KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: Boydy on December 18, 2005, 09:31:31 AM

Title: Swelling from quad movements ?
Post by: Boydy on December 18, 2005, 09:31:31 AM
Can anyone shed some light on my query. I think I have narrowed my problem down to Patella-femeral Maltracking. So from what I can gather, does this mean every time I weightbear on my knee, because it is mis aligning, that is what will cause me pain if I do certain things, (squats, extensions). Now if I don't do those things but just do simple slow walking,(which doesn't cause me pain) is that enough friction to cause the swelling that I have daily ??  And has anyone had this sort of experience, even if I am having a so called good day, and there is minimal swelling, I can make it swell up by just standing still and rocking slightly & gently (without lifting my feet off the ground) shifting my weight from one foot to the other. I only have to do this about 5 times and it just puffs straight up. (Swells above the kneecap). I watch my legs when I do it and I notice that my quads are flexing as I do this, (I don't go around doing this all the time, it is something that I have done a few times to show PT and OS what I am talking about )  ::)     ;)  .   Just wondering if anyone else has such sensitivity to swelling when trying to work those quads. I know they are all supposed to be connected some how but it just seems that as soon as I try to work my quads my knee swells instantly, but that is the only thing I'm told that will help my knee, is to get those quads working again, but they won't work if there is swelling.   SEE MY DELEMMA    :o      ::)    Any one in the same boat  ??? Boydy
Title: Re: Swelling from quad movements ?
Post by: shade on December 18, 2005, 11:47:56 AM
Boydy,

As you know I'm no doctor, but sure sounds like tendinitis..... Do you use ice on your quad/patella tendon daily?  Just wondering because this helps.  These ice bags are very convenient to use.
(http://images.google.ca/images?q=tbn:2v6W7Ym0Ng3wqM:www.canesgalore.com/acatalog/33801.jpg)

If you are not swelled you can use hot water bottle to loosen up muscles and the heat soothes the muscles.  Sometimes I'll do an ice pac, then wait ten minutes and change to a hot water bottle. Another thing you can do is elevate your legs as much as possible, this helps with swelling.
http://www.footsmart.com/Ailments-Knee-Tendonitis.aspx

http://www.physioroom.com/injuries/leg/patellofemoral_maltracking_sum.php

Hope your cho-pat dual strap comes in soon and will relieve some leg stress so you can get out walking again.  Also, hope you can find a surgeon that will treat your condition.  Good Luck.  ~Shade
Title: Re: Swelling from quad movements ?
Post by: Nettan on December 18, 2005, 01:44:48 PM
Not easy to get around it then Boydy. Maybe you need to have other exams then a OS to see why this happens, if there's any other condition behind it.
I don't remember if you have done that. Just a thought.
I wish I had a clue how you can work around it. Does same thing happen if you work with completely straight knee ?

HUGS NETTAN  8)
Title: Re: Swelling from quad movements ?
Post by: stgiles16 on December 18, 2005, 01:46:40 PM
Boydy , I am in a similar boat. My knee swells every evening (sometimes during the day) and it swells when I try to do quad exercises. It also hurts alot when I do quad exercises which means that my muscles are not growing even if I work thru the pain. I just got this speech from my OS and his PT this week. It is a vicious cycle that I dont know how to stop. I am really frustrated withthis too. If you can figure out an answer, please share, I will bet that there are lots of us out there.

missy
Title: Re: Swelling from quad movements ?
Post by: shade on December 18, 2005, 02:02:15 PM
Missy,

Know what you mean - I'm in this pain-cycle thing and so is Karen S & probably many other people out there.  It is a very hard cycle to break as I've been learning and with the help of bracing and pain killers, knee injections etc.  it has to be broken or you will never get the quads strengthened.  This is quite scary.....
Everything we have tried so far hasn't worked so I'm down to trying to go for a walk when I feel good and recumbent biking without tension.  Tried using a stationery bike and can't stand the pressure it puts on the knees, so had to purchase my own recumbent bike....
Had really hoped that the knee injections would have done the trick, but that did not happen, now I'm hoping the bracing will help get me moving enough to strengthen the quad without further setbacks. 
I've learned to stop everything and rest, elevate and ice if I get pain.....
Good luck Missy, let us know if you find anything that works for you....  ~Shade
Title: Re: Swelling from quad movements ?
Post by: stgiles16 on December 18, 2005, 02:31:40 PM
Shade, my OS wants me to come down there and stay for two weeks to do intensive therapy , 5 hrs a day. I dont see how that is going to break the pain cycle but it might just show him what I have been trying to explain all of these visits. The thought of leaving my kids for 2 weeks sucks though and just the thought of the pain terrifies me.

