Thursday was low-key. The knee felt good all day. I hit the gym and did 25 mins of cardio, including 5 minutes of high-intensity stuff that got my heart rate to 194bpm. It's been a while! The knee did feel a bit more painful after the intense cardio, so I think I ought to tone it down a bit.
Thursday did stretches before leaving work, after the bike.
Friday, hit the gym before leaving work. 25 min moderate intensity cardio (150-160bpm hr) on the stationary bike. Did all my strength exercises, including 5-lb SLRs on both legs. The left leg is not used to doing 5lb SLRs, so it's good I'm starting now, as it will take a bit to catch up with the right leg. Did balancing and step-us. Also calf raises. Pretty much everything I do at the PT except for the leg press. Stretched and went home.
Saturday, October 31, 2009
Wednesday, October 28, 2009
Week 7, day 3
The knee is feeling good. I slept until 8am with no pain--amazing!
My roommate asked me if I wanted to go kart racing in mid-November. I checked with the surgeon and he replied "I do NOT think Kart racing is a good idea. Too high a chance of injury." Love the ability to get questions answered quickly by email from my surgeon.
Forgot about ibuprofen until 3pm this morning. Normally, after an 8am ibuprofen intake, the knee would remind me about itself by noontime. So yeah, these are all good signs.
PT tonight. Went well. Stayed at 5lb ankle weight, 4 plates on leg press. Step ups off a taller step now. Balancing was perfect for 3 sets of 30 seconds. After all that when I lied down for towel-assisted hamstring stretces, my right leg was shaking. Maybe the leg press and the straight leg raises did the
job?
The plan for off days is stretches and cardio. Friday is all weights, except the leg press, which I can't do at my work gym. Will also start SLRs and balancing on my left foot.
My roommate asked me if I wanted to go kart racing in mid-November. I checked with the surgeon and he replied "I do NOT think Kart racing is a good idea. Too high a chance of injury." Love the ability to get questions answered quickly by email from my surgeon.
Forgot about ibuprofen until 3pm this morning. Normally, after an 8am ibuprofen intake, the knee would remind me about itself by noontime. So yeah, these are all good signs.
PT tonight. Went well. Stayed at 5lb ankle weight, 4 plates on leg press. Step ups off a taller step now. Balancing was perfect for 3 sets of 30 seconds. After all that when I lied down for towel-assisted hamstring stretces, my right leg was shaking. Maybe the leg press and the straight leg raises did the
job?
The plan for off days is stretches and cardio. Friday is all weights, except the leg press, which I can't do at my work gym. Will also start SLRs and balancing on my left foot.
Week 7, day 2: Back in the gym for real
Slept alright, still woke up at 4:30pm with some knee ache and popped two ibu as usual. Then slept in until 8-8:30am (had a weird dream too...).
Knee was feeling good today. My walking is good most of the time--the limp is almost invisible. One of my coworkers commented that I wasn't limping anymore. As I walk though, especially after a little bit more walking, I feel a bit of a crunch/crack in my right knee as I step (feels that it's happening just below the knee). I wonder if it's the muscular imbalance or just the regular motions of the knee going thru the healing (scar tissue affecting tracking of things etc).
I decided to hit the gym proper today, attempting to get back to my upper body program. It was good, though very tiring! (especially after a looong day at work)
I jumped on the stationary bike and did it pretty intensely for 23 minutes. I turned up the resistance just a little and sped up my cadence. On this bike, 90rpm feels about normal, 80rpm leisurely. After doing about 90-95rpm for 12 minutes, I sustained about 100-105rpm for about 4-5 minutes, hitting a 180bpm heart rate. Then back to 90rpm for a few minutes and another 2 minutes of high intensity. I noticed that after this section, at about the 20 minute mark, my knee was a bit bothered and I could feel a little irritation/pain at the top of the tibia. So I cruised at a slower, 75-80bpm pace for another 3 minutes. It didn't feel quite right still, so I decided to get off the bike (hence the 23 minute session).
I then did some weights for the first time in a long time. I wasn't able to do quite the same weights I did before my ACL injury. For example, on a 45-degree wide-grip lat pulldown, I used to be able to do 3 sets of 12 of 122.5lbs. I attempted 120lbs today and did 12, 11 (with the last two weak) and 9. Same with biceps curls... Used to do 3x15 of 20lb weights, but opted for 15lbs today and did 12, 10 and 6 (so way weak there!).
At the end, I hopped on the stationary bike for another 5 minutes at a slow pace. I was wiped out from the exercise and maintaining a 75-80rpm pace with the lowest weight was still keeping my heart rate at 150-155bpm.
It's been months since my heart rate has seen 180bpm or any decent cardio exercise. If I can keep this up once or twice a week, I'll be happy. I'm sure I'm going to be hurting the day after tomorrow from delayed onset muscle soreness. My heart rate monitor logged a 1hr 13min workout with an average heart rate of 149bpm! Not too shabby!
I forgot to do my stretches at the gym, but I did them at home before going to bed.
Knee was feeling good today. My walking is good most of the time--the limp is almost invisible. One of my coworkers commented that I wasn't limping anymore. As I walk though, especially after a little bit more walking, I feel a bit of a crunch/crack in my right knee as I step (feels that it's happening just below the knee). I wonder if it's the muscular imbalance or just the regular motions of the knee going thru the healing (scar tissue affecting tracking of things etc).
I decided to hit the gym proper today, attempting to get back to my upper body program. It was good, though very tiring! (especially after a looong day at work)
I jumped on the stationary bike and did it pretty intensely for 23 minutes. I turned up the resistance just a little and sped up my cadence. On this bike, 90rpm feels about normal, 80rpm leisurely. After doing about 90-95rpm for 12 minutes, I sustained about 100-105rpm for about 4-5 minutes, hitting a 180bpm heart rate. Then back to 90rpm for a few minutes and another 2 minutes of high intensity. I noticed that after this section, at about the 20 minute mark, my knee was a bit bothered and I could feel a little irritation/pain at the top of the tibia. So I cruised at a slower, 75-80bpm pace for another 3 minutes. It didn't feel quite right still, so I decided to get off the bike (hence the 23 minute session).
