Therapy eval for knee pain

Today we had Amaya's physical therapy evaluation for her knee pain. Her official diagnosis is chondromalacia of the patella. The therapist, Jennifer was great. She spent an hour and a half thoroughly looking at Amaya.

Here's the good stuff...

• Amaya has really good strength overall
• Her alignment is good
• Her range of motion is great! Like really great! Her left leg is symmetrical with the right leg. This is a great achievement following a femoral lengthening.
• The therapist is optimistic that 6-8 weeks of therapy can give her some progress and can help alleviate her pain
• The therapist said she was glad we found some areas of weakness. Because that gives us something to work with

Here's the bad stuff and the stuff we need to work on...

• Amaya is in pain (sadly, all of the time. When she stands to long, when she sits to long, when she steps, walks, runs, hops, etc.). She's so sweet and tolerates the pain really well. She is such a tough girl and endures so much without little to no complaints 
• Amaya has little to no strength on her left leg (mostly on the outside and inner part)
• Amaya is favoring her right leg for many activities. The therapist thinks its because she's in pain and compensating for it. 
• She has three therapy exercises to do daily. They will focus on strengthening her outside and inner thighs muscles as well as calf muscles. Amaya is such a good sport about it and did her exercises tonight without any complaints. Lidie is a sport and she's excited to do therapy with Amaya 
• The therapist is pretty booked for the next month so were on the waiting list for many of our visits
• Amaya had some trouble with balance
• Her bedsore could be affecting her balance and/or how she moves her leg
• After the session Amaya was in some pain (4-5 out of 10. Even though we had giver her Motrin before the appointment).
• If we find that bone structure is an issue then therapy won't do much, (at that point we may have to look at surgical options). At that point we can teach Amaya pain relief strategies and body mechanics to help her.
• Amaya's left knee has a great deal of laxity. Her therapist was confused and very concerned with this. When you push on Amaya's lower leg the knee moves a great deal, with ease. There's a huge difference between the left and right knee. The therapist doesn't know if that's normal for a PFFD knee, especially after a superknee surgery. She is going to call Dr. Nelson to ask him his opinion on the knee and how she should progress in treating it. 

This girl is so funny. I love that she manages to be silly and funny and stay upbeat, always.

Here's a short video of her walking up and down a step. The therapist noticed that Amaya favors her right leg when she's stepping. She think its because Amaya is in so much pain when she steps that she tries to shift her weight to her right leg. Amaya says it hurt when she steps up and down.a

Sleepy girl. She was so tired on the way home. And when I went in to give her a kiss goodnight she said, "I'm so tired."