May 19, 2016

We're done with physical therapy! (mostly)

Tuesday morning we had Amaya's last physical therapy session!Woohoo! No more three hour round trips to and from therapy! No more leaving school and work midday, or leaving early or coming in late! No more dealing with traffic! No more therapy!
Well, that's not entirely true. Although we won't be going to therapy anymore Amaya still needs to continue with the exercises at home. She will continue to do them every day until she has her knee surgery (in about 3 & 1/2 years). She has seven exercises on her routine to do (some she does on both legs, some just on her left). The therapist suggested splitting them so she has two different exercise routines to do. She'll alternate them every other night, that way she doesn't get too tired each night or worn out.
Her therapist did post treatment assessment. Here's how it went...
Therapist-Do you ever not have pain?
Amaya-"No"
T-What is your pain level when you're resting?
A-"3-4 (before she came to therapy). 2, it's a constant pain, but spikes to a 7 with some activities" (now that she's done six weeks of therapy)
T-Describe the pain?
A-"It's usually achy, but gets sharp with walking, lunging, squatting, etc."
T-Are you still using medication?
A-"Yes, but only about once or twice a week"
T-How long can you sit before you feel pain?
A-"5-10 minutes"
T-How long can you walk before you feel pain?
A-"5-10 minutes"
T-How much pain do you feel when you do leisure/recreational activities? Like basketball?
A-"It's a little easier sometimes, but pain is about the same."
Then we moved to the physical assessment. She had Amaya stand, walk, step up and down, sit, squat. The therapist pointed out that Amaya favors her right leg (she leans toward that side). She said it may just be a bad habit, but hopefully as we continue with the exercises Amaya will improve and won't do that anymore. The therapist did point out to Amaya that she corrected it pretty quickly on her own, so perhaps Amaya is "getting" it. Her increased strength and awareness are helping and will continue to do so.
She didn't asses Amaya's range of motion (ROM) because, "it was never an issue. It's normal. Well actually, it's amazing!" Her ROM is minus 10 to 155. She said that's better than most people without leg issues. And in the PFFD post lengthening world, that's very amazing!
The therapist tested Amaya's strength and saw some improvements. She said that the pain isn't as good as we had hoped (didn't decrees as much as she had hoped it would have). But she was optimistic that it would continue to as Amaya continued to work on her exercises. She said, "its a long term goal." So definitely something we have to keep working toward. The therapist commented that Amaya's alignment is pretty good, especially when she does her exercises. She recommends wearing her knee brace more often. She said long term the best thing is increasing her strength. Jennifer was very helpful and gave us a great plan to follow.
She reminded us that the typical physical therapy cycle goes like this: patients go to therapy because of pain, but stop once the pain decreases or goes away. Then the pain returns. Then they return and begin doing exercise again, but later stop. And another cycle begins. She said she's pretty confident Amaya won't do that because she does so well doing her exercises nightly, has improved already and has a good support team.
As for us, we've got some work to do. Amaya needs to keep doing her nightly homework. I need to help her with her stretches (checking alignment, increasing weights as needed, monitoring her reps and growth, rotating exercises, etc).
Amaya has done amazing through all of this. Never complained, never whined, never threw a pity party. She said she knows the exercises will help her so she does them. She was hoping to have an end dat etc when she could stop her exercises, but understands the need to keep doing them and dint complain about it.
Me and my sweetie at her last appointment.
Toe lifts.
Terrible picture, but she's doing weight lift shoes.
Stepping on the step in her Darth Vader long socks.
Silly faces!
More silly faces!
Strength testing.
New exercise- side leg lifts. This girl loves tights and long socks!
Here's her doing more leg lifts. In more long socks!
Amaya lunging and stretching in her cool Starry Night long socks. 
One of Amaya's newer exercises. Using her toes to pick up a towel (to strengthen her arch to help stabilize her foot. She needs to stabilize her foot, ankle, knee and hip.)

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