I then did some weights for the first time in a long time. I wasn't able to do quite the same weights I did before my ACL injury. For example, on a 45-degree wide-grip lat pulldown, I used to be able to do 3 sets of 12 of 122.5lbs. I attempted 120lbs today and did 12, 11 (with the last two weak) and 9. Same with biceps curls... Used to do 3x15 of 20lb weights, but opted for 15lbs today and did 12, 10 and 6 (so way weak there!).
At the end, I hopped on the stationary bike for another 5 minutes at a slow pace. I was wiped out from the exercise and maintaining a 75-80rpm pace with the lowest weight was still keeping my heart rate at 150-155bpm.
It's been months since my heart rate has seen 180bpm or any decent cardio exercise. If I can keep this up once or twice a week, I'll be happy. I'm sure I'm going to be hurting the day after tomorrow from delayed onset muscle soreness. My heart rate monitor logged a 1hr 13min workout with an average heart rate of 149bpm! Not too shabby!
I forgot to do my stretches at the gym, but I did them at home before going to bed.
Monday, October 26, 2009
Week 7, day 1: less pain w00t!
Six weeks have passed. This is the best-feeling morning in the recent memory. Woke up at 7am with just a slight ache in the knee. Not even really painful. Iced it anyway, then got up to go to work.
So hopefully, this pain at top of tibia/around incision site is a thing of the past. Hurray healing.
The PT visit went well! The PT suggested to hold off the elliptical until I start hamstring strength in the middle of November. Leg press went well, no pain, and the balancing was fine for the first time (just a little pressure on the medial side, but no pain). The knee felt fine for the rest of the day after the icing.
I must have quite a bit of muscular imbalance in the right leg now, with the hamstring being very weak and the quad a bunch stronger.
So hopefully, this pain at top of tibia/around incision site is a thing of the past. Hurray healing.
The PT visit went well! The PT suggested to hold off the elliptical until I start hamstring strength in the middle of November. Leg press went well, no pain, and the balancing was fine for the first time (just a little pressure on the medial side, but no pain). The knee felt fine for the rest of the day after the icing.
I must have quite a bit of muscular imbalance in the right leg now, with the hamstring being very weak and the quad a bunch stronger.
Sunday, October 25, 2009
Week 6, days 6 and 7
The pain went down a good amount this weekend. Saturday morning I woke up as late as 7am, though Sunday I still woke up at a middle-of-the-night 4:30am.
I am walking better and the top-of-tibia pain around the incision site was mostly not there. I am just getting some now as I am going to sleep, so I hope I didn't jinx it.
I did my stretches today and yesterday.
Attempted to go up a few steps with the other leg a few times throughout the weekend. Probably did something small like 15 steps during the whole weekend, spread out in chunks of 3-5.
Excited to go to the PT tomorrow with this reduced pain.
I am walking better and the top-of-tibia pain around the incision site was mostly not there. I am just getting some now as I am going to sleep, so I hope I didn't jinx it.
I did my stretches today and yesterday.
Attempted to go up a few steps with the other leg a few times throughout the weekend. Probably did something small like 15 steps during the whole weekend, spread out in chunks of 3-5.
Excited to go to the PT tomorrow with this reduced pain.
Friday, October 23, 2009
Week 6, day 5
First glorious full day without the brace today. Now, I have no excuse for not walking without a limp. I need to concentrate on walking right. I'm telling everyone to tell me I'm limping if I'm limping.
No PT today (down to 2 visits a week), but did strength exercises at the work gym today before leaving work:
* bike 20 min low resistance
* gentle heel raises
* 4.5 lb ankle weight no shoe straight leg and side leg raises
* heel-raises off a step w/ a calf stretch in between
* step-ups on a 4" step
* hamstring stretch w/ a towel
all strength exercises are 3 sets of 15 reps...
Went out at night today and the knee felt pretty good (though I did take 400mg ibuprofen some time ago). I think that top-of-tibia part is starting to heal.
No PT today (down to 2 visits a week), but did strength exercises at the work gym today before leaving work:
* bike 20 min low resistance
* gentle heel raises
* 4.5 lb ankle weight no shoe straight leg and side leg raises
* heel-raises off a step w/ a calf stretch in between
* step-ups on a 4" step
* hamstring stretch w/ a towel
all strength exercises are 3 sets of 15 reps...
Went out at night today and the knee felt pretty good (though I did take 400mg ibuprofen some time ago). I think that top-of-tibia part is starting to heal.
Thursday, October 22, 2009
Week 6, day 4: We may be hurtin', but we kickin ass!
Slept better than before, but still had to do a middle-of-the-night ibuprofen "shot". Leg felt less painful in the morning, though still not as painless as in the beginning of week 3.
THE BRACE IS GONE! OK, I am getting ahead of myself.
I had a followup appointment with my orthopedic surgeon today. The summary is that I am kicking ass and ahead of schedule. He said the pain levels will go up and down (good weeks and bad weeks) and this is just a part of the healing process.
I asked about the pain just above the incision site and he said that it's near where the screw enters. He said there are three things involved there: hamstring graft, screw and the tunnel. Any of these things could be hurting.
My knee looks good and the wounds look good. My flexion is great and he confirmed the full extension. He felt my quads (put your dirty mind away!) and said they were good.
The Dr suggested I massage the hamstring graft incision site with some cream. I need to find out what kind of cream to use.
