karinajean: the strengthening!

[karinajean]

My first NF challenge involved a full tear of my ACL.

My second saw a surgery to replace the ACL, and initial recovery.

My surgeon is happy with my progress and this challenge will dovetail with my physical therapy goals: strengthening! I need to get my surgery leg back up to beast leg status.

I've been away (I'm still away) for a long weekend so I am putting up the bones of my challenge here and will need to revise it with more specifics. And like last time, these goals feel a little non-assassiny, but I need the support, and y'all are fun.

GOAL 1: most awesome and best effort PT.
I'm prescribed physical therapy 3x a week for 7 weeks with my next check up 9/3.

I have a set of at home exercises - every day.

I need to sit with my PT this week and find out what else I should be doing at home, and how to structure a gym program, and how many other things I can be doing.

I'll get all the details straightened out this week (tomorrow?) and post updated specifics.

GOAL 2: the rest of my body.

It's time to start upper body and abs again!
Everyday is leg day, so the challenge is fitting it in. I'm going to start a dumbbell arms/back and neilaray abs workout 3x a week. 2x this week, 3x the following weeks.

I'm also going to start fitting in pull-up practice, but I have to test my feelings about using a pull up band with my surgery leg. Pull-ups are a long term goal, and I don't want to leave them out.

GOAL 3: on purpose veggies.

It's summer, and the farms around me are amazing and productive. I am going to eat on purpose vegetables every day. This means going to the farm stands and prepping something, not just relying on hands-full of lettuce every night.

LIFE: be nice to myself and ask for help.

 

It's going to be hard fitting in PT with my regular job, and picking up the boys on our nights. I need to get sufficient sleep and enjoy the summer a little. So every week, I need to think about my stress level and if I'm doing too much. I have a summer to enjoy!

(Other.) I track calories and weigh myself with the goal of ultimate weight loss. I have about... 10-15 more lbs before I sit back and evaluate what I want to do with my body shape. For now, I'm too out of control of my exercise to make weight loss a goal. It should follow with the rest of a healthy lifestyle.
 

 

Goals | Week 1 | Week 2 | Week 3 | Week 4 | Week 5 | Week 6

[Sloth the Enduring]

This looks like a solid plan. Getting your healthy habits in place before you think about weight loss is very sensible.

If you don't want to use a band for pull ups, you could substitute inverted rows for now.

[karinajean]

I have a set-up for inverted rows but it involves climbing up and balancing on the top of my dryer, and I'm not sure my legs are stable enough for that too. I was doing both assisted pull-ups and inverted rows before my ACL tear - but I'm just going to have to experiment with what I've got for this challenge.

Sent from my iPhone while riding a unicorn through the cosmos.

[RedPandaOne]

Excellent challenge with a nice solid plan of attack. Subbing of course

[Nymeria]

Yay!  You're back!

 

The pull-ups can be really tricky at first.  I'm sure it was mostly a psychological hurdle for me, but I was terrified about standing on a chair to get up to the bar or falling off somehow.  My solution was to suspend my rings low enough where I could grab on, then lower myself into a hang by pulling up my legs, and then doing my pull-ups.  That way, I was much closer to the ground.  I don't know if I'd do band ones at this point.  If you could find an appropriate height bar, maybe negatives or flex hangs would be a good idea.  

 

Also, while it's not ideal, you could for now do a lot of lat pulldowns at the gym.  You'll work the same muscles while protecting the knee.

[AnnieP (respawned)]

Yay, you're back!

The BBWW uses bent over rows as the "pull" exercise. Obviously, you'd use heavier weights than an 11 pound milk jug, but perhaps that would be easier with your knee.

Sent using Tapatalk Owl Post.

[Elastigirl]

Great plan. Share with us the veggies you eat, I need the ispiration.

[Twilight]

OMNOMNOM veggies! They get tastier the cleaner you eat!

 

Woohoo, new challenge!

[karinajean]

Great plan. Share with us the veggies you eat, I need the ispiration.

OMNOMNOM veggies! They get tastier the cleaner you eat!

Woohoo, new challenge!

I used to belong to a community supported agriculture group and got a basket of veggies every week from a local farmer - it was so great, I never knew what I'd get and it was like a kitchen challenge to use it all up before the next basket was due. My farmer stopped the CSA a couple of years ago and I've been backsliding ever since. I think this will be really good for me - I'll take pics, for sure.

