Friday, April 4, 2014

Let's Get Physical (Therapy)

I don't actually know anyone who enjoys physical therapy.  I guess in a way that makes sense.  You're there because you're in pain and you have to keep going there instead of doing the things you actually like to do until you're not in pain anymore.  It's not hard in the way that actual exercise is hard.  You don't sweat and groan and pant your way through it.  You also don't get the resulting high and sense of accomplishment that comes with a good workout.  Instead, PT is often comprised of small repetitve strenghtning exercises that don't feel like much except an exercise in endless, purposelessness tasks.  For instance, yesterday I saw a guy putting marbles into a jar with his toes.  I don't think that people would choose to do this of their own accord for fun (although it's probably a heavily featured activity in a porno somewhere online).
As I sat in my car in the parking lot outside my PT office yesterday before my appointment, it occured to me that it would be in my best interest to develop a somewhat more positive attitude toward my upcoming weeks of appointments.  Everything I've read about PCL injuries indicates that recovery is mostly dictated by patient compliance with PT.  That means I can't pull all my usual crap - like not following through with the exercises at home and forgetting to ask the questions that occur to me between sessions because they never do when I'm there.  Most of all, I have to try and believe it's going to work.  For me, that's the hard one.
When I sat down with my appointed therapist, an earnest woman about my age sat across from me and asked, "so, what's your time frame?"  My time frame?  I get a time frame?  I can tell you how long this is going to take? 
"The doctor thought I could get back in two or three weeks."  She frowned a little. 
"That's pretty aggressive.  How many times a week do we get to see you?"  She started flipping through my chart.  I know that it says twice a week and it wasn't long before she saw the script. 
"OK.  This says twice a week but we may want to get you in for three."  I decided I liked her.
From there she went through a lot of poking and prodding and bending and stretching to compare my left leg to my right.  She also went through a series of strength evaluations and measurements for how far each joint could bend.  Some of the things she found were no surprise, but not all. 
"Your hamstrings are weak."
No kidding.  I used to do some running and a lot more on the bike to prevent my quads from completely outbalancing my hamstrings, but I haven't been so good about it lately.
"Your quads are actually pretty solid."
I know.  I have a friend who makes everyone feel my quads every time I go over to her house for a party. 
"Both your adductors and abductors are weak and your glutes aren't as strong as they could be either."
What?  Your adductors are located on your inner thigh and your abductors are located on your outer thigh.  I always get them confused, so she demonstrated a sweeping motion, reaching out her foot and pulling it from the outside inward.  "That's your adductor."  That's a left foot crossover.  THAT'S weak?  Shit.
As we went through the exercises to strenghten those muscles groups, it became clear to me that these are the things that I probably should have been doing all along.  Those muscles all work to stabilize your knee and when one of them is too strong, it pulls your knee out of place and causes all kinds of imbalances.  I knew all of that before yesterday and before my 'big fall,' but it seems a hell of a lot more important now.  Damn you human nature. 
I asked about how much I could do at home. 
"Let pain be your guide.  You can do anything that doesn't hurt."  She glanced at the paper of exercises she had given me, "that says once through a day but you can do twice."  Twice it is.  Good thing I like her.  I'm about to start seeing her three times a week...
<posted on 4.5.12>

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