The Dynamic DynaSplint

Last Friday (a week ago) I got my DynaSplint. The rep came to the physical therapy office to fit it on me and show me how it works. It didn't take long to get a good fit and I picked up how to put it on and adjust it quickly.

The splint is held in place by four velcro tabs, two above the knee and two below. There is a set of two cams, one on each side of the knee, that assist in applying pressure to the leg, from two linear adjustment pipes below the cams. The rep started my splint out at level 3. She said she starts everyone there. It gives a lot of wiggle room. I am supposed to work up to wearing the splint from six to eight hours a day, preferably while I sleep. With my sleep problems I am not seeing this happen particularly easily. After taking off the splint, my knee is expected to feel stiff for a while. If it is stiff for less than an hour it is time to increase the tension. If it is stiff much longer than an hour or if it causes pain it is time to reduce the tension by a half-step. The goal is to get my knee straight! Zero degrees.

I have been wearing the splint for more than one session per day, and have worked up to about 3-1/2 hours total. Today the level is at six.

Unfortunately, the splint seems to encourage that "restless leg" feeling, so I tend to take it off often. However, I have had some longer stretches of time, asleep, no discomfort. As with everything else, I think the key is to get myself into a good solid sleep, which is much harder than it sounds.

Meanwhile, I continue with therapy as usual, no change. The various machines, then step-ups, maybe some rubber-band sideways steps, some "mobes" to help straighten the knee, then finally the infamous stim machine for fifteen minutes, both legs. All of these activities together, added to the work I do at the gym, should be helping with the straightening as well as the strengthening of the thigh muscles.

I have added a few more exercises to the gym routine after meeting again with Clara last week: rolling my thighs on a foam roll, to massage the soft tissue (pain!) and pressing a 12-lb medicine ball between my legs (quite effective).  I find that I enjoy hanging out on the mat after doing the bike and other machines at the gym. I feel like I can take my time there and get it all done.

I just read the title of an article that says you can do your exercises at home, you don't need a gym. I know that I don't need a gym but I find it much easier to get the work done there than I do at home. It is well worth it to me and I get the added benefit of having others around me encouraging me or offering additional examples of what I might achieve over time. If I devoted as much energy to keeping my house clean it would be some kind of miracle.

My right leg continues to cause me problems, although not all the time. I try not to let it discourage me.

On the Right Leg and Work at the Gym

Yesterday afternoon I had another appointment with Paul, the physical therapist. Almost immediately I asked him about the difficulties I am having in my right leg. He said it may be because I am not putting my full weight on the left leg, so the right is picking up too much. I said no, I am not skimping on using my full weight on the left. So he suggested that I try using my cane in the other hand for a few days to see if the legs can even out the load. I'm trying that.

He worked on pressing the knee down more, then flexing it, then pressing, then flexing. Most of the work initially was on straightening the knee. At the end of this part of the session he measured the range of motion and the extension - I am up to about 122 degrees flex and down to -5 degrees extension. That last five degrees reminds me of "that last five pounds". The hardest to get rid of.

The rest of the workout involved machines: the Total Gym, which allows me to do a modified squat, without putting my full weight on my legs, first. I found it harder to do for some reason, than last time. But certainly easier to get to a lower squat than I can do on the leg press at the gym. Following the squats I did leg curls, then leg extensions. And here a difference: Paul went to a class within the last six months and learned that doing a full extension (pushing all the way up and forcing it) on the leg extension machine is not advisable. Because the feet are not grounded, not carrying weight, there is a chance of damaging other parts of the leg, as I understand it. So he said to go about 3/4 - maybe 7/8 - of the way up, do not extend fully using that machine.

Then the bike, ten minutes at level 5 as compared to fifteen at level 4, which I did handily, again, averaging probably 65 rotations per minute. I guess that's hardly fast, is it?? But good enough. Lastly I got the stim machine again, this time both legs, ten minutes of straightening both for ten seconds on, ten seconds off. I'm glad we're paying some extra attention to the right leg too now.

I told Paul I'd be meeting with trainer Clara soon and what might I tell her about what I can work on. He said the extension (as explained), the bike of course, the leg press - but ask if there is another piece of equipment similar to the Total Gym for that. And he said she can call him. I felt like he was more open to my using the gym this time than the last time I asked, probably because I said the name Clara. She can make sure I don't hurt myself.

I made my way home stiffly, as usual. What will I do when I no longer have a physical therapist to look forward to? Honestly, it's going to be hard!  I am so glad that I have managed to stretch it out as long as I have.

Revenge of the Right

Today I went to the Strawberry Festival in Arroyo Grande, about 13 miles from home. This is a giant street fair, covering many streets up and down and back and forth in the "Village", which is the older commercial part of town. I parked on a dirt lot some distance away and took the shuttle to the festival. I spent about an hour walking up and down and around and finally back to the bus pick-up spot so I could return to my car, carrying strawberries of course.

Lately, and especially today, my right leg has started to complain when I walk. My hip hurts, my knee hurts, I feel twinges in different parts of my leg. My last therapist warned me that this would happen, that the change in alignment of my body would start to aggravate the pain in that leg. The ultimate solution is the right knee replacement, but for now I have one straight and one crooked leg and I have to figure out how to deal.

I thought maybe if I just walk longer it will ease up. It did seem to ease, just a little, but not much. I'm fretting about this a bit because I don't want to be limping on that side, I don't want to be just as gimpy as I was before surgery. I want to walk as normally as I can and feel as good as I can. So I will continue to work it very slowly and carefully, and when I see Paul on Tuesday I will ask about it.