Category Archives: Rehabilitation

Back on the saddle

Earlier in the week I was cleared to ride my bike and this morning I finally seized the opportunity and went out for my first post surgery ride. Just four and a half weeks ago I had arthroscopic surgery, notchplasty, and a hardware removal procedure preformed on my right knee and this morning I was riding my bike on the streets. It was amazing.

Being a new cyclist, I am still a bit weary of the road and the drivers that zoom by me. I am still learning cycling etiquette, and the feel of my bike. Despite being a novice cyclist, I am finding that each and every ride I go on I have a new sense of confidence on the bike.

This morning, I did a fun and easy 9.05 miles on my bike.  There were some small rolling hills and one gigantic overpass that seemed like it would never end. However, I steadfastly kept pedaling and eventually make it to the top. I got stopped by, what seemed to be, the longest train ever, coincidentally while I was on Railroad Road. On my way back home, I rode down the above mentioned overpass hill and hit 27.1 miles per hour before slowing it down a bit. It was such an exhilarating rush going that fast, but I had to slow down. Maybe in a few months I will be much more comfortable at speeds like that.

Overall, it was a great ride. I rode 9.05 miles and averaged 13.6 miles per hour with my fastest speed topping out at 27.1 mph for a brief moment.

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Uppin’ the ante in PT

Rehabilitation in physical therapy is going better than
expected so far. I am amazed at all that I can do, and I even feel like my
right quad is getting stronger by the day. My therapist even gave me more
exercises to do. Now, I also do the leg press, leg extension, hamstring curl,
and butt kick machines at therapy each visit. When those are combined with my dead
lifts, calf raises, squats, bird dips, and leg lifts, and 20 minute bike ride
warm up (that I really push myself on), physical therapy is more of an actual
gym session. I love it! I’ve even upped some of the weight resistance on those
machines since I started doing them last week.

While I said that I am feeling stronger, my right leg is
still noticeably smaller than my left leg and does not have as much muscle
definition, but that is more than a year of atrophy, so it will take some time
to get back to normal.

In the meantime, I have been looking at some bike tours in
the area. I am cleared to ride my road bike and I really miss the race
atmosphere that accompanied marathon running. I found one bike tour in San Diego in August that
looks especially promising. It is a 26 mile bike ride and it looks fabulous. I
really want to do it, and I hope it is my future. Eventually, I would love to
do a century ride, but just like with running, I’ve got to start small.

Surgery is over

THE SURGERY

I had my surgery 10 days ago and so far things have been going great. Compared to my previous knee surgeries, which have all been some sort of ACL reconstruction surgeries, arthroscopic surgery is a walk in the park!

Zac and I arrived at the hospital and they shortly took me back. I got dressed in the ever-so-fashionable hospital gown that was ten sizes too large and was hooked up to an IV. It was all pretty standard, but I remember having the nicest nurses. They were sweet and funny ladies.

My surgeon and anesthesiologist came in to talk to me and ask me questions. While talking with the anesthesiologist, I gave him to okay to give me the femoral nerve block, which is administered through a long needle in my groin region. This, he told me, would numb my entire leg and take away all of the pain. While on the way to the OR, the anesthesiologist gave me some sedative that I forgot the name of and everything from there is a blur. Luckily, I don’t even remember the nerve block.

Upon waking up from anesthesia, I recall being the most coherent and feeling the best that I ever had after surgery. I was upbeat, happy and chipper. I chatted with my nurse and then he wheeled me to recovery where Zac was able to join me.

Several minutes later, the doctor came in and spoke to us. He said that the surgery went well, but that my knee wasn’t in good shape. I asked him if he would have performed the osteotomy had the insurance company approved it, and he replied, “yes.” The doctor went on to say that I only had about two percent of my medial meniscus remaining, which was shredded. He had to clean it up, which left me with only about one percent. Additionally, he said he started to see some wear on my articular cartilage because of the lack of meniscus. (This is what the osteotomy would have helped. It would have prevented further damage to this cartilage and possibly would have saved me from experiencing arthritis in the future). Furthermore, he told me that the bad placement of my ACL from my previous surgery was in such a bad spot, that the impingement actually rubbed so much that it caused microscopic tears in the ACL graft. However, he was able to shave down the area in my knee causing the impingement and he cleaned it up to be the best that it can.

RECOVERY

I was walking a couple days after surgery. I still experience some stiffness and pressure caused by the swelling, but I think I am doing unbelievably well. I have a request in to start physical therapy, and I should be starting that hopefully next week. Surprisingly, the part of surgery that was the most painful so far was the area where I received the femoral block. For a few days after surgery, my groin was in pain and I could painfully feel the line where the long needle travelled. It doesn’t hurt anymore though.

Good news in PT…and a possible setback

I am back in physical therapy this week, which is such a relief after missing a week because I had to wait for insurance authorization. To date, I am a little more than 10 weeks past my surgery. My therapist told me that at about this time after surgery, the ACL graft is stronger and there is more blood flow and circulation to the area. This means that I can now start doing open-chain exercises in addition to the closed-chain exercises I am already doing. Currently, the closed kinetic chain exercises I am doing in physical therapy require that I always have my foot planted on a firm surface (leg press), however, now that I am okay to do open chain kinetic exercises, my leg is free to move and my knee is bending (leg extension). This is a big improvement for me because now I can work out my quad muscles more.

 My first and only open kinetic exercise I did today was the leg extension with 5lbs of free weight. It was tough, but I was able to complete my 5 sets of 10 reps. In addition to the leg extension exercise, I also did two different lunges. I did full walking lunges (still without any weight) and I also did stationary lunges with my front leg on an inflated disk. That one was a challenge.

