Medial meniscus trim report

[grapplingdude]

Day 14: Just saw the surgeon and he said that things were as expected. He believes that the swelling and restricted flexion are due to fluid that is left in the knee. This may also cause stiffness and tightness around the knee as I have experienced.

It will take 2-4 weeks from now for this to go down and I should now start doing physio proper and perhaps using the exercise bike or cross tariner. This may cause swelling up of the knee top begin with so he gave me more anti-inflammatories in case it does.

Also I can probably start going back to the gym for more serious exercise in about 2-4 weeks and should have full flexion/function back in 6-8 weeks. I hope for the BEST!

[Ilya]

I advise against doing any exercise except stretching untill all swelling is gone.  You will only irritate the knee more and slow the healing process.  Coming from a guy who had a full recovery from a partial trim. 

[grapplingdude]

@Ilya: Thanks buddy and I think you may have a good point there. At the moment whenever I get cocky and start walking long distances, say 2 miles plus over the day, it slightly stiffens and swells up so I will probably wait another week or so..

[Ilya]

Walking and streching is key.  Stretch every change you get, walk every day.  Try to get some stairs action.  When you can do this comfortably then start PT. 

[grapplingdude]

Day 15: Well past the 2 week mark now and perhaps its time for a more detailed report. I did a lot of walking yesterday and standing around in a crowded pub watching football and I definitely felt some fatigue towards the end of the day and I walk up with a slightly stiffer leg again this morning - this is reminiscent of what happened last Thursday and Friday. Thursday was my first day back at work and I felt fine walking a total of maybe 5 miles over the day. Waking up on Friday then felt like a setback with a stiff knee and I took a weekend of resting to straighten this out. Whilst I am not as bad today as I was on Friday it's definitely a warning sign not to overdo anything at too early a stage.

On the plus side I have an appointment on Friday (2 days from now) with a very promising sounding physio. He does grappling/wrestling/BJJ himself which is exceedingly rare and has rehabbed both amateur and professional athletes. I am quite excited to hear his advice.

I am also thinking (pending the above appointment) that I might start using the exercise bike.

Other than that flexion is pretty much unchanged at c. 120 degrees and I remeber the surgeon saying that this wont go up until the swelling is down but I think general strength and stability are up a notch...
I dont know if it is the right course of action but the surgeon yesterday prescribed me another round of anti-inflammatories and I have started them today but only 1 a day.

[grapplingdude]

Walking and streching is key.  Stretch every change you get, walk every day.  Try to get some stairs action.  When you can do this comfortably then start PT. 

Yep I havent been stretching enough and can feel how my entire left side has been regressing...
I am quite comfortable with walking but when I toatl more than 2-3 miles a day I start feeling it. Stairs are only slightly uncomfortable first thing after getting up.

[grapplingdude]

Day 16: Well the swelling has never been so low probably because I took another anti-inflammatory yesterday. In fact, the nodular swellings had near disappeared yesterday evening so I stupidly started picking the left side scab hoping it might have healed. Of course that was wrong and I had a small amount of blood coming out the side where I picked. I am slightly panicking now that I may have caused myself an infection and that it may be serious since the incisions go all the way in and have evidently not healed yet.

Well, the swelling is still as low today as yesterday but obviously an infection would take a while to materialise - how stupid! 

Particularly, since everything else is so good. General swelling almost gone, nodular swelling almost down to nought as well and much much better than say yesterday morning (but this is probably down to anti-inflammatories). This has noticeably improved my range of motion now which looks more like 125+ degrees now. This is still far from satisfying and must be a direct consequence of reduced swelling.

I did have a quick check with the surgeon re the potential risk of infection and he thinks its very low since the tissue low down would have largely healed by now so hope he is right - PLEASE be right surgeon!

Also, walking has been much better since and the leg feels more stable although I am really starting to notice the loss of muscle in both legs but left one at much higher pace. Only getting knee fatigue towards end of the day now.

[grapplingdude]

Day 17: Swelling both general and nodular is unchanged and low but still present. Flexion is also unchanged around 125 degrees.

