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Author Topic: 4 weeks post knee arthroscopy, symptoms persist  (Read 9751 times)

Offline Rob Shillito

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4 weeks post knee arthroscopy, symptoms persist
« on: May 06, 2011, 07:21:29 AM »
Hi,

just wondering if anyone can give me some advice?

I had an arthroscopy on my knee 4 weeks ago and had some of my meniscus shaved. I had symptoms of a dull ache on the medial side that got worse over two years. This came on after exercise, but came to a point were just walking would set it off. I had about a week were the knee didn't ache after the op and just felt weird cos of sticking things in there. I went for a 30 minute walk as it was feeling good and all was fine until a couple of days later when it swelled up a bit and the dull ache returned. The knee now pretty much aches from when i wake up. It doesn't hurt to weight bere, it just aches when i stay still for periods of time or after any walking.

I'm in the uk and the aftercare from the nhs is crap at best. Got an appointment in three weeks, but getting frustrated as I'm not sure if im meant to be working through this? Is this normal and just part of the healing process?

Any advice and exercises that might help would be appreciated. I bought a static trainer for my mountain bike and would like to start building up, but not sure if I should wait for the ache to disappear?

Thanks

Rob

Offline Nettan

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #1 on: May 06, 2011, 09:29:26 AM »
Very normal. You need to be careful with that leg and not overdo. So don't work through pain. You have a healing process going on in there and porbably the soft tissue is a bit irritated and swollen yet. Have you tried to ice when you have this dull pain ? Put a towel or something in between the skin and the ice pack(a bag frozen peas works perfect!) and ice for 20 minutes. Also let the leg rest above heart level to get swelling down.
Seeing a PT maybe could give you a hint and some tips about how you can move on.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline Rob Shillito

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #2 on: May 06, 2011, 09:44:48 AM »
thanks for the reply :) I'm the type of person that questions everything so when I don't get to ask the questions it's frustrating :(

I was using the ice on and off, but think im going to stick to a bit of a regime with the old bag of peas.

Leg above heart level is the tricky one. Pretty hard to work like that, but i guess Ive gotta give it a go.

Much appreciate your advise on this as it's difficult been immobile for this long. Used to getting about a bit.

Cheers

Rob

Offline klinkmcbear

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #3 on: May 06, 2011, 01:03:04 PM »
Hi Rob,

I had a similar procedure 6 weeks ago, and was given a sheet of exercises at discharge. I have also been doing PT, which I think has been a huge help. Here's some links to the exercises that they have had me doing - starting with earlier, more basic exercises -

ankle pumps - http://www.youtube.com/watch?v=kVt4fgia1jc&feature=relmfu

heel slides - http://www.youtube.com/watch?v=okhFhILVBCA    (putting a plastic bag over your foot helps your foot slide easier)

quad contraction - http://www.youtube.com/watch?v=4z3C1sIcsJU   The most important thing on this one is to try to straighten your knee as much as possible during this exercise, and really try to push the back of your knee down into the towel. The towel gives you the stimulus against your knee to do this - but you can do it without the towel too.

straight knee lift - http://www.youtube.com/watch?v=vU185f-zfTM&feature=relmfu - I was told to hold for 10 seconds at the top of the lift, which is not shown in the video

lunges on step -  I couldn't find a great video of this one, but the video I am linking you to at least shows you the motion. In this video, the guy is doing them on the floor, very quickly, which you don't want to do. I was instructed to do them slowly, placing the foot from my surgical leg onto to a step and slowly lunging forward. (Now that my range of motion has increased, I am lunging to the 2nd step - allows for a better bend) Use your hands on the step if needed. Lunge into the "bad knee" slowly, and slowly pump at the end of your range of motion. Do about 30. This is the one that I found most helpful to loosen up the front of my knee and increase my range of motion during flexion.
http://www.youtube.com/watch?v=P3BYD0bXXIw

calf raises/stretches - http://www.youtube.com/watch?v=wGTZyp1sbuw&feature=relmfu

heel walk - the worst part for me was trying to straighten my leg. Walking across the room on my heels was the best of the exercises to help loosen up the back part of my knee. I will do these any time during the day when I feel my knee stiffening up and wanting to stay bent.

