A week at the clinic

No sooner had I settled in here than the weekend arrived.  I had a taste of the physiotherapy on Friday and on Saturday morning, then half the population disappeared to spend the weekend with their families, and those of us who remained were cared for by nurses and auxiliaries while the ample staff car park was pretty well empty.  However, a very nice young woman physio gave me some useful exercises to do over the weekend.  Otherwise those of us like me who could not sleep away (not allowed till the 3rd or subsequent weekend) had visits from family and friends.

Early signs that I had started to recover well did not include more sleep, the swelling around the knee remained obstinately there and the pain from inflammation and swelling moved round my leg like will-o-the-wisps, always just out of reach of the latest painkiller.  By Monday when my full programme began I had also succeeded in adding an anti-inflammatory to my prescription, in the hope of calmer nights.  By Tuesday morning the improvement had begun with the first good night's sleep since the operation and outside physio sessions the pain had hugely diminished.  But as is usual with me, sleep is still not always easy to come by.

Analysing the task ahead, there were 3 or perhaps 4 challenges.  First, the tight tendons behind the knee needed to start to regain their length and suppleness after 5 years or more, helped by the 'mobilisation' sessions each day, which I'd call massage with torture thrown in.  Second, the swelling and bruising from the operation needed to go down with the aid of ice, exercise and the compression stocking I put on each day.  Third the muscles (quadriceps above all but others too) traumatised by the surgery needed to regain their stability and strength, with the aid of exercise and electrical stimulation.  And fourth, of course, I needed to learn to walk.  Now, towards the end of a full week of treatment I am making very good progress - the pain has mostly gone and under the supervision of the physiotherapists my knee bends at least 95°, which they say is excellent.  The swelling and bruising is beginning to go down though they tell me it may be months before it all disappears, and the muscles are improving fast.  The biggest challenge is straightening the leg fully, which is still sore if maintained too long, but that will come.  My principal physio thinks I shall be on an exercise bike next week.

During a long morning session and a shorter afternoon, I have 2 periods of 'mobilisation', one-to-one manipulation and massage by a physio during which the movement of the joint and leg muscles are tested and extended thoroughly.  One of the most surprising part of this has been the prolonged manipulation of the kneecap, with very delicate movements and massage.  Then the degree of bend is tested, a little further each day.  After all this I have 20 minutes of electrotherapy, 4 electrodes attached to the thigh and jolts of electricity passed through.  The third kind of treatment is gym work in small groups, which by now includes walking, climbing and descending stairs under careful supervision.  All the physiotherapists are friendly and obviously very skilled.  Between treatments we have ice packs at regular intervals, and we're encouraged to get more ice in the evening and overnight, though it is difficult to keep in place when sleeping!

The treatment only takes a fraction of the day, and there are hours of longueur, but I don't think I could manage more - resting is also very much part of the recovery process.  I have lots to read!  It's just a fortnight since I had the operation and the progress seems very good.