Has my improvement stalled??
It was great to have the go ahead from Pete to begin eccentric and isometric focused quadricep exercises. While I remain able to cycle and swim (with a pull buoy to avoid kicking), I really miss running, so having focused gym sessions has been so positive.
At this stage in my rehabilitation, there remains a focus on avoiding anything that aggravates my knee, so while I have progressed to eccentric and isometric loading, I remain very mindful of other day to day movements such as stepping backward and walking downstairs that continue to cause me pain.
These past few days I have progressed my exercises again to include gym ball wall squats.
- Great way to begin to increase the concentric component of quadricep loading
- Leaning back onto the ball helps to reduce knee stress and increase gluteal strength
- If I am not squatting centrally (ie my right leg is working harder) I will feel the ball move off to the side
Maintaining core strength with Pilates exercises during these times is also vital, so my programme now also includes:
- Shoulder bridge
- Deadbugs (with my knees at 90° flexion to reduce the leverage on my patella tendon)
A lot of waste products can build up in the muscles during healing periods and strength training. Sports Massage is a perfect way to aid this, flushing through the muscles via the lymphatic drainage system. Last night I had a massage with Dan. He continually checked that the pressure was ok and that my knee was comfortable throughout. He was also quick to establish that my adductors were becoming tight (the joys of all my swimming currently being with a pull buoy) so whilst the massage will have helped, this was also a much-needed reminder to continue to stretch my adductors and use my massage gun between sessions, rather than to purely focus on my glutes and ITB.
However…we are now at a rehabilitation decision junction. Should I still be experiencing anterior knee pain when going downstairs or stepping backward? Have I sustained a bony stress response to my tibial plateau? Answers to these questions will now determine if my knee needs further loading or if I should be avoiding loading my knee and focusing on strength of the surrounding tissues. It is time for an MRI referral ☹