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Pilates
In the last few years I’ve had issues enough that I see my physiotherapist reasonably often. Well, the past few months it’s been quite often as I have had one issue after another. A few weeks ago it was suggested I try the clinical pilates classes they offer so I decided to give it a go. I had to attend an assessment session first but I’ve now gone to two classes and it’s been quite interesting. I have used some of the machines in the regular appointments but it’s quite different using them for a whole hour. The first week the exercises weren’t too difficult although a couple really brought on a muscle burn. This week they have ramped up a couple to more difficulty. The worst one is standing on a bosu ball for balance. I can stand on the flat side and let go but balancing on the ball side was a bit too hard when I was there this morning.
I also said I wanted to work on my abdominal muscles as they tend to be pretty weak much of the time. I can’t help thinking it will be beneficial to get that toned up a bit. It might make a different in my swimming when I one day get back to lessons.
I’m scheduled for ten sessions and then we will see how I am doing and reassess my needs. I will likely take a break at that point since I can’t afford to do it through the year. But it’s nice to have this option available to me.
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Aches and pains
In the last few weeks I’ve had quite a few aches and pains that were notable. The first one was some lower abdominal, possibly pelvic pain on the left side. It wasn’t constant but it recurred enough that I would have sought out a doctor’s opinion. Then it had disappeared. Next was the lump that appeared in my armpit and didn’t cause any pain although was later irritable to touch. That one also disappeared.
A couple weeks ago I was swimming and afterwards I was really quite sore, such that I wasn’t up to practicing more during the week. Most of the pain was along my shoulder/neck area and I figured it would go away after a few days. There was a shift in the pain and soon it was all about tenderness along my collarbone and that is something I’ve not had before. Last Monday I was at the doctor for other reasons and I mentioned the above issues even thought two had already resolved. She suggested I wait and see what happened on that as this too seemed to be resolving. I only mentioned it because I was already there.
Meanwhile I had made an appointment with my physiotherapist and then cancelled as I didn’t think I needed it. This was all done online. I was called by the receptionist/front desk manager and I mentioned that it had seemed to be gone but then it was back again. So another appointment was made for Thursday morning. By this time the pain seemed to be mostly gone again so I wasn’t sure whether it was worth going or not. But I dragged myself out that morning and went in and it turns out I had an AC sprain in my shoulder. And some movement were actually painful and I had weakness in some movements too. She sent me away after a painful massage and some exercises to do until Monday. So I’ve been doing these exercises and find my hand gets numb while doing them so have to spread them out. It’s not too time-consuming and two of them involve stretches that actually feel pretty good. Three days later my should is feeling better and times and not better. It seems to be hurting more today than it’s been. Apparently it’s a grade one injury and should get better in a few weeks.
I forgot to write about the previous injury. It’s usually caused by a fall or running into another person as might happen in playing a football game or similar. I obviously haven’t done that nor have I fallen down. But there’s a bit of a niggle of a memory that I ran into a corner in the house once not too long ago and it hurt a lot at the time. But then I forgot about it until later. I thought it was the swimming that set this off but it seems that might have just aggravated it. So that’s my theory and I’m sticking to it! :D
On top of all that, I’ve had a stomach bug or something since Friday. The Scientist and I had plans for yesterday but had to cancel as I wasn’t up to going out. Even today I stayed home from a lunch at my MIL’s place. I am better but my stomach is still quite sore and I really don’t want to pass along anything contagious. So I’m alone at home with the dogs.
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3 months post-op
It’s actually a week past the three month mark but I don’t suppose that matters at this stage of recovery.
I think I am doing well at this stage of my recovery. Not that I wasn’t before but I have again seen a bit of progress in the past week or two, which makes the end result seem a bit more realistic. It’s strange to think I won’t know for sure the surgery has been a success until I regain all my muscle strength and that could still be a few months away. Â I saw a different physio at my appointment last week. My usual one was on holidays and scheduled me with a colleague and now it seems I will stay with the new physio for the next appointment. I don’t really mind this aside from it feeling a bit disloyal to the original one. The “new” one is probably a bit older and more experienced and her assessment methods were more hands-on this time. Perhaps that would have been the case with the usual one too but I don’t suppose I will know now.
She has revised my home exercise routine now that I am back to more regular walking. I’ve been taking one of the dogs out three or four times a week, as the weather allows and I’m getting through the typical dog walk more quickly now than a month ago. Even when I’ve overdo the exercise I am recovering pretty quickly instead of being sore for a day or more. I am forcing myself to increase my pace while walking which seems to be working well. However, the mental aspect of concentrating on walking properly plus dealing with one of the dogs can be exhausting.
