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Has Anyone Skied Aggressively on a Total Knee-Replacement, a relatively modern one?

post #1 of 38
Thread Starter 

I'm on the front end of recovery from a total knee-replacement.  I had a top surgeon do the procedure and it went very well, everything's tracking. 

 

I've been told that once this fully heals, 3-5 more months from now, that it'll be as good as new so to speak. 

 

Has anyone here skied on a TKR and please tell me about it. 

 

Obvious concerns are stability over anything else and given that they remove your ACL when doing these part of me is concerned despite that I've been told that it's no worry at all and that the "ACL" has been built-in to the new hardware. 

 

I'd like to know that I can get back to aggressive skiing with it.  I weight ~ 250/6'2" now, hoping to get down to 230 or so by the ski season and once I can get cycling again, which should also have the muscles around the hip/knee/leg back in good enough shape to render the knee stable from a muscular perspective. 

 

Anyway, I'm worried a little and it's obviously going to affect my skiing incrementally as I gain faith in the new knee. 

 

I doubt I'll go hit mogul fields again but I must admit, even at 53, they'll be tempting.  I would definitely like to hit some good blacks tho as I increase in my ability. 

 

Moderator note: move to Fitness, Health, Nutrition, Injury and Recovery

post #2 of 38

Here are a couple threads that should make you feel better.

 

http://www.epicski.com/t/70774/skiing-with-knee-replacement-surgery

 

http://www.epicski.com/t/130279/im-happy

 

Best of luck with the knee rehab.  I have a friend (not a skier) who did both knees when she was close to 60.  Took her time with the rehab.  End result was very good.

post #3 of 38
A friend, expert skier, still skis bumps on an artificial knee.

However, biking will not be enough to build leg muscle.

at your weight. You should leg press 800+ pounds.
post #4 of 38

Hmm, didn't realize how many threads there are about knee replacement surgery.  Listing a few more until I have time to create a new Tag.

 

Here is the story @Bob Peters wrote about his double TKR from 2014 that I couldn't find before:

 

http://www.epicski.com/t/127829/double-total-knee-replacement-pre-op-through-surgery-through-rehab-through-returning-to-skis

 

This is a thread from 2007 that was bumped in 2016:

http://www.epicski.com/t/54780/skiing-after-knee-replacement-surgery

post #5 of 38
Quote:
Originally Posted by rod9301 View Post

A friend, expert skier, still skis bumps on an artificial knee.

However, biking will not be enough to build leg muscle.

at your weight. You should leg press 800+ pounds.

Who says he should be able to leg press 800+ pounds??  Why?? Leg press is relatively useless for measuring strength as different models have the weight track at different angles to the ground and it is impossible to directly compare weights leg pressed on different models.  Leg pressing 800 pounds on your gym's leg press might be like 400 pounds on a different leg press. Additionally, leg press isn't exactly transferable to real life unless you plan on laying on your back and pressing things up into the air at a certain angle on a closed track with your legs.

 

That being said, squat would be a much better measure of applicable leg strength.  But, the squat itself requires a good amount of technique and I would never tell someone what they "should" be able to squat unless they are training for competitive powerlifting.  

post #6 of 38

Maybe not "total knee replacement", but close..

 

post #7 of 38

I have a 72 year old friend who had both knee's replaced last September, by January he was skiing the double blacks in Telluride. If I had to estimate I'd say he skied 80+ days and he skied great.

post #8 of 38
Gnar, that's the answer I typically hear when I recommend working with heavy weights.

People are against it because it's hard.

