KNEEtalk

The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Articular cartilage repair => CARTILAGE REPAIR - Marrow stimulation techniques (eg microfracture, abrasion arthroplasty) => Topic started by: Scooter72 on July 26, 2009, 04:45:12 PM

Title: Microfracture on 37 year old male soccer player
Post by: Scooter72 on July 26, 2009, 04:45:12 PM
Hello to everyone in this forum!
My name is Scott, and I am a microfracture newbie.† I had my surgery done June 25th, on a non-weight bearing portion of the trochlear groove.† I would like to give some background, before I go into the experiences of my surgery and recovery (thus far).

-I am 37 years old

-Before my knee started giving me serious trouble, I played soccer or did resistance training five days out of the week.† †I worked out my legs hard.. perhaps too hard, along with playing most of my soccer indoors.. on turf.† (Not good for the knees, I think, especially during collisions)

-I imagine, that like most people with cartilage damage, I have no idea what caused my injury.† I can tell you that I started feeling a bit of pain in my knee around September/October of 2008, and kept playing through the pain all the way through about March of í09.† How stupid of me!† (I am stubborn when it comes to pain and injury)† I thought that the pain would go away by taking it easy.. maybe cutting back on leg exercises and how many games I played per week.† I started taking anti-inflammatory meds before and after each game.† Truth be told, the pain actually did vacillate in intensity, over† time.† There would be days where it wasnít bad, or even non-existent.
But, eventually it got to the point where I started limping during games. I remember my last game, during which my teammates told me to quit for a while. (And they told me in not so kind a fashion.. which I deserved for selfishly inserting myself as a liability on the pitch)† They were right, and I didnít argue, considering the pain I was experiencing.

-So I scheduled an appointment with my OS, who I must say is a class individual, although I wish I had pushed for an MRI much earlier. This guy was as conservative as can be.

† After† ruling out any kind of ligament damage, he put me on with physical therapy with the diagnosis of patellofemoral syndrome (which is very non-descript ).† He told me that he was pretty sure there was a tracking problem that may be solved with physical therapy.† Internally, I agreed because I have one leg that is 1/4inch shorter than another, and I imagined that over time, that would cause muscular imbalances, especially given my level of activity, that might lead to patellar tracking issues.† He also told me, ďIf it were my knee, Iíd try everything and anything to avoid surgery of any kind.Ē† Now that is the† kind of doctor you want in any situation! One who cares about you, more than the procedure/money.

† I went to PT, and letís just say that after two months, it did NOT solve the problem. (Side note.. donít settle for a physical therapist with whom you are not satisfied.† Mine was gods awful in more ways than one, and didnít care about me, so much as just getting through the session in mimimal time) I was still experiencing pain, and no amount of specific strengthening exercises was helping.

† I went back to my OS in May, and we decided an MRI was best.† The MRI revealed a suspected (and later confirmed) grade 4 defect in the trochlear groove.† At that time, I reached the point that many here do, in that I was tired of experiencing pain while doing simple movements.† Going up stairs, going down stairs, bending down to pick something up, trying to bowl.. I was angry at the situation.† So on with the scheduling of the surgery which was to occur June 25th.

-Now, I had a choice for my surgery; I could be put under general anaesthesia, or be given a spinal block, and be conscious for the surgery (paralyzed from the waist down, of course).† I chose the block, and watched the entire surgery on a monitor.† Quick side note:† My OS and staff were spectacular during and after the surgery.† We were telling jokes and talking about the procedure.† It was great, although I daresay I asked so many questions during the surgery, that I am sure my OS was close to having the anaesthesiologist put me under completely! LolÖ

-During the surgery, my OS visualized the knee joint, and pointed out various anatomical references.† My meniscus and ligaments were in good order.. until he got to the lesion.† The lesion was indeed a grade 4, but small.† Maybe 1cm by 1cm, if that big.†
So my OS started to clean the area, and probed the cartilage on the periphery of the lesion.. oh NO! The cartilage is LOOSE.† There is a pause in the conversation at that point, and I knew exactly what he was going to tell me.† He would have to lift up the loose cartilage and cut it out, which he told me was not going to recover, and would eventually fall off and create a new lesion.† So he did.. and what was a small hole ended up being about 1cm wide by 1.5 inches long.† Thankfully, all of it was still in the non-weight bearing portion.† My OS told me that there was still a bit more he could have cut off, but his hope was that in doing the microfracture, the bit of loose cartilage would ďreform its connection with the bone underneathĒ.†

-I went home that night, and my discharge orders said that I could be weight-bearing with the caveat that I avoid bending my knee, especially in the 40-70 degree range.†The nurses that took care of me were so surprised that one of them double-checked with the OS. I wasnít prescribed a brace to restrict flexion.† This was puzzling to me, because as you can imagine, even the most disciplined people are going to have a lapse, and accidentally bend their knee.† This happened to me, and when I called my OSís office (after about the fifth time of bending), I was informed that it was ďokĒ to accidentally do so on occasion, and that they expected such to happen.

-The pain the first few days was annoying, but not unmanageable. Percocet helped a bit.† My knee was so wrapped up in dressing the first five days, that I could scarcely bend my knee, which in turn made walking a pain.† After I took the wrapping off at the end of the fifth day, the swelling and bruising was not too bad, by my subjective view.† However, I could not walk normally (i.e. without a limp) for another week.

-Right now, at 31 days post op, I can walk without much of a limp.. maybe a slight one.† I have the expected quadriceps wasting.† I have some swelling on the knee.† I have some odd pains, none of which are the intense ďshooting painĒ experienced by some here.† Well, maybe some of the pains I have had can be described as such, but itís borderline.† My OSís evaluation on Wednesday of this week (July 22nd) was positive.† He said I have two more weeks to wait before allowing me to resume normal activity, such as going up/down stairs, flexing knee under stress (right now, I am allowed to bend, but without stress), lifting weights etcÖ I will be going to PT at that time.†
However, there is one issue that is puzzling and disturbing to me, that I failed to address at my last doctor visit. When bending my knee (again.. under no weight/stress), I cannot flex past, say.. 110 degrees (assuming an unbent leg is 0 degrees).† At that 110 degree mark, I feel a lot of pressure on the patellar tendon,I think.† There really isnít much pain.† I donít really feel like it is locking, per se.. I just feel resistance.† I am wondering if anyone else has experienced something similar to this after a microfracture?

In any case, I know my first post is long-winded, but I certainly wanted to add to the tapestry of experiences here.† I am positive about the outcome of my surgery, and am sure I will resume soccer and weights at some point in the next three months.† Thus far, I havenít experienced anything too troubling (other than what I just mentioned with range-of-motion).† I hope I can draw upon the strength of those who frequent this forum, as well as offer it.
Thanks!


Title: I want to add a bit more...
Post by: Scooter72 on July 26, 2009, 04:58:43 PM
I am a strong believer in the effect of one's diet, upon life.  As such, after some research, I adjusted my diet to suit the repair process of my knee.  I just want to throw this out there, in case it helps anyone.

-I take a teaspoon of an omega-3 based fish-oil supplement.
-I take a teaspoon of a high potency cod-liver oil supplement.
-I take a vitamin D3 supplement.
-I take Cosamin DS 2x/daily.
-I eat fish at least 2x/week.
-I eat a lot of blueberries, cherries, and even grapes. 

I do take other supplements that are not directly related to repairing my knee, but the ones above are important, in my opinion.  Another note is that the supplements I take are not the "garden variety" one may pick up at the grocery; in my opinion, 99% of those are utter crap. 
Title: Re: Microfracture on 37 year old male soccer player
Post by: hungry on July 26, 2009, 05:32:35 PM
Scott,

First off, welcome to the forum!

I have a small log I've posted on this forum as well (under Former College Basketball Player...) and had my trochlear groove microfractured on June 22nd. What surprises me most about your post-op is the immediate weight bearing, as well as you make absolutely no mention of using a CPM. As I had mentioned in my log, I was prescribed to be NWB for 6 weeks (although my surgeon has moved me up to PWB ahead of schedule) and I had used a CPM for 6 hrs/day. Hopefully you're surgeon prescribed some sort of passive motion for your knee in the post-op period.

Secondly, I'm amazed that you had the surgery performed with a spinal block, that's the first I've ever heard of! Great stuff, although I imagine it must've been tough to watch.

You also mentioned some pain in your patellar tendon. I've experienced the same thing, and my PT and OS have both suggested that it is simply as a result of the lack of quad strength. Nothing serious to worry about, and something that will go away with PT and strengthening. A

Another area you mentioned was that you had no idea how you're injury occurred in addition to having one leg shorter than the other. I am a firm believer that faulty movement patterns and muscles length/strength imbalances are what caused my cartilage defect. In my log I had mentioned that I had performed a functional movement screen which sought to identify and resolve these patterns and imbalances. After 2 1/2 weeks on the movement screen program I had even been able to play basketball with minimal pain. Having a functional movement screen (some may call it a Total Kinetic Chain Assessment as well) is something I HIGHLY suggest you look into before returning to soccer.

I also completely agree with you in terms of the influence of diet in one's life. Similar to you I had been eating a lot of fish as well as berries (I also tried to eat a more alkaline diet by eating a lot of spinach, raisins, etc.) but I think the biggest difference for me was drinking a gallon of filtered water throughout the day in addition to taking 3 caps of fish oil 3x per day. My knee has had minimal swelling and I think my diet has played a big part in it.

Finally, I hate to be a wet blanket, but I think a full return to sport by 3 months may be wishful thinking. From all I've read, most of the professional athletes that have had microfracture don't return to their sport for a full year, the newly formed cartilage simply takes too long to strengthen to the point where it can sustain heavy impact from sport to return within 3 months. In addition, many people on this board are still experiencing pain post-microfracture at 4-6months. Its my personal opinion that if you combine a quick return to soccer along with not addressing any muscle imbalances (which may have caused the injury in the first place), you may be setting yourself up for disaster. I know it really sucks to look at it that way, but I've started to develop the mentality that I've been living my life at a sprint's pace, but unfortunately the road to recovering from a microfracture is a marathon.

Nonetheless, I wish you the best in your recovery, and if you can make it back to soccer in 3 months without injury, all the more power to you!

David
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on July 26, 2009, 08:22:43 PM
Scott,
First off, welcome to the forum!
I have a small log I've posted on this forum as well (under Former College Basketball Player...) and had my trochlear groove microfractured on June 22nd. What surprises me most about your post-op is the immediate weight bearing, as well as you make absolutely no mention of using a CPM. As I had mentioned in my log, I was prescribed to be NWB for 6 weeks (although my surgeon has moved me up to PWB ahead of schedule) and I had used a CPM for 6 hrs/day. Hopefully you're surgeon prescribed some sort of passive motion for your knee in the post-op period.

Thanks for the welcome!
No, my doctor did not prescribe any kind of passive motion for my knee.† Before the surgery, I even asked him about that; he said there was no need to weight-bearing restriction or a passive motion machine.† Odd, eh?†

Quote
Secondly, I'm amazed that you had the surgery performed with a spinal block, that's the first I've ever heard of! Great stuff, although I imagine it must've been tough to watch.

Yeah, that was interesting , to say the least. But it also allowed me to develop great trust with my OS.† I saw everything he did, and while I am (obviously) not an expert, I think he took care in the placement of the holes, and with how much loose cartilage he took off.

Quote
You also mentioned some pain in your patellar tendon. I've experienced the same thing, and my PT and OS have both suggested that it is simply as a result of the lack of quad strength. Nothing serious to worry about, and something that will go away with PT and strengthening.

Itís not the pain that is troubling; itís the tightness, that comes with trying to flex it past 110 degrees (which I canít do, or at least wonít push myself to do for fear of injury).† I just want to know why I canít flex past this point, and how to get past it.

Quote
Another area you mentioned was that you had no idea how you're injury occurred in addition to having one leg shorter than the other. I am a firm believer that faulty movement patterns and muscles length/strength imbalances are what caused my cartilage defect. In my log I had mentioned that I had performed a functional movement screen which sought to identify and resolve these patterns and imbalances. After 2 1/2 weeks on the movement screen program I had even been able to play basketball with minimal pain. Having a functional movement screen (some may call it a Total Kinetic Chain Assessment as well) is something I HIGHLY suggest you look into before returning to soccer.

I read your log, and I am comforted by the suggestion.† It makes sense.† But I wonder how, after just 2.5 weeks on the program, you are able to play with minimal pain?† Could you elaborate on the technique(s)?†

Quote
Finally, I hate to be a wet blanket, but I think a full return to sport by 3 months may be wishful thinking. From all I've read, most of the professional athletes that have had microfracture don't return to their sport for a full year, the newly formed cartilage simply takes too long to strengthen to the point where it can sustain heavy impact from sport to return within 3 months. In addition, many people on this board are still experiencing pain post-microfracture at 4-6months. Its my personal opinion that if you combine a quick return to soccer along with not addressing any muscle imbalances (which may have caused the injury in the first place), you may be setting yourself up for disaster. I know it really sucks to look at it that way, but I've started to develop the mentality that I've been living my life at a sprint's pace, but unfortunately the road to recovering from a microfracture is a marathon.

No, I do understand, and even agree with your assessment.† I am not experiencing any significant pains right now, but I also consider that under my current restrictions (which last for another two weeks), I am not even allowed to lift trash can with my knee bent.† So what is going to happen when I try to bend my knee, or run?† Will I experience a lot of pain? I donít know.†
Considering the fact that I wouldnít have undergone the surgery, if I didnít love soccer so much, Iíd rather be guarded during the recovery process.
Now, where do I get a functional movement screen?† And how long do I wait to get it?† Surely, at least until some time after the six-week period.
Title: Re: Microfracture on 37 year old male soccer player
Post by: hungry on July 26, 2009, 09:43:31 PM
Scott,

With regards to the patellar tendon tightness, I'm sort of in the same boat as you. Although I'm able to go to about 130 degrees, I still do feel the tightness in the tendon itself. In my case, I feel its caused by some residual underlying swelling, but my ROM gets better everyday with light stretching. For you I would also suggest some stationary biking. Put the bike to zero resistance and pedal away, this will help bring blood to the area and is within accordance of your post-op rehab. Just going through that ROM will help loosen up some of the tightness.

I'll do my best to explain the functional movement screen here.
The FMS is a series of tests to determine where your muscle strength/flexibility imbalances lie. For many of us, because of the way our society is structured, we will have issues with out hips and thoracic spine which will lead to injuries of the knees and lower back. How would something like tight hips lead to a knee injury? To quote a recent article:

"Tight hips will lead to forward trunk flexion, when an athlete lands from a jump, instead of keeping their trunk upright and parallel to their lower leg, their chest collapses toward their knees. When the athleteís trunk flexes forward, they lengthen the gluteus maximus, which forces the hamstring to eccentrically control the lower leg and the loading of hip flexion. This results in a faulty movement pattern which causes stress at the knee.Ē

The body itself is an intricate system, for example if you have perhaps sprained your ankle in the past and thus its ROM is impaired it will affect the knee as well. To quote again:

ďLetís say itís the right knee thatís bothering an athlete,Ē Clark says. ďIn many cases, we see that the left ankle is restricted. If an athlete jumps for a rebound and lands, the dorsiflexion when landing from a jump needs to be at about 15 degrees. But many NBA players we see only have five degrees of dorsiflexion.

"If their ankles donít bend, their knees must deal with the force," he continues. "And the next joints up from the knees are the hips, then the spine. When they land, they have to shift the weight over to their right and their right knee takes most of the eccentric load, and you get shear, compressive force on the joint that creates trauma.Ē

Can you see how all parts of the body are interconnected? Many times people think that because they have a problem with there knee that they need to focus the rehab solely on the knee... While this may work some of the time, most often you are just treating the symptoms rather than solving what caused the problem in the first place (which is a HUGE issue in medicine today).

As for my experience with the FMS? I had many issues which needed to be dealt with. Top to bottom. I had poor range of motion throughout my Thoracic spine and tight lats which pulled my center of gravity forward. I had a weak intrinsic core which forced my knees and low back to absorb a lot of the stress from basketball. My hips were just god-awful terrible, they were ridiculously tight which not only pulled me forward but also inhibited my glutes (which are an incredibly important in becoming a good athlete, if you have inhibited/weak glutes, you wont be a good athlete). Finally I had poor ROM and proprioception with my ankles as a result of years upon years of cumulative ankle sprains.

I had followed the program very diligently for 2.5 weeks, doing it 6 times a day (I had 10 years of basketball injuries built up, I really had no other choice than to make a drastic change). After following the program and just before my surgery, I decided to give basketball another go around. The difference was huge. In the past, every move, cut, sprint, and jump required a ton of energy; after everything felt much more fluid and effort-less. In the past, I had a lot of trouble staying low to the ground on defensive slides and drives, after I was able to get into and stay into these positions easily and I was much quicker as a result.

Obviously I could go on and on about the FMS but I'll cut to what you want to know.
I had the FMS done by a certified kinesiologist and personal trainer at my chiropractic clinic. You are going to have to ask around where to find one, your physiotherapist or surgeon will likely know where to have one done.
When should you have it done? Ideally, you should have had it done before your surgery. However, it will be best to have it done when you are comfortably able to squat and lunge with your own body weight (there should be NO pain), which for most seems to be around 4 months post-op.
Finally, the screen works like this: You will perform the tests while being video taped. The person performing the screen will analyze the video and determine your weaknesses. From there they will build a corrective exercise program for you to follow. My program took me about 90minutes to complete, but got easier and faster as I progressed.

Also, if you want an in-depth read about the screen itself, I suggest you give "Athletic Body in Balance" by Gray Cook a read.

Let me know if you have any other questions and good luck!!
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on July 27, 2009, 12:32:15 AM
Hey Scott,

I am athlete who had a mfx of a small lesion in the trochlear groove as well.  My advice to you is to be patient.  Originally my OS told me I'd probably be better in 3 months (because I'm young), but when that didn't happen he revised it to 6-12 months.  Don't do ANYTHING that causes pain, even past the 6 week mark.  I started pushing things a little then and now I'm worried I did some damage.  But only time will tell.  At 5 months post op, some activities hurt less than pre-surgery, but others hurt more.  And I have not been able to return to my sport yet (distance running).  Also, I would try to get some massage therapy to loosen up your lateral quads and IT band, as tightness there could possibly be causing your problem with flexion.  I've had some problems from pain with passive flexion as well, but massage seems to help.
Title: Re: Microfracture on 37 year old male soccer player
Post by: John1 on July 27, 2009, 04:56:29 AM
Having a little extra fluid in the joint will cause it to not flex completely. That is because the joint capsule has the most volume at 30 degrees of flexion. If you try to bend it more there is less volume, so any extra fluid will be trapped and prevent it from bending.

Did you have loose quadriceps before you developed pain? I ask because in my case I think having tight muscles contributed to my cartilage getting worn away. If your muscles are tight and you sit with your knee bend then the extra pressure on the cartilage makes it lose it's elasticity for a few hours. If you run around and play on it, then the cartilage will be vulnerable to damage.

I'm not sure if it's a good idea to even be trying to bend your knee that much so soon after the surgery. You definitely want to get the flexibility back, but I don't think it's a good idea to put pressure on the microfracture location by stretching it hard. You can try to get the extra fluid out by flexing your quadriceps repeatedly with you knee straight or by riding a stationary bike. The knee joint drains through the lymph system which is driven by muscle contractions. It's a matter of flexing your quadriceps without putting too much pressure on the microfracture spot.

If it's not fluid causing the lack of flexibility, then it could be some scar tissue in which case you need to balance the stretching with the risk of damaging the microfracture. If the doctor says that is not a concern then I guess you have to go with what he says.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on July 27, 2009, 08:11:35 AM
  David, I will definitely be getting an assessment when I am in a safe zone, which at this point is looking more like it will be months, not weeks, before I can do so.  (I.e.,I am not jeapordizing anything here)  In the meantime, I really plan on using you and others here as an anchor.  Maybe emotionally/mentally as well as for knowledge.  I am thankful to have met you all.

  Madel, I thank you for your advise, and sympathize with you a lot, because gods know that distance running is potentially worse on the knees than soccer, or basketball. But I am confident, after having read some of your posts, that you will persevere. A common theme that recurs with people posting their microfracture stories, is that it's also a huge mind game.  Unless you are on the verge of having your leg amputated, don't believe anyone that hints that you may not be able to return back to your previous running levels.
  As for not doing anything that causes pain.. that is a bit subjective, I hope.  Because if I were to take you literally, I'd be lying down all day, strapped to a bed. Right now, I welcome the dull pains, and testing my ROM in association with such pains, because it tells me where I am at.  Keep in mind, I am doing such testing with care.  It's not as if I am squating weights (even my body weight), or attemtping to pick things off the ground by bending my injured knee; I usually take care to place any torque/pressure on my good knee, even when performing the most mundane of motions.
  John, there was NOTHING loose about my legs, prior to injury! Lol.. I had ultra tight eveything (including quads).  It was so bad, for the very reason I am in this predicament now.  I surmised that one day my tight legs would get me into some kind of overuse/unbalanced injury trouble, but didn't do anything about it.  Part of the reason was, and I know this will sound strange, due to the "spring" that having tight leg muscles would give me, when I was sprinting.  I can't describe it any beter than that.
  As for damaging the mx location; that is in the 40-70 degree area.  I cannot bend my knee much past 110 degree.  Now obviously, I have to get past the 40-70 to get to the 110-120 degree area, but I do it lying in bed and slowly bending my knee.  I don't dare do it standing up, or placing any excess force upon it other than what it takes to stretch it a bit past the "tight" point, which is again, well past the ROM that the mx injury is contained within.

