Ultimate Frisbee has ended for the season (for some reason frozen ground is not ideal..!) so after the holidays I'll have to find something besides soccer 1 day/week to keep the knee moving and the muscles strong. Perhaps the BOSU will come in handy here.
All little update details aside, tonight I will be heading to northern Michigan to get back up on the snowboard which I haven't ridden since days before I tore my ACL last March 1!! I was so excited to dust off the 'ol board bag and load up on thermals and snow gear. I will take it easy to start (as the first few runs of every season feel like learning all over again!) but expect to feel nice and strong over the 2 days of boarding! One challenge I expect to face is any kneeling on the snow while strapped into the board. Having a stationary foot in respect to a large board is a challenge either way, and I want to be aware of my motions so I don't do any unnecessary twisting!
Until the next update... Happy Holidays to all!! :)
The fun news is that life is mostly back to normal, and now that I've a few more indoor soccer games under my belt (and yes, since you asked, I scored a goal last night! hehe) I see I am still timid, but getting a little better with each game in respect to my knee. Unrelated to my knee, I could definitely use some more skills when the ball is at my feet!
Ultimate frisbee is still going strong on most weekends, and that plus soccer is pretty much the sum of my activity. Although one exception was my halloween costume, which ironically is based on a SNL character whose signature move is lunging. I was more than proud to show off my 'Superstar' moves to anyone who asked! But halloween aside, I willingly admit that I have not been focusing on my knee like I should, and I hope to change that -- after Thanksgiving!
Day-to-day activities (including stairs) feel good, and even lunging or squatting while on the BOSU don't seem to induce any pain in my knee. The one movement I can think of which does bring on a twinge of pain is when I am standing on only my surgical leg and I do a one-legged hop. If the knee doesn't bend much, there is little to no pain. However, if I try to bend more to get lower to the ground and then push off and try to repeat this motion a few more times, there is definitely an uncomfortable feeling. I wonder if this is directly related to my patellar tendon (which is what was used to reconstruct my ACL)? I would guess yes.
Lastly, the 'popping' in the kneecap when going from straightened to slightly bent has been happening less and less with time. Typically when it DOES happen, it is just the once and I can't recreate the popping again right away. I think more muscle work on my quad would help eliminate this noise/feeling-- we shall see!
I'd like to say: I consider anyone who's been through, going through, or will be going through this whole ACL mess is a SUPERSTAR! :)
Last night I was happy to be back (even though I am far from a star player)! Having played ultimate frisbee for a few weekends now had me somewhat prepared for the stop-and-go as well as quick changes of directions... But, as my teammate Berkley John so kindly put it, when I play UF "no one's trying to kill me" because we're all friends and it's just pick-up. That said, there were a few times when I saw more than one person coming hard at a ball and I was definitely more timid than usual... but in my defense, I feel like last night's team was pretty talented with lots of fast, aggressive players, so perhaps it was the right way for me to play. With time, I'm sure I'll get more comfortable out there (and, hopefully back in 'soccer shape' so I can handle the more sprint-like running!). Until then, all I can do is keep showing up and try to get better-- which would have been the case, injury or not!
One exciting point in the game was a sweet pass to fellow post-op teammate, Jordan (who is just returning from back surgery). It was a textbook play, with the ball going from me, right onto his foot, and moments later, hitting the back of the net. Just try and call us gimps! ;)
- Walking without a limp
- Running (not rumping!)
- Reaching pre-surgical leg strength (using 1-leg press as a judge)
- Gaining most (but not all - yet!) of my quad muscle mass back
- I've got back my entire Range of Motion (ROM) with the exception of a little hyperextension (Dr. S said it's not necessary to get this back anyhow...)
- My balance and control is comparable to pre-surgery, just lacking a bit still
- For the most part, I have 'forgotten' about the knee and can enjoy my normal lifestyle!! Yippee!
Some other items of note:
- There is still some numbness to the outside of where the incision was made, but seems to be reduced
- Kneeling (think: yoga) is an odd sensation (probably due to partial numbness) which I believe my mind tricks me into thinking is painful, but it really isn't too bad, just uncomfortable
- On days after lots of activity my NON-surgical leg is sometimes sore, suggesting I still overcompensate
- I typically don't feel a difference as I go down stairs anymore, but on the aforementioned 'sore' days, that old feeling creeps back in a little
For Wendy (who 'rumped' for the first time yesterday at 5 weeks post-op!) and Bill, who went under the knife this morning -- Keep your eye on the prize! It will be worth it in the end!
For anyone else who finds or reads my blog- I hope it's useful and if you ever want to 'comment', I'm happy to give you my take on the "ACL Journey", or just hear how you're doing or about your experience!
My next goal still remains: Indoor soccer with my beloved Hooligans!!
We got a group together for the 3rd round of pick-up Ultimate Frisbee on Saturday, which as usual was a lot of sprinting, stopping, changing directions and a bit of jumping. Being that we play outdoors and in cleats, this has been a major confidence booster for me when considering my return to soccer.
Our normal co-ed team won't be starting indoor soccer for another week and a half or so, but the outdoor season is still wrapping up. I've heard the fields are in pretty rough shape, and fellow ACL rehabber, Jeff, opted out of the outdoor seasons entirely this summer partially because of the pounding and poor field conditions. So when I got a text from our captain on Saturday asking if I'd be able to sub on Sunday (yesterday) for outdoor, I was a combination of excited and nervous! I said yes, but worried because I'd hardly touched a soccer ball since surgery, and because I didn't want to hurt myself if the fields were that bad.
Luckily, the ground was kind of soft thanks to the previous week worth of rain, and aside from some expected ruts in the field, the game seemed to be pretty forgiving to my knee. [Note: I have not and don't plan on using a knee brace.] Once I got out there, I felt pretty strong and even tallied an assist with a corner kick! Otherwise it wasn't a brilliant game for me by any means, but it was on par with where I was pre-surgery, and that's all I can ask for!! I must also say that it was fun to be welcomed back to the field by my teammates-- I've missed being out there with you all!
I was delighted that things had gone so well in soccer, only to come home to a message asking if Eric and I would mind subbing for 2 games of softball that afternoon. How could I say no, seeing as how I'd conquered UF and soccer already this weekend?! Softball's never been a strong sport of mine, but it was fun to get back out there, toss the ball around and take a few swings. It feels good to be back!!
One day later, I am pretty sore, but I'm sure part of that has been some laziness in my exercise routine prior to this active weekend. I think there was a little unintentional overcompensation at times, because my non-surgical leg (quad, calf and even shin!) is more sore than my surgical leg... but for the sudden spike in activity in 2 short days, I don't think I would have expected any less.
Tonight, it's off to yoga, which I hope will end up with some much-needed stretching. But I couldn't be happier with the weekend's turn of events and opportunities to get back in action. My nerves are (mostly) settled and now I can look forward to my next activity to conquer: Indoor Soccer!
Until then, a big CONGRATS to Missy and Nic for their wedding this weekend-- I can't wait to walk (not limp!) down the aisle and be a part of your big day! And in addition to all this fun stuff to celebrate, I now have my own engagement to add to the list, as of 9/26/09! Perhaps it's time for me to start a new blog! ;)
One activity that has been a real confidence booster is Ultimate Frisbee. The constant changing of directions, quick sprints and sudden stops, and 'going long' for a scoring catch in the endzone remind me a lot of soccer or flag football (but with more running!) and I feel this is similar to a 'worst case' activity, yet I have very little hesitation! On top of that, there is no pain or soreness afterwards, which is key!
