Your body does also need some fat, even if it's currently more than you'd like. Right now I think maintaining your weight and nourishing your body as well as you can so it can do the hard work of healing should be the goal. After that I'm sure slow fat loss is in the cards again if you want it to be.
Alligatorob's Diary
- Thread starter alligatorob
- Start date
Cate
Long term member
with Llama. Concentrating on healing & nurturing your body with sound nutrition I think would be the best focus for now. Try not to worry too much about losing weight for now. We all know you have the knowledge & the capacity to do that when you're back to full strength.
alligatorob
Respected Member
Today was a better food day, I ate pretty well and feel good tonight, except for my knees of course.
Went to the gym today and spent almost 30 minutes on the elliptical, as the physical therapist suggested I should. It does help loosen my knees a bit. The therapist also told me I would be ok to restart my leg weight lifting, gave me a little advice but said it would be good for me. He did say that range of motion was more important for me right now than weight. I tried some today, leg press, leg extensions, and rdls. Could not do as much weight as before, but that's not too surprising. And I did try to max out range of motion, though it hurt a bit. The leg extensions were the hardest. Also am doing assisted squats, squats while holding onto something for help. And then when I got home I did all the PT exercises. My knees hurt tonight, but I think its ok.
I have completely given up the cane, can even go up and down stairs without it. I do have to hold the handrail pretty tightly, but don't need the cane anymore, that feels good. I do still plan to take it to my Tabata classes, some of the exercises require more balance than I have right now. No one would mistake me for a healthy walker, but at least I am doing it, still a bit of instability and pain, but much less than a week ago!
Went to the gym today and spent almost 30 minutes on the elliptical, as the physical therapist suggested I should. It does help loosen my knees a bit. The therapist also told me I would be ok to restart my leg weight lifting, gave me a little advice but said it would be good for me. He did say that range of motion was more important for me right now than weight. I tried some today, leg press, leg extensions, and rdls. Could not do as much weight as before, but that's not too surprising. And I did try to max out range of motion, though it hurt a bit. The leg extensions were the hardest. Also am doing assisted squats, squats while holding onto something for help. And then when I got home I did all the PT exercises. My knees hurt tonight, but I think its ok.
I have completely given up the cane, can even go up and down stairs without it. I do have to hold the handrail pretty tightly, but don't need the cane anymore, that feels good. I do still plan to take it to my Tabata classes, some of the exercises require more balance than I have right now. No one would mistake me for a healthy walker, but at least I am doing it, still a bit of instability and pain, but much less than a week ago!
Thanks Llama, you are the voice of reason. And you are right I don't really need to lose weight right now, healing is more important. However the binge yesterday didn't help my head a lot...
And thanks to you too Cate, nice to have friends set me straight.
Honestly I'd leave the leg extension machine until at least 6 weeks post surgery. All the others I'm fine with but the... shearing forces (? not sure how to say it in English but the fact that there's a lot of force perpendicular to your bones) of the leg extension (and to a much lesser degree flexion) machine is not to be trifled with. I don't expect it to cause lasting damage at this point but it could do more harm than good. Squats and the leg press are better options for now, I think.
Rob, great to read about your recovery from the knee surgery and how well you're doing.
One day, you're going to be immersed in something and all of a sudden, you'll realise that the pain is gone. Hopefully that day is not too far away.
You should be very proud of yourself, you've coped admirably.
One day, you're going to be immersed in something and all of a sudden, you'll realise that the pain is gone. Hopefully that day is not too far away.
You should be very proud of yourself, you've coped admirably.
alligatorob
Respected Member
It was a good day, I ate well, got some exercise, some PT and feel good tonight.
My knees hurt a bit more than yesterday, so I did a bit less exercise and PT, hope that helps. I was able to mow the lawn, first time since surgery. Don't normally need to mow much in October but the first couple of weeks were warm so the grass grew a bit. Last mowing of the year I am sure, the grass in shade had frost on it.
My knees hurt a bit more than yesterday, so I did a bit less exercise and PT, hope that helps. I was able to mow the lawn, first time since surgery. Don't normally need to mow much in October but the first couple of weeks were warm so the grass grew a bit. Last mowing of the year I am sure, the grass in shade had frost on it.
