The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: lululocket on November 18, 2010, 11:57:24 PM

Title: rubbish quads post TTT - fun ideas?
Post by: lululocket on November 18, 2010, 11:57:24 PM
Hi All,

After two big bad dislocations and about 8 other fun occasions sitting somewhere between sublaxation and full dislocation, I had TTT and L/R on my left knee back in March, and 8 months down the line my quads are still fairly limp. I struggled initially with a bad PT (for 4 months we didn't do any exercises that looked at knee tracking, duh) but I now have a great guy trying to encourage me with some pilates based movements.

However, I'm still struggling with frequent pain, and just massive weariness with the whole stupid process. I need to have the right knee done too, and there is no way my left knee is recovered enough to support the other leg. Walking down stairs is still a challenge. Despite my exercises, the muscles don't seem to be 'taking', and my physio and I have talked a lot about pain inhibition. We can see the muscles firing, but after a week of exercise they will be just the same as if I hadn't bothered. I still have numbness in an area the size of my palm on the outside of my knee, so perhaps some genuine nerve damage is the issue. The hardest thing is going from about 5-20 degrees in either direction, it feels like someone is squeezing down on my kneecap and putting pressure on the whole joint, and my instinct is to just lie down and take all pressure off it.

Does anybody have some ideas for:
1. tricking my sorry brain into growing some quads that will work going down stairs
2. getting some feeling back in the numb area
3. motivating my bored, flat shoed, boring self into doing something radical. I had wanted to motivate myself with nice heels as a goal, but they are waaay off given a knee extension puts almost unbearable pressure on my kneecap still. Vogue is both comfort and curse.

PS I wish I'd discovered this site earlier, it's amazing!

Lululocket, Londoner with knees much older than she is
Title: Re: rubbish quads post TTT - fun ideas?
Post by: duckie857 on November 19, 2010, 05:03:56 AM

Welcome to the TTT club. You and I are soul (sole? ;)) sisters! My quads hate me. I also have an infinite love of shoes buy had to stop wearing anything more than a kitten heel in the last 2-3 years. I make up for this by owning an ungodly amount of ballerina flats in all different colors and patterns!

As for the quads... Oy. They are finicky! I had quad advancement surgery in January to tighten them up ( in lieu of a TTT) and it worked great...for a bit. My q-angle was just too far off and my knee started going out again. I had a TTT in October to rectify the pull on ny kneecap. My quads are still in poor shape but better than they were pre-January surgery. They are my biggest obstacle right now! I have a huge divot where my inner quad should be. It fires but it's weak.

I'm not going to assume anything, you do quad sets? I've been told to do them any time I'm sitting still. How about the tens unit? I hate the electrical stim but I know it helps to use it while exercising. Squatting, lunging, and squeezing a ball between your knees will help strengthen you quads, too. Oh, and straight leg raises. I find the SLR is more challenging with weights on my ankle.

If you can do all of that try doing squats ( or wall slides) with a ball between your knees. Have you done theraband exercises where you stand on one leg and pull the band with you bad leg...a standing SLR? You tire the band around a post and use it for tension. Tightening your quad and balancing on one leg is another good one.

That's all I've got! Unfortunately, I learned them all in PT so you've probably done them.

Good luck!


Title: Re: rubbish quads post TTT - fun ideas?
Post by: duckie857 on November 19, 2010, 05:12:00 AM
Oh! I forgot captain morgans! Take a step master and step up with your bad leg and pull your good knee up to you chest. Stand there balancing for 5 seconds and then descend off the step. Turn around, repeat!

As for motivation...can't help you there. I'm horrible at that.

Unfortunately, I've heard the numbness can be permanent. Sucky, right? I heard rubbing different textured fabric over you numb spot can wake up nerves. Other than that my only advice is to see a neurologist and have the area tested for damage.
Title: Re: rubbish quads post TTT - fun ideas?
Post by: lululocket on November 19, 2010, 07:55:44 PM
Hi Duckie,

Nice to hear from you, I hate that you have problems too but I'm so happy to have someone to talk to! I've never met anybody who'd even heard of TTT, let alone done it! I get the feeling from the three PTs I've got through that it's still less common in the UK than the US.

Oooh dear from your post I'm still really behind. I kind of knew that, but hopefully being reminded will kick start me. I'm so exhausted from the effort of trying to get better. Happy with quad sets and SLRs, my sticking point has been arc extensions. I have an icky bit between about 10-30 degrees from straight. It's fine contracting the quads (ie climbing stairs), but when allowing my knee to bend it's rubbish. In a chair getting my ankle back down to the floor is still uncomfortable after 8 months, and my physio has me doing arc extensions from lying on my back, leg straight up in the air then move just the ankle down to get to a 90 degree bend. The idea is to try and change the pressures on the knee cap.