The yoga I am doing with Jen (today will be the 4th class) has been an eye opener mostly in the case of kneeling poses. When we lunge or stretch or sit in most positions, I do not feel a major difference from left to right. However when I have to put weight on my surgical knee (seeing as how I had a patellar tendon graft) it can become painful after a long period of time or even a short time if it's taking most of my weight at once. To help curb any kneeling pain, I use a foam pad beneath both knees whenever I can. One thing that makes me feel a *little* better is that Jen, an otherwise very healthy and active person, also thinks we are kneeling too much and it bothers her knees a little too... so maybe it's not just me!
One thing I have gotten away from is PT directed at just my left knee and surrounding muscles. When getting into a more active regimen (including running, UF, or BOSU DVD workouts) it's easy to forget to focus on the surgical leg. If it feels good, why keep the focus on one side? But I don't think this is the right approach, since just last night I was looking at the quad muscles from side to side and while it feels good in most activities, there is still a significant difference in muscle mass. This is where having a gym membership or personal trainer might come in handy (which I don't have), but also going back to the basics and doing exercises Drew left me with in our last meeting would probably help.
Finally, I am trying to do the BOSU a little more now that weather is starting to cool down and the local HS track is rarely available with school is back in session. The DVDs are some good direction for working up a sweat and getting some jumping and squatting in, but I definitely need to research some more exercises which will target my knee. I am open to suggestions!
We're creeping up on the indoor soccer season (late October, I believe) but I hope to get out with a ball and work some more soccer-like movements into my routine so I am a little more confident as I hit the turf later this month!
In just 9 days I will be at the 6 month mark. My, how time flies!
The BOSU wasn't enough for the day though, as I have gotten pick-up ultimate frisbee back on the radar and we had a group planning to meet at 4pm. Eric and I have gone and thrown around a little, but that never prepares you for the stop-and-go running of a true pick-up game. So prior to getting started I strapped on my cleats and did some jogging on the field to remind my body of the ground conditions and being in cleats instead of runners. I also spent extra time stretching my legs out and doing some side-to-side jumping to imitate a quick change in direction. Besides the butterflies in my belly, I felt prepared to give it a try.
Originally I thought I'd have everyone huddled up and be making a blanket statement of 'take it easy on me!' but since we're not that hardcore (and, maybe the opportunity didn't really present itself) we just kind of got the game going and slowly but surely I reacclimated to the game and the feeling of being out on the field and active again. As soon as I started to feel comfy, the enjoyment really came for me... As out of shape as I might be for the sprinting aspect of the game, the knee held up amazingly and there hasn't even been any soreness since! There were a few plays where I became a little timid and avoided jumping up against other people for a free frisbee, but I will probably avoid major contact like that until I feel closer to 100%.
And my latest accomplishment on my 5 month anniversary from surgery, is that I've started a yoga class with my friend Jen! We chose a beginner level class we've taken before to try to get back into practice, and I am looking forward to the first session tonight where I can continue to monitor the progress in my knee and work on balance, strength, flexibility and relaxation! I am bringing along a foam pad to provide extra padding to my patellar tendon area during various kneeling poses, but aside from that I feel I have my entire range of motion (ROM) back, and hope there won't be many poses where I even feel a difference from side to side!
On another note: Today was my friend Wendy's ACL surgery... So, for her I have this...
I know there will be setbacks along the way that will make the word 'discouraged' seem like it's not strong enough to describe how you're feeling. You'll get upset over the smallest tasks that you'll be forced to learn all over again, but you will also get excited as you overcome those very same challenges. As the days and weeks pass, the pain (and, even the memory of the most painful moments) will subside and will be replaced by excitement about the little things -- which you will soon be taking for granted all over again! So, enjoy the ACL journey, because I've got my fingers crossed that this is the only time either of us will ever have to go through this!! ;)
The money I would have been spending on PT should be going towards a gym membership or equipment or something along those lines, but I just hadn't pulled the trigger... until now! I decided a BOSU ball would be a good purchase since I'd used it before in PT, and my therapist, Drew, also confirmed it's a good tool for rehab. Not to mention, it helped to get rave reviews from fellow blogger, Andrew, and also my friend Chris who has done some of his pre-med work with ACL rehabers. And BOSU isn't just good for balance and PT, but there are tons of exercises to be done on it which help all kinds of muscle groups. My arms and abs should be very, very afraid...
My dilemma was to decide if I should buy the consumer model or the commercial model. For about the same price I could get consumer +4 DVDs, or commercial +1 DVD. (See the difference HERE). In the end, I went with the consumer one, because while I'm all about getting a more 'durable' product, I will never put it through the use that a gym would if it was used for daily classes, etc. I hope I don't regret this decision!
Despite halting doctor and PT appointments, I'm not done yet! PT (at home) will be ongoing, as I hope to stick with doing things on my own at least 3 times a week until I can work my way back into sports. For instance, today I strapped on my soccer/UF cleats for the first time and got a taste of the field. Unfortunately tomorrow's soccer practice was cancelled, but I will be doing a workout and eventually heading up to the driving range to dust off the 'ol golf clubs too! Knowing the doctor doesn't need to see me again gives me that 16-yr-old-with-a-set-of-car-keys feeling of freedom again!
But I must share... Yesterday's 'closure' with Dr. S did end on a bit of a personal sour note. My good friend Wendy was in one of his OTHER exam rooms, getting the news that she'd torn her ACL (just like me- playing flag football!). So, as much as I would have liked to avoid my injury, I am almost glad I have the experience (and blog!) under my belt to help reassure her that she'll come through it just fine!! [You can do it, Wendy!]
The gorgeous bouquet I received from Miss Wendy... just for helping! Aww, shucks!
Things I'm looking forward to: Golfing this weekend, Yoga class starting in 2 weeks, and hopefully dusting off the frisbee one of these weekends for some good 'ol fashioned pick-up games!
For instance, today I woke up, got out of bed and walked across the room. Ta-da! There once was a time when that was my biggest challenge! But now I'm back to my groggy "I don't wanna get up" mindset, instead of thinking step-ouch-step-ouch as I used to hobble away from my resting place. Then it's showering. And getting back upstairs to get dressed. And putting on high heels! And yes, even taking out the trash-- because before I was helpless, and while it's not a desirable task, I can.
Next, it's pivoting on my left (surgical) leg as I get into my car (which is quite low to the ground). No more backing up near my seat, having weight on both feet and gingerly lowering myself into the seat. Plant, pivot, sit and DRIVE-- one (mostly) fluid motion! At work it's lots of sitting, but there is still getting in and out of my chair, crossing my legs, or scooting around in my cube on my wheelie chair and not feeling any pain. Ah, the little things!
Today at work I had to cut a strip away from a very large piece of paper from the plotter. Given the size, I figured the floor was my best work space. So this meant squatting down (and getting back up!) and also some kneeling (*gasp*)! I am still cautious when kneeling and putting weight where they took my graft from, but it turned out to be a surprisingly normal feeling!
Regarding my PT-at-home: jumping is getting easier but still challenging. I can run on pavement w/o additional soreness. I even completed a yoga DVD (complete with child's pose!) on an 'off' day, and there were lots of movements I am proud to be able to do again, no matter how simple.