He said that he can't test the graft at this point (too early). I asked about my concern with the CPM machine causing anterior translation of my tibia because my butt sank lower than the base of the CPM machine (during the first two weeks). He said that it wouldn't mess anything up, so not to worry.
The brace is off! Yay!!! The Dr did not allow me to burn it in a ritualistic fashion, in case I still need to wear it (if I'm feeling sore and need a gradual weaning off).
I asked about the knee buckling a little bit in the morning until I get out of the shower or walk around some more. He said that it's no big deal at all and reminded me that I just had major knee surgery.
I am now cleared for non-impact cardio, but I still have to wait until 11/14 (8 weeks post-surgery) before I can start hamstring strength.
When asked about using stairs, the Dr indicated that I can use them, but I should ramp them in (and all the other cardio) gradually. So don't do five flights of stairs on the way out. I will be incorporating some steps in gradually (though I may wait until my Monday PT appointment before I start playing with the stairs or other cardio).
I scheduled a followup for just after the return to running date (Dec 10). So this pushes my return to running date by a few days, but that's OK.
SO HELLS YEAH!
I did remember to get on the stationary bike for 15 minutes today before I left work. Did my stretches before bed.
THE BRACE IS GONE! OK, I am getting ahead of myself.
I had a followup appointment with my orthopedic surgeon today. The summary is that I am kicking ass and ahead of schedule. He said the pain levels will go up and down (good weeks and bad weeks) and this is just a part of the healing process.
I asked about the pain just above the incision site and he said that it's near where the screw enters. He said there are three things involved there: hamstring graft, screw and the tunnel. Any of these things could be hurting.
My knee looks good and the wounds look good. My flexion is great and he confirmed the full extension. He felt my quads (put your dirty mind away!) and said they were good.
The Dr suggested I massage the hamstring graft incision site with some cream. I need to find out what kind of cream to use.
He said that he can't test the graft at this point (too early). I asked about my concern with the CPM machine causing anterior translation of my tibia because my butt sank lower than the base of the CPM machine (during the first two weeks). He said that it wouldn't mess anything up, so not to worry.
The brace is off! Yay!!! The Dr did not allow me to burn it in a ritualistic fashion, in case I still need to wear it (if I'm feeling sore and need a gradual weaning off).
I asked about the knee buckling a little bit in the morning until I get out of the shower or walk around some more. He said that it's no big deal at all and reminded me that I just had major knee surgery.
I am now cleared for non-impact cardio, but I still have to wait until 11/14 (8 weeks post-surgery) before I can start hamstring strength.
When asked about using stairs, the Dr indicated that I can use them, but I should ramp them in (and all the other cardio) gradually. So don't do five flights of stairs on the way out. I will be incorporating some steps in gradually (though I may wait until my Monday PT appointment before I start playing with the stairs or other cardio).
I scheduled a followup for just after the return to running date (Dec 10). So this pushes my return to running date by a few days, but that's OK.
SO HELLS YEAH!
I did remember to get on the stationary bike for 15 minutes today before I left work. Did my stretches before bed.
Wednesday, October 21, 2009
Week 6, days 2 and 3: OW! continues
Monday night had poor sleep. Woke up in the middle of the night, popped 400mg ibu, iced the knee for 20 mins, did some patellar mobilization, then managed to fall asleep in an hour.
Last night had slightly better sleep, but basically the same pattern. I was able to fall back asleep sooner.
Tuesday I did stretches before bed. When doing the calf stretch on the right leg, it feels like I aggravate that hamstring graft spot a little bit. I still did two calf stretches, and tried to make them gentle.
I also noticed that Tuesday morning, I wasn't able to immediately get my full extension while walking. Also, the leg tended to want to give out, so I limped into the shower. Concerned with losing that full extension, I did a no-weight prone hang for 3 minutes. I also tried to extend the knee a bunch throughout the day. This seemed to do the trick, as this morning, I had full extension right away.
Tuesday and Monday I felt a little bit of soreness in my right glutes. This is probably due to an abnormal gait from the pain. I must be compensating for something. Same thing today, just not as strong. I am concentrating on having as normal gait as possible.
When I woke up this morning, I still had that painful spot right around the hamstring graft incision site. The knee itself felt fine. So today, most all the pain is top of that leg. I am popping 400mg every 4 hours pretty much on the clock. I think the knee felt better this morning than Tuesday morning, but this afternoon, it feels worse.
I wonder if I made it worse because I lifted some 35lb snow tires (one at a time) yesterday. I tried to do all the lifting (deadlift pose) with my left leg, but I may have inadvertently used my right foot. Maybe this aggravated the leg? Who knows...
The pain is pretty annoying at work this afternoon. It's about 4/10 or 5/10. I am sitting at my desk with the calf portion of the brace unbuttoned, to provide a bit of pressure relief.
Did I mention I hate this brace? I am inclined to burn it in a ritualistic fashion when it comes off.
The PT appointment this evening was good. The bike did not feel as painful as Monday and I was able to handle 4lb ankle weight plus the shoe. The flexion was measured as 135 degrees, but I have been doing very gentle heel slides, so it wasn't as much as I was able to coax before. Did step-ups and skipped the leg press. Step-ups aggravated the pain site just a touch on the comedown, but not too bad.
The PT wrote up a note for the appointment with my ortho tomorrow. Can't wait for that. When I get home, I need to come up with a list of questions for the doctor.
Last night had slightly better sleep, but basically the same pattern. I was able to fall back asleep sooner.
Tuesday I did stretches before bed. When doing the calf stretch on the right leg, it feels like I aggravate that hamstring graft spot a little bit. I still did two calf stretches, and tried to make them gentle.
I also noticed that Tuesday morning, I wasn't able to immediately get my full extension while walking. Also, the leg tended to want to give out, so I limped into the shower. Concerned with losing that full extension, I did a no-weight prone hang for 3 minutes. I also tried to extend the knee a bunch throughout the day. This seemed to do the trick, as this morning, I had full extension right away.
