By Kate Vander Wiede

Caroline Greineder, 20, had been dealing with pain for seven months before she came to Performance’s East Greenwich clinic in October. Unable to walk without pain, let alone participate in the activities she loved like running and soccer, Caroline hoped physical therapist Dr. Nicole Coogan would be able to help her get moving again without pain.

“My goal was that I would be able to gain my strength back in my left leg and be able to be pain free so that I could participate in any exercises that I enjoy doing,” Caroline said.

After two months of physical therapy working to address the pain, Caroline decided to move forward with exploratory knee surgery to see if the pain was being caused by something that only surgery could fix. The surgeon removed tissue that they suspected had been causing at least some of Caroline’s pain and sent her back to physical therapy for post-surgical rehab and strengthening. Almost immediately, though, Dr. Coogan and Caroline hit a snag. On one of her first visits back to Performance after the surgery, Dr. Coogan noticed Caroline had possible symptoms of a blood clot – discoloration, swelling and pain in her calf. A blood clot in the leg, left untreated, can travel through the body to the arteries that supply blood to your lungs, damaging your lungs and other organs, affecting your body’s blood supply and sometimes leading to death. After getting in touch with her surgeon about Dr. Coogan’s comments, Caroline headed straight to the emergency room, where she was subsequently put on blood thinners.

But soon enough, Caroline was cleared to go back at East Greenwich and physical therapy, though the blood thinners and a risk of more blood clots meant that Caroline needed to progress more slowly than usual. Dr. Coogan spent time working with Caroline on range of motion exercises, did scar tissue massage to decrease pain and sensitivity, and performed joint mobilizations to increase the amount that Caroline’s knee could bend. Once cleared, she was able to progress to lower body and single-leg strengthening and stability exercises to regain lost strength and ensure she could move around without needing crutches. Eventually Caroline was able to start doing more challenging, higher-impact exercises.

Dr. Coogan said Caroline progressed despite the setbacks they faced in part because of her persistence in doing exercises and stretches at home. “Caroline was a fun patient to work with,” added Dr. Coogan. “She was motivated throughout her treatment to do as much as possible.”

Five months post-surgery and blood clot, Caroline is able to walk without discomfort or crutches and she’s feeling stronger than before. Though she still has some pain when working out and can’t run without pain yet, she’s feeling positive about the future, and more patient with herself and her progress.

“As a patient you want to see results quickly,” Caroline said, noting that when she first came to physical therapy, she was hoping for a quick fix. In the last several months, though, Caroline said she’s come to realize that progress takes patience, persistence and time. “You are not going to just wake up feeling much better one day,” she said.

As she works to get back to soccer and running, Caroline said that working with Dr. Coogan toward that goal has been great. “I really enjoy working with her,” Caroline said, adding that Dr. Coogan and her communicated well. “She makes it evident that she truly cares about her patients’ wellbeing.”