The new physio told me it’s likely she will be signing off on my treatment as of the next appointment. I guess that’s her way so saying there isn’t much else they can do and it’s just a matter of carrying on with the exercises I already have. She also said that one of my muscles is particularly strong compared to others with this surgery. I can’t recall which one it is but apparently others have a lot of trouble with it. The other physio did say a while back that most people struggle with leg extension so I wonder if it’s related to that because I have never had difficulty there.
On a related note, I made a sort of risky purchase online yesterday. The tread on my current shoes has been pretty worn for a while so I’d been planning to buy new shoes at some point. I read about a clearance sale by New Balance at their website and took a chance on buying some walking shoes. I normally prefer to try shoes on before buying but took a chance this time as I have been wearing NB shoes in the same size for several years now. I should have them by early next week so will know then whether it was a worthy risk or not.
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Knee update-10 weeks
Wednesday marked ten weeks since my knee surgery and the healing continues. After the first couple of weeks I could see definite improvements from week to week until I got to about seven weeks. Now the improvements are pretty subtle and sometimes it feels like I am going backwards from where I was earlier.
The incision has healed quite nicely and looks pretty good considering it’s only been a bit more than two months so far. I still believe it will be barely visible once it fades. I had an x-ray done and saw the surgeon last Friday. He says the bone is mending nicely and I am doing fine. BUT…it’s still pretty early days in the grand scheme of things so I shouldn’t get too frustrated at the slow progress.
I’d succeeded in getting full range of motion for my knee within the first four weeks and since then have been working on building up the muscles, of which there seem to be so many. Sometimes I feel like I am doing quite well but then run into problems when trying to use muscles that are still weak. Â I am doing better with my walking but still find myself limping at times. This is particularly true when I’ve tired myself out so it possibly is a matter of working out my own limits. I saw my physiotherapist this afternoon and she said I can walk or ride the stationery bike as long as is comfortable. I’d already been pushing beyond the original times she’d given me anyway, so I guess that will be okay…just that I have a bad habit of overdoing it sometimes and put myself at more risk of injury.
The night before my appointment with the surgeon, I started having knee pain again where it had been mostly absent for several weeks. I’d been having sporadic pains before but they usually only lasted for a few seconds and then I was fine. I mentioned the pain to the surgeon and he asked me a lot of questions about it. I was feeling okay by that time so I wasn’t too worried about it. It’s been more of a problem over the past week but I managed to avoid medication until last night, after what amounted to a particularly difficult day of trying to walk and not doing very well at it. I’d gone to a shopping mall for an hour or so and left with legs that felt much like jelly. It had been raining and the tread on my shoes was worn so I walked much like I’d have walked on an icy surface…and wore myself out really quickly. I’ve also experience my knee buckling more often than I’d like and that another mental factor last night that created more of a physical issue than I’d started out with.
The physiotherapy is going okay but it’s often hard to remember to do everything as many times and as often as I should. My physio stopped me doing mini-squats and switched me to a modified lunge instead. I’d been doing the mini squats for three weeks and still found they were hurting so I’m hoping the lunges will work better for me. I’m also to practice walking up and down stairs more. I apparently should be able to handle them with ease but I find it too difficult most of the time.
Today I was feeling rather adventurous and took one of the dogs out for a walk for the first time since surgery. It’s been a while since either has been out on a walk so I was kind of prepared to deal with some unsociable behavior. Overall it went reasonably well. Lots of nuisance barking and an attempted attack on a dog running loose. I spent much of the time correcting him so my very slow pace came in handy. Weather-permitting, I plan to do another walk tomorrow and keep working on the behavior problems. Fun stuff.
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The knee bends!
This is what I learned on Saturday when I went for my first physiotherapy visit. This appointment was far more useful than the post-op visit with the surgeon on Friday and I came away with new-found confidence. The physio got me properly walking toe-heel and she also had me bending my knee and hanging it over the edge of the table. It didn’t hurt! I think she thought I was worried about doing damage to my knee but I have every confidence that it will be just fine. I wasn’t confident that it wouldn’t hurt.
The physio also showed more interest when I mentioned the ankle pains and bruise that had come out. She suggested a couple of possible reasons and said we’d just keep an eye on it. I don’t think there’s anything to worry about exactly. Just would like to understand what is happening.