My PT and I reckon it's my inner quad, which like you is a bit of a dent in my leg still. It fires, every time, but the muscle just doesn't seem to grow. Squatting and lunging still a bit of a way off because of the pressure it seems to cause on the kneecap (I'm doing a 'quarter lunge' and even those we had to back off over-contracting the quads because my knee swelled up like a balloon and we had to ultrasound it after just a week of doing 20 a day). No bone contact according to my PT, but it sure feels like it. I'm still a bit scared of weights because of the swelling I've had, but I need something to aim for.

I'd never heard of a tens unit (yay google), and will be asking my PT about it. Thank you for that tip! Also squeezing a ball should help in the next two weeks before I see my PT again, I remember doing that before after a dislocation when I ripped lots of muscles, but for some reason I forgot about it.

I haven't seen my surgeon for a few months, I'm starting to wonder at what point I should give up on physio and go back to check for other problems as to why the muscles aren't growing. He's not very sympathetic...I think since the x-rays show that mechanically he put the TT in just the right place, he thinks I surely should be completely fine now. Ah dear, you really need two OS I think, one gung-ho confident one who is technically excellent to chop you up, and then a gentle caring one to be nice afterwards and worry about little nerves and muscles. And not do any positive apprehension tests. Ever.

Title: Re: rubbish quads post TTT - fun ideas?
Post by: cdubb on November 20, 2010, 02:57:37 AM
I'm only 2 weeks out of my TT w/ ACI, but know I'm going to need a lot of work get my quads going!  Although, I am not permitted to do many of these quad builders Duckie suggested for quite some time due to the ACI and needing to avoid the shearing forces on the graft, so I will be even more limited and need more motivation to get me going to get my quads back.  At PT today, I did a SLR on my own! Yea! My PT's had was right below my leg though to ensure there was no lag. I can fire my VMO, but it's just not very strong, so we put the stim on it to force it to fire and had me contract with it and that seemed to help a lot to retrain my muscles how to fire. 

Title: Re: rubbish quads post TTT - fun ideas?
Post by: duckie857 on November 20, 2010, 06:32:47 AM
Quads are really hard to build back up once they die. Dint fe bad if you're lagging. I couldn't do 3/4 of that crap even up to my most recent surgery, and in still not doing standing exercises after my TTT. It's a slow process,

I've said it before on this site buy I'm lucky to have found an amazing surgeon. He's exactly what you're asking for and more. Confident but with amazing bedside manner. I actually look forward to seeing him. He also avoids putting me through unnecessary apprehension tests. He didn't even do it when we met because I had a previous consultation that had marked "positive." Bless his heart. 

As for appointments...after my vmo surgery I saw him at 2 weeks, 6 weeks and 12 weeks. I had to go back at 8 months because of pain in my knee. It was rapidly decreasing in strength. PT aggrivated it more and I was loose again. I saw him after 4 weeks of pt. That was September. He recommended surgery. So, I scheduled it. I had my surgery on October 6th. I went back 10 days later for my follow up. 5 weeks if PT. I have a 7 week post-op on Tuesday. My guess is he'll want to see me again in 4-6 weeks after my next round of PT and strength training. Then probably a 4 or 6 month  follow up. After that I'll probably be discharged.
Title: Re: rubbish quads post TTT - fun ideas?
Post by: lululocket on November 20, 2010, 10:47:19 AM
Haha, in comparison my OS did a positive apprehension test six weeks after surgery! Well, he didn't really push it far, he was just going 'look it stops now, aren't I clever I've fixed it', meanwhile I've got tears streaming down my face and I'm trying my best not to kick him in the face with the other leg. I think he and my darling mum think I'm just a total wimp, but if for the past 8 years doing that would push it out, then is it really surprising that after someone goes in and mucks around with it, I still think it's going to sublax? He'd also said I gave the 'most postive reaction' he'd ever seen. I kept saying I trusted him that he knew what he was doing, but my body wouldn't obey my mind - controlling my instinct to flinch away left me shaking.

Man for the other leg I need somebody else I think. I just don't want to go back to him at all. I can be tough up to a point, but I need him to be on my side a bit more! I'd forgotten how bad it was seeing him, I just never went back after the 4 month mark (I was meant to go at 6 months for discharge, but I've been so weak I keep thinking 'just two more weeks physio then I'll make an appointment'. And I'm going to do physio as surgery prep this time so I've got loads of muscles to work with.

You girls are awesome - I'm going to start my own very late post op diary too, hopefully the things I CAN do will be an encouragement to those of you a few months behind.

