And so six months has gone by since I went under the knife. In a planned 18 month rehab program, I’m 1/3 of the way through. I don’t know why six months is significant but it’s certainly beyond the initial stages of pain management and learning to walk again but not quite to complete recovery. For those interested in milestones or how you should be going at this stage I thought i’d record some observations. What do you think of the photograph above? Isn’t it great. This was taken yesterday, on my first Wednesday after arriving back from the Jatbula track. I’d had a couple of days off and decided to join the Balmoral Beach Club gang and the Bold & Beautiful gang for the 6:30 AM swim at Manly. The moon that had hung lamp-like over my campsite, lighting the pandanus and casting a silvery glow over the waterholes,  was now but a faint sliver. As I always do when I walk out in the morning, I stopped and stared at a pristine dawn. Not pristine like the Australian outback with all its silence and stillness and its ancient loneliness, but pristine nevertheless. On the fringe of a major international city that is remarkable.

Today on the long Thursday swim at Balmoral the showers were broken and it was below 14°c. I couldn’t adjust to the cold during the swim and was shivering so much back in the clubhouse I couldn’t put my shirt on. I ended up wrapped in a space blanket.  Welcome back to winter in Sydney.

On May 15, this year, I published, on this blog, a 3 month milestone table. It’s interesting to go back and have a look. At six months quite a bit has changed. Some things are still the same.

WHAT YOU SHOULD BE ABLE TO DO
1) Walk with a natural gait without limping.

2) Walk 20km without feeling excessive fatigue, without frequent stopping and without any pain around the surgical incision or in the tendons around the knee or in the leg muscles

3) Carry a light backpack – no more than 20kgs – for medium distances – say 17 kms over fairly flat ground – without pain, discomfit or exhaustion and using both legs evenly for stepping up and down.

4) Stand with the injured leg straight and able to support the entire weight of the body. At six months I can now do this indefinitely

5) Lying on your back you should be able to draw the heel of your injured leg towards your buttocks with the flexion through the knee joint virtually identical to that in your good leg.

6) Swelling in the calf, foot and around the knee area, should have abated by now. If it hasn’t you should be seeking help. At six months you should be able to wear all types of footwear including leather business shoes and Australian elastic-sided riding boots. I don’t know if I could fit into my custom made Surefoot ski boots yet. I haven’t tried. That would be getting way ahead of myself.

7) Definite muscle definition in the quadriceps and calf should be evident

8) You should be able to bench press 10 kg with the injured leg five times. This should be capable of repetition at least three times without pain. This should not be done except under close supervision from an experienced personal trainer or physiotherapist. It should not be attempted without a month of buildup exercises to stabilise the injured knee joint. This should not be attempted if it causes any pain

9) You should be able to flex 5 kg with the injured leg at least five times. This should be capable of repetition three times.

10) Static lunges with injured leg both forwards and backwards in the lunge should be possible with a hold counting to 5 on each one

11) Sets of five sitting squats, with weight equally divided on each leg and back supported by a gym ball against the wall should be possible without pain

12) Step ups onto a 30cm bench holding a 10kg dumbell in each hand should be possible in repetitions of 10 step ups and five sets. Both legs.

13) Walking normally down stairs leading off each leg without discomfit and without hanging onto the handrail

14) Thirty minutes on a stationary bike, with the chain on the big ring at the front and on the middle cogs on the back of a ten speed bike i.e. the fifth and sixth cog. This should be done with a cadence between 70 and 80rpm. This should not cause any pain or resistance in the injured knee. Care should be taken that power is imparted to both pedals equally and the exercise is not done just with the uninjured leg.

14) Swimming, both with and without flippers, both in the pool and in moderate surf, should be improving. I can now comfortably swim 4km in open water but am still very wary getting in and out of the surf and will not go out in big surf. I may not venture out in big surf again.

WHAT I CANT DO
1) I still can’t step confidently out onto an escalator with my broken leg without hanging on .

2) I can’t comfortably do many one legged squats on my bad leg. Too much pain in the kneecap.

3) While I can walk properly, my stride has shortened up a lot. I now walk roughly 4km hour when I used to walk 6km hr. This may change.

4) I still can’t hyper extend my broken leg. Maybe this will never come

5) My balance is still very shaky. This I discovered on the Jatbula track and my self confidence has been effected.

6) I can’t swim quickly. While my distances are building up,  I’m only swimming about half the speed I did before I was injured. Not sure why. This is a lack of “wellness” that I struggle to define ie I don’t feel healthy like I used to. This may change.

WHAT YOU MUST NOT DO:
1) Attempt snow skiing I have been advised by my physio that I could probably ski again now. I would have to take it very carefully. I’m not prepared to risk it. Muscle and tendon structures around my knee are not strong enough yet (I don’t think)

2) Running and jogging. I couldn’t run at the moment but I’m told keen runners get going about now ie six month after surgery. I couldn’t do it though. After jumping off a small rock shelf on the Jatbula track I know my leg wouldn’t cope with the impact.

3) Golf   May be it’s ok now. Ask your physiotherapist.

4) Field sports such as cricket, baseball, hockey and tennis. I couldn’t, maybe you can. Ask your physiotherapist.

5) Body contact sports such as AFL, Rugby League or Rugby Union where lateral force can be applied to your knee in a tackle, should still be right off the agenda.

6) Sports involving sudden stops, twists and turns particularly basketball and netball

7) Anything involving high-impact downward force to the tibia. Gymnastics of any form should be right off the agenda.

8) Road Cycling. While a stationary bike is ok riding a bike on the road with fixed cleats is more problematic even at 6 months. If you were on the road and had to suddenly uncleat using the broken leg, it’s unlikely that, even at six months, you would have the strength and may seriously damage your knee with the rotational force necessary to get the shoe out of the cleats. Ask your physiotherapist.