acl recovery | granite mountain

3800 ft gain . 5630 ft high . 8.6 miles

Preface

I wrote Part I shortly after my first major hike just under 3 months post ACL surgery and Part II is about 8 months post surgery in a full circle moment back at Granite. They’re written in a format like a diary entry, both recalling details and reflecting on the physical changes due to the injury and recovery. I wasn’t sure I wanted to share Part I because it feels too personal, but now that I’ve had a full circle moment, it seems sensical to share my journey. I found very few sources on the internet regarding ACL injuries and getting back to mountain sports, so here is my account.

Part I

This is half way. Half way through recovery. Or at least the projected minimum time to full recovery, termed as “return to sports”, which include activities like volleyball and tennis that apply high torque to your knees. With every minute progress I made, I felt like I should shout it to the world and celebrate. But I’ve kept it mostly quiet since I’m not one for sharing personal details. No one really tells you what ACL recovery looks like. Obviously it looks different for everyone, but I always wished to have a simple metric to measure progress. I google searched so many times for when people were able to hike again. Even asked many friends of friends who’ve gone through this. But one reason or another, I never got a straight answer. According to my PT, I could start somewhat hiking before my 3 month mark. The definition of hiking was easy trails with little gain to minimize the downhill impact on my knee. And even up to that 3 month mark, I was still unsure that I could hike up any summit within the summer. 3 months is insignificant in a life time, but in healing timelines, it seems like an entire lifetime. Here’s my story to my halfway point and the joy I found again on trail.

Early Days

Flashback to the first few days post surgery. I agreed to both an ACL and MCL surgery and kill two birds with one stone instead of taking the risk if my MCL would heal on its own. That added 4 extra weeks of minimum weight bearing. No big deal, weeks go by fast right? Entirely wrong. When you’re less mobile than normal, feeling weaker, time moves slow. It’s like molasses all around you. I hoped to avoid taking the strong pain killers, but realize now, sometimes you really feel the need to calm the fire. Thankfully that was a short stint. Once the first couple days passed, I felt excited to add more movement to my life. That consisted of crutching around the house and starting to go up and down stairs. Movement took a lot of energy, but it also wasn’t easy to stand or sit or lay down. It was all weird. 

You’re told things to prepare yourself physically and mentally, but you are never fully prepared. The pain was more intense than I’d imagine. I naively thought that my days post surgery could mean catching up on photo editing, but I could barely look at a screen longer than a minute. I followed the nutritionist’s advice and increased protein intake with my daily Ellenos yogurt, smoothies, and other snacks. The make up of my food intake was correct but my smaller appetite meant I was eating a lot less than normal. Living normal life was simply energy draining and I welcomed an early bed time, unusual for my typical night owl habits.

Atrophy is a big thing. I dutifully did straight leg raises and quad squeezes to keep the muscles in check. But it all felt like nothing made a difference to combat the atrophy. Within a few days post surgery and wraps were removed, it was visible that my muscles forgot what they were and became blah. It shrunk. It not only felt weak, but also looked weak. It was only a squishy mass with little definition. No way was I gonna hike again in a few months. Exercise doesn’t come easy to me and intense strength training sounded horrible. Not to mention, there was a disconnect between my brain and patella tendon to move my lower leg. It was a very specific paralysis. However, with steady physical therapy (PT) guidance and diligence with home exercises, I started to gain mobility. And then strength. 5 weeks post surgery, I was off crutches and brace. I felt like a new fawn taking her legs out for the first time. Uncomfortable with the legs, a little shaky, but still grounded.

It took another week or so to correct the limp as I kept strengthening the leg muscles. At PT, they started piling on the weights and amping up the exercises, focusing on endurance, strength, and power. I started biking outdoors on flat paved trails which increased mobility. The best exercises were honestly all the variations of single leg squats. If your friends tell you to squat more, listen to them, cause they’re probably right. (I’m still doing single leg squat variations months later)

Throughout all of this, even with the brace on and crutching around, I was already introducing modified yoga for the off days from my PT home exercises. I’d like to attribute my progress to diligence in doing both. Yoga is low impact and certain sequences still really worked my muscles just like my PT exercises but in a different method. Having a dance/yoga background made it much easier to correct postures in the exercises and knowing how to target the right muscle groups. But even as I felt stronger, the idea of hiking was still daunting. Was I even ready for the cardio, for the gain? How would I know when to turn around if the limiting factor is how much impact my knee can take on the downhill?

