Wednesday, January 19, 2011

Six Weeks After Surgery

Progress continues to be very gradual, no significant leaps forward. I am noticing increasing strength in my leg. This week I am regularly walking up/down stairways in my home with one foot at a time, but holding on to the railing for support. No noticeable change in the swelling this week. Looks to be the same as the previous week at 18 inches in circumferance. By comparison, my good knee measures  at 16 1/4 inches in circumferance. The picture below shows both of my knees for comparison. The knee to your right is my good knee which shows the quadricep muscle. The knee to your left is my surgical knee which shows excessive swelling, thus concealing the quadricep muscle. However, the incision on the surgical leg appears to be healing nicely.


I continue to go to physical therapy on Monday, Wednesday, and Friday afternoons. I am also doing my own private PT on the alternate days at my home. Saturday is the only day of the week where I rest and refrain from doing any exercise therapy for my surgical leg. Now that I am working 1/2 time, I am also finding that the afternoons are the ideal time to do PT. Doing PT before work would be very difficult as my knee swells/aches after PT which would making moving around at work problematic. Doing PT late in the day is the best time for now as I can go directly home and ice the knee.

I have not been sleeping soundly through the night for weeks. My sleep is broken into 2 and 3 hour increments. At night, my knee sometimes aches and the pain (although mild) wakes me up. I suspect that the nightly pain is due to the late afternoon PT sessions. When awake during the evening, I am not aware of much discomfort, but at night when sleeping, the minor aches when moving my legs seem more pronounced and wake me up. Some times I toss and turn until I fall back to sleep; other times when there is too much discomfort, I take a 1/2 tablet of the Norco pain medication to go to sleep.
Two developments occurred this week. I am now able to rotate the pedals on a stationary bike, and I was able to max out on the Biodex by reaching a knee bend of 100%.  For my "at home workout", I am pedaling on the stationary bike for 10 minutes as a warm-up. I am using a seat position of 11 and a resistance level of 4. When pedaling the stationary bike, my surgical leg feels awkard, not sufficiently coordinated to make the pedaling feel natural. As the muscles in the leg get stronger, I believe the coordination for bike pedaling will return.

A 100% knee bend on the Biodex translates to a 90 to 95 degree knee bend. Over the last week I have been starting the 15 minute session on the Biodex machine at 85% and then advancing it into the 90's. This past Monday, I got up to 100% which really stretched the tissues and muscles around the knee. Maxing out on the Biodex is a good sign of progress for knee flexion. Should I continue to max out on teh Biodex, they may switch me to an exercise that increases knee flexion beyond 100 degrees.

Overall, I think I am doing okay. I am noticing that I am using the cane less often when outside or when at work. However, the cane does give me security when walking outside on ice, and I believe, the cane also serves the purpose of validating to others that I have a temporary disability. People do make accommodations when seeing me walking with a cane.

In the below video you will see two exercises that I am doing at home to improve knee flexion. One exercise is called the floor slide and the other exercise is called the wall slide. Both serve the purpose of stretching the muscles around the knee and forcing it to bend.

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