missy
Title: Re: Swelling from quad movements ?
Post by: shade on December 18, 2005, 03:04:50 PM
Missy,

I'm with you on that one, but the reasoning might be for his PT's evaluate your pain levels and find a treatment program to accomodate you - so you can do exercises without pain during and afterwards.  They have not been able to achieve that with me yet.  If I can do the exercises without pain about three hours later I can barely walk due to the pain.   It is so very hard when you feel that no one is getting it - that is how I felt for so long, but even if they understand that you are trapped into a pain-cycle it is still hard - trying to find a way to exercise & not create pain while exercising or afterwards.  That is where everyone is having such a hard time with me.  Heck, I'm still taking percocet to get through the day and I'm over 5 months post-op..... Yikes!!  that sounds awful......
It would be hard leaving for two weeks though, I agree.   To tell you the truth it makes me cringe thinking about you doing this, but they might find out what is going on and maybe will be able to devise a plan of treatment that will be beneficial to you.  I'll keep my fingers X'D for you - if it was me I'd go for it, just because I've been seeking answers for three years now and would jump at any chance to get back to a more normal life...... Well, if I could jump.....  ~Shade
Title: Re: Swelling from quad movements ?
Post by: stgiles16 on December 18, 2005, 03:52:05 PM
Shade, I will go down there for a week first to see if it is helping but the thought of leaving my family is not a good one and I am soooooo afraid of how much this is gonna hurt. Like you, I hurt everytime that I do exercises, shoot, I hurt if I shop for a couple of hours and I love shopping. I am really frustrated right now. The expenses are a little frightening too. Yikes, hotel bills, new deductable on insurance, that will be one pricey trip.

missy
Title: Re: Swelling from quad movements ?
Post by: Nettan on December 18, 2005, 04:03:12 PM
I'm like you...doing excercises aggravate all of the pain...so for me it's totally up to me how much I do. No phys nowadays or OS will give me a level. So when doing watertherpay sometimes i'm only in there not doing any special, depends on how the day is.
Title: Re: Swelling from quad movements ?
Post by: shade on December 18, 2005, 04:15:07 PM
Missy,

Think a week is a good compromise..... It's very hard when your surgeon does not live nearby, I have that problem also. 
We plan on another roadtrip in the new year, around the middle of the month - seeing if the injections worked or not, but since I've found no real relief yet - sounds doubtful that they are going to start working now.....
It does become very expensive and with motel rooms in the mix - very expensive. 
Good luck, Missy..  ~Shade
Title: Re: Swelling from quad movements ?
Post by: Boydy on December 18, 2005, 09:46:28 PM
Hi all,  this time difference is wierd, so many conversations happen, while I'm sleeping.  ;) 
Shade -  Funny you should say Tendinitis, that is what my PT is saying, OS says Maltracking,  ::), but after reading those great sites you gave me, it sounds like both of them.  :-\ . Yes I do ice EVERY day sometimes two or three  times, (plenty of time on my hands now I'm not working) I use a wheatbag that I keep in the freezer, (very similiar to your picture) I even take it away with me. I have the same thing with the bikes, Stationery is a no go, I can only use recumbancy bike. Yes, I am holding out for my brace, thought it would have come Friday, but didn't, so am thinking TODAY is the day, hope it helps. Is yours still giving you success,? hope you are feeling a bit better, shook that bug, and getting back into it, have to be good for xmas.
Nettan - Yes I have had quite a few opinions, have seen 4 different OS and the last one 2 weeks ago also sent me to a Nuerologists (saw two of them) to rule out muscle or nerve problems, one was concerned by my muscle responses to stimulie, and sent me for Brain and spinal cord MRI's (was testing for MS etc) & fortunately these came back all clear, so back to square one. As to your query on straight leg, do you mean straight leg raises ? If you do, then yes it does still swell if I do them,  the weird thing is , it also swells if I have acupunture or have it massaged ( when they find those lumpy sore bits and massage them out  :o   :'(   that really kills. Weird when it is my thigh they massage and my knee swells  ???.
Missy - That sounds like a good thing to do if you can manage a week at least,  I've often thought, I wish the PT or OS could see me the next day after they have got me to do all those things in their office, because after I have been for a visit, my leg takes about a week to settle down !!! I don't think they beleive me when I tell them, so one day I went back in the next day to show him (PT) and he was dumbfounded, so then he just gives in because its in the too hard basket. (All 5 PT have done that,) that is why I have to do what you guys seem to be doing as well and just going by your own instincts and trying to work out your own programs. (With a lot of helpful advice from this site, and listening to people who have the same sort of symptoms). Whew , sorry this is so long, but there is a lot to cover.  :P
Boydy













Title: Re: Swelling from quad movements ?
Post by: shade on December 18, 2005, 11:28:52 PM
Boydy,

I do agree that you can have both...... Know that the rehab for maltracking usually leads to tendinitis.  I know for a fact that my patella is medially subluxed because the new brace that I have the tru-pull wraparound really pulls my patella over to the groove and my knee feels much better now, but as soon as the brace is off the patella subluxes again......
When patellofemoral pain due to maltracking is associated with patellar tendinitis, both pathologies need to be addressed.

