Monday, January 17, 2005
Knee Therapy Photos Added
Since my last entry, I've had three physical therapy visits, with six more currently scheduled at twice weekly intervals, at which point I will be reevaluated to determine how things are looking then, and have also had my bike fitting session. Photodocumentation of some of these visits are available in my galleries linked to the left of this page. Unfortunately, it's looking like this is going to be a long, slow and frustrating healing process. My bike fit was yesterday, and perhaps I would feel more enthusiastic about it had more changes needed to be done, but it seemed like a lot of money and time for just a couple of the most minute adjustments - raising my stem a few millimeters and lowering my saddle 3 mm - in addition to moving the cleats forward on one pair of my shoes - things I possibly could have figured out on my own; but then again, who knows if I really would have or not, since obviously I hadn't so far. I know, I know - most of what you're paying for with a bike fit is the experience and time of the fitter. But this whole situation has just been very frustrating, time consuming - and expensive - and has not been keeping me in the most pleasant and tolerant of moods! Of course, the fact that my bike was already set up nearly perfectly for me is a wonderful testament to the skill of my husband who is also my very capable mechanic. And I will give Lori, my bike fitter, credit for being quite a good listener who paid close attention to the answers I gave to her questions regarding my pain, my cycling history and goals, as well as my likes and dislikes about my biking. She also sent me a detailed summary of her biomechanical exam and findings, although I'm not completely certain I know what to do with that information (well, other than the comment that said to follow the advice of my physical therapist), and would have liked to have gotten a little more feedback on the multitude of data that appeared up on the Computrainer screen during my fitting. One disappointing thing to me about the summary is that the data recorded by the Computrainer is not accurate, since I was never told when or if I was actually being tested. The only thing I was ever instructed to do while on the trainer was to "Just pedal easy and warm up", so that is all I did. I was never told the test was beginning or anything, so all those measurements reflect is me just toodling around, not actually the way I really ride following warming up. The other disappointing information in the summary was the recommendation to either drop down to basically a granny gear on my singlespeed or switch to gears (singlespeed is my bike of choice and also is all I have), cut my rides short (I'm an endurance specialist and that is my greatest strength) and to not ride hills (going to be difficult since I mountain bike). But the most disappointing thing was when the shop owner Laurin, who had never met me before, walked over and told me "You treat your cycling like crap!" I'm sure she didn't mean it to sound so harsh, but I honestly didn't know how to respond to that so said nothing - all in all that whole day was a pretty depressing experience for me. On a more positive note, physical therapy still encompasses heating pads, deep tissue massage and ice application, along with routine iontophoresis. However, tonight we also began some light exercises. The interesting thing was when the therapist had me exercise my unaffected leg to the point of exhaustion, I noted an improvement in strength in the injured leg. His explanation was that by doing that, I was equalizing the muscular fatigue level on both sides. So I am to fatigue my good leg 3-5 times per day, and as that happens, retest the strength of the injured leg, but not fatigue that leg - just test it - until both sides appear equal. He is allowing me to continue riding and wants me to perform this fatigue/muscular equalization procedure prior to my rides. He still is not having me do any stretches yet, preferring deep tissue massage instead to help lengthen my iliotibial band. He also determined at tonight's session that there is very likely an additional component of patellofemoral pain syndrome associated with my iliotibial band shortening which is causing the pain to extend down in front of and below the kneecap as well, particularly with walking up and down stairs. Fortunately, the treatment for both is virtually the same, so we are on the right track.