Sent from my iPhone while riding a unicorn through the cosmos.

[karinajean]

Yay! You're back!

The pull-ups can be really tricky at first. I'm sure it was mostly a psychological hurdle for me, but I was terrified about standing on a chair to get up to the bar or falling off somehow. My solution was to suspend my rings low enough where I could grab on, then lower myself into a hang by pulling up my legs, and then doing my pull-ups. That way, I was much closer to the ground. I don't know if I'd do band ones at this point. If you could find an appropriate height bar, maybe negatives or flex hangs would be a good idea.

Also, while it's not ideal, you could for now do a lot of lat pulldowns at the gym. You'll work the same muscles while protecting the knee.

Yay, you're back!

The BBWW uses bent over rows as the "pull" exercise. Obviously, you'd use heavier weights than an 11 pound milk jug, but perhaps that would be easier with your knee.

Sent using Tapatalk Owl Post.

These are great ideas, thanks!

We are still traveling (we drove to a family wedding this weekend - so over 2000 miles trip from Thursday to today) but tonight I mean to get out my "new rules for lifting" and check the bodyweight exercises here and at the NF academy to develop a program.

Sent from my iPhone while riding a unicorn through the cosmos.

[karinajean]

Excellent challenge with a nice solid plan of attack. Subbing of course

Yay! And thanks. I feel really unprepared for this challenge. I've been thinking about it a lot.

Sent from my iPhone while riding a unicorn through the cosmos.

[MasterOfCows]

YAY!!

 

I keep marvelling at the differences in PT programs.  I'm only going to formal PT once a week, but like you at home exercises every day.  Last time when I was there I asked about all the different leg raises and I'm going to be covering off the ones I'm not currently doing with other exercises.  Protocols from different hospitals in the city even have some major differences.  It's weird.

 

Also, I miss dumbbells, so hit them extra hard for me.  I'm excited to do arm/back and ab stuff too again.  My ab stuff will be a little lacklustre for the first bit, probably just hollow holds for now.  I'm hoping to get a more comprehensive program put together on Wed. when I see my physio next.

[VTSPE772]

I have been waiting for your new challenge post...glad you could get it posted while on vacation!  Have a great time.

[karinajean]

YAY!!

 

I keep marvelling at the differences in PT programs.  I'm only going to formal PT once a week, but like you at home exercises every day.  Last time when I was there I asked about all the different leg raises and I'm going to be covering off the ones I'm not currently doing with other exercises.  Protocols from different hospitals in the city even have some major differences.  It's weird.

 

Also, I miss dumbbells, so hit them extra hard for me.  I'm excited to do arm/back and ab stuff too again.  My ab stuff will be a little lacklustre for the first bit, probably just hollow holds for now.  I'm hoping to get a more comprehensive program put together on Wed. when I see my physio next.

 

it's CRAZY how different they are - and my PT seems to be marveling at my surgeon's direction. Apparently most doctors in this area brace after surgery, which is a really big difference - mine doesn't at all. And I had forgotten my prescription sheet on the first trip so the PT based the first day off of another protocol he was familiar with, and when I went on the 2nd day with my sheet, he had to add 3 more exercises to the list.

 

and dude. Hollow holds are NOT lackluster. I'm actually just trying to get my guts up to do them! I'm going to be following this set of exercises because I don't think they will strain my knee too much - no elbows to knee, and no planks.

[karinajean]

I have been waiting for your new challenge post...glad you could get it posted while on vacation!  Have a great time.

 

thanks! it was a long fiddly typing session on my iphone, that's for sure.

[Nymeria]

it's CRAZY how different they are - and my PT seems to be marveling at my surgeon's direction. Apparently most doctors in this area brace after surgery, which is a really big difference - mine doesn't at all. And I had forgotten my prescription sheet on the first trip so the PT based the first day off of another protocol he was familiar with, and when I went on the 2nd day with my sheet, he had to add 3 more exercises to the list.

 

 

It's especially funny in that I went to PT 2x/week throughout (so different from both of you), and did some different exercises and progressions.  I didn't do any freestanding squats of any depth until I was 3 months out of surgery, but instead did wall squats, and then later TRX squats.  

