My leg seems to be getting stronger, I still have not progressed to weight lifting but I’m hopeful that is in the near future. I think by next week I’ll be starting lunges. Yesterdays PT session started out with a quick bike ride and then work on the ball doing both of the exercises I described last time. From there I moved to the disk, this is just a disk shaped object that is mounted on a half ball. I stand on that with one leg and rock it under control front to back. With two feet on it I rock it left to right. The next balancing exercise I did was stand on a snowboard shaped object that sits on two cushions. While balancing on that I play catch with Karen the Physical Therapist. The next exercise was side steps. With a tightly tied band around both legs a step to the side across the room. The next thing we did was walk on the treadmill backwards with tension on my leg. Not done yet, it was a long session. The last new exercise was I lay on a half cylinder with the flat side on the ground. I had to balance on that and march (lift both legs up and down in place). Surprisingly it was very difficult at first to balance when I lifted my right leg. The last thing I did before I left was work with the exercising balls again.

My home regiment has not changed much. I need to continue to do all of the exercise I had been doing and ad the side steps with the band tied to my legs.

It’s the day before Thanks Giving and I am working my but off. Karen had me doing a couple of new exercises today as well as riding the bike. She had me using one of the exercise balls. First I started in the sitting position on the ball and then slid down so that my shoulder blades were on the ball and I was making a table with my body. I needed to balance my shoulder blades while maintaining a flat surface. This exercise seemed like it was more work on my stomach than my knee. The second one we did was I was lying on the floor and I put my legs on the ball. I then raised my hips, this one was very similar to the bridges I am currently doing at home. To make it more difficult on my legs and less on the balancing I did it with my knees bent.

I hope everyone had a nice Thanks Giving (or weekend if you’re not from the States). Mine was very nice but I didn’t do many of my exercises. Really, the only exercising I did get in was walking my dog every day. Walking the dog tends to aggravate my knee and has been recommended by Karen not to do. I’ll have to get back into the swing of things this week.

The quads are very sore today. Better that than the knee itself. Once again started off the same way we always do, riding the bike. From there we worked on straighten my leg. Karen thought it was looking much better. Talked a bit about the how I think my knee is doing and what causes it pain. I mentioned that going down stairs still causes pain. We then proceeded to do stair exercises for about 15 minutes. From there I worked out on the treadmill while Karen put tension against my knee. I will be having PT again tomorrow.

I’m now at 10 weeks out from the surgery. If I look at stage II (6 – 12 weeks) of the rehabilitation the goals are gradual increase range of motion (ROM), gradual improve quadriceps strength/endurance, gradual increase functional activities. I have been working on all of the above. The criteria to progress to phase III is to gain full ROM, acceptable strength levels (hamstring 10-20% contra lateral leg, quadriceps 10-20% contra lateral leg), balance testing within 30% contra lateral leg, able to walk 1-2 miles or bike 30 min. Of the criteria I can understand, my ROM is now at 135°, so I am close. I can already walk over a mile and bike for 30 minutes. I’ll have to find out in understandable terms how to measure how close I am when it comes to strength and balance.

My next post will probably be on Monday so have a very nice Thanks Giving all.

Most of my PT yesterday was spent on straightening my knee (again). It started out like it almost always does with me warming up on the bike. From there I started a new exercise, I laid on my belly with a rubber band strapped to my ankle and the other end strapped to a table. I then had to bend my leg up toward my head and hold it. This is to help strengthen my hamstring. From there I went on one of the beds and Karen (the physical therapist) worked on my knee. This is probably the third time we have done this, I lay on my belly and she puts a foam cylinder or other object under my thigh and bends and massages my knee back (to straight). By the time she is done my knee hurts but I guess it is straighter. From there I went to the treadmill to walk backwards once again. This time I walked with tension on my knee. Again I used a rubber band wrapped behind my knee and Karen was holding the other two ends. She would then pull back on the strap forcing tension on my leg while making steps back.

For my daily exercises I can now drop the knee extensions as long as I get Mrs. Bentley to put tension on my knee while I do the treadmill. I have to also add the leg curls that I described above. So that makes it for strengthening: calf lifts, mini squats, leg curls, bridges, and stairs; for gait: treadmill with tension (walking backwards). I still need to continue to do balancing exercises and stretching.

As an added bonus this week I was sent home with an electrolysis unit (free use for one week). This is different than the micro-current unit I used earlier in the rehab. The electro-stim is the unit that will actually make your muscles contract. I actually enjoy this unit, I find it a really cool sensation having the muscles do that.

November 14 and the PT is starting to get long again. There is good and bad in this also (see my last two posts). The walking is getting better but it still doesn’t feel exactly right and when my leg gets tiered I start to limp in a big way.

I started off my session the same way I seem to always do, riding the bike for about 20 minutes. My right knee seems to bend back a bit and Karen (the physical therapist) seems to now think the left will never do that again but it should be able to make it to full straight. On the bright side it is probably a good thing that it does not bend back at all. From the bike Karen worked on my knee trying to increase the bend. From there I went to the treadmill. She had me walking backwards on it to help with my gait. I continued on the treadmill for about 15 minutes. We then worked a bit on balance and then step-ups; I am now doing side step-ups.

By the end of this session my leg was quite tired. By that evening my leg was once again screaming and I was totally wiped. Wow is it nice to be back to the old regiment!

