Bone breaks around the knee :

2.5 yrs post patella FX: Recent dev of VMO! - - Posted by Rhonda (Rhonda), 1 November 2004

I havent' posted  in a while, but I had a new development I wanted to share! (Hi Pat, Liz, KAthy, and everyone else!)  Recently tried Spinning class- best late-in-game- rehab you can ask for!

This advice is more for later rehab, not really for those who are in the first few months post-op.  More for people who are long past the initial injury/surgery/ First round of PT, but just cant' seem to get back the VMO muscle.   My injured leg will probably never be the size of my good leg, but I cannot believe how much ground I gained in the last two months, and so long after my injury!  

Long story short, shattered patella beyond all recognition 2.5 years ago.  Went thru surgery, h/w removal, etc etc...  After a few months of rehab, got back to normal everyday functions..  Took longer for athletics to come back.  I could run, but it was always with a limp (didn't hurt, but looked funny)..  Sometimes it was worse than other times.. Had a fall skiing in March 2004.  Set me back a bit- running limp was worse, and even lost some of ROM that I had  worked hard to regain.

Saw a couple of specialist docs since the ski fall, didn't really seem helpful at the time, but advised me to give it time, and suggested that I shouldn't rely on running for exercise..  The last one suggested stationary bike.  Now, I've always been a frequent gym-goer, but HATE the stationary bike.  But I figured I had to make the switch, so I tried Spinning class.  First  time I did it, I had some minor knee twinges, but that was a combination of not having proper form, and simply adjusting to the new activity.  I had a conversation with the instructor after my first class, and she mentioned that spinning works different muscles than the normal Stat bike (very different from the recumbent bike)- and said it really worked the VMO.  And you know what- she was RIGHT!!!  I've only been doing it two months, and my knee muscles are stronger than ever..  While I don't' run simply for cardio anymore, I do play floor hockey (kind of like you did in gym class as a little kid) .  The last couple of weeks, my running limp is GONE!  I can run almost as well as I did pre-injury.

Just a bit of advice for those that want to give it a try:

1. Obviously clear it with doc first, if you are still under their care..

2.  Make sure you have proper form!   Arrive early, and tell the instructor you have a bad knee and ask them to show you how to set up the bike for your size, and also  proper form and to keep an eye on you throughout the class.    Choose a bike with a mirror next to you, so you get a good side view of yourself.  At no time should your knee ever go beyond your toe.. (I found one instructor at my gym has a move that is dangerous and moves the knee over the toe, but I just do something else when she does this.  Most instructors don't do moves like this.)  Just keep your weight back over the seat when standing and glance at the mirror occassionally and it is easy to achieve this..…

3. Go at your own pace..  If knee (or anything else) others you, back off the tension.. As you get stronger, you will be able to use more tension.    The first class I took, I found my selft getting "stuck" when I would put up the tension too high for the bad leg..  The good leg got around, no problem, but I'd get stuck when the bad leg needed to puch- ha ha..  But now I'm evening out as the bad leg is getting stronger...
Posted by Timo (Timo), 1 November 2004

Good stuff.

Always like hearing sdtories like this becuase it gives me a bit of hope!

Could you expand a little on the difference between 'spinning' and a normal exercise bike??
Posted by kgrosskurth (Kathy G), 2 November 2004

Hi, Rhonda. I've been using a recumbent stationary bike and found it to be a GODSEND in my recovery! I still use it at least 4x a week and have found it now great in rebuilding the muscles along with using a Treadmill. (I have increased the tension on the bike now to work out those quads!!). Like Timo, I'm interested in finding out the difference between spinning and regular bike riding. I guess I can do a Google search, and I will do that after posting.

At any rate, glad to hear your update, and I wish you all the best in your continued recovery!  
Posted by Rhonda (Rhonda), 2 November 2004

Hi again,

To be honest, I don't know if I can give a techincal answer to why spinning hits the vmo better than the recumbant bike.  When the instructor first told me that, I really took it with a grain of salt and didnt' ask her to elborate (maybe I should have...)  ... then once I got to the point where I took 2-3 classes in a week, I really felt it in the VMO's - they were actually sore - not a bad sore- but the "good" kind of sore you feel the next day or two after a heavy workout.  I've never felt it there before.. (I do personally notice that when using a recumbant bike, I feel it more in my hamstrings than with a standing bike)..  And then a couple of weeks later, I subbed for my old floor hockey team, and realized that I was running a lot better..  Also, played hockey two nights in a row last week with no soreness/heat/swelling  in my bad knee whatsoever -  I had never been able to play two nights in a row without some mild adverse effects since my accident...
My guess is that the standing positions (and constant changing  from sitting to standing  and vice versa) are part of it..  My Monday instructor  also mentioned last night that you get more out of the VMO's if you concentrate on keeping the knees in towards the bike (not flaring out to the sides) when pedaling...  
I can try to ask her next Monday for more techinal info, and if I get some good info, I'll dig this post back up and reply to it...     Like I said, I didnt' really buy that much into it until I felt it for myself....

Hey, if the Sox can win the World Series, I can run with a broken kneecap!  GO SOX!!!  

That said, I'm trying to improve running  more for sport performance.... I will probably take the doc's advice and not run too much distance as a form of exercise  (although I would like to be able to run 2-3 miles once in a blue moon - I've only done that a couple of times since the accident- between the setbacks of my knee and an on again/off again achilles tendon issue on my other leg, I was never able to do that regularly anyway... )  The wear and tear risk is higher with a broken kneecap than with a good knee..  My articular cartilidge is cracked and bumpy, but it is STILL THERE for now and  I'd like to keep it that way as long as possible.. SO I think spinning will be my primary cardio from now on...



Good Luck All!  


Posted by kgrosskurth (Kathy G), 7 November 2004

Thanks for your response, Rhonda - and I wish you all the best in your recovery. Keep Spinning!  
Posted by Pat_A.E. (Pat_A.E.), 8 November 2004

Hi Rhonda!  Just checked in after a long absence.  Thanks for the heads up on spinning.  I love the gym, but like you, hate a sationary bike.  However, with what you have posted I'll give it a try.  I've given up running, or trying to anyway, due to tendenosis.  When I have tried running or making quick moves that right leg just doesn't have any "oomph."  I'll see how it goes after a few weeks on the bike.  
Good to hear from you!
Posted by lizl (lizl), 12 November 2004

Hey, Pat and Rhonda!

. . . voices from my past . . .

I'm amazed that 11 months since my last surgery, I do still discover little improvements.  It's great to hear from those who have gone before me. I just can't imagine ever running again without the odd little limp! I guess I need to get a gym membership and give that spinning a "whirl."

Is your injured knee still noisey? If I try to go up stairs with the bad leg leading, the cruchies are so loud others can hear them! Of course, I also feel the friction of all that moving stuff. In a effort to cut down on "wearing" of the joint, I usually avoid the two step approach.

I'll bet spinning would be less stressful than full weight bearing required by going up a step.

Great to hear from you!

LizL
Posted by kgrosskurth (Kathy G), 14 November 2004

I bought a recumbant stationary bike over a year ago from http://www.fitnessquest.com for around $150 with free shipping. I am not sure if a similar deal exists on this or any other bikes, but it may be worth checking out. I love my bike and I use it at least 3-5 times a week, along with a motorized treadmill that was given to me by a co-worker of my husband.

Again, all the best to each of you in your recovery, and it's great to hear from some of the KneeGeek "old timers"  
Posted by KNEECAP (KNEECAP), 26 November 2004

i may need to try that, my town is pretty small so it may be hard to find that class

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