Back On The Court & Setback

A couple weeks ago, I thought I was getting close to a near full recovery from my ACL surgery. I was doing agility and jumping exercises, cutting, and had pretty good numbers on the Biodex machine (shows strength deficiency on injured leg relative to non-injured leg). With all these positive signals, my physio suggested I get back to playing some very light 5-on-5 basketball. It was Thursday morning, and I told myself Saturday is going to be the day I get back on the court.

I took the train out to NYU Brooklyn Athletic Facility at the MetroTech campus. I’ve only been to this facility 1-2 times before, and never actually saw the basketball court. The gym is still new and shows signs of construction around the locker room and weight rooms. I made my way to the locker room and took out my Nike Hyperdunks from my Nike duffel bag which I’ve done hundreds of times. I also took out a compression sleeve I had received a few years back when I had a minor strain to my MCL.

When my Hyperdunks hit the locker room floor, something clicked in my brain. It was a strange sensation, almost like deja vu. This was an act I’ve done time and time again, stopped doing for 9 months, and picked it up again after the break. It feels like seeing your high school friend, no matter how many years have passed, you still feel a sense of familiarity and closeness regardless of time passed.

Akin to a soldier putting on his gear to go into battle, I too felt like I was finally getting a shot at some action. I loosely tied my shoes, locked my duffel bag, and made my way up to the court.

There was already a 5-on-5 game going on and I saw a few people shooting around on one side of the court. An all too familiar feeling. I casually walked up to the guys shooting around and asked if they had next. They said they had 4 guys and I would be the 5th, so I came just in time. I walked over to the sideline and did my normal routine of dynamic stretching and got my legs warm.

I’ve written about my routine before, and the routine of playing a pickup basketball game is no different. The current game finally ends and there’s always a downtime of 5-10 minutes when the winning team takes a break to recover. Our team is waiting to play but no one’s ready and no one wants to be “that guy” who rushes everyone to get back on the court, so I just shoot around some more and get my body ready for what I hope to be a “light” game.

I end up guarding the best guy on the other team who is checking the ball, and in my mind I’m already saying “oh boy, here we go.” We’re at the top of the key and the guy checks me the ball. In this moment of getting passed the ball, I feel a smile come across my face. It was a smile I couldn’t hide because of all the giddiness and excitement I was feeling from actually getting to play again with guys who were semi-decent.

Over the last 9 months, this feeling made up for all the pain the few days following surgery, the helplessness during the first two weeks when my dad and friends helped me with the basics of life, and the rote stretching and strengthening every Sunday morning in my building’s small gym.

If I could bottle up that feeling of checking the ball and getting into a defensive stance, I would take that bottle and chug it every single day to re-live that euphoric experience. Perhaps it shows the influence basketball has on my life, or the satisfaction coming from working towards a goal, I knew that this would be a defining moment in my recovery process.

From that point on, the instincts and training took over. As I ran up and down the court on offense, started shuffling on defense, and jumped with 50% to grab rebounds, an internal voice told me to not give 100% and still guard against injury. I knew it wasn’t worth re-injuring something or trying to get back to the level I was before. I still remember a few moves that as I was doing them, I affirmed to myself that I could still do certain things and “this felt like the old me.”

For instance, I caught the ball in the high post on one play, turned around to the defender and did a quick pump fake to get him in the air, and then dribbled into the lane for a light jump hook. On another play, I went around a screen on the baseline going towards the sideline, caught a pass, and hit a medium-range jumper. As I ran towards the screen and flared out, I remember feeling all the training of pivoting and change of direction coming to the surface, like this was the exact move I was supposed to do at this point in the game. After I sank the shot, a few of my teammates mumbled “nice shot” even though it was just a medium-range jumper on the baseline. That feeling of doing something good, and being recognized for it, is one of the reasons that keeps me going back to this game even though the play was short of extraordinary.

I lost all 3 games I played, but didn’t care since I was able to play full court and was actually contributing on both offense and defense. I remember one play I got a little ambitious, and actually had the ball on a fastbreak with only one defender in view. I passed half court dribbling as fast as I could, and knew the defender had good handles since he was the other team’s point guard. He cleanly swiped the ball from me and I broke my fall as best as I could careful not to injure anything, and as I got up told myself internally that was not the best idea (but I had to give it a shot any way).

