What a difference a week makes. Last Wednesday (nine days ago now), T-Bone and I were quickly reaching the conclusion that formal physical therapy (PT) sessions were not useful, despite my surgeon’s recommendations. This realization just made me angry. The worst part was not being able to do my active extensions without assistance from my good leg (meaning that I had to use my good leg to assist while sitting on the edge of the bed or in a chair and raising my leg straight out in front of me from a 90 degree bend). So, for the next four days, I did nothing but active extensions. No bike, no elliptical, no squats, no nothing. I just sat on the edge of my bed, repeatedly raising and lowering my leg.
I worked up to 160 extensions (in 4 sets of 40) last Sunday by yelling, cursing, begging and bargaining with myself to get through each one. Those four days were the worst since surgery. The worst, in fact, ever. I didn’t have that kind of pain before surgery either. But then! Then I went to PT on Monday.
I started out with the elliptical because another patient was on the bike. I can do the elliptical fairly well, as long as I do not engage my quad. After I warmed up, I walked over to the table so that T-Bone could do the Graston. He asked me to do an extension before we started, and I swung my leg up. And then realized that the enormous amount of pain that I’d been experiencing with every one I’d done over the previous four days had lessened enough that I didn’t need to assist with my good leg. So I drilled out 4 more. The pain was there, but it didn’t get worse as I did more repetitions. I just kind of sat there and looked at T-Bone incredulously.
One thing I forgot to mention (and purposely didn’t tell T-Bone) is that I cracked my leg pretty good on Sunday (the fourth day of extensions). I planted my foot and turned my knee inward, resulting in a very big, very deep POP. It wasn’t uber painful, so I didn’t think too much about it at the time. I still don’t know if it matters. What matters is that I was able to do those extensions in PT, without assistance from my good leg, and I didn’t even want to swear.
We went ahead and taped my knee before I did any additional exercises. I was able to do the single-leg bridges without much trouble because those keep my leg from reaching the point in ROM that causes pain. I did a few more glute/hip strengthening exercises, and then T-Bone told me to give the step-ups a shot. I hadn’t done them in weeks because the pain while doing them had become unbearable.
I walked over to the box where I can do 2-inch, 4-inch or 6-inch step-ups. Prior to the recent onslaught of pain, I’d been doing the 6-inch version. But that day, I started with the 2-inch. Pain, but bearable (perhaps bearable because I’d taken one of my left over pain pills before therapy). T-Bone was distracted with another patient, so I thought, “Hey, why not try the 4-inch since I can do the 2 with tolerable pain?” So I did them. Like a boss.
T-Bone came flying over when he saw me try out the step-downs. Those have always been the most painful exercise, bar none. What made me think it was a good idea to go ahead and push the envelope, I don’t know. I just couldn’t help myself. But no worries; he stopped me before I did any permanent damage.
My second PT session of the week was similar. I was able to do the extensions unassisted, and I was able to do the 4-inch step-ups. The one difference is that T-Bone didn’t tape my knee. He’s concerned that the tape is compressing the patellofemoral joint too much and exacerbating my pain.
So far, the improvement in pain during extension and step-ups has not translated to decreased pain while doing other things… like walking. But at least something is better than it was a week ago. I don’t know what, exactly, is better, but something.