Wednesday, 7 March 2012

Hyperextension is Vital

Since I'd last seen Clodagh, the hospital appointed physio, I had had two hydro physio sessions but other than that had been left to my own devices. She had, on our first session together set me a target for the knee.

"You need to be able to fully extend it, and bend it 90 degrees." Should be simple. Sit up in your chair now and put your foot flat on the floor. Well done, that's part two, now straighten it, don't kick your desk. Easy. You'll notice that you can actually hyper extend it so that not only does it go straight, it bends upwards. That is was I am trying to achieve.

On the morning of the visit, I couldn't quite do the 90 degrees. I reckoned about 85. As for the straight it just wouldn't go. If straight is 180 degrees, I could only manage about 170. Part of the problem is that because they have used some my hamstring for the new cruciate, I don't have the muscles there to do it. My thigh and hamstrings have gone all saggy. You can bend your leg because your hamstring tightens and your thigh muscle relaxes. My hamstring won't tighten enough. You can hyper extend because of the opposite actions. I can't do that either.

So I spent the whole journey dreading Clodagh telling me off. I felt like a school kid who had not done his homework, even though I had tried really hard. The other problem was that the swelling still hadn't gone down. I'd had more ice on it than the arctic circle and yet it was till swollen. As I removed my trousers there was disappointment all over Clodagh's face. I'll beat you to the joke that I should be used to this reaction when I derobe but we were both upset.

I lay down and she stroked my leg.

"It's still swollen a lot."

"I know."

Sharp intake of breath.

"Bend it for me."

I really tried, gritted my teeth and forced it to 90 degrees. Clodagh cheered up a bit. "Good. Now straighten." Not so good. She got her protractor out. "That's actually straight." She said without belief. "Can you push your knee down?"



"This is me trying." She stroked the leg again, the project we were both disappointed with. Then without warning, like she was annoyed with it, she pushed down. I whimpered in pain.

"Did that hurt?"



"It's okay." She took to mean she could do it again, so did. It wouldn't hyper extend.

"Too much swelling, not enough muscle. Wait here." She bustled out in the way that only hospital people do. I stayed, lying there in my pants. I suddenly thought of a friend who is also having physio at the moment. He had told me the day before about some inappropriate swelling he'd had during his last physio session. Lying there in my pants I tried to remember England's starting line-up from last week's game against Holland. Clodagh returned with massage cream.

"I'll try this. Should relax the muscles and shift some of the fluid." She started with deep, painful massage around the knee, trying to push the excess fluid away, and then started more gentle soothing massaging of my thigh muscle to bring it to life.

"Hart, Baines, Cahill.."


"Nothing, just thinking about the football." She carried on massaging my thigh. I continued through the team, all the way to Wellbeck. It did the trick, and her massaging also seemed to work as, when she pushed down on the knee, it touched the bed beneath.

"How was that?"

"Hurt a bit, but not bad."

She then got me to stand up and watched me walk. I felt like a catwalk model. I was managing a not bad bit of walking. Yes, I can walk. Having assessed my walking she gave me a list of exercises to add to my daily routine: stand on one knee, leg straight for 3 x 10 seconds, then same again with bent knee, marching slowly on the spot, lifting knees high, and a funny straightening thing using a big elastic band. I wrote all these down and we booked the next meeting.

I hadn't managed to get a lift there and so had spent £15 on a cab. I couldn't afford to get one home again, especially as she wanted to see me in just four days, so I got the bus.

Luckily there is a bus almost directly outside which drops me about 10 minutes walk from home. 10 minutes walk with normal legs, in my current state it took at least twice that long but was not bad. The bus had been busy and I had nabbed a disabled seat. As each old person got on I made sure they could see my crutches. Only one person barged into my knee and my swear word was only heard by a few people.

I've introduced a new icing variant. With the shower hose I get the water as hot as possible on the knee. Then I slowly reduce the temperature, until it is as cold as possible, freezing almost. I keep it on the knee for a minute. It seems to really have a good effect. I read about this about 10 years ago. It does something with the red blood corpuscles, pulls them through to the surface, and they do something good. As you can see I didn't read it properly, hardly remember any of the details but I'm doing it. Anything to get the swelling down...Hart, Baines, Cahill....

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