This Started Out As a Very Different Post

Monday was a stunningly good day.  I’d had a good weekend, spend doing physical activities outdoors.  I got the dirt in the garden and planted my spring seeds!  I rode my fancy new bike outside!  Twice!  Then, when I got to my PT appointment that afternoon, I was asked if I wanted to try running on the treadmill for a bit.

Did I?  Of course I did!  Let’s go!  It was all I could do to get through the warm-up exercises, because in the back of my head it was all, “wegettorunyayrunningyayayayayayayay!”  I got on the treadmill and walked for a bit, then I picked it up for 5 minutes of running.  In one minute segments.  With a minute of walking in between.  At a very, very slow jog.  In the 15 minutes I was on the treadmill, I covered less than a mile.  Less than half of that was running.

But it was fantastic.  The knee felt fine and, despite the fact that I felt like I was clunking all over the place and had sort of forgotten how to run, I felt fine.  Everything looked great.  The clouds parted, angels sang.  It was basically the high point of my week.  At 4:30 Monday afternoon.  I was told to let the knee rest on Tuesday, but that I could try and do the same thing on Wednesday.

By 7:30 Monday night, it was a slightly different situation.  The knee was sore like it hasn’t been in weeks, and I seriously contemplated tossing back some ibuprofen before falling asleep.  I didn’t, mostly because I was already in bed when I had that thought and couldn’t justify getting up to do so.  However, when I woke up Tuesday morning?  It felt fine.  I listened to instructions and took it easy on the knee, skipping my planned bike ride in favor of doing some swimming.  When I woke up Wednesday morning with no pain?  I hit the treadmill again.

Once again, I ran my slightly-less-than-half-mile in one-minute chunks.  I took my one-minute walk-breaks in between.  And I added a nice long walking warm-up and cool-down to bring me to a nice even 30 minutes on the treadmill.  All of which my knee tolerated like a champ.  Until Wednesday afternoon, when I noticed the soreness creeping back in during class.  By the time I got home, it was aching enough that I actually threw an ice pack on it for a bit.  Again, something that I haven’t done in weeks.  As much as I wanted to ignore it, I couldn’t: the knee was not at all happy about running again.

Bummer.

So when I went in for today’s PT appointment, I told them exactly what happened.  I rested.  I ran.  Inside and on a treadmill, as per instructions.  And the knee was very clearly unhappy about it.  Heck, the knee was still sort of sore off and on today.  Clearly, this new activity was not, as the PT would say, well-tolerated.  She simply nodded and said, “OK.  So we still need to do more strengthening work.  Let’s try pool-running for now and see how that goes, and then maybe we can get you back running on land again in a week or so.”

So, that’s what we did.  We progressed the strengthening work I’ve been doing there up another level, so that my quads can hold my kneecap right where it needs to be, and I left with instructions to try pool running and yoga this weekend to see how those go.

I’m not going to lie: it’s disappointing.  I was so very sure that I was on the tail end of this, but apparently there’s still a good deal more work to be done.  My PT asked me today if I was getting tired of all the cross-training, and I said, “Sort of… but mostly I’m just tired of not being able to do things.”  Sure, the list of things that my knee can do is growing, but it’s definitely the limiting factor on how hard I can work.  I miss finishing a workout and feeling like I’ve actually done something.  Blessedly, I’ve been given the all-clear to get back to yoga, which will at least provide some sort of challenge.

But what I really, really want to do?  What I would just about pay someone for the experience of?  Is to go out and spend an hour sweating and panting and end up feeling sort of like I want to throw up and/or pass out.  I don’t even care if I do that running or biking or in some sort of crazy boot-camp workout.  I just want to get back to that sense of accomplishment that comes with finishing a crazy-hard workout like that.

So, yeah, not the “WOO YAY RUNNING I’M BACK BITCHES” post I was hoping for just a few days ago.  Maybe next week.

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Progress… Finally

A week ago, I was feeling pretty discouraged about my knee.  The swelling was pretty much unchanged, which meant I was still hobbling around to a degree that was noticed by other people.  Both of my physical therapy appointments were… well, they were sort of iffy, as the knee didn’t really want to cooperate with doing anything.  Both PTs that I saw looked at my knee and inquired as to when I would get in to see the doctor next.  One of them even went so far as to mention that, yeah, this was sort of a lot of swelling for as far out of surgery as I was and it was a little… unusual.  Great.  Exactly what I wanted to hear.

