By Nazleen Reed (Senior Physiotherapist & founder of Ultimate Performance Lifestyle).
After 22 years of playing netball, I sustained my first injury shortly after my 45th birthday in July 2022. During an evening game I jumped to retrieve a high ball and as I landed, I felt my left knee give way with a loud clunk and it took me to the floor. Instantly I had no pain but knew I could not place any weight through my left leg.
I chose to follow the M.E.A.T principle (Movement, Exercise, Analgesia, Treatment) Treating an acute injury? Go for M.E.A.T. over R.I.C.E. | Lifemark over P.R.I.C.E (Protection, Rest, Ice, Compression, Elevate). My reason for choosing this method was so that I could increase the blood flow to the damaged ligament, as ligaments do not have a good blood supply (Vascular anatomy of the human cruciate ligaments and surrounding structures - Scapinelli - 1997 - Clinical Anatomy - Wiley Online Library), therefore I believed this was the best method for me. I used paracetamol and avoided anti-inflammatories and ice (this would stop the natural process of healing), kept moving my knee by bending and straightening (before pain set in), acupuncture and K-taped the knee for the first 3 days. This method was surely more painful as my knee was able to swell causing compression on my nerves. Whether this method was better than P.R.I.C.E I will not be able to determine as I have nothing to compare it to.
With 3 children aged 20 months, 3 years, and 12 years (at the time of injury) made recovery challenging however with the support from my husband, mother, and colleagues this made rehab much easier. I am not a person who likes to sit around therefore movement and getting back on my feet were my main objectives.
I headed off to London for the day only 2 weeks after the injury to meet up with friends. I hired a wheelchair and was able to see first-hand the challenges of using London public transport and was overall pleasantly surprised with the help I received from everyone.
As a Physiotherapist one of the first goals is to encourage a “normal” movement pattern and to reduce supporting aids, like crutches, as soon as possible. I did go to 1 crutch from an early stage and the brace was removed after 6 weeks. I returned to teaching Pilates online after 3 weeks, where I still had my brace on, as I knew I had to keep my spine, core and gluteals strong to speed up my recovery. I was able to teach and also adapt the exercises by lying on the floor to prevent excess weight through my knee.
Ironically just a few weeks before my injury we started teaching a physiotherapy-led hip and knee class (Knee Osteoarthritis - Peterborough Physiotherapist Advice and Exercises (upl.life). So, to practice what I preach, I wanted to access this class as an attendee. I did teach this class whilst in my brace and with crutches within 4 weeks and even returned to teaching my Pilates classes in the studio at this time.
Returning to normal activities and continuing my rehab was very important and I wanted to demonstrate to our clients at UPL the services we provide really do help. I did follow an ACL rehabilitation protocol by Professor Leo Pinczewski. ACL-Reconstruction-Rehabilitation-Protocol-Updated-June-2018pdf (leopinczewski.com.au). I was able to use the protocol as a guide to know where I was in my recovery which I did need. I did think I was further on sometimes and this was a reminder we cannot accelerate the healing process.
I chose not to go for an ACL surgical reconstruction as like with any surgery there are side-affects and operating into a joint can cause early arthritis which is something I really wished to avoid. Risk of Osteoarthritis After ACL Surgery | Knee Specialist | Minnesota (drrobertlaprademd.com).
My determination of being able to return to work, get back to mum duties and play with my children was a huge goal for me. I would say I managed my recovery with the knowledge I already had and researched thoroughly rehabilitation exercises, kept mobile from the start to prevent further muscle weakness and sheer determination of proving I could do it without going on the operating table.
One year later and I can say I do not think about my knee. I have done squats with both my 3- and 4-year-old on my back, had my 13-year-old daughter on my shoulders at a festival, all without any fear of my knee giving way. As of yet I have not returned to playing netball and this is something I need to seriously think about as my knee has sustained a serious injury and shows some signs of degeneration. My consultant and GP have advised me not to return however as a Physiotherapist and sports person who loves working with clients to achieve their goals ’watch this space’.