Thanks Llama, that makes some sense. I only used the lowest weight the machine would let me do and it still really hurt. So did not do it today, tomorrow is 4 weeks so 6 weeks isn't too far away. I do a lot of leg extensions with no weight, that is a suggested exercise. When they measure my extension its with my heal propped up and a lot of downward pressure on the knee. What I would really like to do is get to 0 degrees when I do the no weight extensions, I may ask them to start measuring that, I am sure it's no 0. Do you think getting to 0 in that way is realistic? At least I know from the measures done that my joint is capable of 0, but getting my muscles to do it is another problem.
I know you are right, but it sure doesn't feel like that day is close, not yet. Thanks for the note, always good to hear from you.
No, we still have a lot of it. I had fish today. Since my surgery I am doing less of the cooking, and I am usually the one to cook fish. Should be back to it soon. If you come by I'd be glad to give you some, we have a good selection!
I do feel good about it. Still carry one in the truck, just in case.
It's been unseasonally warm here as well but now the fog has arrived... I enjoyed seeing the sun in October but the temperature was a scary and undeniable sign of how much we've messed up our world.
Very long answer: given how long it's been since you were last able to extend your knees those last 10 or so degrees I assume your vastus medialis muscle (one of the four "heads" of the quadriceps femoris, basically only important over those last degrees and rather prone to laziness after trauma or restriction) is mostly or completely inactive. If you don't have specific exercises for it yet: the best way I've found to activate it is to put something soft (like a rolled-up towel) under your knee when lying on your back and pushing down (actively, no outside help) while mentally focusing on the vastus medialis muscle (look up its position: if it activates you can generally feel it just proximal of the knee on the frontomedial side of your upper leg). Make sure not to arch your back while doing so. You may need a relatively thick roll at first but after a few tries you should be able to unroll it a bit and still feel tension. Once you can actively push down even on a reasonably thin roll you try to raise your heel while maintaining downward pressure with the back of your knee. It often feels like nothing is happening at first and especially with both legs having been restricted for years there's no guarantee it will work but the muscles are still there so it generally just takes practice and mental focus.
Short answer: probably, if you're working on it actively.
Very long answer: given how long it's been since you were last able to extend your knees those last 10 or so degrees I assume your vastus medialis muscle (one of the four "heads" of the quadriceps femoris, basically only important over those last degrees and rather prone to laziness after trauma or restriction) is mostly or completely inactive. If you don't have specific exercises for it yet: the best way I've found to activate it is to put something soft (like a rolled-up towel) under your knee when lying on your back and pushing down (actively, no outside help) while mentally focusing on the vastus medialis muscle (look up its position: if it activates you can generally feel it just proximal of the knee on the frontomedial side of your upper leg). Make sure not to arch your back while doing so. You may need a relatively thick roll at first but after a few tries you should be able to unroll it a bit and still feel tension. Once you can actively push down even on a reasonably thin roll you try to raise your heel while maintaining downward pressure with the back of your knee. It often feels like nothing is happening at first and especially with both legs having been restricted for years there's no guarantee it will work but the muscles are still there so it generally just takes practice and mental focus.
alligatorob
Respected Member
Today wasn't the best day, I ate too many Halloween treats...
Lots of exercise today, about 4 hours between the gym and physical therapy, tired tonight. Knees a little sore, but not too bad.
Had the 4 week physical therapy evaluation today, had 0 degrees on both knees without pushing, that surprised me. And flexion was 130 degrees, both knees, good news. However the right one still hurts a lot more than the left. Therapist says I have pretty much made the extension and flexion goals and he would start shifting my therapy to more strength building, I guess that's good news.
Well, I gave it some today, LOL.
Lots of exercise today, about 4 hours between the gym and physical therapy, tired tonight. Knees a little sore, but not too bad.
Had the 4 week physical therapy evaluation today, had 0 degrees on both knees without pushing, that surprised me. And flexion was 130 degrees, both knees, good news. However the right one still hurts a lot more than the left. Therapist says I have pretty much made the extension and flexion goals and he would start shifting my therapy to more strength building, I guess that's good news.
Llama, you are a good friend, and a real expert. I read your post before going to PT today and quizzed him a bit about what you said. He did not disagree, but your advice was clearer and more to the point, thanks for that! I have done some research on the vastus medialis muscle, I can see you are right, and I got some exercise ideas. Also discussed it with the trainer at the gym, she seemed to understand as well and has ideas. She did know what the vastus medialis was, well ahead of me. Thanks again for taking the time to help me, I understand you cannot diagnose me without seeing me, but you have given me some very useful ideas to explore.
Thanks, it was a riding lawn mower, but I wasn't sure I could get on and off, or empty the clippings bags. No problem! That felt good.