I saw the physio today for the first time and he thinks that I can get back into shape very quickly. He thinks that and incredibly tight IT band and tight muscles in my left thigh cause some of the issues around kneecap maltracking and slowness.

The tightness in turn is thought to be due because my left outside glutes are very weak causing the knee to rotate inwards and the muscles to seize up to overcompensate. I also resist any flexion too much which is thought to be a psychological response to months of knee slipping when hyperflexed and the more recent surgery.

Foam roll exercises, some specific stretches and light cycling is the immedaite step to take and I will have a follow up with the guy in a week and a half. I will also see his exercise guru colleague in 2 weeks for more demanding work. I like the sound of that 

The physio also performed an incredibly painful massage on my IT band, and thigh muscles wher they attach to the knee and mobilised the knee cap. The immediate effect has been that knee feels a tiny bit more mobile and my upper thigh is really sore. Took about 2 hours for soreness to go down and now the knee feels slightly loose walking (not necessarily in an uncomfortable way but not really comfy either)

[grapplingdude]

Day 18: A bit of a non-event but I did do a lot of walking around and even spent two hours on an airplane travelling to Europe. Walking seems almost back to normal at least slow speed walking on concrete. Stairs are still a bit dodgy. No complaints from all the walking travelling at night but did not really do my exercises so feeling slightly resentful about that.

Day 19: Had 2 post-op firsts today. 1. Went onto the exercise bike and 2. used the sauna. Did a 10min session on my exercise bike and first had a weird pull and slight pain not so much in my knee but the ouside of the left muscle just up where it attaches from the knee. That went away after 2 mins and cycling was fine just slight stickyness and weird feelings around the knee. No flaring up or swelling afterwards. Then did another 10 mins some 5 hours later and that went even better with just a fainst sense of "weirdness" in the knee. Then used sauna for 10 mins and that felt fine but knee felt like it was gonna flare up afterwards but 2 hours later and still nothing visible. There was also slight pain around the meniscus area afterwards.

I attribute this to increased blood flow and maybe the heat and hope that this is a rather good sign if anything. Surely increased blood flow means quicker recovery. Then again the slight discomfort / pain since speak a different language.

Well, we will need to see tomorrow and I may need to ditch the sauna and stick with exercise bike. Also, I started doing a stretch the physiio showed me on friday. The background is that my left (I believe) gluteus medius is underdeveloped. Apparently this one stabilises the whole leg and knee. If underdeveloped the knee apparently rotates inwards, the patella gets pulled to the lateral side and the outer muscles of the upper thigh and IT band seize up. All this creates long term strain on the medial side of the knee. The approach will be two-fold: Relax and stretch the thigh muscles / IT band and strengthen the gluteus medius to prevent them from seizing up again.

I was given this stretch as a first starting point to relax the muscles . It consits of standing on my right leg and pulling my left heel to my butt with my left arm but only as far as comfortable. This is not comfortable at all since my flexion is still too restricted. I am then meant to bring the knees together, straighten my back and "pull the left side of the hip up". I kind of know what is meant and I feel it stretches the outside of the thigh but it also creates a massive lateral pull on my patella and some pain around the knee which has been disappearing quickly after. I think I need to talk to the physio about this exercise asap. I am either doing it wrong or not ready yet.... Would be more interested in strengthening the gluteus medius.

[grapplingdude]

Day 20: The post-sauna diiscomfort has all but disappeared by now and the swelling remains very low unchanged from the past couple of days. The inner incision has almost healed and the scab is coming off with just redmarks remaining. There is a lot of hard scarred tissue underneath and it is painful on touch (mildly). The outer incision is still healing with a noticeable scab but less painful on touch and decidedly less scar tissue underneath.

I moronically ran my knee against a chair as well but other than some immediate pain it all seems fine. I did another 20 minutes on the bike as well and similarly to yesterday some "weirdness", stickyness and mild discomfort at the start. Also, the same funny pull on the outer thigh to begin with. It all disappears after 2 minutes and only some slight maltracking sticky feeling around the kneecap persists.

