My $15,000 Knee Injury: A Year of ACL Recovery
A year ago back in May of 2022 I rejoined CrossFit. I went religiously from 2011 all the way up until COVID closed down gyms in 2020.
Growing up with asthma I never considered myself athletic. By when I graduated high school, I’d been to the ER because I couldn’t breath more times than I’d ever ran a mile. At my athletic peak of the time I’d consider myself at the “intermediate intramural ultimate frisbee” level of fitness.
A coworker of mine, Casey Jenks who would later go on to found TrueCoach, was an early CrossFit devotee and started his own gym back in 2010-ish. On his encouragement I went in for an hour-long “foundations” coaching session with one other new member.
I remember doing a 7 minutes of half “Cindy”, one of the iconic CrossFit workouts with assisted pull-ups, assisted push-ups and air squats. Even from that I was exhausted in a way I’d never experienced. I joined on the spot.
For years I went 3 classes a week – Monday, Wednesday and Friday at 8 AM. I ended up putting on muscle in places I never knew about.
Even though I never reached anywhere near the competitive level of CrossFit, I had a blast challenging myself with difficult movements. I loved the challenge of seeing something I couldn’t do and then forming a plan on how to get there.
I saw my engine, my ability to perform work, grow more each year. Eventually I was snatching my body weight, squatting double it, performing legless rope climbs, walking across the gym on my hands and (on good days) being able to do a few ring muscle ups.
When I had to stop going in 2020 I was sad to lose that piece of my routine that me feel stronger.
Returning to CrossFit
When I rejoined 2 years later I thought I was still in decent shape. During COVID I’d switched from weightlifting to mostly cardio – slowly increasing my max running distance up until running a marathon in July 2021.
On my second day back at the gym I had a life-changing injury. I was stepping down from a 20″ high box while holding 2 20lb dumbbells when my knee buckled under me. Looking back I should have been stepping backwards rather than forwards. My knee went sideways and I saw stars. I don’t remember it being painful, but when I went to take another step my knee was no longer able to support any weight.
Diagnosing and Healing
After a few days I was still not able to walk right. After some research I found that the University of Utah has an amazing Orthopaedics center. They were very quickly able to make a guess that it was an ACL tear.
I immediately went home and started googling “what is an ACL tear”. Turns out it’s not great. The ACL, or Anterior Cruciate Ligament, is a tendon inside the knee that helps connect your thigh bone to your shinbone. Without a torn ACL the two segments of your leg can’t work together.
I wrote a lot more about the experience in my post I’m 40 Today. Here’s What I Want From My Next 10 Years To Look Like.
What I didn’t know at the time I wrote that was how much the injury would cost or how long it would take to recover.
Turns out it’s about $15,000 and around a year to get back up to 90%.
The Financial Side of an ACL Tear
I’m terrified of medical expenses. As a planner and budgeter, unexpected medical bills are one area that you can’t plan, but you also can’t ignore.
As soon as my wife and I stopped working we switched to a Bronze health insurance plan from healthcare.gov. It was shockingly easy to enroll in, and I’d absolutely recommend it.
We went with a Bronze plan for three main reasons.
First, we didn’t have any current medical conditions or expenses. If we’d had ongoing issues we would have upgraded to a Silver or Gold plan.
Second, the Bronze plan has an out of pocket max per year of $14,000. The Gold plan would have cost almost that much by itself.
Lastly, the Bronze plan came with an HSA, a health savings account. We could start saving and investing money in there that we could then use anytime in the future while also reducing income.
It’s no secret that health insurance in the US is expense. We paid $255.23 each month for my wife and I to be covered. We also received a $417 rebate each month due our artificially low income (see: How We Plan to Spend $80,000 a Year & Pay Nearly $0 Taxes). Without this rebate we would have spent another $5,000 in health insurance to get the exact same service.
Like the OCD tracker I am, I’ve kept track of our expenses in Tiller for the last decade. I pulled some numbers for the 14 month period from when I tore my ACL to 1 year after surgery. Here’s the high-level breakdown of how much everything cost.
|Diagnosis – MRI||-$1,899.18|
|Physical Therapy & Gym||-$303.63|
|Peloton – Bike & Subscription||-$3,088.20|
X-Rays were $300, but the MRI was $1,500 – MUCH more than I would have expected.
The surgery itself was the biggest expense. They required a $5,000 down payment before the surgery. The rest of the expenses were dripped in one by one over the next few months.
