Happy Halloween

This pumpkin was carved by Anh and myself. First time participating in any sort of pumpkin carving :-). We picked out a perfect size and shape pumpkin a few weeks ago and finally carved it today. It was carved using a utility blade, kitchen knife and wooden bamboo skewers. Being that we both are triathletes and I completed my first Ironman this past July, this theme felt appropriate. Happy Halloween from us.

The Bamboo Skewers were perfect for marking out the shapes

Swim Bike Run Halloween Pumpkin Carving

3 Sports Pumpkin Carving

Physical Therapy: Week 7

First full week of work. Also worked Saturday. My knee is getting use to work now. It’s not as sore as the first few days back, but it still gets swollen as expected given that I’m on my feet for eight hours or so. During PT days I have shorter work days. I have been icing during lunch breaks to keep the swelling down and the knee happy. Still walking backwards on the treadmill. PT said I should be progressing to running maybe at the twelfth week. After receiving insurance authorization more weeks were added to my physical therapy. This is welcome news as I was hoping to progress to running on the treadmill during the PT period.

The PT told me its okay to run 10 – 15 minutes in place at home. I was a bit worried with this task given the surgery was two months ago. However she reassured me that this would be fine, as it’s still considered low impact and won’t impede on my recovery. Running in place did feel okay when I did it. Actually felt great to burn a few calories. Mentally a bit tough, if you think the treadmill was dreaded, wait until you run in place with no sense of distance gained. A bit boring but otherwise no pain whatsoever.

Added exercises:
- running in place at home (10 – 15 minutes)

Physical Therapy: Week 6

I resumed work this week. As expected my right knee got swollen during those hours. With icing it went back down. This was a concern of mine. However the physical therapist reassured me that this is normal. That the muscles in adjusting to such activities will result in increase inflammation. I am also limiting my work hours for now.

After using a stretch strap at the PT clinic and realizing how great it was with stretching, I felt that it would be a great asset to my rehab and inquired about purchasing one. Sure enough it was being sold there, so I bought one. Since then I have been using it twice a day and it is working wonders with my flexibility – the PT was impressed :-).

With two weeks left of physical therapy I am looking forward to it being as efficient as possible.

Added exercises

- more lateral agility exercises

- additional stretches

- increase duration walking backwards on the treadmill

Peak week of knee rehab so far

Below is a calendar representation of this week’s knee rehabilitation workout. As per hours, this is my peak week so far. Over fifteen hours. Feels like Ironman training hours. Then again my peak IM training was about seventeen hours. I am incorporating exercises as my body can handle. This week I started working on core and upper body strength workouts. Kept it simple with short reps. Also more flexion knee stretching was involved in the week as well. This concludes week seven post knee operation and week five of physical therapy. Three more weeks of physical therapy left to go. Hopefully flexion is the same as other knee by then. Fingers crossed!

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photo edited using iOS 5

Meniscus Repair Rehabilitation

Meniscus Repair Rehabilitation

(cited from the Stone Clinic

General Considerations:

• Weight-bearing as tolerated status. Walk with crutches
• Surgical knee will be in a hinged rehab brace locked in FULL EXTENSION for 4
weeks post-op
• Regular assessment of gait to avoid compensatory patterns
• Regular manual mobilizations to surgical wounds and associated soft tissue to
decrease the incidence of fibrosis
• No resisted leg extension machines (isotonic or isokinetic)
• No high impact or cutting / twisting activities for at least 4 months post-op
• M.D. follow-up visits at Day 1, Day 8-10, 1 month, 4 months, 6 months, and 1 year
post-op
• During the first 4 weeks: TWICE PER DAY: Without brace, allow GRAVITY ONLY to
bend knee back as tolerated BUT NO MORE THAN 90 DEGREES for a good knee
stretch without increase in pain. Relax knee and stretch for 60 seconds

Week 1:

• M.D. visit day 1 post-op to change dressing and review home program
• Icing and elevation regularly. Aim for 5x per day, 15-20 minutes each time. For ice
machine: use as directed
• Exercises:
1) quad-sets 10 sec. holds every 30 minutes
2) straight leg raise exercises (lying, seated, and standing): quadriceps/adduction
/abduction/gluteal sets
3) ankle pumps
throughout the day
4) well-leg stationary cycling
5) upper body conditioning and core strengthening
• Pool / deep water workouts after the first 8-10 days once surgical wounds are healed
and with the use of a brace
• Soft tissue treatments for edema / pain control and to posterior musculature, patella
and incisions
• Knee extension range of motion should be full

Weeks 2 – 4:

• M.D. visit at 8 – 10 days for suture removal and check-up
• Manual resisted exercises (i.e. PNF patterns) of the foot, ankle and hip. Trunk
stabilization program. Single leg balance exercises
• Continue with pain control, range of motion, soft tissue treatments and
proprioception exercises
• Non-weightbearing aerobic exercises (i.e. unilateral cycling, UBE, Schwinn Air-Dyne
with uninvolved leg and arms only, pool workouts)