One thing I am curious about though, is why you and David suggest riding a stationary bike, which would naturally hit that 40-70 degree area?  My OS suggested the same, using zero resistance (as you two have noted).  But, it runs contrary tothe whole "don't bend your knee too much" advice.  Riding the bike wold do so with great frequency.

Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on July 27, 2009, 01:33:21 PM
Hey Scott,

I think the dull pains when you are walking around or whatever is ok.  It's the sharp stabbing ones you want to avoid.  Also, I didn't have a CPM machine or leg brace after surgery, and while I can't tell you whether that was a good idea yet, just letting you know there are other OS's besides yours who do not prescribe those. 
Title: Re: Microfracture on 37 year old male soccer player
Post by: John1 on July 27, 2009, 06:43:28 PM
One thing I am curious about though, is why you and David suggest riding a stationary bike, which would naturally hit that 40-70 degree area?† My OS suggested the same, using zero resistance (as you two have noted).† But, it runs contrary tothe whole "don't bend your knee too much" advice.† Riding the bike wold do so with great frequency.

The stationary bike will help get any excess fluid out of your knee. Of course, you don't want to over do it on a high resistance.

Another reason is that the movement is actually good for the cartilage growth. The mesenchymal stem cells that come from the bone marrow onto the microfracture site can differentiate into fibrous cells, cartilage cells (chondrocytes) or bone cells (osteoblasts). This differentiation is partial determined by the amount of stimulation given to them. If I remember correctly, less stimulation results in osteoblasts, more results in fibrous tissue and in the middle makes chondrocytes. The problem is because there is never equal amounts of stimulation to all parts of the microfracture site, you can never end up with all cartilage. You typically end up with a layer of cartilage cells near the bone, but fibrous tissue near the surface. I never came across any definitive advice on exactly how much movement a patient should do the get optimal results, but doctors seem to advise doing the stationary bike because it's low impact but will get the fluids in the knee sloshing around to help stimulate the healing.

I think they don't want you to bend the knee with your weight on it, but bending it on the stationary bike won't put much pressure on the cartilage, so it is OK.
Title: Re: Microfracture on 37 year old male soccer player
Post by: hungry on July 27, 2009, 09:08:42 PM
Very well put John!!  ;D

Basically, passive motion = a very good thing for recovering knees!
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on July 30, 2009, 07:10:42 PM
I just wanted to give an update on how I feel.  This is week 5 for me.  I still have some aches and pains, but they are not troublesome by any means. I can straighten my leg easily, without pain, while sitting in a chair. There is some cracking, and occasionally my knee cap will ďclickĒ, which it did before. Of course, I have yet to really test my knee with some serious weights/resistance training (which I would start off lightly).
However, I have cheated a bit, and carefully, slowly tried to go up my basement stairs, which are about eight inches tall for each stair.  I didnít have any problems with pain in doing so, except going up the stairs at a certain angle, that bothered me before the surgery.  I know itís hard to visualize, but imagine going up stairs, while holding your  back and head straight (i.e. perpendicular to the ground), so that the full weight of your trunk and head is erect.  The good news is, that it doesnít hurt nearly as badly as it did before the surgery.  If it keeps the same pain level with more vigorous activities, I will be happy.. but that remains to be seen.
The bad news is that my left leg (the injured one) is so very weak.  Going up stairs required a lot of effort and the stabilizing muscles are clearly out-of-whack.  I can tell that at this point, I couldnít even jog if I wanted too.  In fact, I am willing to bet that I will have to re-learn how to run.
Furthermore, I cannot yet go down stairs.  Iíve prepared to try it, but each time, as I was about to step down (using my injured knee), I could easily tell that the muscles necessary to complete the motion were just weak.. as in, if I had tried to step down, it would not have been a controlled motion at all. 
My range of motion has improved, but I still do not have full flexion.  I am confident that it will return with time, but I wonít push it.
I do have PT starting next week.  My OS said that the PT wonít be ďeasyĒ, as in I will be motivated to really work the knee, but of course, without injuring it.  Thatís going to be an interesting line to explore, since I have a natural  tendency to be impatient with these matters.
I hope some will take heart with my experiences so far.  I believe the microfracture will work for me, but only with time and proper care of the knee.  I donít think that the knee will be the same, but honestly believe that I can return to the same level of performance I one enjoyed, on the field.  It may take an incredible amount of work, but I was committed to such the second I accepted this surgery.
Title: freaking ouch!
Post by: Scooter72 on July 31, 2009, 05:32:34 PM
So, I think I pushed my knee a bit too far last night. I was running it through a range of motion test.. one that I made up on my own.  While my ROM is better, because I can bend my knee further than was possible, even four days ago, the fact is that I still have pain when using my leg in the positions/angles that caused pain before.  Of course, the pain occurs with resistance. 

That's ok though, I am guessing that this is normal (since I am only at week 5).  I think I'll take it easy until I go to see my physical therapist next Friday. 

I will be so glad to get something going.. anything.  My exercises routine has been nearly non-existent compared to what I am used too, and I am very antsy over the umm.. "body change" that has resulted. Lol! 

Anyway, if I can offer any assistance to people here, please feel free to hit me up with questions. Thanks!
Title: Hmm.. the pain is still there...
Post by: Scooter72 on August 02, 2009, 06:40:54 PM
I am four days away from being cleared to do rehab (through a PT), which will include a vigorous weight schedule, I am guessing.  So, I decided to test my knee a bit early, and attempted a reverse lung, in a slow, controlled matter.  The reverse lunge happens to be one of the moevement types that caused a lot of pain.

The good news, is that I made it through the lunge..

The bad news is that it feels almost as bad as it did before the surgery.

So, of course, I am wondering if the procedure was a failure and/or if I somehow caused this.

I know that the defect is likley not filled in and "mature", but it's still disconcerting, and leads me to consider that it is a failure. I would think that an initial layer of fibruous cartilage would have been layed down in the defect.

If it is a failure, I will wait a while, strengthen my leg as much as possilble and play soccer as I can, until I can decide on another course of action.

One possibility is called articular cartilage paste grafting, whihc is done at the Stone Clinic. This procedure results in a much better repair cartilage that is mostly hyaline in nature.
Title: Re: Microfracture on 37 year old male soccer player
Post by: PieceDesigner on August 02, 2009, 07:14:37 PM
Hi Scooter. I had my surgery the day before you did.

I had MFX in the trochlear groove, and MFX & TruFit plug installed in the medial femoral condryl. Since the most serious injury was to a weight bearing area my rehab is much slower than yours. I just started PT Friday. I am not completely off crutches or cane yet.  My rehab is mostly ROM work now. I am OK with slow and steady. Would rather err on the side of caution than go through this surgery again!  I have a long ways to go to build my muscles back.

I cringe when I think of the pain you must have after attempting that lunge!  :o   I would think the MFX would still be very fragile at 5 1/2 weeks.?? I'm thinking it's would also be too soon to know if it was a success or failure. What is your OS saying?

Take it easy until you see you PT this week.  This journey does try one's patience, doesn't it?   ;)

Nan

Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on August 02, 2009, 07:55:16 PM
Hi Scooter. I had my surgery the day before you did.

I had MFX in the trochlear groove, and MFX & TruFit plug installed in the medial femoral condryl. Since the most serious injury was to a weight bearing area my rehab is much slower than yours. I just started PT Friday. I am not completely off crutches or cane yet.† My rehab is mostly ROM work now. I am OK with slow and steady. Would rather err on the side of caution than go through this surgery again!† I have a long ways to go to build my muscles back.

I cringe when I think of the pain you must have after attempting that lunge!† :o† †I would think the MFX would still be very fragile at 5 1/2 weeks.?? I'm thinking it's would also be too soon to know if it was a success or failure. What is your OS saying?

Take it easy until you see you PT this week.† This journey does try one's patience, doesn't it?† †;)

Nan

Oh, you're not kidding, Nan!  It does try one's patience, no matter how long or short the restriction period might be. 

One thing I decided was that I was going to trust my OS and any advice he might give unless he proved to be very very strange and/or incompetent ;)  So, when he told me that I was going to be full weight bearing after my surgery, I asked why, and he explained (that my lesion was in a non-WB area of the trochlear groove)  His only restriction was to keep the knee as straight as possible (to avoid the 40-70 degree range especially), and if bending the knee, to avoid "shearing" force. 

So for the first four weeks, not only did I avoid putting any force on my knee (other than body weight), I pretty much avoided even bending the knee, save for a few occasions where I "forgot" not to bend it.  It has only been in the past week or so that I have started to bend my knee, and test it in various ways.  One instance was today, doing the reverse lunge, using only my body weight.  I have also gone up stairs, again.. in a controlled and slow manner.. with success. However, I have not tried going down stairs using my injured knee, because that motion caused pain before the surgery, and for some strange reason, the fine muscles that control one's leg during that motion are so weak that I can't capably go .  (The reverse lunge same ROM and muscles as going down stairs) The only other activity I have done is ride a stationary bike with low resistance.

At my last OS visit, on July 22nd, my OS told me that I could go ahead and bend my leg, and perhaps try to test it a bit, because the clot was "attached pretty well at this point".  I took that to mean that unless I am going nuts with my knee, doing heavy weights and sprints (which I couldn't due anyway, because of muscle wasting), that I am not going to ruin the microfracture by doing a reverse lunge, or carefully going up stairs.  And if it is that fragile, then I should have been put in a brace, but at this point, it's impossible to know and futile to blame.

I am pretty frustrated, but overall positive.  I think that if this procedure doesn't work, I will still rehab my leg back to good strength while wearing a brace that moves my kneecap to track over a spot that doesn't include my microfracture area.  Then, I will contemplate the lateral release procedure, as well as the one done at Stone Clinic.  I will not, however, just "retire" from active sport; it's too much a part of me.  I will have ample time to sit on my ass when I am 70, if then.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on August 05, 2009, 06:40:31 PM
Oh.. dear.

Well, it seems as if all of the optimisim I displayed in my previous posts is crawling back to me as a sussurus of pessimism, that may get worse.

I tried bounding up the stairs, and some other odd lunging motions (other than the one I described previously in this thread), and experienced the shooting pains!

The horror! Lol.. :P† I am 6 weeks post mfx as of this Thursday, 8/5, so I don't think that I was trying such things too early according to the "standard" mfx waiting period.† However, my knee is telling me differently, in a bad way.† I won't even try to jog, for fear of what I would feel.

And now, I am also experiencing something so many here have gone through, which is questioning one's OS.† I said before that I think he is a quality surgeon, and general good guy.† But now.. lol.. I called him today and explained my symptoms, and asked if I should lay off the knee, and thus not attend my first PT appointment this Friday. He summarily told me to "work through it, doing the same activities" that I had been doing, and to still go to PT on Friday.† He also told me that the pain does not indicate the mfx failed (which I believe).

So now, I am confused.† Either I trust my OS, who I still believe to be a good person and quality surgeon, or incorporate my own thoughts which are shaped by what I have read here, and on other sites (such as Dr. Steadman's).† I just don't get how his.. "workout warrior" approach to rehab can be right, since it runs contrary to what you good people have relayed.† I am of (at least) half a mind that this mfx has, or has a good chance of failing. But the other half says there is still a decent chance.† No matter.. I have to ride it out.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Marjan on August 05, 2009, 08:09:51 PM
Hi Scooter.........

6 weeks out from MFX surgery is still very early.  Most OS's will tell you that "recuperation" is 6 weeks, but that's just the recuperation from the surgery (ie, expecting most of the swelling to go down, etc).  At 6 weeks the clot is fairly well "attached" but it has not "ripened".  It was explained to me that the cell organization at this point is very disorganized and therefore has little strength or "cartilage like" characteristics.  As it matures, the cells will settle in an organized matrix that becomes as strong as possible.  This can take up to a year!
In the meantime when that spot is "in use" it will be tender and result in fairly scary bone pains.  Bounding up stairs is probably too much force on the knee.  Good exercises should be of the type that never have both feet off the ground at any time. Wall squats, BOSU ball balance, hip flexor exercises, and when you feel up to it, elliptical training are good ways to stay in shape.  Swimming is excellent (don't use a "frog kick") and any kind of water aerobics is good.
I'm 10 months out and still recuperating.  I've started doing more and more stuff, but everything needs to be brought into the picture at a rate that would have frustrated me years ago. 
I believe most OS's are very capable, but from having had two MFX surgeries, I've gleaned a lot on just how long this rehab takes and it's one of my pet peeves that OS's call it 6 weeks, when it's actually closer to 6 months.  Oh sure, you'll be getting around just fine in a while, but the pain, irritation, muscle aches and stabbing medial pain will go on a lot longer than 6 weeks.  So, go slow.......don't overdo, it's not a "no pain no gain" situation....

Good luck and hang in there....

marjan
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on August 06, 2009, 02:43:42 AM
Marjan, as usual you are a voice of reason, and also a calming influence.  I appreciate the advice.  Sometimes we need the voice of others to help keep a level head. 

In the meantime, I will continue to follow your long-running thread in this forum.  Am glad to hear that you are getting about with your dogs Boomer and Sneakers. and making it to agility trials, at this point.

I will continue to update my progress.
Title: another update
Post by: Scooter72 on August 17, 2009, 03:32:27 AM
So I am in my 7th week post-op (my surgery was June 25th.. for details, please refer to the original post in here).† I just had my first PT appointment last Monday, and I want to throw some random thoughts out here...

† I always seem to have a little to moderate swelling on the knee. The "moderate" swelling usually occurs after exercising it.† It's not painful, with an exception; I am still missing a small amount.. maybe 8 degrees of flexion in my ROM.† When I approach that limit, a pain starts. (BTW, this area is not in the range of the mfx site)† While that may seem insignificant, it's going to be a problem if I ever get back to a sporting activity, which was the point of this surgery.† My PT also seems to think it's trivial, and sort of blew it off.† However, I am sure there will be times when I land awkwardly, for whatever reason, and reflexively bend my knee to the full.†

 Despite my physical therapist's optimism upon my initial evaluation last Monday, he is still starting me out basic.† He has me doing body-weight squats, where I touch my butt onto a chair and then come back up in a controlled motion.† I do calf raises, using the injured leg, as another exercise.† And the final exercise is weird.. I lie flat on my back, bend my knees, squeeze my butt-cheeks; do a plank while keeping the soles of my feet off the floor (thus using my heels to contact the floor); once in the plank position, extend the leg that is not injured, and then reverse the steps until lying flat once again.† The PT stressed that I do all of this last exercise in a step-wise manner, as I described.

 Aside from the above PT prescribed exercises, I also ride the stationary bike at light resistance, 2-3x/week, and use a wobble board every day for ia few minutes at a time.

 My PT is against leg extensions on a weight machine, due to the force placed across the patella, I think (?)† He also advised me to avoid stairs, for presumably the same reason.† And in general, he advised, "if it hurts DON'T do it!"

† With the above said, of course, I have tested myself.† I find that I can casually go up and down stairs. At this point, only pain occurs with going up stairs, and it is mild-moderate, depending on the day, and how I choose to go up the stairs.† In other words, I vary the angle, position and force exerted on my affected knee and corresponding foot.† No pain going down stairs, but it is not smooth, because the muscles that control such motion are weak.

† Today, I went to my father-in-law's house for dinner. He has a nice, plush backyard.† I took a soccer ball and started to dribble at a light jog, with only mild cutting.† To my surprise, I didn't experience any pain, until I cut a little bit too hard, at one point, which gave me a bit of the old "shooting pain" under the knee cap.† I stopped all activity for the day, immediately, and iced the knee down.

† So, upon reading all of the aforementioned parts of this post, you may think I am optimistic. I would classify my feeling as cautious optimism.

† I also want to re-iterate to all who are considering or have had mfx.. unless your name is "Wolverine", and you happen to have adamantium claws, tailor your diet to heal.† Eat the blueberries and cherries.† Eat the fish.† Get a good cod liver oil supplement.† Get the Cosamin DS and use it. (Remember that almost every other chondroitin/glucosamine supplement is not going to work). Take high doses of vitamin D (while under a physician's supervision) I strongly believe that I am advancing properly due to such measures.

Title: Re: Microfracture on 37 year old male soccer player
Post by: chariotson on August 18, 2009, 09:56:07 PM
Hi Scooter,

I'm a 42 year old soccer player, I had microfracure of the medial femoral condyle on October 7th 2008, which was a 12 mm tear. They said the rest of the cartilage was in good order.
This was most certainly the weight bearing region and so did the full 6 weeks NWB. I never cheated much to the suprise of my PT.

To cut a long story short, I first hit the soccer field again (in a match) in May this year about 7 months post op. Scored my first goal in early June (header of course).

I do still get some pain, but its quite minor, but I don't overdo it and tend to only play once per week, the rest of the time I'm in the gym. I actually had some knee cap pain up until July this year, but after coming back from vacation found that has totally gone now. I tend to agree with you if it hurts don't do it, but there comes a time, that you do have to push it, for me it was the 6 month mark.

I kind of expected to be limited more in the game, but I find that I've not lost any speed or motion at all.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on August 18, 2009, 10:47:07 PM
Hi Scooter,

I'm a 42 year old soccer player, I had microfracure of the medial femoral condyle on October 7th 2008, which was a 12 mm tear. They said the rest of the cartilage was in good order.
This was most certainly the weight bearing region and so did the full 6 weeks NWB. I never cheated much to the suprise of my PT.

To cut a long story short, I first hit the soccer field again (in a match) in May this year about 7 months post op. Scored my first goal in early June (header of course).

I do still get some pain, but its quite minor, but I don't overdo it and tend to only play once per week, the rest of the time I'm in the gym. I actually had some knee cap pain up until July this year, but after coming back from vacation found that has totally gone now. I tend to agree with you if it hurts don't do it, but there comes a time, that you do have to push it, for me it was the 6 month mark.

I kind of expected to be limited more in the game, but I find that I've not lost any speed or motion at all.

Awesome. What a great story, because it shows that even "older" athletes can come back from this procedure, and perform at their previous level.

So what is your experience with soccer?  And how do you think your injury came to be?  I feel as if playing too much on turf, and taking too many rough tumbles, caused my injury over a long period of time.
Title: Re: Microfracture on 37 year old male soccer player
Post by: chariotson on August 19, 2009, 05:20:50 PM
Mine was a couple of incidents, I had no real knee trouble before the first incident.

Take a seat and get comfortable :)

It all came about when we had a game, and the other striker missed his second penalty in a row, so I said to him I would take the next. That week I was on the field and decided to practise a couple, and on our field the grass is too long and even worse on the penalty spot. I went up to take one, and stepped funny in the long grass in the run up, I shoot with my right and injured the right, so it was simply the step before the plant to take the shot.

I just felt a pop in the knee, it hurt a bit but not much. I even took a few more shots before I decided to rest it. Next day I sent an email to our manager (this is amateur O40, nothing special), and said I'm doubtfull for Sunday. But by Saturday it seemed alright and I played the game, with no ill effects. During this time I was playing indoor and Wed and outdoor on Sunday. So I played a few more games, before I really hurt it.

I can only assume that this initial injury was a crack in the cartliage, is that even possible. I played on it with no pain, and forgot about it.

Then I did it, played another game and had a ball come over me that I could not reach and kind of landed funny, and the knee exploded. I assume at that point that the crack became a hole in the cartliage, with the cartliage floating around the knee. I didn't play again from June 08 to May 09

Although knew that MRI was needed I gave it a coupld of months, before I did the right thing and saw the specialist.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on August 19, 2009, 10:04:57 PM
Mine was a couple of incidents, I had no real knee trouble before the first incident.

Take a seat and get comfortable :)

It all came about when we had a game, and the other striker missed his second penalty in a row, so I said to him I would take the next. That week I was on the field and decided to practise a couple, and on our field the grass is too long and even worse on the penalty spot. I went up to take one, and stepped funny in the long grass in the run up, I shoot with my right and injured the right, so it was simply the step before the plant to take the shot.

I just felt a pop in the knee, it hurt a bit but not much. I even took a few more shots before I decided to rest it. Next day I sent an email to our manager (this is amateur O40, nothing special), and said I'm doubtfull for Sunday. But by Saturday it seemed alright and I played the game, with no ill effects. During this time I was playing indoor and Wed and outdoor on Sunday. So I played a few more games, before I really hurt it.

I can only assume that this initial injury was a crack in the cartliage, is that even possible. I played on it with no pain, and forgot about it.

Then I did it, played another game and had a ball come over me that I could not reach and kind of landed funny, and the knee exploded. I assume at that point that the crack became a hole in the cartliage, with the cartliage floating around the knee. I didn't play again from June 08 to May 09

Although knew that MRI was needed I gave it a coupld of months, before I did the right thing and saw the specialist.

Sheeeesh.. yeah, that sounds about right.  What a bad way for it to occur.. taking penalties on a crap pitch?  Eh?  Achh...

You did almost exactly what I did.. kept playing on it until the pain wouldn't allow it.  I played on my knee with pain for months before I couldn't take it anymore.  And even then, it was another few months before I got the proper diagnosis. 

So how competitive is your O40 league?  Any ex-college or pro's in there?
Title: Re: Microfracture on 37 year old male soccer player
Post by: chariotson on August 24, 2009, 02:22:34 PM
Mine was a couple of incidents, I had no real knee trouble before the first incident.

Take a seat and get comfortable :)

It all came about when we had a game, and the other striker missed his second penalty in a row, so I said to him I would take the next. That week I was on the field and decided to practise a couple, and on our field the grass is too long and even worse on the penalty spot. I went up to take one, and stepped funny in the long grass in the run up, I shoot with my right and injured the right, so it was simply the step before the plant to take the shot.