But if you want to ski well after injuries, the answer is get way stronger than you think you need.
post #9 of 38

I used to compete in powerlifting, so I think I know a little bit about working with heavy weights.  I am all for lifting heavy, but I don't think lifting heavy is a requirement for coming back after a knee replacement and nor do I think it is absolutely necessary for recreational skiing.  I think that proper rehab with PT which likely will include some degree of weight training is necessary for optimal outcomes after knee surgery/knee injury.  If in doubt, listen to the orthopaedic surgeon and PT, not random people on the internet (including me). 

post #10 of 38

I would suggest finding a good sports physical therapist, and much, much better if you can find one that specializes in working with skiers.  They can get you into 'ski shape' properly.  I do stress 'sports' physical therapist, as there are some that are content in getting you to walk from the la-z-boy to the fridge.  Than there are those that will work with you to ensure you reach your athletic goals.  The absolute best would be to find one that works with skiers, as they understand the movement and load patterns encountered, and can work with you to get the proper strength, range of motion, agility, alignment, etc.    If you look at a lot of top pro athletes, including skiers (Lyndsey Vonn as mentioned above) many have had knee and joint reconstructive surgeries - and they continue to compete at the top levels of their sport.  Than, I've seen people I know that once they have a knee surgery, they back off of every athletic endeavor, no more skiing, golf, cycling, etc, and they start living a sedentary life.  I think two things determine what happens after a surgery like yours 1) your desire to get back to it - which it definitely sounds like you have - good on ya mate! and 2) the quality of the surgeon (sounds like you got that covered) and the proper  physical therapy.  

post #11 of 38
Thread Starter 
Quote:
Originally Posted by Gnarvin View Post
 

Who says he should be able to leg press 800+ pounds??  Why?? Leg press is relatively useless for measuring strength as different models have the weight track at different angles to the ground and it is impossible to directly compare weights leg pressed on different models.  Leg pressing 800 pounds on your gym's leg press might be like 400 pounds on a different leg press. Additionally, leg press isn't exactly transferable to real life unless you plan on laying on your back and pressing things up into the air at a certain angle on a closed track with your legs.

 

 

In case you want to launch yourself off the mountain on the way down. 

 

:D

post #12 of 38
Thread Starter 
Quote:
Originally Posted by Gnarvin View Post
 

I used to compete in powerlifting, so I think I know a little bit about working with heavy weights.  I am all for lifting heavy, but I don't think lifting heavy is a requirement for coming back after a knee replacement and nor do I think it is absolutely necessary for recreational skiing.  I think that proper rehab with PT which likely will include some degree of weight training is necessary for optimal outcomes after knee surgery/knee injury.  If in doubt, listen to the orthopaedic surgeon and PT, not random people on the internet (including me). 

 

LOL

 

Actually, typically weights aren't part of the initial or even intermediate therapy at all for knee surgeries of most any kind.  That stuff would be reserved for once the knee is fully better and then dependent upon the condition of the knee otherwise, may or may not be wise. 

 

I know that leg extensions on a machine are a no-no for good knee health either way. 

post #13 of 38
Thread Starter 
Quote:
Originally Posted by ILOJ View Post
 

I would suggest finding a good sports physical therapist, and much, much better if you can find one that specializes in working with skiers.  They can get you into 'ski shape' properly.  I do stress 'sports' physical therapist, as there are some that are content in getting you to walk from the la-z-boy to the fridge.  Than there are those that will work with you to ensure you reach your athletic goals.  The absolute best would be to find one that works with skiers, as they understand the movement and load patterns encountered, and can work with you to get the proper strength, range of motion, agility, alignment, etc.    If you look at a lot of top pro athletes, including skiers (Lyndsey Vonn as mentioned above) many have had knee and joint reconstructive surgeries - and they continue to compete at the top levels of their sport.  Than, I've seen people I know that once they have a knee surgery, they back off of every athletic endeavor, no more skiing, golf, cycling, etc, and they start living a sedentary life.  I think two things determine what happens after a surgery like yours 1) your desire to get back to it - which it definitely sounds like you have - good on ya mate! and 2) the quality of the surgeon (sounds like you got that covered) and the proper  physical therapy.  

 

Yeah, thanks, I'm actually working with an alternate pysical therapist(s)/group that specializes in stuff like this and are cutting edge.  Perhaps needless to say, they don't work using prescriptions and don't take insurance for that very reason, because it limits them as they see what needs to be done but are limited by scripts.  Both used to be traditional physical therapists, now they own their own biz.  In fact, if you ever have specialized needs in that way, give me a shout, depending upon where you live it might be very worth your while to fly in and visit them. 

post #14 of 38
I know a bunch of skiers that have had TKR, including a few pro patrollers.
I'm four years post op THR and I can still ski at a very high level.
I ride my ass off and swim as much as possible.
I think swimming helped me the most.
post #15 of 38

There's a ton of TKR people on EpicSki.

