Lesson relearned: Establishing strength and stamina requires discipline – and a long, uninterrupted period of time, daily.
After ten days in the hospital, I lost a great deal of exercise time because we needed to complete a major move from Rome, Italy to Bangkok Thailand. Between July 12 when I had revision knee surgery and September 24 when we flew out of Italy, we had to do what moving people have to do: sell many of our household items, arrange for movers, pay off utilities, demolished our car, thin out our supplies, scrub down the apartment and say goodbye to choice friends. Thanks to a three-week visit from my sister, I was able to incorporate some physical therapy between these essential moving demands and was allowed a bit more rest in between activities. And, thanks to a rolling office chair, I was able to roll around the house doing what I needed to do when my knee was too tired or painful from bearing my weight walking or standing. Even with the pushing and pulling required by the rolling chair, and my three-day a week PT sessions followed by some thera-band work at home, I did not know just how much I had regressed.
When I arrived in Bangkok, the first appointment I made was with an orthopedic specialist in revision surgery. He made quite clear that I needed to resume physical therapy as if I had just completed surgery – I had regressed that much due to moving distractions. Thanks to his sound PT direction, I am now feeling stronger and more confident.
Here is what I now strive for daily, finally after 11 weeks and 4 days since my surgery.
Exercise routine for Strengthening
100 Straight legged lifts = Straighten leg, lift 30-40 degrees off firm couch, bed,or bench, with toes lifting towards knee. Hold for ten seconds, leg down (completely!), repeat. Pull heel towards wall in front of you to help position the leg correctly. Quads should feel tight and the knee should feel strong. Watch for hyper extension of the knee and adjust.
100 Hamstring lifts = On same firm couch, bed or bench and with firm rolled blankets or pillow or cushion under your pelvis, bend knee towards buttocks to a 25-70 degree angle. Feel for an angle that tightens your thigh muscles and pulls from your buttocks, keep lower pelvis pressed into the cushion so that your lower back straightens rather than crushes your lower vertebrae. Hold bend for ten seconds, bring leg down (completely), repeat. Hams should feel nicely tightened after this routine. Check for more shapely legs in a week!
Exercises for Stretching
1) Straight legged bend = Sitting straight backed, legs straight out in front of you, lean chest towards knees keeping back straight – feel the stretch for 10-20 seconds, release. Repeat.
2) Knee Bends = Stand and with hand or belt, grasp ankle and bend knee behind you, hold until the knee joint tells you to stop and or/ the front quad stretch has been exhausted. Repeat 2 more times, several times a day.
3) Various Yoga twists that massage the spine and that stretches the Iliotibial Band
Exercises in a Pool
1) All stretches named above, using the ladder into the pool to hold the ankle or to flatten both feet to reach for a Hamstring/Iliotibial stretch.
2) Bicycle motion for endless periods of time (usually between 10-20 minutes).
3) Straight legged crawl kick with or without a floating device (5-10 minutes). If you are a swimmer, enjoy swimming the crawl but mind the need for straight legs while doing it.
4) Kickboard drops = With kickboard, hold board down with revised knee leg, let board rise, push down, lift and push down repeatedly (i.e.3 sets of 20 per).
5) Walk backwards in water levels that you are comfortable with. The lower the level the more weight your knee bears (5 minutes) .
6) Walk forwards (5 minutes).
7) V to l – shaped sitting kick =sitting in deeper end of pool, press lower abdomen muscles towards spine using arms to hold you up, separate legs from hips to either side of your torso, turning feet toward each other press legs together. Turning feet away from each other, push legs apart. Repeat (60 times).
8) Leg Pulls = In lower end of pool, bend knees and lower body so that when the legs straighten out in front of you your chest to neck remain out of the water. Bend knees, take revised leg and straighten it out in front of you with the heel down on the pool floor. Require the leg to pull you forward until your straightened leg is now bent under you. Repeat with other leg. Right then left. Feel the quads tighten and the ham strings work (5 minutes).
Walking: 1.5 hours today in humid Bangkok. Home rest of the day. Still stiff legged and out of balance. Lower leg pain restrains me from walking anymore than I have today.
Golden Rule: Do not feel pain to gain strength. Feel tightening and then release. Feel for agreement by the knee to accept these exercises. No acute pain allowed, and no additional swelling encouraged. Tailor these exercises to your needs. Enjoy your icepacks afterwards if needed.
I have about one hour’s worth of walking stamina to manage the out of doors in humid Bangkok. Having the stamina to walk to metro stops and to grocery stores and back are currently a real challenge. Pavement is bad, sidewalks are crowded and traffic does not stop for pedestrians, even if they use the zebra-stripes….Today, I will take the metro two stops and back, with a half hour walk in between and a meeting in the late afternoon, a few stops north. I trust this will work….?
What do you do on a daily basis? What are your Challenges?