I was given three exercises to work on every day. The main one is about bending my knee as much as possible and I really don’t like it because it hurts. There are two others that are done less frequently and also cause less pain.
After that appointment I was out and about twice that afternoon. The first time I felt quite alright when I got home but the second time I pushed things a bit too far so that I was worn out when I got home. All the activity caught up with me and my knee got really swollen so wasn’t very good for movement. I’ve stayed off my feet most of the past two days and it’s still fairly swollen but I think it may be improving.
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Patella issues
Last year I started seeing a physiotherapist regarding my knee problems. After several visits with somewhat limited improvement, she referred me back to my doctor. I saw my gp, who referred me to an orthopedic surgeon and I first met him last month. After some examination and discussion of issues, he surmised there are actually two problems occurring. Firstly, I seem to have some sort of cartilage tear behind my patella and that’s causing the pain on one side. That is relatively easy to repair using a keyhole procedure called a knee arthroscopy. The second problem is my patella tracks well off to the side of my knee instead of up and down like it should. He sent me for a CT scan which confirms this and also shows it’s a bilateral problem. Correcting this problem requires something called a tibial tubercle transfer, which essentially moves bits around so that my patella tracks up and down again. It requires open surgery and an overnight stay in the hospital. I agreed to have the surgery but did have some concerns as to whether I was being rushed into it.
The Scientist suggested I go back to the physiotherapist to discuss from that perspective so I went to see her last week. She read the report of the CT scan and was of the opinion that I should go ahead with the surgery. She even asked if anything was said about my right knee, which rather surprised me as I don’t have nearly the same problems there. The physio seems to think having this surgery may prevent me ending up with a total knee replacement twenty years down the road. More importantly, she didn’t think the recovery would be all that bad as I will be fully weight bearing from the start. From what I’ve been reading, this seems to be reduce recovery time significantly.
Anyway, my surgery is booked for April 4th which hopefully will give me enough time to recover so that I might miss only one term of my tai chi class this year. The physio even suggested I might be able to get back to it much sooner but I will just have to wait and see how it all goes. And fortunately I only have to fast from 7am and don’t arrive for admissions until 11am. So no rushing out into early morning traffic for us.
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Physiotherapy
Back when I originally dislocated my kneecap, I was referred to the local physiotherapist to aid in the healing process. The physio I saw was an older lady and was perfectly nice and seemed to know what she was doing. She taped my foot to provide support, told me I needed a knee brace and should see a podiatrist for orthotics. Then she told me to do this very specific muscle tightening exercise where it was difficult to be sure I was doing the right thing. I followed her instructions and eventually my knee did get better. I’m not totally sure it wasn’t just due to the passing of time and the healing of the muscles or a combination of the two.
Since then, the problem has recurred from time to time and I have procrastinated about going back to the physio. After the current flare which doesn’t seem to have any specific cause, I finally got around to making an appointment and saw somebody today. The previous physio must have retired as the practice now has three young practitioners.
The practice had changed to a new computer system and it seems they didn’t get my old notes so there was no information on my previous visit. The physio today took a new history then had me lie on the table for examination. Then she suggested that we first try some dry needling, which seems to be a form of acupuncture. I was rather surprised at this since there isn’t scientific evidence of its efficacy. It wasn’t going to incur an extra charge so I thought I would go with the flow and see what it was all about. Three needles were used and placed in muscles in my thigh. The first one I hardly felt but the second one made me jump and the third was much like the first. Except that I was anticipating more that time and was probably a bit tenser than before. The needles only stayed there for a couple minutes and that was the end of that. I was told I might feel a bit sore there for a few hours but that didn’t happen and I haven’t noticed any effects. I think it was supposed to relax the muscles.
Then she had me try some exercises that she wants me to practice twice daily for the next three weeks. Unlike the one I was asked to do before, this one  made sure I was working the correct muscles and was easy to do. She then had me do a variation on the exercise and that was pretty much the end of the consultation. I am booked for another appointment in three weeks to see how I am going and to check how my knee is functioning. Also she doesn’t want me to wear a knee brace as it doesn’t let the muscles strengthen enough to function properly. Aside from the dry needling, I was pretty satisfied with the consultation and felt confident with the program prescribed.
I am now wondering if the previous one was a bit old school and possibly not up to date on current practice, especially as she was nearing what I assume was retirement age. I think she stopped practicing a couple years ago. It was quite a different experience from the first visit, considering this is the same problem.