Here's Shredhead THR at Aspen, two seasons ago:

 

Marcus, friend of Laurel Hill Crazie has been skiing at a very high level and he's about five years post TKR.  He was a very strong skier before and remains very competent in moguls and all other terrain.  He's in his late 60s and instructs at Seven Springs, PA.  Here at Blue Knob Feb 2016:

Marcus (left) on Chute trail at Mad River Glen, VT, 2013:

post #16 of 38
Thread Starter 
Quote:
Originally Posted by SHREDHEAD View Post

I know a bunch of skiers that have had TKR, including a few pro patrollers.
I'm four years post op THR and I can still ski at a very high level.
I ride my ass off and swim as much as possible.
I think swimming helped me the most.

 

Interesting, thanks Shred! 

 

Not sure swimming would do much for my knee but I'll definitely be cycling asap.  5 weeks post-op now, a little frustrated with the progress altho everyone says I'm ahead of average on recovery.  I still want to know when I'll be able to ride. 

 

I know that the muscles aren't the same for as skiing, but they will build up both leg as well as hip muscles/glutes, etc. which will add to the stability of the knee, which is what I need prior to hitting the slopes. 

 

No matter what it'll be better than it was.  I hadn't skied in several years because I was basically unable.  Last year I took the plunge and instead of watching my kids do lessons I went out and "hit the slopes" as it were.  I had no muscle control at all, it was pure experience and equipment/edge getting me down the mountain.  I did a few "runs" and called it an afternoon.  Was able to help my youngest daughter a bit at least. 

 

No fun.  At least the fun and ability will be restored. 

 

I'll try to remember to post a thread about the specifics as to how my knee et al felt once I get to that point, more from a technical standpoint from a physical perspective. 

post #17 of 38
Thread Starter 
Quote:
Originally Posted by Jamesj View Post
 

There's a ton of TKR people on EpicSki.

Here's Shredhead THR at Aspen, two seasons ago:

 

 

Marcus, friend of Laurel Hill Crazie has been skiing at a very high level and he's about five years post TKR.  He was a very strong skiing before and remains very competent in moguls and all other terrain.  He's in his late 60s.  Here at Blue Knob Feb 2016:

 

Marcus (left) on Chute at Mad River Glen, VT, 2013:

 

 

Thanks James! 

 

Good reassuring stuff!  That looks so great, it's been years since I've been anywhere good to ski.  Prolly Whistler/Blackcomb 15 years ago.  My knees have slowly been getting more shot for a decade or more.  So glad I had this done. 

post #18 of 38

The HDPE meniscus in your superalloy knee is the same polymer as the bases of your skis.

Last time I checked a knee joint is rated for about 20 million walking flexion cycles before the meniscus is worn out.

Replacement of a total knee is a nightmare involving big guys and a slide hammer.

Skiing loads this joint much more than walking.

You might only get a few million flexion cycles at carving loads.

Decide how you want to use up your new knee and pay the price.

Me, I'm trying to stick with my old worn out natural one until age 75.

That way I don't think I will wear out a replacement no matter what I do.

post #19 of 38
Quote:
Originally Posted by Wingmaster View Post

 

Not sure swimming would do much for my knee but I'll definitely be cycling asap.

 

Swimming and exercising in a reduced weight bearing environment, is about the best thing a big person can do.

I started off just walking in chest deep water.  Then I added crab walks, frankenstiens, walking lunges, skating, etc.

 

The trouble with PT, eventually insurance will stop paying.  Then unless you are rich or an elite athlete, you won't go.

Your rehab is totally up to you and you need to find something,  that you enjoy, so that you will do it often.

 

I got a high energy dog.  We ride every day at dawn and then again after work,  as much as possible.