I just felt a pop in the knee, it hurt a bit but not much. I even took a few more shots before I decided to rest it. Next day I sent an email to our manager (this is amateur O40, nothing special), and said I'm doubtfull for Sunday. But by Saturday it seemed alright and I played the game, with no ill effects. During this time I was playing indoor and Wed and outdoor on Sunday. So I played a few more games, before I really hurt it.

I can only assume that this initial injury was a crack in the cartliage, is that even possible. I played on it with no pain, and forgot about it.

Then I did it, played another game and had a ball come over me that I could not reach and kind of landed funny, and the knee exploded. I assume at that point that the crack became a hole in the cartliage, with the cartliage floating around the knee. I didn't play again from June 08 to May 09

Although knew that MRI was needed I gave it a coupld of months, before I did the right thing and saw the specialist.

Sheeeesh.. yeah, that sounds about right.† What a bad way for it to occur.. taking penalties on a crap pitch?† Eh?† Achh...

You did almost exactly what I did.. kept playing on it until the pain wouldn't allow it.† I played on my knee with pain for months before I couldn't take it anymore.† And even then, it was another few months before I got the proper diagnosis.†

So how competitive is your O40 league?† Any ex-college or pro's in there?

Our top league has some very good players, but I'm playing at a lower league level than that, serious but fun.

worse thing about my penalty is that there was no keeper, just a practise shot. I think its just a fluke, I could have done that running for the bus
Title: Re: Microfracture on 37 year old male soccer player
Post by: Greenfire083 on August 25, 2009, 03:11:26 AM
Hey Scooter72!

I just had microfracture this last Friday.  I went in for a menisectomy and the doctor discovered a 4mm hole in my cartilage.  I was told afterwards to begin putting weight on my leg as soon as it was not painful for me to do so and that I would not need a CPM.  I was confused at first from reading a bunch of other post op instructions that told people to be NWB for at least 6 weeks and here I am already off the crutches.  I was told not to bend deep or use stairs.  I am glad I was finally able to find someone else who was told to stop using the crutches ASAP!

My doctor is very well respected and considered a perfectionist.  Have heard nothing but great things from him, but it still worried me not finding any other cases with people being WB as soon as possible.

I'm assuming the tear in my cartilage came from soccer just like my torn meniscus.  I play indoor about 2-3 times a week and on an outdoor team.  I know when I did the meniscus tear, but still not sure what happened with the cartilage.  Just glad the doctor was able to find it before it got any worse!

As I said earlier, I am only a couple days out of surgery and walking without crutches with a little limp.  I'm afraid of rushing it and messing the surgery up.  Just wanted you to know that there are others out there who were told to get off the crutches as soon as possible!
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on August 25, 2009, 05:42:23 AM
Good to hear from you Greenfire!  Yes, I am glad others have had the same recommendations with weight bearing, as I.  So you play soccer too? Well, let me in on what your level of play is, and whatnot!  I love the sport, as does chariotson.  So you played 2-3x/week on turf, eh? Well, that is becoming a recurring theme; I did the same, and I can't tell you how many times I landed on my knees as the result of hard collisions.  Let's not mention that playing on turf puts a lot of stress on the patella, in the first place. 
Greenfire, you will experience a lot of ups and downs, even within the first two months (which is where I am at).  You may have limited range of motion, when you (get clearance to) test it.  Just post here, and I will try to answer in a timely fashion.  As has been mentioned by many others, it's a mental battle, as well as a physical one. 

A question for Greenfire and chariotson.. either one of you have a favorite professional team that you follow?
Title: Re: Microfracture on 37 year old male soccer player
Post by: Greenfire083 on August 26, 2009, 03:26:55 AM
Well I played in college with the club team there, and a few of us moved to the same area so we play together now in both indoor and outdoor leagues.  Typically we try to play at the highest level that the league offers.  Living in the states, there just isn't the interest in soccer as other sports, but when I get a chance to watch league play I love watching the EPL and have to say that Man U is my team there! A lot of my boys that I coach favor teams such as Barca and Real Madrid(I'm a teacher/coach).  What about you and what level do you play at??

I'll keep you updated with the progress!  Hope all is going great for your rehab!
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on August 26, 2009, 04:00:19 AM
Well I played in college with the club team there, and a few of us moved to the same area so we play together now in both indoor and outdoor leagues.† Typically we try to play at the highest level that the league offers.† Living in the states, there just isn't the interest in soccer as other sports, but when I get a chance to watch league play I love watching the EPL and have to say that Man U is my team there! A lot of my boys that I coach favor teams such as Barca and Real Madrid(I'm a teacher/coach).† What about you and what level do you play at??

I'll keep you updated with the progress!† Hope all is going great for your rehab!

I started seriously getting into the game, when I was 30, and have loved it every since.  Before that, I had only played as a child.

The leagues I play in vary widely with the experience any player may have.  There are ex-college all-americans, and newbie's and/or people who will never be good, but love to play.  I really enjoy playing against the best (in my age group, obviously) because it's such a test.  For example, there's this guy in one of my leagues who was a 4-time collegiate all-american for a prominent NCAA Division I program, who plays forward.  He is almost impossible to stop due to his combo of size, pace and ball skill. But I get a rush out of competing with him nonetheless.

As for "soccer" in the states.. it is slowly catching on.  The survival of MLS, and the fact that ESPN has now picked up the EPL are some of the signs.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on September 01, 2009, 02:20:27 AM
I went to see my OS last Friday, and he told me to go ahead and start jogging, and also to do leg extensions with as much weight as I can tolerate.  The problem with this advice was that it directly conflicted with what my PT wanted me to do.  So, I went to my PT immediately after (seeing as how his office is down the hall from my OS's office), and conferred with him.  He hesitantly agreed to go with the OS and allow jogging, but was non-commital with allowing leg extensions. 

So a few days ago, I went for a jog.  It hurt at first, producing the "stabbing under the knee" sensation.  But after a couple of minutes, the pain diminished to barely noticeable levels.

The next day, I jogged again, and there was no pain.  I broke out into a sprint, with some pain, but nothing significant.  Note, I have not tried to do any cutting.  Just jogging/running on a flat surface, for short amounts of time.

I still have problems with doing "step-downs" using my left leg (microfractured knee) to support my body weight, because for whatever reason, I still have pain when bending it around the 25 degree mark.  It's not only pain, but also lack of strength.  As a substitute exercise, my physical therapist has me doing wall-squats, with my left leg positioned forward moreso than my right.

I am pleased with my progress thus far. 
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on September 01, 2009, 04:13:22 AM
That is amazing progress!  I wish I could heal that fast!  How far past the op are you again?
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on September 03, 2009, 02:51:31 AM
That is amazing progress!† I wish I could heal that fast!† How far past the op are you again?

Thanks madel!  I had my surgery June 25th, so I am about 11 weeks post-op. 

Knee is a bit more sore today than last time I reported, but that's because I have been putting it through the ringer, with the added physical therapy exercises.

I will keep reporting my progress.  Thank you!
Title: Re: Microfracture on 37 year old male soccer player
Post by: Greenfire083 on September 04, 2009, 04:01:05 AM
Sounds like rehab is going great!!  I'm 2 weeks out now, and I'm walking with no limp.  Other than being a little sore from being on my feet a lot during the day (I'm a teacher/coach and coaching football right now), my knee seems to be doing great.  Meet with my PT for the first time next week!  Sometimes I just forget and try to put weight on my left leg when standing up and it reminds me pretty quickly that wasn't a good idea, but I think things are going well.

Keep you updated with how it goes!
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on September 04, 2009, 12:40:28 PM
Sounds like rehab is going great!!† I'm 2 weeks out now, and I'm walking with no limp.† Other than being a little sore from being on my feet a lot during the day (I'm a teacher/coach and coaching football right now), my knee seems to be doing great.† Meet with my PT for the first time next week!† Sometimes I just forget and try to put weight on my left leg when standing up and it reminds me pretty quickly that wasn't a good idea, but I think things are going well.

Keep you updated with how it goes!

That's fantastic, Greenfire!  However, I want to mention, that at least for me, the first two weeks were the "honeymoon" period for this surgery, because one is not testing it, and the expectations are exactly what one would surmise.  Later, as weight-bearing and rehab begins, the mind game will become apparent as one goes through peaks and valleys.  And while I am sure you have read the same from others here, as I did, it doesn't really hit you until you start to experience it.

But hey, that's what we are here for.. support.  So please keep posting on your progress, as I will.
Title: Re: Microfracture on 37 year old male soccer player
Post by: chariotson on September 15, 2009, 10:41:51 PM

I still have problems with doing "step-downs" using my left leg (microfractured knee) to support my body weight, because for whatever reason, I still have pain when bending it around the 25 degree mark.† It's not only pain, but also lack of strength.† As a substitute exercise, my physical therapist has me doing wall-squats, with my left leg positioned forward moreso than my right.

I am pleased with my progress thus far.†

Sounds like you are doing great. Took me a long time to be able to do step downs comfortably, maybe 9 months in total. We each have our own schedule of course.

Played our second game of the fall season on Sunday, I scored twice in the first 5 minutes with break aways where I outran the defence each time. Shows there is life in the old legs :) No pain in the game at all, but can certainly feel it two days later, not just my knee.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on September 17, 2009, 04:36:04 PM
Hi Scooter72 and all your respondents,
I am a 52year old soccer referee and referee on football conference (one down from the football league) on Monday this week I went in for a cartliage tear repair as the MRI suggested to the OS that it was a simple procedure.
Following the operation the OS came to me and said it was bad news and that my knee on the inside was bone on bone and he had to shave my knee bone before doing a MF procedure.
He said that this may last me a couple of years if I am lucky before I need a new knee replacement. I am on crutches and no weight bearing for 6 weeks and I am still devastated by the news, he said I cant consider sport for at least 6 months, I also play golf.
Hope you continue with your recovery and any advice you could give would be helpful
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on September 17, 2009, 06:51:21 PM
Hi Kevin

I had a MF procedure done back on the 5 June so am 15 weeks out just now. My knee so far really doesn't fell any better than pre-surgery but its still early days. I'm 40 next month and used to do a lot of running. I've been advised that my running days are now over.

It doesn't sound good if your surgeon is already talking about a knee replacement in a couple of years. I suppose it depends on the location and the size but this procedure can last a lot longer than 2 years. My surgeon has also talked about alternatives such as OATS and ACI if the MF doesn't work.

There are a couple of good blogs out there that show the progress of others who have this operation:

This first one is from a cyclist who had MF 2 years ago and you can follow his progress right through -

http://www.podilato.com/category/microfracture/page/5/

This next one is from a runner who had the op last year. Again, you can follow his progress over the year. He was back running, albeit short distances, after 6 months and was back doing 60 miles a week a year later, although he was still reporting some pain. -

http://www.podilato.com/category/microfracture/page/5/



Title: Re: Microfracture on 37 year old male soccer player
Post by: PieceDesigner on September 17, 2009, 10:20:41 PM
Hi Kevin, Your story sounds similar to mine. I'm 48.

I had MFX and TruFit Plug surgery in June. Doc found another spot that was bone on bone and did MFX on it.  I was told before surgery that any work might be a temp fix, as my knee cartilage was in bad shape, and I'd probably be looking at knee replacement in a couple years.  Plug work is doing great, but the other area is not so good. Doc mentioned knee replacement in my future again last visit. Am hoping to do anything I can to delay it as long as possible.

Wishing you a speedy recovery.

Nan
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on September 18, 2009, 07:39:55 AM
Sounds like you are doing great. Took me a long time to be able to do step downs comfortably, maybe 9 months in total. We each have our own schedule of course.
Played our second game of the fall season on Sunday, I scored twice in the first 5 minutes with break aways where I outran the defence each time. Shows there is life in the old legs :) No pain in the game at all, but can certainly feel it two days later, not just my knee.

Absolutely fantastic, Chariotson.† You are where I aspire to be.† I feel great for you, and I think that your example should serve as a beacon for others here (including Kevin3004).† Please keep me posted on how you do as the season progresses. I still can't do the step-downs with much proficiency, but I have improved since my last post about it!

 Speaking of.. Kevin, I feel for you.† There are a hundred things I could tell you about my experiences, as could others here.† But the number one thing is to keep a STRONG WILL and thus, a positive attitude.† This is a mind game.† The surgery is so easy, when looking at it from a technical standpoint.† However, the recovery is deceptively difficult.†

† I would emphasize that you MAKE SURE your surgeon is competent and amicable; if he isn't willing to deal with you asking a bunch of questions before and after the surgery, about any and every detail, then find someone else.† Nail down what you will be doing in terms of rehab, from day 1 after surgery.

† Also, I would highly recommend taking Cosamin DS, and a high quality fish oil daily (green pasture's "blue ice" is an excellent brand).† There are dietery adjustments you could make as well, such as loading up on blueberries and cherries, but in my opinion those first two supplements are vital. I did a lot of research into diet and supplementation to aid me, and I seriously doubt I would be healing so rapidly without such diligence.†The Cosamin especially has been shown in studies to improve the ration of fibruous to hyaline cartilage. I had my mf surgery June 25th in the trochlear groove, and my lesion was absolutely huge: about 1cm wide and almost 2 inches long. And even then, my OS said he could have "flaked off" more because the cartilage was so loose in the damaged area (I just recently found out that these were the dimensions; I originally thought it was much smaller)† I am now doing sprints and able to do leg extensions with my healing leg, with 20lbs.† Before the surgery it was agony to do 2.5lbs.†

† Keep us up to date, Kevin!

Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on September 18, 2009, 10:34:51 AM
Thanks Guys for all your replies I have my first session with the PT next week and I am seeing the OS on the 9th October. I will take your advice Scooter 72 on the food supplements and see where that takes me but its hard to be positive at the moment. The really hard bit is one minute I was really physically active and the next I am on cructhes for at least 6 weeks.† †
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on September 21, 2009, 10:46:24 AM
Monday 21st Sept 09.
Hi everyone well its been a week now since my surgery and I have reduced taking my painkillers to once a day. I see my PT for the first time this Thursday and don't see my OS until the 9th Oct, I removed the outer bandage and put tube-a-grip dressing on it but I haven't removed the inner bandage, I think I'll wait to see the PT first.
Can you guys tell me when you were allowed to drive, I have an automatic but as it is my right knee that I had the op on all my work would be by my right foot anyway.
Also if you were also non weight bearing for 6 weeks on crutches, what happened to you after the 6 weeks i.e. did you walk with walking stick etc?
Cheers
Kevin†
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on September 23, 2009, 03:50:29 AM
Monday 21st Sept 09.
Hi everyone well its been a week now since my surgery and I have reduced taking my painkillers to once a day. I see my PT for the first time this Thursday and don't see my OS until the 9th Oct, I removed the outer bandage and put tube-a-grip dressing on it but I haven't removed the inner bandage, I think I'll wait to see the PT first.
Can you guys tell me when you were allowed to drive, I have an automatic but as it is my right knee that I had the op on all my work would be by my right foot anyway.
Also if you were also non weight bearing for 6 weeks on crutches, what happened to you after the 6 weeks i.e. did you walk with walking stick etc?
Cheers
Kevin†

I was weight-bearing almost immediately, so I can't help you with your query.  However, I would suggest that you read the initial post of people who started their own threads in this forum, to get an idea of their experience.

Title: Re: Microfracture on 37 year old male soccer player
Post by: PieceDesigner on September 23, 2009, 05:38:44 AM
Hi Kevin, I was non-weight bearing for 3 weeks, but after a painful first few attempts at weight bearing, I stayed off it for another week, or so. Then I was partial weight bearing for 2 more weeks. Was not fully weightbearing for 6-7 weeks, used crutches for a couple of weeks, then the cane for awhile, and even now I occasionally use a cane or crutches on bad days. I had work done on medial chondyl (plug), and also Trochlear groove, so probably could have been weight bearing right away, if I hadn't had any of the work done on the medial femoral weight bearing spot.  Where was your MFX on?
I drove at 3 weeks, if I remember right, but it was not easy. Mine is right knee, with automatic car. Worse part was acutally getting into and out of the car. Most of my driving was highway, so I set cruise control, and fortunately did not have to do much braking. Braking was actually not too bad, as I did not get myself into a sudden braking situation if I could help it.  It was the gas pedal that was most painful as I steadily increased speed before I could put cruise on. I finally wised up and used the cruise control lever to notch up the speed a couple miles an hour between about 45mph and higher. After 45 mph my knee was screaming if I exerted more pressure on gas pedal.  It was probably 3 weeks after going partial weight bearing before I could drive without a lot of pain.  Bending knee to get it into and out of car was a killer!

Wishing you continued healing,
Nan
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on September 23, 2009, 10:27:04 AM
Hi Kevin, I was non-weight bearing for 3 weeks, but after a painful first few attempts at weight bearing, I stayed off it for another week, or so. Then I was partial weight bearing for 2 more weeks. Was not fully weightbearing for 6-7 weeks, used crutches for a couple of weeks, then the cane for awhile, and even now I occasionally use a cane or crutches on bad days. I had work done on medial chondyl (plug), and also Trochlear groove, so probably could have been weight bearing right away, if I hadn't had any of the work done on the medial femoral weight bearing spot.† Where was your MFX on?
I drove at 3 weeks, if I remember right, but it was not easy. Mine is right knee, with automatic car. Worse part was acutally getting into and out of the car. Most of my driving was highway, so I set cruise control, and fortunately did not have to do much braking. Braking was actually not too bad, as I did not get myself into a sudden braking situation if I could help it.† It was the gas pedal that was most painful as I steadily increased speed before I could put cruise on. I finally wised up and used the cruise control lever to notch up the speed a couple miles an hour between about 45mph and higher. After 45 mph my knee was screaming if I exerted more pressure on gas pedal.† It was probably 3 weeks after going partial weight bearing before I could drive without a lot of pain.† Bending knee to get it into and out of car was a killer!

Wishing you continued healing,
Nan



Thanks Piece Designer I am not exactly sure where my OS did my MFX as initially I was only expecting what was expected to be a small repair to† a torn cartliage based on what the MRI had shown. So when my OS told me post op at the hospital what he had needed to do I was so shocked and devastated I asked him very little.
I am due to see my OS on the 9th Oct where I will have a lot of questions to ask him.
Cheers
Kevin

Title: Ouch ouch ouch ouch!
Post by: Scooter72 on September 25, 2009, 10:53:37 PM
An update: I think I pushed it way too hard this week.

As you know, I have been running, doing physical therapy (pretty hardcore) and generally trying to recoup the strength of the injured leg.

Well.. this week, on Monday, the pain got bad.  As in.. almost as bad as before the surgery.  All the progress I have made has been (temporarily) lost.

I hope this doesn't signal anything terrible, for the long-term.  But even if my mfx ultimately fails, I will try again with a different procedure, at the Stone Clinic.  Come hell or whatever else can be thrown at me, I will be playing footy, and leading an active lifestyle, at some point in the near future.

I'll update sometime next week.
Title: Re: Microfracture on 37 year old male soccer player
Post by: PieceDesigner on September 25, 2009, 11:16:38 PM
Ouch, Scooter!  Sorry to hear that.  Hope easing off and resting it will help.  I went through some increased pain a few weeks ago, and eased off the PT some. It helped a lot. 



Nan
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on September 26, 2009, 12:40:53 AM
Ouch, Scooter!† Sorry to hear that.† Hope easing off and resting it will help.† I went through some increased pain a few weeks ago, and eased off the PT some. It helped a lot.†
Nan

Thanks Nan!

I hope that's the case with me.  It's a bit depressing, but I am 100% sure that I will recover.

On a different note, I did some research on my down time, recently, and came across a paper on a "new" technique for cartilage repair, that involves direct application of stem cells.  It's not ACI, and obviously not mfx, or the like.  The research was done in 2007, and published by Japanese researchers in a publication in 2008.  I am going through my school to get a copy of the article. Once I do, I'll summarize the findings here.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on September 26, 2009, 11:36:45 AM
Hi Scooter sorry to hear of your setback but I hope with you easing off the PT will get you back on track. Forgot to say when I put on my first post that I live in the UK in the West Midlands and have a seson ticket with Wolverhampton Wanderers who got promoted to the Premier League this season, I also watch the MLS on ESPN.
I played soccer at semi-professional level until I was 32 and the continued to play local league until I was 46. I then retired and took up Refereeing and got promoted each season and this summer I was promoted to the national list of semi professional referees. However, I only refereed 6 games at my new level before I went in for what I thought would be a minor cartliage repair but it turned into MFX and my career as a referee is now in doubt as I am 52 and will have to retake the FA fitness test again which is a requirement to referee at national level. The FA have been very understanding about it and have given me until up to next June to do this.
However, at your age you are young and strong enough to get back to full fitness and I can share and admire your desire to play soccer again, as it is the best sport in the world.
My advice is when you get back play as long as you can because life isn't a dress rehearsal, let me know your pogress.
Cheers
Kevin
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on September 26, 2009, 05:49:11 PM
Hi Scooter sorry to hear of your setback but I hope with you easing off the PT will get you back on track. Forgot to say when I put on my first post that I live in the UK in the West Midlands and have a seson ticket with Wolverhampton Wanderers who got promoted to the Premier League this season, I also watch the MLS on ESPN.
I played soccer at semi-professional level until I was 32 and the continued to play local league until I was 46. I then retired and took up Refereeing and got promoted each season and this summer I was promoted to the national list of semi professional referees. However, I only refereed 6 games at my new level before I went in for what I thought would be a minor cartliage repair but it turned into MFX and my career as a referee is now in doubt as I am 52 and will have to retake the FA fitness test again which is a requirement to referee at national level. The FA have been very understanding about it and have given me until up to next June to do this.
However, at your age you are young and strong enough to get back to full fitness and I can share and admire your desire to play soccer again, as it is the best sport in the world.
My advice is when you get back play as long as you can because life isn't a dress rehearsal, let me know your pogress.
Cheers
Kevin

Wow! As you gathered, I follow the Premiereship closely, and I usually root for the promoted teams because they are invariably underdogs.  I like the Wolves this season; when is Ebanks-Blake coming back to start?  Based on his history, especially last season in the Championship, I certainly thought he would put on a show for at least the first half of the season before the grind would start to affect him. It'll be a tough test at the Stadium of Light, tomorrow.

