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NOTES - Your success stories / Re: Lacerated peroneal nerve injury
« Last post by Arya4745 on Today at 02:10:19 AM »
Hi Sharp saw,

Hopefully this finds you well and out living your life.

I was hoping you could give me a little bit of your time as i believe i recently underwent a similiar injury to your own. I was hit by a car whilst crossing a pedestrian crossing and has a shard of glass penetrate into my knee lacerating the gastrocnemius and the common peroneal nerve. They did a primary end to end repair and i had a similiar recovery in range of motion brace. I am 7 weeks out and have no movement and sensory loss.

I was wondering
1. What did you feel when you got movement back?
2. What exercises you did to help promote healing and recovery?
3. What physio specialist did you see or was it a general physio?

Any information would be wonderful, thank you.
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NOTES - Your success stories / Re: Any Peroneal Nerve recovery stories?
« Last post by Arya4745 on Today at 02:01:43 AM »
Hi Everyone,

I am aware this is an old thread but there has been so much good content i was hoping to get some information and guidance.

I am a young 33yoM doctor from Sydney training in O&G. 7 weeks ago i was in a freak accident when leaving work. I was struck by a car whilst crossing a pedestrian crossing. As a results i was airlifted to a tertiary hosital. I had a big piece of glass penetrating into the back of my right knee lacerating the lateral head of gastrocnemius muscle and complete laceration of the common peroneal nerve. I was operated on within 12 hours and had end-end anastomosis of the nerve and kept it off tension during recovery.

As a result i have complete peroneal nerve deficit and subsequent foot drop. I am very eager to hear of anyone elses stories of complete laceration of grafting.

I am also very eager to do everything i can to improve axon/ nerve regeneration and prevent atrophy of the dennervated muscles. I have had very limited luck speaking to specialists and digging through research (mostly animal trials) on the internet.

I am rather dissapointed that i cannot find a physiotherapist who is engaged and interested in peripheral nerve injuries. I feel as though every physio and their dog recognises foot drop and purely wants to help me live with it.

Any help would be very much appreciated. I am more than happy for people to message me directly.

I hope eveyone is doing well and on the road to recovery.
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I guess at some point you decide to just start running/training even though there is pain as long as it doesn't cause inflammation or too much inflammation? I somehow hope my knee becomes fully normal again - that I can run without any pain and I think I will wait for 1 year after cartilage surgery before just deciding to run into the pain.

At what point is the healing process over/so far that not doing the sport you like outweighs the movement/muscle building/happy hormones you get from it?

Reading studies it seems kinda 99% of people will still report 1-2 out of 10 pain anytime after surgery. Many more. Clearly whenever you start something new after surgery you have to go through some pain to adapt. At the beginning of this process - you know this pain is actually needed and part of your recovery (studies backing up that faster weightbearing is better or at least equal to using your crutches for longer). But then with running (and all sports requiring running) the studies become very hard to interpret.  Looking back it is always easier to see progress than at the current state.

For me it's hard to understand that you run while you still have problems with stairs - but then your surgery is well over a year ago so I guess further keeping it safe and not running will not profit you. I really have to look to get BFR training going - my left leg muscle is so strange - around the knee it's 90% back in size - same around my butt. But in the midsection the muscle is kinda missing - it's like the muscles from my butt extend down 5-6cm further on my healthy leg. I guess this has to do with the ROM in which I have pain. Are your muscles just tiny bit smaller or different in shape too?

I kinda guess if you start with higher impact sports too late - you run into risk of implant overgrowth with cartilage surgeries - well not likely on OATS as you have bone/cartilage full piece replacement. Oats usually has the fastest recovery of any cartilage surgeries. Seeing that you damage was rather small - you were quite unlucky I guess that recovery takes so long. I think without BFR training you would be way more behind.
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Thanks John, will do. Glad to see you’re still on the board. Comfortable so far. Just rather bored. Surgeon has me non weight bearing for 6 weeks so doing some quad setting and heel slides in prep for proper physio. Seems to think I’ll make a full recovery but seem to recall last time it took a good 9-12 months to get going properly last time. Not been able to fit in a car is a bit of a bummer. Now I wish I wasn’t 6 4 and all legs!!
Steve
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One Year Follow Up:

As promised a few posts ago, I'm back with a one-year follow up. The topline is that I'm still improving...I'm running longer, back at work a few days per week, and I'm starting to make some progress on stairs finally. A full year after my 2nd surgery (and over 1.5 years since the "big" cartilage surgery) and I'm still not close to "normal", but I'm grateful to be still moving in the right direction.

My right knee pain is pretty minimal right now. There is some occasional discomfort when I move in certain ways and I have a lot of stiffness still when I get to 100+ degrees of flexion. There is much less swelling now, but if I'm on my feet for hours I still experience some. I wear a gently compressive knee sleeve for most of the day when I'm up and around and that seems to minimize the swelling. I'm running with a knee sleeve as well (not sure I need to...but I'm making progress so I'll keep doin' what I'm doin'). I don't notice any swelling after running and only a little bit after BFR and strength training to total muscle failure.

I have continued to run every other day (until today...see below) and continued to very gradually nudge the duration of my runs up. About 6 weeks ago, on a day following a rest day with no running or weightlifting, I awakened with a flare up of pain in my right knee. I have no idea why. The day before I had only cycled a little and did some PT exercises including bands and balance practice. I decided to shut down the PT exercises and took a few extra days off of running. When I started running again...I kept it much slower. This seemed to work. The pain gradually disappeared and I was able to resume running every other day and weightlifting every fourth day. I have not gone back to some of the PT-type work I was doing, but I have started working on going up and down stairs a bit.