Tuesday and Monday I felt a little bit of soreness in my right glutes. This is probably due to an abnormal gait from the pain. I must be compensating for something. Same thing today, just not as strong. I am concentrating on having as normal gait as possible.
When I woke up this morning, I still had that painful spot right around the hamstring graft incision site. The knee itself felt fine. So today, most all the pain is top of that leg. I am popping 400mg every 4 hours pretty much on the clock. I think the knee felt better this morning than Tuesday morning, but this afternoon, it feels worse.
I wonder if I made it worse because I lifted some 35lb snow tires (one at a time) yesterday. I tried to do all the lifting (deadlift pose) with my left leg, but I may have inadvertently used my right foot. Maybe this aggravated the leg? Who knows...
The pain is pretty annoying at work this afternoon. It's about 4/10 or 5/10. I am sitting at my desk with the calf portion of the brace unbuttoned, to provide a bit of pressure relief.
Did I mention I hate this brace? I am inclined to burn it in a ritualistic fashion when it comes off.
The PT appointment this evening was good. The bike did not feel as painful as Monday and I was able to handle 4lb ankle weight plus the shoe. The flexion was measured as 135 degrees, but I have been doing very gentle heel slides, so it wasn't as much as I was able to coax before. Did step-ups and skipped the leg press. Step-ups aggravated the pain site just a touch on the comedown, but not too bad.
The PT wrote up a note for the appointment with my ortho tomorrow. Can't wait for that. When I get home, I need to come up with a list of questions for the doctor.
Monday, October 19, 2009
Week 6, day 1
5 weeks in, the countdown to losing the brace begins. Doctor's followup is scheduled for this Thursday.
Still had to take two more ibuprofen tablets in the middle of the night to go back to sleep.
It seems like the leg/knee is better. Better than Friday, for sure. As good as week 3 or 4? No. But I am hoping that I am on the downward slope as far as the pain goes.
Another PT appointment today. Skipped the leg press. Couldn't go as fast on the bike as I could a week ago, pushing faster and I could feel an increase in the pain at the top of tibia. The same spot was aggravated by quad sets: when I release the tensed muscles, I could feel a throb of pain below the knee. The PT decided to cut the quad sets out, since I am doing 4lb weights for my straight leg raises (with zero quad lag).
The step ups off a low 4" step were fine, just adding some stiffness to my knee. No pain though.
So the protocol for tomorrow at home is merely doing the stretches. Oh and some stationary bike, which I'm hoping to be able to do for 15 mins during work tomorrow.
Still had to take two more ibuprofen tablets in the middle of the night to go back to sleep.
It seems like the leg/knee is better. Better than Friday, for sure. As good as week 3 or 4? No. But I am hoping that I am on the downward slope as far as the pain goes.
Another PT appointment today. Skipped the leg press. Couldn't go as fast on the bike as I could a week ago, pushing faster and I could feel an increase in the pain at the top of tibia. The same spot was aggravated by quad sets: when I release the tensed muscles, I could feel a throb of pain below the knee. The PT decided to cut the quad sets out, since I am doing 4lb weights for my straight leg raises (with zero quad lag).
The step ups off a low 4" step were fine, just adding some stiffness to my knee. No pain though.
So the protocol for tomorrow at home is merely doing the stretches. Oh and some stationary bike, which I'm hoping to be able to do for 15 mins during work tomorrow.
Week 5, days 6 and 7
Tried to take it as easy as possible during the weekend. Skipped going to a party Saturday, stayed home instead. Spent most of the time on the couch or the bed without the brace on.
Lots of ibuprofen.
Decided to skip ALL exercises. Felt some pain in the shin on the release of a quad contraction, so decide to skip quad sets. Didn't want to do the stretches because that may irritate hamstrings (probably a dumb idea).
Sunday the leg seemed to get better, not nearly as bad in the shin anymore. Some clicking when flexing the leg, but that's not a big deal.
The pain is less in the shin and more in the knee itself now. Perhaps that's from lack of use of the knee. Should've done the stationary bike or something over the weekend at least.
Meh, the pain is annoying.
Lots of ibuprofen.
Decided to skip ALL exercises. Felt some pain in the shin on the release of a quad contraction, so decide to skip quad sets. Didn't want to do the stretches because that may irritate hamstrings (probably a dumb idea).
Sunday the leg seemed to get better, not nearly as bad in the shin anymore. Some clicking when flexing the leg, but that's not a big deal.
The pain is less in the shin and more in the knee itself now. Perhaps that's from lack of use of the knee. Should've done the stationary bike or something over the weekend at least.
Meh, the pain is annoying.
Friday, October 16, 2009
Week 5, days 4 and 5: Ow!
So yesterday Thursday (day 4), top of my tibia kept acting up. I did super-gentle heel slides ONCE. Took two ibuprofen overnight, before bed at 11pm. Woke up at 3am, feeling the pain. Decided to take two more ibu, but couldn't fall back asleep.
Today (Friday), went to the PT. The PT suggested taking it easy, so we skipped heel slides, step-ups and balancing. Unfortunately, I opted to do the leg presses anyway... unfortunately, because in the middle of the first set, I felt some pain at top of tibia when coming back down on the leg press (knee flexion at 10-15 deg), but I kept doing it anyway. After 3x15, my leg was not happy. Electronic TENS stimulation helped for pain management there, but it was still pretty intense. I went home at 3pm and took a sorely-needed nap.
I hope I didn't mess it up much worse with that leg press. Anyway, the plan is to take it wicked easy, no heel slides, only quad sets and stretches over the weekend. Also ice ice ice...
So yeah, the recovery was going fairly smoothly up to this point.
I think what's acting up here are the healing hamstring tendons, which attach at the top of the tibia (and fibula). It could just be the healing itself.