It is very strange we are from all over & none of us can find physios who seem to be able to treat our conditions properly.  I've been to several therapists and they all try to slap weights on my ankles and look at me like I'm crazy when I refuse...... Then they think I'm difficult..... Argg!!

http://www.physioroom.com/injuries/leg/patellofemoral_maltracking_full.php

Hope your brace arrives soon.  I'm wearing two braces right now - fun, fun, fun.....  Think I'm over the bug now, feeling better each day.  Will start walking on the trails again soon and will let you know how it goes......

PATELLA MALTRACKING
The normal patella should track in the groove of the femur in a relatively straight manner.  There are varying degrees of malalignment and tracking.  In some cases the patella may tend to track more to the side of the knee or actually be tilted as it goes back and forth in its groove.  On occasion it may actually come partially out of the groove, which is called subluxation.  Some patients have a positive “J-sign” in which, in full extension, the patella tilts and is pulled strongly to the side of the leg.
The tracking of the patella can be influenced by different things.  Most of it is influenced by the anatomical shape of the knee.  The following can all contribute to the maltracking of the patella:  shallowness of the femoral groove, the angle of the knees (knock-knees), rotation of the hips, foot positioning on the floor (pronation or flat feet), weakness of the quadriceps, and the shape of the patella.

Treatment
Treatment for this emphasizes quadriceps strengthening.  The middle muscle of the quadriceps, called the vastus medialis obliquus, or VMO, is the muscle that is focused on to try to balance the patella in its motion.  Occasionally, taping can also help with this.  If conservative measures are not helpful, surgical treatment is reasonable.  Rebalancing the kneecap by opening some tissue on the outside of the knee can be done arthroscopically.  Occasionally tightening the medial structures can also help.  In most patients, this type of surgery would be all that they would need.  In some patients with a significant problem and with patella subluxation or dislocation, a more extensive realignment procedure is sometimes used.

Hope everyone has a great evening.....  ~Shade
Title: Re: Swelling from quad movements ?
Post by: KarenS on December 19, 2005, 12:26:35 AM
Shade, I read the information you posted, and I'm so disgusted right now (not at you -- just in general!  ;) ). Deep down inside, I feel that the LRs I had years ago to correct patellar tilt in both knees set me up for this horrible experience I'm having. It's far from a "simple" surgery and it changes the mechanics of your legs. I couldn't push my self to do much rehab after those surgeries because, sort of like now (but not nearly as bad), some of the more advanced exercises seemed to make my knees feel irritated. (And now I realize that it probably was because I still had some inflammation in there and my kneecaps were maltracking a bit, which causes pain -- same as what's going on now!). So I just backed off the exercises and walked to exercise my legs. I was lucky that eventually I did get most of my quad strength back, but I was told by my therapist that after knee surgery, most people never get back 100% of their quad strength unless they are very aggressive with their rehab. So I think my quads have a tendency toward weakness to begin with...add that to the "miserable malalignment" I have, and add that to the fact that I was working out like a maniac at the gym without a stretching program, doing the same type of exercises over and over instead of working all muscle groups...and there you have a huge, unbalanced, atrophied MESS, named Karen. ;)

Anyway, I'm just ranting a bit. It just annoys me when I read about how "cut and dried" they try to make LRs out to be, and they really are a big surgery. I still feel that in my case it needed to be done because nothing else was working therapy-wise, and I wanted to kiss the ground my surgeon walked on when I was able to walk around like a normal person once again with no pain. But now I'd like to slug him for not warning me that I needed to be very careful in my rehab and to stick with it until I could do it pain-free. I think I entered this recent knee problem at a disadvantage because of that. I honestly thought I was going to get through the next 50+ years without more than a peep or two from my knees. HA.