Duckie I heard you weren't sleeping - I hope you're feeling ok in the morning. I can't imagine having to share a bed post surgery, I have a double to myself and I was stressed enough with the cat coming in, I had to shut the darling out at night so she wouldn't go near my knee! For me the issue was twitching - I'd get almost asleep, then jerk and wake up suddenly, then the pain followed, argh so bad, and you feel like it's self inflicted because your muscles just spasmed! Hah what a joke, my OS actually said 'urgh I don't want to know what you get up to in bed' like complaining about twitchy nerves was irrelevant and somehow inappropriate! He's so fired.
Title: Re: rubbish quads post TTT - fun ideas?
Post by: soozles on November 20, 2010, 12:45:55 PM
I say book a vacation for about 2-3 months from now. If anything will motivate you, a vacation will. I myself Leave for a cruise 8 weeks after surgery. I figure it will give me a push and I think psychologically people do better if they have some sort of reward waiting for them. But there is no harm in seeing someone else for the other leg but I doubt they will help much for your current issue. Most surgeons don't want to touch a knee that was operated on by someone else.
Title: Re: rubbish quads post TTT - fun ideas?
Post by: duckie857 on November 20, 2010, 05:53:01 PM
I would have smacked my OS if he said something like that to me! Not that he would have, he's way too polite and shy to make such a comment. The hospital and office staff call him McDreamy behind his back, and I'm fairly certain he knows but ignores it out of sheer embarrassment. He's really such a sweetheart it's sickening. When I had to come back in for the second surgery he apologized for not fixing me the first time around every. single. time. we spoke. I finally told him to quit it, and he apologized for apologizing!

Mostly, I was just in a bad mood last night on top of over-working my muscles.  I think that made for a restless night. Sleeping in the bed with Adam isn't as bad as it could be...I've definitely shared a bed with worse sleepers than him (kickers are the worst!). He usually doesn't toss or turn so he's fairly easy to share a bed with. I was worried that things would be a bit difficult the first week I was home but it worked out fine. However, when he leaves in the morning I definitely spread out in the bed! ;) But I did that pre-surgery!
Title: Re: rubbish quads post TTT - fun ideas?
Post by: cdubb on November 21, 2010, 12:48:44 AM
I couldn't imagine sharing a bed at this point. I have no idea how you manage Duckie.  I'm in the guest bedroom to avoid stairs and also because I take up so much room.  Last night, my cat couldnt' even find a spot for a while and kept crosing over me, sitting, then crossing back over.  My cat is probably grumpy to have to share a bed with me since it's normally her room. I actually have taken to sleeping without my brace and doing okay.  I'm generally a back sleeper, so my leg doesn't move a lot anyway. I started to sleep without it because I had to sleep with ice on the ankle and knee just to get to sleep, so I couldn't use the brace with both ice packs on.  Plus, I've had the all clear to sleep braceless since day 9 post op. 
Title: Re: rubbish quads post TTT - fun ideas?
Post by: duckie857 on November 22, 2010, 07:09:31 AM
Cdubb, I'm sure I annoyed him with my adjusting and what not but he generally sleeps like the dead. We're just one of those couples that can apparently share a bed even when one of us is sick as a dog. He's the only person in this world that I can tolerate sleeping in the same bed with under any circumstance. I'm an only child and do not "share" well. I get really annoyed if people snore or make weird noises in their sleep but I can actually sleep through him snoring. It's bizarre! I also didn't drive him insane with my sickness this past week...which is a miracle.  We must be meant for each other, LOL!

But don't get me wrong! I'm back at my aunts tonight and enjoying sprawling out on the bed. I'm sure he's spread out in our bed right now, too! ;)

Title: Re: rubbish quads post TTT - fun ideas?
Post by: lululocket on November 22, 2010, 09:34:27 AM
Much as I love the vacation idea, it's not really an option for me due to a work project. However, I have a friend from church who is a physio, currently off work after her own foot surgery, but she has sweetly agreed to bring me some kind of electric conducting nerve tape to see if we can trick the muscles into firing, and even offered to call my current physio about e-stim if I wanted. She reckons although it's very unconventional so late in recovery, the total brick wall I've hit makes it worth a try. Has anybody ever had this neon electrical tape stuff? Apparently rugby players sometimes wear it during matches.

She also had heard of my OS and says he is extremely well respected, but very cocky and with terrible bedside manner, which made me feel much better about my fear of going back for follow up, and more confident about him possibly doing the other leg too.

PS duckie enjoy the big bed at your aunt's :)
Title: Re: rubbish quads post TTT - fun ideas?
Post by: duckie857 on November 22, 2010, 02:19:07 PM
Lulu, I haven't heard of the tape. I've only head of kinseio tape for patellar tracking. Never heard of anything that worked the nerves. Let us know how it goes!