bend it till i scream..please help!

[Heather M.]

Sheesh this computer is giving me fits today.  I had some links I wanted to put into the above message, but they were about two characters too long and the darned editor kept zapping them!  For future reference, whenever you type a message that is more than a few paragraphs, be sure to copy it into word or your microsoft notepad before hitting 'post' or 'preview.'  Because if your message is longer than the character limits arbitrarily set by the system, it will tell you 'Your post is too long, please go back and shorten it.'  But when you go back, your ENTIRE post is gone.  Never to be recovered.  I've learned to do something when I reach the end of my post and finish typing my name--I hit CTRL + A (select all) so the entire post is highlighted.  Then I hit CTRL + C to copy it.  This keeps the whole post in the invisible editing clipboard that Microsoft was kind enough to create for us.  That way, if I press Post and the whole thing goes away because it was too long, all I have to do is got to my notepad or MS Word and click CTRL + V to paste the whole message into the notepad--then I can either edit to shorten, or break it into multiple messages as I've had to do here.  I guess that will teach me to be too wordy, eh?  Unfortunately, I type very, very quickly.  So I get carried away--sorry.

Here are the threads I tried to post above:

Hope some of this information helps.  Definitely look up patellar mobilizations:
http://www.kneeguru.co.uk/cgi-bin/KNEEtalk/YaBB.pl?board=4;action=display;num=1084920388

Here's a link that might help--I listed all the tenets of my 'scar tissue rehab' and went over the stuff that I could do that didn't irritate the knee and cause further swelling.  You want to keep swelling to an absolute minimum, as it can indicate creation of scar tissue.  Very bad, in other words, although some swelling is inevitable.
http://www.kneeguru.co.uk/cgi-bin/KNEEtalk/YaBB.pl?board=softtissue;action=display;num=1079869380;start=3#3

Here's another great link from Laurie, who did her own rehab at home--no PT at all.  She has a lot of great advice, and in this post is telling a person who has been treated as a normal knee patient how very complicated scar tissue and ROM restrictions can be.  Many things she lists for her PT would be very appropriate for you:
http://www.kneeguru.co.uk/cgi-bin/KNEEtalk/YaBB.pl?board=softtissue;action=display;num=1072423595;start=32#32

As you can see, there is a lot of information on this board.  Sometimes it's overwhelming.  But I guarantee that whatever you are going through, someone else has dealt with and likely has some good advice for you!

Heather

[ntrgrl]

Frog, I feel your pain, truely.  :-/  

I was in the same situation after my LR and hematoma infection after surgery in July '04.  My PT made me cry ALOT!!!!            I would be (what I thought at the time) worse off.... but come to find out that the night he broke through the scar tissue while extremely painful      was the best night. (I can say this now). I was able to bend like never before and have been slowly improving.

Hang in there ! Trust in the physical therapy.    

Sending good thoughts your way,
Ntrgrl

[Heather M.]

Hang in there ! Trust in the physical therapy.    

Sorry, but for me to trust a therapist they have to prove that they are competent.  And bending the knee until scar tissue--and god knows what else--ruptures is barbaric, unwise, and simply bad medicine.  Things in the knee can be a lot weaker than the scar tissue--just tonight a kneegeek found out her quad muscle was *ruptured* during a manipulation (forceful bending of the knee) done by her orthopedic surgeon.

There is simply no reason to stand for this kind of treatment, especially not when it is counter productive.  There's a difference between holding flexion and cranking on someone's knee until they throw up.

Some people do okay with forced bending, but others have so much pain that they vomit, pass out, or have their quad muscles shut down.  Or worse, have vital ligaments and muscles around the knee get ruptured.  Your PT has gone to school for perhaps 2-4 years after college.  Therapists are a vital part of getting back to your normal life after surgery.  But there is a very specific limit on what the therapist is qualified to do.