And with that, I'm off to bed. (I'm sorry, Boydy, for highjacking your post! I'm grouchy because I felt really good today and attended a Christmas party...only to end up with that weird sore area on the inner portion of my knees on the way home. What IS that?!? I sure hope the OS I see next week will give me an answer -- and I'm praying it's nothing to be worried about. :( )
Title: Re: Swelling from quad movements ?
Post by: lilrosie06 on December 19, 2005, 03:43:29 AM
Boydy, I have a subluxing problem, and any use of my quad causes pain and swelling. I cant squat, kneel, and have to be real careful on stairs. If my condition doesnt get any better by spring, my OS is gonna do a patellar reconstruction. You are not alone. Hang in there...

DONNA
Title: Re: Swelling from quad movements ?
Post by: Boydy on December 19, 2005, 03:49:56 AM
Hi Shade,
OK,  I'm starting to get the drift of all this now, seems important to get the VMO in working order, any ideas on how to do this if I can't do leg extentions or squats, lunges. When I looked it up that is what was recommended. Will the VMO muscles get stronger by just doing a few quad sets and a few leg presses (no weight).??  Because (like you)  everytime I see PT or OS they insist that I will not get anywhere just doing the things I am doing.  Even this new OS I saw last said," strap those ankle weights on and sit in front of the tv at night and work your way up to 100 lifts " !!!      :o  Don't you just feel like slapping them !!  I know that for some patients that may be some good advice,  but just once I would like to go see someone that has an incling into what my knee is all about, and just say, "most cases this is what you should be doing, BUT, in your case we will have to do this instead !!!  ::)
Yay, I just picked up my brace, have gone up and down the stairs a few times and it feels good, so far. Test will be at the gym tomorrow, and when I take the dog for a walk,  then the real test will be the next day, (see if it swells up) !!  Bugger it if it does,  at least I might be able to do a few more activities with it on, (without limping)  and start to do a few more social things, sick of being left behind all the time because I can't do this or that. Especially over the holiday season.  Fingers crossed, I will let you know how it goes.  :D  Thanks for all the info it has been a good read. I need to have as much knowledge as I can to do this right.
Karen S -  go for it , I don't mind sharing, anytime,  we are all in the same boat !!!  ;)
Boydy
Title: Re: Swelling from quad movements ?
Post by: Boydy on December 19, 2005, 04:01:55 AM
Hey Donna,
not sure what a 'subluxing' problem is, does that mean it dislocates,? or is it another name for maltraking,?  Gosh I sure hope your problem does get better before the spring, I have read so many posts (myself included) where you just keep letting them go in 'one more time' to see if it can do the trick, but some people just don't handle the after effects of surgery well, and it just goes on and on. I'm sorry I'm being so negative about surgeries,  its just one of those days,  ::).  Thank you for your encouragement,  :D,  Let us know if you find any answers out there that might help.  I'm hoping my new brace will be my 'saviour'  !!!     ;D
Boydy
Title: Re: Swelling from quad movements ?
Post by: lilrosie06 on December 19, 2005, 04:14:38 AM
Its the same as maltracking. It doesnt sit in the groove properly and keeps slipping out. And it HURTS!!!! Ugh....This  has been going on since 1-3-05 when   I hurt it at work. I just wanna be able to get back to all the things I  used to do. I hope your brace helps. I have a patellar J brace. It helps some, but the kneecap still fights the brace to sublux. Good luck! And keep me updated. Thanks....DONNA
Title: Re: Swelling from quad movements ?
Post by: shade on December 19, 2005, 12:19:51 PM
(http://www.sportsmed.buffalo.edu/info/patsub.gif)

http://www.sportsmed.buffalo.edu/info/patellarsublux.html

Hi Donna,

Sorry that things have still not happened for you.  Did you read this article by John Fulkerson, MD - it is really good and has helped me tremendously.

http://ajs.sagepub.com/cgi/content/full/30/3/447

I medially sublux and I'm now trying the tru-pull wraparound brace and it is actually working.  This is a universal brace - meaning it works for medial or lateral subluxing patella so, you can wear it either on the left or right hand side of your knee. 
This guy is pulling his left patella laterally...so, he medially subluxes like me.....
(http://ajs.sagepub.com/content/vol30/issue3/images/small/sm0321331003.gif)

My pain has decreased tremendously and hopefully if I can now find a brace sleeve I'll get rid of the sore spots from the brace.  It really keeps my patella where it belongs and I am feeling so much better and hoping that now I'll be able to start building up the quads again.  Know that the brace is not a cure and I'll probably need more surgery like the article says, but it is nice in the meantime to get some relief. 

