Three days after surgery I have my first physical therapy (PT) appointment. My physical therapist, Shelly, unwraps my leg, and we begin by moving the knee cap around a little to make sure there is still mobility there. Then we do some electric stimulation of the muscles around the knee, particularly the inside portion of the thigh muscle just above the knee cap. They are particularly focused on this muscle. Lastly, I am asked to lift my knee to see how much the leg will bend. Did I mention that my surgeon said I will be in a locked straight brace on my right leg for four weeks? Of course, it came off first thing during PT, but now we are already trying to see how much I can bend it. I think I manage about 15-20 degrees of flexion at this point.
The first week after the surgery is focused on swelling and pain management. I also spend an hour or more each day doing the rehab exercises I have been assigned. Most of these are straight leg lifts in various directions with just the leg. Near the end of the second week, I am starting to get edgy. However, I review the doctor’s rehab prescription and see that stationary bike riding is allowed after the second week if range of motion allows. So, I email Shelly and ask her how much range of motion is necessary. As I am up to about 80 degrees of flexion, she says I can probably do it now and says to go ahead and try it over the weekend and tell her how I did when I see her on Monday.
So, at two weeks and one day after the surgery, I attempt to pedal the stationary bike. The first step is to raise the seat as high as possible while still being able to reach the pedals. Then I carefully put the right foot on the pedal and attempt to slowly move the pedal around. I quickly determine that while I thought the seat was as high as it could be, it couldn’t hurt to raise it up some more. Then I repeat the process with trying to get the right foot through the top of the pedal cycle. Before I manage to get the right pedal through one full cycle (with my foot on it), I adjust the seat higher two additional times. Finally, with just my right heal on the pedal, and some discomfort in the thigh as the pedal comes through the top of the cycle or the point where my knee is flexed the most, I begin to rotate the pedal at a painfully slow cadence. This first time out, I wouldn’t call this riding the exercise bike, but I do spend about 10 minutes moving the pedals around.
The next day, Sunday, I get back on the bike, and since the seat and bike are all perfectly adjusted, I start more quickly. The thigh is a little more flexible, and someone might mistake what I am doing for actually pedaling a stationary bike. I do this for a total of 15 minutes, but I don’t think I broke a sweat. I was able to get the cadence up to 30 RPMs. On Monday, I have another PT session, and Shelly is so impressed with my progress that she decides to start me on the treadmill—walking, that is, with anti-gravity assistance. Getting into this machine is no small act, but then we set it up for 50% of my body weight on my legs, and I walk forward for eight minutes and then backwards for two minutes. My pace is really slow at just two miles per hour, but that is faster than I have been hobbling around with the brace in the locked position. At this point, I am still wearing the brace when I go out of the house, but that need is slowly fading for me. I take it off to drive anyway. I will likely put the brace on to go see the surgeon next Monday as he told me to wear it locked until then.
On Tuesday and Wednesday, I ride the bike again, this time for 20 and 30 minutes, respectively. On both of these rides, I actually break a sweat, and during Wednesday’s pedaling, I get the RPMs to top out at 100. On Thursday at PT, I do some exercises and then it is back onto “the mill.” This time, Shelly says, okay let’s walk for five minutes at 50% body weight, and then reduce the body weight to 20%, speed it up, and try to slowly run. So, after five minutes, I punch a few buttons on the machine, and I am running. Shelly is surprised that I am not favoring my right leg at all. It is a weird sensation running with only 20% of my body weight on my legs, but I will take it just one day shy of three weeks since the surgery. After five minutes of running, I slow things back down, up the body weight, and walk for another five minutes. Overall, it feels awesome—even if I only traveled a little less than a mile (with a lot of assistance). The legs are a little tired, and there is a slight strain on the outside of my right hamstring muscle, but progress is being made. 7 months and 5 days until Hellgate—it sounds like an eternity, but I have a long way to go.
Never stop running,
Darin
