I had microfracture surgery in late December (22 DEC, to be exact) to repair a defect in the patellofemoral groove in my right knee. I spent six+ weeks in a locked brace, just getting out of it this past Friday (5 FEB). My doctor appears knowledgeable about the surgery, but not as knowledgeable about recovery for an endurance/industrial athlete. I’m wondering whether there are any other STers out there with similar experiences who can share how their recovery went, from the return to activity period (where I am now) all the way up to full recovery and activity (where I hope to be this summer, at about the six month mark).
I had that surgery twelve years ago. I wouldn’t describe my recovery as “textbook”, so maybe you can learn from my mistakes. I was mainly running at the time. It sucked. it hurt. I couldn’t run. I was impatient.
I took the first 5-6 weeks off and then got in the pool, hit it too hard and hurt my shoulder. Picked up Total immersion for that. Got on the bike trainer but not religiously. Rode a bunch out side that summer. That may have actually been my savior.
Later that year I resumed coaching and playing soccer (with a brace). That always seemed to aggravate my knee(my “condial pothole” was prone to the hyper-extension of the kicking follow-through) I stopped playing soccer.
It wasn’t until at the age of 42(six years later) that I got smart, learned how to take care of my core, strengthen my knee, not to run on pavement, rest, and realize that you don’t need to run every day that I was able to resume running. I started with long walks. Mixed in a short run and then a walk, before proceeding to longer runs. Now I’m 48 and have done a bunch of Oly’s and Sprints. I’m really working on stretching out my run. Did a 1/2 mary in November.
Be patient and disciplined in your rehab. Hang in there.
Mine never was the same but it is now good enough that I can run.
It’s better to have something back that I feared I’d lost forever.
had mine done in the middle of November 09. Six weeks of non weight bearing. I started walking/limping the first week of January. I could not believe how much strength I lost in my quad. I am only now starting to walk without a limp but still can’t make it up the stairs naturally. I had tons of clicking and catching early on but that has gone away since the quad has gotten stronger. My recovery has gone slow with a few minor setbacks. I’m doing a lot of biking in low zones and swimming. PT is done everyday. I hope to start run/walking in April- 6 months post surg. My PT is an triathlete so he has really helped me stay busy and focus on the important strengthening exercises. PM me if you want to compare notes- looks like i am 5 weeks in front of you. good luck- the hard part starts now, be patient.
I have a buddy that is back to IM believe it or not and he hasn’t lost a step. Sub 9:50 in fact. He may chime in as he’s on ST but I don’t know how often he takes a look. I know that his surgery was a 4 or 5 years ago and took a season or 2 off. You just can’t be in a hurry. He is a small guy which i’m sure helps with less stress on the knee. Not all microfracture surgeries go that well. Femoral cartilage injuries like that are tough and success largely depends on the size and location of lesion. A large lesion over a large weight bearing area is tough.
I shattered my left kneecap in a bike wreck on wet RR tracks ten years ago. I had two surgeries about six weeks apart. My left knee was immobilized for twelve weeks. Then I had to sleep with my leg in a machine that kept flexing it and bending it all through the night to break up scar tissue and restore mobility. Rehab began concurrent with that. In my case, because my kneecap was shattered, it was eight months before I bore any weight on my left leg at all. All my rehab to that point was for mobility/range of motion. Shortly after I was able to bear weight, I was finally able to complete a full pedal revolution on the exercise bike at the rehab center. The day I did that, I literally cried. It had been a long, hard road to that point. Nine months. Anyway, that same afternoon I rode my bike 12 miles outside. Within a week I’d done 100 miles. Within a month I was doing 250 mile weeks. Within eight months, I did the Assault on Mt. Mitchell (actually, I think it did me).
I had a limp for years. I might have been able to run by 18 months out, but I didn’t try. A few years later I was hit by a car and broke my hip and ankle on the left side. That was the end of all hope that I’d ever run again.
There are a lot of nay-sayers regarding weight training here on Slowtwitch. You need to disregard them. When you’re ready, you need to hit the gym and build some muscle to help stabilize that knee. I suspect you’ll have some good rehab program that will be a good base for starting some weight work. I’d also suggest that, as soon as you can, you start to walk and get your gait squared away before you try to start running. It took quite a while for me to re-learn how to walk correctly. I can’t imagine what running would have done to me if I’d tried to force it at that point.
Obviously, my time frames are way longer than what yours will be. But the sequence will probably be the same. I pushed the envelope. When the rehab folks said to do X, I did X+1. They’re used to treating old folks who’ve had knee replacements at age 70. They don’t do as well with athletic types. We’re still a relatively rare breed.
PF is typically a better recovery and return to sports than tib/fem, b/c it doesn’t get quite the impact. I had mine 8 years ago (god, has it been THAT long???). Mine was femoral, and a rather large defect (too large, really, IMO to be successful, esp. given the state of my meniscus…or lack thereof). BUT, my rehab protocol was basically a lot of building up my walking and cycling for several months once I got off crutches (about 8 weeks), along with a ton of quad and core (hips, glutes, back, and abs) stuff. I resumed run/walking a year or so post op. Built up slowly, etc etc.
I kept my mileage relatively low–although a few folks out there keep doing marathons (again, I think where and how big you lesion is, along with any other factors, play a role in this)–max was about 25 mpw, and never ran on consecutive days, and kept to soft surfaces whenever possible. I had 7 successful tri seasons, did a bunch of half marathons, and raced at the Velodrome and on my MTB.
I will give you a caveat: I was never without pain, as my MF did actually fail, but that failure was due more to complicating factors than my athletic predilictions (although I’m sure that didn’t HELP). As we speak, I am couchbound again, trying a different procedure
I had microfracture on my right knee in April '04. Rehab started 6-weeks post-op, and it was all in the pool until the 6 month mark. I did my first run at 8 months post-op. Since then, I’ve done 4 IMs with a PR of 9:32 and have absolutely no pain.
Just stay patient and conservative with your rehab, and when in doubt, back off. Take your rehab very seriously, as a proper rehab program is vital to the success of this surgery. MicroFX is pretty stressful on the body, and your body needs time to properly heal from it and to let the new fibrocartilege form and take hold.
Side note: when I really started moving around again (about 2 months post-op), I would occasionally get terrible shooting pains in my right knee. If that happens to you, don’t worry about it, it’s just scar tissue breaking up and is a normal part of the recovery process.
Hope this helps, and feel free to PM me if you have any more questions,
-Doug
This helps me- alot. My rehab is going as scheduled but I occasionally get that pain. It scares the crap out of me. Its not consistent and doesn’t last long but I wonder what the hell is happening. anyway- good to hear of some success.
BH - as you’d expect, each person’s response to microfracture is unique. So many vaiables, where is the lesion/lesions, how big is the lesion, what is the condition of the rest of the knee, what is the status of the menisci, how much does the person weigh, can they follow directions, etc.?
In other words, I’ve had people sail through this…“What operation?” to those who have many recurrences of on again/off again pain that need significant interim support, but in the end most do well. So, a close working relationship with your doc and your PT will go a long way on many planes.
I had mf sx the end of Nov so a few weeks ahead of you on the rehab curve. There is wide range on my day-to-day evaluation of how the knee is doing. We had a warm day a couple of weeks ago and I got out for my first ride since Aug. The first hour was bad. I was thinking this might be it. Some downtime at the turn around and on the trip back I rode relatively strong and without pain. Hard to sort it out. Probably best to evaluate the knee on a month-to-month basis rather than daily. In the last week I’ve had trainer experiences of low intensity with knee pain post ride. I’ve had trainer efforts with internal efforts and no residual… I let the knee design the training.
