A Long Road. That’s what everyone keeps saying. That’s right people, you are not original, it’s a cliche for a reason. I went to the university of Buffalo orthopedic office Wednesday, to discuss what to do about my f’d up knee. For a place where injured people gimp into all the time, it was not the most easy to navigate. I had to stand to be covid screened, stand to wait to check in, stand to check in, and then hobble on crutches all the way down the hallway which was roughly the length of a football field. Or maybe football was on my brain because there was Bills paraphernalia all over. I don’t give a —- that you are the ortho office for a professional football team, crutches are still hard to walk with. In any sense, I was exhausted before I even reached the room.

They downloaded my mri, and then the overseeing physician came in. He wiggled my knee, pressed his fingers into my swelling, and then we talked about the plan. Both my MCL and my ACL were torn, and the healing strategies for both are completely opposite.

First, heal the MCL. The MCL is the medial collateral ligament that runs along the inside of the knee and keeps you from being bow legged. Apparently MCL tears are rated on a scale of 0-3. I don’t want to brag, but I’ve always been an overachiever. I’ve been falling for years, all in preparation for The Fall. I managed to score a 3, against all odds. That’s right folks, I did it. The elusive 3rd degree tear. According to Dr. Rauh, MCL tears are not surgically repaired. The treatment is 1 week in the immobilizer, non-weight-bearing, for every degree of tear. So I get, that’s right, 3 weeks immobilized. Then, after everything is nice and stiff and weak, we begin ‘rigorous’ physical therapy (PT), 6-8 weeks. Somewhere in the middle of PT I will graduate to a hinged brace. Yay. He was vague about when the crutches go away.

Then, after the MCL is sorted, we can move on to the ACL. The most famous of ligaments. I remember as a teenager a cousin tore his ACL. I knew that it was a knee injury, but I had no idea what a ligament was, let alone what the anterior cruciate ligament did. inside the middle of knee, there are two ligaments that make an X to stabilize the knee, and the ACL is the front of that X. This is the ligament that won’t heal itself, the one that is flipping the bird at me, laughing as I try to put weight on my leg and I feel the whole joint slide. According to Dr. Rauh, a lot of people live forever without ACLs. Without an ACL, I can still bike ride, I can run (on smooth surfaces), I can do daily activities. However, if I want to do anything that requires stabilization, such as hiking, skiing, running from the lake to the biking area in a triathlon, etc, then he would recommend a repair. Surgery would be outpatient and I would go home that day, and then have another 8 weeks of therapy after that. Because of my age, and my activity, and my potential years ahead of me, he would recommend a surgical repair.

What I remind every patient is that every choice is up to you. If you don’t want to take a pill, you don’t have to take it. If you don’t want to have surgery, you don’t have to do it. So this choice lays before me, in 10 ish weeks. A Sword of Damocles, what to do. In 10 weeks I’ll be out of the immobilizer and done with my first round of therapy, and surgery is going to set me back to ground zero. Then I’ll have another 8 weeks of therapy, and THEN after 4-5 months, is when I will have to start all over with actually exercising; building up my strength and endurance, learning to bike ride and run and swim all over again.

When we were talking, I wanted to make it clear what level of activity I aspired to. “I know I don’t look super sporty, but this past summer I worked hard and did several sprint triathlons. Is this something I will be able to do again?” Dr. Rauh, “absolutely.” His immediate, unquestioned response was very reassuring. Me,”possibly this summer?” Him,”weelllll…..” sigh. So no, I’ll have to work all year to get back to here, where I am now, and no events to spur me on. But if anyone knows me, I’m a hard worker, and I’m stubborn AF. There’s a large goal, surrounded by smaller goals to get me there. And there will be setbacks, and frustrations, and a lot of tears. I know I can do this. To end with another cliché: set ‘em up, knock ‘em down.