Today (Friday), went to the PT. The PT suggested taking it easy, so we skipped heel slides, step-ups and balancing. Unfortunately, I opted to do the leg presses anyway... unfortunately, because in the middle of the first set, I felt some pain at top of tibia when coming back down on the leg press (knee flexion at 10-15 deg), but I kept doing it anyway. After 3x15, my leg was not happy. Electronic TENS stimulation helped for pain management there, but it was still pretty intense. I went home at 3pm and took a sorely-needed nap.
I hope I didn't mess it up much worse with that leg press. Anyway, the plan is to take it wicked easy, no heel slides, only quad sets and stretches over the weekend. Also ice ice ice...
So yeah, the recovery was going fairly smoothly up to this point.
I think what's acting up here are the healing hamstring tendons, which attach at the top of the tibia (and fibula). It could just be the healing itself.
Wednesday, October 14, 2009
Week 5, day 3: Evening
After taking two ibu before going back to bed, I finally fell asleep by 6:30am. Decided to sleep in until 9:30 to let the leg heal and let myself rest. The leg felt good all morning until I got to work, and then it got a bit achy again.
Did ROM exercises at work at noon and then went to the PT at about 5:30pm.
I told my PT about the pain and she said not to worry. First of all, many people are in more pain 4 weeks post-op than me. I am also way ahead of the game on flexion. If I had only 90 degrees flexion after 4 weeks, then we'd be worried, but I have more flexion than most people at this point in time, and so that's not a worry for her. I think I have been overdoing the heel slides, pushing them to too high a point of discomfort and pain. The PT suggested that I take it really easy on the heel slides.
I have been thinking that, since I now have full extension, I might as well get my flexion ASAP. I just need to relax and be gentle to my knee. So, gentle heel slides from now on. Hopefully this means the knee will calm down.
Attempted leg press with weight plates set to "4" (whatever actual weight that is), which felt easy, but trying to be careful with the motions not to upset the knee. I felt myself pushing most of the weight with the left foot, instead of using both feet equally. I guess this kind of thing will take a while to work out.
Taking two ibuprofen right before bed again today. Iced my knee before bed as well. Let's hope for a good night's sleep.
Did ROM exercises at work at noon and then went to the PT at about 5:30pm.
I told my PT about the pain and she said not to worry. First of all, many people are in more pain 4 weeks post-op than me. I am also way ahead of the game on flexion. If I had only 90 degrees flexion after 4 weeks, then we'd be worried, but I have more flexion than most people at this point in time, and so that's not a worry for her. I think I have been overdoing the heel slides, pushing them to too high a point of discomfort and pain. The PT suggested that I take it really easy on the heel slides.
I have been thinking that, since I now have full extension, I might as well get my flexion ASAP. I just need to relax and be gentle to my knee. So, gentle heel slides from now on. Hopefully this means the knee will calm down.
Attempted leg press with weight plates set to "4" (whatever actual weight that is), which felt easy, but trying to be careful with the motions not to upset the knee. I felt myself pushing most of the weight with the left foot, instead of using both feet equally. I guess this kind of thing will take a while to work out.
Taking two ibuprofen right before bed again today. Iced my knee before bed as well. Let's hope for a good night's sleep.
Week 5, day 3: a painful night
A painful night. Woke up around with throbbing/ache (pain scale about 5/10) around the tibia, despite taking two ibuprofen before bed. Finally got up around 5:40am, popped two ibu and went to ice the knee and write this blog entry. Alarm is set for 2 hrs for now, but I'm not sure how fast I will fall asleep.
Tuesday, October 13, 2009
Week 5, day 2: insurance fun
Knee still more painful and sensitive around incision site. Took one ibuprofen 4 hrs before bed, then another 2 hrs before, then another right before bed (figured the first one was "expired" by then). Slept well, but could feel it in the morning when I woke up.
Did a set of ROM exercises when I got home, but forgot to hop on the stationary bike at work. Need to NOT forget to do that. Still need to do another set of ROM exercises and the stretches before bed. Not sure if I'll do that just yet.
Got a bill from the hospital for the MRI, $1550, and the X-Ray, $122. Both services were supposed to be covered entirely by insurance and the MRI was not given until pre-approval. The note on the bill says "insurance denied." I hope it's some silly little error and not the start of some immense battle with the insurance co.
Did a set of ROM exercises when I got home, but forgot to hop on the stationary bike at work. Need to NOT forget to do that. Still need to do another set of ROM exercises and the stretches before bed. Not sure if I'll do that just yet.
Got a bill from the hospital for the MRI, $1550, and the X-Ray, $122. Both services were supposed to be covered entirely by insurance and the MRI was not given until pre-approval. The note on the bill says "insurance denied." I hope it's some silly little error and not the start of some immense battle with the insurance co.
Monday, October 12, 2009
Week 5, day 1
Slept well for most of the night and then the ibuprofen must've worn off (and then I decided to straighten the leg a few times while half-awake and that didn't help things).
PT session today. Flexion is continuously improving, though the PT said not to worry about the flexion. I was worried for a moment when I only improved 1 degree over a week, but I have definitely made gains over the weekend and at the PT session today, so my flexion is coming surely and not even that slowly.
Attempted balancing again. This time, standing up perfectly straight was not painful, but leaning in to the left caused some pain on the medial side. Just a little pain at first, so I actually completed 3 30-second balancing acts, but towards the end of the 3rd, that pain increased and I think I probably overdid it. It's definitely a lot better than last week, so I'm sure one more week and I should be balancing pain free.
New exercise today: step-ups on a 4" step. No pain doing this one, though the knee felt a bit stiffer (perhaps a reaction to the balancing, who knows) towards the end of the 3 sets of 10 reps. So will continue doing this exercise going forward.