Today I ran for the 2nd day in a row. This is my first week attempting a 4-days-per-week running pattern (with 2 days of strength/BFR and one total rest day). It went very well and I was able to run 6.5 miles (~10.5K) after doing a short run (2.5 miles) yesterday. I've also started to do one treadmill workout per week where I do some 30-second intervals at faster speeds. Well...not very fast right now, but you have to start somewhere. I didn't push anywhere near the outer limits of what my knee can do and I held good form.

Well, that's it for now. I'm going to continued to very, very gradually nudge my activity levels upward and see just how far I can go (literally and figuratively). I'll back off a bit if I experience an increase in pain or stiffness or decrease in ROM or mobility.
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` that`s bad luck - however you will take extra  care  = keep posting

Best JohnK4221  Manchester UK 
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Back on this forum after 10 years. Ruptured left patellar tendon back then playing football. Pretty much full recovery but always a bit weak. Never went back to football but golfing, running and hill walking. Of all things did the school sports egg and spoon fathers race and managed a bilateral rupture. Both knees operated on and surgeon happy. Back in ROM braces and at 30 degrees 2 weeks post op. No weight bearing and in a wheelchair. Anyone active on here done the same as wandering how ,inch longer recovery time may be for both….
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@skishikes ignore Felix, you're doing just fine. Supplements have a marginal effect at best. The most important element of stem cell therapy is choosing the right clinic and Regenexx is by and large the best, based on my extensive research.

And those comparisons with European practitioners are not useful either. Our market baskets are totally different. ;D

The only thing that Regenexx has proven well - is that it's safe (no adverse reactions). The studies supporting that it works in treating cartilage damage are very low quality/less effect than UC2 collagen (which is the food additive with the highest quality positive research).

In order to prove that Regenexx works - there would need to be a double blind study comparing it to another proven treatment (like ACI). Regenexx charges so high prices that they could easily afford such a study. The fact that such a study doesn't exist is quite telling (instead they did a big study proving that it is safe).
Alone the process of taking a longer break, then doing rehab - likely has a bigger impact then those stem cells they inject.
There are 2 things I really don't get over Regenexx - a) price b) that it kinda has a rehab that isn't much shorter than from ACI.
So why get Regenexx if you could get some proven treatment like ACI with the same rehab. If it's about price then go for minced cartilage surgery which will be about the same price as Regenexx but with small scale studies so far showing actual great effectiveness (for long term studies need to wait another 4-5 years until the 5 year studies will be published).


For grade 2-3 osteoarthritis I think getting full muscle back for example with a high quality BFR cuff would show way more promise. Making sure that your diet is not junk food/no sugar, no muscle disbalances - and you are on a better track.

So far there is not much track record for stem cells solving any kind of bigger problems in real life (be it cancer, arthritis or other problems where stem cell advocates thought a simple injection may cure it). ACI/MACI is not stem cell treatment but specialised cells.
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Injury

19M, no history of knee injuries, very active, rowed competitively for a bit.

Around 3 months ago I tore my lateral meniscus in my right knee squatting. The first two doctors I saw thought I had bursitis, and the tear was only diagnosed correctly on week 7 post-injury after I went to an orthopedic specialist. A MRI confirmed the tear on week 8. The MRI revealed a tear near the anterior horn, extending from the free edge nearly to the lateral edge.

Pain

For around 8 weeks prior to my diagnosis, I was in fairly severe pain. Note that I was following the RICE method throughout all of this, but the only thing that decreased pain was time. Additionally I was in college, and throughout my recovery I never went to class because of the pain (thank goodness for recorded lectures).

(1-2 weeks): Walked with a limp, continous pain, could not bend my leg without pain. Squatting was out of the question. Going up and downstairs was very painful. Physical activity of any kind was out of the question.
(2-6 weeks): No limp, pain was brought on by walking more than ten minutes. Still pain when going up and downstairs.
(6-8 weeks): At this point I started physical therapy. My pain had decreased significantly, I was back to my daily routinue, and I felt a lot better mentally and physically. Had my MRI around Week 8. I was hopeful that I wouldn't have to get surgery on my knee. Then I went to a concert that caused lots of pain the next day, then was dropped on my knee after being lifted up.
(9 weeks): Went back home from college early after my ortho told me I'd need surgery, was devastated, but I had essentially no pain. Occasional flareups, but nothing major. Still can't squat without pain. Running, and jumping is out of the question. Occasional pinching in my knee.

Current Outlook and Questions [Advice Needed]

I got a second opinion the week I went home, and I was told because of my decrease in pain, it wouldn't hurt to do a followup MRI in a month to see if there had been any healing. Unfortunately, that MRI showed no healing, the tear remained the same, but I didn't have any OA development and everything else in my knee came up clean.
 
Fast forward to now, we're around 3 months post injury, with the occasional pain flareup, but mostly no pain 90% of the time. Noted, I've had to significantly modify my activity level to accomadate for my injury. I don't run, jump, or squat, and its an ever-present worry that I might injury my knee further. I also don't want to shred up the remaining structure.

Because of this, and because conservative rehab didn't work, I've opted to have meniscal repair surgery done. In five months I want to be back to my previous levels of activity, without worrying about my knee.

Here's what I was told: I'm young, and due to the nature of my tear, 2/3 of it is in the red blood zone. I was told that the success rate would be around 70%-80%, and I may only experience partial healing. All things to think about as I look for surgeons.

Has anyone been in a similar position? And if so, what did you do?

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Thanks for the detailed information. Wow that makes it even harder to decide. If I lived in Australia or US I would know what to order. I may rather go for smartcuffs then, and hope they are more reliable.

91 % is really a great result.
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