Afterwards, we were all hanging out on the bleachers and I noticed a light scar on the knee of the guy who I was guarding. He was a black guy, about 5’11”, and similar build as me. I asked him if he had surgery and he said he had broke his knee back in high school hence the scar. I showed him my relatively fresh scar, and we both commiserated about the recovery process despite my injury happening a decade or so after his. For those who have gone through knee surgery recovery, that experience is fresh in your memory and gives you a perspective on conditioning, sports, and life that only others like you will understand.

The gym closed soon after our last game, and I headed back down to the locker room to pack my stuff. I left the court feeling high on adrenaline, and wish I could’ve played a few more games with these guys since it wasn’t a super serious game but still competitive enough for people to care. The next morning, the reality of what I’ve done set in.

A Hopefully Minor Setback

Long story short, I went a little too hard during pickup, and my knee swelled up a bit so I did the normal REST routine plus some NSAIDs. In all my years playing basketball, I’ve never had my knees swell up before after playing, but I’ve come to terms with the reality that this is my condition and will most likely happen in future games where I play too hard on my knee.

I went on vacation for a week and after coming back, swelling went down and I was ready to get back into strengthening and playing again. The problem was, I couldn’t run on the treadmill past 6.5mph without feeling some pain on my patella. I would try to warm up and stretch as much as I could, but once I started running/jogging at 8.0mph, the discomfort would set in and I didn’t feel like my knee was strong enough to maintain the fast speed.

After seeing my physio last week, the diagnosis is that I may have some light patella tendonitis or patellofemoral pain which is associated with over use of the knee joint. Apparently all ACL recovery patients who have used a patella autograft will go through this type of pain or discomfort at some point during their recovery, but it usually happens earlier in the recovery process, not this late in the game. I’ve never really had any issues with patella tendonitis so my physio said this may just be the syndrome catching up with me after I played those few games of basketball. Additionally, my Biodex measurement went to a 30% deficiency on my injured leg in terms of endurance or “slow” strength on my quad. My deficiency up until that measurement was only in the 10%-15% range.

The prescription, for now, is no agility or jumping, and no running at fast speeds for a week or so for the flare up to calm down. My routine is back to good ol’ strengthening doing squats, deadlifts, and other closed-chain exercises. I’m doing the elliptical now for cardio to avoid flaring up the patella on the treadmill.

Was it all worth it? Were those few pickup games worth the condition my knee is in right now? Absolutely. As irrational as it sounds, recreational athletes beat themselves up, recover, and get back into their sport to have the process start all over again. This constant performing and rebuilding cycle is what keeps you healthy and active to a certain extent, although my performance over time will continue to decrease with age. I’m getting a little poetic now, but I can’t help thinking about the work going into the last 9 months and the goal I’ve set for myself which is getting back to playing in various leagues and pickup ball.

 

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New Non-Invasive ACL Surgery?

Tried my best to get through a detailed post from b-reddy about a new form of non-invasive surgery championed by Dr. Martha Murray:

Detail of the actual operation from b-reddy’s YouTube channel:

I posted a comment on b-reddy’s post about this new surgery, and I tend to agree with his point that this surgery is still way too new, but maybe that’s how all revolutionary movements start? The gold standard has always been a patella autograft, and those who are going to undergo ACL reconstruction or have had ACL reconstruction may harbor confirmation bias towards this operation over inferior operations (i.e. allograft). In other words, the sample set is not big enough for this new form of surgery and thus I would not elect to get this operation if I tore my ACL today and needed to select my preferred ACL reconstruction operation.

ACL Recovery Day 199

Passed the 6-month mark, and honestly the rehab and training now just feels like I’m, well working out. The exercises are more intense and high impact such as agility work, jumping, and deadlifts/squatting. Been seeing a new physio every week for about 8 weeks now, and I can honestly say the rehab process feels like I’m training for a sport. Which is exactly what I’m looking for (going back to basketball), but sometimes I miss the more laid back rehab from the early months when I couldn’t do a lot of dynamic exercises yet.

Throughout the week, as I’m going to the gym and doing my exercises, I sometimes lose focus of what I’m doing all this for. At this stage, I can go about what physical therapists called ADL (average daily living) activities. This means that the only real reason I’m still training hard at the gym is to go back to basketball and sports. Lately, I’ve been contemplating if I even want to go back to playing basketball and high impact sports. Ever since my surgery, I’ve had more time to watch documentaries, read, and pursue other hobbies. I didn’t realize how much time league games and pickup took from my life.