Monday (8/31) is another follow-up with Dr. Shapiro, and Wednesday (9/2) has a high potential of being my first soccer practice! [Despite being given the OK to 'practice' last time I saw Dr. S-- I've still been sticking to PT routines. I may be eager to get back out there, but I want to feel confident first...]
Have a wonderful weekend!
Over the weekend I got yet another medical bill, and while I am blessed to be insured, I'm also blessed with a mathematical mind. Is what I'm paying for in PT really worth it anymore? Before I used to tell myself that having someone guide me, albeit 1x per week, was worth any cost to know I'm on track. However, the last month or so was very hands-off for Drew, and even regarding equipment use- aside from the 1-leg press and a BOSU ball here and there, most everything I can do at home. So, I approached Drew yesterday as I came into PT, asking "Is it OK if this is my last visit?" Drew gave me a long look and asked, "Are you breaking up with me?!"
We did some L-to-R comparison of lunging, jumping, balancing on each leg individually, as well as measured circumference at my knee, lower and mid thigh. Here's how I see my progress as of today:
Strength ~ 90%: For instance, I can 1-leg press pre-surgical weight, but it's still a little shaky. Which brings us to...
Control ~55%: It is still difficult to absorb the impact when jumping and landing on my surgical leg. Controlling the motion of something like a 1-leg squat is very difficult and borderline painful to do as I work into deeper bending. I think toning the muscle around my knee as I get it back will help improve this.
Mass ~85%: I still have mass to regain in my L quad, but even the mass I do have is not as solid as my R leg. I know this will come in time, but as trainers have told me along the way, I have further to go than most people based on the large size of my non-surgical quad!
Endurance ~95%: I might be guessing high, but if my knee were miraculously healed tomorrow, I think my endurance would be pretty good. Although I might take that down to 90% or so when I think of playing the full duration of a soccer game with minimal subs, or the continuous sprints of ultimate frisbee.
Now that I'm PT-free I can consider my options (what unattached girl wouldn't?!). Buy some equipment for home exercise, like a BOSU ball? Or spring for a gym membership to have equipment at my disposal? Or go to some open swims at a local pool for some 'low impact' jumping to work on control? I know I can always call Drew for questions, pointers, or help… plus he provided me with a few pages of exercises to keep working on. Any way I work it, I'm pretty confident I can do this on my own now.
Sorry, PT… It's not you, it's me. ;)
One question I had was about distance running. I've kept to 1.5 miles or less up until this appointment, because I don't want to develop bad habits since my surgical leg still has muscle to get back. [Yes, I do still favor my leg a bit when running.] I figure if I keep the distance low, I can pick up the speed, and when I run more quickly, it seems to lessen any limping. Dr. Shapiro said up to 2 miles would be fine, so I will stay under that until I see him again in a month. I hadn't planned on running the Detroit Marathon in October anyhow... ;)
While it's nice to get back into running, that's not all I've been eager to do! Since I'm up for most any sport (except basketball, which I've never been too great at) I had to ask, what ELSE can I do? Dr. S threw a blanket statement out there, "You can run some drills and practice pretty much all of your sports now, just don't participate in any competitive games." I eyed him skeptically because really, isn't it the motions, not the contact I need to be worried about? But I also wasn't going to look a gift horse in the mouth either. So, to be sure he meant 'all' I thought of one of the sports that would be rough on the knees and said, "Even sand volleyball?" His response: "Well, no. That'll be next year. Too uneven." Luckily that's the answer I expected, so I went for a more hopeful one... "Soccer?" "Yes." Woo hoo! Look out local high school turf field!
In hindsight I should have asked about more activities, but by the time I would have gotten through the list of sports I want to start playing again, I might have kept him there another 10 minutes. ;) For now, it's all about doing what I am comfortable with, and stopping if there's pain.
Being over 3 months out, I figure I'm more than halfway to recovery. At my last follow-up appointment with the surgeon, he said we're looking at a 4 month recovery, which normally I'd be super excited about. However, seeing as how I'm not a professional athlete (surprise!) I believe I'll be taking the full 6 months before I decide to commit to a sports team, perhaps subbing once in a while before that. We'll see-- I want to be steady and confident before I go out on a field and act timid and end up doing something dumb because of my fear.
- Walking without a limp (including speed-walking)
- Running (slight limp when I'm slower, but the faster I go, the less I limp). I have not tried a dead sprint yet, but really, what's the rush?
- Going up stairs- Very even and seems controlled. Even taking stairs 2 at a time doesn't seem to show much weakness.
- Going down stairs- I can still feel the unsteadiness in my surgical leg as I move my non-surgical leg to the next step down. While some days it seems easier than others, there isn't a time I've gone down stairs and 'forgot' about my knee.
- Jumping- When jumping on both legs (think: jumping rope) I can feel my right leg doing more work the longer I jump. When jumping on just my surgical leg, it's still not developed enough to accept the impact of the jump like my other leg does.
- Bending/Straightening- I can bend my knee so my heel touches my butt, though I'm still not confident when squatting all the way down and using my body weight to bend it. For straightening, there is some uncomfortable feeling when it gets close to hyperextending, but I think I need to keep working to make sure I don't lose range of motion there. My kneecap also seems to 'catch' or 'pop' every so often when I go from straight to bent, but it's not painful.
- Doing PT at home: I've been a lot better with this since my birthday, keeping a promise to myself to do my part in my recovery. I take 1-2 days off per week, but otherwise try to run every other day, and on the in-between days I'm doing more pointed exercises like lunges, step jumping, shuffling... etc.
- Physical Therapy with Drew: I am happy to announce I'm back up to my pre-surgical 1-leg press weight, as of a week ago! It feels good to be 'back to normal' in that sense, even though it doesn't translate to a 'back to normal' leg as a whole. PT will continue 1/week at least through the end of this month.
- Quad Strengthening: Lunge, lunge, lunge!!
- Calf/Knee/Jumping: Lots of jumping and quick shuffling to build up not just my muscle, but also the motor skills to be using the muscles AND moving at the same time. One exercise I do- Stand on L leg at a step with R leg resting up on step; In one jump, land with R leg beneath you, and at the same time lift L leg to touch up on step; Alternate which leg you land on (and which touches the step) after each jump, and do this as fast as you can for 30 seconds. I find this is a great gauge of how 'steady' my surgical knee is underneath me, as well as controlling that leg as I quickly touch the step through the repetitive motion.
- Jumping on one leg: Being able to balance just isn't enough. Trying to jump and accept the impact (as I mentioned before) is a whole new game. In PT on my own I try to jump forward in a straight line on just my surgical leg, and land softly. I still have a ways to go here.
Drew told me that the exercises I still feel 'unsteady' doing are the ones that are the last to come back, so I'm well on my way to recovery. Also, I have another follow-up appointment with Dr. Jeff Shapiro next Monday afternoon, and I expect more good news there!
I think age 26 will forever be marked in my mind as "the year I tore my ACL." It's wild to think that initial injury was over 4 months ago, and surgery over 12 weeks ago. Time sure flies!
I've been blessed with a great network of support, a fantastic doctor, a wonderful physical therapist and lots of resources, including my fellow fallen friends who are going through their own ACL journey! Thanks to everyone (again.. and again.. and again..) for your support!
