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Author Topic: opinion needed re 13 year old daughter's knee  (Read 52301 times)

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Offline upset mom

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opinion needed re 13 year old daughter's knee
« on: April 30, 2005, 05:53:05 AM »
My daughter has just finished her second week of physical therapy (5 sessions so far).  They are doing exercises to get her to strengthen her muscles, one where they lift her leg up high.  She seems to be in more pain from the therapy and told me she couldn't sleep well last night as her muscles felt strained in the back of her knee.  They say it's patela femura related - the injury - and that she is very tense and stiff when they try to work with her. Would you believe, one therapist said if she wasn't 13 years old he would push her off the table onto the carpet because she's so stiff and tense.  He sort've mumbled it.  Unbelievable!  She tells me she's not tense but in pain.  It now is going on 2 months since the accident at school and she is still limping, on crutches to help her walk correctly.  The OS who sent us to therapy didn't even want her to use crutches - it was almost like they feel she's making this up and saying she's favoring the other leg.  She limps so bad without the crutches.  My question is this - does anyone know how long after starting physical therapy there should be an improvement with the pain and alignment.  The therapists can't answer that - I am going to play out the therapy course and then pursue another OS.  I'm sure I must've wrote this somewhere before but guess I'm getting frustrated after seeing no improvement and it's going on 2 months with her limping.  The therapists sometimes hold her leg and work the knee and then say "look it is aligned now" but as soon as they stop holding it the knee looks off track.  I guess I don't have much faith in this therapy thing.  Once again, sorry to complain but just want to know if any of you guys had more pain after starting therapy.  I've heard it does get worse but I don't see any improvement.  Thanks for listening.

Lisa

Offline casey2291

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Re: opinion needed re 13 year old daughter's knee
« Reply #1 on: April 30, 2005, 02:43:10 PM »
Hi,

I'm sorry to hear that your daughter's knee is not getting any better.  It is my opinion that a good PT will know when therapy is no longer beneficial and when to send a patient back to the doctor.  My problem is totally different than your daughters, but I tried the PT route before my surgery and had six sessions of PT over a three week time period with increased pain before my PT sent me onto an OS.  You could always pursue a second opinon right now even while your daughter is getting PT.  Also, if you don't like the PT that your daughter is working with, you could always try a different PT in the clinic.  Go back with your daughter while she has her sessions and just kinda check out the other PT's and see which one you think is doing a good job with their patients.  I've watched each of the PT's in my clinic and I make the decision as to who I will allow to treat me.  Good luck.  I hope your daughter gets some relief soon. 

Casey  :)
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #2 on: April 30, 2005, 06:48:02 PM »
Hi Casey,

Thanks for writing.  Guess we'll continue the pt route.  Actually we've been to 2 OS's - and they both seem to have said the same thing re doing pt.  Of course, where I live, the doctors all know each other - work at the same hospital (at least these 2) so if I go for a 3rd opinion, I'm going to try and go out of the area if possible.  Thanks again - hope you are feeling alright these days.

Lisa

Offline Ronxski

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Re: opinion needed re 13 year old daughter's knee
« Reply #3 on: May 01, 2005, 09:17:19 PM »
My OS and PT told me that I should take whatever pain med was recommended for me an hour prior to PT or right after PT. I took it before hand so I could get more benefit out of the session. I still had some pain when doing the PT. And everyone I talked to while we were exercising said the same thing. Did they tell you that? And when we got done with each session we were told to go home and do the elevate and ice it.

I have found you have to ask every little question. They do their jobs so often in PT and OS that they begin to assume you know what to do. I go by what one of my teachers said.  The only dumb question is the one not asked...
partial meniscus removal, posterior horn of medial meniscus tear,horizontal cleavage type. Dec. O4
Age 56
back to cross country skiing and biking.

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #4 on: May 04, 2005, 04:42:26 AM »
Hi Ron,

Yesterday, Monday 5/2 we went to physical therapy and the therapist made her lie on her stomach and raised her leg, bending the knee.  She was wincing and told him to stop, it hurt.  He applied ice before we left.  When we got in the car she started crying as she was in a lot of pain.  They keep saying she's very tense and has to relax but that's her makeup so to say and she can't relax any more than she's trying to.  Anyhow, I phoned the OS who said stop the phy. therapy and bring her in Friday.  Her knee looks so distorted - it is really misaligned, off to the inner side of the leg.  Patients in the waiting room of therapy looked at her leg and said there is something really wrong.  It is so obvious to anyone who sees it, yet the MRI and xrays showed nothing.  They say she's babying it because of the pain, but this kid wants to run and play and not limp and drag her leg.  She wanted to get involved in cross country running and I know she's not trying to nurse the pain but really wants to walk and look normal again.  Thanks for your advice.  I agree that there is no dumb question.  Believe me I question these therapists and the 2 specialists that she saw so far but am not comfortable with their answers.  So, if Friday's appointment doesn't go well, I will seek a third OS opinion.  It's been 2 months since the accident in gym and no improvement.  Will keep the board posted and I really appreciate all the advice and support we're getting from everyone here:)

Lisa

Offline sparkle999

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Re: opinion needed re 13 year old daughter's knee
« Reply #5 on: May 04, 2005, 08:46:21 AM »
I've just been sant back to the doc after PT not being helpful. I tried 3 weeks and made little progress but had lots of pain.