I started easy, started slow. After feeling decently comfortable with flat trails, I went to Dirty Harry’s Balcony (~1300 ft gain). Many people passed me, and normally my prideful self would want to compete and push faster. But this time, that was okay. I would take my sweet time to get the hiking bug back again. And boy was it nice to be out in the mountains after what felt like  several months away. Add one more activity to the my small deck of cleared activities. Just before my 3 month mark, I challenged myself with a little more gain. This time, I’d hike with Cleo who was also recovering from a different knee injury. As unfortunate as it was to be both injured, we both found solace in each other. We surprised ourselves by our fast pace, something similar to our usual pace pre-injury. But after 2000 ft gain, a bit past the Teneriffe Falls, I could already feel the fatigue. I felt a little disheartened. Bigger hikes sounded intimidating once again.

The epiphany

Just shortly after my 3 month mark (one week after Teneriffe), a sunny day came along and I was free from other obligations. There was absolutely no way I was going to waste this day and I was absolutely going to challenge myself to another hike. I have no idea why I didn’t choose something shorter like Mt Si (~3100 ft gain) or Mt Washington (~3200 ft gain). Both would have been a significant increase on Teneriffe Falls. No, instead, I went straight for Granite Mountain (~3800 ft gain). At least I was smart enough to avoid Mailbox Peak with a mere extra 200 ft of height. I guess part of my choice was knowing that 1000 feet of snow existed on Granite which holds deeper snow longer than the foothill mountains. Snow is good because it meant a softer descent for my knees.

Despite having been up Granite twice previously, I had zero views both times due to low hanging clouds. Two falls ago, I made a fun solo trail run loop connecting the Pratt Trail to West Granite and some off trail to the lookout. It was speedy, taking just about 2 hours up including off trail work and just over 1 hour down. Not much of a baseline because I knew I would 100% not meet that. But I was still excited to finally get a chance to see the summit views.

Solo hiking is all about knowing how to pace your own self because you have no one to talk to keep you steady. No other person to help gauge if you should speed up or slow down. I arrived to the trailhead a little later than I normally would like but there was still plenty of parking. When I solo hike, I like to be around fewer people, fewer people to pass, fewer people to  interact with as I huff and puff away, so I was eager to get going. Ready with hiking poles, snacks and water (plus unintentional weight training from about 5 lbs of camera gear), I quickly walked passed a few hikers at the trailhead. When trails start off mellow, you can speed walk quite briskly. I was barely breaking a sweat as I passed a few more.

But that quickly came to a halt as I made a turn at the intersection and the trail got significantly steeper. Out of breath, I thought, for sure I was in over my head. Thus began my internal battle to continue or to turn back. Fortunately or unfortunately, my brain always wins and forces me to continue. I started using my poles a bit more, remembering to breathe through it all, and most importantly, remembering that there are views ahead to be found! In the first 15 minutes or so, I realized that someone was walking somewhat my speed. Never quite catching up but never falling behind. That was mildly irritating. Selfish as I am, I like to be the one to pass on these trails, except when a runner comes along. So I kept pushing forward to add more space between us. That is until I could no longer keep it up.

I surrendered. I admitted that I couldn’t keep up the speed I set and finally accepted the fact that I had to let this person pass. I was recovering from injury after all and probably shouldn’t be pushing so hard. So I stopped to take my water break and let him pass. But I quickly got back on the trail before the next group caught up. It’s this weird thing where once you pass a group, you feel like you should stay ahead of them or else run into a leap frog situation. It’s sometimes fun to leap frog but tends to be more time consuming than necessary. I quickly started hiking too fast again, but slowly catching up to the person I let pass.

Curious as I am, I sometimes make small talk with people as we pass. Usually it’s “where are you headed with that big overnight pack?” Or “how are snow conditions ahead?” As expected, we had a short exchange as I passed. While I generally hiked ahead, we were still nearly the same pace. So every time I’d stop, he’d catch up again and take a break too. By this point, I realized it was no use speeding ahead anymore but welcomed the friendly trail talk. It was surprisingly fun! I used to wonder how likely I’d ever meet someone on a trail to hold conversation longer than a brief chit chat. As we started to climb above the trees, we spread out again, taking slightly different approaches to the summit. I later found out it was just respecting each others space as strangers.

When snow appeared on the trail, the summit was still about 1000 feet of elevation gain away, as expected. But seeing Rainier in the distance and these awesome mountain views gave me so much hope and motivation. It soon became another fun game of passing more people and then my favorite – boulder hopping to the top while avoiding the snow. After 2 hours of hiking, I had the summit to myself for a brief moment as everyone else rested near the lookout. I was completely elated. 360 degree views are what I live for in the mountains. Looking as far north as Baker and as far south as Adams and all the mountains in between. I still had that fire inside me. The mountains beckon to be explored!

