The Bends

24 days down! You’ve all been very nice to check in every so often and ask for updates, so you will probably find several parts of this post redundant. Hopefully there will be a little new info for everyone, though.

The biggest change since 2 weeks ago (can’t believe it’s been 2 weeks since the last post…it feels much more recent) has been starting physical therapy, which I’m actually really enjoying. My orthopedist recommended 2 places—a small therapy studio in Carrboro or a new UNC therapy center in Chapel Hill…I looked at the websites for both, and was ready to call the UNC site (they had lots of pictures of fancy new therapy equipment) until I saw the google reviews for Carrboro’s Balance Physical Therapy. Everyone raved and raved about Balance’s staff and therapy programs—reviews so laudatory that I started to suspect they were written by the therapists themselves to try and get more business. I put that cynicism aside and made an appointment (they are also a closer drive and have more PHDs on staff), which I think was a good choice. It’s a very small facility, but everyone is really friendly and knows their stuff. It also manages to incorporate just the right amount of Carrboro-hippy vibe—free hot tea is served in the waiting area, and one therapist brings in her two golden retrievers who go around and make sure everyone is doing ok.

I work mainly with Chad, a therapist who grew up in/near Boston (we complain together about how much it costs to fly there these days) and got into physical therapy after suffering a few sports injuries of his own. The main goals at this stage are to get my range-of-motion (knee bending) and quad strength back. Most of my trips at this point, then, go roughly as follows…

• 15 minutes of massaging the knee and leg, getting my patella comfortable and kneading my IT Bands (these run along the side of the thigh and help with stabilization—they often tighten up after ACL surgery, doing extra stabilization work since the ACL isn’t contributing yet). This part’s pretty great.
• 15 minutes of knee bending. I lay flat on a soft table, my leg up on the therapist’s shoulder. He’ll push the knee back and lower his shoulder, bending my leg a little farther each time. As we get to my flexibility limit, this starts to really hurt (I try to remember to take a pain pill before each appointment), so I’m not particularly fond of this part. This is when I want golden retriever time.
• 15 minutes of quad firing. I sit up some, legs still flat in front of me, and just flex my left quad as hard as I can, taking breaks as it gets tired. We’ll also do single-leg-raises, lifting my leg up while keeping it as straight as I can. If I can keep it completely straight (i.e., the knee doesn’t start coming up before the foot…aka no ”extension lag”), this is done without the brace on.
• 15 minutes of exercise bike—not as advanced as it sounds. I don’t actually peddle away, but rather start with my left leg extended, then peddle as far as I can forward, then back down, then as far as I can backward. Repeat for a while. It’s another way to push my bending limits, letting my right leg boss my left leg around to try and get its flexibility back.
• Wrap up with new walking instructions and brief practice. For example, my first trip I was told to start letting my left foot hit the ground as I walked, putting as much weight on it as I could safely bear. Next time we unlocked the brace for bending-while-walking, mimicking a normal gait but keeping the crutches for most of the weight-bearing. Now I’m up to unlocked brace and one crutch, though I have to move very slowly and deliberately.

In between appointments I’ll do as much as I can on my own (“biking” at the apartment fitness center or RTI gym, leg lifts on the couch/floor, knee bends, etc). So far I feel I’ve kept with it fairly well—between my Monday and Wednesday appointments this week I gained 20 degrees of bending range, which impressed/surprised the therapist. And just a few hours ago I actually managed to peddle all the way around on the exercise bike!—which means in the coming days I’ll probably be able to use one like a normal person, building a little muscle back and getting some much-missed cardio activity.

So things are going pretty well. There are still a few lingering negatives. I’m still struggling to get comfortable in bed, resulting in many less-than-satisfactory nights of sleep, but it’s better than it used to be. I’m also a bit saddened by the amount of atrophy I’ve already suffered. This week’s lovely legs picture shows the contrast in calves:

You’ll notice the knee is still pretty swollen—apparently it will stay that way until I’m walking without crutches and without a limp (a few weeks away?). All in all, though, I’m making a lot of progress and am pretty close to ditching the crutches and brace. It won’t be long before I can walk on a treadmill and use an elliptical machine, and if I keep up this pace I should be able to bike in Hilton Head without any problems. Just in case I can’t, I’ve gone ahead and ordered one of these for Meredith to tow me around: