Day 272

Welcome to PT, Phase 3.0

First there was the challenge of pre-op physical therapy. Twenty visits, maybe more. Then there was post-op PT - another couple dozen visits to the original pre-op clinic, a handful of encounters with the painfully competent Stone Clinic torture crew, and one stop at a third place where a still-in-school therapist spent most of my session consulting a PT book to determine how far he should try to bend my leg. He never got the chance.

Shortly after that I fell off the PT wagon. I was back to riding. I was playing music. I built a patio cover in my backyard. I was too busy getting back to my life to bother with mediocre PT and far too discouraged to find anything better. Maybe I could just finish recovering on my own.

Fast forward to my six-month follow-up with the Stone, and another visit to his PT room. “You really need to get back into therapy”, I was told by the therapist, her eyes staring directly into mine to clearly convey the “or else” element of the message. “You don’t want to wait too long.”

Too long, she explained, was now quickly approaching. One year is the the generally accepted window for improvement. Beyond a year, physical improvement, although possible, is as about as likely as keeping all of your blood on the inside during a shark attack.

So at the direction of the Stone therapist, and from somewhere in the haze of discomfort following the Condor Century, I decided to follow my neighbor's recommendation and check out yet another local PT clinic - BodyMax. With little in the way of expectations, last week I went to my first appointment. Craig, the owner, met with me and assessed my progress: “You're a bit behind”, he pointed out. "Well we've covered the obvious", I thought to myself, "So what now?". But before I could ask he moved directly into explaining what I needed to do to catch up – stretching, ultra-sound, myofascial release*, and targeted weight training. No surprise, the BodyMax PT clinic looks like a gym, with an impressive assortment of weight machines and cardio contraptions - stationary bikes, ellipticals, stair masters - all in a large open room. Surrounding the gym area are a dozen smaller rooms - therapy rooms and offices. In short, the facility is excellent and Craig and the rest of the team are pros. By the time that first appointment was over it was clear to me that I was finally in the right place. In fact, it was so overwhelmingly obvious that my joy quickly devolved into a subtle resentment of the situation as I realized that had I started there first, I would probably be done by now.

*Technical note: The web has abundant information about this but the following should suffice for our needs here: Fascia is the seamless web of connective tissue that covers and connects the muscles, organs, and skeletal structures in the body, which is located between the skin and the underlying structure of muscle and bone. Muscle and fascia form the myofascia system. Myofacial release is the name of the therapy that is designed to release bound up or stiff areas of that system. Apparently the foundational premise of this therapy is “if it hurts to rub there, then keep rubbing”.

In any case, I have now completed five sessions with Craig at BodyMax. My strength and flexibility are both improving. I am thrilled with the results already. There has been an increase in pain but seemingly as a necessary and presumably temporary result of the therapy. Craig was not satisfied with the zero degrees that I had achieved in extension and wanted as much hyper-extension as the “good” side so we're "fixing" that. He also reasoned that in order to protect the joint during activity, the end point at extension needs to be slightly soft and pliable. Before I started at BodyMax, my knee still had a rather painful and abrupt stop at full extension – no give. In the world according to Craig, no give is no good. For one, it’s asymmetrical, and two, it causes the knee to be more injury prone. Creating “pliability” where none currently exists is not a pleasant process to say the least, but that kind of unpleasantry is nothing new at this point either.

I suppose the message of the day is Hope. It is a sensation that I have only recently begun to regain in terms of recovery and although I’m definitely not ready yet, when I’m sufficiently rehab'd I will be eligible for the BodyMax ACL Bridge program – which is designed to bridge the gap between simply functional and athletically able. Hopefully by the time I post next, I’ll be knee deep in that program. If I’m still not ready, it sure won’t be for lack of effort.