My goal is to take 27 and make it a strong, healthy year. Obviously injuries like this can't necessarily be avoided (unless an active lifestyle is given up - which I'm not willing to do) but I will do what I can to control my rehabilitation and future athletic endeavors!
On that note, I will be making a much better effort at doing my at-home PT. I've gotten lazy in the last week or two, and it is showing when I now go to do simple exercises at home, including lunging and some jumping tasks. Since I'm down to 1 PT session per week with Drew, I need to make sure I'm doing my part so he can progress me to the next exercises and lift any limitations aong the way!
I am sorry to bore you, but happy to say, there haven't been many blog updates because there hasn't been anything out of the ordinary that seemed worth posting. I see this as a good thing though, because while maybe I'm not breaking major boundaries, I don't seem to be hitting any walls either! Progress seems slow, but steady...
The big items recently still involve jumping. Jumping rope for 3x3min intervals... Jumping onto and off of the Bosu Ball (bubble side up)... Starting with weight on one leg, the other resting up on a step, and while jumping into the air, switching both legs at the same time, landing on the opposite leg.... (This last one we pushed to do 30 times in 30 seconds -- I was definitely getting a cardio workout then!).
With PT visits only 1x per week, we tend to fill the time with lots of exercises, but I have to be sure to do items on my own during the other days of the week. I could be a little more religious with these, but I don't feel I'm falling behind by much, if at all. I recommend finding a workout buddy to take with you to the track or jump rope with you-- You'll see the exercises you've been doing will wear out even a non-surgical buddy! :)
On that note, I feel like each day is getting closer to 'normal' (with the exception of muscle mass from surgical to R leg) and it's wonderful to be getting back the independence I've been working so hard to regain! For instance, yesterday I ran just short of 2 miles on pavement, and while it was tiring and left me a little sore-kneed, it's progress!
Dr. S: "Two down, two to go!"
Summer: [Obviously confused] "What?"
Dr. S: "Well, you're at two months, and only two more to go!"
Summer: [Still obviously confused] "Oh, um, for recovery? Or..?"
Dr. S: "Yeah!"
Summer: [Yep, still confused] "I thought it was more like 6 months... No?"
Dr. S: "Nope!"
Playing back this conversation now still makes me chuckle, because even though he clearly stated it was a 4 month recovery (total), I still don't really believe it. I mean, PT has been going well and all, and aside from some muscle I need to get back in my surgical quad, I'm feeling pretty confident so far. However, when I've had it in my head that all my fave activities are off-limits for 6 months, it's hard to change that placeholder in my head from mid-October to mid-August. Plus, a big fear of mine is coming back too early and not being back to 100%. But if I can't trust my doctor's word, who do I listen to??
The rest of the 5 minutes (if that!) with Dr. S was uneventful- Range of motion is "great", swelling is minimal, and I have no complaints of pain... "See you in a month!"
So- I am resisting the urge to be completely ecstatic and drunk with happiness about this 2 month shave off my 'return'. Why? Well... while I feel I'm a positive person, I want to remain realistic and, perhaps, a little on the 'safe' side. We'll see how things work out, but I guess I'll limit myself to just a sip of this delight cocktail for now!
In the event I'd like to celebrate by jumping up and down - well, now I have been advised by my physical therapist to go on ahead and do it! Today in PT, among other things (see my ACL calendar), I started jumping. It's really a strange experience to try a simple motion like that, which I've avoided for the last two months, but is so elementary. Like everything else, I started with a little hesitation, but once I realized my knee wasn't giving out on me and there wasn't even a pang of pain, I became a 3x30 rep jumping bean! PT also brought on more Bosu Ball fun too...!
So, between the good news from the Doc and trying new things in PT, today was a great day! Not to mention, by next week I'll only be at PT once a week (currently at 2/week)! Booyah!
Instead of trying to bust out more PT exercises on Friday, I thought trying a yoga DVD would be better, to stretch and work on breathing. It was nice, including some lunging poses, however, about half way into it there were some poses I chose to skip. For example, one req'd kneeling and putting weight on the area where they took my graft, and by the time that one came about, I decided I had stretched enough for the time being!
To feel like I'm still doing what I can on my own, today I did some walking and a mile run on the track [where my new iTouch helped break the monotony of going round and round- Thx BB!]. That was followed by lots of stair work on the local HS bleachers. Since they're half-steps, I would go up taking 2 steps at a time, always leading with my surgical leg, forcing that quad to do most of the work. Going down I would step down with non-surgical leg, forcing the surgical quad to, again, bear the burden of controlling the balance and movement as I stepped down.
Stairs are one of the things I am using to track my progress. When I end up ahead of someone (going up or down) in the stairwell at work, I feel myself getting flustered as I hear them galloping closer, and I can't seem to go as fast. I am noticing some improvement, but for now they'll just have to deal with it - I refuse to take the elevator!
Now, back to enjoying the weekend! Happy (early) Father's Day to all the daddios out there, and especially the best one I know-- Papa John! ;)
Today's surprise was the 'timed 1-mile run'. As an ex-cross country runner and being an athlete in general, I know I used to be able to easily run 1 mile. Plus, I've done previous sessions of run-walk intervals in PT, covering more than 1 mile, but today's challenge was to do 1 mile running, and at a decent pace. So, once I'd done an 8 minute warm up on the elliptical and stretched a little, I headed for the treadmill. Drew was not over my shoulder during the run, so I didn't burn myself out on it, but I did make sure to turn up the pace from previous PT runs (from 6.0 to 6.5). I finished in ~9:30, and for my first mile back after knee surgery, I am OK with that! (Plus, I know I could have gone faster if I had to, but I still had a full slate of PT ahead of me!).
The run left me whipped, but as usual, I felt really good about it once I was done! I did a handful of other exercises (including shuffling side-to-side between cones; also pushing off side-to-side in a speed skater fashion on a slip board) which had me working on sideways movements and adding in a little squat motion as well. It's good to know I'm getting to a point where it's not all about the range of motion in a straight line!
While I did have to go down in weight on the one-leg press today by ~10#, I was fine with exhausting my leg muscles to the point where they were shaking throughout that exercise, and others. Lunging is still difficult to put the weight evenly through my surgical leg, but practice makes perfect, right?
Next Monday (just shy of 10 weeks post-op) I'll see the Doctor again and make sure I'm on track!
I passed my 8 week mark on Tuesday and am cruising to 2 months post-op this weekend, on June 14. On Monday I went to PT and pretty much did my whole routine without any pointers, new exercises or even manipulation/ stretching by Drew, my therapist. Even though I did some treadmill time and feel my strides are becoming more even, I was disappointed at the lack of personal attention and was glad that I’d gone down to 2 visits / week. However in yesterday’s PT, Drew decided to mix it up for me, and it felt good to try new challenges, even if it left me whipped afterwards!
First, we skipped the 10 minute warm-up on the bike, since initially this was used to help get back range of motion and in later weeks, loosen up the knee w/o putting too much weight on it. Instead, I did 8 minutes on the Elliptical (Drew said to be sure I was a little tired and breaking a sweat when done), and after some calf and hamstring stretches, it was over to the treadmill. There I did 15 mins of alternating between speed walking and a run. I am gaining lots of confidence here and am sure I could have run longer, but didn’t know what else was in store for me.
