My Knee

I tore my left ACL playing basketball in 2010. It happened the way most ACL injuries happen, on a mundane non-contact play. I jumped, grabbed a defensive rebound, and felt the pop when I landed with most of my weight on my left leg and my upper body already turning towards the fast break as my leg stayed planted. PAIN. I was 27 at the time, and how many rebounds had I corralled since I started playing hoops? Hundreds. The routine play of routine plays, and yet on this day it turned out differently.

There’s no way to put it other than that I had no business being on the court that day. Two weeks previous, I had been playing when a not small dude ran full bore through me (on another rebound, no less), planting his knee into the back of mine. He was one of those guys who’s real strong but didn’t have the body control or awareness to be on a basketball court. The smart move would have been for me to go straight to a doctor, get an MRI, and see what kind of damage he’d caused; looking back and knowing what I do now, it’s likely that I had a partial tear. But, it didn’t occur to me at the time. I could walk well enough, so I decided to give it a couple weeks off and then see how I felt. The night of “my knee,” as many ACL Club members shorthand the injury, was one on which my buddies had only 4 players available for a city league game. The stakes in the game couldn’t have been lower, but as a basketball junkie and a good friend, I went against my better judgement and agreed to play. Literally 2 minutes into the game, POP.

It's not that my basketball “career” was going anywhere at this point; I just loved to play. Needed to, was obsessed, derived worth from it; that’s another story, which you can read in the archives. For this story, what’s important is that I was partly in denial of the seriousness of the injury and partly determined to not let it stop me from doing what was important to me. When it happened, as all ACL-injured athletes instinctively do, I recognized the pop. Even for those who’ve never experienced it, there is an innate understanding of what that unique, cringe-inducing feeling represents. You just know, and the memory of that moment sticks forever; I can still feel that pop if I close my eyes.

The pain and the implications kicked me into a shutdown. After the game (the guys won with only 4, proving conclusively that I should have stayed home), I put the knee on ice and found myself in a manic state. This was similar to coming down from the experience of a nasty car crash, when I walked away unscathed a couple summers before. When the initial panic and adrenaline subsided, I was left in a state of part shock, part denial, part determination, with a wild mix of emotions that I think is unique to the injured athlete. There are fear, uncertainty, disappointment, and resentment; there is also sometimes a sense of relief, which lasts until you get the MRI report. I’m no doctor, but I know what a “fully ruptured left anterior cruciate ligament” is. It’s literally nauseating to read that report, and no amount of manic denial was saving me at this point. Reality set in, followed pretty swiftly by a shift into “next steps” mode.

Lessons learned

Lesson 1 – maybe you shouldn’t play tonight! – was “listen to your intuition,” delivered with a 2x4 upside the head in the manner that the most stubborn people receive their instruction after ignoring it several times. This was not the first or last time that I received an important lesson in this fashion. I am, without a doubt, one of those stubborn people.

For anyone not playing a sport within a college or high-level club environment, getting in to see an orthopedic surgeon can take weeks; for me, because I knew people in the ski community, it took a couple of days. The doc was the dad of a couple girls I had ski raced with in high school. So, good for me. He advised me not to have surgery, despite a full rupture of my ACL and a flap tear in my lateral meniscus, because I was young and strong enough that I still had some stability even without one of the four major ligaments in my knee. Plus, it was ski season, not to be wasted. Here's what I know now, call it Lesson 2: When someone tells you exactly what you want to hear, be skeptical. Maybe get a second opinion. It’s not that the doc was wrong, necessarily. It’s just that neither of us were thinking about the ramifications of a potentially unstable knee 10 or 15 years down the road.

I rehabbed it for 15 months after the injury, then played ball for another 4 years. After I stopped playing in 2015, I kept working out – it helped having an office upstairs from a training studio – and I was skiing a lot, which turns out to be a pretty stabilizing activity as long as you keep your skis on the snow. The knee actually held up pretty well. But now, I’m down that road, and my knee, over the last 5 years, has been getting progressively worse.

Things really started to change when I went to grad school in 2017. My schedule – classes, work-study job, internship – meant that I didn’t have as much time to devote to the gym. Also, my priorities changed. At least from a mental standpoint, I was transitioning into a different way of being involved in sports than the life of a dedicated athlete. Furthermore, class and homework and my job were all seated activities, and the combination of less working out and more sitting proved to be problematic. I was living what has become an alarmingly common lifestyle as we transition to a digital economy: I was, at least by my standards, sedentary. After I finished school, I had a couple of phases where I worked out a lot, but in general my presence at the gym has been on a steady decline. And man, am I paying the price.

