One of my closest friends, fellow ballplayer and trainer, and occasion contributor to this site, Andrew Sacks, just underwent PCL surgery on his right knee. He is chronicling his recovery, which I think is a great idea – one that I wish I had done myself with my elbow. Unfortunately, Andrew has an even longer road than most, as his left knee needs at least one ligament replaced as well, so two or three months into rehab on his right, he is going to be on the surgeon’s table again to get his left knee repaired. For a lifetime athlete, he is in for a long battle with inactivity and rehab.

Apparently Andrew bruises easier than grandma.

So, check out his blog entitled Life After Knee Surgery. Andrew writes well, and if you’ve ever laughed at one of my random thoughts or jokes, then you’ll enjoy his brand of humor as well (we basically share that brand). And if you further find yourself wondering about the difficulties of going to the bathroom while in a straight-legged knee brace, look no further.

October 23, 2008
It was the 8th inning in a fall league game and I was rounding third to score, the catcher came across the path with the ball and I slowed down when I hit him, which turned out to be a big mistake. I jammed my left knee either into the plate or into his shinguards, and the pain was immediate. I figured if I slowed down it would soften the blow, but if I had just kept sprinting through him he would have taken the hit and not my knee. I kept catching and dealt with the pain, nothing popped and swelling was minimal. The game went 14 innings and ended just after midnight, I went home and iced and went to bed. When I woke up in the morning my knee was tight, no swelling, and pain index of 6 from 1-10. I rested for a week with no action at all, and tried to get it ready for a Florida tournament the second week of November. I caught 2 games in 4 days, which was not out of the ordinary, and while my knee was sore it was not in any real pain. Rounding third as the winning run in the second game my knee gave out, snapping backwards. I went from full sprint to 0 in one step, and knew it wasn’t good. I caught one game after this and went home to see my doctor. After an MRI the diagnosis was a grade 1 sprained PCL and ACL, as well as a deep contusion on my patella. I was instructed to take it easy for 6 weeks and then try a running program. Step 1 of the running program was January 1st, and my knee again buckled and I ate it. I went back to another doctor, who had previously taken care of a SLAP Labrum tear. He diagnosed my knee as a grade 2 PCL tear, and informed me if I wanted to keep playing at a high level, I would need surgery.
March 9, 2009
Two weeks after seeing my doctor (Richard Levine) I had surgery. He used a 20 cm strip of my hamstring to repair the PCL and that was bolted down by 2 large bolts, he shaved a lot of bone as well because they had been rubbing from the knee slipping. The surgery lasted 90 minutes, and I was in an immobilizer with my leg locked at full extension for the first two weeks. I started therapy and I progressed well, my recovery was expected to be 9 to 12 months. I did therapy three times a day on my own and met my therapist 2 to 3 times a week, and after 3 months I was able to run on a treadmill. At 6 months I was cleared to begin playing. My hard work and dedication to my knee made it all possible. However, I am almost 8 months post surgery and still have hamstring issues. I can squat, my left knee is still slightly more tight than my right and the power in my left leg is still lower than that of my right. I cannot fully sprint because of the lack of ability to push off, my hamstring cramps if I push off with my left leg at maximal effort. My doctor expects a full strength recovery by this coming March, I feel like I am at 90-95% now but my hamstring has been a problem for 2 years so hopefully this does not continue. Overall, my knee surgery was the right decision, the result was better than expected, and my recovery was extraordinary minus the hamstring issues.
My recommendations for anyone undergoing a knee surgery are to find a great surgeon who is comfortable working with you and understanding your needs. Also, make sure you push yourself. My trainers did not like the pace at which I wanted to work but they also don’t know my body or what it was capable of. I am not saying to disobey your therapist, but find a healthy balance of what your body can handle. Recovery should never cause more pain, and if so you are likely doing too much. A healthy diet definitely played a role, as well as dedicating my time to my knee.
For now, I am still playing and have played for the last few months, I began by DHing and then playing first, I pitched a few innings, and then began catching at 6 and a half months. I started with half games, and am now catching full games. The only complaint remains the knee tightness and weak hamstring. My hamstring is really not responding well as it cramps when it exerts force, making recovery hard. I feel if I keep working and doing my therapy exercises and strengthening exercises I will be 100% by the end of the year.

