Thursday, 10 April 2014

Alex Galchenyuk suffers mild MCL strain in his right knee, out for a few weeks.

Interesting that Alex Galchenyuk has a 'mild MCL strain' on his right knee, since that's the injury I suffered about three weeks ago.  When he skated away after the contact with Marian Hossa, and I saw him shaking and testing his leg a little bit, and then left the game, I thought that might be what happened to him.

I incurred my injury while snowboarding, hitting a tree at low-ish speed on the outside of my right thigh.  This caused the classic cause of the MCL sprain, the inward-lateral buckling of the knee under load.  After extricating myself from the tree hole I was caught in, and clambering up a steep bank to get back to flat ground, I felt a looseness in my knee, on certain movements.  No pain really, just something wonky.  And I knew instantly what it was, because I'd done the same injury years before when I slid off a rail and hit it with my left thigh.  That one was worse, a second to third-degree strain, but at the time I'd felt the exact same looseness, with no pain, and something wonky while I slowly made my way back down to the base, riding as cautiously as I ever have.

What worries me about Alex's is that he was on crutches yesterday, whereas in my case, with a very mild strain, I didn't need to dust off the crutches.  I have a neoprene compression knee brace, with metal hinges on the side, and I've been able to walk and weight-bear from the get-go with that on.  Maybe his physios are being very aggressive, not taking any chances.

The first couple of days the knee swells up and the pain gradually builds, but it's not intolerable, I didn't even have to take a Tylenol with my current injury.  The rehab work is very simple at first, following the RICE principle: Rest, Ice, Compression, Elevation.  So Alex will have a compression or tensor bandage on, probably the same brace I'm using, to minimize swelling.  When he takes it off, it's only to ice, ice, ice the joint, baby.  He'll have his leg propped up while he watches quality TV programming, maybe he catches up on his "Game of Thrones".

At first, he'll spend a lot of time on the exercise bike, at first just going back and forth on the pedal according to his range of motion.  He may only be able to go through 180 degrees on the pedals at first, then slowly increase the range, until he eventually can go all the way around on the pedal stroke, and will slowly spin, with no resistance.  The goal here is to increase circulation in the joint, and preclude the formation of scar tissue.

When the pain is mostly gone and he has almost full range of motion with no stiffness, they'll add some light resistance to his regimen, and some balance work with his body weight, on the BOSU or balance board.

Based on the severity of the injury, or lack thereof, and the fact that Alex is a young buck, a teenager who's still growing and in peak physical condition, I could see him being back in two or three weeks.  Or it could take longer.  My first time around, for a bad second degree/mild third degree injury, with a good level of fitness and diligent rehabbing, I was back on snow within three months.

The thing Alex will need to understand, and I'm sure the docs and physios will explain this to him, is that even when he feels 100% in the gym and on the examination table, and he gets cleared to return to the ice, he won't be back to 'normal'.  He'll feel twinges in his knee, some transient instability during certain movements or in certain postures.  He'll instinctively feel cautious, he'll guard against re-injury in certain situations, and this will be almost impossible to control.  It'll take him a while (months) before the knee injury is well behind him, something he doesn't think about anymore, and is truly 'one hundred percent'.

He'll probably have to wear a brace while he plays too, it won't have to be a honking RoboCop brace like Alexei Emelin wears to protect his ACL reconstruction, probably more of a neoprene jobbie with hinges like the one I have, that provides compression and some stability, and doesn't impair movement too much.  Don't sweat it Alex, it's not that bad having to wear it, it keeps your knee nice and warm, and it'll come in handy the next time you get hurt.

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