I may just be in a funk since I haven’t played in so long, and when I get back to playing my addiction to the game will come back and this whole train of thought is moot. Nonetheless, this is what I’ve been thinking about when I’m working the agility ladder on  Friday night.

Hoop Dreams

Literally, dreams about hooping. On two different occasions, I had these vivid dreams where I felt the longing to play basketball more so than when I’m conscious. Here’s a description of one of these dreams where I was half awake but felt the impact from the dream after I woke up.

It’s hella early in the morning, maybe 5-6AM. I was waking up to go to the gym and walked by an outdoor basketball court with flood lights keeping the court and backboards lit. I swear this was a dream, despite it sounding like real life.

The basketball court is on my way to the gym, and as I get closer I see that there’s a  5-on-5 game going on and the guys are going at it. I stop and watch and see players driving, pivoting, and getting fast break layups. My natural reaction in this situation is to walk up and see who’s standing on the sidelines and ask who’s got next. But before I can do this, I’m reminded about my injury and the rehab I need to do at the gym. I see the guys play and reminded about the times I was trying to really play ball and make a career out of it, and I see that dedication in each of these guys who are up and playing at 6 in the morning.

In addition to this dream, I’ve had another one where I am doing a fastbreak layup. That feeling of gliding through the air, getting past the defense, and laying the ball up is one of the more positive feelings I get when playing ball now that I think about it, which is why I probably dreamed about it in the first place. When I woke up from this dream, the reality about my injury came forward and I contemplated whether I would be able to do this action again. I quickly dismissed the fact that I wouldn’t be able to do this again, and just trusting in my physio and rehab will get me back on the court to hopefully 90% of what I used to be before.

Exercises

I’ve still been posting most of my exercises on insta, but the exercises are, as I mentioned earlier, becoming more dynamic and sports-specific versus building function back in my knee and leg.

 

ACL Recovery Day 129

Took a break from my rehab for about a week for the holidays, and haven’t been keeping up with my exercises for the last few days because of New Year’s, but am getting back on track with a good workout today. At my last PT appointment, my physio said that I’ve progressed really well and on track in terms of what activity level is 4 months out. The problem is that she can only do so much for me, so now I’m on the hunt for a new physio focused on basketball-specific training.

My friend is a PT in NYC and I had my first screening with him a few days ago. His assessment of my condition:

  • On track for 4 months from surgery (knew this already)
  • Quad strength is good (but can always be stronger)
  • Glute and hamstrings could be stronger
  • Hip muscles pretty weak on both sides (wtf?)
  • Flexibility needs work

The last two points were surprising to me since I’ve never had any hip strength problems, but now that I think about it, it might be that I never had good hip strength since I’ve don’t consistently do exercises focused on these muscles. The flexibility aspect was also interesting, and he worked on my flexion and extension (pushed me to a little hyper extension) and was able to get my leg to 150 degrees flexion by me laying on my back and bending my leg backwards.

Next Steps

My focus will be on the jumping and agility for the next few weeks, and hopefully getting into a regular routine with my friend who does basketball-specific training. Aside from all the workouts and exercises, dealing with all the logistics of scheduling the training is also a headache (but nonetheless necessary). My original physio accepted my insurance, but my friend’s clinic doesn’t take my insurance so I’ll be paying out of pocket, although we’re going to try to work something out.

When it comes to my healthy, I’ve never been shy about spending the money or resources to get the best treatment, but at times the reality of the cost of healthcare leads me to fall back on what providers accept my insurance. This is always a slippery slope, but in this instance of getting back on the court, I can’t see no other option but to pay for this myself since it’s important to re-gaining a healthy knee for the rest of my life. Once I’ve set up a schedule with my new physio, I’ll still see my old physio for checkups on my progress, but they will most likely be limited to once per month.

Additionally, the surgeon’s rehab protocol kind of “stops” from 4-6 months. The primary goal during this phase (according to the protocol):

Gradual return to athletic activity; Discharge onto home program

The exercises prescribed include “Jumping,” ” Unilateral hopping,” and “Agility drills; running, cutting.” Not super helpful in terms of detail so I’ll have to start doing my own research on what kind of drills and exercises I should be doing to build up the endurance and speed I need to get back on the court. Most likely, it will be a combination of agility and jumping, mixing in the usual strengthening and conditioning exercises I’ve already been doing. On top of this, I need to allocate more time for stretching to re-gain flexibility in my quads (to prevent tightness around my patella). It feels like the exercises just get added on top of each other, I almost miss Day 1 when the main exercise was the leg raise.

