Things they don’t tell you about going under the knife

Often times I have patients who are fed up with the injury rehab process and want to look at surgical options. I avoided surgery for a long time before I came to the conclusion (with recommendations from specialists) that it was time to consider a meniscal repair or partial meniscectomy. Over 5 years I tried every conservative treatment available (that was evidence-based) and although I got to 80-90% I never could get that last 10-20%. Mostly it was just pain that I was dealing with, and definitely some compensations, which I dealt with and was able to get back to my activities. But when I re-injured my meniscus in summer of 2018, I could not get the function back. This time it had locked, and even once I got it unlocked I couldn’t load it properly despite continuous treatment and progressive rehab. So on the waitlist I went..

I had a partial meniscectomy on January 30, 4 days ago now. It’s been interesting to be on the other side. I’ve helped countless patients prepare and recover from surgery, but this is the first time I’ve had an orthopaedic procedure myself. I do recognize that not only is this an opportunity to get back to what I love, but a chance to learn through experience. Let me tell you, it is not easy!

So, if I was going to prepare you for surgery, here are the things they don’t tell you (but you should be prepared for):

1. The stronger you are going in, the better – anytime we introduce pain, inflammation and/or disruption to the tissue, the risk of muscle atrophy is high. Especially if the limb was injured for a long period of time prior to surgery. I spent 3 months prior to my surgery on specific strengthening for that leg and I am so glad I did. This will mitigate atrophy, increase the speed of return, and decrease my chances of compensation as well.
2. The first day is a honeymoon – I felt amazing when I got home from the hospital. I even told my husband that I felt like I could go back to work. I did the exercises the surgeon prescribed and even walked to the bathroom without my crutches. The next day was not so optimistic, once the swelling and inflammation increased and the good pain meds wore off I realized that the honeymoon was short 😉
3. Post-Op rehab is a full-time job – I’ve taken 5 days off work, and the day is still full. I cycle through 30 minutes of rehab exercises, 20-30 minutes of general movement, 30 minutes of Game Ready (cold compression) and 30 minutes of electrical stim with feet elevated, 3-4 times per day! I also sleep a lot more.
4. Post-Op rehab is not pain-free – a lot of times in the clinic, we encourage pain-free movement and gradually increase intensity, range of motion, and/or volume so that the body feels comfortable doing what you’re asking it to do. Unfortunately post-operatively, we sometimes need to push through pain, as the quicker we can restore full range of motion, the better the outcomes are. There are still limits to this so it is important to stay within the surgical guidelines and work closely with a qualified therapist.
5. Healing is not linear – sometimes I feel awesome, sometimes I don’t feel awesome. You feel worse before you feel better which can really play with your mind and can get discouraging.
6. The recovery time varies, and is sometimes unknown beforehand – depending on what they find when you’re in the OR, or what type of surgery they are able to perform, it might affect your overall recovery time. I didn’t know until I woke up if I’d be in a locked brace for 4-6 weeks or I’d be off crutches within a few days. This would significantly change my recovery and even when I could return to work or travel. You must prepare for all possible scenarios.

It’s a long road ahead. Overall, I am feeling positive about my surgery and my recovery thus far, but it’s important to highlight that surgery is not the easy way out, nor is it an alternative for getting out of doing the work, because preparing and recovering from surgery is much more work than conservative care.