Tuesday, January 27, 2009

One down, four to go

Monday was my 6 week mark. This represents being 1/4 done with the 24 week protocol!

I celebrated today by forgetting my appointment to check in with Dr. K, and re-scheduled it for Thursday morning after my PT session.

Today's report: 30 reps @ 4 pounds, 32 sit-ups and push-ups. Numbers keep going up as the days go down!!!

Thursday, January 15, 2009


This morning's PT report:

- Flexion at 138°, full extension.
- Approved for slow-count kicks with the operative leg only, supporting on the non-operative leg. Cool!
- Step-down exercises are assigned to work further on strength and smoothness of transition when walking down stairs.

My last measured flexion in the other knee was 138°, so they both seem to be about the same. Further flexion is limited simply by my physiology, at least until I can kneel and sit on my feet!

Using 2lb. ankle weights for straight leg exercises (raises, abduction, adduction, standing hamstring curls). I can do about 20 reps without a pause, working up to 30 solid reps before increasing weight. By the end of the program, the goal is 10 pounds, 30 reps.

My non-operative leg is no stronger than my operative one, so I'm making an effort during PT to emphasize both legs equally.

For those who don't know what they are, slow-count kicks are an excellent exercise for strengthening your hip flexors. Their purpose is to enable greater height and control of kicks.

You begin in a fighting stance, then kick in 4 steps.
This example is for round kicks:

1. Pick up your kicking leg in its chambered position.
2. Slowly extend it out.
3. Slowly swing it just across that centerline.
4. Slowly swing it back.
5. Repeat 3 and 4 until your leg drops like a lead weight.
6. Re-chamber the kicking leg.
7. Put your kicking leg down (if it hasn't dropped of its own accord!)
8. Switch your stance and repeat with the other leg.

They are murder to do at first, but I've grown to enjoy slow-count kicks. When you begin, start on a wall or with a barre to grab, gradually progress to doing them without holding anything for support. Your hip flexors will be crying for mercy, so watch those first steps when you're done! If you do them for a while and they start to feel too easy, try adding ankle weights. Even 1/2lb. at the end of your leg is a huge challenge.

Kicking high takes two things: flexibility and strength. Leaning the torso way back does very little for improving kick height if you don't have strength, and slow-count kicks are probably the best exercise I know of to develop that strength. Enjoy trying them out--I know I will!

Thursday, January 8, 2009

The 30's: Arriving and Leaving

Tomorrow I enter my 40's.

Today my PT confirmed that I've entered my 30's, so to speak...I have 133° of flexion in my knee!

That gives me a great feeling of accomplishment, especially in light of being just over 3 weeks out of surgery. By comparison, I was at 126° at this point with my right knee.

My final ROM in the right knee settled in at about 138° of flexion, -10° extension, so hearing my left knee is "in the hood" is quite exciting.

My extension still needs work, as I'm not quite into negative (hyper extension) numbers, but that mostly comes with time. I plan on prone leg extensions to push that issue. You lay on a bed face down, dangle the leg out with your knee at the edge of the bed and allow gravity to gently stretch things out into a slight hyper extension.

Taking stairs going up has become quite easy, but I'm still a bit unstable bending the operative knee going down. I'm fine until the last inch or two before my other foot lands, so I need some more strength work in that part of my range. I expect massive improvement when I begin squats in the next week or two.

I'm hoping my nighttime leg cramps go away soon. Other than ibuprofen--which is eventually gonna wear a hole in my stomach if I'm not careful--the practical solution has been a combination of a hot water bottle applied to the thigh and a large pillow between the knees.

The pillow keeps stress off of my sprained MCL, which I'm still nursing while in rehab for the ACL. Padding between the knees gives Mrs. Shaft a better night's sleep; I can sleep on my side comfortably and avoid waking her with snoring!

The weather around here is hovering near zero degrees, with forecasts into the negative double-digits next week. Boy I sure hope it warms up a bit before I start running!!! I'm looking forward to Robert Frost moments.

Happy Thursday, everyone!

Tuesday, January 6, 2009

Phase Won.

My rehab program is in 4 phases:

I. 0-4 weeks: Range of Motion. Goal: ROM of 0-120° and walking without a limp.
II. 4-6 weeks: Strength, balance, and proprioception. Goal: Unrestricted walking, including stairs.
III. 7-12 weeks: Power, speed, and more strength. Goal: Begin return to running program.
IV. 13-24 weeks: Function, agility, hopping, sport specific drills. Goal: Complete rehabilitation.

Sunday marked the end of week 3. My last PT visit had me at -3° to + 116° ROM, which seems far ahead of my prior rehab! I've been taking stairs leading with the operative leg going up now, but we're waiting on leading with the good leg going down until I demonstrate more control.

The busyness of the holidays has kept my mind occupied, and these first 3 weeks have simply flown by. Here's the basics of where I'm at currently:

- ROM: Objectively I'd say I'm well into 120°+ of flex, and extension isn't hardly uncomfortable at all.
- Swelling: I have dimples around my kneecap again!
- Scarring: Scars are healing up nicely, just one persistent site that's still rather swollen but not painful. My PT is having me massage the scars to keep them from bonding to the underlying tissue.
- Mobility: Haven't used a cane since the first week.
- Bruising: The last traces of pooled fluid in my foot have faded to nearly nothing now.
- Walking: I still catch myself in a conservative gait, working on lengthening my stride.
- Strength: Strapping on 2 lbs. of ankle weights for straight leg lifts currently.

Since swelling has gone down, my other ligaments have taken the opportunity to get some exercise of the knee-cracking variety. Things are still a bit tender in that area, so I'm careful whenever getting up from sitting for long periods. I still get these wicked charlie horse cramps in my thigh in the evening, but ibuprofen usually takes care of those. If they continue much past about week 6, I'll get them investigated in case there's funny business with nerves in my back.

I'm two days into my resolution for sit-ups and push-ups, hoping it's a good habit that will develop over the next few weeks. Can't wait to start running in another 3 weeks, which is odd since I'm not normally much of a runner to begin with--but it always manages to fire me up for the day.

Black Belt Mama is heading in tomorrow morning for some corrective surgery on a protruding sheath from the interference screw installed in her shin. Keep her in your thoughts that her healing will be quick and devoid of any PT requirements!

Thursday is the next check-in with my PT. Friday is my 40th birthday. I expect great things from both.