the day after the day after

Summary: Two PT sessions today with Luke, great guy. Lots of knowledge about the knee. Goods news in the afternoon session I was at 113 and 10 (as usual, there's no way I could move between the two, but it's a start). Need to keep inching upwards and downwards and see where we get.

Morning session was with Luke, again with 15 minutes of wall slides. Did some assisted knee raises with my knee hanging out over the side of the bed - I was mostly raising it myself for the last set of the 2x10, but was having a little pain in the pateller tendon. Can't quite remember the order on these, but did a prone hang for about 5 or so and I pushed down with my other leg, received an 'overachiever' for that. We then did a little extension/flexion work, where Luke would place his left hand just below the patella tendon around my knee and gently lift up my heel with his right hand. Used a biofeedback machine to provide visual feedback on how strong I was flexing my quad muscle - it has a little indicator that raises and lowers as you squeeze the quad muscle. Got a little JAS (Joint Activation System) brace, which helps to both apply slight downward pressure while seemingly pulling your tissue away from your knee, so to not create additional tension on the knee. 20 minute of elevated ice on the GameReady machine, which pumps water at a constant 37 degrees around your leg and also compresses a little. At 2.5K, it does what it should do - keep my knee freakin' cold.

Subjectively, Luke mentioned that the patella is the key to the knee and that the joint was good; not really sure what he meant by the last statement, unless he meant it was only the tissue causing real problems, not the joint. Rae said hello again and we shared the Steady suplex where he pushed on my knee under anethesia. Rae wasn't sure about biking either, as Luke had asked me earlier.

Hit the afternoon session about 2 and headed straight to wall slides for 10 minutes or so. Hit 113 at the end of them. Evidently Luke had seen Steadman earlier to ask about me on the bike, and his response was the non-committal "if he has the range". So we were a go, and I pedaled forward and backwards on a recombant bike with little pain and little hip movement. Definitely a good step. After 10 minutes of that, hit the table again with the physioball, with Luke pushing on it back into flexion and out into extension, for a couple minutes. We then again did a little extension/flexion work, where Luke would place his left hand just below the patella tendon around my knee and gently lift up my heel with his right hand. After 20-30 seconds, he would gently bend my knee to maybe 50-60 degrees, and then repeat.

Patella mobs next and tendon mobilization next. Definitely tough to get straight enough to even move the patella coming from flexion. Luke had me lie on my back, which seemed to naturally help my mechanics. My tendon was moving pretty well, and I was having the hardest time with the up/down motion with the patella, which evidently is common, since that's where the scar tissue can form (Steady mentioned in the office visit that I had lots of scarring below the patella and a little above as well). Hit the prone hangs off the table for 10 minutes as well. We then used the biofeedback machine again, 2x25 with the quad, and then two one minute holds, keeping the monitor within the yellow, higher band. Then to the JAS brace for another 30 minutes, and 20 minutes of GameReady ice. Did I mention that thing is freakin' cold. Evidently, I startled a couple other younger patients who saw my knee. I'm still about the same level of pain but still have some significant swelling. Hopefully we can get that to drop soon. Forgot to ask Luke about exercises for tonight, so I'll do similar to last night and hit the CPM and ice.