walking backwards on a treadmill - this helped a lot with straightening too. You can go as slow as you want, (.5 to 1.0) and it's fine to hold on. The important part here, which is not shown that great in this video, is to be sure to exaggerate the toe to heel motion and have a long stride. When you first put your foot down, reach right back with your toe and role fully to the heel, flexing the toe up towards your head at the end.
http://www.youtube.com/watch?v=hNAMw5JnHS8&feature=related

wall sits - http://www.youtube.com/watch?v=tDjKeOCgisw  (if you do these against a door, you can tip to the side a little and use the door jam to help straighten when you're done)

unweighted squats - I couldn't find a great video of this. This video shows the guy squatting down to 90 degrees -  I started only going maybe 45 degrees or less - just until I started feeling pain. Also, in this video, the band is connected to something on the floor - you will want to use a resistance band and loop it around a bannister, or if you can find something overhead, that's even better to start (I went to the gym and looped it overhead at first - on a piece of equipment)

step ups - you can do these as shown in this video, or laterally - instead of facing the step, you turn your body 90 degrees so that instead of facing the step, your hip faces the step. These can be done on a regular step, and you can use a railing if needed. Also, if you are not able to lower your foot flat foot down, once you raise up, point your toe to the floor, and lower down with weight on your toe:
http://www.youtube.com/watch?v=I_RaJyG61RA

A couple of very helpful things that my PT told me -

- concentrate your work at the end of your range of motion, where applicable
- respect pain - a little pain is OK, but not too much - basically, you have to find the balance between being a baby and pushing too hard
- ice for about 20 minutes after exercising
- if you are still limping, a couple of things that helped me was to be sure to land with your heel, roll to your toe, extend you hip bakwards, and lift your leg high enough so you don't come close to dragging your toe.
- it's a good idea to do these on both sides
- Flexibility is important - Be sure to stretch - hamstrings, quads, hip flexors, calves - you can search on you tube if you don't know how to do these.
- Balance is also a very important component - to strengthen the small stabilizer muscles- again, you can youtube balance exercises.
- Hamstring, glute and quad strength are all important, as is core strength. Once you are doing good with the these exercises, working on strength in these areas will be helpful....youtube again!

Hope this helps. There are more, but this should get you started. From what I have seen, a lot of the exercises that I am being given parallel those for knee replacement, so you can do some searches on that if you need more.

Kathleen



Left knee - partial menisectomy & debridement - 3/2011

Offline Rob Shillito

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #4 on: May 06, 2011, 04:29:43 PM »
thanks for the reply :)

good few things to go through there.

I was just wondering if you have a dull ache as well where they did the op inside the knee?

Guess its the lucky people that only takes a couple of weeks to be back on the go :(

thanks again :)

Cheers

Rob

Offline klinkmcbear

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #5 on: May 06, 2011, 05:54:43 PM »
Hi Rob -

One thing that I don't think I mentioned, that makes our surgeries a little different, is that in addition to having the meniscus trimmed, I also had pretty severe degeneration of the cartilage, which they debrided and smoothed. They told me that it was very advanced and widespread - in some areas, bone on bone, and that a knee replacement will be in my future. That probably would lead to some different types and/or location of pain, I would think, anyway.

I have had several different kinds of pain in my 6 weeks post-op. At first, I had a lot of pain in the back of knee especially when trying to straighten it. It was like it was catching and I would have to wiggle it to just the right position so that I could try to straighten it without pain. That kind of felt like a scar tissue kind of thing to me.

I have pretty good range of motion on flexion now, but while that was more limited, I had a dull type of pain right at my kneecap. This was especially true when I would push the limits of bending it.

All along I have had what I think is a lot of stiffness. It is worst when I am sitting for any stretch or time, or if my leg is straightened for a while, or bent in one position for a while. This has decreased a ton, but still seems like it has a ways to go. But now, when I first stand up, I do a few different strecthes, and am able to shake out the stiffness pretty quickly.

Currently, the bulk of what I feel is a sharp pain in the location of the meniscus tear - for me, this was the medial meniscus. That just started a few day ago though, and I was really concerned about this sudden onset and increase in pain. It seems to coincide with a marked decrease in the stiffness that I have been feeling. I told my physical therapist about this at my appointment today. She believes that the fact that I am not as stiff any more is resulting in more movement in my knee, but I don't yet have the strength I need to control the additional freedom of movement....thus the pain. I will be working on increasing this strengh over the next several weeks.