 

 

He's a drill Sargent and doesn't tolerate me sitting on the couch.

post #20 of 38

I forgot to mention the most experienced EpicSkier, Bob McNeil, both knees and hips replaced and still skiing.  Life story here:  http://www.epicski.com/a/the-most-experienced-epicskier-bob-mcneill

post #21 of 38


I would like to suggest that you get a Skiers Edge, the Big Mountain series with independent Black Diamond foot pads. Using one works the same muscles as skiing. They are not cheap, but probably cheaper than a couple months of PT on your own dime. If you use it regularly your legs will be in the best shape for skiing they have ever been. Good luck!

post #22 of 38

Hi, Wingmaster.

 

I'll just chime in here as well.  I'm about a week away from the second anniversary of my total replacement of both knees.  

 

I don't think there's any question that you CAN ski at a very high level following TKR if you work hard at recovery and rehab.  I know at least a dozen longtime skiers here at Jackson Hole who ski extremely well and in every imaginable condition on replacement knees.  Several of them were my inspiration in making the decision to have my own replaced.

 

As for my own experience, I truly believe that my on-snow capabilities didn't suffer at all from having artificial knees rather than real ones.  I had the surgery on May 21 (2014) and did a little bit of hike-to skiing in the Tetons that September.  By the time we had natural snow in October, I was out skinning and skiing as soon as the snow was deep enough.  When the ski area opened in December, I was out there every day and skied something like 125 days at the resort that season.  I never shied away from any run or snow conditions because of concern for my new knees.  I was actually rejoicing in the fact that I could ski the junkiest snow conditions on the mountain with no concern about pain in my knees.  

 

I couldn't possibly be happier with the results of my knee replacements.  I'm 13 years older than you, a couple inches shorter, and 50 or 60# lighter.

 

I agree with some of the comments above that strengthening is absolutely critical for a successful return to high-level skiing.  I would really stress going with as wide a training regimen as possible.  I did a ton of biking, but also lots of time in the gym with various weight machine work.  Also, for me anyway, I think off-trail hiking in hills or mountains is outstanding for building strength in all of the tissues that stabilize the knee.  I did a great deal of hiking in the mountains starting at about the 6-week point post-op.

 

Anyway, I hope you have a great experience like I did.  Assuming your range of motion numbers (both flexion and extension) reach really good levels, I think you're going to find that your knee is going to be strong and reliable and will do what you ask of it.

 

Good luck! 

post #23 of 38
Thread Starter 
Quote:
Originally Posted by dakine View Post
 

The HDPE meniscus in your superalloy knee is the same polymer as the bases of your skis.

Last time I checked a knee joint is rated for about 20 million walking flexion cycles before the meniscus is worn out.

Replacement of a total knee is a nightmare involving big guys and a slide hammer.

Skiing loads this joint much more than walking.

You might only get a few million flexion cycles at carving loads.

Decide how you want to use up your new knee and pay the price.

Me, I'm trying to stick with my old worn out natural one until age 75.

That way I don't think I will wear out a replacement no matter what I do.

 

I have no idea how far 20M walking cycles even is. 

 

As to the artificial meniscus, I'm not sure they know what the capabilities are because the technology that I have is fairly new. 

 

Cycling's my big summer thing, I can't imagine that takes it down much. 

post #24 of 38
Thread Starter 
Quote:
Originally Posted by SHREDHEAD View Post
 

 

Swimming and exercising in a reduced weight bearing environment, is about the best thing a big person can do.

I started off just walking in chest deep water.  Then I added crab walks, frankenstiens, walking lunges, skating, etc.

 

The trouble with PT, eventually insurance will stop paying.  Then unless you are rich or an elite athlete, you won't go.

Your rehab is totally up to you and you need to find something,  that you enjoy, so that you will do it often.

 

I got a high energy dog.  We ride every day at dawn and then again after work,  as much as possible.

 

He's a drill Sargent and doesn't tolerate me sitting on the couch.

 

Beautiful looking hound!  LOL

 

He looks hi-energy.  Good points on the insurance and the like, I'm eager to get away from the rehab however, once they get that range-of-motion back. 