It really would be nice though if something like a brace could be the answer instead of surgery.  ~Shade
Title: Re: Swelling from quad movements ?
Post by: KarenS on December 19, 2005, 12:48:30 PM
Boydy, I really hope the brace works for you. It's not always a temporary thing -- sometimes a brace can help keep your patella in place so that you can get your quads back in shape and that will help or solve your problem. Or it could just be temporary relief (like Shade said). Don't lose hope that this will be resolved with therapy! And yes, try to get those VMOs working -- do the pillow squeezes (if you can), and turn your foot outward a bit when doing SLRs. You have to do the exercises that target it, although the quad sets work it, too (as long as it's firing, that is).
Title: Re: Swelling from quad movements ?
Post by: shade on December 19, 2005, 12:54:44 PM
Boydy,

Oh my, it is my PT's that kept trying to put the weights on me..... My OS says, absolutely not.....
I've had OS's in the past though that actually told me to take up running and that would fix me right up.  Ya, that would be good for a person that can barely walk without pain.  It is awful hard with all the conflicting info out there also.  You like me seem to have had one problem and then it led to another condition.  Think what happens is you have maltracking and after you try to fix it with exercises and find that exercises hurt - your choices of exercises are cut back so much that you tend to do the same things over and over and that is how we get into this overuse thing.  I could be wrong about this, but that is how it seems to me anyway.  Right now the only thing that I'm doing at all is the recumbent biking, think I've reached a point where I really am afraid to get back into the pain cycle again. 
Since I've gotten used to the tru-pull wraparound I'm feeling pretty good and afraid to go backwards again..... I went the whole day yesterday without a percocet and the only pain that I had were the sore spots from the brace (need a brace sock, I think).  Did not do much but go up and down stairs and walked around the yard and up and down the driveway, but things feel pretty good. 
Today I plan on going for a little walk and doing a little recumbent biking - fingers X'D that the spell won't be broken.  If the tru-pull brace works then it's the medial subluxation that is creating the problem and the tendinitis is secondary, which is usually the case anyway. 
Keep up with the biking and for VMO do you do the exercise where you just sit on the floor and put an exercise ball between knees and squeeze - I was told this was a great VMO exercise.  This exercise can also be done while sitting in a chair. 

Sure hope that you can find a comination of things that will work for you - think that is what it takes for some of us to find relief.  Sure hope that this cho-pat dual strap will do the trick to get you going again and give you some needed relief.  Think that is half the battle - many people just go to therapy and their problems seem to look after themselves and some of us just do not fit into those categories..... Would be nice if the physios picked up on these situations instead of sometimes creating more problems like some of us have gone through, but to get there eventually would be nice and hopefully we shall..... I do not mind the rocky ride if we can get to smooth ground eventually.....  ~Shade
Title: Re: Swelling from quad movements ?
Post by: Boydy on December 19, 2005, 10:54:52 PM
Karen,   the way you describe those exercises I take it the VMO are the ones on the innerside of your thigh, (they seem to be the ones that work when you turn your foot outward in the SLR, thanks for that hint,)  it helps when you know what area you are suppose to be 'targeting'.
Shade, just doing the bike, mmmmm wonder how things will go when you start introducing back some of the other exercises. It will be interesting, maybe thats the answer, give it a rest, (but not totally) then reintroduce (especially now you have your braces) other things slowly.  Maybe that has been my mistake, when I have had enough of the swelling, (and when I go away for a week holiday) I give up everything, no gym, and don't even do any floor work or stretches, just sit around visiting , eating,  and going to movies etc, ;D (not to mention the 4 or 5 hours in the car there and back). By the time I get home the swelling is worse then ever !!! Thats why I feel I'm damned if I do and damned if I don't.  :-\  But I could be going about it wrong, if I go away like that, maybe I should try to just do some daily stretches , to keep it 'limbered up'.  Who knows, you can second guess everything till the cows come home. Lets face it, it is all just trail and ERROR, ( more emphasis on the error I think)  ;)
I had my first walk with my brace on this morning, will take a bit of experimenting, I think, not sure how tight to pull velcro, box said firm but not tight, but half way around I didn't feel like it was working (even had some pain, which haven't had for awhile) so I stopped and pulled it really tight, and it felt much better and pain went away, but am finding it swells up quite quickly when I take it off, only walked for 15 minutes. ( I ice and elevate as soon as I get home) Will give the gym a miss for today and go tomorrow to see how it goes there. Do you find your tru-pull brace is better than the cho-pat dual strap? Do you where them on different legs? Which one is for which complaint ?  I will take my brace next time when I go see PT, he might be able to guid me on how to use it properly for my problem areas, unfortunately can't go until January, so will have to wing it until then.  By the way, they are great web sites that you are sharing with us, great info in them. Thanks.  :D
Boydy
Title: Re: Swelling from quad movements ?
Post by: shade on December 20, 2005, 01:13:52 PM
Boydy,