 

And yeah, hollow holds are not at all lackluster.  They're one of those exercises that are really easy until they're suddenly not.  I think they're much better than planks for core building, and my hollow hold time is maybe half of my plank time.  Just make sure that your arms and legs are close to the ground, and your back isn't arched at all.  You'll feel the burn.  

[karinajean]

SOOOOO I'm back from our trip from NY to Columbus Georgia (via a construction meeting in NJ) and then back home via Columbia SC. I saw a wedding, two new babies, and 5 of my 7 cousins on my dad's side. We could have flown, but my husband just wanted to spend some quality time together not rushing around from airport to rental car to event to airport, so we cleared a little extra time and held hands in the car. We are good driving companions. I really appreciate that.

 

 

I also appreciate that we spent seriously, over 30 hours driving and eating road snacks, and more cheez-its than I've had all year (possibly all last year), and I only gained a tiny bit of road weight. I'm going to be tricky and use this as my starting point for the challenge even though I fully expect one more day of regular life to flush all the extra salt and water out of my body.

 

 

* we did concentrate after day 2 on making sure we were eating things with fiber in them. that's a good road food requirement. we had fruit in the car on the way home. I ate some salads. I chose the steak instead of the waffle at waffle house. in general, I didn't have the sweet tea - this is a BIG sacrifice when car-tripping through the southeast!

 

and I did my leg exercises EVERY DAY.

My leg got stiff and sore in the car, but we stopped and I made a point to walk around for a bit.

It turns out that standing up and letting my weight adjust between the two legs before taking a step is MUCH more effective than trying to "walk it out." walking it out = staggering around in a way that was a little too uncontrolled for me.

 

so because we just got back yesterday evening after waking up way too early to get on the road again, I'm having a soft start this morning. I did order groceries for the week, so I can pick them up at the store tonight. I'm going to stop by a farm stand tomorrow on my way home from work/way to physical therapy, so I can get my on-purpose vegetables. And tomorrow morning I'll start the abs/etc.

 

Because I'm hung up on schedule, notably -

 

up at 5:00

Leg exercises done by 5:30 (YAY, fastest EVER)

out the door by 6:25 (about 10 minutes later than I wanted to be)

at work by 7:15.

today I'm off to PT at 4PM from work.

 

I'm a little stressed out about all the things I need to do this week (including! birthday dinner for littlest dude on Wednesday, attending his summer camp play on Friday, and fitting in 3x PT this week while making plans/getting gym membership for the PT next week when my PT is out on vacation and his office is closed). but I'm talking it out with my husband and I am sure we'll get it done.

 

it DOESN'T HELP when my iphone helpfully tells me "you have a busy day today. you have 10 events scheduled." I'm going to stop looking at that screen.

[airinpie]

Would you be willing to share your leg exercises?  I have had meniscus surgery on both knees this year (5 months apart), and am working on getting my strength back up.  My doc has not sent me to PT, and had me up and walking around the same day of surgery.  I feel like my range of motion is good, but my strength sucks, and I still have pain to deal with. (ie getting on and off the floor is a challenge).  I just started my first challenge, and one of my goals is to do a strength / rehab workout 2x a week, so I'm looking for ideas, and someone sent me here

[karinajean]

oh, yes totally! I was going to write them all down here anyway, so I can track my compliance.

 

they didn't give you any at home exercises at all? I'm sorry about that. my stepmom just had meniscus surgery too, and they sent her home with a photocopied sheet of exercises to do - maybe they just forgot? of course I'm not a doctor, and meniscus repair is a lot different than ACL surgery, mostly because you're up and walking immediately after the surgery, while with the ACL I was off of my leg for a week, and had muscle atrophy. If you haven't already, I think it's worth checking in with your surgeon... can you email a list of exercises to your doc or to the PA and get clearance?

 

here's what I'm currently doing at home every day (the PT said I could do it 2x a day, which I try for when I'm not doing in-office PT):