My daily workout schedule is now riding the bike for 20 min. For strengthening I do calf lifts, mini-squats, bride and step-ups (front and side). For gait knee bends and walking on the treadmill backwards. For balance I stand on one leg, usually on a pillow so that it is not an even surface, and play catch with one of my boys. I also continue to bend the knee to increase its range of motion.

November 10th and the PT sessions are still not very long. The good of it, I don’t feel totally wiped when I get home and my knee is not screaming. The bad of it, my knee and leg are still not strong enough to do a lot of work.

I did a lot of the same basic things, rode the bike, did calf lifts (still could not do many) and walked on the treadmill a bit. I did add one new exercise this session, step-ups. It’s just as it sounds, I stand in front of a step and step-up. I still am not doing step-downs yet.

As just an aside, today (Nov. 10) is my birthday. I know you all wanted to know.

November 7, 2005 was a feel happy day. I walked into the physical therapists office and got the nice fan fair about being off crutches. Spent a little time talking about how I am doing off the crutches. Said how my calf seems to be bothering me more than my knee itself. The pads on my foot were also bothering me after the walk to work. Karen figures it is just because of lack of use (kinda what I figured also).

The session was spent working on balancing exercises and calf rises. Just as an example of how weak the calf is I could do 40 calf raises with the right leg without issue, I could only get 16 with a lot of strain with the left. The good and bad of being off the crutches; Good: the session went very fast, there was not a ton I could do and Bad: the session went very fast because my leg is so weak.

For this week my exercise regimen includes biking for 20 minutes. To build up the calf and thighs I will be dong calf lifts, mini squats and bridges (lay on your back and raise you hips into the air trying to put most of your weight on the left leg). To improve my gait I am walking backwards, knee bends (using tension from a rubber band) and walking on the tread mill. For balance I am standing on one leg (left leg) and tossing a ball with one of my boys.

November 4th I meet with the surgeon. He takes a look at the incisions and the knee itself. He has me do a leg lift and asks a couple of questions and for the most part that was my appointment. That morning I was able to put all of my weight my leg. I asked the doctor about any limitations to weight bearing and he said I was all set, as for strengthening I needed to proceed slowly.

One very interesting thing did happen at the doctor’s office; he asked if I had seen pictures of my knee. I said not from this last procedure. I was expecting to see scope pictures like the previous ones I have seen and can’t total understand. I was very wrong, he pulled out two regular developed pictures of my knee. It was very cool and a bit gross.I was wrong about the scars on my leg, I am so used to the very long scars from reconstructs of the past that I just assumed that the larger scar on the left of my knee was from the reconstruct and the two smaller ones were for the reconstruct. Well, the long one is for the cartilage replacement. The pictures show that part of the knee being pulled open and you can clearly see the large area of my knee that is missing cartilage. The second picture shows the knee after they have sown on the periosteal patch but before they inject the Carticel. Not only was I blown away by the pictures but how small the scars are now for the reconstruct. I am going to try to get a copy of those pictures at my next visit (mid December).

I went to work that afternoon only for a couple of hours to tie up some loose ends and then headed home. Once home I practiced walking around the house until the boys came home. That night was the last home football game for the High School so I figured I would take the boys to the game and daring as I was go without crutches. All of the games I went to last year I would park at the Middle School which is behind the stadium and there was a small gate behind that you could get into the stadium through. I made the assumption that the gate would still be open, I was wrong, it was chained shut. I was forced to walk around to the other side of the stadium and then back again to get into the bleachers. I had to do the same thing at the end of the game to get back to my car. The next morning I was hurting quite a bit from overdoing it. The funny thing is that my calf hurt a lot more than my knee did and I think that was limiting my walking ability more than the swelling on my knee. Regardless of the pain I had to suffer through for those couple of days I Was Off Crutches!!

November 3rd late in the evening, I had to schedule this session late due to work once again. Tonight Karen wants to work on balance. Since I am still unable to get full weight bearing on my knee she had me standing with one leg in front of the other and my left leg (the bad one) being in back. She then wanted me to put as much weight on my back leg as possible and balance there. It was no challenge at all.

She then had me get on the bike for about a half hour and then work on a couple of other exercises. By the end of the work out the leg was feeling a lot more tired. She then had me try the balancing exercise. This time it was quite the challenge, for most of the time my leg had the quivers. It is still upsetting to see the difference in the size of my quad and calf compared to the right leg.

Sorry for the long laps in posts, this past week has been very long and busy at work. So since I last posted there have been 3 PT sessions and one doctor’s visit. I am going to try my best to catch you up.

October 31st in the AM, I had to schedule an early PT session because of work. I had another 2 hour session! Boy Karen (the physical therapist) likes to work me. The good news is by the end of the session I got my 120° and just under one week later then I was supposed to (Tuesday, tomorrow, would be week 7). I can now take the brace off while I am walking and start to move toward full weight bearing. Karen suggested that I wean the brace off, especially since I have a long walk from my garage to the office, nope! I could not wait to get pant on and get out of shorts.

Tonight I spent the evening crutching around the neighborhoods with the boys. I probably did too much for the first day without the brace. Thankfully the knee doesn’t seem to be too much worse for the ware and hasn’t swollen up.