By Jon Hart, Assistant Coach Harford Community College Baseball

To me, nothing is worse than being injured. For as long as you are too hurt to play, you are on the outside looking in as your team continues on without you. You have to sit out of practices and games while you wait to heal up, which could take weeks or even months. During my senior year of high school I broke my thumb in our homecoming football game and had to sit out the last game of the season (and my career), which was against our conference rivals to determine who would take home the championship that year. I watched helplessly from the sideline while my teammates played and won the championship game and I celebrated with them afterwards, but the win was completely unsatisfying for me and the experience left a bitter taste in my mouth. After that experience of watching my team win a championship without me, I decided that no future injury was ever going to keep me from playing again.

Over the course of my athletic career I have suffered several injuries including a partial tear of my Tommy John ligament, the broken thumb, and various sprains and strains. All of these were relatively minor injuries and none required surgery, so I usually played through them. As a result, I have become accustomed to playing with some degree of pain and discomfort. However, when I tore my ACL in December of 2007 I thought for sure I was going to miss my entire junior season of baseball.

I have always loved sports and I rarely turn down an opportunity to compete, so when a few of my teammates asked me to join their intramural basketball team at school I agreed to play. In our second-to-last game of the year, I planted awkwardly while trying to guard an opponent and twisted my left knee. I felt a strange crunching sensation inside my knee, followed by intense pain and a sense of “looseness” within the joint. I immediately dropped to the ground and nearly blacked out from the pain. I managed to hobble off the court and later drive myself home, but I couldn’t sleep due to the fact that my knee hurt no matter what position it was in. The next day my knee had swelled and I was unable to bend it enough to even get up and down the stairs.  A few days later I went to see our trainer, and he told me I had torn my Anterior Cruciate Ligament. Of all the possible things I thought I had done to my knee, a torn ACL had never occurred to me, and I was immediately filled with dread that I would have to get surgery and sit out the season.

I had spent the first few years of my college baseball career as a backup catcher and had finally been able to crack the starting lineup as a junior after a solid showing in the fall season. When I got the news about my knee, I was devastated. I thought of all the time I had spent in the gym and the batting cages and how it was all for nothing now that I had suffered this injury. I remember telling my dad the news, and how disappointed he was. He had been looking forward to seeing me play that season, and he was just upset as I was by the news: I would not be playing for another year. I also knew that with only two catchers on our roster, I would be hurting my team by sitting out the season. I weighed my options and I decided that I wasn’t going to miss my opportunity to finally play, so I decided that I would play the season ACL-less.

Playing with a torn ACL is not easy, and I would not recommend it for everybody. I spent 4 miserable weeks over winter break just trying to get my knee to bend enough that I could comfortably get into a catcher’s squat. I went to see a doctor and got a prescription for a custom-fitted brace to protect my feeble knee from sliding in and out of place. I also spent hours in the gym working to strengthen my quadriceps and hamstrings to take some of the strain off my remaining ligaments and stabilize my knee. Throwing became a difficult and often painful chore, as the rotational forces on my knee during my follow through caused it to buckle several times. Though I suffered a few setbacks over the winter, I was convinced that I could be in playing shape by the first game of the season in the last week of February.

