May 9, 2008

Ouch!

On Monday my physical therapist, the other Kaycee in my life, started me on ultrasound treatments. Ultrasound has been shown to cause increases in tissue relaxation, local blood flow, and scar tissue breakdown. The effect of the increase in local blood flow can be used to help reduce local swelling and chronic inflammation. Kaycee is very interested in breaking up some of the scar tissue in my ankle to try and increase my range of motion.

Ultrasound works by generating high frequency sound waves that are transferred to the hurt spot by a round-headed probe (looks similar to the probe used on a sonogram). The sound waves travel deep into tissue creating gentle heat. As the probe glides over the skin's surface, sound waves penetrate the skin's surface causing soft tissues to vibrate creating deep heat. Then, the heat induces vasodilation: drawing blood into the target tissues. Increased blood flow delivers needed oxygen and nutrients, and removes cell wastes. The deep heat helps to relieve pain, inflammation, reduces muscle spasms, and accelerates healing.

Ultrasound is a really great treatment and I actually used it in the fall when we were trying to avoid surgery. This time Kaycee prefaced my first treatment with a warning. I have a steel bolt in my foot, and as we all learned in science class, steel is a conductor of heat. It is possible that with ultrasound, my foot would heat up and cause unbearable pain. Kaycee said that she would start slow and if iy got uncomfortable she would stop.

My Foot Is Still Numb! It never got uncomfortable and we went through a full fifteen minute treatment. After the ultrasound Kaycee removed the lifts from my boot to force my foot to stretch a bit further when I walk. By Monday night I was in serious pain and swollen pretty large again. The swelling and pain was still there when I went in for physical therapy again on Wednesday, so she had me take it easy and everything we did was for pain management (whirlpool, light stretching, game ready, stim, etc.) We both came to the conclusion that the change in the boot most likely caused the pain.

Today, I went to physical therapy again, and before the ultrasound treatment Kaycee again told me about the potential heat issue and then briefly mentioned that I should be aware of my pain level after the treatment – only two things changed on Monday that could have possibly caused the pain and swelling. Kaycee’s comment was that after I came in on Monday and reported to pain Friday night we could definitively rule out the ultrasound as the cause of my pain and she could add to my chart that I had discomfort following the removal of boot lifts.

There is only one problem with her scenario. I am once again in unbearable pain and swollen – A LOT. My ankle is so swollen right now that my sticky-outy-bone (medically called the lateral malleolus) isn’t sticking out. The swelling covers it up. That isn’t normal.

I think when I go into physical therapy on Monday morning, Kaycee will be able to definitively write the cause of my pain and excessive swelling in my chart. It just isn’t going to be from the lifts.

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