Objects in motion

One of the central post-career challenges for athletes is finding the motivation to keep working out (the others are “what do I do now?” and “who am I without my sport/community?”). When you’re playing a sport, you have a reason – a mandate – to work continually to be in the best shape of your life. It’s certainly not easy, but hard work is part of what you sign up for, and there’s real satisfaction in seeing how strong and dynamic you can make yourself in service of that goal. I remember days where I accomplished things physically and athletically that I had never thought were within my capability, all of them the direct result of consistent training and relentless stretching of my comfort zone. The trouble is, the goal eventually disappears, and if one’s drive to stay fit is wrapped up in that goal, the drive goes with it and it’s really easy and common for athletes to stop moving once their playing days are done.

Coming back to my knee: Especially over the last few years and really especially the last year, I’ve been in pain frequently. With the exception of a cortisone shot before my ski trip to Japan last year that worked brilliantly until the early summer, my knee just hurts. There’s instability, muscular imbalance, inflammation, and connective tissue breakdown. There’s also more instability and weakness in my ankle and in some of the muscles of my hip. My interpretation is that it’s what I get for not having surgery, not stretching enough when I was younger, not properly rehabbing other injuries, and not doing what I know I have to do to keep the knee supported.

I’ve had an MRI recently and according to my ortho (a different one), I’m in a weird spot. Too degraded for an ACL reconstruction, too young for a knee replacement. For the past couple of months, up until last week, I’ve been in pain off and on every day, if not all day. Sometimes I can feel the head of my fibula and/or my patella slip in and out of alignment, as the imbalanced muscles around the joint fight each other in a panicked attempt to stabilize. This causes immediate inflammation and makes it so I can barely walk up a flight of stairs. My knee also makes A LOT of noise - mostly clunking sounds - almost every time I stand up and sometimes when I just move my left leg. Sounds pretty rough, right? It feels that way more often than not.

And yet: Sometimes it feels ok. As is often the case with athletes, it often takes things getting really bad for me to ask for help, and now I have an osteopath, an amazing chiropractor, several ortho friends, a bevy of therapy tools at my disposal, and it’s all helping. I have years of experience working out, including having been through a full ACL rehab. I have a gym membership; I have a little gym in my garage. What I have been struggling with is what many, many athletes struggle with when their playing days have ended: Consistent motivation. It’s ironic that it took me this long to figure out what’s going on and what needs to change, considering my profession, but it is what it is. The problem is that my mindset around training has been all wrong.

Post-post-post-career realizations

Thing 1: By the standards of how strong I used to be – and how strong athletes in general are – my legs are weak. This mindset of comparison to others (people with a process totally different than mine that is also out of my control) and comparison to a past version of myself (who I no longer am, and can’t go back to) is keeping me stuck. In order to get moving again, I need to change my mindset about working out: I have to treat it like rehab. This makes comparison to anyone else irrelevant as I focus on my own process, and it removes any expectations about how strong I “should” be. With those things out of the way, I can just go in and do the work with no distraction.

Thing 2: Reaching for an impossible goal is not a stable source of motivation, and my drive to lift weights has been the definition of unstable; swimming has kept me in shape, but I’ve been skipping the hell out of leg day. Up to now, I’ve been lifting to try to reclaim some of the strength I feel that I’ve lost. But why? The reality is that I’m done playing basketball. My goal has to reflect where I am right now.

So, where exactly is that? What I want right now, at this moment in my life, is to be pain-free. I am blessed and privileged, mostly very healthy and still mobile with an awesome life – and what I want more than anything is to get out of bed and just go about my day without hurting. I want to be able to swim breaststroke without feeling my knee grind in and out of alignment, without limping away from the pool. I want to ski, if it ever snows. I want to not have to think about it all the time. What all that really means is that I have to take responsibility for the work it’ll take to get there; no one is going to do it for me, and I’m not going to get there in one giant leap.

Thing 3: Because I spent SO MUCH time in the gym when I was playing, because the gym came to represent or become entangled with something complicated (basketball), and because I’ve been approaching it through a lens that doesn’t fit who I am anymore, I’ve been avoiding working out. The athletic identity is amazing, powerful, and also problematic; even 8 years out from the last time I was serious about ball, I’m discovering lingering rigidity, self-criticism, judgment, and expectations around my fitness. However, what I have now that I lacked then is (a) the ability to reflect on what I’m finding and (b) the skills to reframe and take a new approach that incorporates the best of what I learned from being an athlete without the self-flagellation and shaming. Rather than lamenting what was, I can be where I am right here and right now, both in my life in general and in the specific needs of my body. In that place, I have my “why,” I have a goal, and I have the means to accomplish it.

So, Saturday was a good day. I had the best workout I’ve had in as long as I can really remember. My knee actually feels pretty good. They say that we teach the things we need to learn, and I can confidently say that I am the poster child for that, at least in this moment. I’m also happy to report that I’m getting better at listening to my intuition and being discerning about the information I take in; these days, a nudge is usually all I need to course-correct, and I sleep on major decisions. I consult people I trust, not just latching onto the first answer I receive. I haven’t needed the 2x4 method in years.

Alright, pep talk over. It’s time to get to work.

Originally published on January 1, 2024