Re: La's new knees (recovery diary) - PT Good, Bad, Ugly
Well, today marked a month of outpatient PT for me, and I'm moved to reflect on the experience so far.
Outpatient PT was a big change from the in-home work I'd been doing since surgery. The home care therapy (excluding my run in with Evil Chester) was mild and gentle, focused on simple things like standing, walking and getting in and out of chairs.
Outpatient PT, on the other hand, was a bit of a workout - kind of like a mild day at the gym. And at first, it was a plain, brute force effort. I struggled to make the motion or haul myself into the position assigned, with no real concern for control or technique - it was all I could do to finish. Over the month, therapists have dropped little hints - don't use your hlp, lift with just the quad, toes straight up, hold for five seconds at the end, etc, so that even though it's hard to say I'm doing better when I'm still doing mostly the same workout, I can certainly say I'm more in control, doing things consistently with some level of form and finesse. That doesn't seem like much of a breakthrough so far, but that's what I have.
Actually, there are a few advances - added weights on leg raises and such, a few new activities, but...to a large extent it feels like I'm doing the same things I was at the start.
One point of interest is that my right leg seems to be a bit lazy - the toes want to point out to about the 2 o'clock position in stretches and exercises where they should point straight up. The therapists remind me of this a lot, and so does my knee, I think. I have some pains on the interior side of that knee that I think come from the torsion of toeing out. My therapist thinks this is a case of lazy muscles, not some sort of misalignment, and suggested that I do an exercise she calls a "windmill", although it doesn't look like one to me. It consists of turning your toes in, using your whole leg, not just the ankle - it's supposed to strengthen the interior rotation muscles. I'm working on that, will report back on results.
I asked recently if I could get back on the elliptical trainer, and the response was, "Can you do a one-legged calf raise?". (The answer, btw, is "not very well." I'm shaky and have to hold onto something for balance.) The PT says that's a good test for whether you're ready for exercises that put all your weight on one leg. So...I'm working on those, too.
I also just started working on a groovy machine called a balance trainer. You stand on a little platform that has sensors in it, and the machine shows you where your center of gravity is. (Mine tends to the left, probably because I've been favoring my right knee for the past four years.) Then you do different exercises where you shift your weight front to back, side to side or randomly. It has some more challenging programs where the platform moves and you try to stay centered. I'm not doing those yet. In fact, today was the first day they had me close my eyes while standing on the balance balls - makes it MUCH harder.
So today, being my month anniversary, I got my measurements taken, and now I'm not sure they mean anything at all. When I exited in-home PT, TJ measured me at 101 and 103 degrees of flexion respectively. He did it with me sitting in a chair and he pushed my leg into position. Then, when they measured me the first time at outpatient PT, they had me lie flat on my back and actively flex my legs - and I went back to about 92 degrees. BOO! But it was a different technique of measurement, and today was looking forward to seeing how much progress I'd made. But guess what? It was a different therapist, using yet another technique! She had me sit up on a table with my legs out in front and flex my leg actively, but she held my foot and provided an "assist". So I don't know what the heck my readings (102 and 105 degrees for left and right respectively) actually mean. If they won't do them the same way twice, how the the heck can they measure progress????? I have similar issues with every other test they did - each therapist did it differently. I know I'm improving, but I really have no idea how much. BLAH. Anyway, the doc continued my PT through the 23rd so I am going to ask for the same therapist who measured this time to do the next set. We shall see.
Oh, and I start back to work on March 20, but wil work from home for the first month. Wish me luck!
Best to all,
La
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