We did 3lbs of weight on the straight leg raises and it was just the right amount of weight. The muscles that get fatigued at the end though are not my quads, but the inside of my hips. I guess we gotta get those muscles back before we can start stressing the quads.
PT session today. Flexion is continuously improving, though the PT said not to worry about the flexion. I was worried for a moment when I only improved 1 degree over a week, but I have definitely made gains over the weekend and at the PT session today, so my flexion is coming surely and not even that slowly.
Attempted balancing again. This time, standing up perfectly straight was not painful, but leaning in to the left caused some pain on the medial side. Just a little pain at first, so I actually completed 3 30-second balancing acts, but towards the end of the 3rd, that pain increased and I think I probably overdid it. It's definitely a lot better than last week, so I'm sure one more week and I should be balancing pain free.
New exercise today: step-ups on a 4" step. No pain doing this one, though the knee felt a bit stiffer (perhaps a reaction to the balancing, who knows) towards the end of the 3 sets of 10 reps. So will continue doing this exercise going forward.
We did 3lbs of weight on the straight leg raises and it was just the right amount of weight. The muscles that get fatigued at the end though are not my quads, but the inside of my hips. I guess we gotta get those muscles back before we can start stressing the quads.
Week 4, day 7
Took it mostly easy today, except for walking about a half-mile in the morning. Did all the exercises for the day, even tried an 8-lb prone hang in the morning. I'll have to ask my PT whether I should still be doing prone hangs, as I didn't do any on Saturday (since I have full extension--I guess, looking to be validated?)
The knee felt better today and by staying at home at my computer, I spent less time in the brace. I slept well last night with two ibuprofens, so going to repeat the same tonight.
It seems that flexion keeps getting better. Just a little over a hand's width between the heel and my butt now.
The knee felt better today and by staying at home at my computer, I spent less time in the brace. I slept well last night with two ibuprofens, so going to repeat the same tonight.
It seems that flexion keeps getting better. Just a little over a hand's width between the heel and my butt now.
Saturday, October 10, 2009
Week 4, day 6
Knee is acting up. Didn't take any ibuprofen before bed and had a hard time sleeping with the aching knee. There seems to be some inflammation around the hamstring incision site and the top/medial arthroscopic incision site.
Went to a wedding today (no dancing!) and had the brace on under the suit. I don't know if it was twisted underneath, but the knee became pretty uncomfortable over time (sitting at a table with my knee flexed at 90 deg). I got home and couldn't wait to get the brace off and have the knee "relax."
I popped two ibuprofens (200mg each), did ROM exercises and stretches, then iced the knee for half an hour. I'm hoping it'll feel better.
The plan is to do another set of ROM before bed (with gentle heel slides), ice again and take it easy tomorrow.
Went to a wedding today (no dancing!) and had the brace on under the suit. I don't know if it was twisted underneath, but the knee became pretty uncomfortable over time (sitting at a table with my knee flexed at 90 deg). I got home and couldn't wait to get the brace off and have the knee "relax."
I popped two ibuprofens (200mg each), did ROM exercises and stretches, then iced the knee for half an hour. I'm hoping it'll feel better.
The plan is to do another set of ROM before bed (with gentle heel slides), ice again and take it easy tomorrow.
Friday, October 9, 2009
Week 4, day 5
Knee felt inflamed and hot this morning, even though I iced twice before sleep. Achy today, not walking quite as normal.
Went to the PT: flexion up by 1 degree to 136, less than what I hoped. It felt like I made more progress than that with flexion. Oh well.
Going out for a few drinks to a bar tonight, so most likely going to skip the second set of ROM exercises before bed. I will be tired when I get
back and I want to give my knee a bit of a break. This is the first time I'd be skipping a set of exercises--not a good thing to start.
Went to the PT: flexion up by 1 degree to 136, less than what I hoped. It felt like I made more progress than that with flexion. Oh well.
Going out for a few drinks to a bar tonight, so most likely going to skip the second set of ROM exercises before bed. I will be tired when I get
back and I want to give my knee a bit of a break. This is the first time I'd be skipping a set of exercises--not a good thing to start.
Thursday, October 8, 2009
Week 4, day 4
ROM at work in the afternoon, the usual in the evening. ROM, stretches. 5-min prone hang with a 6lb ankle weight felt a touch too easy, so going to try 8lbs next time around.
Did a 15-minute stationary bike session before leaving work. Everything felt good. Walking keeps getting better, just a touch of limping, sometimes even none. I almost walk better when I don't think about trying to walk properly.
The flexion keeps getting better. A bit more aching in the knee today, I definitely was popping that ibuprofen every 4 hours throughout the day today.
The brace is less bothersome, as the hamstring incision site is no longer painful/irritating. I tighten the top of the calf portion of the brace quite tightly with no pain.
Did a 15-minute stationary bike session before leaving work. Everything felt good. Walking keeps getting better, just a touch of limping, sometimes even none. I almost walk better when I don't think about trying to walk properly.
The flexion keeps getting better. A bit more aching in the knee today, I definitely was popping that ibuprofen every 4 hours throughout the day today.
The brace is less bothersome, as the hamstring incision site is no longer painful/irritating. I tighten the top of the calf portion of the brace quite tightly with no pain.
Wednesday, October 7, 2009
Week 4, day 3
Did ROM exercises at lunch today, then another visit to the PT in the evening. The knee was feeling good this morning.
The knee flexion is doing ever so better, probably better than 135, though we didn't measure. The PT confirmed full extension visually.
Attempted balancing on my right leg at the PT, but felt pressure and some pain on medial side of the knee, so we aborted those. Too early then.
Still no hamstring strength exercises until 11/14, though the PT will ping the Dr about straight leg raises on my stomach, as those work the glutes more.
