This morning I did the full count of all my exercises. 20 Heel Slides; 1 minute Hamstring Stretch; 30 each of all three leg raises; 5 minutes Passive Extension; 20 Knee Bands with 1 second pause; 20 Knee Bends with 1 second pause; and a full 1 minute of balancing on the involved knee! It’s one of those mornings where I love physical therapy. Funny in a way because…
Physical Therapy Hurts!
When I First started doing my pre-hab, I couldn’t even believe the things they were asking me to do. My knee had really become stiff while in the immobilizer. The first thing to do was regain flexion and extension. Flexion was accomplished by doing ‘heel slides’ where you sit on the ground with your leg out comfortably in front of you. You hold a towel or strap in both hands, loop it around your foot, and pull, flexing your knee as much as it will go. That hurts…but it also kinda feels good; inevitably the knee flexes more with each slide. Sure you backpedal for the next session, but in aggregate your knee keeps flexing more and more. In my case, it felt as if the muscles and tendons had settled into odd positions during the immobilization and now as I was working to get range of motion back they’d ‘pop’ around. It feels gross, yet also in an odd way it feels good. I was also dealing with a LOT of swelling; I could feel the fluid moving around to get out of the way of the flex. That, too, felt weird, sometimes felt wrong; ultimately it felt good too.
There’s always one exercise that is your least favorite. For me it was ‘passive extension’. Seems easy, right? Put a rolled up towel under your heel, lay down and just relax your muscles. Let gravity do the work. My goal was to do this for 5 minutes. The first time I tried to do it I thought I would cry after 30 seconds. I started sweating. I just could NOT convince myself to un-clench my muscles. Now keep in mind that my injury was a knee hyper-extension. All I (and my muscles) could think of was that if I relaxed my knee would just hyper-extend again, an awful feeling. My physical therapist had me modify the exercise so that the towel was under my knee at first. I would progress to no towel, then to towel under heel. It took a long time to get there, but I did make those transitions over the course of about 3 weeks. Now that I’m in rehab I think Passive Extension is one of my favorite ones (It helps the hamstrings).
Physical Therapy & 1 week Surgeon Consultation
IT feels a bit lopsided going in on Wednesday and Friday for physical therapy. Still, I managed to make some strides between the two days. Having the greatly reduced leg pain means that my stamina is on the rise; Adam decided to have me start walking around as much as possible with a single crutch and no immobilizer. He also gave me one new exercise, Step ups; and modified my knee bends so that I do a 3 second pause at the bend. He had me drop the weight shift. There was just enough time for me to do a 10 minute icing on the ‘game ready’ before heading upstairs to meet with Dr. Fetzer.
When we got upstairs and into our room, I found out that the stitches were coming out today! The student nurse took off all the steri-strips, pulled some of the stitches, and cut the exterior off others that will dissolve. She then put on a new batch of steri-strips.
Once that was accomplished, Dr. Fetzer came in to see how I looked, and to generally talk about the surgery etc. He said I was looking great and that I could stop wearing the immobilizer to sleep! This is big news because that thing is very uncomfortable for sleeping. He also told me to get my normal step back and get off the crutches ASAP, which matches Adam’s plan for me.
Then we talked about the surgery. He brought up arthroscopic photographs of the whole thing and talked us through it. All of my menisci looked great given my age (they have some wear and tear) the ends of the Femur and Tibia joints were in good shape too. He showed us where he’d ‘mowed the grass’ clearing up some ragged cartilage and such. Then he showed us the drill holes in my Tibia and Femur and the anchors and the tendon that will become my new ACL. We have copies of all the photos but it was great to have him explaining it all to us.
Finally he asked if it was OK to do one more X-Ray to see how everything had settled. I said, of course! He then showed us on the X-ray where the anchors are. And with that the meeting was over. I go back in 5 more weeks for the next follow-up appointment.
Evening Physical Therapy
I was pretty tired by the time I did the evening PT, but managed to get through it all, new stuff included. I’m really looking forward to getting completely off crutches, they are fairly uncomfortable and my right underarm is complaining a bit (yeah, I crutch incorrectly sometimes when I’m tired).
Posted by Greg on July 16th, 2011 :: Filed under
ACL Files