Beyond ACL Surgery: What to Expect 4 Years Down the Road

This is a blog based on a video from my YouTube channel. If you prefer to watch that, click here.

Four years ago, I underwent ACL surgery, a pivotal moment that changed my athletic journey forever. As I reflect on this milestone, I'm amazed at how quickly time has flown and how much I've learned about my body, resilience, and the long-term realities of ACL recovery. This past year has been particularly enlightening, filled with both struggles and victories that have shaped my perspective on post-surgery life.

Transitioning from Recovery to Maintenance

The fourth year post-surgery marked a significant shift in my recovery journey. I moved away from the ATG (Athletic Truth Group) program as my primary workout regimen, instead incorporating it as accessory work. This transition brought its own set of challenges, as I found myself in a new phase of recovery - maintenance.

One of the most unexpected hurdles I faced was the anxiety that came with reaching a plateau in my recovery. After making substantial progress in the first three years, I found myself in a position where there weren't many more significant landmarks to achieve. This realization was both liberating and daunting. As an athlete, the idea of simply maintaining rather than constantly improving felt foreign and, at times, unsettling.

Navigating Setbacks and Limitations

Despite being four years post-surgery, I encountered several setbacks that served as reminders of my knee's limitations:

1. During a 100-mile bike ride, I experienced sharp, jabbing pain in my knee for about 75 miles of the journey.

2. While playing beach volleyball, I frequently felt a pinching sensation when landing with my knee slightly extended.

3. Sudden increases in my training schedule often led to Hoffa's fat pad inflammation and impingement.

These experiences were frustrating, especially considering how far I'd come in my recovery. However, they also provided valuable data points, helping me understand my body's limits and needs better.

Embracing New Athletic Horizons

Despite the challenges, this past year has been incredibly rewarding in terms of athletic pursuits. I fully embraced my inner athlete, participating in a wide range of activities with minimal psychological or physical caution. From ninja warrior classes to CrossFit, from hardcourt to beach volleyball, and even dabbling in tennis and basketball, I threw myself into joint-intensive sports with renewed vigor.

This adventurous spirit allowed me to rediscover the joy of athleticism while also teaching me important lessons about my body's capabilities and limitations. Each new activity provided insights into how I could better care for my knee and overall physical well-being.

Adapting and Growing as an Athlete

One of the most significant developments this year was learning to adapt my playing style, particularly in volleyball. As a traditionally aggressive, power-focused player, I had to develop a new skill set to accommodate my knee's needs. This meant improving my game IQ, learning to conserve energy, and playing smarter rather than harder. While initially challenging, this adaptation has made me a more well-rounded athlete and will serve me well as I continue to age and navigate the long-term effects of my ACL surgery.

Non-Negotiables for Knee Maintenance

Through trial and error, I've identified several non-negotiable practices for maintaining my knee health:

1. Backwards sled pulls or incline treadmill walks

2. Tibialis raises

3. ATG split squats and VMO squats

4. Regular hip flexor stretching

These exercises have become cornerstone elements of my maintenance routine, helping me perform better in my chosen activities while minimizing discomfort and setbacks.

Answering Common Questions

As I share my journey, I often receive questions from others going through similar experiences. Here are some of the most frequent questions:

1. Mental barriers

   While I occasionally experience fleeting moments of caution, I've largely overcome mental barriers to movement and sports participation.
   

2. Explosiveness and mind to muscle connection

   My explosiveness feels solid, thanks to targeted work during physical therapy and ongoing training.

3. Inflammation and discomfort

   I still experience some inflammation, particularly in the Hoffa's fat pad area, but it's mostly activity-dependent.

4. Overall knee function

   On average, I'd say my knee is about 95% back to normal, though this can fluctuate based on recent activities.

5. Mobility and scarring

   My mobility has returned to pre-surgery levels, and I haven't experienced significant issues with scarring.

6. Wearing heels

   I was able to comfortably wear heels as early as 6-8 months post-surgery, though I remain cautious with extended use.

7. Bracing

   I still use a sport brace for activities that risk hyperextension, particularly in volleyball.

Lessons Learned and Moving Forward

If there's one thing I wish I had known at the beginning of this journey, it's how long the recovery process truly takes. While we're often told that ACL recovery is a 6-12 month process, the reality for athletes can be much longer. Understanding this from the outset might have helped manage expectations and reduce frustration during the lengthy recovery period.

As I look towards the future, I'm grateful for the resilience and self-awareness this experience has fostered. Each challenge has been an opportunity for growth, pushing me to become a more adaptable and knowledgeable athlete. While there have been moments of anxiety and setbacks, the overall journey has been incredibly rewarding.

To those embarking on their own ACL recovery journey, remember that progress isn't always linear. Embrace the ups and downs, learn from each experience, and don't be afraid to adapt your approach as you go. With patience, perseverance, and a willingness to listen to your body, you can navigate the long-term realities of ACL recovery and emerge as a stronger, more resilient athlete.