 

Right now, about five weeks out, I've got only about 90-degree ROM.  Unhappy about that, but they tell me that's normal. 

post #25 of 38
Thread Starter 
Quote:
Originally Posted by Jamesj View Post
 

I forgot to mention the most experienced EpicSkier, Bob McNeil, both knees and hips replaced and still skiing.  Life story here:  http://www.epicski.com/a/the-most-experienced-epicskier-bob-mcneill

 

Encouraging.  Bob's a couple of categories up from me tho.  LOL

post #26 of 38
Thread Starter 
Quote:
Originally Posted by JW MN View Post
 


I would like to suggest that you get a Skiers Edge, the Big Mountain series with independent Black Diamond foot pads. Using one works the same muscles as skiing. They are not cheap, but probably cheaper than a couple months of PT on your own dime. If you use it regularly your legs will be in the best shape for skiing they have ever been. Good luck!

 

Thanks for that advice!  Unfortunately cash is an issue for me right now, particularly since I haven't been working due to the pre-surgery hardship and now the recovery.  Eager to get back to work, but that doesn't help me presently. 

 

I've got it bookmarked tho and will follow-up on that. 

post #27 of 38
Thread Starter 
Quote:
Originally Posted by Bob Peters View Post
 

Hi, Wingmaster.

 

I'll just chime in here as well.  I'm about a week away from the second anniversary of my total replacement of both knees.  

 

I don't think there's any question that you CAN ski at a very high level following TKR if you work hard at recovery and rehab.  I know at least a dozen longtime skiers here at Jackson Hole who ski extremely well and in every imaginable condition on replacement knees.  Several of them were my inspiration in making the decision to have my own replaced.

 

As for my own experience, I truly believe that my on-snow capabilities didn't suffer at all from having artificial knees rather than real ones.  I had the surgery on May 21 (2014) and did a little bit of hike-to skiing in the Tetons that September.  By the time we had natural snow in October, I was out skinning and skiing as soon as the snow was deep enough.  When the ski area opened in December, I was out there every day and skied something like 125 days at the resort that season.  I never shied away from any run or snow conditions because of concern for my new knees.  I was actually rejoicing in the fact that I could ski the junkiest snow conditions on the mountain with no concern about pain in my knees.  

 

I couldn't possibly be happier with the results of my knee replacements.  I'm 13 years older than you, a couple inches shorter, and 50 or 60# lighter.

 

I agree with some of the comments above that strengthening is absolutely critical for a successful return to high-level skiing.  I would really stress going with as wide a training regimen as possible.  I did a ton of biking, but also lots of time in the gym with various weight machine work.  Also, for me anyway, I think off-trail hiking in hills or mountains is outstanding for building strength in all of the tissues that stabilize the knee.  I did a great deal of hiking in the mountains starting at about the 6-week point post-op.

 

Anyway, I hope you have a great experience like I did.  Assuming your range of motion numbers (both flexion and extension) reach really good levels, I think you're going to find that your knee is going to be strong and reliable and will do what you ask of it.

 

Good luck! 

 

Wow, thanks!

 

Big guys, like me, LOL, seem to always have more hardships, so I might not expect the same recovery time that you had, but I'm being as aggressive as possible within the pain restraints. 

 

Right now I'm five weeks out and am just starting to walk semi-normally again.  Driving is still tough but doable given that my flexion is at about 90 right now.  I've been 0-degrees on extension since the surgery which I'm told is the more important of the two.  Seems as if they can always task you to get another 5 or 10 degrees, eh. 

 

That hiking sounds good, I'll pursue that.  We've got a ton around here w/ the Appalachian Trail at my disposal. 

 

Question for you:

 

I'm not so concerned about pain re: skiing/activity, as I assume that will eventually diminish.  I'm more concerned about stability.  I know that they take your ACL out when they do these, and mine was problematic anyway so that's probably a good thing, and that there's a built-in "ACL."  I'm not convinced tho, particularly not for someone my size.

 

Do you use a brace, Donjoy or whatever, when you ski?  Or do you feel perfectly stable w/o anything? 

