Rehabilitation: Post-surgical Phase 1
____________
Post-op Day 1: this was a fairly simple arthroscopic surgery to remove a large loose body. While there was evidence of significant osteoarthritis in my patellofemoral joint my complaint was mechanical catching from this piece of cartilage floating around in my knee.
.
Phase I of rehab: PRICE or POLICE?
Most people have heard the acronym PRICE, however I prefer one coined by @liftersclinic, P.OL.I.C.E: Protect. Optimal Loading, Icing. Compression. Elevation.
.
Optimal loading vs. rest: Yes you want to avoid excessive loading but you do want to load, what does that mean? Right now that means active gentle pain-free motion to restore range of motion. Stationary bikes are a great option as it is partial weight bearing to minimize stress but also allows you to move the joint.
.
Quad atrophy: Atrophy of the quadriceps muscle group is very common post-surgery. Arthogenic muscle inhibition is subconscious feedback inhibition to the muscle to reduce pressure on the joint. Even with simple surgeries the muscle can atrophy extremely fast. Quad sets are a great way to restore muscle activation. Once you can do a proper quad set and lift the leg without any lag, also known as “extensor lag” , you can progress to focusing on the single leg raise for quadriceps strengthening. In the video I use my unaffected leg to demonstrate what it should look like.
.
Managing swelling: In my professional opinion compression is the best method of reducing excessive swelling. While there is some controversy about ice vs. heat when there are acute injuries, or in my case post surgical, icing is a good method of decreasing pain and swelling.
.
Next phase is restoring range of motion and strength. The final phase is return to sport.