It was too nice of a day to pass on enjoying the summit and way too long since I’ve taken a long break at the top of anything. In the past, my friends and I would easily spend 30 minutes to an hour on a summit to soak in the views and take a long lunch break. In reality, this time I was just delaying the inevitable downhill. I had no idea how my knee would handle it. Do I take the solid rocks or the soft but unsteady snow? Future me would definitely have to answer to that. Meanwhile, my trail friend Errin offered to take my picture. 9/10 times I’d say no, but I’ve been learning to say yes. Little did he know, I’d do my usual mountain pose. Most bystanders would just comment in amazement, but Errin took it as a challenge to try it too, which gave me a good laugh! 

As I descended a steep snow section, I met some strong gusts that nearly knocked me over, the only time I felt unsafe on the trail. Cautiously working my way down, I eventually found my rhythm and remembered what it’s like to frolic in snow, carefree of wet feet and nearly wiped out a few times. But it’s soft snow after all and I strategically lead with my good leg. Although I had long bade Errin goodbye, I definitely wondered if he’d catch up due to my slower downhill pace. My leg was doing better than expected as I soon passed other people going downhill. I wondered if it was too fast but there was no pain. So I took it as a good sign.

Just when I thought I’d never see my trail friend again, he appeared out of nowhere! Probably because I stopped too many times to take flower photos on the lower half of the trail. It was still too early for the upper meadows to bloom, but the lower forest flowers were all out. Anyway, it was fairly clear that we hike at the same speed even for the downhill. I’m not sure that I even share a natural hiking speed with any of my friends, so this was very exciting. It was nice to have someone to talk to again and make the rest of the hike go by faster. Sometimes when you’re bored, going back to the car feels a lot longer than the way up. But usually if you’re in conversation, it’ll seem like little time has passed. So just under 2 hours from the summit, I found myself back at my car. Reflecting, I realized I’d done a very big hike compared to previously. And the best part was my knee survived and felt strong. Coming out of this hike, it gave me the confidence to evaluate with a good metric future day hikes and backpacking trips. No more wishy-washy feeling not knowing where the limits are.

My PT told me that with every check point, I’d feel way better than before. They were pretty right about that! 3 months ago, I wouldn’t have imagined myself on this trail. Heck, I didn’t even believe it one week prior. It’s a glorious feeling to be continuously smashing down barriers you thought existed (applies in so many ways too) and it’s freeing to know that you are strong and capable. It took work, no doubt. And it took a bit of courage to face my fears of the unknown. But cheers to being half way through recovery and making a new friend!

Part II

Summer was filled with more outdoor adventures than I would have imagined on a normal year, let alone coming out of an injury. From long mountaineering day trips to multi-night backpacking trips, I feel blessed to have the friends and physical ability to do these objectives. In general, they were less ambitious in distance and gain as previous years, but considering I was barely walking a few months prior, I call this a huge win. Every trip, I would realize I could handle more and more. My cardio was coming back and my strength as well.

At this moment in writing, I’m still working on evening out the leg strength but empirically, my recovering leg is very strong. It’s just that my good leg also got way stronger as it was over compensating. Due to my high impact summer from hiking, other goals were pushed out like getting back into running and skiing, which were both lower priority to enjoying the beautiful Washington summer weather. With a more steady focus on getting back to skiing as ski season ramps up and feeling the freedom to run when I want, I’ve been a bit less ambitious with the hikes. November delivered a surprisingly dry spell, which was perfect for I-90 hikes with a dusting of snow.

Lu and I decided on Granite, which at first I was reluctant to repeat a hike so soon, but Granite is so lovely that I quickly became eager to hike it again. There was a surprising number of people on the trail for a fall day. Everyone was taking advantage of the good weather! On the way up, we weren’t charging, but a few short breaks here and there to catch up on water and snacks. I felt that we were going a little slow, but actually, we were going faster than my speed earlier this year. It’s amazing how much improving your cardio does. There was heavier breathing due to exercise and uphill walking, but no severe huff and puff like my previous solo hike. Or maybe this is pacing at its finest where you can keep going forever with fewer breaks and it somehow ends up being faster than rushing with more frequent breaks. 