Well, what I've done is I've tried to keep doing something all along this journey.... for instance I was doing alot of leg exercising and biking and walking and found that the physios were wrong and I was really overworking and that is how I got into this pain cycle thingy.... Then everything was taken away for about two weeks and I do absolutely nothing but rest then slowly starting biking with knee sleeves on and then gradually started walking on a soft surface, but only went about a 1/4 mile and worked myself up.  Same with the recumbent biking, but never using tension only increasing the time and worked up to twice a day for 30 minutes..... then walking up to two miles, but then the pain all came back again - so, now I trying to start biking again with the new braces and going to be adding the trail walking very soon also to see how that goes....
I wear the tru-pull on my right leg, as that knee subluxes more than the left and the cho-pat goes on the left knee.  I also notice swelling after wearing the cho-pat but think it is because it puts so much pressure on the quad....
If you do not sublux then the tru-pull wraparound would not help you at all - it is only for medial or lateral subluxing...... meaning your patella slips out of the groove or hangs over the side while standing...... Mine is very visible whenever I stand my patella goes right over to the inside of my leg.
I've found it very hard to find a brace that helped my condition - first off I had those PTO braces from Breg and they put just too much pressure on my knees and made them ache worse, but now I know that the tru-pull is definately right for my right knee - it takes the pain right away.  Yesterday we found a brace sock and that has stopped the brace rubbing and makes the brace even more comfortable. 
(http://www.kneeclinics.co.uk/assets/images/MES_patient2.JPG)
look at this guys knees as he stands with his feet facing forward..... his knees are pointing inwards - this is what my knees do and this means that your kneecap is slipping in the groove or subluxing..... (also called squinting patellae).
I went to quite a few doctors and they just said this is genetic and nothing could be done about it.... Hmmmm!!  Anyway, through research you can find answers & hopefully the right doctor to help with your condition.  It is very hard to find a surgeon that is willing to help patients with these pain issues....
I'm with you about the second guessing - it is horrible to be afraid to do things and yet we all need answers and the only way to find answers seems to be by trial and error.  I call it the Catch 22....

The cho-pat helps my left leg especially up or down inclines - it takes the pain away.  Left leg gets pain over and under the patella tendon with walking.   
My right leg is a different story though - it did nothing to help with the medial subluxation & therefore was not enough brace for my right leg.

Karen,
You are so right, guess I just don't explain things very well.  Some people have great success with finding the right brace & doing the proper exercises through PT & being able to return to normal activities without having surgery, and that is great!!
Unfortunately, there is a percentage of people this will not work for & it's mainly because their condition was left untreated.  I have read this over and over and it really bothers me as I know I am included in this category -  If you have a problem for a long period of time & it goes untreated - it takes much longer to correct the condition as other problems compound the original condition....
No one should give up!!  There are answers out there & although it is difficult sometimes there are surgeons that are willing to take on tough cases & willing to help patients with pain-cycle conditions
I feel better today that I have in three years.  This new brace has given me pain-free walking & more of a lifestyle.  Don't know what is in my future, but know that this Dr. Fulkerson article & his brace have changed my situation and I'm very pleased with the results to date.  Maybe it is a permanent fix, maybe not!!
Don't think it should be this hard to find answers, but in reality it is sometimes.
Hope everyone has a great day...... ~Shade
Title: Re: Swelling from quad movements ?
Post by: KarenS on December 20, 2005, 06:07:28 PM
Quote
If you have a problem for a long period of time & it goes untreated - it takes much longer to correct the condition as other problems compound the original condition....

