Hard to believe that day 500 of my recovery is Friday and I am not running, jumping or landing yet. I mean I can king of do these things if I had to, but they don't feel good enough yet to be part of my workout.
Why is that? Well the answer is lack of strength! I'm only 5 months into my complete do-over rehab. It's amazing how withered that leg was after a year of chronic pain. Based on studies I've read about patellofemoral pain therapy, this could take up to 12 months or longer to build muscle. I've put 12 months in my head just to call it safe. So that means I'm not even half way through the strength part. How do I know I am strong enough to move forward? I am using the Melbourne Return to Sport Score as my guide. It's goal based, not time based, great for me who fell off the timeline months ago. This patient friendly PDF has recently been updated by two physiotherapists in Melbourne, Australia. Just looking at the new pre-hab suggested requirement, I was no where near this state going into surgery. Hmm this tells a lot. Single Leg Squats are the keystone of Phase 2 of MRSS. While I just started these using TRX straps at the gym, I am pretty far from doing them for testing purposes. The knee still swells up, it has limits, I can't push super hard. The MRSS PDF goes into much more detail about the tests and referenced that support the tests. From the MRSS on Phase 2: "Regaining muscle strength, balance, and basic co-ordination are the goals of Phase 2. This phase usually commences with easy body weight type exercises and progresses into a gym-based regime with a mixture of resistance, balance, and co-ordination exercises. It’s important for clinicians and patients to ‘listen to the knee’ during this phase and only progress as quickly as the knee will allow. Increase in pain and/or swelling are the two main symptoms that indicate that the knee is not tolerating the workload. Typical exercises and management activities during this phase include lunges, step-ups, squats, bridging, calf raises, hip abduction strengthening, core exercises, balance, gait re-education drills, and non-impact aerobic condition such as cycling, swimming, and walking. Some clinicians may start some introductory impact type activities such as walk-jogging or mini jumps during this phase, but the bulk of this type of training should be reserved for Phase 3." Three most important goals of Phase 2 are:
0 Comments
This is an exciting update! For the first time ever since surgery, I am finally strong enough and pain is manageable enough to do ASSISTED single legged squats and lunges!!! (Photo below is not of me, but the move I am referring to.) Day 491 is about 16 months post op FYI.
I am using the straps on a TRX rack, 4 sets of 10 on each side. They do not hurt during or after, but yes they feel weird because of the weakness. This will surely get the vastus medialus and vastus lateralis working! Right now those areas look kind of indented due to lack of mass. Eventually I will use no straps and only body weight, then one day segue into using some weight. I also upped my leg extension weight on my operative leg (from 30 to 35 pounds) and for the first time ever last night, it didn't hurt (aka that doesn't mean normal)! I felt like I was doing the move proper. I just about cried at the gym! Ahhhh! 5 months of proximal muscle rehabilitation using heavy load and I think this is the biggest breakthrough so far! Lastly, a new exercise was added: the hip adduction machine (inner thighs). DPT said I can use the seated machine for this and use two legs at the same time. This saves me time because I'm already at about 2 hours at the gym each session. I'm thinking of using my NMES on my VMO and looking up the best way to do that now. UPDATE: These were later removed from my workout because I think they were a source of extra pain! |
AuthorA 45 year old active female who tore her ACL in January 2017 (at the age of 40). Reconstructive surgery in February 2017 with bone-patellar tendon-bone autograft. Archives
November 2022
|