Used a 2lb ankle weight for straight leg raises and side leg raises. Straight leg raises produced a burn in the hip, on the inside, and some burn in my hip on the outside with side leg raises... so staying with 2lbs for the next visit.
The knee flexion is doing ever so better, probably better than 135, though we didn't measure. The PT confirmed full extension visually.
Attempted balancing on my right leg at the PT, but felt pressure and some pain on medial side of the knee, so we aborted those. Too early then.
Still no hamstring strength exercises until 11/14, though the PT will ping the Dr about straight leg raises on my stomach, as those work the glutes more.
Used a 2lb ankle weight for straight leg raises and side leg raises. Straight leg raises produced a burn in the hip, on the inside, and some burn in my hip on the outside with side leg raises... so staying with 2lbs for the next visit.
Week 4, day 2: Strer-strips removed and a bruising journey
Took off all the steri-strips tonight! Some of them were just barely hanging on the incision sites, holding on to a little bit of hair, so I just said F it and took them off.
First impression is that the arthroscopic incision sites are barely visible. Given how much dried up blood and "goo" there was on the steri-strips, I expected 4x4mm scab. Instead, it's just a tiny strip, like a little cut.
The only nasty looking thing is the hamstring graft incision, about 1.5" long. That scar will definitely stay with me for a while.
Here's a little photo series between my bruised leg and the not-so-bruised leg and the latest steri-strips-removed leg.
So, bruising and steri-strips after removal:
Week 1, day 6: lots of bruising:
Week 2, day 5: a lot of the bruising has faded:
Week 3, day 7: steri-strips barely hanging on:
Week 4, day 2: steri-strips removed:
Side view, the side arthroscopic cut is probably the most visible one:
First impression is that the arthroscopic incision sites are barely visible. Given how much dried up blood and "goo" there was on the steri-strips, I expected 4x4mm scab. Instead, it's just a tiny strip, like a little cut.
The only nasty looking thing is the hamstring graft incision, about 1.5" long. That scar will definitely stay with me for a while.
Here's a little photo series between my bruised leg and the not-so-bruised leg and the latest steri-strips-removed leg.
So, bruising and steri-strips after removal:
Week 1, day 6: lots of bruising:
Week 2, day 5: a lot of the bruising has faded:
Week 3, day 7: steri-strips barely hanging on:
Week 4, day 2: steri-strips removed:
Side view, the side arthroscopic cut is probably the most visible one:
Tuesday, October 6, 2009
Week 4, day 2
Decided to drive the Miata in to work today!
The tricky part is ingress and egress without twisting my right foot.
It's not too bad to plop into it, but getting out is quite tricky. The car is wicked low to the ground and the driver's compartment foot space is small. This makes swinging both feet out AND getting up pretty tricky. Thankfully, the steering wheel being there helps getting on my feet.
It was very nice to drive the convertible top-down though. It was 50 deg in the morning and I went for a lunchtime drive in 65 degree and sunny weather. Not too many days left in New England for this.
Did 15 minutes on the stationary bike at work in the afternoon. Knee felt fine, except for about minute 12, where it felt a bit irriated. Then I did my ROM exercises and stretches at home and walked around a mall for a while. I think this inflamed my knee somewhat, as it felt achy at night. I haven't been taking any ibuprofen today, so I took some before bed. I did ROM exercises, then iced the knee and went to bed.
Only one 5-min prone hang today, in the afternoon. I used 5lb weights and it didn't feel quite heavy enough (it was much more bearable). So that means that I'm getting my full extension, or at least I'm very close to it. I am going to try 6lb or 8lb ankle weights Friday.
The tricky part is ingress and egress without twisting my right foot.
It's not too bad to plop into it, but getting out is quite tricky. The car is wicked low to the ground and the driver's compartment foot space is small. This makes swinging both feet out AND getting up pretty tricky. Thankfully, the steering wheel being there helps getting on my feet.
It was very nice to drive the convertible top-down though. It was 50 deg in the morning and I went for a lunchtime drive in 65 degree and sunny weather. Not too many days left in New England for this.
Did 15 minutes on the stationary bike at work in the afternoon. Knee felt fine, except for about minute 12, where it felt a bit irriated. Then I did my ROM exercises and stretches at home and walked around a mall for a while. I think this inflamed my knee somewhat, as it felt achy at night. I haven't been taking any ibuprofen today, so I took some before bed. I did ROM exercises, then iced the knee and went to bed.
Only one 5-min prone hang today, in the afternoon. I used 5lb weights and it didn't feel quite heavy enough (it was much more bearable). So that means that I'm getting my full extension, or at least I'm very close to it. I am going to try 6lb or 8lb ankle weights Friday.
Week 4, day 1
Waking in the morning, the knee feels stiff and doesn't quite want to extend all the way or flex much. First steps until after out the shower are limpy.
Everything seems to work better today though! Did a set of ROM exercises at work at noon, before the PT at 5:45pm.
Good progress at the PT! Switched to 1lb ankle weights. Straight leg raises on my back with 1lb seem to generate muscle burn inside my hips instead of on the quads. (I guess that's normal, everything coming back into action...) The side leg raises definitely took a little effort to finish on the last set.
Also, 135 degree flexion! w00t w00t!
And, best of all, it seems I now have full extension! We didn't measure it, but it sure looks that way (and feels that way).
I asked the PT to evaluate my walk, as I still have a touch of a limp. Of course, I walked almost perfect in front of her. It seems that I'm not letting my right leg flex enough (maybe no confidence in it holding?). I tried flexing the knee more and it was better. I had a better gait for the rest of the day. Some times I didn't even think about it and just seemed to walk right! The key is to get to that state all the time.
Everything seems to work better today though! Did a set of ROM exercises at work at noon, before the PT at 5:45pm.