The most entertaining, by far, was using the Bosu Ball, which is basically an inflated exercise ball, sliced in half with a hard plastic board across the flat. I had to stand on the flat part, meaning the half-sphere was towards the ground, and I had to balance on it, or risk falling off! I have never used a Bosu Ball, so I was very cautious. At first I thought the goal was simply to stand and balance, but then we added squats, which would mean having to distribute my weight evenly across both legs. I looked kind of like THIS, but kept my hands out in front of me for more balance. My surgical leg was a little shaky, and this was intensified by the Bosu Ball, making it even more difficult!
30 squats later (and, a careful dismount of this potentially dangerous piece of equipment), my surgical leg was ready for solid ground again!
I thought I’d be sorer today because I felt like we really pushed it (and, mixed it up, finally!) but perhaps the soreness will be another day behind. Or, maybe I’m further along than I thought, and ready for some more challenging tasks!
Other items of note:
- With the exception of an anti-inflammatory now and again, I haven’t had to pop pills for pain much since about mid-May (1 month post-op)
- The skin to the outer side of my vertical incision is still a giant numb spot, maybe 2/3 the size of my palm
- While I’m still able to ‘forget’ about my knee sometimes, I have noticed an aching feeling that comes about sometimes just when sitting
- More often I am able to get in and out of my car by pivoting on my L leg, instead of getting in or out of the car with both feet on the ground first
- I take the stairs up and down to my 2nd floor desk whenever I can, and going up remains pretty even while going down still requires some strengthening to even it out
- I can walk w/o limping, but if I’ve done a lot of activity or walking in any given day, my limp creeps back to a quite obvious favoring by days end
- I touched my butt with my heel! While standing I was able to grab my ankle and (with my foot slightly pointed/ while wearing tennies) was able to bend my knee so far as to feel my shoe hit my butt! (I even showed an assistant at PT just so someone else could share my glory!)
What’s wrong with getting excited about the little things? :)
Also, they finally picked up the ThermoCompression Unit I'd been "renting" (as shown in my 4.18.09 Blog Post), which I was under the impression I'd have for 3-4 weeks, not 7! I'll miss the 'ol girl, but I s'pose an ice pack will do me just fine these days, as I have VERY minimal swelling anymore, and I would only ice after a long day on my feet.
Otherwise, today's PT went well with two nice surprises... Firstly, I bumped up to 105# for 1-leg press (using my surgical leg, of course) and it was easier than I expected! (I was doing 165# prior to surgery, so there's still work to be done..). Secondly, we got back on the treadmill for run/walk intervals, and not only was there no pain in my knee, but the limp as I run (aka "Rumping") was not nearly as severe. 15 minutes later I'd covered 1.25 miles, and it felt wonderful!! [Note: You can open up any 'PT' appointment in my ACL Calendar to see what exercises I'm up to. Keep in mind my surgery was 4.14.09...]
Even though I still have a ways to go, I am feeling very good about progress thus far!
My dad, a seasoned tree-cutter-downer and general outdoors man, offered his services, but this is a big task for just one person. So, in addition to keeping him well fed and hydrated, I decided to monitor how my knee felt as I helped with the take down. I was aware that the backyard is a bit soft and, in some spots, uneven. Also, there is always the chance that a limb can come down more quickly or in a different direction than anticipated, so it meant being smart about where I was in relation to the action. Luckily Eric was able to be a big help when it came to needing extra elbow grease for the big cuts, and some of those times I was happy to stay on the sidelines instead of risk any injury.
2-day story short- and because you were surely holding your breath- there were no injuries, or even pain beyond normal use! There were even times I was able to plant both feet firmly and tug on guide wires, and I felt strong in my foundation. Or if I needed to step on a branch to hold it down as I broke it into smaller pieces, I could use either foot and wasn't nervous to do so.
This definitely isn't how I expected to be 'celebrating' my 7-week post-op anniversary. At the same time, if you would have asked me a few weeks ago if I would be helpful in an activity like this at 7 weeks, I might have thought you were crazy!
Meanwhile, PT is focusing on the same strength building exercises and transitioning me into running. Drew worked a lot on stretching my hamstring and really straightening out my leg at last PT, and I felt a lot better when I jumped on the treadmill immediately after. 10 minutes of speed walking followed by 3 minutes of running left me tired, sweaty, but most of all confident of my eventual return! Yay!
Today I gave the run/walk intervals another try. I was advised by Drew to go to a track (meaning level surfaces and a nice padded course) but since there was a soccer game going on in Berkley's track infield, I refused to run around the game and provide entertainment for the ~100 people there. So, I went outside of my trainer's wishes, and hit the streets (very carefully, might I add). First, it was taking my walk from a slow, to normal, to eventually quick pace. Then, once I felt comfy, I tried running again. It felt just as awkward as the first two times, but if nothing else, it felt good to be out, trying, and breaking a sweat!
I believe the reason I can't shake the limp while running is I am (1) still having a hard time mentally trusting my surgical leg, (2) my muscle mass in my surgical quad is substantially less than my non-surgical and (3) when I do run, I am not letting my surgical leg extend out all the way, therefore I'm running shorter strides on that leg versus my 'good' leg. This overcompensation caused a little pain in my 'good' leg's hip towards the end of the run, but nothing I feel when walking or going about my day-to-day.
Otherwise I feel I am reaching a point where I actually sometimes FORGET about my 'bum' knee! It is a wonderful thing. The more I find myself putting it out-of-mind, the more I realize I am getting back to that 'normal' lifestyle I so desire. In the coming week I'll still be seeing my trainer 3x, but after that we've decided I'm ready to go to 2x / week. This can only mean one thing... PROGRESS!! :)
The last few sessions of PT have me improving by leaps and bounds, being able to do exercises I haven't touched since pre-surgery therapy. This includes more challenging balancing exercises, squats, and adding more weight (or resistance) to previous exercises. I am up to 90# on the one-leg press; I am confident I could do more, but am trying to only gradually increase the weight.
Going down stairs is getting much easier, partially due to trust in my leg and the exercises in PT that have helped me break the mindset that my leg will give out if I put the opposite one down on the next stair first. There is still some favoring going on, but it's much improved.
Otherwise, my focus has been to get my walk to normalize, and I know I am capable, but the thing most often holding me back is habit, and maybe the *littlest* tweak of pain in some motions. They said I was not letting my leg extend all the way as I worked through my gait, but I am shaking that habit. Today there was proof of this, since in PT I was put on the treadmill for ~5 minutes and Drew kept bumping it up until I was at a speed-walking pace. At first I was hesitant and favoring my surgical leg. As I eased myself into it and realized the pain that's held me back in the past was not showing itself, I was able to get a normal stride.
My big event of the day was my first attempt at running!! Drew was there to push the 'speed up' button on the treadmill until I finally couldn't speed-walk any more. I'm the first to admit, the run was not pretty (by any means), but I think, again, it was habit and a mental block more than anything, which kept me from evening it out. I didn't run long - perhaps 1 minute, but when I haven't done anything (but putt-putt) since my surgery 6+ weeks ago, 1 minute of running was plenty for me to see where I stand today!
