I finally got back on the physical therapy wagon today. (Read: ow ow shit damnit ow.) I took a break for a couple weeks to deal with the start of classes, as well as some stuff in my personal life. (When you measure your energy in tablespoons, even essential things get cut.) However, as of this afternoon, I’ve picked it up again. An hour and a half of lower body exercises and stretches later, I went from having the heater on in my apartment to flipping on the air conditioner, so I certainly wasn’t slacking.
Not as much changed as I thought. I’ve lost a bit of strength here and there, but I still did everything with added weight. Clearly things didn’t degrade much.
The right side of my body is still distinctly weaker than my left side. While I find it annoying, it’s been going on long enough that it isn’t unexpected at this point. It’s not simply that it fatigues more quickly; I have problems with muscle recruitment from the beginning.
If I were to draw out what my muscle contraction looks like over a set of exercises, the shape of the graph for the left side of my body would be like a platform with a playground slide towards the end. I start strong and then taper off as successive reps wear out my muscles.
The right side is like a standard bell curve: hard at the beginning and hard at the end. Once my muscles get used to the motion, that’s when they start to contract with more force, but it doesn’t last long. Along with the perpetual hamstring weakness (despite there being plenty of muscle in the area), it’s more evidence that I’m having underlying neurological issues, but I can only handle dealing with so many problems at one time. Right now, my focus is my knees, as that’s the reason I’m doing this round of PT anyway.
If I’m honest though, I’m not seeing much of a difference. My pain with standing and walking is about the same as it was in the beginning, both the level and the time until onset. My cheapo hinged knee brace from Rite-Aid frankly does more to keep me functional than the 45+ hours of physical therapy I’ve put in so far. This is a pretty poor return on investment, if you ask me.
On top of that, I’ve come very close to dislocating my knees a total of four times (twice per knee) in the last few weeks. My fibula already partially rolls out of the joint, but this is a different type of slipping. It’s more lateral, whereas the hypermobility around my fibula is rotational.
Since I am noticeably building muscle in my legs (even though half the time it won’t contract for shit), I’m lightly theorizing that under certain types of loads, the added muscle is more likely to pull things out of place. Fundamentally, my joints move in ways they aren’t supposed to, and now it feels like I have the strength to (inadvertently) force a joint completely out if it gets put in the right-wrong position. It wouldn’t be the first thing in my body that works in a way opposite of what is expected, but if that is indeed what is happening, it would be one of the more counterintuitive malfunctions.
I have another appointment with my physical therapist in two weeks. I’ll talk with him then, but really, I think it’s time to seriously push Kaiser to get me custom-fit knee braces. Based on how much the store-bought one alone helps (I switch it between knees), I can only image what having durable braces to keep everything tracking properly will do for my quality of life.
Unfortunately, the fact that proper bracing of joints is considered first-line treatment for my genetic disorder doesn’t seem to have made much difference to Kaiser in terms of how they have handled my issues. As a whole, they’ve had serious difficulty understanding that joints that don’t stay in place on their own need to be held in place by external supports. (That’s not the only thing heavily documented in the literature with respect to my genetic disorder that it has taken close to an act of god to get them to move on, but that’s a rant — err, post — for another time.)
Fundamentally, my joints do things they’re not supposed to do. It’s just the way it is. They need help. While I appreciate the pretty abs I’m getting from all the physical therapy, I’m not paying Kaiser for a personal trainer, I’m paying them to help my shambling corpse of a body hold itself together. It’s time to try other things.