Good progress at the PT! Switched to 1lb ankle weights. Straight leg raises on my back with 1lb seem to generate muscle burn inside my hips instead of on the quads. (I guess that's normal, everything coming back into action...) The side leg raises definitely took a little effort to finish on the last set.
Also, 135 degree flexion! w00t w00t!
And, best of all, it seems I now have full extension! We didn't measure it, but it sure looks that way (and feels that way).
I asked the PT to evaluate my walk, as I still have a touch of a limp. Of course, I walked almost perfect in front of her. It seems that I'm not letting my right leg flex enough (maybe no confidence in it holding?). I tried flexing the knee more and it was better. I had a better gait for the rest of the day. Some times I didn't even think about it and just seemed to walk right! The key is to get to that state all the time.
Week 3, day 7
Another quiet weekend day. Did ROM + prone hangs two times, plus stretches and no-weight straight leg raises.
The marked improvement in flexion is sticking. We'll see how much flexion I gained over the weekend. Also did some patellar mobilization--not sure if it really helps, but can't hurt.
In the morning, walked about 3/4 mile to a diner. The walk was not quite right, still some limp at the end of the flexion. The knee felt a bit tender afterwards. Still trying hard to walk normal.
The marked improvement in flexion is sticking. We'll see how much flexion I gained over the weekend. Also did some patellar mobilization--not sure if it really helps, but can't hurt.
In the morning, walked about 3/4 mile to a diner. The walk was not quite right, still some limp at the end of the flexion. The knee felt a bit tender afterwards. Still trying hard to walk normal.
Saturday, October 3, 2009
Week 3, day 6
A quiet day at home. Walking around home doesn't make it that easy to concentrate on the correct gait, as the distances are very short and there aren't more than 3-5 step straights.
Turned in the Game Ready machine today, switching to the CryoCuff for my nightly icing.
Exercises:
Morning: ROM and a 5-min prone hang
Evening: ROM, straight leg lifts on my back, stretches, 3-min prone hang (these have all been with a 5lb ankle weight, but I couldn't keep going for 2 more minutes this evening)
After these ROM exercises, it becomes kinda tender/painful to fully extend the leg while standing. A bit weird. That goes away over time (15-30 mins) though.
It feels like I made good progress tonight with flexion. At the end of the heel slides, my heel was ever so closer to my butt. Let's see if this improved range holds up tomorrow. Before the heel slides, I did some patellar mobilization, focusing on the forward/backward motion. I hope that helped.
Turned in the Game Ready machine today, switching to the CryoCuff for my nightly icing.
Exercises:
Morning: ROM and a 5-min prone hang
Evening: ROM, straight leg lifts on my back, stretches, 3-min prone hang (these have all been with a 5lb ankle weight, but I couldn't keep going for 2 more minutes this evening)
After these ROM exercises, it becomes kinda tender/painful to fully extend the leg while standing. A bit weird. That goes away over time (15-30 mins) though.
It feels like I made good progress tonight with flexion. At the end of the heel slides, my heel was ever so closer to my butt. Let's see if this improved range holds up tomorrow. Before the heel slides, I did some patellar mobilization, focusing on the forward/backward motion. I hope that helped.
Week 3, day 5: I can drive!
At the physical therapy, the therapist watched me walk in my brace without crutches. She approved of the gait--it had just a touch of limp, but seemed OK. Some of the limp felt like it was caused by the pressure of the brace.
So I am now cleared to walk without crutches! I am going to leave one crutch in the car, just in case, if I go to a mall or some crowded place, such that people wouldn't bump into me.
And best of all, I can drive!!
I drove home from work. It was so great to drive again. I have to be a little careful, trying to pivot the foot less and shift it between pedals more. Trying to heel'n'toe downshift less. Still, it's very great to be able to drive again. I really missed it.
Feels like my quads are firing more when I do static quads. So that's a good sign.
Did ROM exercises and a 5-minute prone hang at night before bed.
So I am now cleared to walk without crutches! I am going to leave one crutch in the car, just in case, if I go to a mall or some crowded place, such that people wouldn't bump into me.
And best of all, I can drive!!
I drove home from work. It was so great to drive again. I have to be a little careful, trying to pivot the foot less and shift it between pedals more. Trying to heel'n'toe downshift less. Still, it's very great to be able to drive again. I really missed it.
Feels like my quads are firing more when I do static quads. So that's a good sign.
Did ROM exercises and a 5-minute prone hang at night before bed.
Thursday, October 1, 2009
Week 3, day 4
Still using one crutch, even though I can probably manage without. Trying to pay more attention to turning today and trying not to twist at all on my right foot. I think I didn't pay as much attention to that since Monday, but I hope I didn't mess anything up (I didn't think I twisted far at all, but I was twisting more than I am now).
Tomorrow at the PT, we are going to re-evaluate my walking and see if I can be cleared to walk crutchless. Yesterday, the PT was suggesting using one crutch as a publicly-visible "I'm injured" marker. That makes a lot of sense. I think that when I am walking without a crutch, I may still grab one crutch if I'm going somewhere with a bunch of people.
Afternoon:
Did ROM exercises at work before lunch.
Evening:
Hopped on the stationary bike at work for 10 mins before leaving.
Did ROM exercises, straight leg raises and stretches. Prone hangs for 5 minutes with 5lb ankle weight. (unpleasant!)
Tomorrow at the PT, we are going to re-evaluate my walking and see if I can be cleared to walk crutchless. Yesterday, the PT was suggesting using one crutch as a publicly-visible "I'm injured" marker. That makes a lot of sense. I think that when I am walking without a crutch, I may still grab one crutch if I'm going somewhere with a bunch of people.
Afternoon:
Did ROM exercises at work before lunch.
Evening:
Hopped on the stationary bike at work for 10 mins before leaving.
Did ROM exercises, straight leg raises and stretches. Prone hangs for 5 minutes with 5lb ankle weight. (unpleasant!)
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