So when I left town for a weekend in Chicago, I thought nothing of the fact that I wouldn’t be anywhere near an exercise bike for several days.  When I came home with a cold and decided to sleep instead of going to the gym?  I didn’t care.  And that was apparently exactly what my knee needed, because it has been worlds better this week than it has since the surgery.  I’m back to driving my own car and can even get comfortable sleeping on my stomach.  If I think about it, I can even walk just about normally.  They’re little things, for sure, but they’re little things that I haven’t been able to do in a month, so it’s pretty exciting.

Even more exciting is that since the knee was behaving, I was able to work it pretty hard in both of my PT appointments this week.  No complaints, no angry post-PT swelling or discomfort.  Just a much more functional knee than I have seen in quite some time.

Even with this week’s jump forward, I’ve basically let go of any time-based goals related to running, which has let me focus on what I can do now and how to improve that.  Even with the improved motion, that leg is still far weaker than the other one.  Today, the PT had me do some basic leg raises with a 2-pound ankle weight, and that was depressingly difficult.  Clearly there is still some work to be done there.  (On the flip side, though, doing those leg raises with a 1-pound ankle weight was almost impossible two weeks ago, but now it’s absolutely no problem.  So there’s progress being made.)

Here’s hoping that the upward trend continues.

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On Gaining Valuable Patient Experience

Earlier this week, I had my post-op appointment and got cleared to start hitting the exercise bike for short periods of time with no resistance.  I was also told that as long as I did that and range of motion exercises on my own, I’d probably be fine without physical therapy.  However, if I wanted to go that route?  My insurance would cover it, because we have really, really good insurance.

I went the PT route.  I figured that in addition to making sure I had a well-rounded rehab, it would also keep me on track.  Having to check once or twice a week with another person would keep me on my exercises, and it would also give me someone to bounce ideas off of, and they could tell me if it was going to be a good idea or bad idea.  Basically, I’m using the PT as a babysitter to make sure I don’t try to do too much too soon.  While there’s very little chance of me hurting anything in my knee, I could definitely piss it off pretty good and set myself back a good week or so.  No thanks.

Hey, insurance will cover it.  Thank you, Giant Software Company.

So I had my evaluation appointment Wednesday morning, and it sucked even more than I thought it would.  I knew they were going to test my range of motion.  I knew they were going to see how much motion they could get out of my knee (i.e., more than I can).  I knew it was going to be uncomfortable, but I wildly underestimated by just how much.  As I was sort-of whining to a couple people about that, they all said the same thing: “Hey, this experience as a patient will just make you a better therapist down the line!”

Which, while true, is akin to hearing that a period of seriously sucky experiences “will build character.”  However, they did have a point, because up until this week, I had no idea that post-injury and post-operative PT were so wildly different.  Post-injury PT is a bit uncomfortable, but it’s in ways that you’re pretty much used to.  If you’re active enough to hurt yourself, you know how it feels to do tough strengthening exercises and stretching.  Sure, having someone use manual therapy to loosen up your IT band isn’t exactly a walk in the park, but you don’t really have to do anything besides sit there and take it.

Post-op PT, however, is all about moving whatever joint it is that doesn’t want to move.  It wants to stay in one spot until all of the swelling is down.  It doesn’t want to stretch the range of motion it has available, and it most certainly does not want to hang out at the end range of motion.  Yet, that’s exactly what you need to do.  And you can’t just sit there and take it, you have to actually do it to yourself.

Yeah, that’s a difference I wasn’t really expecting.

However.  I’ve been good and doing my exercises and I’m continuing to see small improvements every day.  A little bit more motion here, a little less discomfort there.  On Wednesday morning I could barely get through one set of 10 leg lifts, and tonight at the gym I busted out 3 sets of them without a problem.  (That’s another thing I was horrified to see: how much strength I lost out of that leg in less than a week.)  I’ve hit the bike for 10 minutes the past couple of days, and while the first few minutes are a little rough, by the end of the time it feels awesome.  The motion’s getting a bit smoother, and today I made it a little further than I did yesterday.  As long as my knee doesn’t feel awful in the morning, I might try and see how 15 minutes goes.

I can’t wait until I get back to running, but that’s still several weeks away.  So for now I’m focusing on what I can attain in the next week or two.  15 or 20 minutes on the bike.  Sleeping on my stomach again.  Driving my own (manual transmission) car.  I’m not quite there yet, but I’m thinking that two out of three in the next week is totally reasonable.

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