Isokinetic exercise

i·so·ki·net·ic exercise  (s-k-ntk, -k-) n. Exercise performed with a specialized apparatus that provides variable resistance to a movement, so that no matter how much effort is exerted, the movement takes place at a constant speed. Such exercise is used to test and improve muscular strength and endurance, especially after injury.

The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.

I first heard the word "isokinetic" at the physical therapist's office where I worked on my left knee. Paul, the therapist, was testing an intern, asking her what it meant. She did not know. I guessed from the name something close to what it means.  In essence, however hard you work, the machine or exercise responds with an equal resistance.

In my present therapist's office is an isokinetic machine hooked up to a seat with a removable leg holder. My leg goes into the holder, is strapped in with a soft padded brace and velcro, and the machine is set. Right now I do eight sets of ten leg lifts using this apparatus. The harder I work the harder it works.  But never beyond what I can handle.

When I am on the stepper - a step machine in which I sit and step in a recumbent position - the machine is also set to "isokinetic". The harder I work the harder it works. So far, from my looks at the gauge, I don't work it particularly hard. But what I seem to get most from that machine is a stretch. I stretch each leg each time I push the step.

Swimming is a type of isokinetic exercise. If you move your arms slowly through the water you encounter a minimum resistance. The faster you move, though, the greater the resistance of the water. This may be one (of many) reasons swimming is such a good all-around exercise for just about everybody. I do wish I liked it more!

Today's therapy went well. I felt better, moved better, and Chuck noticed I was walking better too. Over this past weekend I have felt like I turned a corner. I still have a lot of pain walking much of the time, but I am noticing that more and more often the pain is not centered as much in my knee as in other body parts. My foot. My hip. Perhaps this is because they are adjusting to this new alignment. I still have pain in my knee, particularly in one place, and I just have to ride that out.

Just Cut off the Legs, Please

Yesterday my therapist joked, "just leave the leg here and I'll fix it". If only. I keep trying to find a way to detach myself from the hard part of therapy, the pushing done by hand. It not only hurts because it is stretching those long-tight muscles in back, but also because I am still having trouble with some pain spots on either side of the knee.

Lately I am having more restless leg issues, both during the day and during the night. I have increased the dose and used up all but one of the Requip (Ropinirole) tablets already. I need to get back to the doc to get the prescription amped up. But yesterday I looked at askapatient.com as well as medline to find out more about patients' experiences with this drug. Over 300 people had reported on their experience with it on askapatient, and some of the reports were frightening: "I wish I had never started it." "I want to get off it but can't". "I am taking more all the time". Signs of addiction, in other words. Among other "side effects".

I know of no other alternatives. I tried many remedies before heading for the doctor, and none worked.  I used to think I'd have this nerve manifestation less often if I were more active but it seems to get me no matter how active I've been. I am going to try to get into the doctor's office today because it is open on weekends and even into the evenings. Unfortunately, their early fame to short waiting times and on-time appointments have mostly been thrown away by an increased patient load. I'll bring a book, of course.

Getting On

I am feeling hopeful again. For the last few nights I have awoken less often and had less difficulty getting out of bed - less pain. I felt I got going more easily this morning. And the therapist continues to be confident that we'll get my legs straight.

I asked him today if we can get Medicare to pay for the extra therapy that is needed to get those straight legs and he said absolutely. My condition warrants it and my goals are reasonable - to have straight legs so I can walk right.

I will be going to Las Vegas for Christmas, spending ten days, so I also asked Chuck, the therapist, if he can let me know what I can do at Las Vegas gyms while there to help stay on track. He will do this. He's very easy in this way, flexible and helpful. He also has 42 years' experience, which pretty well speaks for itself. If the number of clients didn't already, including many with sports injuries. I learn different stories all the time, making my time there seem pretty darned mild in comparison sometimes.

Chuck told me that the stiffest leg he ever dealt with was on a nine-year-old boy. The boy had injured it skiing and it did not need surgery but it would not bend. He evaluated it in conjunction with the boy's doctor and found that he could bent it less than an inch. The boy was going around with crutches and a useless leg. The surgeon decided to do a "manipulation". This means the boy gets put under anesthesia and the surgeon then bends the leg. No cutting, just bending. The surgeon invited Chuck to join him in the operating room and the two of them tried to get the leg bent while the boy was under anesthesia and it still would not budge! So it was not merely a matter of the boy's fear. This is how they approached it: they put him in a rehab center, in bed with a Continual Passive Motion machine bending the leg as best as it could 24/7, for a LONG time. I do not know how long, but until it started to overcome the resistance and show some softening. Once he got to that point, he got to get out of bed and undergo more traditional physical therapy four times a day. And this way they got it to bend again. He is now in high school and remembers those days well, Chuck said. Doing well.

And here I am, going to PT three times a week and getting to the gym for Aqua classes three times a week and I moan about pain and inability to do everything I want. Seriously!

Driving is still painful but a wee bit less so. I figure I'll take the plunge and drive myself to the Santa Maria airport for my trip this time. Extending the effort.

In general I am trying to get up and move around more frequently. I was doing this while seeing a home therapist but somehow lost my habit when I moved to outpatient. Get up, move around, sit down again. Rest, get up and go again. I am using my iPad and my iMac to play favorite music on iTunes a lot more, too. It just cheers me up. Cat Stevens right now. What can I say? Some things don't get old.