What to Expect When You’re Expecting Orthopedic Surgery: Part II
Join us as we follow HSS athletic trainer Kara Federowicz through her journey of orthopedic surgery. This is the second installment of a three-part series discussing coming back from orthopedic surgery.
And we’re back!
As I mentioned in my last post,my first physical therapy appointment happened in week 6 at the James M. Benson Sports Rehabilitation Center. Although I only live 10 blocks away, I found just getting to that first appointment was incredibly difficult. I’m used to teaching 6+ spinning classes a week, and my cardiovascular endurance has always been pretty good. However, traveling on crutches changed everything! To make matters worse, it was raining hard during the NYC rush hour. It was one of those days where it seemed like nothing was going my way,and I was thinking “Get me out of this brace, I’m over this!”
Although drenched in rain and in tears, I finally made it to my appointment. All I can say is bless my therapist Jessica Hettler. She was patient and calm and helped me shift my perspective so that I could see that despite what I was feeling I was actually right on track for my recovery. Throughout the rest of that rainy day I just had to keep going. I called my mom, who told me “Just remember this will all be worth it in the end,and remember the amount of pain you were in before this. It will be a journey but you can do this.” Of course she was right.
From the beginning of week 4, I added new exercises and established a daily routine. With my leg immobile I was losing muscle mass, so I needed exercises that would keep my leg as strong as possible and help maintain fitness in the rest of my body. Some of them I did at home, and sometimes I went to the local gym. Before we get into my regime, I just want to make a point of saying that this was the program that worked for me. I stayed in the parameters my physical therapist and Dr. [Beth] Shubin Stein set for me,and you should do the same with your own physical therapist and physician. I want to share this with you so you can get some idea of what my day-to-day routine was like, but this is by no means a program for anyone else to follow. Everyone’s situation is going to be different,and you want to make sure that you’re safe and smart about your recovery while still challenging yourself.
Every day at home:
- 20 minutes of quad stimulation and contraction with a Kneehab® unit, 4 times a day
- 20 minutes using a bone stimulator, 3 times a day
- 4 hours a day on a continuous passive motion machine. The motion becomes almost soothing after a while, and it’s a great conversation starter: your visitors will want to try it! Mine did anyways.
- 3 sets of 10 ankle pumps with a green theraband
- 3 sets of 10 calf stretches, holding each stretch for 15 seconds
- Assisted range of motion stretch, with my lower leg hanging off of the bed
- Using my Game Ready® and the ICE method (Ice, compression, elevation) as often as possible
Now, just because my leg was in a brace didn’t mean I couldn’t work out the rest of my body. I usually went to the gym for this part – they have more equipment, trainers who can help with form, and it got me out of the house.
Safe and efficient workout routine (4 times a week):
- Upper body ergometer: this is that funny looking arm bike you have seen in the gym but have always judged it because it looks too simple. Don’t let it fool you – this thing is challenging!
- Glute squeezes
- Cable unit: lateral pull downs, bicep curls, chops, trunk rotations, lifts, and overhead presses
- Free weights: as long as I was sitting or lying down, I could do all of the usual free weight exercises for arms and chest, such as dumbbell presses and tricep extensions
- CORE: I did a lot of Pilates-based roll ups with and without weight, medicine ball throws against the wall, regular and side curl ups, and my personal favorite: battleropes
I couldn’t have done all of this on my own. Thanks to great friends and being open to asking for help, I was able to be successful in these sessions without hurting myself. Follow the advice of your physical therapist and physician, ask for help when you need it, and don’t let a brace and crutches define who you are.
Staying strong mentally is important too!
This second chapter was rough. Now that I understand that my legs can’t do all the work, I have to keep my mind strong as well.
Know that there are other people out there that are going through (or have been through) the same thing as you are.
Going through this journey has taught me a lot about patience. By switching my role from clinician to patient I have learned to have a better appreciation for a healthy body. There could be points where you feel bad for yourself, but then you look around and realize the strength of everyone else that you’re surrounded by in the physical therapy center and it makes it a lot easier.
I had a great 6-week follow up with Dr. Shubin Stein. She was impressed by my progress and how strong my leg was after 6 weeks of not really using it. I was instructed to start putting a certain amount of pressure on it every two days so that I can eventually begin putting weight on the leg, using the brace and crutches for support. Overall I was doing well: I just took me much longer to get places.
After 7 weeks, my left foot was able to touch the ground again. Hooray! That didn’t mean I was ready to start training for my next triathlon, or even for taking a bike ride. But it did mean that I was officially able to put weight on my left leg, and being learning to walk normally again. It’s the small things in life that make it all worth while.
Kara Federowicz is a certified athletic trainer at the Tisch Performance Center at Hospital for Special Surgery. Kara has a degree from Penn State in kinesiology, the scientific study of human movement. This material is adapted from the personal blog Kara kept to record her experiences throughout her recovery.