I played football as a kid, and then fell out of it, and then rediscovered it at age 30, only to wonder why I didn't play it my whole life.  It's so natural to me, and just being on the pitch fills me with joy, no matter what kind of game it is.  (Actually, that's not so true! The really ďhackyĒ games, I can do without at this age)  So as you can imagine, I really haven't gotten ďmy fillĒ.  I am pretty miserable with this mess and am considering returning to playing even if this surgery is a failure, although I wouldn't be happy playing at half-speed. I definitely would research and book myself for another surgical option, in the meantime.

So after having read your story, I can't imagine how you feel.  So much experience with the game for you, in a country that reveres the sport.  That being said, I am 100% confident that you will recover, as long as you are diligent with following whatever protocol is laid out for you.  Don't worry about your age; it's irrelevant at this point. Besides, there is a 42 year old in this thread who had the surgery, and is now scoring goals again in his recreational league.  I was sprinting last week, at only 3+ months out from this surgery.  There are other stories about ďolderĒ people who have gone on to do well.  And in any case, I don't care how old you are, you are a footballer, and as such you likely have good recuperative abilties.

Please, don't forget to adjust your supplement intake; the fish oil and Cosamin DS.. they help.  Another thing to consider is your weight.  I don't know what your body composition is like at the moment, although I'd guess you are in good shape to have been approved by the FA, but keeping a good body weight is critical.

On another note, my wife and I are coming to West London on our honeymoon, in December! We hope to catch a game.. ANY game!  At this point, we have set our sights high, and are hoping to get tickets to Fulham-ManU.  If there's any chance of catching you at a pub, I'd love to chat with you!

Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on September 27, 2009, 01:29:59 PM
Thanks Scooter for your comments, my daughter who is 19 supports Chelsea and we try and get down to Stamford Bridge 3 or 4 times a year.
If you are coming to West London for your Honeymoon I recomend you do the tour of Stamford Bridge Stadium. They do it everyday other than match days and it is truly a worthwhile experience, seeng the players changing room, the managers office and the press room as well as the stadium itself, the new Wembley stadium is also worth a visit.
As for Ebanks-Blake he played for the 1st time on Wednesday night against Man utd in the League Cup and looked well short of match practice and I think he will revert back to Keogh and Doyle at Sunderland this afternoon.
Going back to my MFX I saw the PT on Thursday for the first time who just said to continue with the NWB leg exercises and R.I.C.E. until I see the OS on the 9th October. The PT said my notes stated that I had 2 parts of my knee MFX''d on, my troch groove and on the bootom of my fib. He had also shaved some excess arthricitic growth off the top of my tib. However, he couldn't say what my long term prognosis was as only the OS knew that, so I will have to wait until the 9th Oct when my OS will give me the knews and what PT I can move onto and when.†
Keep in touch and nearer the time let me know the dates you will be in the UK in December.†
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on September 27, 2009, 08:59:01 PM
Hi Scooter again please log onto the following website in the UK

http://www.bristol-knee-clinic.co.uk/boc/v2newsfull.asp?ID=112

It is an artical on cartliage transplant which you may find interesting.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on September 27, 2009, 11:00:38 PM
Forgot to say when I put on my first post that I live in the UK in the West Midlands and have a seson ticket with Wolverhampton Wanderers who got promoted to the Premier League this season, I also watch the MLS on ESPN.

You've got no chance with that big diddy Berra in defence.† :P

When is Chris Iwelumo coming back? He started out with my team, St. Mirren.


Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on September 28, 2009, 09:47:53 AM
You've got no chance with that big diddy Berra in defence. 

When is Chris Iwelumo coming back? He started out with my team, St. Mirren.


Thanks AndrewH infact Berra hasn't been too bad of late, as for Iwelumo he is a few weeks off fitness yet, I watched St Mirren v Celtic on ESPN at the weekend and thought you put in a decent performance.
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on September 28, 2009, 11:10:50 AM

Thanks AndrewH infact Berra hasn't been too bad of late, as for Iwelumo he is a few weeks off fitness yet, I watched St Mirren v Celtic on ESPN at the weekend and thought you put in a decent performance.

We're not good enough to match a team like Celtic. Scott Brown gets paid around half of our entire wage budget!  :-\

Bad result for Wolves yesterday. Thought you were looking like getting back into it and then it all caved in. I was happy enough though as I transferred Darren Bent into my Telegraph Fantasy team in the morning and now lead my work's super league.  ;D

As for the knee, I'm now just over 16 weeks since operation. Still not sure how things are going. I think its heading in the right direction but am still worried. I realise it will take time though and am planning on putting in a couple of months decent rehab, biking, strengthening, etc over the next couple of months before going back to see the surgeon.

Keep your chin up Kevin. We all know what you are going through. Andrew Flintoff had MFX surgery 3 weeks ago now I think and they don't think he'll be back until next summer. If someone like him with all his resources is looking at a long recovery then we have to be realistic.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on September 29, 2009, 02:03:51 AM
No way did the Wolves deserve to win 5-2.. I would argue that they played Sunderland equal, and just got unlucky with their chances, whereas Sunderland were very lucky.

Also, who is Andrew Flintoff?  Thanks!
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on September 29, 2009, 10:51:26 AM
AndrewH thanks for your comments I agree we have to be realistic in terms of recovery time, that said its getting the right balance with optomism and determination. I know I will have set backs and suffer the demons that other posts have suggested but I try hard not to feel sorry for myself.

Scooter, Andrew Flintoff is an England Cricketer in his early 30's and reputably one of the worlds best of his generation. As AndrewH said he had MFX 3 weeks ago and is going to Dubai for 3 months shortly to undertake extensive rehabilitation. However, he only intends to return to one day cricket when he recovers. I don't wish to sound disrespectful but as an American you may not fully understand cricket (to be fair as an Englishman I don't fully) so this may not mean much to you.

As for the Wolves, Saturdays game against Portsmouth is now a 6 pointer and although perhaps we were unlucky at Sunderland defensively we were shambolic.
Keep in touch
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on October 12, 2009, 04:08:48 PM
Hi Scott not heard from you for a bit hows it going?
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on October 15, 2009, 06:18:01 AM
Hi Scott not heard from you for a bit hows it going?
Kevin

It's going quite well, actually!

My physical therapist challenges me every week, with something that is designed to get my biomechanics "back in sync".  I can't believe how weak my hip flexors are, in particular.  There are body weight exercises that I can't do, because my hips are weak. 

At this point in my rehab, I still deal with pain, but it seems to be less frequent than a month ago, and certainly, my leg is stronger than a month ago.

I am able to do step-downs with far better proficiency at this point (moved from a 4" stepdown to nearly 7" stepdown now).  This is due to my PT giving me exercises that, in short, have lead me to this point. 

In case you can't tell, I can't say enough about my PT.. there is simply no chance that I would have progressed so far so fast, without his guidance, despite my exuberance.

So how are you, Kevin?  What is new with you, and how are you liking The Three Lions, in light of their recent matches?  (Keeping in mind, Belarus isn't exactly a powerhouse!)
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on October 15, 2009, 11:20:23 AM
Hi Scot glad to hear you are going OK and the PT sounds good.
Its been just over 4 weeks since my surgery and I am now driving and weight bearing, however, I am still using the crutches as I have to learn to walk properly again and the leg feels so weak. I was with my PT on Monday this week and he gave me some weight bearing exercises and encouraged me to use 1 crutch around the house and try to do a few steps per day without crutches which I am doing.
The pain I get comes from under my knee which he said is OK and normal from the trauma of the surgery although it is good the pain is in that place because that isn't where I had surgery.
The mfx is mainly on the inside of my knee where I have grade 4 arthritis, I get frustrated at times but my PT says I am doing OK and see him again next week.
As for England well weve got to the World Cup but we shall see who Fabio picks and who remains injury free.
Keep in touch
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on October 15, 2009, 12:59:37 PM

As for England well weve got to the World Cup but we shall see who Fabio picks and who remains injury free.


Looking forward to supporting whoever England get drawn against.  ;D :P
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on October 15, 2009, 02:22:12 PM
Thanks Andrew spoken like a true Scotsman!!!!!!!!!!!!!!!!!!!!!!!!!
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on October 15, 2009, 11:42:32 PM
Thanks Andrew spoken like a true Scotsman!!!!!!!!!!!!!!!!!!!!!!!!!

Ha!  Well, at least you will have plenty of teams to root for, Andrew!

I am of the opinion that Darren Bent will make the final squad; Capello simply can't keep him out, should he maintain his current form.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on October 16, 2009, 09:54:57 AM
Hi Scot yes I think he has a good chance of making the squad if he keeps scoring.

By the way Scot are you able to run on your MFX yet and if so what have you done?

Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on October 18, 2009, 01:56:34 PM
Hi Scot yes I think he has a good chance of making the squad if he keeps scoring.

By the way Scot are you able to run on your MFX yet and if so what have you done?

Cheers
Kevin

Wow, funny you should ask that, Kevin.

I wasn't supposed to do this.. but last night I played my first two games, in over 6 months.  It is definitely early for me to try such a thing, but I figured, "what the heck".

So I warmed up at home, went to the indoor footy center and played.

It was obvious to me, that my left leg (the mfx leg) was weak.. too much so to provide for quick cuts and acceleration on turf. 

I had my worst two games since I first started to play football.  I had an awful first touch, could not line up a shot to save my life, tripped on the turf without anyone near me, multiple times, and just generally looked like a fool. The only positive was that I had no significant pain during or after play; the knee was sore and achy, yes, but who wouldn't expect that?

But I couldn't be happier!  :)  It was so much fun to get out there and just play.  Objectively speaking, I have to get my knee stronger, in order to be effective.  It will take time, but at least I know where I am at, and am positive that with further rehab, and continued discipline with training, I will be back to "normal" soon enough.

Thanks for asking!  What's new with you?
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on October 18, 2009, 05:15:04 PM
Hi Scot WOW!!!!!!
For you to just play in a match is brilliant and you must be so pleased with yourself as its just less than 4 months since your operation. You must have been very apprehensive about the game but now you've done it I think mentally that's another hurdle for you and you can now get more strength in the knee to play again.
As for me I am seeing the PT tomorrow I am now 5 weeks post op, last week he got me full weight bearing on the knee but still walking with crutches. He then gave me some exercises where I rock from side to side putting weight on both sides. I then lift my good leg and stand taking full weight on my bad one for 5 seconds. At first this hurt under my knee but as the week as gone on I can do it with little pain. He also encouraged me to walk around the house with just 1 crutch which I have been doing and do it all the time now around the house. Finally he encouraged me to try a few steps each day without any assistance which I have been doing but I can't do this without limping. On a positive note though I am a 100% better than where I was last week with NWB at all. I have also been reading up on aqua jogging which sounds good for injured athletes and will give it a try when I can walk a bit better.
Keep in touch and let me know your progress
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on October 18, 2009, 06:28:04 PM
Hi Scot WOW!!!!!!
For you to just play in a match is brilliant and you must be so pleased with yourself as its just less than 4 months since your operation. You must have been very apprehensive about the game but now you've done it I think mentally that's another hurdle for you and you can now get more strength in the knee to play again.
As for me I am seeing the PT tomorrow I am now 5 weeks post op, last week he got me full weight bearing on the knee but still walking with crutches. He then gave me some exercises where I rock from side to side putting weight on both sides. I then lift my good leg and stand taking full weight on my bad one for 5 seconds. At first this hurt under my knee but as the week as gone on I can do it with little pain. He also encouraged me to walk around the house with just 1 crutch which I have been doing and do it all the time now around the house. Finally he encouraged me to try a few steps each day without any assistance which I have been doing but I can't do this without limping. On a positive note though I am a 100% better than where I was last week with NWB at all. I have also been reading up on aqua jogging which sounds good for injured athletes and will give it a try when I can walk a bit better.
Keep in touch and let me know your progress
Cheers
Kevin

Thank you for the encouragement.  It was a bit emotional for me.  I don't want to distort how playing recreational football fits into the grand scheme of things, because after all, it is only a game.  But somehow, those games or activities in life that make us happy, seem so important, when one is unable to do so.

The jogging under water is an absolute must, in my opinion.  I did it vigorously a few times, in my second month of rehab, and for whatever reasons, it gave my legs a fantastic workout with little pain and a great burn.  The next day, I had no pain.

You mentioned pain at first, with the leg lifting exercise.  In my experience, every exercise hurts at first, and in my case, some hurt badly.  But the pain seemed to go away with subsequent repetitions.   

As many here have said, it's a mental challenge.  Some weeks will literally be taking two steps forward, and one or two steps back.  It's infuriating, sometimes depressing, but one thing you cannot do, is give up.

Speaking of giving up.. I think Liverpool should give up at this point! Terrible play against Sunderland, yesterday, and without Gerrard and Torres, they look very mortal.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on October 18, 2009, 06:40:32 PM
Cheers Scot I think its Man utd's to throw away after Chelsea also lost, good point for the Wolves at Everton though.
Post again soon
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on October 18, 2009, 09:41:58 PM
Thanks Andrew spoken like a true Scotsman!!!!!!!!!!!!!!!!!!!!!!!!!

Ha!† Well, at least you will have plenty of teams to root for, Andrew!

I am of the opinion that Darren Bent will make the final squad; Capello simply can't keep him out, should he maintain his current form.

Not sure if Darren Bent would be as good without the help of a beachball! :lol:
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on October 18, 2009, 10:02:14 PM
Thanks Andrew spoken like a true Scotsman!!!!!!!!!!!!!!!!!!!!!!!!!

Ha!† Well, at least you will have plenty of teams to root for, Andrew!

I am of the opinion that Darren Bent will make the final squad; Capello simply can't keep him out, should he maintain his current form.

Not sure if Darren Bent would be as good without the help of a beachball! :lol:

Oh so true! But isn't that the way with strikers and form?  When they are doing well, they even get the lucky breaks.  In the opposite situations, they can't hit an open goal from 5-yards out.  (E.g. Tevez two weeks ago at home, should have had a hat-trick)
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on October 19, 2009, 01:38:57 PM
Great study at this link about microfracture on UK football & rugby players:

http://www.josr-online.com/content/4/1/13

Article says that its not really until after 6 months that you start to see big improvements after microfracture.

I see that Bolton's Sean Davis is out for the season now after having surgery for articular cartilage damage - can't find out what surgery he has had but chances are that it'll be microfracture.

Its amazing what you find out when you have this injury! I discovered that Man Utd's supersub Ole Gunnar Solskjaer's 2 year injury before he retired was articular cartilage damage. I read a big article where he was talking about the pain and the depression..... all sounds very familiar!

He had ACI done to fix his however - but still made a comeback after 2 years out!

Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on October 19, 2009, 03:23:55 PM
Thanks Andrew just read the article really interesting and although these studies are mainly of professional players it does give grounds for optimism in recovery.
Cheers
Kevin
Title: Over-doing it
Post by: Scooter72 on October 25, 2009, 10:07:03 PM
Played two games yesterday, and today my knee feels like it did pre-microfracture.  It began to hurt and give during the second game, but I played it out (albeit at a reduced pace).

Now, I know I didn't "ruin" the microfracture, rather, I think that the cartilage at the site of microfracture is simply not thick enough yet to take the pounding of playing footy on turf.  The paper that Andrew linked in this thread reinforces my opinion. I'm just under 4 months post-op, and according to that paper, most of the footballers and rugby players approached or achieved "normal" function and MRI  scores between 6-12 months.  And to boot, my lesion was very large, so with that in mind as well, I am happy to be where I'm at.  Which brings me to...

the fact that I've noticed some people get down about their progress thus far (in other threads).  In my opinion, one shouldn't get too "down" about their peaks and valleys as long as they are short of the 1-year mark and are doing their physical therapy religiously.  And I cannot emphasize that enough.. do the PT as if it were the only thing in your life.  And don't just do it haphazardly.. do it with the proper form, and push yourself.  From all I have read and discussed, PT is the major determining factor of mfx success, post-op. 

I am sure everyone here knows this, and I am just preaching known words.  But sometimes it helps to have someone else say it emphatically, so as to invigorate another who is despairing. 

Despite the pain, it has been good for me to get on the pitch, because I can feel my muscles working in ways that PT exercises can't mimick.
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on October 26, 2009, 08:36:55 AM
Good stuff Scooter.

4 months is still early days, I don't think I've read of any professional sportspeople coming back that early.

I read an article from an American basketball player who had microfracture who said that when he started back playing he could hardly walk between games due to the pain. As you say, I seriously doubt you have ruined the microfracture - its just that the cartilage won't be strong enough yet for the demands of playing two games of football (two games??? you nutter!)

I'm really getting into my PT now. I managed 4 days of cycling in the gym in a row last week, first time I'd managed more than 2 consecutive days without pain forcing me to rest. I even did a double session on Friday. Hoping to get 6 days in a row this week with a few doubles!

Keep up the good work.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on October 26, 2009, 03:10:50 PM
Well done Scooter and Andrew great to hear you're both progressing at different stages post op.
I am 6 weeks post op today and saw the OS on Friday who was very optimistic of my recovery and he said it is also down to the individual's motivation as well as the surgery, taking a point scooter raised.
I saw the PT today and I am now on one crutch and he hopes I can do away with the crutches totally fom next week.
He has encouraged me to walk around the house without a crutch which I have been doing for a week with a limp.
Today the PT started working on my Kinetic Chain Assesssment whereby he has given me exercises to do to balance up my hips, backside muscles, hamstrings and quads to improve both my posture and walking gait.

Keep positive
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on October 26, 2009, 10:32:30 PM
It's very good, today, my knee feels much better (albiet after taking some prescription anti-inflammatories and extra supplements). Also, I did better today on one of my PT exercises, namely the one-legged squat than I have previously.† Some pain, but not enough to stop me from forcing it.†Just to clarify, the term "squat" is being used liberally, here, as I really cannot bend my injured leg too far while attempting it.

 Andrew, it certainly seems as if you are making strides, by judging how much cycling you can tolerate.† My guess is that you'll be able to do 6 days/week easily, if you don't crank up the resistance too high.† Progress is something to be very excited about in this "business".† And yes, I am a "nutter" but not one on 'par' with Craig Bellamy.† (Pun intended.. err.. if you got the joke in the first place)† By the way, I wonder who the basketball player you speak of, might be?† There have been a few in the NBA that have had microfracture.

† Kevin, I think it's great that you are getting a Kinetic Chain Assessment, but I am curious.. how is your PT assessing you, when you are essentially weak in one leg?† I thought such an assessment was to be done on people who are not injured, after all, how can he be sure of your "normal" imbalances while you are injured?† But otherwise, I think it's great you are off the crutches, limp or not.† Soon enough, I believe your limp will become barely noticeable, although it may take a month or two to completely lose it.† The next step after for you might be going up/down stairs without pain.†

† By the way, can either of you believe Liverpool actually won???† I am shocked; I thought Liverpool was surely on the ropes.† Kind of surprised though, that Mascherano got red carded.† I know he is a hothead, but I thought that he would reign it in for this all-important game.† Same with Vidic.† Ah.. I wish I could have actually seen the game... was too busy with other things (i.e. activity my wife set up)
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on October 27, 2009, 08:57:02 AM
Andrew, it certainly seems as if you are making strides, by judging how much cycling you can tolerate.† My guess is that you'll be able to do 6 days/week easily, if you don't crank up the resistance too high.† Progress is something to be very excited about in this "business".†

Bad news is that I possibly cranked up the resistance too high....

Didn't have a great day yesterday, pain was worse than usual. Did some squats and lunges on Sunday along with a 45 min sessions on the bike and then did two 30 min sessions on the bike yesterday - but knee was sore in the afternoon. Not too bad while actually walking but getting a burning sensation while sitting at my desk at work.

Going to give the cycling a rest for a couple of days now and see what happens. I'm still at this stage of wondering if the operation has worked and I'm improving or whether its failed and I'm just now able to tolerate the injury better.

Going to give it a couple more weeks then make an appointment to see my OS. I'm then going to see if he thinks an MRI would be able to show whether their is cartilage in the defect. I'll be around the 6 month mark by then. I'd just like to know one way or the other whether this op is working or not!

Frustrating!
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on October 27, 2009, 10:10:13 AM
Andrew just read your blog on the MRI scan and to let you know that when I saw my OS last week (6 weeks post op) he said that he intends to do another arthroscopy on my knee at 6 months to check on the mfx, as an MRI wouldn't give as good a conclusive result as the camera.

Scooter take your point on the KCA being done before the op but like most people I never considered it.
So you're right in that sense but it is still important to get my body balanced with corrective exercises to differing muscles to ensure I return as good as I possibly can.

On the Liverpool game I think it was good for the Premiership title race that Utd lost, as for the red cards both were justified as they are both hotheads.
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on October 27, 2009, 11:42:03 AM
Andrew just read your blog on the MRI scan and to let you know that when I saw my OS last week (6 weeks post op) he said that he intends to do another arthroscopy on my knee at 6 months to check on the mfx, as an MRI wouldn't give as good a conclusive result as the camera.