I think one thing that I have learned from all of this is that there are many different types of pain, and at different points in your recovery, you might feel these various forms of pain come and go. I also think that much of the pain is very normal and just a part of the process. Most of these different pains that I have felt in the past 6 weeks have diminished or completely gone away. At first, each new type of pain worried me that I was regressing, but I have come to realize that new pain does not, in and of itself, mean that things are not going well. The only problem that really remains for me is the sharp pain medially. I am confident that this new sharp pain will be relieved, or at lease decrease significantly, as I work through the new exercises that are being added to my regimen this week. I have been doing a ton of physical therapy, and think that has been a huge help in my progress.

Good luck with your recovery!
kathleen

Left knee - partial menisectomy & debridement - 3/2011

Offline Rob Shillito

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #6 on: May 06, 2011, 06:20:06 PM »
Hi,

blimey, sounds like you had the full treatment.

To be fair I only have a little stiffness if I walk a bit too far and it swells up, apart from that I seem to be ok. It's just cos it is the same feeling as before the op so it had me worried. I guess the cartilage has no nerves so it must be the surrounding tissue that's causing the ache/pain. It's just so easy to make it flare up again by overdoing it a little too much.

I'm going to take it steady but do some of those exercises you gave me to keep the leg in half decent shape. Guess if I leave it I could cause more problems with muscle tracking issues and atrophy. 

Hope you are back on your feet properly soon and can put off the replacement for as long as possible. All we need is a genius to come up with a better knee than everyone else has got then everyone will want one ;) Cross fingers :)

Again, thanks for the insight into your experience as people dont really appreciate how much they need their knees. Might have helped if I had built up to full trail mountain biking, but I guess I've learnt my lesson.

Many thanks

Cheers

Rob

Offline Rob Shillito

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #7 on: June 18, 2011, 08:33:03 AM »
Hey,

bit of an update.

I've been 2 months and 2 weeks post op and to be honest there hasn't been a great deal of change. The knee still aches and swells up if I do an hour or so of walking.

I got the results of what they actually found and it was the front medial horn of the meniscus that had some scaring. the doc said he smoothed it over and the rest of the knee looked in good shape. He seemed very nonchalant about it and thought it would be fine. I would say I saw him about 4 weeks ago.

i'm gathering at this point the op as been a bit of a failure as the pain is coming from exactly the same place as it did before the op. I just dont get what is making the pain inside there as I keep being told there are no nerves. Something has to be causing the discomfort.

My follow up is in sept, but Im wondering if I need to pursue it earlier as this is no road to recovery at the moment?

Any thoughts on this would be appreciated?

Cheers

Rob Shillito   

Offline Nettan

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #8 on: June 18, 2011, 05:24:28 PM »
You've tried off to use some antiinflammatories ? Sorry to say but this doesn't have to mean that your knee surgery was a failure. Some do have a quick and easy recovery and some don't.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline Rob Shillito

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #9 on: August 01, 2011, 06:46:43 PM »
Hey,

5 months post op now and I still have pain and swelling when I use my knee. If I'm on the knee for more than about 5 minutes the knee goes red and it feels hot. It does sometime look normal, but there is generally discomfort there all the time.

Should I really be chasing this up now or could it be that it's taking a hell of a long for the soft tissues inside to heal?

Not really sure where I go next with this :(

Any thoughts appreciated :)

Offline Rob Shillito

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #10 on: August 01, 2011, 06:49:26 PM »
Also, doc told me to squat to stretch out the scar tissue. This seams to upset the knee more. I'm not really sure if I kinda need to make it worse to get better?

I have full range of motion in the knee so should i not be doing this? BTW, I haven't for about a month or so now.

Thanks

Offline caliKnee

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Re: 4 weeks post knee arthroscopy, symptoms persist
« Reply #11 on: August 12, 2011, 02:35:03 AM »
Hi there.  Just read your posting ... Hope you are feeling better.  I'm going through this, too, though just a few weeks into the post-op from a torn meniscus trim, but am disappointed that I still have pain on that side (and worse at the moment) as before the surgery.  I've been doing some searching for reasons and one thing that I've seen come up a few times is that the pain we had been feeling in the knee could really have been due to arthritis settling in and the meniscal damage was not really the cause of the pain.   If your health plan allows it, maybe see if you can get a fresh x-ray of the knee and have them tell you if it looks clean or not... at least that might eliminate one possible cause.

Anyway, best of luck to you.
torn meniscus

 















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