By the time February rolled around, I was able to throw, hit, and run, but I still could not fully get into my crouch behind the plate. Nevertheless, I went back to school to begin spring practice with the rest of my team. I hadn’t told my coach about my injury for fear that he would be hesitant to let me play, so I had to hide my knee brace by wearing long pants to practice every day while my teammates all wore shorts. A few of my teammates knew the full extent of my injury, but most just knew that I had “tweaked” my knee playing basketball. During the first week of practice I was able to keep up with my teammates during running and agility drills, but my mobility behind the plate was absolutely miserable. To make catching possible, I had to change my stance so that almost all my weight was on my right leg. Blocking balls to my right was an especially daunting task, since it required me to push off of my left leg at an angle. Every bullpen session would end with my left knee swollen and my right leg on fire from doing the work of both legs, but I suffered silently and kept my knee on ice for hours after every practice to try to keep the inflammation down.

By the time of our season-opener in North Carolina (2 months after my injury), I had regained full range of motion and felt confident that I would be able to play. There was still a shred of doubt, though; a lingering worry in the back of my mind that my knee would just give out on a throw or a swing and end my season for good. Thankfully, that moment never came. Instead, I was encouraged by a play that I made behind the plate that nobody else noticed.

When playing with an injury, an athlete will usually remain cognizant of the fact that something about their body is not healthy and will change their mechanics to keep from causing themselves pain. But sometimes, a player will be so locked in and focused that they essentially forget their injury and revert back to old mechanics, which may or may not result in pain. I had this experience during our fifth game of the season in Stafford, VA. I was catching in the early innings, and our pitcher bounced a curveball in the left-handed batters box. Without thinking, I pushed off with my left leg, slid in front of the ball, and blocked it. To everybody watching the game, this was probably a very forgettable play. But for me, it was huge. I had just used my knee exactly the way I used to, and had felt no pain whatsoever. The shred of doubt in the back of my mind disappeared just like that. I even hit a triple later in that game, a fact that I am particularly proud of since I doubt very many people with torn ACLs have legged out a triple in college baseball. If you don’t believe me you can watch it here:

I played the entire season without any problems, and planned to have my knee operated on in June. However, as my surgery date approached I began to have second thoughts. I didn’t want to be confined to my bed or crutches for any amount of time. I also didn’t want to miss the fall season of my senior year. During the week leading up to the day of my surgery I thought constantly about whether or not I should have the procedure done. Ultimately, I made the decision to push back my surgery a second time. I played with the brace again during my senior year and only had one minor flare-up in my knee during the season. I didn’t have a great year, but I did hit .478 with runners in scoring position and played well behind the plate.

My college baseball career is now over, but I still play semipro ball in the summer and I still play basketball, lift weights, and take part in many other physical activities. Since the summer, I have been weaning myself off of the knee brace, and I’m now able to play sports and run without using it at all. The only time I wear my brace now is when I play flag football just in case somebody decides to take a cheap shot at my legs. Other than that, I am now completely free of the brace and my knee feels stronger than it has in years. The first few times I played basketball without it, my knee felt a little unsteady, but as the days went by I could feel my knee getting stronger and tighter. This progress continued, and my knee now feels almost like it did before my injury. Every once in a while I can feel it give a little bit if I plant too hard on my left foot, but the joint is not nearly as lax as it used to be.

The point of my article is this: if you suffer a torn ACL, don’t automatically think that your playing career is over or that you’ll be crippled for life. Obviously, if you’re young or a professional prospect with a long career ahead of you, you’ll want to have surgery. But if you’re like me and you just want to squeeze as many games out of your remaining time as possible, you can play without your ACL. The most important thing is to strengthen the muscles surrounding your knee as much as possible to keep the joint tight. It also helps to have a fairly high pain threshold and a little bit of mental toughness.

I often think that I could have been better if I hadn’t hurt my knee, but I have never second-guessed my decision to forgo surgery in favor of playing hurt. When I was trying to decide whether or not I wanted to have my knee operated on, I kept thinking about how I felt while I was watching that football game in high school, knowing that I would never get to play again. For years I regretted my decision to sit out that game, and I didn’t want to have those same feelings of regret when I looked back at my college baseball career. I did whatever I could to play as many games as possible, and I don’t regret it one bit.