 

It's weird, I'm told I'm ahead of schedule, but then I read how people like you did and feel inadequately behind. 

post #28 of 38

I did not use a brace.  I had an acl replacement 25 years ago and wore a brace the first winter post-op, hated it, and never want to wear one again.  My own tkr doc told me a brace was optional and i optioned not to wear one.

 

I totally understand what you mean about hearing about other people's recovery from various surgeries.  What counts, however, is where you are at about 3 months rather than how you compare to someone else at week 2 or 4 or whatever.  Everybody heals at their own pace.

 

That said, I'm going to inject a little bit of a discouraging tone here with regard to your flexion range of motion.  I'm not your doc or your physical therapist, I'm just some guy on the internet, but I'd be concerned if I had only 90 degrees of flexion at week 5.  Have you been progressively gaining on that number or have you plateaued?  Not sure from your original post, but I'm not sure if you had one replacement or both?  Doesn't really matter that much, but I'm just curious.

 

From my own experience, most of my flexion improvement came during weeks 2-4.  From then on, it was gradual but slight improvement.

 

Have you talked with your doc about where your range of motion is at this point?  If he/she is happy with where you are, then that's great.  I just feel that you will need at least 120 degrees of flexion to be able to ski at a relatively high level.  

 

One of the most "enlightening" experiences all of my tkr friends (and I) had was that first time getting on and off a chairlift.  That move forces a pretty dramatic degree of flexion on your knees and it was a bit of a revelation.

 

For me, getting improvement on flexion was by far the most painful part of the recovery process.  I did prone heel slides, sitting heel slides, and back-on-the-floor-with-feet-up-the-wall heel slides, all of which were aimed at improving flexion.  My PT had a resistance-band machine that did leg presses with progressively more flexion.  All of that hurt - a lot - but got me to where I have excellent flexion.

 

Have you been riding an exercise bike?  Another thing my PT did was have me start on an exercise bike with a very upright seat.  Once I could comfortably make full revolutions with my legs relatively extended (the seat really high), he started gradually lowering the seat so that I had more flexion.  My PT also did ultrasound treatments on the incision site as well as a lot of manual manipulation for increased flexion.  All of that was painful but it was also successful.

 

Sorry so be a little bit of a bummer, but I think you need to make sure your surgeon is okay with that degree of flexion.

post #29 of 38
Had both knees done several years ago. Also had hips done.
I am 75 ,,going on 55!
Ski every day. In all but moguls!
What changed?
More technique,,,less muscular moves. I am a better skier now.
Must do more flexibility warm ups. Must learn to watch other skiers, since I have been hit twice due to " extreme skiers"!
Do not do power lifts,,,rather more lower weight reps.
Enjoy skiing.
Ski man
post #30 of 38
Thread Starter 
Quote:
Originally Posted by Bob Peters View Post
 

I did not use a brace.  I had an acl replacement 25 years ago and wore a brace the first winter post-op, hated it, and never want to wear one again.  My own tkr doc told me a brace was optional and i optioned not to wear one.

 

I totally understand what you mean about hearing about other people's recovery from various surgeries.  What counts, however, is where you are at about 3 months rather than how you compare to someone else at week 2 or 4 or whatever.  Everybody heals at their own pace.

 

That said, I'm going to inject a little bit of a discouraging tone here with regard to your flexion range of motion.  I'm not your doc or your physical therapist, I'm just some guy on the internet, but I'd be concerned if I had only 90 degrees of flexion at week 5.  Have you been progressively gaining on that number or have you plateaued?  Not sure from your original post, but I'm not sure if you had one replacement or both?  Doesn't really matter that much, but I'm just curious.

 

From my own experience, most of my flexion improvement came during weeks 2-4.  From then on, it was gradual but slight improvement.

 

Have you talked with your doc about where your range of motion is at this point?  If he/she is happy with where you are, then that's great.  I just feel that you will need at least 120 degrees of flexion to be able to ski at a relatively high level.  

 

One of the most "enlightening" experiences all of my tkr friends (and I) had was that first time getting on and off a chairlift.  That move forces a pretty dramatic degree of flexion on your knees and it was a bit of a revelation.