I will be eating a lot of it. I also eat, and like canned fish. Just don't need it right now.We had fish yesterday but it was cannedI do like it though, but I think I would eat fish a lot if we had heaps in our freezer.
Wow on that mobility, that's SO good! 20 years ago 120° flexion was the most artificial knees were capable of and most people struggled to reach it. 130° is still amazing, especially this quickly. Being a bit less ruthless* about your mobility goals from now on might help with the pain though.
*Less ruthless sounded silly to me so I looked up if ruthful was an option. Turns out it's almost 2 centuries older than ruthless and has been considered archaic since the late 17th century. Language is fascinating, although my first thought was that's it's very human to ditch the ruthfulness in favor of ruthlessness...
*Less ruthless sounded silly to me so I looked up if ruthful was an option. Turns out it's almost 2 centuries older than ruthless and has been considered archaic since the late 17th century. Language is fascinating, although my first thought was that's it's very human to ditch the ruthfulness in favor of ruthlessness...
Cate
Long term member
Wow!
That's great news, Rob
We are very lucky to have Llama xo
alligatorob
Respected Member
Another not great day foodwise, ate too much...
Exercise however is going well, I did a bit over 3 hours in the gym today, including my first cycling class since surgery. It felt good. Also did all of my home PT exercises, at home.
What do you think my flexion goal should be?
The trainer in the gym told me today that she could see my knees were bending, both ways, more than before surgery. I was pretty sure of that also, good to hear confirmation.
Exercise however is going well, I did a bit over 3 hours in the gym today, including my first cycling class since surgery. It felt good. Also did all of my home PT exercises, at home.
I like it, beginning the ruthful phase of exercise! I will continue to do some aggressive knee stretches at home anyway. I think they are good for me. I did ask the therapist about extensions specifically and he backed down a bit, agreeing with you that its too soon to be doing them with much, if any weight.
What do you think my flexion goal should be?
The trainer in the gym told me today that she could see my knees were bending, both ways, more than before surgery. I was pretty sure of that also, good to hear confirmation.
Thanks Cate, I know the exercise is not a vigorous as it was before surgery, not that it ever was real vigorous. However, just being able to do it feels good.
Thanks again, it made me feel better about things.
Absolutely!
I think you've mostly reached it. 125° is generally considered enough for ADL, and full flexion is somewhere between 135° and mayyybe 145° for fully healthy knees. You will need to continue mobility exercises and quad stretches for a while (at least 3 months post surgery or until you're back to normal activities without pain) to avoid losing what you've already got (and you may gain another couple of degrees that way) but unless there are specific activities you can't do yet because of a lack of flexion there's no real reason to keep pushing it and overdoing it can irritate things unnecessarily so don't do it just to be able to say you did. Do you know what your flexion was before surgery?
alligatorob
Respected Member
Not been doing well with the food, too much and the occasional binge. Good news is, no binge today.
Exercise and PT is going fine, averaging about 3 hours a day total. However my progress has slowed, don't see big changes in a week now. And the pain and all is beginning to wear me down. Good news is I went to the doctor yesterday, 5 week check up. He said I was doing what he expected I would be doing after 12 weeks, that was good news. However when I pressed him on how long it would take for me to be back to some semblance of normal, he said it could be 6 to 12 months, this is going to be a long slow process... My quads are still weak and hurt a lot. I can't stand up from a chair without assistance and while I can walk up and down stairs, its not pain free...
Something seems wrong with the myfitnesspal food log, the food is right but totals make no sense.
Exercise and PT is going fine, averaging about 3 hours a day total. However my progress has slowed, don't see big changes in a week now. And the pain and all is beginning to wear me down. Good news is I went to the doctor yesterday, 5 week check up. He said I was doing what he expected I would be doing after 12 weeks, that was good news. However when I pressed him on how long it would take for me to be back to some semblance of normal, he said it could be 6 to 12 months, this is going to be a long slow process... My quads are still weak and hurt a lot. I can't stand up from a chair without assistance and while I can walk up and down stairs, its not pain free...
No, I did not measure. However now that I am doing this I know it could not have been better than 120 degrees, it is better now than before, for sure. Also extension, I know my pre-op extension was no better than 10 degrees. Its not hard to see that I have noticeably more range of motion now than before, it just hurts more...
Something seems wrong with the myfitnesspal food log, the food is right but totals make no sense.
alligatorob
Respected Member
Today was a good day, reasonable food and some good exercise. Two days in a row now!!
Thanks, I'm going to hold your to it, LOL! "Mostly back to normal" would be great!