A couple of days ago I also strated doing anotrher "unauthorised" exercise which I think has been helping lots. Those familiar with Muay Thai will know what I mean when I say a shin block type exercise. I stand on one leg raise myself to tiptoes and lift the other leg up bent at the knee. I derlibaretly started flexing the gluteus medius as well as I do it and I seem to have first results already... 

[grapplingdude]

Day 21: 3 weeks tomorrow morning since surgery. Woke up last night and had some local pain on the medial side of the knee but not very bad and I went straight back to sleep. The feeling was near gone in the morning and I have done a lot of walking arouind since including a short "powerwalk" / weird jog down the platform to catch the train. When I go into a run (obviously not a proper run" I get some mild throbbing knee pain specially on the medial side and the lateral side feels like flaring up but it didnt which maybe due to shortness of the run.

Havent been good with my exercises since I was out and about all day and only doing some tonight. Did another 12 mins and later 15 mins on the bike which was fine. Some mild discomfort at first but faded quickly, more quickly it seemed than the prior 2 days.

[grapplingdude]

Day 22: By and large everything seems unchanged but when I walked to the bakery this morning I suddenly had a weird throbbing sensation around where the outer incision is. No swelling though - thats unchanged. The inner incision is definitely the more scarred / painful one even though it has superficially pretty much healed.

Did 3 times ten minutes on the bike which is pretty fine with just mild discomfort at first. Also started another set of exercises for the gluteus medius. Still very basic stuff but seems to address the right area.

[haero]

Keep posting man, I am about to book the same surgery, to get it done in about month or two, so keep giving updates how you're recovering. On the same left knee, I already did ACL reconstruction about 1 and a half year ago, and indeed after 8-9 months, I was playing volleyball again with no problems. After couple of months though, I started to have this pain (not too severe though, but good enough to prevent me from running, jumping and just about anything active) at the back and center of the knee... the MRI showed mild tear on the meniscus...surgeon said it's up to you - you either live with it, or do partial removal of the meniscus...said recovery is way faster than ACL...still seeing yours it seems like it's pretty much the same with ACL one... I am worried if this partial removal becomes a reason for developing arthritis when I reach my 50s (hopefully reach them)?

Anyhow, thanks again for posting, I'll  follow your posts

Greetings from Vancouver, Canada

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Radev Trade - Importing Wine & Spirits From Bulgaria to Canada
www.radevtrade.com

[grapplingdude]

Keep posting man, I am about to book the same surgery, to get it done in about month or two, so keep giving updates how you're recovering. On the same left knee, I already did ACL reconstruction about 1 and a half year ago, and indeed after 8-9 months, I was playing volleyball again with no problems. After couple of months though, I started to have this pain (not too severe though, but good enough to prevent me from running, jumping and just about anything active) at the back and center of the knee... the MRI showed mild tear on the meniscus...surgeon said it's up to you - you either live with it, or do partial removal of the meniscus...said recovery is way faster than ACL...still seeing yours it seems like it's pretty much the same with ACL one... I am worried if this partial removal becomes a reason for developing arthritis when I reach my 50s (hopefully reach them)?

Anyhow, thanks again for posting, I'll  follow your posts

Greetings from Vancouver, Canada

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Radev Trade - Importing Wine & Spirits From Bulgaria to Canada
www.radevtrade.com

I hope recovery will be quicker than ACL surgery. The surgeon keeps telling me that I will be back to full pain-free flexion after 2 months and can go back into contact sports then. I hope this is true.

The mixture of uncertainty and relative inactivity is killing me though things are getting better and I did another 30 mins plus on the cardio bike and my physio and some biceps and triceps curls today.

Greetings from London (England not Ontario) / Munich (Bavaria)

[grapplingdude]

Day 23: did 3 sets of cycling today 15mins, 12 mins and 10 mins. Went fine even though knee doesnt feel entirely right.

I have also done my physio exercises and the exercise the physio gave me last week where I pull my heel in still feels very dodgy - cant wait to talk to the guy about it next week. Started doing biceps and triceps curls as well 2 sets of 25 reps each - nothing special but at least it was some thing!