In PT there are 2 other young ladies I see often, I believe 1 week and 4 weeks behind me (same procedure and Doc...). They were both there today, and it's hard for me not to look at them and compare myself in the way of progress. Two of us seem roughly the same, but the girl who's at 2 weeks (versus my 6 weeks) was ALSO on a treadmill today (albeit at a slower pace and a more obvious limp...). But I'm blown away by this girl's progress and have so many questions - What did I do wrong? Why isn't she in as much pain as I was? How is she asking questions like "Can I ride my bike now?" when at 2 weeks that was the last thing I wanted to do? I remind myself that everyone truly has their own schedule. I make sure to congratulate her on her progress, because we all can use words of encouragement as we work down the winding road of recovery!!
So in my continued efforts to get back to 100% (or better!) I returned to PT today assuming I'd have pretty much the same routine as normal: Ultrasound (locally @ incision), a few painless exercises and stretching, and eventually 'ice' by rubbing ice directly on my knee until it's numb! I was right on everything, but then I got a little more in the way of exercises.
At 26 Days Post-Op (just 10 days ago) I mentioned some 'upcoming milestones'...
One goal is to get back to a 'normal range of motion' , which is from zero to 130-135 degrees. Drew told me that I am within a few degrees of that as of today (Yay!) but that my 'good' leg is closer to 160, so I definitely have some more work to do!!
Another ongoing goal is to normalize my gait. Today I was told I have all the PARTS of walking normally, I just need to piece it all together in one fluid motion. I like to compare this to learning to golf -- it's not easy to do everything right at once! While I may be able to control my walk enough to appear not to have a limp, it is still a very conscious effort (hence my previous post, 'Could the limp be gone?!' not stating that it was gone!). Drew would watch me walk and of course compare- What was my 'good' leg doing that my surgical leg was not? [Answer: My surgical leg is slightly bent through the whole stride; I'm never completely straightening it out.]
My goal to walk smoothly comes back to another goal I was perspicacious enough to realize over a week ago- being able to trust my surgical leg as I balance on it and at the same time go between straight and slightly bent. I brought this up to Drew today and he had me 'practice' doing this very motion. There were some new twinges of pain as I did it, and my leg was shaking (oh, how sad the weakness is!), but it was good to be forced, because I hadn't challenged myself at home just yet. I had to stop a few times and do the same motion with my 'good' leg, just to remember how it's supposed to look and feel!
And so the battle of Surgical vs 'Good' Leg continues.... As for the other milestones I'd set:
- I'm happy to say I can go up stairs without favoring my surgical leg
- I can balance on my surgical leg when it's straight (as well as slightly bent) without pain or feeling like i'm going to tip over (it's going between the two that's tough!)
- I can go down stairs with one foot per stair (though I favor my surgical leg VERY much when doing so)
- I continue to massage around the incision to get the skin to move freely over the knee cap (and I've also been using Mederma to hopefully reduce visibility of the scar... eventually)
Pic as of today (you can ignore the waffle imprint- that's from using my ThermoComp icing machine...)
And, since I may not post again before the Memorial Holiday - I hope everyone has a safe and fun weekend, and I'll try not to do anything dumb to mess up all my hard work on my knee!!
Firstly, I had another set of x-rays taken. I mentioned that I already had x-rays taken at 1 week post-op, but the assistant said she was just following doctor's orders, so we both went along with it. Since the x-rays were identical to the last set, I felt they were a waste. Perhaps there is a small percentage of patients whose titanium screws (which hold the graft in place) may shift? Perhaps I'll google that... ;)
When Dr. Shapiro entered the room, we exchanged pleasantries, and I dove right into the discussion Drew and I had about my potential tendonitis, and how we felt it was setting back my recovery. When I told him that the tendonitis was in the area of the patellar tendon (where my graft was taken from), he seemed to pause a second and cock his head in misunderstanding.
"Well, you know, pain in that area is not necessarily tendonitis. I mean, that is where we took your graft from, so of course there is going to be some pain in that area.." he said. Well, this was followed up with how every recovery is different, and launched a discussion of pain management. I told him I've been off Vicodin for some time now, and only popped some Motrin (~600mg) every now and then for a two-birds-with-one-stone throw at both pain and inflammation. Can I really tell the difference when I take it vs not? Not really. But people also told me that Vicodin would be a god-send, and while I'm sure it helped dull some pain, it wasn't all I thought it'd be either. In the end he wrote me a prescription for something comparable to Motrin and told me to take that, mostly for inflammation that could be causing my pain. I am not a fan of popping pills, but Doctor's orders!
So, after our brief discussion of my maybe-tendonitis-but-not-necessarily, Dr. S had me sit with my legs extended out in front of me on the exam table. With my leg relaxed, he carefully manipulated the knee cap and poked around a little at the swelling, which seems to be in control. Next he had a look at my extension, which we haven't measured lately in PT, but is definitely at zero, if not -1 or so. Then, he had me slide my heel towards my butt and bend the knee as much as I could. Range of motion was "great" (though I still have some work to do on that bend!)... But for now- I'm on track!
After this, I extended my leg back out, and he grabbed my lower thigh with one hand and upper shin with his other hand, and did a little jiggle-jiggle to test the stability of my ACL (I assume, anyway) and those few things wrapped up the physical exam.
Once done, Dr. Shapiro was pleased with where I was and said I was right on track. God, that was good to hear after beating myself up over the last 2 weeks about my inability to walk w/o a limp or being 'behind schedule'. I was so happy that he didn't push the thought of tendonitis on me or give me any indication of being off track in general. I have too competitive of a spirit (even with myself) to have to deal with negativity that would have come from such focus.
I had them print me today's set of x-rays (which, truly, ARE exactly like the 1-week, so I won't bother uploading) and headed for PT. Drew was glad to hear the doctor was happy, and between the three of us, I think we will all be delighted as I can focus on the coming weeks and getting back to 'normal' !!
Note: I just heard meow-ing on my porch (we do not have a cat!) and it's a black cat! I hope that's not a bad sign... !!
While I'm still at PT 3 times per week, we've been taking it easy for about a week and a half, doing ultrasound in the area of my patellar tendon and locally icing directly on the skin. I knew patience (and a positive attitude!) would be a must as I overcame this hurdle.
I must say I'm having a bit of writer's block to describe just how I've come to ask myself... Could the limp really be gone? It comes down to this- up through this morning (I think!), I still couldn't seem to stop favoring my surgical leg. However, this afternoon I was on the phone and decided to take a short walk down the street and back. I was walking with control, but the pain was minimal if anything, and I realized I could walk normally!
Perhaps it helps that I was just doing PT at home and stretching. Or maybe it's that I was distracted with conversation. But this little triumph had me excited, so I had to share!
Meanwhile tomorrow is my 5 week follow-up with Dr. Shapiro. I'm looking forward to getting his opinion on my progress, and moving on from here!!
Bear with me, and let me preface by telling you a few parts of my day ...
I realized that as I walked around work I thought of statements I might blog, (similar to how I always think of captions for my photos, for those of you who know me!). Sadly, one statement that came to mind today was, "I am feeling a sense of disappointment [frustration? defeat?] with every step I take." What?! Did I just think that? True- it is hard to ignore my slow pace or pain every few steps, but DEFEAT? C'mon now. Lighten up, Louie.
Then, checking my (personal) email at work (shh!) I received today's dictionary.com 'Word of the Day': Abnegate which, has a second definition of "to relinquish; give up." You might think in my original state of rut, I would have thought, Gee, how fitting! But, I looked at that and asked myself, is that what I'm doing? Of course not. But where did I fall on the scale from frustration to giving up?