Scooter take your point on the KCA being done before the op but like most people I never considered it.
So you're right in that sense but it is still important to get my body balanced with corrective exercises to differing muscles to ensure I return as good as I possibly can.

On the Liverpool game I think it was good for the Premiership title race that Utd lost, as for the red cards both were justified as they are both hotheads.

That might be what my OS suggests, I'll just need to wait and see.

We've already talked about what the next stage might be if microfracture doesn't work. I know that he is involved in the ACTIVE trials for ACI in the UK for the NHS and fixing articular cartilage defects seems to be his speciality so I'm comfortable that he knows what he is doing.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on October 27, 2009, 02:31:30 PM
Andrew sounds as if you've got a good OS so best of luck and I hope it's a positive outcome for you
Cheers
Kevin
Title: update 11-6-09
Post by: Scooter72 on November 06, 2009, 06:05:38 PM
First, thanks for the message, Kevin.  I had not forgotten about this board, it's just that I haven't had much to report.  And as you say in your message, there are days where the knee feels awful, and others where it feels as if superb progress is being made.  Truly, the latter will outweigh the former, over time.

At this point, I am making small gains with my knee.  Is it stronger? Yes, by a small amount (e.g. I can do 5lbs more on a leg extension, without significant pain than a couple of weeks ago) 

My PT gave me new daily rehab exercises yesterday, one of which involves doing one-legged wall squats, and another which is the one-legged hop (over a small barrier, such as a 2x4).  I didn't realize how much farther I have to go until I tried the hops.  I can hop.. certainly.. but compared to my right leg, I am off! 

Last week, I had something called a biodex test done.  You may know what a leg extension exercise is?  Well, this biodex machine measured how strong my left (injured) leg is in comparison to my right leg, using the leg extension motion, both in forward and reverse!  The forward motion measures quad strength, while the reverse measures calf strength.  Overall, my calves are within 10% of each oter, which is what I want.  However, my quads are only within 30% of each other.  This isn't bad at this point, but it is a large discrepancy. 

Kevin and Andrew (and anyone else).. any predictions for the Reds and Blues this weekend?
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on November 07, 2009, 02:23:13 AM
Kevin, I'm assuming he'd only do this second arthroscopy if you're still having significant pain?  Otherwise, it seems a little crazy to have surgery again just to check and see how things are going.  An MRI would give you at least some idea without further disturbing your knee.  Even if you are still having pain then, an arthroscopy is only going to further delay your recovery.  FYI, the most dramatic improvement in my knee after microfracture has occurred after the 6 month mark, so just be patient!
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on November 08, 2009, 01:31:01 PM
Hi Scooter72(Scot) glad your progressing well as you say as the weeks go by you get ups and downs and you have to saty positive and focused. On the weekend footie I think  Chelsea v Man Utd will be a draw.

Madel23 I take your point about another arthroscopy, however, what the OS has said that he has done this with a number of his mfx patients to see if the fibre cartliage has taken. But it may be as you say that this dependant on if I have any significant pain still at that stage. As for being patient I find that the hardest challenge of all.

Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on November 08, 2009, 01:50:40 PM
Hi Scooter72(Scot) glad your progressing well as you say as the weeks go by you get ups and downs and you have to saty positive and focused. On the weekend footie I think† Chelsea v Man Utd will be a draw.
Madel23 I take your point about another arthroscopy, however, what the OS has said that he has done this with a number of his mfx patients to see if the fibre cartliage has taken. But it may be as you say that this dependant on if I have any significant pain still at that stage. As for being patient I find that the hardest challenge of all.
Cheers
Kevin

Ha! Kevin, I find patience to be elusive at times, as well.

Just wondering, how are things going at home with respect to the microfracture?  Getting about okay, I take it?  Any ribbing from your family (in good nature, of course).  Also, what news from the FA since your surgery? Are they still being understanding about it, and will they let you back in once the knee is healed?

I remember my first week at home from surgery, my wife was having a time of it.  She would tease me, call me a "crippled old man", and of course, I couldn't  do anything but hop after her on my good leg!  Ah well, at least I got to be pampared by her; she took great care of me.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on November 09, 2009, 01:48:26 PM
Ha! Kevin, I find patience to be elusive at times, as well.

Just wondering, how are things going at home with respect to the microfracture? Getting about okay, I take it? Any ribbing from your family (in good nature, of course). Also, what news from the FA since your surgery? Are they still being understanding about it, and will they let you back in once the knee is healed?

I remember my first week at home from surgery, my wife was having a time of it. She would tease me, call me a "crippled old man", and of course, I couldn't do anything but hop after her on my good leg! Ah well, at least I got to be pampared by her; she took great care of me.
Quote

Hi Scot family were very good although they did rib me about it in jest of course, when I was NWB they waited on me, but now they think its pay back time so I'm making the tea/coffee.
Been to the PT today I am now 8 weeks post op, he is working me with various squats and weights. The limp is slowly improving as I get more strength in the knee.
As for the FA they have been OK and initially they have closed my dates until the end of February 2010, thats when they will want an update. Obviously at that stage it will be too early for me to return to refereeing but it will be 6 months post op so they will be looking for a prognosis from the OS and PT.
Realistically I have to write this season off as it finishes in early May 2010, however, I will need to be able to pass the FA's preseason fitness test in June/July 2010 or I think that will be it.
The initial fitness test I would have to pass would be running a minimum of 2700 meters in 12 minutes around a 400 meter track. Then after a 5 minutes break you then have to do 3 x 50 meter sprints in 7 seconds per sprint.
However, I can't look that far ahead at the momement so I am putting 100% into my PT sessions and exercises he gives me and I will see where that takes me.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on November 12, 2009, 09:40:01 PM
Just an update.. I am doing well this week.  I actually have improved strength, compared to two weeks ago, doing one-legged squats (with back against a fitball, on the wall).  Minimal pain.  I am also doing an exercise called "lunge jumps", along with all the other rehab exercises. 

All-in-all, an improvement.  I guess the true test will be after a game of footy this Saturday (we haven't played in two weeks due to the scheduling of the facility).  The level of pain and soreness during/after is the real gauge, for me.

Kevin, how are you doing this week?  Any plans?

Also, Andrew, I read in another thread that you are getting an MRI; I sincerely hope it is decent news, although if you say the pain is no better than pre-surgery, such is not good. I must ask; is the pain level the same as "pre-surgery", all of the time, or just when you exert yourself?  Just curious.
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on November 13, 2009, 05:08:53 AM
Andrew,
I wouldn't worry too much just yet.  We don't all heal as fast as scooter does!  I experienced little improvement for 6 months after mfx, thought it didn't work, but now after 8 months I'm starting to run again.  My OS said it takes up to a year to get back to normal sometimes.  Just give it time!
Title: Re: Microfracture on 37 year old male soccer player
Post by: Tom Footballer on November 13, 2009, 11:10:31 AM
Gents,

Good to hear how your rehab is going as I am in the same boat (Microfracture on signifantly sized cond' defect in lat' side of left knee), I am 7.5 months post op and desperate to get back to playing football. I, like you, have the dilema of when to return to sport, my knee feels OK apart from the same burning sensation after sport or long periods standing that you guys describe. I have returned to some light jogging on grass and this also feels OK although I am wary of the fact that when I sustained my original injury I didn't actually feel anything until resting after a match - hence I am aprehensive of tearing into games at this stage.

Good luck with your goals and thanks for providing some interesting information. 
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on November 13, 2009, 01:48:10 PM
Hi Tom.† I understand your apprehension, and like you, I ended up having a sizable defect (except in the trochlear groove), once the surgeon actually got in to look at my knee. What was supposed to be a small defect grew larger and larger as he debrided the edges, because the surrounding cartilage was so loose that it pretty much fell off.† †(I actually got to watch my surgery, and while it happened, I wasnít exactly happy, even with the ďhappy juiceĒ they gave me)

In my case, I was weight-bearing immediately, and did not have to use a CPM; all I had to do for the first few weeks was avoid bending the knee (which was tightly wrapped up).† At about the 7 week point, my OS literally told me to "start running, because there isn't a point where you will feel that it's 'ok' to return to an activity.† You have to push it."† So, since then, I have pushed myself, and I can tell you that there has been plenty of "two steps forward, two steps back, two steps forward, one step back... etc..."† †I would think that you, and anyone else that has undergone this procedure experiences the same.† Hopefully you have a good support group to push you through the tough times, because that kind of mental and emotional fortification is needed with microfracture, unless one is some kind of jedi with the utmost self-confidence.

In comparison to your experience with running 7.5 months pot-op:† when I began jogging, it felt awful at first, but eventually the pain went away.† I was happy, and misdirected by that success, as I thought it wouldn't be long before I could play a game of football.† Unfortunately, there proved to be a huge difference between jogging and sprinting, and especially cutting with sharp lateral movements.† And for me, at least, the high impact movements such as turning at a sprint, and jumping/landing during a header, are what cause the most problems.† It gets better with strength, endurance training (utilizing the rehab exercises) over time, but my goodness is it awfully slow.† What Iíve also found is that recovery time after a game or workout is getting shorter, although for me, after my second game of footy, I couldnít walk without some pain for four days.
So maybe you should try running an obstacle course of sorts that tests your lateral agility, and thus gauge your pain.† I wish I could tell you that at 7.5 months post-op, youíll be playing footy in no time, but as madel has mentioned, everyone heals at a different rate despite the fact that the symptoms while recovering are the same.† But without testing a bit, I donít see how you could know the tolerance of the injured knee.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on November 13, 2009, 06:40:47 PM
Just an update.. I am doing well this week. I actually have improved strength, compared to two weeks ago, doing one-legged squats (with back against a fitball, on the wall). Minimal pain. I am also doing an exercise called "lunge jumps", along with all the other rehab exercises.

All-in-all, an improvement. I guess the true test will be after a game of footy this Saturday (we haven't played in two weeks due to the scheduling of the facility). The level of pain and soreness during/after is the real gauge, for me.

Kevin, how are you doing this week? Any plans?

Also, Andrew, I read in another thread that you are getting an MRI; I sincerely hope it is decent news, although if you say the pain is no better than pre-surgery, such is not good. I must ask; is the pain level the same as "pre-surgery", all of the time, or just when you exert yourself? Just curious.

Hi Scooter thanks for asking I was 8 weeks post op this week and starting to biuld up PT with weighted squats, lunges and core exercises. My PT has started giving me full weight bearing stuff on my injured knee i.e. step ups and lunges. Just giving all the PT 100% as per your advice and my limp is gradually getting better. The knee certainly feels stronger but I'm always cautious because as you know you have good days and bad days.
Andrew all the best with your MRI scan and I hope it turns out as madel23 says that its just not yet settled down.
On the comments of madel23 can I say your positive advice and experienced assurance are of  great comfort
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on November 13, 2009, 08:56:59 PM
Also, Andrew, I read in another thread that you are getting an MRI; I sincerely hope it is decent news, although if you say the pain is no better than pre-surgery, such is not good. I must ask; is the pain level the same as "pre-surgery", all of the time, or just when you exert yourself?† Just curious.

Sometimes I think there is improvement other times I don't think there is any difference from pre-surgery. To be honest, due to work, circumstances and having a cold, I've done absolutely no exercise now for 3 weeks. That's by far the longest I've went without biking at the gym since I came of crutches. Most weeks I've been on the bike at least twice a week, on occasions up to 6 times. The complete rest has made no difference - no change whatsoever.

I'm still hoping that the MRI will come back and tell me that something is happening, we will wait and see. I may be losing my job at end of May next year so if I do need more work on my knee I want to get it done before my private health insurance expires with the job.  ;)
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on November 13, 2009, 09:03:12 PM
Andrew,
I wouldn't worry too much just yet.† We don't all heal as fast as scooter does!† I experienced little improvement for 6 months after mfx, thought it didn't work, but now after 8 months I'm starting to run again.† My OS said it takes up to a year to get back to normal sometimes.† Just give it time!

Thanks madel. I've not given up hope. Its just that after 5 and a half months I thought I would have felt a lot better than this by now. It doesn't feel much different now than it did pre surgery. I think I'm just better now at tolerating it. I really can't imagine being able to run in just two and a half months time - although I'd love that to be true!

Not that I'm going to run again anyway. My mind is firmly made up that I won't ever run again. I achieved some great things running which I never thought I was capable but I'm going to keep them as memories. Done that, been there, nothing to be gained by attempting to back. In any case, I look a lot healthier now that I've put a bit of weight back on. My plan is to take up cycling but not get as obessed as I was with running!
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on November 14, 2009, 10:25:45 PM
Ok, but if running is what you want to do, don't write it off.  I was ready to write it off at 5.5 months, it hurt slightly to even walk at that point, but then around 7 months I suddenly started feeling dramatically better.  Although I don't know if this will last, things can still improve a lot for you.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on December 01, 2009, 10:43:02 AM
Hi Madel, Andrew and Scooter just wondered how things are progressing with you all?
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on December 02, 2009, 02:42:36 AM
Hi Madel, Andrew and Scooter just wondered how things are progressing with you all?
Cheers
Kevin

Doing well, Kevin!†

At this point, I do not have much that is "new" to report, because the gains I am making are less dramatic.† Mostly in how I recover, after vigorous exercise.†

I guess if I were to be asked, at this point, how I feel about the results of my microfracture, given the size of my lesion?† I would say that I am very happy, and that my surgeon and physical therapist are pleased with my progress.† Not that I am a "finished product", because I won't judge that until next May/June.† I don't want to give the impression that my knee is 100%, as if nothing happened.† Far from it.. I still feel pain and soreness on the field, during rehab exercises, and during weight training.†

How about the rest of you?† I'd certainly like to hear it.

Kevin, on a side note, are there "scalpers" around stadiums on gameday?† I became a Fulham international club member just to get tickets to the ManU game, but they sold out almost immediately.† We would definitely be happy going to a pub, but would still like to try and get tickets if we can.
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on December 02, 2009, 07:57:31 PM
Hi Madel, Andrew and Scooter just wondered how things are progressing with you all?
Cheers
Kevin

Hi Kevin

I'll be 6 months post surgery this weekend. I think things are improving but still have my doubts. Had an MRI scan a couple of weeks ago and the OS reckons there is some healing going on and need to come back in 6 months. I can certainly go on the bike at the gym for longer and faster and am improving all the time. Still getting pain walking about but its not as bad as before..... I think.

I've been stepping up the weights work however, mostly upper body but also been doing a lot more leg work. Problem is that I did my back in yesterday morning at the gym. It was so bad I had to leave work at lunchtime and take the day off work today! Pain was so bad I ended up going to A&E this morning but thankfully it seems its just muscular. Gave me co-codamol and pain has eased off a bit.

Yesterday was terrible, had to get my wife and son to help me into bed! Got up in the middle of the night to take some kids medised to make me drowsy as the pain was stopping me sleepingand couldn't get back into bed! Had to wake my wife up to help me back into bed. She wasn't happy as I fell asleep almost immediately and then kept her awake for 2 hours with my snoring!  :D

I've been getting more sore backs this year than ever before. Think it might be related to compensating for my knee. Anyway, the back seems to be easing off now. It certainly took my mind off the knee. Will hopefully get back to the bike in the gym next week.

How is things with you Kevin? How far out from surgery are you now?

Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on December 03, 2009, 11:41:18 AM
Hi Madel, Andrew and Scooter just wondered how things are progressing with you all?
Cheers
Kevin

Hi Kevin

I'll be 6 months post surgery this weekend. I think things are improving but still have my doubts. Had an MRI scan a couple of weeks ago and the OS reckons there is some healing going on and need to come back in 6 months. I can certainly go on the bike at the gym for longer and faster and am improving all the time. Still getting pain walking about but its not as bad as before..... I think.

I've been stepping up the weights work however, mostly upper body but also been doing a lot more leg work. Problem is that I did my back in yesterday morning at the gym. It was so bad I had to leave work at lunchtime and take the day off work today! Pain was so bad I ended up going to A&E this morning but thankfully it seems its just muscular. Gave me co-codamol and pain has eased off a bit.

Yesterday was terrible, had to get my wife and son to help me into bed! Got up in the middle of the night to take some kids medised to make me drowsy as the pain was stopping me sleepingand couldn't get back into bed! Had to wake my wife up to help me back into bed. She wasn't happy as I fell asleep almost immediately and then kept her awake for 2 hours with my snoring! :D

I've been getting more sore backs this year than ever before. Think it might be related to compensating for my knee. Anyway, the back seems to be easing off now. It certainly took my mind off the knee. Will hopefully get back to the bike in the gym next week.

How is things with you Kevin? How far out from surgery are you now?



Hi Andrew good to hear from you and it sounds as if you're doing OK (other than your back of course).
I will be 12 weeks post op next Monday (7th Dec), PT has been going OK and in the last 4 weeks I have† been stepping up full weight bearing squats, lunges and core exercises as well as the bike.
I came off the one crutch 2 weeks ago and now walk around crutch free, although I have a limp mainly down to weak hip muscles and VMO. Whilst the limp has got better it still gets on my nerves and I get frustrated. I think the knee is getting stronger although I can't walk very far without it hurting but I feel that I can walk further each week. Wolverhampton Wanderers have recently offered to give me free PT (as I am a referee with their Academy) so the hospital PT has signed me over to them and I am due to see their PT this Sunday morning coming. Like most contributors to this website and MFX inparticular, I have good spells and bad spells both pain wise and psychologically but you have to keep going.
Keep in touch and keep smiling :)
Cheers
Kevin
Title: New update: My OS tells me to come back as needed.
Post by: Scooter72 on December 06, 2009, 03:51:25 PM
  I went for an appointment with my surgeon on Friday.  He evaluated my muscle tone (primarily looking at the VMO muscle) and asked the usual questions.  Among other things, I told him I was pleased with the result thus far, but still had pain problems with pain when doing high-impact motions such as jumping with force.. actually that would be the main thing. Jumping, and the fact that my knee starts to really hurt towards the end of a second game.  (Minor overall, really, but notable in that the pain is significant)

  He told me that he was happy with the result this far and to come back only as needed.  However, there are a few notable comments he made:

1) He said it is possible that if I hadn't had the surgery, and had followed the same rehab program that I am doing now, I would be in the same position.  He wasn't trying to be discouraging, but just laying a possibility out there.  When I asked him the why of this, he said that eventually a layer of calcification would have formed that may have smoothed over. (I am guessing to the shape of whatever my kneecap smoothed it too).  Interesting point.

2) He re-iterated that my lesion was absolutely huge, and that he was not happy with how the cartilage around the lesion flaked off, during the surgery. He said that he did the least possible with the repair, because that is his philosophy (as it should be for any surgeon).  He mentioned that he didn't want to do ACI due to the quality of my cartilage; this makes sense, because the microfracture brings stem cells to the clot that eventually forms the cartilage, which presumably will NOT flake off.  For me, this was a disconcerting thing as well (since I watched the surgery), because I have no idea if the region around the microfracture repair site has flaked off as well, creating ring-shaped zone that is going to be problematic in the future.  Whatever happened to my cartilage in that area was not good.. and I surmise having some kind of long-term consequence outside of the pain I feel from playing football.  Maybe that will be mild arthritis? 

3) When I asked him why my outcome was so good, for having such a large lesion, he just shrugged his shoulders.  He has apparently seen patients come through that shouldn't have, and vice-versa, which lends credence to the idea that this procedure can be a grab-bag, when it comes to results.  He did however mention, that I need to stay active.

4) He seems to think that the cartilage at the repair site will last for "many years", which runs contrary to the statements I've seen on this site.  Then again, I strongly believe that diet and rehab affect the kind of cartilage, and the amount that grows back.  This is according to the research, and not just my opinion.
Title: Re: Microfracture on 37 year old male soccer player
Post by: b5 mlb on December 06, 2009, 09:48:48 PM
hi to you all ,i had a microfracture on the mfc about 4 years ago. it was a long rehab but i got were i could do a little jog. but it has always been a little sore   . i have had 2 scope in the last 2 years just a clean outs the last one showed that i had same damage to trochlea.and in aug i had it microfracture i think it was 2CM . i am 5 Months now its not to bad.but the mfc is very bad. the last 4 weeks i can just walk.when he went in to do the trochlea he said the old microfracture was ok but a bit rough.so i do not no what is going i am a bit ped off. :'( :'( after
the microfracture on the mfc i took up biking 100 miles a week . i think it was the biking that started it all of. and i think the other may need looing at soon i get pains in the trochlea. i see the os next monday . do they wear out and can it be microfracture again.i live in the uk and the os is very good i hope. :'(
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on December 07, 2009, 03:12:01 PM
I went for an appointment with my surgeon on Friday. He evaluated my muscle tone (primarily looking at the VMO muscle) and asked the usual questions. Among other things, I told him I was pleased with the result thus far, but still had pain problems with pain when doing high-impact motions such as jumping with force.. actually that would be the main thing. Jumping, and the fact that my knee starts to really hurt towards the end of a second game. (Minor overall, really, but notable in that the pain is significant)

 He told me that he was happy with the result this far and to come back only as needed. However, there are a few notable comments he made:

1) He said it is possible that if I hadn't had the surgery, and had followed the same rehab program that I am doing now, I would be in the same position. He wasn't trying to be discouraging, but just laying a possibility out there. When I asked him the why of this, he said that eventually a layer of calcification would have formed that may have smoothed over. (I am guessing to the shape of whatever my kneecap smoothed it too). Interesting point.