Exercises

Not a whole lot of new ones, but I recently purchased an agility ladder to help with all the agility exercises I want to do built speed and quickness. Having a ladder has allowed me to use my creativity and doing exercises that I wouldn’t do otherwise. Who would have thought a simply object as a ladder could be so beneficial for sports recovery?

Discipline Equals Freedom

Not my words, but a phrase I’ve been thinking about the past few days after listening to Tim Ferriss’ podcast discussion with Jocko Willink.

Jocko Willink & Tim Ferriss

Talk about a power-hitting duo. For the last few months, I started listening to podcasts at the recommendation of my friend TJ, and I constantly find myself going back to Tim Ferriss’ podcast since I have always been a fan of Tim since reading the 4-Hour Workweek. So this podcast brought out the precision of Tim’s interview style with a guy that has looked at death right in the face as a bad ass Navy SEAL in Iraq.

Thoughts About Discipline

Tim asks one of his classic questions “What would you put on a billboard?” and Jocko answers:

Discipline equals freedom.

His belief is that being disciplined in all aspects of your life, be it work, gym, eating healthy, etc. rewards you with more free time (and freedom) to do other things you want to do. The counter-argument is that being disciplined in these areas of your life also can mean you are locked in to a way of doing things and following a protocol that is the opposite of being free and creative.

In my life, discipline means being able to control my destiny to a certain degree. Being able to follow a process and protocol that I know will lead to an outcome I want, whether it’s work, working out, basketball, etc. I know I can control the outcome with X% confidence, and the rest is left to luck and the higher powers.

A few examples:

  • ACL Injury – My last few stories have been about my recovery from ACL reconstructive surgery, and no other injury in my life has been as physically challenging as this one (typical ankle injuries and bone bruises from playing basketball). The protocol from the PT office and from other resources I’ve found online break down the exercises you need to do on a daily basis. There is no room for error, if your goal is to recover and build strength back in your leg. Straying from the protocol, for me, means failure. So on the days I was tired, sick, or had other things to do, I found time to get in my exercises because I did not want to fail. It boggles my mind that one could forego a life of a healthy knee because they were too tired or lazy to get their ass off the couch and onto a yoga mat to do some stretching and exercises.
  • Eating Healthy – Some people say I am the most boring person to eat with, and I don’t blame them. I am disciplined about what I eat because I feel that I am able to really enjoy other foods and meals when I have a baseline of meals I always consume. This means the same omelettes, chicken, salads, spaghetti, and newly added steak make up 90% of my diet. Part of it is that I know how to make all these meals very efficiently and there is not a lot of room for experimentation or fucking things up. Every meal does not need to be laced with truffle oil or ice cream, because if they were, wouldn’t the enjoyment you derive from these “unhealthy” foods be less?
  • Morning Routine – Much like I follow a protocol for my ACL recovery, having a morning routine prepares me for any shit I have to deal with that day. This is where I see Jocko’s point a little more clearly, because I feel that if I don’t go through my morning routine, I don’t have the energy and stamina to get through my day. More specifically, I do not feel equipped with those attributes. I eat the same shit for breakfast, do my pushups and pull-ups, and everything is done in a specific order. I remember Tim talked about this in one of his podcasts but accomplishing these small tasks in the morning such as making your bed have profound effects on your mental capacity throughout the day.
  • Work – This is a little harder to find the connection, since I’m working on a startup and every day new problems and challenges come our way. However, we could easily let emotions and anxiety rule our minds and respond to these challenges in unproductive ways. Instead, my team approaches every challenge the same, by prioritizing which problem needs our attention the most and then doing a triage from there. If you become too emotional about someone who has brushed you off or losing a deal, you will fail. Your business will fail. In this context, discipline around how you conduct operations and business processes helps you control the final outcome.

Being A Man From a SEAL

Tim also asks Jocko what 3 events led Jocko to feel like a “man.” A big question that could yield all sorts of answers, but Jocko gives his top 3:

  1. Jiu-jitsu
  2. Combat (in Iraq)
  3. Getting married and having kids

These seem like pretty generic answers to me, but the theme between all three answers is that these events gave Jocko confidence in himself. I wrote about being a man in a previous story, and confidence is probably the main quality trait Jocko has that many men lack. He was unwavering in his answers back to Tim and it showed that these events truly turned on a light switch in his mind about what it means to be a man.