Aside from the agony of having your knee bent for you by someone who doesn't listen to your screams to stop, numerous medical journals have come out with the position that 'injudicious bending' of the knee can actually make problems much worse if there is a lot of scar tissue in there.  

IMO, it's just not worth it, when there are other ways to get your flexion back that don't make you throw up on yourself.  I have ruptured my own bands of scar tissue while doing ROM work at home, and the 10-20 degrees I gained were eventually lost again when the knee reacted badly to the trauma.  This may not be true with all people--YMMV--but that's my story and I'm sticking to it ;-)  And I feel good about it, having had 4 procedures for scar tissue removal--the last two with a scar tissue specialist who wouldn't even let the PT touch my knee for flexion work.  Not one single time.  The PT did tissue work, patellar mobilizations, and other fun stuff, but NEVER forced my knee to bend.  And strangely enough I had full flexion within a week....go figure  :-/

Lots of people have reported great success getting their flexion back on their own--slowly and surely.  Laurie, MHB, Soccermom, Janet, and others that I'm too tired to come up with right now.

Heather

[Knee_Queen]

Wow, that poopy pt had you throwing up over yourself- that definately sounds negligant. I'm having problems getting my ROM back after my last surgery because of scar tissue, yes the sessions hurt (I like to gradually slide away from my PT's grip on the slippery plinth when things get bad- and she usually picks up on this cue before I get to the screaming out stage), but I've never been sick! My physio suspects I might be having an MAU if my ROM doesn't get better in the next four weeks and thats why she is pushing my ROM so hard (I hate ops because of needles and so I'm happy to try this up to a reasonable level if there's even a small chance of preventing extra surgery on top of my forthcomming hardware removal)- but I'm hoping my OS doesn't make a habit of doing those as I don't want a knee that's any more poopy than it is already! Good luck finding a new PT!!!

Heidi

[TCO]

Heath,

There is so much good stuff in here and in your links.  I will read it and try to understand what applies to me and what not.  I do want to get into PT soon to start getting some more advice from another source as well.

My doc said that my lack of movement was abnormal and he has a pretty good feel for patients and stuff, very intuitive.  I think it might have been because I wrenched it so much traveling a couple days after operation (for Xmas) and because I worked afternoon after operation and went shopping on crutches instead of lying in bed.  Doc says that is no biggie either.  Doesn't think I damaged it.  And he totally showed me how to start lowering leg.  Wish he had showed me that before I left hospital.  I'm really not a baby though. Took zero pain pills after LR and after Bankhart repair.  Skiied down an expert slope AFTER dislocating a shoulder and instructed skiing for a season (sans poles) 3 days after my dislocation.  I'm not a baby.  I'm really a fighter, ready for combat.  I just need to learn what to do and how much to push...and then I think I can do a lot to accelerate my recovery.  Don't like being in behind.  Like being faster (like with my Bankhart repair).

[Tropical_Breeze]

Frog~~

Two weeks ago one of the therapists bent my leg while i was laying on the mat... prior to that session I was at 60 passively.... then here come this chick and she bends it and asks me if it hurts....  I guess the fact that I was digging my nails into the mat wasn't proof enough.... so I asked her to ease up just for a sec to let me relax my leg so it won't hurt.....  which she reluctantly did AFTER maintaining a "good stretch" as she put it....
The she put the death grip on me again... and i turned around and said to her... is that my leg shaking like that   and she says.... yes....
like that's normal!!!! and i said can you please let it down just a liitle!!!!   i hate to be a whiner, but %**%&^%%!!!!!!!!    When she measured it she took me to 75 degrees...  Luckily the pain went away after my leg was lowered but that was pure AGONY!!
Anyway, little missy was not there when i went today...
and i was able to get to 90 passively and 85 actively....

Take care everyone.....  
~~~stay warm.....

~~~Michelle

[TCO]

Ok.

1.  I am now doing 3-5 times a day:  20 wall slides* (sometimes substitute with "kneeling on it" or "pulling into a bend seated or standing"...just if I'm out and about and not near a wall).  Is that ok?

