On Day 17,  I noticed only after processing the picture that there is bruising from drainage:

(I used a gray card to make sure the color balance was accurate).

For exercise, I used a stationary bike pursuant to doctor's recommendation to increase range of motion at minimal resistance. At home afterward, I elevated my leg above some pillow with ice packs to reduce swelling.  It was shocking at first how tiring it was do do even 15 minutes of continuous pedaling.

On what would be leg days in my exercise program, I started doing one-legged leg presses on a horizontal machine at very low weight, approximately half my weight.  A few sessions later I added about ten pounds.  It was a far cry from the pre-operative workouts, which normally included barbell squats.

On Day 19, you can see the atrophy in close comparison:

By Day 21, the swelling above the knee has almost fully dissipated:

Day 13

Today was rough.  I continued to have difficulty sleeping through the night, with considerable discomfort below my knee upon rising and walking.  My hamstring muscles on my right leg have tightened over time from lack of tension from the quadriceps muscles in front.  This results in the sensation of sudden tight pain on my inner hamstring muscle when I extend my right leg walking. 

I noticed as well that I can't fully extend my leg (see picture).  I hope this is from the swelling only, and not a permanent condition.

My left knee makes a "squishy" sound whenver I bend it under load.  It hasn't swelled noticeably, but it's not quite right either.

Day 12

Tuesday morning seemed to start with a little more swelling than the morning before.

I decided go to back to my normal gym for working out.  I felt self-conscious stumbling about, but no one seemed to mind, and there was someone else who was also limping there too. I tried the leg press machine with one leg at a time at low resistance and long sets.  It was grueling and a little embarrassing.

Folks at work noticed that I was moving around a little faster.  I still am annoyed by the lack of swelling reduction.

Day 11

I really wanted to get quality sleep on Sunday night, before going to work Monday morning.  Unfortunately, I still had swelling that prevented sleeping on my stomach.  This meant that during the night, when my body would naturally turn in bed, I would wake up.  In addition, there was aching below my knee, toward the center of my body (medially).  I'm not sure the cause, but the first real cycling workout may have done the trick.

On a positive note, my calves weren't as sore.  As in previous days,  the first steps out of bed were the hardest.

In terms of flexion, I couldn't bend my knees any further.  It looks from the pictures that I actually lost some range of motion there.

At work, everyone noticed the limp, but were glad to see that I was off crutches. Given the limited amount of handicapped parking, and the distance I needed to walk just to get to my office, I was quite grateful.  As I walked the halls, my right foot would start to shuffle the floor.  The joke I made was that I should attach Swiffer Dusters to my feet, so that in time I would end up cleaning the dusty tile floor.

After work I used the fitness center on site, since I knew that there wouldn't be a whole lot of cardio to be had and the place is usually vacant.  I discovered that I can't do the seated calf machine anymore, as the pad puts quite a bit of pressure on my knee, and it's difficult to get my right leg in position in the first place. I closed out the workout with 15 minutes on a recumbent bike at minimal resistance.

Day 10

Sleeping was slightly better Saturday night, but I still can't sleep on my stomach.  When I first try to walk, the Frankenstein walk predominates.

As you can see from the picture, flexion has improved somewhat, due to reduced apparent swelling.

I decided to go to back to the gym for my first "real" workout.  I normally would start with a 10-15 minute run on the treadmill at about 7 mph.  Since this was not an option, I decided to wait until the end of my workout to do some very low resistance cycling on a recumbent bike.  The rest of the workout (shoulders, triceps, abs) seemed to go well, though my limp was quite noticeable, and somewhat of a conversation starter.

I went to bed early knowing that the next morning would be my first day back since the 8th.

Day 9

In terms of sleep, Friday night was again restless - my favorite position on my stomach just isn't bearable at this time.  When I woke up this morning, I had hoped to be "back on my feet", but without the sleeve around my knee, the first few steps were tenuous at best.  I've found that stretching my calves for about 30 seconds each helps quite a bit in lessening the Frankenstein walk.

Outside of those early morning steps, I've started to walk about the house without a crutch.



I've been working out on my home gym (a cheaper, earlier variation of the Bowflex machine, called the Crossbar, which I knickname the "faux-flex") since Monday.  Given the additional stability in my right knee, I'm able to move around without having to move my leg over the bench manually or use the machine itself as a temporary crutch.  I really wish I had one of those adjustable dumbbells; it would be so much more efficient.

The atrophy in both my legs, but particularly the operated one (right), is much more than I had expected in this time.  My last workout using my quadriceps was on Labor Day, September 6.  I had done lying leg curls with fairly heavy weight the next day for hamstrings.  Now the hamstrings in both legs are tight from lack of use.

Day 8

I woke up groggy again this morning, the swelling preventing me from sleeping on my side or stomach.  Swelling looks about the same as yesterday, and flexion was slightly more than 90 degrees.  Here is the side-by-side:

I had my surgical follow-up with the orthopedist.  He explained how the procedure went using a model and the pictures taken during the arthroscopy.   He threw away the loose body, which was 1cm x 1cm x 0.5 cm (about the size of the end of your fourth finger, but only half its thickness).  The prognosis is good for my right leg, though my history makes the onset of arthritis in that joint more likely.

Regarding my left knee, which is making "squishy sounds" when I extend, the news is not so good.  He mentioned that it wasn't a temporary condition or a compensatory result of shifting my weight prior to surgery.  Rather, that knee is likely experiencing a cartilage defect on the kneecap (patella), which will progressively become worse over time.  Pain tolerance will decide whether further action is necessary there, as the sound itself is innocuous.

Regarding the cause of the loose body, he explained that in most cases the originating event is unclear, or idiopathic.  Trauma can start the cascade of events that lead to the condition, but I didn't have a clear traumatic episode for this loose body.  Many times, lack of blood flow to a certain part of the bone causes the cartilage to start detaching from the bone.  Once a piece of cartilage and bone is loose in the knee joint, it will get nourishment from the sinovial fluid and grow over time.

He recommended that I discontinue the use of crutches as soon as I am able, and to be careful not to do too much too soon.  He did not believe that physical therapy is necessary.

To reduce swelling, he provided some celebrex and some compression sleeves.

Throughout the afternoon I tried walking around without crutches.  I could do so fairly well, though it was somewhat "Frankenstein"-like, due to tightness in my calves and a limited range of motion.  As the Romans say, the journey of a thousand miles begins with a single step.  Ageamus.

Day 7

It's been a week now, and I still couldn't find a comfortable position in which to sleep.  This makes me wake up several times each night, and then finally get up feeling groggy.

The swelling seems to have gone down overnight.  Flexion has less pressure at 90 degrees, and I can go about 5-10 degrees more than that without considerable discomfort from the swelling.  Most of the swelling is above the knee joint, though I can feel some laterally.

My calves on both legs are sore, I imagine they have been doing the bulk of the load bearing over the last week.

In small spaces like the bathroom and kitchen, in which a counter is only a few shuffle-steps away, I am able to work without both crutches.  My left leg, which is been doing nearly all the load bearing recently, makes a squishy noise when I bend it.  It's not painful, but not something I've had forever.  I'm hoping this is simply overcompensation.

Day 6

I tossed and turned all last night; I still can't find a good position that reduces the discomfort from the swelling.

I can bend my leg just slightly more than 90 degrees -- which is important for driving. This was just in time today as I drove myself to get a haircut, the first time driving since the surgery.


I noticed that the doors closest to handicapped parking at the mall were not handicap accessible. I wonder if someone else has noticed this.  I instead parked by a department store that had automatic opening doors.