We caught up with Alex “AJ” Jacoski to hear about his recovery journey since his November ACL tear and subsequent surgery in December. This is the second in a series on AJ’s recovery.
Hey AJ! You’re 5 weeks out of surgery. What are your general impressions, emotional, mental and physical?
The first 2 weeks have been rough, but my mantra has been “the only way to go from here is up!” Fortunately, I was able to take time off of work and stay at home with my folks for the immediate recovery process. I’m super grateful for their support and to live in a time where this procedure is somewhat routine, otherwise I would just have a bad knee the rest of my life. Still, nothing is guaranteed and I have a lot of work to do.
Injuries teach patience. After doing a pro and club season commuting from Ocean City, running Ocean City Beach Ultimate leagues and clinics through the summer and fall while working a full time job, I felt like I was constantly on the go. Being forced to stay still for a few months has been tough, but I’ve used this time to reflect a lot on 2016, set goals for 2017, and read a lot of good books.
After surgery I felt very out of place and out of my groove of being an active person. Really, I had been feeling this way since early November when I initially hurt my knee. In the future I know that I’m never going to take a single point, throw, or game for granted. I can’t wait to train and play frisbee again!
What was the procedure itself like? Take us through it. What can other first-time ACL tear patients expect?
The procedure was about 2 hours long. I was under anesthesia the whole time, and was out of surgery and home that same day. I woke up and my leg was wrapped up in a compression sleeve and in a straight leg brace. I got a “nerve block” where they can numb the nerve for your entire leg, it really helps manage the pain of the first 24-48 hours. But when it wears off, you feel it.
There are 3 common ways to replace the ACL:
- Cadaver graft where an ACL is removed from someone who has donated their body to science or is an organ donor and it gets implanted in your knee.
- Quadriceps or hamstring tendon graft: They take a 2-3 inch piece of your quad or hamstring tendon, and fix it where the ACL should be.
- Patellar tendon graft: This is what I had done. They take a piece of your patellar (knee cap) tendon with a bone block on each end, and screw it in place inside your knee (one screwed to your thigh [femur] bone, the other to your shin [tibia] bone). According to many textbooks I’ve read, this is the “gold standard” of ACL reconstruction as the patellar tendon can actually support more force than your original ACL.
For people under 35, it is recommended that you use your own body tissue as the body accepts its own tissue better. In addition to your ACL implant healing, the site where they take it from will take time to heal. For me, that’s my knee cap area. Ouch.
You have a unique relationship with your doctor. When did you first work together and what has your relationship been like during surgery prep and recovery?
Dr. Robert Frederick of the Rothman Institute also did surgery on my rotator cuff in my left shoulder in 2012 (surfing wipeout injury), before I played with the Breeze. I have continued working on my shoulder mobility and strength over the past several years and haven’t had any issues. Generally surgeons at Rothman specialize in 1 or 2 joints, and luckily for me, he does shoulders and knees. Dr. Frederick is very personable and took the time to understand my lifestyle and my goals for recovery. But hopefully I’ll never see him again.
Have you passed any recovery milestones, so to speak? If so, what?
Before surgery, I had to restore full range of motion of my knee and strengthen my quad through some physical therapy. Strengthening the quad and regaining mobility really accelerates post-op recovery.
After surgery, the first step was getting off crutches, which took me about 10 days. Amazingly, you can start putting full weight on your knee (as tolerated) only a couple days after surgery, but you have to wear a straight leg brace 24/7. Also, my knee was about the size of a grapefruit so getting it down to normal size was a relief, which took about 2 weeks. Compression and ice (20 min on, 20 min off) are useful recovery strategies for any athlete, and especially for injuries.
How are you managing your normal daily life around recovery? How have you made time to fit physical therapy and stretching and strengthening into your day?
Ditching crutches and being able to walk was amazing! I could carry something and walk at the same time again. After about a week I resumed workouts, combining my home PT exercises with general upper body and core workouts. Still couldn’t put much pressure on the leg, but felt really good just to move again.
I started physical therapy 2 weeks after surgery back in Ocean City. Many places have great equipment, but it’s important to find someone who has worked with athletes and understands your goals for recovery.
Any notable successes to share in your recovery so far? Any particular struggles?
You can work on knee flexion also within a few days just by sitting on a countertop, and using your good leg to move your injured leg through range of motion up to 90 degrees. It hurts but feels great to bend your leg after it is straight for so many hours a day.
A big task for any ACL patient is to get full extension back, that is, being able to fully straighten your leg. Out of comfort your leg will want to stay slightly bent, but you risk losing this last bit of mobility if you don’t actively try to straighten your leg. Propping something under your heel and letting your leg hang is painful, but necessary. The first 6 weeks are critical in re-establishing full range of motion before any knee strengthening happens.
Anything surprising to you about the recovery process– an obstacle or success you didn’t anticipate? New body awareness developed? New relationships formed?
Biggest piece of body awareness I’ve gained is the importance of the kneecap. Without it, your leg would just buckle in any direction. The quad’s ability to contract and hold your knee cap in place is one of the first exercises. Seated with a straight leg, contract your quad and push your knee into the ground. With swelling and new hardware in there, this was uncomfortable and hard but felt good to get better every day at this simple muscle contraction.
What role has social media played in your recovery?
I’ve been posting updates on my Instagram @sagebroj and the random people, both from ultimate and the rest of the world, who have messaged me words of encouragement has been incredible. I’ve also heard from several friends who have gone through ACL surgeries and their hard work and success is a huge source of motivation for me. I’ve been following @ACLrecoveryclub for guidance and support. In addition, I’ve found a lot of great training tips from following @movementasmedicine
Of course, I think everyone should follow the MP team: @morrillperform @timmorrill @goose00helton and our dude from Australia, @nejiwiz, has been making some great videos.
Anything else you’d like to share?
Nobody plans for bad things to happen. Keep your eyes open and look for positive outcomes, or new opportunities that come your way. Greet challenges with optimism and when you overcome them, it’s that much sweeter.
I want to say Thank You to my teammates and everyone else who has reached out to me through this process. Ultimate is such a tight and caring community and I’m very grateful to be a part of it.