• Quad set: with towel under knee joint, tense and hold quad muscle for 6 seconds 10x. [3 sets per session]
• Knee flexion: lying down, put towel behind heel and gently pull towards butt until stretch felt. 10x per set, 3 sets per session.
• Straight leg raise w. 2 sec hold at top: 10x per set 3 sets per session
• Side leg raise w 2 sec hold at top: 10x per set 3 sets per session
• leg raise on face w 2 sec hold at top: 10x per set 3 sets per session
• Seated knee flex/extension stretch: push right leg back under chair or table with good leg until you feel a stretch. Hold 20 seconds. Spotting with good leg, slowly straighten right leg out. 5x per session, 5 sessions per day. -- this one I am not doing as much now.
• thigh squeezes - put a rolled towel between my knees and squeeze legs together for 6 seconds. 10x per set, 3 sets.
• extra quad lifts - put rolled towel below my thigh right above the knee, and with thigh resting on towel, lift lower leg up until leg is straight. 10x per set, 3 sets.
• extension stretches - lying on belly with legs off of edge of bed - keep knees at edge of bed ON bed - gently allow surgery leg to straighten out until stretch is felt. OK to use other leg to gently push down until stretch is felt. hold 20 seconds. 5x per session. gently flex leg (ankle towards butt) between holds to loosen leg.

At the PT office:

• warm up on the bike with no resistance
• leg presses with both legs together so my beast leg can support my surgery leg / alternating sets with calf raises at same weight on the same machine
• closed-circuit steps on a stepper machine (closed circuit means my feet don't come off the ground so no impact)
• step-ups onto a low box - step up with surgery leg, bring beast leg up, then beast leg down, and put surgery leg down to floor.
• standing adductor/abductor for both legs (so I have to stand on my surgery leg on its own which ALSO strengthens it), but with the leg at my thigh so there's no torque on my knee.
• hamstring weight machine with both legs together (again, so my beast leg can support my surgery leg).
• 25% depth standing squats.

[MasterOfCows]

it's CRAZY how different they are - and my PT seems to be marveling at my surgeon's direction. Apparently most doctors in this area brace after surgery, which is a really big difference - mine doesn't at all. And I had forgotten my prescription sheet on the first trip so the PT based the first day off of another protocol he was familiar with, and when I went on the 2nd day with my sheet, he had to add 3 more exercises to the list.

 

and dude. Hollow holds are NOT lackluster. I'm actually just trying to get my guts up to do them! I'm going to be following this set of exercises because I don't think they will strain my knee too much - no elbows to knee, and no planks.

I actually asked my surgeon about bracing and he said that he probably wouldn't have done it if I was just getting my ACL done, but with all the other stuff it was probably best.  He said it was more to protect it from banging on stuff than anything else.

I didn't quote, but yes.  THE STAGGERS!  It is hard to remember to stand up slowly, redistribute weight and then move when you have to pee at 2 am.  I mostly just shuffle around all hunched over like a troll until my leg wakes up and remembers that it can walk again.

 

Would you be willing to share your leg exercises?  I have had meniscus surgery on both knees this year (5 months apart), and am working on getting my strength back up.  My doc has not sent me to PT, and had me up and walking around the same day of surgery.  I feel like my range of motion is good, but my strength sucks, and I still have pain to deal with. (ie getting on and off the floor is a challenge).  I just started my first challenge, and one of my goals is to do a strength / rehab workout 2x a week, so I'm looking for ideas, and someone sent me here

How long ago was the last meniscus surgery?  I had my meniscus done as part of my ACL and ALL reconstructions as well.  The tricky part with it is that it can't stand compression/flexion for for about 6 weeks, so you can't do a bunch of stuff until after that.

[airinpie]

I actually asked my surgeon about bracing and he said that he probably wouldn't have done it if I was just getting my ACL done, but with all the other stuff it was probably best.  He said it was more to protect it from banging on stuff than anything else.

I didn't quote, but yes.  THE STAGGERS!  It is hard to remember to stand up slowly, redistribute weight and then move when you have to pee at 2 am.  I mostly just shuffle around all hunched over like a troll until my leg wakes up and remembers that it can walk again.

 

How long ago was the last meniscus surgery?  I had my meniscus done as part of my ACL and ALL reconstructions as well.  The tricky part with it is that it can't stand compression/flexion for for about 6 weeks, so you can't do a bunch of stuff until after that.

 

I had my left knee done in January and the right one done in the middle of June, so almost 6 weeks ago.  I was going to try to explain the pain I'm still having, but both are swollen and tender right now so I can't do it accurately.  I worked a party and had to be on my feet for almost 6 hours.  I was literally almost in tears by the end of the night.

[airinpie]

 

oh, yes totally! I was going to write them all down here anyway, so I can track my compliance.

