RTKR Day 8, LTKR Week 16: I had PT again today for my RTKR. I’m going to give more details than most of you will care to read, but I’m doing it for my own records. I think it’ll also answer some of the questions y’all asked.
For my first exercise today, the exercise therapist applied a TENS unit to my thigh along with warm cloths above and below my thigh. My leg was extended over a round bolster, slightly bent at the knee with a pad under my heel to keep the bend from being too extreme since I have such short legs. The TENS unit pulsed 10 seconds on/10 seconds off. My instructions were to try to raise my foot during the 10 seconds the TENS unit was on, and to relax while it was off. A timer was set for 10 minutes. I raised my foot during the first few cycles, but when I told the exercise therapist that it hurt my knee cap, he removed the bolster and told me to just lie there, relax, and enjoy the TENS and heat. Whew – that would have been a long 10 minutes if I’d kept up the exercise. The relaxing felt great. I almost dozed off.
For my second exercise, I did straight leg raises in four directions: 20 leg lifts in each direction. I had little to no pain or difficulty doing the leg raises on my stomach, right side, and left side. I had a good bit of difficulty and some pain doing the leg raises on my back. During the leg raises when lying on my back, my knee cap had mild to moderate pain, but it was a lot less than last Friday or during the first exercise. The biggest difficulty seemed to be getting my leg to act on the signal being sent from my brain. On the first 10 – 15 lifts, I would have to concentrate really hard to get my leg to rise and it would take a second or two before my leg would start moving. The last 5 came a little easier. The exercise therapist was thrilled. He said he didn’t expect me to be able to do a front leg raise at Day 8. He was expecting to raise my foot and let me try to hold it up like we did last Friday. He told the physical therapist about the knee cap pain so he could address that during massage time.
The third exercise was to do 20 mini-squats while holding onto a vertical bar for support. The goal was to keep weight equally distributed on both feet – not to see how far I could squat, and believe me, the squat was minimal. No pain - just felt stiffness in my quads.
The fourth exercise was to sit on a low table, put my foot on a squishy disc, and rock my foot frontward and backward. It was basically ankle pumps while sitting. No pain – felt nice.
The last exercise was to sit on the same low table and push a little “sled” forward along a track until my knee extended as far as comfortable, and then gradually allow the sled to come back toward me. The sled isn’t weighted, but has tension bands attached to it. I did 20 pushes with one band attached with no difficulty or pain so he added a second band. That made it more difficult, but there was still no pain. In fact, it felt kind of nice. It’s a quad strengthening exercise that will, supposedly, lessen my knee cap pain.
After that, the physical therapist massaged my leg. When he “bends” my knee, he doesn’t push on it to bend it. He massages it while it is supported by his arm (my leg lying lengthwise along his arm with his hand under my knee and my foot near his shoulder) or draped across his knee. As he feels my muscles relaxing, he moves ever so slightly toward me which will allow my leg to drape/knee to bend a little more. He never pushes it. It relaxes and bends on its own. He said he’s trying to relax muscles that are tight after surgery, and that they’ll gradually stay more relaxed. Since my leg was bowed and now is straighter, I guess the relaxing also helps the muscles with realigning. While I was lying on my back, he also held my leg up vertically, with my ankle on his shoulder, and massaged my hamstrings and quads. My extension increased a little as my muscles relaxed, but my extension was already pretty good. He didn’t take any measurements, so I don’t know my ROM numbers (and I think that’s intentional).
I was sent home with instructions to spend the rest of the day icing and elevating (toes above nose) as much as possible. I was also able this afternoon to stretch out my pain medicine (Percocet) from every 4 hours to every 6 hours with no noticeable effect so far.
I’m a little amazed at the physical therapist’s ability to connect pain in one place with a problem in a different place. For example, he’ll often start by asking me to do a heel slide and tell him when something hurts. Today, for example, the first pain was on the outside area of my knee. He massaged a place way up by my hip bone, asked me to do the slide again, and the side knee pain was gone. I then pointed out the next place that hurt, he massaged a spot that seemed unrelated, and then that pain was gone. I think he’s a PT magician. I hope these little magical moments keep happening. Fingers crossed. Y'all don't kick me out of this wonderful club for trying this type of PT! I need y'all! Also, if I feel that something is going awry, I can always switch back to a more conventional PT like I used for knee #1. So far, I like this different approach.
United States
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