The actual bill without insurance for surgery was a jaw dropping $32,000. Thankfully we had insurance.
One of the biggest expenses after surgery can be physical therapy. I started going every week and slowly tapered off to monthly. Fortunately for us, physical therapy for 6 months was covered by our insurance. I only had to pay for 2 sessions before I was able to stop going.
I replaced CrossFit with a much cheaper $10/mo Planet Fitness membership. I’ve actually kind of loved it. It lacks the social atmosphere that made CrossFit fun, but I’ve enjoyed trying to optimize a strength plan around my weaknesses.
The other part that was crucial to my recovery: we purchased a Peloton Bike+. We bought the bike before surgery and had it ready to jump on as soon as I was able to.
About 2 weeks after surgery my doctor gave me the go ahead to start cycling. It took a week to get to the point where I had the mobility to pedal all the way around (!). Soon after I started
I cycled 20 times in August, 18 in September and 20 in October. I wasn’t yet cleared to run, so cycling was the only outlet I had. Having that right there in our apartment was amazing. I’d highly recommend getting one if you’re recovering from an ACL tear.
Lately I’ve been cycling much less, but that’s OK! I’ve settled into a routine of one day at the gym, one day off, one day of cardio, one day off. For cardio I alternate between running for an hour, going on a hike or Peloton – whichever feels right.
The OCD side of me doesn’t like that this 4 day pattern doesn’t repeat nicely week to week. Since I work from home on Hardcover, I have a flexible enough schedule, so planning around it hasn’t been an issue.
1 Year of Recovery
This past week I hit the one-year mark since I had surgery. My knee isn’t “healed”, but the muscle strength is comparable to my good leg. It does feel more stiff at times, and it seems to alert me whenever it’s about to rain by preemptively getting tender, but other than that it’s normal.
The biggest part to still get over is the fear of declines with that leg – stepping down or jumping down and landing on it. That’s something in my head I’m still working on, even though the muscles are in good shape after months of jumping at the physical therapy.
To mark the occasion, I went on a 9-mile hike up Black Mountain. At 2,800 ft elevation it’s not the most difficult hike, but 9 miles is still one of the longest I’ve attempted in a day. Getting back up to speed to where I could hike was also one of my goals by the time I was 41.
I have a personal interest in this hike too. For starters, we can see it from our bed. It’s the largest mountain in our field of view just west of Ensign Peak. There’s something motivating to being able to look out my window and know I climbed up the largest mountain in sight.
I attempted this same hike back in May of 2019. It was one of the first “long” hikes I went on during my “summer of hikes”. I’d quit my job 6 months prior in December and it was the first time in my life I had weekdays free. I ended up going on every hike I could find – including this one.
Unfortunately it was May 1st and there was still snow on the trail. I made it within 0.1 of the summit and had to turn around. Here’s why:
Great wildflowers all the way through. Last .1 mile is a Class 3 scramble, with exposure to drops of 5-15ft. On the peak I talked to someone who tried to go around that scramble, but ran into a rattlesnake.Review of Valley View, Twin Peaks, and Little Black Mountain Trail Hard on AllTrails
For reference a Class 3 scramble means “Hands-on scrambling with moderately difficult moves. A fall will break a bone.” It didn’t look too difficult, but was couldn’t even be attempted due to the icy conditions.
I turned around with sight of the summit. It always stuck with me.
Fast forward 4 years later and I’ve been looking at that mountain every day. It’s basically my white whale at this point. At the 364 post-operation mark I made the decision: tomorrow I’m hiking that bastard.
I woke up at 6am and prepared to leave. I packed 3 L of water, a ton of sun screen, a gatorade and pack of nuts. By 6:30am I was on the trail!
I even had a visitor along the way that I believe was a grouse.
The trail itself isn’t difficult. It’s a constant low grade uphill for the first 2.5 miles, then a mile of steep uphill and about 0.25 of increasingly difficult scrambling. Each piece ends up taking about the same amount of time.
The view from the peak was amazing. I could see everywhere from Antelope Island down to Draper.
But more than the view it felt like a symbolic way to move into a new phase of life. A switch from “recovering from an ACL” injury to whatever comes next. I don’t have a plan for what that’ll mean yet, but I’m sure it’ll happen in time.
One thing I do know is I’ve made the decision that my 40s will be the best decade of my life. I’m doing what I can to make that a reality.
Oh, and the Nashville hot chicken sandwich from The Crack Shack I had afterwards was delicious.