Stupid Knee - Time for Physical Therapy

[dex]

Intro/Disclaimer: I'm feeling a little guilty for constantly bothering the wonderful Knot (who has been very, very helpful) with PM updates about my knee. Because I tend to have a hard time vocalizing/describing physical stuff (mind-body disconnect thing that I've had problems with my whole life), I've found it helpful in the past to write things down. Also, even when I can find the words to describe something, I tend to forget things when asked by a health care professional about what's been going on. And I forget questions I mean to ask. So, I thought I'd record my PT stuff here, so I have a place to reference later. (And doing it here means that I'm no longer bombarding Knot's inbox with updates.)

After an MRI done right before Thanksgiving, my doctor prescribed many weeks of physical therapy (something like 1-2x/week for 16 weeks). So, I started physical therapy today for the knee that has been giving me grief since the summer.

Here's what the physical therapist saw: overpronation, tight hamstrings and ITB, really weak VMO because I've been favoring the knee (a lot--I go up and down stairs one step at a time, if that's any clue), tilted kneecap, inflammation around my knee, and something else with my feet that I don't remember the word for but basically I point my toes pretty far out when I walk (which I already knew).

She explained everything that she was doing and why, but I was feeling a little dazed, so I didn't catch a lot of it. (Fault of my own brain deficiencies, not anything to do with her.) After all of the assessment stuff, there was some massage/manipulation of the ITB. That was uncomfortable, but I expected it would be since any time someone has tried to massage my legs (particularly my quads) I experience something that seems to be somewhere between extreme pain and tickling--to the point that I sometimes scream obscenities, hit and/or laugh and cry (no, I wouldn't subject the PT to that behavior...just the one friend who I sometimes trust to massage my legs when they're really tight).

Then we tried a couple of exercises. First was a leg raise thing--lying on back, right knee bent, left leg straight, raise left leg--that one wasn't a problem. Then we tried something else that was painful enough that I yelped--a stretchy band around my legs above the knees and small side steps--we tried a couple of different bands in different positions before deciding I wasn't going to be able to do that one just yet. After that was a hamstring stretch--lying on the floor with my foot up on a wall.

Then 15 minutes of electro stim and ice. I didn't get the impression that this was a longterm thing, but rather something to deal with the inflammation around my knee right now. After that, she taped my knee. She mentioned a name when she was talking about the tape, but I don't remember it now...um, McConnell, maybe? Anyway, it's just a single strip of tape (well, actually a gauzy looking piece of tape with a brown piece of tape on top of it) across the front of my knee. This is to pull my kneecap into the right place and help it track better, I think. And actually the tape does seem to be helping. I didn't have any pain while getting into my car and driving home (yes, even driving has been awful, because I drive a manual transmission little sporty car that's really low to the ground), and I managed to walk down the stairs to my front door with only a small amount of discomfort instead of the sharp pains and shakiness/instability I was experiencing before.

So, what I'm supposed to do now:

1. Get Superfeet insoles
2. Hamstring stretch - 2x30sec, twice a day
3. Leg raises - 2 sets of 10-15 (1x a day, I think...the paper doesn't say)
4. Swim for 30 minutes 2x between now and Tuesday (my next PT appointment)
5. Try to go for a 20 minute walk
6. Ice nightly

The goals:

1. Walk up and down the stairs normally
2. Get back on my bike!

Sheesh...that was long.

[sgtiger]

((((((dex)))))))

I don't have any advice to offer, but know that I'm here for you.

Your PT sounds great for explaining everything. I have the same problem remembering my doctors' reccomendations, so I ask to have them write it down and carry a notebook with me. It has the questions and observations that I have at random moments that I always seem to forget when I'm face to face with my docs.

[KnottedYet]

Girl, I am VERY interested in your PT! Bombard away!

Once you love your Superfeet (did she fit you and tell you what color to get?) she should wedge them for you. If not, let me know.

Yup, it's McConnell tape. Good stuff. She should teach you how to do myofascial release to your retinaculum soon, too. (same thing the tape helps do, you just do it to your own knee while watching TV or something)

So far, so good! PM me whenever you want, and keep us updated!

[crazycanuck]

Dex-I understand how annoying knees can be I do wish you good progress with your physio.

Are you able to do any water walking?

I'm happy to be part of the unhappy knee club (unhappy yet happy ya know) and will be joining the world of physio on the 15th(?)..

Throw your thoughts or frustrations at me if you want ..However Knot's a bit closer!