Yes, insert me into that category, too. It forever amazes me that "knee experts" tend to blow off these chronic conditions that develop, instead of hammering into our heads that we need to do something about it ASAP instead of trying to "rest it away." I now know that the longer someone walks around with severe quad atrophy, the more and more likely they're going to develop additional problems. GRRRR... Don't get me started.  ::)
Title: Re: Swelling from quad movements ?
Post by: Boydy on December 21, 2005, 04:05:14 AM
Hi Shade & Karen,
Shade I can't believe you were, so far down the recovery trail just to go back to square one again ! ??? That is what I am scared about, (trying not to look to far ahead & be all negative etc) but I too have been a lot further down the road ( I was even managing to do some leg extentions in my daily gym work outs ) but all came crashing down (for no apparent reason) and went back to the daily swelling etc. That is the hardest part of all, everyone commenting on how well your walking now and, "gee you must be getting better, your not even limping now !!"  Then the next time they see you your back to walking stiff legged at a snails pace and limping around !!  ::)  "What happened, they say"    :o   (IF ONLY WE KNEW) !! This is why I can't get my life back, just when I start thinking that it is getting stronger, and I might start to look for a job, it backslides, I'm just not game to go and take the risk of putting my knee under anymore strain, ( I don't know how you other people are managing to go to work, or look after  a young family !!!) I had to give up my job a year ago, there is no way I could stand ( or sit for that matter) for longer than two hours at a time. Most jobs that I know of,  that is exactly what you would have to do.  How do you all cope !!!  :-\  And my children are all grown up, (actually my son (22) has just left home this morning to go and work in the big city. So now just my hubby & I at home. I have been bawling like a baby all morning!  :'(    So really I am very spoilt and have the time to concentrate on my knee, exercise, ice , elevate as often as I need too. Maybe thats the problem, too much time to focus, might need something to take my mind off my troubled knee. :P   OK,  enough waffling on, thanks for listening, depressing day for me, missing my boy tremendously already, (its only been 3 hours) think I need some chocolate !!!   ;)
Boydy
Title: Re: Swelling from quad movements ?
Post by: KarenS on December 21, 2005, 12:27:17 PM
Boydy, I'm sorry you had such a bad day. Does it make you feel any better that I was crying last night, too? ;) (I'm sure it doesn't!) Don't feel like you're spoiled because you have more time to work on your knee problems. It's depressing whether you have kids, or a job, or whatever else! And I think you hit the nail right on the head: When you have too much time to spend thinking about your knee problems, it does make them seem (and feel!) worse. Seriously, I'm convinced of it! If I go out for the night with friends, or go to a party with family, I don't even notice my knees much -- whereas, if I had been at home, I would be obsessing over them practically every single minute. It does become an obsession! And I don't know about you, but the more I worry about something that ails me, the worse I feel physically. So, long story short, maybe you *should* try to do something to take your mind off it. I know it's hard when you're limited by where you can go and what you can do that involves walking/standing. But surely there must be something...?? (I've been thinking I need to find something, too!)
Title: Re: Swelling from quad movements ?
Post by: shade on December 21, 2005, 01:23:31 PM
Hi Boydy and Karen,

Think you are right. 
I agree - that is the reason I ended up on this site to begin with.  I tried taking time away from my knee by delving into PC games that took a long time to play, ones where you developed the characters etc like Diablo or Neverwinternights or Morrowind.  If you don't like these strategy games you can play online puzzles or scrabble type games.  Also, you have to try to get out each day, even if it is just walking around your yard or going to have a tea or coffee with someone..... It all helps.  Original fall for me was almost ten yrs ago now.  I fell off my horse & landed on both knees & one arm.  Then had fall in house three years ago & that is when the limping and the subluxed patellae began.
What I've learned is that you definately have to find hobbies, movies, friends, pets, or tv.  Whatever works for you.......
Sorry about your boy moving away for work, but it eventually happens to all of us. You'll feel better soon.....
I can't really relate to this idea about if you don't think about your knees they don't hurt as much but, maybe because my patella was always in the wrong place, I felt my knee with each step. Think getting your mind off the knees is a great idea though.  You just have to try to maintain some sort of lifestyle through all this so that your knees don't take over. 
Guess that is why I've been so surprised, but delighted with my turnaround just because of a knee brace - hope this will happen like this to both of you also.  ~Shade

Title: Re: Swelling from quad movements ?
Post by: Boydy on December 22, 2005, 12:47:51 AM
Karen & Shade,
thanks for the support & encouragement girls, :D, I am feeling much better today, I received a big newsy email from my daughter, and a lovely big phone call from my son when he arrived at his destination. So all is well in that department. (Karen hope your not so sad today, hope something has cheered you up as well   ;))   Maybe in the new year we will both find incredable jobs, I'm thinking about something 'half days', so that if it does play havoc with my leg it won't be so bad as having to deal with an aching leg or pain & swelling for a whole day. I just remember what it was like when I was working all day on my bad knee, by the time I got home it was ssoo swollen, then to have to turn around and take clothes off the line and cook tea as well aarrgghhh !! (yes, I'm one of these women who do EVERYTHING inside the house, hubby does OUTSIDE ) he works very long hours so that is the way it always has been. So it suits me fine, to be 'just' housewife for awhile, but I'm afraid we got used to living a lifestyle with two wages & a bit hard to break those 'spending habits'  :-[ . Don't get me wrong I do fill my day in quite well, I have a little puppy, and I do like to take her out for outing most days, & my house and cupboards have never been so organised and tidy  :o  But it is the money side of it, I really will feel better when I can get some sort of income, (I like my holidays, especially now we have no kids at home, this is suppose to be  'our time' ) Fingers crossed for the New Year.
Shade, I was going to ask you if your brace restricts you from bending your knee. I wore mine to the gym yesterday and because it has about an inch strap that goes aroung the back of the knee it was a bit hard doing the exercises, even the recumbersome bike was hard to do, and the leg curls as well, the brace sort of stops you from bending your leg , (great for just walking , but I really need the support for the gym work)   Does this happen with yours ??
Boydy
Title: Re: Swelling from quad movements ?
Post by: shade on December 22, 2005, 01:41:03 AM
Boydy,