Weeks 4 – 6:

• M.D. visit at 4 weeks post-op, will wean off the use of rehab brace.
• Stretching, exercises and manual treatments to improve range of motion (especially
flexion)
• Incorporate functional exercises (i.e. partial squats, calf raises, mini-step-ups,
proprioception)
• Stationary bike and progressing to road cycling as tolerated
• Slow walking on treadmill for gait training (preferably a low-impact treadmill)

Weeks 6 – 8:

• Increase the intensity of functional exercises (i.e. cautiously increase depth of
closed-chain exs.
• Shuttle/leg press). Do not overload closed or open-chain exercises
• Patients should be progressing to walking without a limp and flexion range of motion
should be at 80%

Weeks 8 – 12:

• Add lateral training exercises (side-step ups, Theraband resisted side-stepping,
lateral stepping)
• Introduce more progressive closed chain and agility leg exercises.
• Patients should be pursuing a home program with emphasis on sport/activity-specific
training
• Knee flexion range of motion should be equal to other knee

Weeks 12-16:

• Low-impact activities until 16 weeks
• Increase the intensity of strength and functional training for gradual return to
activities

Physical Therapy: Week 5

Walking up and down stairs is getting somewhat better now. My knee is still tight and a bit sore during the process, but it is improving. This week we focused more on strengthening exercises. I bought a 10 lb pair ankle weight (1/2lb to 5lb per leg) set to incorporate in my home exercises. Biking is definitely improving as well. I’m up to a comfortable 20 minute spin with variable gearing. Keeping it in the small chainring.

Today my PT was not in for the first time. A temp took her place. He was not in tune with my routine and was about to let me off way earlier than my session prescribed. So I continued with what my PT and I have worked on this past five weeks. After mentioning to one of the assistants that we were to start working with the treadmill this week, he allowed me 5 minutes on it. Not what I was expecting though. He instructed me to walk on the treadmill backwards to initiate the process. It felt good. No strain whatsoever.

I am continuing to ice and elevate as much as possible. I am planning to return to work next week, hopefully I can also get a short swim in.

Added exercises: 

- lateral side stepping

- leg press and curls with light weights

- mini step ups

iOS 5 installed on iPad 2

iOS 5 was successfully downloaded and installed on the iPad 2. Only issue was a fail on restore the first time around. After that fail everything else ran smoothly. There’s a ton of features in iOS 5. Click here for more details on those features.

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Successfully Installed!

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iMessage with Split Keyboard Typing

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Reading List

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Notification Center

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Twitter Integration

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Year View in Calendar

A conversation with Siri on the iPhone 4S

Macworld’s Jason Snell talks with the iPhone 4S’s new Siri technology.

 

Physical Therapy: Week 4

Concluded the fourth week of physical therapy. This week I welcomed continued improvements and good news from my orthopedic. He gave me the green light on a number of questions: ok to give up the cane (especially the fact that I do not want to develop a limp while walking), ok to resume work, ok to hit the pool.

My home exercise program is getting longer. I am now at about two hours with the workouts. Last week I began incorporating upper body strength workouts into the routine. This week I will include core (ab ripper x if not too strenuous) on PT days. Strengthening the overall body and mind will help with my knee rehabilitation.

Since the doctor told me it’s okay to abandon the cane, the last couple of days I’ve been walking without it. We live on a fourth floor walkup so all this everyday taken for granted steps in my life is helping with recovery. Walking without the cane is comfortable. I am not trying to move too fast, just taking every step with caution not to aggravate swelling or pain.

My PT mentioned last week that she may begin to introduce the treadmill into my sessions, this may begin this week. Looking forward to continued improvements with my physical therapy for the next four weeks of it’s duration.

Second Post Surgery Follow up

Today I had my second follow up visit with my orthopedic post knee arthroscopic surgery (meniscus repair). The main questions I had for him was namely when can I resume work and return to swimming. He was very impressed with my progression so far especially with my knee extension (flexion). An observation he was very worried about pre physical therapy and two weeks post surgery. So he gladly gave me the okay to resume both activities.

I have been using a cane for the last month since getting off the crutches, he said I should cease from using the cane soon as to not develop a limp while walkin. As per walk duration he also gave the go ahead not to restrict it. Biking in moderation for now as to not add too much strain on the meniscus. The swelling he said is not a concern and will still take time to completely lose the inflammation. Continue icing as much as possible. With his blessing today I will return to work and swimming in two weeks or so.

In all the three sports that triathlon offers, swimming I miss the most. Being in the water is so therapeutic to me. Can’t wait!

Tentative schedule to return to running may be February. With the NYC Half marathon in Spring I may have to cancel depending on my recovery and training leading up to it.

Next visit in two months. Four more weeks of physical therapy.

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