Saturday, August 13, 2016

Day 26

Physiotherapy yesterday:
  1. Knee press, 2 x 15.
  2. Heel pulls, 1 x 15.
  3. Leg raises, 2 x 15.
  4. Balancing on the foam pad.
  5. Single-legged shallow squats on the foam pad, 2 x 12.
  6. Balancing with opposite leg extensions, 2 x 8.
  7. Squatting while leaning into an exercise ball against the wall, 1 x 15, focused on pushing off with the left leg.
  8. Leg abductions with the elastic band, 2 x 15.
Next session will be Wednesday next week, and we'll be doing some exercises on the stationary bike. The next two weeks I'll be having two sessions per week, and after that my usual physio comes back from vacation, so I will switch to working with him. Most of the exercising will be done at home now, so I bought a Pilates ball and a balance board today.

I went to the swimming pool today, a light session of some twenty minutes in the water. I tried crawl and breaststroke and both are doable, but require careful and deliberate movement. For crawl I need to let the left leg mostly hang in the water, just a little stroke here and there. Breaststroke is OK as long as I go very slowly and I don't force the leg strokes.

In other news, I'm officially descending stairs without any pain. Well, I can make it hurt if I intentionally put the leg into an awkward position, but stepping normally is perfectly fine. I can't really pinpoint when exactly was the first time I descended with no pain, but I noticed it today. Encouraged by this, I tried to run a step or two as well, but that's not really happening yet, though it is better than the last time I tried to take a few quick steps. 

The hematoma is receding but not completely gone, it feels like a slight thickening of the skin now. It is still visible though, when I look at it from the right angle. The bone and the tendons underneath feel interesting, definitely different than the other leg. It will be interesting to see what it will be like once it's fully healed and settled down.

Thursday, August 11, 2016

Day 24

Yesterday at physiotherapy:
  1. Knee press, 2 x 10.
  2. Heel pulls, 1 x 12.
  3. Leg raises, 2 x 15.
  4. Balance on the foam pad.
  5. Shallow one-legged squats on the foam pad, 1 x 12.
  6. Balance on the foam pad, extend the other leg forward, side, back, 2 x 5.
  7. Leg abductions with the elastic band, 2 x 15.
The same as last time for homework, plus balancing with leg extensions (number 6 above) - no foam pad so it will be easier to do, but that's OK. Next week we are starting exercises on the stationary bike - first time on pedals after the operation, very excited to see how it will feel.

Today, the DOMS is subsiding, I can finally feel how the knee is doing (the signal was sort of getting lost in all the noise from the aching muscles). Nothing exciting to report, still the slow march of progress goes on. Standing in one spot for too long is still not very pleasant - after an hour in the kitchen the knee feels swollen and stiff. I was hoping this wouldn't be such a problem by now, but not too worried taking into account the overall improvement that's happening. I haven't gone swimming yet, we had some guests over for a few days so I didn't have too much time in the evenings.

Tuesday, August 9, 2016

Day 22 (3 Weeks)

Yesterday's physiotherapy session (starts and ends with massage):
  1. Knee press 1 x 10 repetitions.
  2. Leg raises, 1 x 15 + 1 x 10.
  3. Squats with vertical lower legs, using wall bars for balance, focused on using mainly with the left leg, 2 x 15.
  4. Balancing on the left leg on a foam pad, not sure for how long.
  5. Shallow single-legged squats on the foam pad (not even close to 90 degrees of flexion), 2 x 10.
  6. Leg abductions with an elastic band, 2 x 15.
Homework for today: exercises 1, 3 and 6, plus a stretch done by laying flat on the back with laterally extended arms, bring extended leg flat down to the opposite side at 90 degrees to the body (e.g. bring left leg flat to the right side of the body) - all exercises 3 x 10 repetitions.

The knee felt very good right afterward, but became a bit sore and sensitive once it cooled down. I've noticed a change: it used to be least sensitive in the morning or after a rest, and it would get more tender and sore the longer I'd spend on my feet. Now it feels worse when I first get up, and then gets a better as it warms up.

Today is DOMS galore. Muscles throughout the thigh are sore and it's been getting worse as the day goes on. We'll see how capable I'll be to push it at therapy tomorrow.

The hematoma feels like it's starting to break apart and flush out. The swelling doesn't look much different, but it is softer to the touch, with less clearly defined borders. I hope it will be gone completely by the end of the week.

Sunday, August 7, 2016

Day 20

Yesterday morning, a phone call woke me up quite early. I checked the incision scar habitually, and the swelling was the smallest I've seen it yet, it looked almost completely gone. This was not very surprising as I did ice it before bed the night before. I went back to sleep after the phone call, and when I got up later, the swelling was back to full size, about as big as I've ever seen it. Strange.

I realized I haven't taken any photos that show the swelling, so here's a couple that show what it looks like these days:

Leg flexed to around 90 degrees
Leg partially flexed, around 45 degrees from fully extended

The incision is almost completely healed. There is just one spot with a small scab remaining:
It looks bigger than it is - actual length is almost exactly 5 cm

Today it's been mostly business as usual. I'm descending stairs almost normally now, just a little hitch here and there. I had a nice walk, forty minutes at least, and it felt quite good. There weren't any big oscillations in the size of the hematoma during the day - even after the walk there was no noticeable increase in swelling. All in all, feeling better and better, looking forward to more physio exercises tomorrow.

Friday, August 5, 2016

Day 18

I had a session with the new physiotherapist today. She started with massage, focusing on stimulating drainage of the hematoma and making sure there is no adhesion of the IT band around the area that was cut.

Next she had me do the following exercises:
  1. Knee press: lying on the back, with her closed hand placed between the knee and the mat; push the knee down into the hand as hard as I can, hold for a few seconds, relax, repeat. Maybe fifteen repetitions, didn't count.
  2. Heel pulls: still lying on the back, pull the heel back until leg fully flexed while she is providing resistance against the pull. Again didn't count the repetitions, but at least fifteen.
  3. Leg raises: same position but with a hard pillow under the knees with an ankle weight. Extend the leg, then raise to 35-40 degrees; hold a few seconds, slowly lower down and relax, then repeat. Around fifteen repetitions.
  4. Repeat exercise 2.
  5. Repeat exercise 3.
  6. Leg abductions with an elastic band: standing next to wall bars, straight leg abductions with an elastic band, around fifteen repetitions in two series.
To finish the session off, more massage focusing again on the swelling and on keeping the IT band free and loose. She told to me do the exercises 1. (against a pillow or a bottle) and 6. (3x10 repetitions) at home at least once during the weekend.

Wednesday, August 3, 2016

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.

Monday, August 1, 2016

Day 14 (2 Weeks)

Still improving, but still very slowly. It goes up and down during the day, so at times it feels like there hasn't been a change in a few days, and later it feels massively better. I guess it's also easy to forget that a particular move or position used to hurt before, once it no longer does. There are definitely no leaps and bounds though; it still hurts a little to go up stairs for example, and I still do the little hop-skip when descending them. The strange pulling feeling comes and goes too, so sometimes the most sensitive spot is there, while other times it's around the actual incision site.

Speaking of the incision site, the one thing that really hasn't changed much is the swelling/hematoma. It decreases a little with icing, but it comes back if I spend too much time on my feet, whether walking or standing in one place. I'm still icing it daily as it does feel better.

Physiotherapy starts Wednesday. The physiotherapist I planned to go to will be on vacation until the end of August, so I had to make an appointment with another physio I found at the same hospital where I did the surgery. My idea is to work on basic strength and coordination of the muscles around the knee in the following month, and then start the specific cycling and running work with the original physio once he comes back from vacation.