2.  I'm not really sure how to do knee slides.  I put my butt about 6 inches from the wall and just slide baddie leg down until it hurts a bit (stretches)...hold that for 30 sec, then raise to semistraight, shakeout for 10 seconds and repeat.  Is this ok?

3.  I also do 20 seated leg extensions.

4.  Also do 20 straight leg raises, back raises, and side raises.  On the front raise, I have to have leg about 5-10 deg bent to raise it, but keep it straight for side and back.

5.  I do the non-hurt leg for everything as well.

6.  I'm enjoying bathing and hot tubbing, now.

7.  Am walking without crutches, but sometimes it catches up to me if I do too much and it "twinges" or just gets stiff.  I still have a limp and kind of land stiff-legged, which hurts a bit after a while.

Q1:  Anything wrong here?

Q2:  Anything to add?

Q3:  On the stretches, it seems that knee flexion is not the only thing giving a stretch, it also matters my hip rotation (trunk towards upper leg or away).  What should I be doing with that?  Anything?

P.s.  I'm about 135 deg now, but that is towards end of set of stretching.

[TCO]

surgery was lateral release, debridement and some sort of "bone shaving" on 16DEC.  Surguen says I'm ok, but slow in recovery.

[sso]

Hello Friend,

Why do some os,and  pt's assume since we're hurt they have further right to take our dignity. I know your situation, and my doctor took me from 15 to 45 on the x-ray table. When I yelped, he scornfully said, " Stop it! Your're not a child and you'll scare the rest of my patients!" and had salt poured in the  How dare such professionals disrespect us as human beings.
Of course I asked my worker's comp for a new doctor, and was told no, no one will touch you so soon after surgery. I continued to see this madman for seven months and was put on anti- anxiety medications by my general doctor to just get through it.

Get the heck away from this p.t. quack asap!
 
I believe you'll try harder to get back your rom with positive confidence from a p.t, rather than physical abuse.
I use to find the most painful position, the tears would fall, I'd take a vicodin and hold it for hours. I'll induce my own pain, thank you very much, and I have back all my rom. Best of luck to you.

[TCO]

I got full ROM back very quick all on my own.  My PT says that stuff like this is nuts.  However the clinic does do assisted stretches for Bankhart repairs.  And does do "strap stretches" (assisted extension) for ACLs.

[arial]

Hi Janet,

Completely new to kneeguru though not to knee agony.
I just moved to Detroit area and am struggling with getting connected to the right people who can hopefully help me.
I ruptured my ACL in Dec/05, had a reconstruction in March/06 and have had relentless post op probs. Intense pain, scarring and
bad ROM main problems. ROM 10-90. Complete muscle atrophy. Anyways, I know you don't know me and this is out of the blue, but please would you send me information about your two PT that you've had positive experience with - please. My experiences thus far have been along the Physical Terrorist lines. In info please include location (like Medsport), their style, if they are relatively accessible or only working a morning a week and stuff you feel is relavent.

Any positive move would be so appreciated. Thank you.

I have had two wonderful PTs in the Detroit area. Probably too far for you, though. I'll send you their names privately.

I did have a PT at the beginning who would "help" me bend my knee. My original injury was a quad tendon rupture, and I had been immobilized for almost three months post-op. I started PT 3 weeks post-op with directions for gentle ROM work. It hurt like h*ll, but she never pushed more than I could handle and always backed off if I said to.

Two doctors and three PTs later, I had the best PTs after my last surgery. My current OS does not want the PT to use pressure for ROM. It is up to the patient to work on their PT on their own, unless it gets to the point where the patient needs help. I eventually asked them to gently bend for me because it was just too tight and I couldn't do it myself. He went very slowly and gently, never measuring or trying to reach a specific goal. The whole philosophy was not to force the knee to do more than it could really do at any point. That doesn't mean PT wasn't painful, but it stopped way, way short of nausea or screaming. You're right to fire your PT!

Janet