At some point my new boss came by and mentioned my knee. He said, "Aren't you some kind of super-jock?" Ha! I may not fall in that category, but there's few sports I won't try. I had to laugh at this rep I didn't realize I had at work...
I eventually left work and headed for PT, and as I hobbled to the front door, I saw a girl being dropped off with immobilizer on her leg and crutches under arm. "When was your surgery?" I asked. "Yesterday..." she said. Ahhh... I remember being there, and the pain just to stand. I felt for her as I held the door and helped her meet her trainer- my good friend, Drew.
A few exercises into my routine, another girl asked me how far along I was, as she was 3 weeks out. "Your scar looks great!!" she told me... Well, that was awfully kind of her!
OK, ok, ok... enough with the stories. I am not sure when, but at some point in the day, negativity started to crumble from my mentality, little by little. I now found myself in my (currently) dreaded position: being asked to 'walk the runway' for the trainer. Despite my hopes, I did not miraculously shake the limp. But this time I was not barked at on how to fix my gait either, which was refreshing. So it came to the next question... Now what?
I confronted Drew about the whisperings of tendonitis from last session. He would not (and I guess, could not) officially tell me I have it, as that is my doctor's call. However, when asked, he said, "You definitely [catch/pause] maybe have tendonitis." Enough said. He said around 10% of people get it (I'll have to research...) and that it's not that anything was done wrong, that it just sometimes happens. I could ask a million questions- did he push me too hard? Did I take my PT at home too seriously? Did I work through pain I thought was normal, but it was over-use? No matter- I now have direction that "if it hurts, don't do it." I'm going to bend that and say, if it feels good, do it! - which I thought a a nicer tone to it!
So for now, that's exactly what I'll do. At PT we continue to do ultrasound in the area of my patellar tendon (which I read, is a way to treat tendonitis) and ice is rubbed directly on my skin near the incision instead of a wrapped ice pack after PT. Other than that, the only way to 'treat' tendonitis is rest, only do the exercises which don't pain that area, and be patient. Isn't it ironic that being patient is the fastest road to recovery? :)
The incision is healing nicely, and I am sure to massage it whenever I think to, which will help loosen the skin (as it's still quite stuck in place) and break up scar tissue beneath it.
Focus continues to be on evening out my gait. I keep thinking it's mental; that I am just not trusting my leg. However some pains can not be ignored (even after popping a Vicodin pre-PT) and just when I feel I'm improving, I get the same pain (more shooting than general) in the area of my patellar tendon, and my body goes back to the exaggerated limp.
Also, today I was given so many directions to correct my stride as I walked the imaginary red carpet for my trainers: "Let your leg straighten out before swinging it forward." "Bend your knee more." "Pull your surgical leg forward more quickly before you step on it." "Go faster." "Hold your shoulders way back..." My head was spinning and frustrations were mounting as I couldn't seem to do what they were asking. Walking the runway was neither glamorous nor fun. I really was (and am) at a loss.
What scares me is that the two people working with me at PT can't seem to figure out how explain the intermittent pain I'm getting and one of them mentioned the possibility of tendonitis today, which, honestly, has me a little freaked out. With overuse being the primary cause of tendonitis, even hoping I don't have it, I wonder if 'powering through' the pain in hopes of a speedy recovery may actually be hindering my recovery??
Tomorrow I will be 4 weeks post-op, and while I knew it was far fetched (even my surgeon uncle said so), I remember Drew telling me I would be running around 4 weeks. I can only hope that statement was made as incentive, and that it doesn't mean that I'm doing something wrong.
I have my 5 week follow up with the Doctor in 1 week (though I did see him briefly today as he made a random visit to the PT area) and hope to have this settled by then, or at VERY least, be able to get some answers as to where I am in comparison to his other patients at this point, and how I can stay (or get) on track.
But I can say that I am in a better place now. Yes, I am still limping, but I am feeling improvement (or, lack of pain I was feeling before) and am working more on balancing on my surgical leg while it is straightened to gain confidence in my leg as it teeters on the edge of locking/straightening or being just slightly bent. Once I feel good there, I think it will really improve my walking.
While I am physically improving, I am also grateful for the support of others who have either been through (or, will be going through!) this type of procedure, as well as those around me who continue to care about my well-being and encourage me to keep at it! I'm sure I'm not the first person to have moments of frustration and weakness in my recovery, so all I can say to those of you who might experience the same thing -- it will get better! I just hope I can remember my own advice as I continue on!
A few points of interest-
- I am no longer on a steady diet of pain medication, as of ~3 weeks post-op. I still pop something before heading to PT, but otherwise think keeping Motrin handy should be enough to curb most discomfort.
- I have no pain in standing for longer periods of time. (Immediately after surgery, this was what caused the MOST pain in normal day-to-day!)
- I will be returning to work tomorrow (mainly sitting at a desk all day) and while I was capable of returning a week ago, due to a temporary lay-off (don't worry, it's just a week here and there!) my start date was pushed back. I was grateful for the extra week of being able to stay home and focus on recovery.
- The most pain I have is in the region of my patellar tendon. Mostly it's caused by the simple motion of straightening the leg from bent, but without any support (As in, if sitting with legs dangling off a chair, trying to lift my foot so leg is straightened out in front of me). Similar to pain felt when trying to do 'straight leg raises' while lying on my back. [Note: I am not sure if this pain is because my graft was taken from this area, or if this occurs in all ACL reconstructions?? I assume the former...]
- Getting my bend to ~135° (considered 'normal' range of motion)
- Walking and climbing stairs w/o favoring my surgical leg
- Going down stairs w/o having to put both my feet on one step before descending the next stair
- As mentioned, focus on balancing on my surgical leg while it's straightened
- Eventually be able to balance on surgical leg w/leg straightened and remain balanced as I work into a slight bend
- Breaking up scar tissue in the area of the incision to allow the skin to move freely over my knee cap
- Continue to ice, elevate and massage around knee to reduce swelling and break up scar tissue
Perhaps returning to work will bring me some new challenges (I am thinking sitting in one spot for a bulk of time will end up with a lot of fidgeting so my leg doesn't stiffen up too badly). Either way I am looking forward to a change of pace and starting my return to a 'normal' lifestyle!
And, some photos of my progress. Enjoy!
I can now bend my knee to this angle somewhat (I say that lightly...) comfortably:
Since I'm a big fan of trying to keep positive, I drove to PT today with my music cranked, windows down, and saying to myself, "Today will be great!" Monday was a tough PT for me (summary: on the verge of tears the whole time with various frustrations; and oh yeah, the pain!) but Tuesday I felt like I was starting to get trust back in my walk, and didn't seem to be limping as much. I thought I'd walk into PT today and wow them with my improvement!
I posted before, and it was to describe the troubles I'm having in getting a normal gait. I know this is all part of the process of recovery, but as of today (Wednesday) the task seems daunting again. My trainer spent 1.5 hours with me today trying to problem solve, and I must say, his actions and conversations make me think I have him stumped. First, it seemed I was having trouble with extension. However a few exercises later it became clear that I have no additional pain, nor problem, in getting my surgical leg completely straight. Then, it was a backwards-skateboarding sort of motion on the treadmill, which didn't seem to loosen me up any more or get rid of the pain I was feeling. If this particular pain is normal, Drew did not verbalize that!