2) He re-iterated that my lesion was absolutely huge, and that he was not happy with how the cartilage around the lesion flaked off, during the surgery. He said that he did the least possible with the repair, because that is his philosophy (as it should be for any surgeon). He mentioned that he didn't want to do ACI due to the quality of my cartilage; this makes sense, because the microfracture brings stem cells to the clot that eventually forms the cartilage, which presumably will NOT flake off. For me, this was a disconcerting thing as well (since I watched the surgery), because I have no idea if the region around the microfracture repair site has flaked off as well, creating ring-shaped zone that is going to be problematic in the future. Whatever happened to my cartilage in that area was not good.. and I surmise having some kind of long-term consequence outside of the pain I feel from playing football. Maybe that will be mild arthritis?

3) When I asked him why my outcome was so good, for having such a large lesion, he just shrugged his shoulders. He has apparently seen patients come through that shouldn't have, and vice-versa, which lends credence to the idea that this procedure can be a grab-bag, when it comes to results. He did however mention, that I need to stay active.

4) He seems to think that the cartilage at the repair site will last for "many years", which runs contrary to the statements I've seen on this site. Then again, I strongly believe that diet and rehab affect the kind of cartilage, and the amount that grows back. This is according to the research, and not just my opinion.

Hi Scooter really interesting story from your comments on what your OS said particularly on how long the cartilage repair site may last.
I visited the PT at Wolves for the first time after my referral from the hospital PT yesterday. I thought I had been doing OK as I am now nearly 12 weeks post mfx. However, when he examined me and looked at my quad, calf and glutes he said my muscle wastage was far worse than he expected at this stage. My limp is not down directly to the surgery area on my knee but itís due to the muscle wastage on my glutes causing me to roll my bad knee inwards when I walk. He then worked on exercises with me in the gym on strengthening quads, calfs, hamstrings and glutes.
He has also asked me to focus on not letting my knee move inwards when it takes the weight of walking on it. This I am finding difficult and painful which is why I have probably got into this compensating habit plus I cannot fully straighten my bad leg inline with my good leg, I obviously have a long way to go but I will persevere.
Has anyone else out there had similar problems?
Thanks
Kevin†
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on December 07, 2009, 04:32:27 PM
Hi Kevin,

I had a problem with walking for many months also (kind of the opposite of yours, I tended to circumduct my leg outwards).  It got better with the combination of me paying attention to it and the knee gradually becoming less painful.  Even now though, I have to stay aware of how I'm moving to walk normally.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on December 07, 2009, 08:09:39 PM
Hi Kevin,

I had a problem with walking for many months also (kind of the opposite of yours, I tended to circumduct my leg outwards). It got better with the combination of me paying attention to it and the knee gradually becoming less painful. Even now though, I have to stay aware of how I'm moving to walk normally.
Thanks Madeline for your comments thats encouraging to know, I think the last time you posted you said you had started running again. Hows it going and how long have you been post surgery?
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on December 08, 2009, 08:36:15 AM
Kevin, that does sound like a serious problem, and I am glad that the physio for the Wolves caught it.† Unfortunately, I would guess that you will experience some amount of pain, and perhaps frustration in correcting that, but it is absolutely critical (IMO) that the mechanics be proper from this early stage on.† Otherwise, strengthening the muscles required for proper tracking, months down the line, would be so much more difficult.†

On the other hand, I am also perplexed by the physio's opinion.† You are not that far removed from the surgery, and thus are not to the point where you can do more vigorous rehab exercises that would dramatically increase the size of your injured leg's muscles.† So I am not sure what he expected as far as muscle tone. (No offense, but you're not a 20-something year old footballer for a premiership team, to be recovering so fast)
I can tell you that my legs were visibily disparate for months, even for a good 2 months after I started jogging, and doing the strenuous leg exercises such as squats, lunges, step-downs etc... mostly due to the pain that limited how much of those exercises I could tolerate with respect to both endurance and weight.† Granted, one difference is that I don't think my glut muscles were visibly different. (But then again, it's not as if I compared them in a mirror, nor did my physical therapist!)

And your post reminds me of something my OS told me at my first visit after the surgery.. he said that if I were to not consistently use my VMO and quads for even two months, that I may permanently lose strength, due to not only muscle wasting, but permanent nerve degeneration (I believe).† I can tell you, that disturbed me so much, that I made it a point to do the exercises with proper form every day.

Is there a brace you can wear that will force your leg to track properly?†

In any case, please let us know about your progress.† Yes, this will be an uphill climb, but so be it.† You can do it.†

Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on December 08, 2009, 09:05:09 AM
Kevin, that does sound like a serious problem, and I am glad that the physio for the Wolves caught it.† Unfortunately, I would guess that you will experience some amount of pain, and perhaps frustration in correcting that, but it is absolutely critical (IMO) that the mechanics be proper from this early stage on.† Otherwise, strengthening the muscles required for proper tracking, months down the line, would be so much more difficult.†

On the other hand, I am also perplexed by the physio's opinion.† You are not that far removed from the surgery, and thus are not to the point where you can do more vigorous rehab exercises that would dramatically increase the size of your injured leg's muscles.† So I am not sure what he expected as far as muscle tone. (No offense, but you're not a 20-something year old footballer for a premiership team, to be recovering so fast)
I can tell you that my legs were visibily disparate for months, even for a good 2 months after I started jogging, and doing the strenuous leg exercises such as squats, lunges, step-downs etc... mostly due to the pain that limited how much of those exercises I could tolerate with respect to both endurance and weight.† Granted, one difference is that I don't think my glut muscles were visibly different. (But then again, it's not as if I compared them in a mirror, nor did my physical therapist!)

And your post reminds me of something my OS told me at my first visit after the surgery.. he said that if I were to not consistently use my VMO and quads for even two months, that I may permanently lose strength, due to not only muscle wasting, but permanent nerve degeneration (I believe).† I can tell you, that disturbed me so much, that I made it a point to do the exercises with proper form every day.

Is there a brace you can wear that will force your leg to track properly?†

In any case, please let us know about your progress.† Yes, this will be an uphill climb, but so be it.† You can do it.†


Thanks Scooter for your comments I am not aware of a brace for tracking my leg properly.
The new PT certainly isn't taking the softly gradual approach that the hospital one did and the daily exercises he has given me to do at home are considerable to what I had been given before.
That said I am giving them 100% effort and 3 days into them my aches are everywhere but not necessarily in my knee which is good news. I am also doing a lot of daily exercises with ankle weights and have started attending weekly hydrotherapy classes.
Cheers for your encouragement
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on December 30, 2009, 08:45:14 AM
Hi Scot, Madeline and Andrew,
As the main contributors to this blog I wondered how you are all progressing?
Please let me know
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on December 30, 2009, 04:47:15 PM
Hi Kevin,

I'm doing really well.  In fact, I ran 15 miles over two days (9 mile run and 6 mile run) earlier this week.  Now that was not smart, my achilles started acting up, but my knee, while not feeling perfect, is not giving me any real trouble.  I've been running around 20 miles a week for a few weeks.  Remember, it was painful for me to even walk properly over the summer.  So don't give up hope!
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on December 30, 2009, 06:02:53 PM
Hi Kevin,

I'm doing really well. In fact, I ran 15 miles over two days (9 mile run and 6 mile run) earlier this week. Now that was not smart, my achilles started acting up, but my knee, while not feeling perfect, is not giving me any real trouble. I've been running around 20 miles a week for a few weeks. Remember, it was painful for me to even walk properly over the summer. So don't give up hope!

Wow Madeline that's fantastic news!
I am now 15 weeks post op and have been receiving P/T weekly from a Premier Division football team in the UK for the past 4 weeks.
During the last 3 sessions they have put me in their Anti-Gravity machine which has a treadmill underneath it and they can reduce your body weight impact on your legs. They have done this to help get me walking correctly starting at a setting of 60% of my body weight doing 10 mins. walks.
However, yesterday they increased my body weight to 65% and I walked for 5 mins and then jogged for 10 mins, yes jogged!
I am naturally aching† in all parts of my legs my today but my bad knee aches no worse than my good one so I hope that's the only reaction I'll get from the jog.†
As you can imagine I am on a high at the moment but I'm also trying not to get too carried away as I know my recovery will continue to be highs and lows.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on December 31, 2009, 11:35:22 PM
Hi Scot, Madeline and Andrew,
As the main contributors to this blog I wondered how you are all progressing?
Please let me know
Cheers
Kevin

Well, walking all around London and Paris was incredible, as we walked a good 7-9 miles/day (just estimating).† It's another world, over there, and I thoroughly enjoyed it all.† Even got to visit several London based grounds, including that tour of Chelsea.. top notch facility and club!

It was good for the mind, and as it turns out, my knee. I say this because yesterday, when I went to my physical therapy appointment, my PT conducted a test to measure the relative strength of each leg (primarily quads and VMO).† The test revealed that the legs are within 7% of each other.† Afterwards, he told me that I only needed to check up with him once a month via email, to make sure things are going alright, instead of coming in weekly.

I think that the last part of the journey towards complete (or as complete as it will get) recovery is my own.† Am simply pleased and somewhat surprised, given just how far away it seemed several months ago.† Looking back, the peaks and valleys of the recovery have been immense at some time spans. (Hence the seemingly dichotomous postings I have made on these boards)

Am very glad to hear about you jogging, kevin! Fantastic!† Believe me, it will get much better.† I have no doubt however, that you will ultimately be running the pitch again.

And Madeline.. 15 MILES! Fantastic! The one words that sums it up.. because what an improvement over the summer!
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on January 01, 2010, 12:41:17 PM
Hi Scot, Madeline and Andrew,
As the main contributors to this blog I wondered how you are all progressing?
Please let me know
Cheers
Kevin

Well, walking all around London and Paris was incredible, as we walked a good 7-9 miles/day (just estimating).† It's another world, over there, and I thoroughly enjoyed it all.† Even got to visit several London based grounds, including that tour of Chelsea.. top notch facility and club!

It was good for the mind, and as it turns out, my knee. I say this because yesterday, when I went to my physical therapy appointment, my PT conducted a test to measure the relative strength of each leg (primarily quads and VMO).† The test revealed that the legs are within 7% of each other.† Afterwards, he told me that I only needed to check up with him once a month via email, to make sure things are going alright, instead of coming in weekly.

I think that the last part of the journey towards complete (or as complete as it will get) recovery is my own.† Am simply pleased and somewhat surprised, given just how far away it seemed several months ago.† Looking back, the peaks and valleys of the recovery have been immense at some time spans. (Hence the seemingly dichotomous postings I have made on these boards)

Am very glad to hear about you jogging, kevin! Fantastic!† Believe me, it will get much better.† I have no doubt however, that you will ultimately be running the pitch again.

And Madeline.. 15 MILES! Fantastic! The one words that sums it up.. because what an improvement over the summer!

Hi Scot glad to hear you enjoyed London and Paris, good news for you on what your PT said, getting within 7% is some going.
Happy New Year to you and keep in touch
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on January 01, 2010, 10:22:46 PM
Hi guys, great to hear you are all doing so well.

BTW, my 5 year old daughter is called Madeleine.....   its a great name (albeit spelt slightly differently!)  ;D

I'm almost 7 months. Hard for for me to tell how its going. I feel a million miles away from running and still have pain walking.

I'm not giving up hope though! Keep up the good work guys!
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on January 13, 2010, 03:30:56 AM
Any updates this week, from you guys and girls?  I'd certainly like to hear about anything, positive or negative. And if I haven't made it known, I really appreciate the support I have received from those here. It is difficult to be positive under duress, and many here have been able to provide it despite their own travails.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on January 13, 2010, 12:12:29 PM
Any updates this week, from you guys and girls? I'd certainly like to hear about anything, positive or negative. And if I haven't made it known, I really appreciate the support I have received from those here. It is difficult to be positive under duress, and many here have been able to provide it despite their own travails.
Hi Scot,
Things are coming along slowly for me, I went to the Wolves P/T on Monday this week and my quad has increased by 1.5cm on 2 weeks ago although it's considerably less than my good leg and the VMO is way down on my good leg.
I did 2km jogging at 80% of my body weight on their anti-gravity m/c and then did circiuts of squats, lunges, glute push ups and theraband stretches.
It takes me a good 2/3 days to recover from the P/T and I still walk with discomfort and full or near full recovery seems way off, but I still try to remain positive, I was 17 weeks post op this week.
Let me know how things are with you
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on January 13, 2010, 07:49:31 PM
Hi Scot,
Things are coming along slowly for me, I went to the Wolves P/T on Monday this week and my quad has increased by 1.5cm on 2 weeks ago although it's considerably less than my good leg and the VMO is way down on my good leg.
I did 2km jogging at 80% of my body weight on their anti-gravity m/c and then did circiuts of squats, lunges, glute push ups and theraband stretches.
It takes me a good 2/3 days to recover from the P/T and I still walk with discomfort and full or near full recovery seems way off, but I still try to remain positive, I was 17 weeks post op this week.
Let me know how things are with you
Cheers
Kevin
Hello Kevin!  I am doing fine.. at this point just continuing to try and get back in shape, which is something that I am finding difficult (i.e. losing the extra kilos).  But otherwise, no real problems.

Kevin, while it may seem as if things are progressing slowly for you, from my perspective you seem to be doing well! At 17 weeks post-op, given your site of injury, I'd say that jogging, even at 80% is good.  Also, the discomfort for a few days after doing serious PT exercises is normal, in case you ever have thoughts to the contrary.

What is your PTs assessment of your progress?  I am happy to hear that you have such top-notch care.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on January 15, 2010, 07:41:02 PM
Hi Scot,
Things are coming along slowly for me, I went to the Wolves P/T on Monday this week and my quad has increased by 1.5cm on 2 weeks ago although it's considerably less than my good leg and the VMO is way down on my good leg.
I did 2km jogging at 80% of my body weight on their anti-gravity m/c and then did circiuts of squats, lunges, glute push ups and theraband stretches.
It takes me a good 2/3 days to recover from the P/T and I still walk with discomfort and full or near full recovery seems way off, but I still try to remain positive, I was 17 weeks post op this week.
Let me know how things are with you
Cheers
Kevin
Hello Kevin! I am doing fine.. at this point just continuing to try and get back in shape, which is something that I am finding difficult (i.e. losing the extra kilos). But otherwise, no real problems.

Kevin, while it may seem as if things are progressing slowly for you, from my perspective you seem to be doing well! At 17 weeks post-op, given your site of injury, I'd say that jogging, even at 80% is good. Also, the discomfort for a few days after doing serious PT exercises is normal, in case you ever have thoughts to the contrary.

What is your PTs assessment of your progress? I am happy to hear that you have such top-notch care.

Thanks for your comments Scot my P/T at Wolves is pleased with my progress and is very supportive, it was also good to see your comments on being in pain after a P/T because I always question if I have damaged the mfx. I also play golf and have been to the golf range the last few weekends and hit a bucket of balls full out from wedge to driver without any reaction so I hope to play a few holes in March/April.
Keep me posted on your progress.
Cheers
Kevin† †
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on January 28, 2010, 09:22:13 PM
Kevin, Andrew and company, how are things for you?  Please, if you have time, give an update.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on January 29, 2010, 08:16:41 AM
Kevin, Andrew and company, how are things for you? Please, if you have time, give an update.
Hi Scot things still going steady I am now 19 weeks post op and saw P/T at Wolves on Monday. Definition in muscle tone on my quad is coming along and VMO is about 70% of my good leg.
Did a 2 km jog at 90% of my body weight on anti gravity machine and been in pain for 3 days which I suppose is only to be expected and I am icing it everyday.
If I can cope with it they intend to get me full weight bearing jogging in next 3 weeks.
I still am in discomfort walking and my main problem is that I cannot fully straighten my leg to the extent of my good leg. Whilst the difference is only marginal they think this is why I still have a slight limp.
Let me know how things are with you.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on January 29, 2010, 03:18:36 PM
Hi Scot things still going steady I am now 19 weeks post op and saw P/T at Wolves on Monday. Definition in muscle tone on my quad is coming along and VMO is about 70% of my good leg.
Did a 2 km jog at 90% of my body weight on anti gravity machine and been in pain for 3 days which I suppose is only to be expected and I am icing it everyday.
If I can cope with it they intend to get me full weight bearing jogging in next 3 weeks.
I still am in discomfort walking and my main problem is that I cannot fully straighten my leg to the extent of my good leg. Whilst the difference is only marginal they think this is why I still have a slight limp.
Let me know how things are with you.
Cheers
Kevin

  Ah, well things are going well for me. My biggest problem now is continuing rehab exercises with due diligence.
 It appears as if you are going through a trying period with constant pain.  While the pain is important as a measure of progress, the mechanics of walking, and the degree of quad+VMO strengthening is key, as you are aware. When I first started to jog, I could maintain a "normal" gait for the initial minutes, as long as I went at a slow pace.  But excessive speeds, lateral movement, or time running would reveal a limp with pain for days afterwards.  Unfortunately, as I am sure you know, there is a catch-22 going on with you.  From what my PT and surgeon explained to me, I gather that the pain you are experiencing is partially related to muscular weakness in the injured leg.  Of course, to lessen and eventually elimiinate the pain, you have to strengthen, which involves experiencing it!
  Question for you: Are you unable to straighten the leg to to intense pain in the affected area, or is it due to something "catching" that prevents it?
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on January 29, 2010, 06:33:30 PM
I'm doing well.  I've been running about 30 miles a week, supplemented with elliptical and uphill forwards and backwards walking on the treadmill.  I'm training for an April marathon.  While my knee doesn't usually bother me while I run, I still can't really do deep squats and things like that.  Hopefully I'm not doing too much damage with the running, but it's what I love to do, and my doctor didn't discourage it so I decided to go ahead with it.  I've reduced my mileage from previous years, so hopefully that will allow my knee to last longer.  My inner quad right above the knee is still smaller than the other side, which might be contributing to pain, but I haven't found a way to strengthen it without pain--quite a Catch-22 indeed!
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on January 29, 2010, 07:26:04 PM
Scot as regards your question the pain when I fully straighten my leg runs across under the knee and not normally in the affected surgery area. Also the area under my knee stiffens after jogging that's also why I limp for days after. By the way I played 9 holes of golf this afternoon hitting the ball full out so I am pleased with that.
Madeline great to hear you are planning a marathon and your recovery positive news along with Scot's progress inspires me a great deal.
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on January 31, 2010, 06:12:29 PM
Hi Madeline. I'm really jealous that you're training for a marathon. One of my mates that I used to train with told me that's he's aiming for a 2.45 marathon at London this year. I'm so jealous of him as well because I was faster than.  :-\

Unlike you my injury was on a weight bearing part of the knee so there is no way I'm going to risk it by returning to running. I'm still got pain when walking so really don't know how its going. My long term aim is to give cycling a go. Don't know if I'd have the same motivation that drove me to 35 min 10ks and 1.20 half marathons but I'd like to give it a go. Will just need to see how it goes.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on February 07, 2010, 01:01:25 PM
Hello all.† Any updates from this week?† Madel, how is training for the marathon coming along? Kevin, Andrew?† Anything new to report, knee related or otherwise?

On a different note, Wolves play Birmingham today.. they have a very tough stretch of games coming up, in which they play nearly all the top clubs (excepting City), so they really need a result today to get out of the cellar, don't they?

I know there has been some anxiety on this board over microfracture, and Andrew, you are particularly apprehensive about the long-term result.† While I would not even consider "giving up" on it, at this point (i.e. with doing rehab and waiting), I want to highlight an alternative, should you arrive at that decision.† Here is a link to a thread on this board, that discusses regenexx, which is a far far less invasive procedure than microfracture, with less "down-time":

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=40048.0

http://www.regenexx.com

I've read up on it, and the science is sound. The only problem is the cost, especially for those overseas (which would undoubtedly include airfare). The advantages it has over microfracture, as far as I can tell, is recovery time, invasiveness, and the fact that it utilizes far more stem cells than microfracture releases.† Those stem cells are the key to repairing the injured site.† Oh, and if I am not mistaken, it also creates hyaline cartilage, instead of the fibrous kind that we see with microfracture.

Again, I only provide this info as hope in an avenue to take if microfracture doesn't work, or as seems to be the situation more often, if it "only sorta works".† If I were ever to decide to try and repair my knee (again), I would go this route.† The surgical methods, while providing decent success rates with adequate patient involvement in rehab, are mentally trying.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on February 09, 2010, 06:54:50 PM
Hello all.† Any updates from this week?† Madel, how is training for the marathon coming along? Kevin, Andrew?† Anything new to report, knee related or otherwise?

On a different note, Wolves play Birmingham today.. they have a very tough stretch of games coming up, in which they play nearly all the top clubs (excepting City), so they really need a result today to get out of the cellar, don't they?

I know there has been some anxiety on this board over microfracture, and Andrew, you are particularly apprehensive about the long-term result.† While I would not even consider "giving up" on it, at this point (i.e. with doing rehab and waiting), I want to highlight an alternative, should you arrive at that decision.† Here is a link to a thread on this board, that discusses regenexx, which is a far far less invasive procedure than microfracture, with less "down-time":

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=40048.0

http://www.regenexx.com

I've read up on it, and the science is sound. The only problem is the cost, especially for those overseas (which would undoubtedly include airfare). The advantages it has over microfracture, as far as I can tell, is recovery time, invasiveness, and the fact that it utilizes far more stem cells than microfracture releases.† Those stem cells are the key to repairing the injured site.† Oh, and if I am not mistaken, it also creates hyaline cartilage, instead of the fibrous kind that we see with microfracture.