C

[Possegal]

i was in PT for what seemed like forever about 8 yrs ago. popped patella, immobilzed, probably for too long, leg wouldn't bend, couldn't walk right, did steps like you say, only leading with the other leg. yr later surgery. yadda yadda yadda. i had to laugh at your comment about screaming obscenities as i was quite well known in my rehab clinic for screaming bloody murder when they would force my leg to bend when it wouldn't bend on its own. the women working on me said scream away, as that way they at least knew i was still breathing. and frankly, it helped. but the other PTs would laugh and ask for warning as i was "scaring the other patients". i loved my physical therapists!

hang in there, you'll be back to normal eventually and you too can then look back on the torture and laugh. my knee is pretty good, not 100% or as i tell the dr, i don't have the knee i had when i was 20. but who does in their 40s. i'm still biking and running and working out and i know none of that would have been possible without the PTs and all their hard work.

of course i'm having some post-traumatic flashbacks with all the news coverage of the washington redskin QB and his popped patella. OWIEEEEEEE. all too familiar, that writing in pain he's doing in all the news clips!

anyway......

good luck, my knee sends it's encouragement to your knee!

[dex]

I had the best of intentions for swimming this morning. My body, however, had other plans. I woke up at about 4 a.m. with a low-grade fever and a stomachache, so I opted for Alka-Seltzer, turning off the alarm clock, and extra sleep. I did eventually get up and do some work, since all of the yuck feelings disappeared with sleep.

The thing I've noticed today is that I'm feeling a different kind of pain than I'd gotten used to over the last few months. Now it's across the whole of the front of my knee, there are occasional muscle twitches across the bottom of my quads, and just a general feeling of slight fatigue in the muscles. None of this is as bad as the sharp pain I was experiencing before, so it's definitely easier to deal with. I have to assume this is mostly a result of the tape. (I haven't done the leg raises yet today...I'm saving that for when I've slathered my hair with pink dye and need something to fill some time in a little while.)

Knot, if the PT told me what kind of Superfeet to get, I've completely blanked. I was planning on asking her about that on Tuesday.

[KnottedYet]

TrickyTiger works at the downtown REI. She is their Superfeet and running shoe goddess. She also happens to be a PT student. I will PM you her "real" name, she can help you find the best Superfeet.

I haven't seen her on the board lately, but you can call REI and ask when she works. I send patients to her all the time.

[trickytiger]

Trickytiger here! And to clarify a wee bit- I'm TRYING to be a PT student. Actually sending in my apps this week to schools! Say a little prayer for me.... and also throw in an extra line or two about how I should rock the anatomy final tomorrow morning. Would greatly appreciate that.

Feel free to PM me- or come see me @ work for Superfeet. Having had a stalker recently, REI will probably not give you my name or schedule over the phone.... but I am pretty easy to find, as I work weekends ALL THE TIME. I am an old hand at ITB issues, having lived through it myself. Come say hi!

[Wahine]

Dex - hugs. This is totally treatable and you'll be back on the bike. This is one of those conditions that often does not like the bike so don't be in too big of a hurry.

I have some good stuff on using a foam roll to release the ITB and hip (also very important for this type of thing). I'll PM ya. Keep us posted.

[Trek420]

Having had a stalker recently, REI will probably not give you my name or schedule over the phone....

Knott, I told you not to send the TE superfeet stalkers to REI Just Kidding.

Dex. Superfeet are great, Trickytiger and Knott both said Superfeet Berry is best for me. And they introduced me to the healing power of the Chaco which had even my podiatrist amazed that it helps my toe.

Listen to the TE PT's and PTA's, they are very wise.

[dex]

Thanks everyone. Y'all are awesome. Support, encouragement, and advice are always welcome.

I'm trying really, really hard to remind myself to stay patient. It took a looong time for things to get his bad, so it's probably going to take awhile for them to get better. I did find myself getting a little excited about being able to walk down two flights of stairs last night without yelping. (It's possible that it helped that I knew that once I managed those two flights of stairs, I would be rewarded with dinner and martinis. )

Now, if only I could get myself a little more excited to get up at 5:30 in the morning to go to the gym to swim. *sigh* Gin probably isn't an appropriate reward for doing early morning exercise, is it?

[trickytiger]

Dex- how are your new blue Superfeet treating you?

[jusdooit]

Don't want to seem stupid, but what's ITB stand for?

Feeling you pain Dex. I have terrible knees. I think I've just gotten used to the constant ache. Bending my knees sounds like gravel. I'm trying to get to the age to be a knee replacement candidate while I'm still able to walk.

Good luck Dex.........I'll be thinking about you.

[Wahine]

ITB = iliotibial band.

[dex]

Dex- how are your new blue Superfeet treating you?

My likey! Though I'm still getting used to that whole there's-something-in-my-shoe-that's-neither-foot-nor-sock feeling.