Climbing the mountain: For Pepperell woman, a year of rehab leads to triumph


12/8/2016

When Carol Rizzitano arrived at the Center for Rehabilitative and Sports Therapies in Westford in June 2015, she was in a wheelchair. The Pepperell resident and her husband had requested a tour. "I remember Carol saying 'I'm not sure there is anything you can do for me,'" says Rachel Kim, PT. Ms. Rizzitano soon learned that, thanks to the expertise of Emerson rehab staff in Westford and Concord, as well as her own hard work, she would make stunning progress.

Still, her case was exceedingly complex. Two months earlier, Ms. Rizzitano was hiking when a tree branch fell on her, causing her to fall awkwardly, dislocating her right knee and severing a major artery and other blood vessels in her leg. Her husband quickly applied a tourniquet, but her leg suffered nerve damage due to blood loss. After having surgery to repair her blood vessels, Ms. Rizzitano was cleared to begin rehab. But her right leg was weak, and she had no feeling below her ankle.

"I knew I couldn't go on vacation," says Ms. Rizzitano, in reference to the hiking trip she and her family take each summer. "When I arrived at Emerson, I tried to imagine going from a wheelchair to a walker to two crutches to one crutch. I had to take it one day at a time."

Ms. Kim's initial objective was to increase the range of motion in Ms. Rizzitano's knee, which was too weak to bear weight. "We started with small, short-term goals, which became increasingly bigger," she says. "The real goal was for Carol to walk again. She was amazing; Carol worked hard and surpassed every goal."

Ms. Rizzitano started by using the LiteGait machine, a harness that supports an individual's weight while they begin moving safely on a treadmill. "This allowed Carol to get back to the mechanics of walking," Ms. Kim explains.

As her nerves slowly regenerated, the numbness in her foot was replaced by pins and needles — not pleasant, but a sign that sensation was returning. "We did everything possible, including massage, to get Carol's foot moving again," Ms. Kim notes. After eight months of challenging physical therapy, Ms. Rizzitano reached an important milestone: she walked on her own on a treadmill.

Aquatic therapy followed by a triumphant hiking trip

There was much more progress to make. In March 2016, Ms. Rizzitano, a manufacturing engineer with three children, began aquatic therapy at Emerson's other rehab center in Concord, which was overseen by Lisa Coppola, PT, DPT. "I continued to focus on Carol's knee," says Ms. Coppola. "The water provides buoyancy, which unloads body weight, so she could move more comfortably."

"The aquatic therapy relieved the stiffness," says Ms. Rizzitano. "I walked on the underwater treadmill and was able to do lunges." In 92-degree water, she could move her toes. The warm water made her pins and needles subside, which allowed her to push herself during physical therapy.

Her nerves were regenerating, Ms. Coppola explains. "We did a lot of work on Carol's big toe, which is important for balance and pushing off when walking, as well as her proprioception — her sense of where she is in space." Ms. Coppola also used tools to assist in soft tissue mobilization, aimed at relieving the tightness around her scar.

Ms. Rizzitano's rehab proceeded in two locations with the two physical therapists. "Rachel and I stayed in regular contact to discuss Carol's progress," says Ms. Coppola. "We knew that the combination of therapy, in the pool and on land, would bring sensation back to her foot and mobility back to her ankle."

Along the way, they developed a lasting admiration for their patient, who never gave up. "Carol was a complex patient who suffered a traumatic injury," says Ms. Coppola. "We challenged her, and we built a rapport with her."

"We were both surprised at how well Carol did," Ms. Kim adds. She had plenty of motivation: a family vacation was scheduled for July, when she would attempt to climb Black Cap Mountain in North Conway, New Hampshire. "We knew it was within Carol's reach," says Ms. Kim.

Using ski poles to keep steady, wearing good hiking shoes and with her husband hiking beside her, Ms. Rizzitano made a successful, four-story climb. "It was wonderful being able to get to the top," she says. "I walk a lot anyway, but hiking keeps me happy."

Looking back at the year of rehabilitation at Emerson that took her from a wheelchair to the top of Black Cap Mountain, Ms. Rizzitano reflects on the staff at the Center for Rehabilitative and Sports Therapies.

"At every physical therapy appointment, I received positive feedback and direction on where my rehab was headed," she says, "and I had faith they were never going to hurt me." She knows she would not be where she is today without the expertise and encouragement of Ms. Coppola and Ms. Kim. "Rachel and Lisa have been wonderful," she says.