We did an ultrasound to send waves of heat deep into my knee to help break up scar tissue and "promote healing", and I was told I may feel less pain immediately after treatment. Honestly, I didn't feel a difference (...and they said I was on a 'high' setting!). Then, when icing, instead of putting a cold pack on my leg (which is typical), we took a block of ice and rubbed it directly on my knee near my incision, and kept the cold localized in the area I feel a 'twisting pain' when trying to walk. Once done with these treatments, I tried walking again, and with a numb knee and my poor walking habits, I still couldn't seem to shake the pain.
So, I wish I was writing to say, Hey, more improvement today! But in actuality, I must say this post is more of a release of my frustrations in my lack of improvement. I know it's a tough road ahead, and I'm not giving up, but knowing walking is my next 'big thing' to overcome makes the frustrations mount as I go in to PT and can't find hint of improvement. Additionally, the incision seems to be stuck in place (skin doesn't move freely over top of the knee/cap area, so there must be scar tissue to break up) and even after going through ~5 minutes of torture/manipulation by Drew today, he didn't get it to loosen any more. How am I supposed to manipulate it at home and see improvement, when there's no way I can inflict that much pain on myself??
To think back on the recent physical pain and mental frustrations I have gone through gets me worked up all over again, and it really is turning into a [negative] vicious cycle. I know I can overcome it, it's just a matter of how.
Just over 3 weeks out, I am still proud of how far I've come and the pain I've tolerated, but I am ready to conquer that next step... this time, without a limp...
So now I am closing in on 3 weeks post-op, and in yesterday's PT I again felt the pains of the forced bending (not sure what degree we got to but I hope it was 120!) and the frustrations of the most simple uses of my leg, which just aren't coming naturally. However, I have been improving every day (some days more than others!) and I'm now being told to work on 'walking'.
I have officially eliminated the use of crutches (even when going on somewhat uneven terrain) and have been walking in a controlled, slow and short-strided manner. I realize this is not how I want my gait to look when I'm done rehab-ing, but as they say... Baby Steps!
When asked to walk by my trainer yesterday, I made a conscious effort to stand upright (instead of look at my feet) and just walk evenly. Drew called me out on it immediately, telling me to speed up (I was going frightfully slow) and to stop trying to 'control' my stride. I followed directions (like the 'perfect princess' I said I'd be in PT) but there was an über-uncomfortable feeling below my kneecap, and at the times when walking requires balancing on the surgical leg at the sensitive position between completely straight and just bent, I felt like Bambi again.
"Let's put you on the treadmill," Drew said. Wha?! Didn't I just prove I'm not even ready to walk 'normally' yet? But sure enough, I climbed on and Drew took the belt speed up to what is probably a normal walking pace... but I looked like a pirate trying to speed-walk on my brand new peg-leg! Oh, and of course there was the return of the aforementioned pain below the kneecap (in the area of the patellar tendon).
This limping pirate look may have brought Drew back to reality, as I just couldn't seem to go with the 'flow' of the treadmill. So, for 5+ minutes I instead stood with my right leg off to the side of the treadmill belt, and at a much slower belt speed, would put down my left foot and 'walk' with my left leg. (I looked like I was skateboarding now) This allowed me to gradually put more weight on the leg as I got more comfortable, and my new task was to work on taking longer strides and stop avoiding straightening my leg all the way before 'pushing off' and lifting the leg up again.
Unfortunately, I do not have a treadmill or stationary bike at my disposal, so I am unable to work on such activities (and range-of-motion exercises) at home. This didn't stop me from going out today (Saturday) in the lovely noon-day sun and walking ~5 blocks. I tried to follow all of the tips and directions that Drew had given me, but in the end I know it still looked 'controlled' if not limping, because I had a friendly passer-by ask, "Are you OK?"
I compare this attempt at walking to learning to golf. There are so many things to remember when you learn to swing a club: head down, legs slightly bent, grip a certain way, twist your body a certain way, backswing so your arms do or don't bend too much... you get the idea. It's just a little overwhelming to try to remember it all and follow it all to a T. Same goes with this whole 'walking' bit. No matter that I've walked plenty in my lifetime, when it no longer comes 'naturally' it's truly an effort to make walking an effortless motion!
So, while I know I still have a ways to go before strangers aren't concerned for my well-being due to my unconventional walking style, I am making improvement, and that is all I can ask for now!
And because pictures are fun:
Day 16 post-op: I 'cleaned up' the incision area before re-taping. Looks good w/ the exception of the zig-zaggy part at the lower kneecap Day 18 post-op: OK, not a flattering pic at all, but for the sake of comparison, this is a pic with legs in the air, slightly bent and completely relaxed. Note the swelling still obvious to the sides of the knee and lower thigh/knee area. Also, major muscle mass difference in the thighs (lower portion of picture) which I hope to reclaim when this is all over!!
In two weeks I've overcome some major milestones, from ditching the crutches and immobilizer, gaining some great range of motion, and slowly regaining muscle back in the quad of my surgical leg. Not to mention, getting out of the house to spectate some of my favorite sports teams!
This is not to say that it's been increasing improvement each day, or, without pain. As you may know, within 1 week of surgery, the goal was to get to a 90 degree bend. I was delighted to be able to reach that goal (even though in PT I went through the worst pain I've felt in my life...). Between that 90 degree PT visit and Sunday's home PT (6 days later) I figured I'd gain 5-10 degrees on any given day, and be flying towards full range of motion. Instead, I found myself getting to what looked to still be about 90 degrees and really beating myself up to get just a little more bend.
Welcome to my (then) pity party with RSVP of yours truly. Instead of being happy with at least remaining around 90, I was disappointed. I was coming up on the 2 week mark, and hardly had made progress in 6 days. Sure, I was walking a little more confidently, but I still had (and have) trust issues with my knee. What did I have to show for the previous week? I had even religiously done my PT work at home on Saturday and Sunday, and felt that it had hardly made a difference.
Reality check: At the time of my 1-person pity party, I was still under 2 weeks from major knee surgery. Recovery takes time. I had to remind myself (and be reminded) that I can't get down on myself when I still have 11/12ths of the road to recovery to go!!
This takes me to PT on Monday, 4/27. I worked with Michelle again and the first thing she asked me to do was try to flex my surgical quad. I did, and she lit up and said, "There you go! Much better [than Friday]!!" and with that, my mood started to turn more positive. I went on to do a few more exercises....
After a few warm-up tasks, it came time for the most dreaded part- forced bending. I mentioned to her that I tried to do it at home, but wasn't getting the improvement I'd hoped for. "We'll see..." she said. She tried to keep me occupied with other conversation, and I tried to relax. The less I fight her, perhaps there'd be more bend and less pain. A few slow bends, reaching a somewhat painful point, and coming back off, we maybe bent my leg 3 times or so. Finally, she got the tool to measure how much I was bending and we pushed it one last time...
"Last Friday you were freaking out around 90 degrees and look at you now! Just shy of 120 degrees! That's some impressive improvement!"
With that news, I was ecstatic. I allowed myself to enjoy the surprise of the new range of motion, and finished my work-out with determination. And while I'm not sure what I'm doing at home that might be helping increase the bend, this new achievement supported my plan to keep up with PT at home as if I had a trainer looking over me!
So here I am, 2 weeks post-op and pain and setbacks aside, I feel confident I'm on my way to that full recovery I keep hearing about... ;)
Bruising on the inside of the calf much less noticeable; Bruising on the back of the knee fading significantly