Again, I only provide this info as hope in an avenue to take if microfracture doesn't work, or as seems to be the situation more often, if it "only sorta works".† If I were ever to decide to try and repair my knee (again), I would go this route.† The surgical methods, while providing decent success rates with adequate patient involvement in rehab, are mentally trying.
Hi Scot,
Yes Wolves are now in a poor position and I fear we will go down.
As for my knee I was in Madrid from last Friday until yesterday ( Mon), we saw Real Madrid play on Saturday night.
I did that much walking over the 4 days and my knee felt great and interestingly enough I have been back in the office all day today and it's starting aching again, which makes me wonder if its related to sitting down for long periods at my desk and the knee stiffens up.
Hope everyone else is OK.
KEEP POSTING
KEVIN†
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on February 09, 2010, 08:54:22 PM
The fact that your knee feels great while walking a lot, and becomes problematic after bouts of sitting, does not surprise me.  Hopefully, continued strengthening of the leg will rectify that problem over time.

Got to see Real Madrid? Wow.. I bet that was something else, eh? I don't think that team has gelled as of yet, even if they are at the top of the table.

You keep posting as well!
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on February 17, 2010, 09:50:45 PM
Anything new with knee(s) this week? Doing ok over here.  For the first time in a long time, my left quad is strong enough to do leg extensions with 40 pounds, using my left leg alone.  It doesn't sound like much, but my left leg hasn't been able to do that in about 1.5 years, due to injury, and of course, the surgery back in June.  While doing the extensions in my basement, I was cheering so loud that my wife thought I was in trouble!

Just caught some highlights of Champion's League between Arsenal and Porto.. I can't believe Fabianski let the first goal in, and am also in disbelief about the second goal.  Arsenal reportedly was being pushed around somewhat, and disposessed in midfield.  I am not an Arsenal fan, but I do respect the way they play, and thus am at a loss for their recent league and CL form.

Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on February 18, 2010, 09:14:45 AM
Anything new with knee(s) this week? Doing ok over here. For the first time in a long time, my left quad is strong enough to do leg extensions with 40 pounds, using my left leg alone. It doesn't sound like much, but my left leg hasn't been able to do that in about 1.5 years, due to injury, and of course, the surgery back in June. While doing the extensions in my basement, I was cheering so loud that my wife thought I was in trouble!

Just caught some highlights of Champion's League between Arsenal and Porto.. I can't believe Fabianski let the first goal in, and am also in disbelief about the second goal. Arsenal reportedly was being pushed around somewhat, and disposessed in midfield. I am not an Arsenal fan, but I do respect the way they play, and thus am at a loss for their recent league and CL form.
Hi Scot glad you're doing OK, I am 22weeks post op this week and was at the Wolves on Monday this week with the P/T and did 20mins session on the anti-gravity machine which consisted of 4x4mins jogging at 85% of my body weight and 4x1mins speed walks at full body weight.
If I don't have any adverse reaction they want me to start jogging on grass this weekend as long as the ground is soft.
The Arsenal Keeper had an absolute shocker but I think they will still go through after the second leg.
Hope Madeline and Andrew are OK
Keep posting.
Cheers
Kevin

Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on February 20, 2010, 11:45:40 AM
Not good news for me I'm afraid.

I went to see my OS on Friday as I'm nearly 9 months now and have seen no improvement over that time and feel as bad as I did pre surgery. OS reckons the microfracture has failed and wants me to consider mosaiplasty or ACI so will need to do some research. Any advice would be appreciated.

Big fly in the ointment just now is that I'm due to be made redundant at start of June and am currently looking for new job. Don't know whether to go for op now and then take time to recover on company time (eg garden leave) or to wait until after I get something secured elsewhere first. Got mortgage, wife, kids, etc to keep! Also, my health insurance is through the work so not sure how that will work. I think I'm entitled to a further 6 months cover after I leave but company hasn't confirmed that yet. If worst comes to worst then AXA will allow me to pay for insurance myself with a discount and my knee won't be excluded.

Decisions, decisions. Any advice welcome.

I have it in the back of my mind that the failure goes back to the very first night straight after having the operation. I was stupidly attempting to go down the stairs on crutches in the dark to get a drink of water, stumbled and had to put my bad leg down hard to save myself from falling. Very stupid of me. I could well have dislodged the blood clot and so the past 9 months have been a waste of time.

What's done is done.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on February 20, 2010, 08:50:50 PM
Andrew, first thing.. no way that "first night" incident caused your mfx failure.  At that point, all you have in the joint is blood with stem cells floating around, so even if the (very beginnings) blood clot dislodged, another would have formed, no problem. It's after an actual clot becomes strongly "fixed", which surely takes more than one night, that potential problems can occur.   

You have my sympathies regarding your situation.  Ideally.. I really wish you had more options concerning treatment.  I want to be forthright with you: after having previously  researched ACI and mosaiplasty, I was not fond of either.  It's a longer recovery (for ACI, at least).   But in your situation, there may not be any other choice.  Here is one article that compares mosaiplasty and mfx and cocludes that mosaiplasty is much better: http://www.ncbi.nlm.nih.gov/pubmed/16171631?dopt=Abstract
Here is a website that gives a good overview of mosaiplasty: http://www.wheelessonline.com/ortho/mosaicplasty_and_cartilage_transplants_for_chondral_injuries_of_the_knee

ACI doesn't involve harvesting bits of cartilage from "non-essential" parts of your body.  Rather, a few cells are taken via an arthroscopy, and grown in a lab for about six weeks.  Then, to make a long story short, the actual procedure takes place which begins by taking a thin section of your shin bone, which is called the "patch", then tightly attaching the patch to the area of cartilage damage on your knee, and then injecting the cartilage cells that were taken and grown to large numbers in a lab, underneath the patch.  Of course, the idea is that the patch will protect the damaged area so that the cartilage cells can attach and fill the defect.

Between these two options, I would choose ACI if I had the time.  In either case, please discuss with your doctor at length.  Actually, before doing anything.. are you satisfied with your doctor?  Does he have good bedside manner, and is he willing to explain things in depth?
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on March 07, 2010, 12:41:20 PM
Hello all.  Anything new with you guys and gals?
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on March 08, 2010, 06:53:26 PM
I'm doing well--I've gotten in a couple 18-20 mile runs, but my training has been really haphazard the past month because I've been in a different region of the country every weekend for grad school interviews!  I need to get more disciplined for this next month, but the knee is holding up!
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on March 09, 2010, 08:09:08 AM
Hello all. Anything new with you guys and gals?
Hi Scooter also glad to hear Madeline is progressing well I am now 24 weeks post op.
Well last night I went outside on the grass soccer pitch with my P/T who wanted to check my running gait as this would be my third jogging session, as I have done the previous 2 on my own. The P/T was generally happy with my posture but my gait is not what it should be, so he gave me somethings to work on such as exaggerating my stride to making it longer and also bring my heel into play when I put my foot down. Also because of the weakness in my glutes after a period of jogging my bad knee starts to drift inwards causing additional discomfort and pain. This morning it hurts as normal but I'm off to the gym later to do some work on the bike to improve my CV, leg presses on the weights and get the theraband exercises on my glutes. The whole experience for me since mfx has been highs and lows and everytime I get aches and pains, which is most days, I think I have damaged the surgery but like you I just try to re-focus and be as positive as possible.
Let me know how you are doing.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on March 09, 2010, 05:52:31 PM
Kevin, I think your PT is wrong about your gate.  I've seen PT's that have the same opinion as yours, but I've seen others I like better that say shorter strides that land minimally on the heel are better.  I think this is especially the case if you have knee issues, because taking long strides and landing on your heel puts more stress on your knees.  Look at the fastest runners, and you will see that they do not land hard on their heels, even when going long distances.  For me, practicing a LITTLE barefoot running when I was coming back from surgery helped me get my form right, and my knee felt much better running barefoot than in shoes.  Just my 2 cents.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on March 09, 2010, 07:29:55 PM
Kevin, I think your PT is wrong about your gate. I've seen PT's that have the same opinion as yours, but I've seen others I like better that say shorter strides that land minimally on the heel are better. I think this is especially the case if you have knee issues, because taking long strides and landing on your heel puts more stress on your knees. Look at the fastest runners, and you will see that they do not land hard on their heels, even when going long distances. For me, practicing a LITTLE barefoot running when I was coming back from surgery helped me get my form right, and my knee felt much better running barefoot than in shoes. Just my 2 cents.
Thanks Madeline your thoughts are interesting and in contrast to what my P/T's advice is, but your experience of running barefoot is also a really interesting concept which I will have to try. When you started jogging did you get much pain and if so in what area(s) ?
Thanks
Kevin   
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on March 10, 2010, 01:12:20 AM
Madel, wow!  I am impressed with your fitness!  And of course, I am happy that your knee is holding up!

Kevin, you may have mentioned this before, but after a few minutes of jogging, does the pain go away?  I realize that after a while, your knee bends in due to weakness, and that is probably "normal" yet, at this point, but what about at the start of your running?

Also, have you asked your surgeon yet, whether he intends to do any diagnostic at the 9-12 month mark?  Maybe an MRI or even exploratory arthroscopy?
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on March 10, 2010, 09:07:14 AM
Madel, wow! I am impressed with your fitness! And of course, I am happy that your knee is holding up!

Kevin, you may have mentioned this before, but after a few minutes of jogging, does the pain go away? I realize that after a while, your knee bends in due to weakness, and that is probably "normal" yet, at this point, but what about at the start of your running?

Also, have you asked your surgeon yet, whether he intends to do any diagnostic at the 9-12 month mark? Maybe an MRI or even exploratory arthroscopy?
Hi Scot,
In answer to your question when I first start jogging I have pain, then as the muscles warm up that eases to more of a discomfort and then returns when my knee gets tired from the jogging. As for the O/S he is due to see me again in June which will be about 9 months post op and he will then decide on an MRI or† exploratory arthroscopy to see if the tissue is regenerating fully. Personally I hope its not the latter as I think that will set me back another few months but that of course depends if I continue to recover in the meantime.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on March 11, 2010, 09:48:33 AM
Kevin, I think your PT is wrong about your gate. I've seen PT's that have the same opinion as yours, but I've seen others I like better that say shorter strides that land minimally on the heel are better. I think this is especially the case if you have knee issues, because taking long strides and landing on your heel puts more stress on your knees. Look at the fastest runners, and you will see that they do not land hard on their heels, even when going long distances. For me, practicing a LITTLE barefoot running when I was coming back from surgery helped me get my form right, and my knee felt much better running barefoot than in shoes. Just my 2 cents.
Hi Madeline one other thing, out of interest, when you say you ran barefooted where did you do this and on what surface did you run on?
Thanks
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on March 11, 2010, 06:17:59 PM
It was early fall when I was doing it, so I just ran on a treadmill in my socks--so not really barefoot, but shoeless.  But you should only do like .25 mile to start out and build by that much each time--I ended up doing too much and got achilles tendonitis in my foot below the good knee.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on April 01, 2010, 09:01:45 AM
Well, it has been almost 3 weeks since last I heard from anyone in this thread.  Anyone have any improvements, setbacks, or otherwise?
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on April 01, 2010, 11:54:29 AM
Well, it has been almost 3 weeks since last I heard from anyone in this thread. Anyone have any improvements, setbacks, or otherwise?
Hi Scot well as of last week I'm up to jogging twice a week on grass, if you imagine a soccer pitch, I put a cone marker on the corner of the penatly area then walk down the pitch to the opposite penalty area and put a cone in that corner. I then walk across put a cone in the other corner and the same opposite down the pitch. That is then my rectangular circuit, I then do 5 laps staight off 3/4 pace down the lenghts and jog across the widths. I rest for 2mins., then do 4 laps rest for 1.5mins, 3 laps rest for 1min., 2 laps rest for 30 secs. and then 1 lap. It's tough but is helping with my stamina.
The knee really hurts arterwards for the first 24 hours on the inside of my knee when I try to fully straighten it and then it gradually settles down after 3 days. The P/T doesn't seem unduly worried about the pain as he says that there are various fluids and tissue that need to settle down inside the knee that its normal but that doesn't make the initial pain any easier. He said if it persisted and wasn't settling down as it is after 3 to 4 days he would be more concerned.
How are things with you?
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on April 01, 2010, 07:46:17 PM
Things are alright with me!  Just enjoying the change in weather we have had here.. in the past seven days, the temperatures have (finally) climbed into the 60s and 70s. Fantastic for getting out! I hope you experience the same if you have not already.

Glad to hear that you are doing laps and pushing through.  If you had to grade your knee right now, about what percentage would you give it compared to the other "good" knee?  I know that can be hard to do, but I am curious.

Also, what about some cortisone shots for the knee?  Any talk of that?

Looks like it will be a tight fight for the last Champion's League spot, although I daresay that City has the advantage since Spurs and Villa have to go to COMS, I believe.

Wolves are 5pts clear of the relegation zone, which is great.  I enjoy seeing new teams stay up. 

Also looks as if Newcastle will be rejoining the Prem.. which is good for a friend of mine (from England) who is a big Magpie fan.  I hope for sake of all their fans, Mike Ashley spends a bit better this go-around.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on April 01, 2010, 10:45:32 PM
Things are alright with me! Just enjoying the change in weather we have had here.. in the past seven days, the temperatures have (finally) climbed into the 60s and 70s. Fantastic for getting out! I hope you experience the same if you have not already.

Glad to hear that you are doing laps and pushing through. If you had to grade your knee right now, about what percentage would you give it compared to the other "good" knee? I know that can be hard to do, but I am curious.

Also, what about some cortisone shots for the knee? Any talk of that?

Looks like it will be a tight fight for the last Champion's League spot, although I daresay that City has the advantage since Spurs and Villa have to go to COMS, I believe.

Wolves are 5pts clear of the relegation zone, which is great. I enjoy seeing new teams stay up.

Also looks as if Newcastle will be rejoining the Prem.. which is good for a friend of mine (from England) who is a big Magpie fan. I hope for sake of all their fans, Mike Ashley spends a bit better this go-around.
Hi Scot I am due to see the O/S again in June but at no stage has anyone mentioned cortisone shots, is this something you had done? I would currently rate my bad knee at about 75% of my good one.
Yes Wolves have done well so far so fingers crossed.
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on April 02, 2010, 01:50:31 AM
75%?!? That is fantastic news!† Very well!† As for the cortisone shot; I haven't had it done, but it has been presented as an option to fight the inflammation that occurs after too much activity (i.e. too many games).† The O/S just drains the fluid in the knee, and injects cortisone which then hopefully prevents further inflammation and subsequent pain.  Despite the fact that I cannot personally speak to its efficacy, others in these forums and to whom I have personally spoken give me a positive impression of it, being a simple yet therapeutic procedure.  However, I would guess that at this point, neither your O/S nor your PT would suggest such measures.
Title: Re: Microfracture on 37 year old male soccer player
Post by: b5 mlb on April 03, 2010, 08:38:35 PM
hi scooter how are u going, i hav not been on the site for a while .the knee has been good until 2 days ago ,i was at work when a box fell and i bent to catch it and got a litte pain on the trochlea were i had microfracture in august  last year.the bottem of my thigh going in to the top of my knee is sore. it also pop and clicks now ,hav i damage it agian ???.i go to see the os on the 19 of this month about my ankle so i will
talk to him about it.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on April 03, 2010, 10:14:54 PM
hi scooter how are u going, i hav not been on the site for a while .the knee has been good until 2 days ago ,i was at work when a box fell and i bent to catch it and got a litte pain on the trochlea were i had microfracture in august† last year.the bottem of my thigh going in to the top of my knee is sore. it also pop and clicks now ,hav i damage it agian ???.i go to see the os on the 19 of this month about my ankle so i will
talk to him about it.

Good to hear from you! Yes, I would talk to your O/S about it, although I doubt that you will get a definitive answer unless an MRI is taken.  For me personally, it is so hard to tell, because there have been numerous times that I have thought my microfracture has failed due to extended pain over a period of days.  But eventually, the pain goes away. Which brings me to another point.. I am fairly sure that I have arthritis in my bad knee.. it explains how sometimes my knee can feel so bad without any obvious preceding event (i.e. serious tweaking, or too many games of footy).
Title: Re: Microfracture on 37 year old male soccer player
Post by: b5 mlb on April 04, 2010, 08:59:57 AM
thanls for geting back to me ,i hope i hav jst tweak it like u . noing my luck i i hav damage it .  :-[i hav done some coaching on it and it has been fine . so could bending down course it to go.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on April 05, 2010, 09:16:41 PM
thanls for geting back to me ,i hope i hav jst tweak it like u . noing my luck i i hav damage it .† :-[i hav done some coaching on it and it has been fine . so could bending down course it to go.

Well, don't assume anything negative.  Keep your spirits up.  Please update us, after you talk to the O/S.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on April 17, 2010, 09:13:02 PM
Any news? 

Kevin, how is the jogging at this point?  And b5, what did your O/S say?
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on April 18, 2010, 09:20:49 PM
Any news?

Kevin, how is the jogging at this point? And b5, what did your O/S say?
Hi Scot thanks for asking, I seemed to reach a Plateau with my jogging 2 weeks ago when I didn't seem to be improving and got down on myself. However, my P/T reviewed my diet and daily water intake and put me on a set diet of 1800 calories per day but insisting that I eat every 4 hours. I wasn't drinking much water so I now have to drink at least 4 pints a day, more if I can. Coincidence or not last Thursday I did a 2 mile run in 15 mins 11 secs whch is a significant improvement and I am managing 2 runs a week so I hope I can continue. If I can shave a small amount off my times I won't be far off my referees fitness test pace I need for this summer. However, that test also consists of a series of sprints† which will be more difficult.
How are things with you?
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on April 19, 2010, 02:39:25 AM
Kevin, there may be something to what your physio says, concerning the water consumption.  I will try it out, and see how it affects my knee pains after footy.  Unfortunately, I am a BIG coffee drinker.. we are talking at least a couple of pints or more per day.  And of course, coffee is counterproductive with regards to staying hydrated.  And the diet.. well that is a tough one.  I don't envy trying to stay on 1800 kcals per day, but I am quite sure that you have the conviction to do se, in light of the gain you just made.

I will be keen on hearing good news regarding your referee fitness test, this summer.

Wolves are hanging in there.. currently 6 points above the relegation zone.  Quite the managerial job by McCarthy.



Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on April 19, 2010, 11:05:13 AM
Kevin, there may be something to what your physio says, concerning the water consumption. I will try it out, and see how it affects my knee pains after footy. Unfortunately, I am a BIG coffee drinker.. we are talking at least a couple of pints or more per day. And of course, coffee is counterproductive with regards to staying hydrated. And the diet.. well that is a tough one. I don't envy trying to stay on 1800 kcals per day, but I am quite sure that you have the conviction to do se, in light of the gain you just made.

I will be keen on hearing good news regarding your referee fitness test, this summer.

Wolves are hanging in there.. currently 6 points above the relegation zone. Quite the managerial job by McCarthy.




Thanks Scot I must admit I have the same problem in the UK with the amount of tea that I drink but I find the water helps to fill me up so that may naturally help reduce your coffee intake. As for the 1800† kcals per day that hasn't been as bad as you think because if you look at the kcal content of the foods you eat you can easily get by on 300 for breakfast, 500 for lunch and that stills leaves you 1000 for dinner and snacks. The secret though is to go no longer than 4 hours between eating because my P/T says that if you do your body stores up the fat, whereas if you eat at least every 4 hours then your body releases it for you to burn off.
On the Wolves I think we need one more win from our remaining 3 games
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on April 20, 2010, 11:43:43 PM
Nice job everyone!  I ran my marathon yesterday, in roughly 3 hours, 30 minutes, which was 10 minutes faster than last time.  The knee feels fine, although i am sore everywhere else and I think I messed up my foot on the other leg.  But I was planning to take some time off anyway.  Next, I am training for a sprint triathlon in June (my first triathlon), so I need to get back in the pool and on the bike!
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on April 29, 2010, 06:55:49 PM
Hello Madel, Kevin and all!

Hope everyone is doing alright.  Kevin, you're still running? And Wolves are out of relegation territory. When is your referee test, this summer? 

Unfortunately, I have gained a few pounds, which is odd at first thought, since I am playing so much football now.  However, on retrospect, my diet is less than ideal, at the moment.  I've been enjoying too many pints with teammates after games, and also eating too much gelato.  My wife makes homemade gelato, which is a bane of mine.
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on April 29, 2010, 10:20:36 PM
Nice job everyone!† I ran my marathon yesterday, in roughly 3 hours, 30 minutes, which was 10 minutes faster than last time.† The knee feels fine, although i am sore everywhere else and I think I messed up my foot on the other leg.† But I was planning to take some time off anyway.† Next, I am training for a sprint triathlon in June (my first triathlon), so I need to get back in the pool and on the bike!

Great time madel23 - very fast indeed!

Makes me jealous - I still really miss running.  :'(
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on April 30, 2010, 07:53:39 AM
Hello Madel, Kevin and all!

Hope everyone is doing alright. Kevin, you're still running? And Wolves are out of relegation territory. When is your referee test, this summer?