This time, I focused more on using my weaker leg to forcibly increase the reps of step ups it was doing. Previously, I’d shy away from that and allow my body to cheat its way up by leading with the good leg. Now it’s a bit more even, although obviously the end goal of being 100% will take quite a while. It’s on a this north of logarithmic growth where you see lots and lots of progress between weeks at the beginning and it sort of tapers in change after a while. In the big scheme of things, I have noticed feeling a lot stronger and more energized and that’s what matters the most to me. 

According to how my phone tracked, I went from an average 2.1 mile/hr with high effort to a 2.4 mile/hr low-medium effort for the same hike just 5 months apart. It’s subjective and there’s so many factors in what progress looks like. Actually, I think these charts do a decent job. In both distance and elevation gain, over the course of about 2 months I was pretty close to normal intensity again. In fact September trended as my most gain and distance over all years. I think due to FOMO and eagerness to get back to speed, I’ve been much more intent about my hikes, and actually doing more backpacking trips than ever, which often pack in more miles than a simple weekly day hike. Poles were a must on every hike, but with each hike, I got a better and better feel for how much I could up it. The limiting factor was still the downhill.

And in this chart, the dark red is day hikes I’ve done, which somehow have added up more than any year ever. Granted, some were 2 miles hikes, but it does roughly reflect the number of days I spent outside. Combining the lower half of warm colors from reds to oranges, those are just normal summer trips from hiking to mountaineering. And I’ve surpassed every year with the injury. Obviously ski season got cut short last season and I’ve yet to get out this year, so that has been lower. Last year I think I skied until June whereas I was doing more trail hikes by then this year.

Needless to say, progress is even more incredible to track post injury than just simply year by year as a healthy and able-bodied person. I’m so thankful for all my support systems from friends and family to my physical therapists and doctor. It’s not an easy journey but knowing there’s an end and that it gets better makes the journey much more bearable and actually enjoyable too. Learning to slow down and savor the small bits has allowed me to pay attention to more around me. Noticing the wildflowers, chatting with friends, not trying to rush from point A to point B.

Long Story Short

For anyone reading this who’s going through an ACL injury, here’s the short: 

• I did about 6 weeks of pre-op PT to get in good shape and minimize the muscle atrophy. 
• I got both ACL and MCL surgery which took grafts from the patella tendon and hamstring. 
• A week later, I began post-op PT and also started doing about 15 min of yoga/pilates every other day, alternating with PT home exercises. 
• It took about 2 weeks for my brain to connect to my patella again (paralysis in the kicking motion)
• Once I got my brace and crutches off (5 weeks for me but standard is 6 weeks), I was cleared to stationary bike and shortly after to road bike. 
• Then, I started doing flat walks. After 6 weeks, I started slowly hiking with very little gain. 
• 9 weeks post-op, I did Dirty Harry’s Balcony (4 miles, 1500 ft gain) at a slow heart-rate pace. It didn’t feel too good to go any quicker. 
• At 12 weeks, I did 2000 ft gain just beyond Teneriffe Falls in 6 miles pushing the effort. 
• At 13 weeks I did Granite Lookout (8.5 miles, 3800 ft) with a harder push but slightly more cautious descent speed. Poles are key! Obviously everyone’s recovery will look different but the best advice I got was to be diligent about PT.

From there I started upping everything. The following was simply what worked due to schedules and reasonable enough for my body physically.

• At 14 weeks I added weight and did Bean Peak as an overnight trip (9.5 miles, 3900 ft). Then a few more decently sized hikes in between.
• At 19 weeks I upped a lot of the elevation on an overnight trip (22 miles, 6200 ft). The way down was through a longer, mellower trail of 14 miles.
• Between week 20 and 25, three more large trips that consisted of 6000+ ft of downhill on a single day. However, they were all very broken up like for Black Peak or had snow for a good portion like Eldorado and Boston-Sahale.

Running was put on hold due to the high impact that hiking naturally gives knees. But for some, that can come sooner. My focus was primarily on hiking and scrambling and skiing come ski season.

My tips:

Find a good surgeon and PT. Finding a good PT makes all the difference. They’ll know how to problem solve anything that hurts and modify exercises so they target muscles in the right way without straining others. They’ll help you figure out how to listen to your body and help find a path to help reach your goals. And for me personally, I love that they explain what the exercises do and correct bad posture so each exercise is as most effective possible. If you’re in the Seattle area, I really do love Experience Momentum. So much that I look forward to going to PT and I know most people tend to dread it. Definitely not sponsored, but I’ve loved my program there thus far.

Photos shot on Canon 5D Mark IV