They saw definite progress in her standing, walking and limb movement of the left leg. Her new goals are to stand from a sitting position unaided and to walk with only the support of a zimmer frame or four-legged walking stick. Jo has a conceptual aversion to both of these as 'old people's things', although I sense less so to the latter. Examination of her leg showed good muscle tone is returning and the ankle is getting looser, snmething Jo's Thai masseuse observed on the weekend. This means Jo will not require botox treatment there but they may look at a brace to support the looser, and hence weaker, ankle until muscle strength is further developed.
As part of the assessment they asked Jo to perform her nine yard walk to the front door. As on Friday, Jo got halfway before the pain overcame her. The physiotherapist echoed my observation that anxiety was causing the pain rather than vice versa. What the physiotherapist observed is that, as Jo's stepping of the left leg is improving, she is neglecting to 'prepare' the left leg for weight transfer by straightening it sufficiently. The consequence of this is that she attempts to put weight on a bowed leg, feels the leg giving at the knee, as it naturally would if any of us attempted the same. At this point panic begins to set in, prompted by a natural fear of falling, a fear exacerbated by the fall suffered at the hands of her carers back in March. This anxiety triggers the pain in the knee that eventually overwhelms Jo. We all perform this leg straightening 'preparation' without thinking about it as it is a response learnt in infancy, one that Jo must now relearn.
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