 Next week will be a very big week for me in physical therapy. On Thursday, I am going to get hooked up to the biodex machine to test the strength of my right leg compared to my left leg. The Biodex machine is an isolated joint isokinetic system used for neuromuscular evaluation and therapeutic exercise to measure the amount of strength produced at different velocities. The machine will conduct this test by measuring the strength I produce in a series of hamstring curls and leg extensions. I will first have my left leg tested as a base measure, and then my right leg will be tested. The therapist told me that he is hoping I will test in the 70 percent range fore strength, which would be a good measure because that would indicate that I have regained about 70 percent of my strength back in my right leg. This test is critical because depending on how I do will determine if I can start with agility and jumping exercises, and eventually running. If I do really well on this test, I may be jogging in about a month. I really hope that I will be back to running soon, but I am not going to push it. Also, my knee is continuing to “pop,” which has me slightly concerned, but it isn’t painful yet, so I am hoping that this is just temporary.

Feeling strong :)

Right now I am feeling especially grateful that I have access to a gym because there is a hold up for my new order of physical therapy visits, which means I am not going to physical therapy this week. Luckily, a while back I purchased ankle weights to help facilitate my rehabilitation and I can do almost all of my exercises from therapy at the gym.

Today was an especially great day at the gym. I felt the strongest today that I have since surgery. This week marks the ninth week out of surgery for me. I am almost to that crucial 12 week mark where I will be able to do so much more in therapy. At therapy last week, I got the go ahead to increase my weight resistance on closed-chain exercises (exercises where my feet are firmly planted on the ground) and I increased my weight resistance on the leg press machine. I did 50lbs on just my right leg and 100lbs for both. I hope to keep steadily increasing my weight for this exercise.

Not only did I feel strong today, but I felt better; my knee felt more normal. It is difficult to explain if you haven’t had knee surgery before, but my knee didn’t feel stiff or odd at all. After knee surgery, your knee feels kind of odd for a while; it feels like it isn’t really apart of your body. Even though I know I can’t just yet, today was the first day where I actually felt like I could run. This is a huge sign of progress in my rehabilitation and I am more confident than ever that I will make a full recovery from this knee surgery. Even more exciting is that I am actively able to strengthen my knee now with only minor pain right below my patella. Before, I was still missing a few degrees in my extension. Each and every single day I am getting stronger and I know that with each passing week I am getting stronger and more capable. However, with my increased strength, I also noticed a new thing with my knee. As my range of motion increases, my knee pops. It is a small pop that feels like a great release of pressure, but I have never experienced this type of popping sensation before with any of my prior knee surgeries.

8 Weeks

I have reached the eight week mark after my revision ACL reconstruction surgery and I am feeling great! I am walking around easier, my leg is feeling stronger, and the swelling continues to slowly go away. Despite all of this good news however, I still need to be extremely cautious with my movements because I am at a time right now because my ACL graft is rather weak.

Physical therapy is also going great. I continue to go three days a week and I had an especially successful visit this past Monday. I added in new exercises, including: half-lunges, one legged wall sits, and the stair stepper! The fact that my physical therapist is adding in new and difficult exercises is proof that I m continuing to do much better as time progresses.

Second week of physical therapy complete

Happy Fourth of July!

This week I completed my second week of physical therapy and it went very well. In addition to the new exercises I am doing, I was also cleared to drive! This is very exciting because I no longer am “trapped” at the house when Zac has to work his 24 or 48 hour shifts. Plus, now I no longer require my husband to chauffeur me around to my doctor’s appointments, physical therapy, and any other place I need to go.

As previously mentioned in an earlier post, my sets have increased from six sets of 10 repetitions to eight sets of 10 reps. Also, my four pound weight I strap on above my knee for the straight leg raises, straight leg raises on side, inside leg lifts, and my straight leg raises on my stomach has been increased to a five pound weight. I am definitely feeling the extra two sets and the extra pound.

 One of my new exercises is one of my favorites that I recall from previous ALC surgeries. I really look forward to doing this exercise at physical therapy because it is so much fun. On just my right leg, stand and balance on the straight and level side of a foam roller cut in half. My therapist says that this really engages all of the muscles in my leg because I am concentrating on keeping my balance. Once I have my balance, I take a small, weighted ball and throw it at a square trampoline (called a plyoback rebounder) that is about six feel away from me. It is like a game. I always try to beat my high score in the number of times I can consecutively throw the ball and catch it without putting my foot down. I do this exercise two ways. First, I stand on the half foam roller and it is directly underneath my foot so that every part of my shoe is touching the roller. Then, I turn the foam roller so that it is perpendicular to my foot and my toes and heal are not touching the roller. My other new exercises include riding the bike with just my right leg and wall sits. I ride the bike with just my right leg for the last two minutes of my biking session and I do wall sits in intervals of 30 seconds for a total of five minutes. Physical therapy is beginning to be a real workout for me and I love how it seems as though each visit I get to do new things. I feel that I am making great progress, even though it is slower than usual.

 Sometimes I wonder if it is safe for me to be working out my leg this much. I am doing 80 weighted sets of exercises everyday. On Thursday I noticed that my right calf was killing me. It felt like a tight, painful muscle cramp every time I moved my calf muscle. This worried me so I told my therapist and he said to give my calf 72 hours to rest. I know that this is a good thing because from experience I know that you can overwork your muscles, and when you do that it is extremely painful. In high school I thought that by doing 1,000 crunches every night I would have a great stomach. Instead, I just had injured abdominal muscles that hurt like nobody’s business every time I took a breath. But I digress… And, even though I am also supposed to do these exercises everyday, I decided to let yesterday be a rest day. I still worked on range of motion though because that does not involve any weighted exercise. I will continue with all of my exercises today to round out my second full week of physical therapy.