Friday (Day 35)
I just got back from the doctor and wanted to post new information before some of it slipped my mind. There was a lot discussed so forgive the length of this post.
He was surprised by the swelling still in my knees, but he said that level was not totally unheard of. The statement "you'll be able to do whatever you feel comfortable doing in four weeks" has now changed to "lets give it another six weeks of rehab and see where we are". I was not happy and we discussed what I had done since the surgery.
He agreed that I had not done anything crazy but I should have more focus on stationary bike work. He was fine with the rehab exercises I was doing and said I would not benefit from working with a physical therapist but he was welling to refer me. I declined the referral. He said I should continue to avoid squats, lunges, and any weight work. We think the problem might be I can tolerate pain pretty well in my activities but that activity is causing the swelling.
Overall I'm happy with my right knee. The only problem is the entry point at the top outside. This did not heal as cleanly as the others and it causes the most pain. All the entry points hurt somewhat if I rub them hard with my fingers. There is a lump under the skin and the tendons/muscles that he "drilled" though are still sensative and therein lies the problem. He said he could give me a shot that would help if I wanted. I declined. He said this will problem improve over time and should be non-existent within 3 months. Once again, I'm thinking "what happened to 4 weeks!?". ROM on the right knee is great and the grating crunchy sounds/feelings when I move the knee are pretty much gone.
The left knee, where more work was done, also has good ROM. The quads have lost more strength on left than right. He said this was normal and more bike work would help strengthen them. He said to avoid the things I mentioned earlier and not to do things like weighted leg curls that would normally strengthen quads. He said the greater stiffness that I have experienced is to be expected and some catching was normal. We would both be concerned if catching occurred after going through some motion early in the day, and that is not the case. Catching pretty much is a first thing in the morning thing. Once again he said the stiffness would go away over time.
We discussed the pain in the back of left leg/knee and he did not seem to concerned. He said it was normal for things not to seem just right for sometime. He said something about my body/nerves/mind still trying to get things back to normal and I would get there. So these issue is also in the "we'll worry about it in six weeks" category.
He once again stated that both my knees were sound and in good shape and that the chances of me hurting them again were not greater than if I had not had any problems to start with. He did say that "excessive" physical activities would continue to cause swelling and delay recovery. He suggested that I start doing ice rubs with dixie cup popsicles and I will as I've done this often in the past with other issues. He said it would be hard to ice to frequently but avoid longer single periods over 15-20 minutes. The goal is to increase blood flow to the area to help clean things out.
One thing that we had discussed in the past was doing hyaluronic acid injections. This is something he does with his knees and he feels it might benefit me. So we tentatively have that scheduled for next week as they have to see if my insurance covers it. I've included a couple of links below with more information in case anyone is interested. If anyone has had this done I'd be interesting in how it went.
So at this point I plan for another of week of limited activity and sitting my butt on the stationary bike at the "Y" each day. I also have some workout bands/tubes that I've started to use more frequently. The community pool opens tomorrow and I'm might add a little swimming to mix. I'll reevaluate the tennis situation early next week. I've already dropped points having been unable to defend my results at the first major zone of the spring/summer season and its just killing me missing the majority of the team spring season.
hyaluronic acid injections links:
http://www.aafp.org/afp/20000801/565.html
http://osteoarthritis.about.com/od/osteoarthritistreatments/f/visco_hip.htm
http://www.webmd.com/osteoarthritis/osteoarthritis-of-the-knee-hyaluronic-acid-joint-injections