 

For me, getting improvement on flexion was by far the most painful part of the recovery process.  I did prone heel slides, sitting heel slides, and back-on-the-floor-with-feet-up-the-wall heel slides, all of which were aimed at improving flexion.  My PT had a resistance-band machine that did leg presses with progressively more flexion.  All of that hurt - a lot - but got me to where I have excellent flexion.

 

Have you been riding an exercise bike?  Another thing my PT did was have me start on an exercise bike with a very upright seat.  Once I could comfortably make full revolutions with my legs relatively extended (the seat really high), he started gradually lowering the seat so that I had more flexion.  My PT also did ultrasound treatments on the incision site as well as a lot of manual manipulation for increased flexion.  All of that was painful but it was also successful.

 

Sorry so be a little bit of a bummer, but I think you need to make sure your surgeon is okay with that degree of flexion.

 

Hey Bob,

 

I agree with you completely.  But I had my 1 month post-op appt. a week-and-a-half ago and they said it was fine at 90.  (88 I measured at on a cold rainy day on which she said that everyone was complaining about pain/stiffness) 

 

I'm seeing two different therapists, one on insurance, the other not because they're better and can do more, but both say they're not concerned.  I don't get it either tho. 

 

As to the rehab/process, pain comes and goes, it seems to be a two-steps forward one-step backwards kinda thing.  I think I'm going to go to a pool several times a week to see if that helps. 

 

I did get to 95 one day at therapy about two weeks ago, but there we mostly seem to be working on strengthening.  One thing I will say is that at the one-month the doc said that they typically stop therapy at the 2-month mark, but I envision absolutely no scenario where I'm at 110 much less 120 by then, three weeks from now on the 6th of June.  She was insistent that the next 2-3 weeks I'd see a significant decrease in swelling, and half-way thru that mark I've seen a little, but I guess "significant" is relative, eh.  As my wife says, my knee at least looks like a knee now and not like a rectangle. 

 

I see it constantly so perhaps my perspective is biased.  Driving is definitely getting easier for example, so there must be some improvement. 

 

I do know that I had some hip issues prior to this whole thing, likely caused because of my knee joint having bent more to the outside due to the greater deterioration of cartilage on the inside (medial side) of my knee causing that, the doc "re-balanced" it thereby lengthening my leg significantly and causing my posture not to be be ever-so-slightly lopsided.  This had caused severe tightness in my Iliotibial band for years that I have a hunch will take some time to correct on top of this standard rehab, I'm worried about that because I sense that it's hindering progress otherwise. 

 

The one therapist, the non-insurance on, understands this and is working on this with me.  He can because he doesn't have to stick to just the script.  He also thinks that strengthening my glutes will be the primary catalyst in correcting that, I suspect he's right.  Problem is how does one strengthen the glutes to that extent w/o the ability to exercise in a manner that works the glutes for extended periods of time, eh. i.e., I can't cycle, not even stationary, glute pumps only do so much as do squats to the extent that I can do them. 

 

And no, I cannot cycle even on the longest seat height.  Keep in mind I'm 6'2" tho with long legs, not a longer torso.  My therapists don't at all seem concerned that I cannot stationary cycle yet. 

 

What did the ultrasound do on the incision site?  The one therapist has been working with me on the incision, they specialize in making that heal supremely, I've gotten complements but both medical as well as other on how good the wound looks, not at all concerned about that.  But there is extreme tightness/pain all the way down the lateral side of my leg from almost my hip, in the knee joint, and then into the calf/shin, particularly the lateral muscle side of the shin. 

 

The one therapist knows that's the hang-up.  The other, the prescription one, seems to be sticking to script (generally speaking) on rehab.  I'm concerned that he's not doing as much as he should be, particularly re: range. 

 

I don't know, all I can do is rely on them I guess.  On a side note, I've been told by the prescription therapist that I need work on my patience.  He says I"m ahead of the curve.  Again, all I can do is trust.  But if by 2-months there isn't significant developments, ...

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