Unfortunately, I have gained a few pounds, which is odd at first thought, since I am playing so much football now. However, on retrospect, my diet is less than ideal, at the moment. I've been enjoying too many pints with teammates after games, and also eating too much gelato. My wife makes homemade gelato, which is a bane of mine.
Hi Scot thanks for asking yes 3/4 pace running twice a week and doing 7 laps of a soccer pitch which will form part of my fitness test in the summer.
4 weeks ago I did it with a light jog in 22mins 15 secs, I then built up my pace to 15mins 11 secs then 14.32 secs and yesterday I did it in 13 mins 2 secs so I am getting nearer my requirement. As I previously posted I have been on a 1800 kcal per day diet during this time and now drink at least 4 pints of water a day which has helped with my fitness and recovery between runs. I hope to referee a mini soccer game in the next 2 weeks which doesn't sound much but it would be a big step forward for me just to don the referees kit again.
Yes wolves are now safe from relegation with 2 games to spare which is an awsome achievement for the club and Mick McCarthy.
As regards you there's nothing wrong with putting the weight on but if you take get your water intake up and reduce your caffiene it will help you.
Keep going
All the best
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on May 19, 2010, 08:15:46 AM
Nice job everyone! I ran my marathon yesterday, in roughly 3 hours, 30 minutes, which was 10 minutes faster than last time. The knee feels fine, although i am sore everywhere else and I think I messed up my foot on the other leg. But I was planning to take some time off anyway. Next, I am training for a sprint triathlon in June (my first triathlon), so I need to get back in the pool and on the bike!
Hi Madeline I have been running for about 6 weeks now (33 weeks post op mfx) and have refereed 2 soccer matches, I note with interest your marathon running and wondered how your knee is afterwards and how long it takes you to recover to run again, also when you first start the run do you get any discomfort and then it settles down. The reason for my question is I tend to have discomfort/stifness when I start my activity and then it settles down as I get into it.
Scot with regards to your soccer playing same question to you please.
Cheers
Kevin†
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on May 22, 2010, 04:17:04 PM
Good to hear that you are reffing again! 

Yes, I have discomfort (not stiffness) before playing a match, but it definitely goes away during. Unfortunately, if I overdo things, I feel it after I sit for a bit after matches, but that's expected.

I am currently doing Supartz injections (one per week, for five weeks).  I got my second injection this week, and I have to say, I didn't have as much pain after my matches yesterday.  It is supposed to take 2-3 injections before a degree of relief is felt.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on May 24, 2010, 08:58:45 AM
Thanks Scot good to hear from you my Referees fitness test is on 11th July so I have got 7 weeks to see if I can get fit enough, over did it a bit last week and knee needs to settle down. On the injections did you ask for them or were they offered.
Cheers
Kevin 
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on May 25, 2010, 02:19:07 AM
Thanks Scot good to hear from you my Referees fitness test is on 11th July so I have got 7 weeks to see if I can get fit enough, over did it a bit last week and knee needs to settle down. On the injections did you ask for them or were they offered.
Cheers
Kevin†

Kevin, they were offered.  I saw my O/S outside of the office, walking around in the hospital, and we chatted a bit.  I mentioned that I had discomfort after matches, and he recommended them.  So after doing a bit of research, I decided to try for it.  After the 5th injection is done, I will post my thoughts on its effect.
Title: Re: Microfracture on 37 year old male soccer player
Post by: Seb_neumann on May 25, 2010, 04:09:41 PM
hi scooter...

i got microfracture surgery done as well.

would you say you got back to your previous level of football?
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on May 25, 2010, 09:09:21 PM
hi scooter...

i got microfracture surgery done as well.

would you say you got back to your previous level of football?
Not quite, because of the discomfort, I cannot cut as well, except on those days where my knee feels 100%.  Of course, those days are few.  But please keep in mind, I do some form of exercise 5-6 days/week (not for more than 1 hour/day unless I am playing a match), which I believe causes a certain "level" of inflammation.  I take the proper anti-inflamms, and follow a good diet most of the time.. otherwise I seriously doubt I would be able to keep up what I am doing.  As a caveat, i must point out that some would say I am being wreckless with this; an O/S friend of mine (who wasn't the one that did my surgery) told me to find another sport.  I don't believe in living that way.. I got the surgery to play football and enjoy life to the fullest I can. 

Also keep in mind that with mfx, comparing two cases/people may be an exercise in futility.  My trochlear groove lesion was enormous; we're not talking centimeters, were are talking about two inches in length. I am not exaggerating when I say that if you were to show a random O/S (with experience in treating such injuries) an MRI or endoscopic pictures of my lesion, they would likely tell you I wouldn't play football again, although I might be able to resume "normal" activities.  I rehabbed diligently, and ate the right foods and supplements, and consider myself lucky to even be on the field again. 


All that being said, I still am seeking solutions for a better "cure".  Even if temporary, I am willing to try the Supartz, because the pallative effect is desirable.  If my mfx fails completely down the line, as it likely will due to the level of activity I maintain?  I will go for stem cell therapy, and just pay out of pocket. 
Title: Re: Microfracture on 37 year old male soccer player
Post by: b5 mlb on May 25, 2010, 11:30:51 PM
hi scooter i have been to see the os last week ,he thinks it has failed so we might do it again in oct ,he said the aci would not work for me becasuse i have other bits of damage. :'(my lesion was 2cm on the trochlear groove . the knee was just feeling good.  :D i just knew it had gone from the fall it was only a litte one. can it be done twice ? i miss my bike also my hip is sore  from the bike 6 weeks ago so i might have to see some one soon about it  :'(,what is going on with my body. i no  i have played a lot of games but my body should be better than it is.


Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on May 26, 2010, 12:34:59 AM
hi scooter i have been to see the os last week ,he thinks it has failed so we might do it again in oct ,he said the aci would not work for me becasuse i have other bits of damage. :'(my lesion was 2cm on the trochlear groove . the knee was just feeling good.† :D i just knew it had gone from the fall it was only a litte one. can it be done twice ? i miss my bike also my hip is sore† from the bike 6 weeks ago so i might have to see some one soon about it† :'(,what is going on with my body. i no† i have played a lot of games but my body should be better than it is.

B5, I am not sure what is going on with you.  However, I can tell you that what you put into your body, as well as stress, habits (e.g. smoking and drinking), and sleep all affect your health.  It's not enough just to try and stay fit with exercise, although that's a big part of it.  And this isn't just some "new age hippie" advice.. it's just the truth, and is even more important as we age.

So, without knowing your habits, I couldn't begin to guess what is going on.  However, I will say that I am surprised that a simple fall would have destroyed the mfx, unless you hit it just wrong.  As for getting ANOTHER mfx, in the same place?  For me, that just sounds odd.  He will be punching through the fibrocartilage scar tissue (that's left), and hoping for what.. that the scar tissue (i.e. cartilage) that forms this time will be less fragile?  What specifics did he give for ACI not being an option? 
Title: Re: Microfracture on 37 year old male soccer player
Post by: b5 mlb on May 26, 2010, 07:21:32 AM
thanks for geting back to me .i dont smoke or drink and i still eat the right food .i am in good health ,a football mate of mine had a mfx  twice
had he is still playing so i will have to see. he said the aci would not work becuase ther was other bits of damage.but when i went to see a os in london he said he could do it.what is the stem cell. also he said i might need a new knee later on in life.
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on May 27, 2010, 07:43:39 PM
Hi Kevin,

After the marathon I couldn't run for a few weeks because of a probable stress fracture in my foot.  Actually, I just started running again today, and everything felt ok.  I've been bicycling a lot, and that actually seems to aggravate my knee more than running. 
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on May 28, 2010, 02:09:06 AM
thanks for geting back to me .i dont smoke or drink and i still eat the right food .i am in good health ,a football mate of mine had a mfx† twice
had he is still playing so i will have to see. he said the aci would not work becuase ther was other bits of damage.but when i went to see a os in london he said he could do it.what is the stem cell. also he said i might need a new knee later on in life.

First.. Madel, I am glad to hear that it was just a stress fracture, and that you are back to running.  Am somewhat surprised that bicycling aggravates it more than running, but then again, everyone's mfx acts differently.

B5, the stem cell therapy can be explained here:  www.regenexx.com

Unfortunately, it costs a lot of money, and until it comes to England, I am not sure how viable an option it would be for you and others over there.  Nevertheless, you should check out the website and read a bit.
Title: Re: Microfracture on 37 year old male soccer player
Post by: madel23 on May 28, 2010, 05:57:50 PM
Ha!  Only on this board would anyone say "just a stress fracture!"  But that's how I thought of it, too!
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on June 22, 2010, 11:51:57 AM
Hi Madeline/Scot,
Just wondered how things are with you both and what you're doing sports wise at the moment?
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on June 25, 2010, 12:27:58 AM
Hi Madeline/Scot,
Just wondered how things are with you both and what you're doing sports wise at the moment?
Cheers
Kevin

Hello kevin!

I am holding up well. Still playing footy, albeit only 1x/week right now.  I had been playing a lot, but me knee was protesting a bit too much, so I decided to lay off of it.

I am watching the replays of the WC, whenever I can, and as many matches as I can.  England and USA both through!
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on June 25, 2010, 07:33:09 AM
Yes Scot and yes USA won our WC group so good luck to you.
I wondered how your knee has been with the injections you've had and do you think that they are worth it?
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on June 25, 2010, 01:59:51 PM
Yes Scot and yes USA won our WC group so good luck to you.
I wondered how your knee has been with the injections you've had and do you think that they are worth it?
Cheers
Kevin

Ah yes! Of course.  No, the injections didn't have any lasting effect for me.  The problem is that, while they provided some therapeutic relief for the first few days, it "wore off". 

But then again, there are plenty of testimonials which proclaim that Supartz worked for them, on this and other message boards. 

Are you thinking about them, Kevin?
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on June 25, 2010, 03:38:43 PM
Scot,
I dont think I am interested in the injections but I see the O/S on 21st July for my next check up.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on July 11, 2010, 08:29:55 PM
Yes Scot and yes USA won our WC group so good luck to you.
I wondered how your knee has been with the injections you've had and do you think that they are worth it?
Cheers
Kevin

Ah yes! Of course. No, the injections didn't have any lasting effect for me. The problem is that, while they provided some therapeutic relief for the first few days, it "wore off".

But then again, there are plenty of testimonials which proclaim that Supartz worked for them, on this and other message boards.

Are you thinking about them, Kevin?
Hi Scot/Madeline,
Just to say I took my Refís fitness test at the FA today and passed it. I had to run continuously for 12 mins. on an 400m track. There were 42 of us taking the test and we had to cover at least 2,500m and infact I managed 2550m which was tough as it was sunny, 28c and humid. After a 10 min. rest I then had to complete a series of 50m sprints each one in 7.5secs. As you can imagine I was really pleased and have been training really hard for it over the past few weeks. It now means I can return to Refereeing  at that level. Afterwards I am aching everywhere and the knee is sore but at least I did something that I wouldnít have thought possible just over 9 months ago after my mfx. Not bad for a 53year old!!!!!
Howís things with you both?
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on July 11, 2010, 11:40:17 PM
Good to hear everything has worked out well for you guys.

I've just been in for mosaicplasty and microfracture on one of 2 new lesions on Friday. I've posted details on the cartilage plug forum. Lesions are relatively small so hoping everything will work out fine this time.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on July 12, 2010, 08:12:53 AM
Good to hear everything has worked out well for you guys.

I've just been in for mosaicplasty and microfracture on one of 2 new lesions on Friday. I've posted details on the cartilage plug forum. Lesions are relatively small so hoping everything will work out fine this time.
Hi Andrew good to hear from you, I've just read your postings on the cartilage plug forum and although its early days it does sound encouraging for you. I see my O/S on 21st July for a 10 month check up and I know previously that he had mentioned cartilage plugging to me if the mfx wasn't a success. I am thankful I am back running and refereeing but I'm not counting my chickens as I know this will probably be for a limited time but I will see where it goes. Best of luck with your rehab as it sound as if you have a really good O/S and keep us posted on your progress.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on July 12, 2010, 12:03:58 PM
If you are back running Kevin then it sounds like a spectacular success to me. I was a million miles from running, indeed, just walking was painful. Despite that, the surgeon said the defect had filled in completely!

I've been following your progress and its made me envious.  :P

Hopefully I'm now back on track myself.  :)
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on July 19, 2010, 02:14:04 PM
If you are back running Kevin then it sounds like a spectacular success to me. I was a million miles from running, indeed, just walking was painful. Despite that, the surgeon said the defect had filled in completely!

I've been following your progress and its made me envious. :P

Hopefully I'm now back on track myself. :)
Thanks Andrew yes I think to be quite honest itís partly down to luck if the surgery is successful or not and it works for some and not for others. There is no doubt on face value I appear to have been lucky in that I am able to run again, albeit far less than I could before. There are days like yesterday when I went for a steady jog and my knee hurt so I had to stop and yet for no explicable reason there are days when its relatively pain free. To a lesser degree itís the same when I walk one day OK and another day with some discomfort.
However, I am not bemoaning the fact that I can run in some kind of fashion and compared to what you went through I am very fortunate indeed. In saying that I think I have a limited time in being able to do what Iím doing so I will just see how it progresses. My season of refereeing starts on 7th August and I will see if my knee will stand up to it or not. I also see my O/S this Wednesday for a check up so it will be interesting to see what he says.
Keep posting your progress
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on July 27, 2010, 08:17:58 AM
Well guys I have bad news to report, on Saturday I was refereeing a preseason friendly and just before halftime I felt pain in my good knee.
I had to pack in at half time and suspect itís my cartilage which is difficult to take as all my life I have never had any problems with that knee. Perhaps I was unknowingly putting too much pressure on it whilst compensating for my mfx knee. I am off to see the P/T today to look at it but the symptoms feel the same as when the other one went. I am naturally disappointed and the thought of further surgery is something Iím not looking forward to so itís hard to be positive at the moment. Hope everyone else is doing OK.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on July 30, 2010, 11:39:01 AM
Go and see your specialist Kevin first before getting too down hearted. It could be something else that has gone wrong?
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on July 30, 2010, 03:50:06 PM
Kevin, try not to assume anything before seeing your specialist. I have had very similar pains in the opposite knee at times, and it may well be that you overstrained it due to compensation, and perhaps have inflammation in that knee as a result.

I am hoping for the best for you.  Keep us updated
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on July 30, 2010, 07:52:46 PM
Thanks Scot/Andrew for your comments, it transpires that I have strained my ligaments on the inside of my knee which is causing the inflamation.  He tested my knee rigorously so it was good news although he thinks I have been compensating unknowingly to protect my mfx knee. I have to wait for a couple of weeks of P/T and then get in the gym to build up the muscle tone on both legs.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on July 31, 2010, 11:54:14 AM
Good news Kevin. You'll be relieved!  :)
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on July 31, 2010, 01:13:31 PM
Thanks Andrew yes relieved indeed, forgot to say I saw the O/S on 21st July (10 months post op) who scanned the mfx knee and said that the cartliage had formed and it looked a lot smoother where he had to shave off some bone. He said he would see me in again 12 months unless I had any problems.
How are you doing?
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on July 31, 2010, 01:45:56 PM
Sounds good Kevin.

I'm okay, out and about on my crutches. Was speaking to the referee of my sons game this morning. He immediately came over to me when he saw my crutches and started to tell me all about his own knee woes!  I had 3 different people all come up to me this morning to tell me all about their knee problems! Being on crutches seems to be a magnet for people with injured knees!  :D

Knee is still very stiff and swollen. I hired my own CPM machine and am up to 110 degrees on it. Its harder to actively reach this sort of range myself. I still can't lift my leg using my quads though and can see a great deal of atrophy.
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on July 31, 2010, 08:10:48 PM
Hi Andrew sounds as if the CPM machine is helping your ROM, the quad wasteage is only natural based on what you've had done so it's not suprising you can't lift it. I'm sure you're getting a bit frustrated but you are at that difficult time of waiting to move onto the next stage.
Keep posting your updates.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on August 24, 2010, 04:23:14 PM
Hi Scot,
I saw your posting to Dr. Centeno on stem regeneration, I take it from what youíve said whilst you are still doing your sports the MFX leaves you in pain for days/weeks after, dependant on the intensity of the sport you undertake. You may remember my last posting said I now had problems with my left knee (my good one) during a soccer game I refereed. It turned out to be a mixture of a slight tear in my knee ligament and a bit of scar tissue at the back of my knee where my hamstring meets my knee ligament.
I had, albeit, subconsciously put excessive strain on my good knee when I began to run again by protecting my right MFX knee. After a lot of thought I decided to retire as a referee with the FA. It was a hard decision to make but refereeing at that high level would have been so demanding and I need to have a quality of life after I eventually finished.
I am road cycling and playing golf and the MFX knee has been quite good as I will be 12 months post op on the 14 Sept but I am still having P/T on my left knee to get it back where it was, but Iím not complaining because a lot of posters on this site have had far less success with their MFX than I have.
Let me know how youíre getting on and what youíre up to.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Scooter72 on August 25, 2010, 02:43:06 PM
Yes, Kevin.  I have had to cut back on how much I play.  I suppose I should be thankful that I can play at all, but it's just in my nature to seek a better solution.   Besides, even if I keep off of it (i.e. quit all strenuous activities), for me,  I would become miserable, and I also suspect that it would only extend the amount of time that I was symptom free for a while longer (until the knee went bad again).

I am very sad to hear about your decision.  I know reffing football was your passion, however, I believe you made a wise (but tough) decision.  Kevin, you do need a good quality of life, and no doubt the running associated with reffing would have worn your knee(s) down again, within a few years.  I think anyone who gets mfx, and knows the details of it, suspects as much.  Enjoy your golf and cycling.  And of course, enjoy watching the Wolves in the Premiership!  Any opinions on the season thus far?

I intend to eventually get Dr. Centeno's treatment, but not right now.  I can get along, for now.  Some would view it as unwise for me to keep playing, and exercising in a manner that affects my knee.  However, as I said before, if the football and (mild) resistance training doesn't get to it sooner, I know that everyday activities such as going up stairs and the long walk to work eventually will do so.   And age, of course, exacerbates all of that.

Keep in touch Kevin!
Title: Re: Microfracture on 37 year old male soccer player
Post by: AndrewH on August 27, 2010, 07:03:54 PM
Sorry to read that you've had to give up the reffing Kevin. Everything comes to an end eventually though so now is probably the best time for you now that you've had a long break from it. At least it gave you the motivation to recover from injury and you're now back doing other stuff.  :)
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on September 01, 2010, 02:06:33 PM
Sorry to read that you've had to give up the reffing Kevin. Everything comes to an end eventually though so now is probably the best time for you now that you've had a long break from it. At least it gave you the motivation to recover from injury and you're now back doing other stuff. :)
Thanks Andrew yes youíre right it did motivate me to try and get back to full fitness but ultimately it would have been difficult to sustain that level of fitness for a season also the full out sprints (when required to get up with play) were difficult.
However, Iíve certainly been lucky so far compared to other mfx victims and will just keep going playing golf, weights in the gym and cycling once my knee ligaments recover. Iíve read with interest your posting on your latest surgery so keep us updated with your progress, your OS sounds really good and positive.
Cheers
Kevin†
Title: Re: Microfracture on 37 year old male soccer player
Post by: kevin3004 on November 07, 2010, 06:54:54 PM
Hi Scooter, Madeline and Andrew,
Just wondered what your progress was (Andrew I know you are recovering from your recent surgery).
I havenít run or jogged since doing my ligaments in my good knee in August but Iím playing golf and doing the weights in the gym. The P/T says Iím OK to start jogging again but on my good days as I walk without any pain Iím slightly reluctant/apprehensive to start again.
Cheers
Kevin
Title: Re: Microfracture on 37 year old male soccer player
Post by: Clarkey on March 23, 2014, 02:18:50 PM
Hi All,

I know this topic is a few years old already and have been reading with interest how other members of KG have managed and coped pre op and post op mircofracture.

I admit I can be a stubborn as mule when it comes to looking after myself properly and always thought I never become a cropper as I am still young. I am very competitive when it comes to long distance running and cannot just run at a slow steady pace. I have to average just under 7 minutes a mile if I go over 7 minutes get annoyed with myself for not pushing myself more.

At the peak of my long distance running my best time was 9 miles in just under 1 hour average pace was 6 minutes and 40 seconds. I did start to get the odd niggling knee pain while running that slowly increased. I just thought to myself it's nothing to worry about as I already had 1 scope to remove the medial plica and fat pad trim.

Also did not warm and stretch properly before and after running and admit overdoing it by running 4 days in a row a 9 mile circuit rather leaving a day in between for the body to recover again. I trained with no advice from a personal trainer and a sports PT and was pre warned by my sports PT not to run so many miles as he had to have a mircofracture from road running.

I only have myself to blame and just like to know if other members of KG that had a mircofracture have managed to get back into sporting activities or had to reduce or give up completely. I am finding it hard to accept as I have high functioning autism know as Asperger syndrome, running long distance meant a lot to me not just physically also helped me mentally to reduce my anxiety and stress levels.

Seeing others running right know is upsetting and was not helped when I had knee problems 10 years ago shortly after my breakdown and diagnoses of AS that the knee pain was all in my head for having autism.

I do have signs of wear and tear of my right knee and too painful to run on it and MRI scan confirms this. Will have an exploratory scope in July and looks likely need a microfracture and read you can still compete but not as competitive.

Running was my life since childhood as I always been a good long distance runner and do not mind to admit is getting me down not being able to run. Frustrating is a good word to describe it if you can only use one word to describe how you are feeling with a certain knee injuries.

Sorry for the long post had to get it of my chest as I am still in shock that there a chance I may not run long distance again aged 35.

Thanks for reading.

[email protected]
Title: Re: Microfracture on 37 year old male soccer player
Post by: Jbenazzi on June 27, 2017, 02:07:25 PM
Scot,  I read this entire thread with the greatest degree of interest. I am two weeks post mfx surgery on a trocheal groove defect. 100mm x 200 mm. I am posting here on the off chance that you receive the email notification and can provide an update on your condition. What? Eight years after your surgery? :D

I am a 40-year-old soccer player (men's over 40 3D division :-), but like you very much want to get back to it. Your posts and the others on this thread make a lot of sense to me. A lot of great information on diet the importance of rehab, etc.i'm certainly going to do everything I can to get back on the field, but again would love to hear an update. thanks!  Best wishes to all on this thread. 

John