Saturday, May 16, 2009

Physical therapy

It was suggested that I note the steps of my physical therapy. That's a great idea. I'm sure I'll forget what I've done if I don't do this, so here goes.

First PT session was one week out from the surgery and then 2x per week for the following two weeks and then one final day on the fourth week post-op.

Session 1 (see attached photos)
1. sitting hamstring stretch
2. standing calf stretch
3. quad flexion (towel or pillow under knee with downward force)
4. knee extension (lying down will pillow under knee and extend lower leg upward)
5. hip adduction (squeeze pillow or ball with inward force)

6. hamstring strengthen (pull heel into surface)
7. heel slide (lying down pull knee toward chest close to 90 degree)
8. trunk stability (tighten buttocks)
9. standing heel raise (flex calves)
10. standing hip abduction (first session only move leg out 6-8 inches)

Session 2
1. Everything from session 1
2. standing knee raises max 90 degrees (use table for support if needed)

3. standing squats (use table for support and keep trunk vertical, squeeze buttocks on each stand)

Session 3
1. recumbent cross-trainer (10 minutes) (Click here to see the type of machine)

2. single leg press operated leg (10 minutes) (started with 60 lbs and moved to 75 lbs which is half my weight - was not to do more than half my weight)
3. recumbent bike (10 minutes)
4. hamstring strengthening (10 minutes) (this was done by sitting on a stool
(see picture) with 20 pounds of weight attached and pulling myself around the room - it really works well)
5. standing knee lift
6. squats
7. electrical stimulation on quads (15 minutes)

Session 4
1. Same as session 3 except no bike because I was doing that from home now
2. knee extensions on a weight machine (10 minutes - sessions with operated leg only and both legs)

Session 5
1. Same as session 4
2. Elliptical (10 minutes)
3. resistance backward walking (10 minutes - this was done by using a strap around my back that was attached on my front to a pulley weight system. I walked slowly backward and then slowly forward. I don't recall the exact weight but it was a comfortably hard weight, meaning safe but beneficial)
4. same as #3 except walking sideways
5. single leg step-ups (30 reps using the operated leg and holding a handrail for balance)

Session 6
1. Same as session 5
2. lying leg abduction (lying on non-op leg and raising op leg 6 inches - 10 reps x 3 - therapist told me to be very careful with this and not rush it - it was hard and painful, especially at first)

Session 6 was my last at the therapist's office, so I've been doing quite a few exercises each day at home. I generally alternate days on the harder exercises. Here are the examples of what I'm doing at home. I don't do each of these every day. I mix them up and alternate days with some, for example I won't bike ride and do elliptical in the same day.

1. stretch hamstrings and calves
2. standing knee lifts with 10 lb ankle weight
3. standing reverse knee extension with 10 lb ankle weight (works hamstring)
4. knee extensions using ankle weights or a bench/weight machine
5. standing side adductions using weight machine for resistance
6. walk 1-2 miles
7. lying leg abductions
8. core and upper body work (arms, shoulders, abs, back)
9. elliptical (up to 20 minutes per session now, increasing intensity and hope to be 30 minutes soon)
10. bike riding indoor on a trainer (essentially a stationary bike, up to 45 minutes now - working on increasing intensity and hope to be to 60 minutes soon)
11. leg press alternative (i don't have a leg press on my home machine so I simulate a leg press by holding onto a surface with my hands and squatting on one leg - I can control the weight/force with whatever I'm holding onto with my hands)

That's about it. I will modify and evolve as my body lets me.

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