Week 0-1

Physical therapy began the morning after surgery. I'm back at the Sports Medicine Clinic, where my first therapist, Chris, identified the potential cartilage tear. But this time I'm with Sam, who is working closely with Dr. Birmingham to refine his rehab protocol.

I was a bit nervous, since my surgery was over less than 24 hours before, but Sam assured me that nothing too strenuous will be done. We talked first. What are my goals? Patients progress faster if they have something concrete to focus on, he said. So I picked getting back to Tae Kwon Do, being able to jog a half marathon, and being able to complete a sprint triathlon in the same amount of time (or better) than I had done beforehand. He thought those were good goals, perfectly within reach, and since they were longer term, I was less likely to push too hard. Sam went on to warn me that women between the ages of 30-45 were most likely to be too aggressive with their rehab, and have the highest risk of developing tendonitis. Duly noted.

For the first week, which oddly is counted as week zero, my rehab consists of the following:
1. 6-8 hours on the Continuous Passive Motion (CPM) machine. This machine moves my leg in a bicycle-type rotation while I lay on my back and study the ceiling. My goal is to increase my range of motion by a few degrees every day until I reach full range of 0-110 degrees.
2. Pelvic tilts
3. Bridges
4. Isometric exercises - squeeze various muscles and hold for 10 seconds, then release. I start with glutes, abductions, and adductions. Range of movement is about a half inch.
5. Game Ready unit icing as needed, but a minimum of 4 sessions a day.
6. Non-weight bearing, wear hip brace whenever not on Game Ready or CPM machine.
7. Sleep with my boots on. These are quite fascinating - very cushy boots that get attached to a large barrel that goes between my ankles by industrial-strength velcro. They prevent external hip rotation during sleep. I have to admit, this is the worst part of the rehab. Having my legs tied together brings me right up to the edge of a panic attack.

Luckily, I was on Hydromorphone, Indomethacin, and an anti-spasmodic since my psoas tendon was cut. These pills knock me right out, so sleeping with restraints is a piece of cake. Even after I gave up the painkiller, the other two kept me in a nice haze so I didn't care.

Amazingly, my post-surgery pain started out at the same level of my pre-op pain, and declined from there. Within two days, I was pain-free. Totally shocked!

Dr. Birmingham called me at home to find out how I was doing. I thought that was very nice, and unexpected. He apologized for the confusion at the hospital and assured me that he was working with them so future patients wouldn't leave in disgust. He asked me how the stationary biking was going. ??? I quickly learned that the hospital was supposed to put me on the bike the day of surgery, and Sam was to put be on the bike during rehab. Since that didn't happen, Dr. Birmingham was disappointed, but assured me that the CPM machine would take the place of the bike, as long as I went for the 8 hours.

Every day, the exercises got easier and easier. I struggled a bit on day 2 or 3 and broke down into tears at my loss of freedom and control. I'm exceptionally independent, and it's very hard to have to ask for the simplest of things, like a glass of water or a blanket. I look forward to getting off the crutchs, and start to understand that I need to be careful, or I will fall into the high-risk category due to aggressive rehab.