 

they didn't give you any at home exercises at all? I'm sorry about that. my stepmom just had meniscus surgery too, and they sent her home with a photocopied sheet of exercises to do - maybe they just forgot? of course I'm not a doctor, and meniscus repair is a lot different than ACL surgery, mostly because you're up and walking immediately after the surgery, while with the ACL I was off of my leg for a week, and had muscle atrophy. If you haven't already, I think it's worth checking in with your surgeon... can you email a list of exercises to your doc or to the PA and get clearance?

 

here's what I'm currently doing at home every day (the PT said I could do it 2x a day, which I try for when I'm not doing in-office PT):

• Quad set: with towel under knee joint, tense and hold quad muscle for 6 seconds 10x. [3 sets per session]
• Knee flexion: lying down, put towel behind heel and gently pull towards butt until stretch felt. 10x per set, 3 sets per session.
• Straight leg raise w. 2 sec hold at top: 10x per set 3 sets per session
• Side leg raise w 2 sec hold at top: 10x per set 3 sets per session
• leg raise on face w 2 sec hold at top: 10x per set 3 sets per session
• Seated knee flex/extension stretch: push right leg back under chair or table with good leg until you feel a stretch. Hold 20 seconds. Spotting with good leg, slowly straighten right leg out. 5x per session, 5 sessions per day. -- this one I am not doing as much now.
• thigh squeezes - put a rolled towel between my knees and squeeze legs together for 6 seconds. 10x per set, 3 sets.
• extra quad lifts - put rolled towel below my thigh right above the knee, and with thigh resting on towel, lift lower leg up until leg is straight. 10x per set, 3 sets.
• extension stretches - lying on belly with legs off of edge of bed - keep knees at edge of bed ON bed - gently allow surgery leg to straighten out until stretch is felt. OK to use other leg to gently push down until stretch is felt. hold 20 seconds. 5x per session. gently flex leg (ankle towards butt) between holds to loosen leg.

At the PT office:

• warm up on the bike with no resistance
• leg presses with both legs together so my beast leg can support my surgery leg / alternating sets with calf raises at same weight on the same machine
• closed-circuit steps on a stepper machine (closed circuit means my feet don't come off the ground so no impact)
• step-ups onto a low box - step up with surgery leg, bring beast leg up, then beast leg down, and put surgery leg down to floor.
• standing adductor/abductor for both legs (so I have to stand on my surgery leg on its own which ALSO strengthens it), but with the leg at my thigh so there's no torque on my knee.
• hamstring weight machine with both legs together (again, so my beast leg can support my surgery leg).
• 25% depth standing squats.

 

Awesome, thank you!  I will show these to my doc when I go back for my follow-up.  There's several that I'm going already.  Even though I've been weight bearing (at some level), the whole time, I can definitely tell I've lost strength.  Just having pain and favoring has caused them to become weak.  I keep thinking that strengthening the joint will help with the pain.  I'm tired of hurting and walking with a limp.  It's starting to affect my lower back & hips as well.

[elsfaire]

I had surgery on my right knee (partial menisectomy) about 18 months ago. For me, one of the keys to getting active again has been flexibility. I was so afraid to move or bend it much for so long that I had a painful tightness in my IT band. It took a sports chiropractor to help me figure out that was why my knee was still hurting. Keeping up with my stretches and yoga makes a HUGE difference for me.

[MasterOfCows]

I had my left knee done in January and the right one done in the middle of June, so almost 6 weeks ago.  I was going to try to explain the pain I'm still having, but both are swollen and tender right now so I can't do it accurately.  I worked a party and had to be on my feet for almost 6 hours.  I was literally almost in tears by the end of the night.

I bet!  Knee swelling seems to take forever to go away in my experience.

 

elsfair is spot on - stretching and improving flexibility will go a long way.

When you go for your followup, make sure to ask your surgeon about sending you to PT.  It really does help.  KJ and I have a lot of the same exercises, but I also have banded clamshells, but don't have some of the leg raises and her in office PT is more advanced than mine is right now.

 

One of the things that suffers when you're not using your leg(s) as much is the inside quad (VMO).  Doing a bunch of quad specific stuff will help take some of the pressure off the joint.  If you have access to a stationary bike, even if you can't go all the way around, use it!  Biking is really really good for this kind of stuff.

[Kailer]

I'm glad you have a plan to combine PT and other exercise so you can take care of your whole body. And I always approve of vegetable goals!

You're going to be brilliant.