I had physio this morning and we measured my ranges, as we normally do once a week. It has been a little over a week this time since we did two hydro sessions last week instead of the usual program. Today was all about trigger pointing to release some muscles, measurements, review of the land program (as opposed to the water) and practice walking with the cane.
There have been improvements on both sides, with the biggest ones on my right side. My passive range of hip flexion on the right side has increased 9 degrees to 80 which I am really happy with. This measurement is made with the left leg straight and assistance to bring the right leg up as to isolate the joint. If both legs are at table top, the range is greater but it isn't an accurate measurement as it isn't just hip flexion. The passive range is less as I don't quite have the strength to bring my legs to a tabletop position on both sides which would improve the 'active' measurements. This is the only way to improve them as my knees are close to becoming the limiting factor measuring from a heel slide. On one of the measuring days, my knees and muscles surrounding them were really tight and before we used trigger pointing to release the IT band, my active flexion range was about 5 degrees less.
It's the muscles that are limiting the range now, not the actual joints. My physio program aims to improve strength and flexibility over time. The ranges that I have in all directions are better than I had pre-op, so the muscles that I am working to grain these ranges haven't been used for quite some time. The only range we aren't measuring is adduction as I'm not particularly comfortable with that range. I think this has a lot to do with 6 week restrictions not to cross the mid-line. I'm not entirely convinced that it is completely muscle discomfort either, I think that my brain learnt during that six weeks that it didn't like that movement as my hip could pop out and it's taking a little while to get over that. I didn't just learn this because I was told, for at least the first few weeks, if I accidentally moved my leg too close to the mid-line, it hurt and the hurt was a bad pain that was quite clear that it wanted to be avoided. It still feels like it wants to be avoided though not with the same level of pain feedback so I am taking it slowly with exercises in this range. I'm ok with that range taking a little bit longer than the rest.
Surprisingly, the muscles on my right side are starting to loosen up a little bit and it's the left side that's playing at being tighter now. Maybe this has to do with the different muscles used while driving, since that's one big change since the last time we released everything using trigger pointing. The clutch movement is very different from moving between the accelerator and brake. It's not really a big deal, it's just interesting to try to figure out what is making differences. The main reason that I know what side is tighter, is that is the side that hurts the most to release and so by contrast feels more amazing after the muscles are released.
Walking with the cane is a lot more difficult than crutches. I practiced for quite a while today. The movement is not natural at all yet and will take a little bit of time before I move to using outside of the house. The cane shows just how much weight I am still putting through the crutch and at what point the pressure is being put through it. Even though I can feel where I'm going wrong, I can't quite figure out what muscles aren't firing the way that they should. To help correct, we are practicing with exaggerated movements and have filmed me walking so I can see what it is that I can feel so that I can try to link the two together and get things working properly.
It feels like I have had another big burst of improvement over the past week and it's spurred me on again. Things felt like they were plateauing and I was having difficult staying positive and on task with everything that needs to be done. From what I've read, it seems this is a normal part of the recovery process. Some days are just harder than others and you need to just push through as some day soon there will be a massive boost which will restore your faith and move you a lot closer to your goals.
This is the first week that I'm going to pick up some more work. Depending on how worn out I end up for the next few days will influence how many updates there are between now and the weekend.
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