Mar 8, 2017

A Pain in the Knee: Part VIIII (aka Outer Quad vs Inner Quad)

In my last edition of A Pain in the Knee I talked about my PT evaluation and where I currently was. I was down to one PT session a week for six weeks ending with my last session being another evaluation. That one I am definitely hoping for discharge but my doubts that that would happen were rising since I was still struggling.

One of the things they are measuring for is for my inner quad muscle strength. The importance of that particular muscle is that is the muscle that holds my knee cap in place. That is the muscle we did all this for - well we technically did it for the tendon that was loose but this muscle is pretty key to all this.

On my first PT session they hooked my leg up to a isokinetic dynamometer to judge how strong my muscles are when I contract them. My first session my high number was about a 3. After nine weeks of PT at my re-evaluation my highest number was about 20. I felt like I had done a lot of work and my number wasn't very high. Just in case you were wondering the number on my right (good) leg is about 120. So I definitely wasn't anywhere close to where I needed to be.

So we continued PT. I continued to push with my at home PT. And yet I felt like I was stuck in a rut. I just wasn't advancing and it was making it even harder to do PT since I felt like I was getting nowhere.

My second PT session in my six weeks I had someone new. I had to take the appointment I could that week and I ended up with someone I hadn't had before. So I was kind of dreading. I already dread PT because of that rut and the fact that I just don't like PT. But the morning of that PT session I was dreading it even more since my leg collapsed on me earlier that day. I was just hanging up clothes and moving into the closet when my quad collapsed. My outer quad activated and caught me, but my inner quad didn't and my leg, knee and all, twisted in and had the wall not been there I would have been on the floor. It hurt a lot and I even had to take a moment to figure out if it slid out of place. It really shook me. And just went to show how weak that inner quad still was.

So when I got to my PT that afternoon, we talked about what happened and she told me that she was talking to one of my other therapist and she wanted to take us back a notch. Instead of steps and walking and squats which I can do, we were going to hook my leg up to a muscle simulator to get that inner quad activating. But first she wanted to see where my strength got up to and watch my leg to see how I was doing.

Immediately she noticed that when I tightened my quad (did a basic quad set) my knee tracked to the side. It was going in the very direction we were trying to avoid. So she had me focus on tightening my inner quad first then my outer muscle. And as soon as I focused on it, my knee stopped tracking and I was even able to get my number to 30. Which in just a few sessions was quite the jump.

We used a muscle stimulator which helps to get that muscle activating even after we turn off the machine. So for the last few sessions that's all I have done. One of my therapist told me that unless I have a move I have questions about that this was the best thing to focus on because this seems to be what's holding me back from being discharged. She also told me that it was on them for never noticing and never explaining to me how to do the most basic moves (that I actually got my very first session).

Of course I don't blame her. It's actually quite the long story and my thoughts and the therapist that gave me this exercise are not the best. So I'm not going to go into all that.


So eleven weeks into this PT and finally we have figured out what the problem is. And now I feel like I have forward motion again. I don't feel stuck in a rut anymore. I just hope that I can my strength up enough that I can finally be discharged (that doesn't mean I'm done with PT, it just means they are putting it in my hands to just build strength and endurance at home without their guidance).

A Pain in the Knee: Part I (aka The Backstory)
A Pain in the Knee: Part II (aka The Surgery)
A Pain in the Knee: Part III (aka The Recovery)
A Pain in the Knee: Part IV (aka Physical Therapy)
A Pain in the Knee: Part V (aka Still Recovering)
A Pain in the Knee: Part VI (aka Knee Surgery & Recovery + Being a Mom = Really Hard)
A Pain in the Knee: Part VII (aka Brace Off)
A Pain in the Knee: part VIII (aka Walk Faster!)

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