2 Months, 3 Weeks

It was good having the two weeks to settle into a workout schedule and really see what the effects would be. I did gym sessions every three days on average, alternating the focus between squats and deadlifts, with leg press and knee extension added at the end of each session plus the full complement of stretches. As a warm-up, I'd spend 20-30 minutes on the treadmill doing walk-jog-run combinations. In between the gym days I did some home exercises, mainly elastic band work for the gluteus medius and some balance work, but not frequently. These were the results.

The good:

• I improved noticeably at doing squats and deadlifts.
• I improved a little at running.
• I no longer get the feeling of tension and pulling in the area halfway between the kneecap and the incision site - I used to get it while walking at first, and later while running ever since the surgery.

The not so good:

• It takes me time to recover properly from the gym workouts, three to four days at least. In the days between sessions the muscles would feel tight and a little sore and the legs would feel heavy. I wasn't able to push myself on the bicycle and I never really felt like running or doing any exercises other than on gym days.
• The muscles improve faster than the joints. I started feeling some soreness under the kneecaps when crouching or kneeling if I wasn't warmed up. It wasn't a major pain, just a warning that I was starting to work them more than they could recover from.
• The area around where the IT band inserts into the top of the tibia started feeling sensitive under my fingers (I got into the habit to poke and prod the area every morning to see how it's doing, if there's any swelling etc.).

The obvious conclusion was that I should ease off on the gym work and replace it with more exercise for balance, coordination and proper muscle activation. The PT agreed with my conclusions and additionally suggested to decrease the loads on all exercises that strain the knees, so squats, leg press and knee extensions. 

The PT recently started training as an ultrasound technician and he acquired a machine for the office, so we used the opportunity to take a look under the skin during this week's session. Everything looks like it has healed up fine and there seem to be no residual swelling in the tissues. He noticed that the surgery was done very cleanly and neatly without any unnecessary damage. The hard bump looks like normal bone under ultrasound. The PT thinks it's most likely the normal epicondyle being more prominent since it's no longer being hidden by the IT band, but to me it still seems like it's slightly enlarged compared to how it was before the surgery. I still need to make an appointment at the hospital for the ultrasound that my doctor prescribed, so we'll see if they have anything interesting to add.

The bump is definitely smaller than before, but is nevertheless still prominent

The next PT appointment is in three weeks from now, so I'll have plenty of time to develop a new exercise routine. So far I've been a bit lazy this week - I've done just one workout session at home, but I did ride the bike more. I've upped the ride distance to over 20 km and so far all is good. I won't be increasing the distance next week since I've made quite a jump, but I will try to do some running outside. That't the plan at least, we'll see how it goes.

Day 16

I had the first physio session today. This one consisted of an ultrasound treatment, followed by electro-stimulation of the quads and finished off with a massage. Starting from Friday, I will be having more active sessions with exercises, three times a week for nine sessions in total (including the one from today).

In regular news, after the previous somewhat doubt-filled update, I'm now positive that the knee is indeed improving steadily. The strength in the leg is improving and I can apply more power before it starts hurting. A lot of everyday activities still cause some pain, but that's because I naturally push to the limit where it starts to hurt. For example, going down stairs yesterday hurt the same as the days before, except that this time I was able to go straight and with no hop-skip for the first time - yay!

The scar from the incision is also looking better and better. There's still some scabbing, so I won't be going to the swimming pool just yet, but I expect it to be fine by the end of the week.

All in all, I'm happy with where I am at the moment and I'm looking forward to starting active rehabilitation on Friday. I hope I'll get an exercise program to do at home as well, but even if I don't, the three sessions a week will provide a very welcome change indeed.