I had my first physical therapy session today. It lasted about an hour and featured “Russian stim,” electrotherapy with an icepack, and lots of leg lifts.
Electrotherapy is intended to stimulate motor nerves and is thought to be beneficial for pain relief. The exact mechanism through which it might relieve pain seems still to be unknown: it may block transmission of pain signals along nerves; it may also promote the release of endorphins.
I’d experienced electro-stimulation before, when I dislocated my shoulder while skiing in late 1988. During physical therapy, electrodes were hooked up to my right deltoid, which had been weakened by the dislocation; the elecrical pulses stimulated the deltoid to contract and, together with exercises, allowed me to regain use of the muscle.
“Russian stim” is a variety of electro-stimulation that makes use of “a symmetrical biphasic square waveform,” which is produced by dividing a 2500 Hz carrier frequency into 50 Hz packets. Its name comes from the fact that it was originally developed by the Russian Olympic team to help its athletes gain muscle mass. Physical therapists use it now to help strengthen muscles and to treat muscle spasms. Like regular electro-therapy, it stimulates motor nerves, but its relatively high frequency of 2500 Hz is thought to enable stronger and more complete contraction of muscle fibers.
So today we had a few minutes of Russian stim for my right quad, combined with isometric exercise: during 10 seconds of electro-stimulus, I would contract the quad as strongly as I could; then rest for 15 seconds; then repeat. We did this for a little under 10 minutes. Then some regular electro-stimulus for 10 minutes under an ice pack. And then leg lifts while in the brace: 3 sets of 10 in each direction (lying on my back, left side, stomach, and then right side).
Given the current restrictions on my leg movements, that’s all we could do. The therapists thought that the muscle strength in my right leg seemed pretty good, so they suggested that we save my visits until we can do more. I’m going to do the leg lifts and isometric exercises at home. I’m seeing Dr, Feldman again on Tuesday, at which point the prescription for physical therapy might be revised.