No, do not find either the cho-pat or the tru-pull wraparound give any problems with doing my biking or walking.  I'm not doing any other exercises and especially not leg curls.  I've really rested my legs this time and only introducing the biking and walking until further notice after the middle of January......

Have you tried using a knee sleeve or just an ace bandage while doing your PT..... Might work better for you......
Title: Re: Swelling from quad movements ?
Post by: Boydy on December 22, 2005, 09:33:50 PM
Shade,
yes I used to use the knee sleeve for PT and that did work well, might have to go back to that and just use my brace for walking. Is there a particular reason you aren't doing anything else besides walking and bike ? Has that been suggessted to you by PT or are you going by your gut instincts that this is the right move for you? Do you do any floor stretches or quad sets at home as well? Sorry about the 20 questions, but just trying to get a grip on what works for everyone,( and also what different PT are advicing people)  I am not game to do any less then I am because I am ssssooo scared of losing anymore quad strength, which I feel will send me backwards even further.
Boydy
Title: Re: Swelling from quad movements ?
Post by: KarenS on December 22, 2005, 09:39:53 PM
It definitely will, Boydy! My new motto is, if nothing else, do the quad sets! I seem to be able to add more and more every few days, and I do see more muscle when I flex. Yay! So, as "wimpy" as quad sets may be, they definitely do *something*!
Title: Re: Swelling from quad movements ?
Post by: shade on December 22, 2005, 09:48:27 PM
Boydy,

Had to fire my pt as she would not follow the surgeons protocol.  She wanted to use weights and he said no way because I have that lesion behind my patella.  Since I've been in this pain cycle so long we are going very slow with my knee and all that I'm doing is walkiing on a light surface and/or recumbent biking.  My surgeon really likes me using the recumbent bike.....

Today, for instance I decided not to put my brace on first thing and just wore a knee sleeve so I would not have to wear the brace for such a long period of time.  Well, hubby and I went out for a walk (with brace on) and I had to return home due to the pain that my lesion was causing.... Grrrrrr!!! But, the brace holds my patella in place - so that is good.   So, guess that I won't try that tirck again.

We just have to find out what works.  Here physios use weights, uprightstationary bikes and tread mills and don't understand why a surgeon does not like these machines.  They do step-up, lunges and wall slides and if you do not do them they don't know what else to do with you.  So that is what a person faces here - so, these are all the things that have gotten my knee into most of these problems and now we are trying to get my quads back without me feeling any pain during or after exercising and so far it is working.  If I have a bad day then no exercising that day - just resting, icing and elevating.... It is slow work, but hopefully the pain cycle will be broken once and for all......

Agree with you Boydy & Karen and I've got my fingers X'd that we all get our quads back again........
Title: Re: Swelling from quad movements ?
Post by: Boydy on December 23, 2005, 11:42:50 AM
Karen & Shade,
am leaving in the morning for the Christmas break, so wishing you both a very Merry Christmas  ;D  and will check in again in a few days when I get back. Am still trying to get used to my new brace, really having trouble with it if I have to bend my leg at all, (even just sitting down), so have reverted back to wearing the sleeve, (hubby is going mad and saying I have to use the brace more and just get used to bending my leg while wearing it) ::). We will see how I go over the holiday. Yes Karen, I promise to do our 'wimpy quad sets' while I am away, I think you are right with that one, that is the least that I should do.  Shade I hope you have a bit more luck with your brace as well, it will be a telling time for us all over the next few weeks. Happy Holidays !!!!   :D
Boydy
Title: Re: Swelling from quad movements ?
Post by: shade on December 23, 2005, 02:38:32 PM
(http://www.petticoated.com/xmas.sceneW05.jpg)

Boydy and Karen,

Hope you both have great knee days through the holiday season. 

Merry Christmas
Title: Re: Swelling from quad movements ?
Post by: KarenS on December 23, 2005, 06:44:53 PM
Wishing you both great knee days throughout the holidays, too! (And great knee days to anyone else who is reading this thread. :) )

Talk to you next week!