One thing that was good for me was the PT talking about pain on a 1-10 scale. I said my initial injury was about a 9 out of 10 with pain. My PT then said that my exercises should mainly be a 4 or 5 pushing into the 6 to try and get flexion back. She never pushed beyond when I said stop. My PT reckons this just increases tension as you lose trust and get scared of the pain coming suddenly. This helped alot as it stopped me feeling scared of how much pain I was going to feel. I also took pain meds 1 hour before PT and cried sometimes afterwards just with the hopelessness of it. Oh. And the other helpful thing I was advised was that my knee should not ache at all half an hour after finisning doing PT exercises. If it still hurt then, she said I was overdoing it.

Good luck with the appt on friday. My own OS has decided to do a scope to see what's really happening as the PT wasn't doing what it should. My OS was initially quite dismissive of me, as though I wasn't trying hard enough, but I reckon that was just to make me give it my all. When I last saw him, after trying PT, he was really different and helpful. I hope you feel better after Friday. It's nervewracking before an appt as, if you're anything like me, you want to be stong and say all the right things but sometimes end up feeling emotional or a little angry. I feel for you. I'd rether have my own knee hurt than either of my daughters' knees.

You sound like a really caring mum trying to do the best for her daughter. Hope you get some answers soon.

xx
35 y/o
ACL rupture
loose body under kneecap
impaction fractures
injury 19th march 2005
scope 9th may
recon 24th october 05

Offline nikki michel

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Re: opinion needed re 13 year old daughter's knee
« Reply #6 on: May 04, 2005, 12:12:06 PM »
hiya lisa

firstly im sorry to hear about your daughter but i know exactly how she feels, my knees have been bad since i was 12 - im now 20 and dislocated my right patella in january 2005.  :-[

although physio is good -(ive been doing mine now for 7 weeks) the problem might be more internal that what they think, what did she do in the 1st place to cause the injury???

has she had an MRI scan done?? this would show up any problem areas with regards to torn ligaments or cartilage damage, they shouldnt be exercising her knee if they havent done a scan - as this could definitely make it worse!!!!! and also where does she experience the pain in relevance to her knee?? - is it on the inner side of her knee or under the knee cap itself or at the back??

she shouldnt really be applying any unnecessary pressure on her knee unless she has too, so make sure she rests and has her leg elivated on the sofa or on a chair....but you also need to ask the physio what implications this is going to have on her hip and back!! if shes been limping this long without a MRI scan or a full investigation then thats definitely worrying and i would personally speak to a different doctor.

Nikki x
Nikki Michel

Age 20
Jan 2005 - dislocated right patella

Offline nikki michel

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Re: opinion needed re 13 year old daughter's knee
« Reply #7 on: May 04, 2005, 12:18:19 PM »
sorry lisa, nikki again, i just read a follow up comment about her having an MRI scan, when i 1st dislocated my knee i had a scan done 2 weeks after and it showed up clear and everyone thought it was 'laying it on a bit thick' - as we say in london! but I KNEW there was something wrong....

i have since had the plaster cast removed and been in a supportive brace for 3 weeks now and i had a 2nd MRI scan done last wednesday which showed that i have a tear in my cartilage which will require keyhole surgery in a few weeks time.........i would definitely request another MRI or even a bone scan

Nikki x
Nikki Michel

Age 20
Jan 2005 - dislocated right patella

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #8 on: May 05, 2005, 04:34:13 AM »
Hi Sparkle and Nikki,

I couldn't get in to post individually to each of you so am including you both in this post:)  Thanks for writing.  And, Sparkle, I am just like you said - worried I'll forget what I really want to say when at the doctor - maybe I'll write it down before I go in with her Friday.  And, yes, Nikki, her hip is hurting her from limping - there is definitely something wrong.  The doctor and PT say her hip hurts because she is walking wrong, well duh, how can she walk correctly if she's in pain?  Just hope I get some answers on Friday that make sense to me, but if he doesn't make me or her feel any better, I am going to ask for a copy of his records re diagnosis and complete chart and will make an appointment with yet a third OS.  I will try and post a note on Friday evening after the OS appointment.  Thanks for all your support.  This is such a great and caring knee site.  It's good to know that we're not alone although I wish all of you had no pain.  Hope the remainder of the week is happy for you.  Speak to you Friday, hopefully.

Hugs,
Lisa

Offline nikki michel

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Re: opinion needed re 13 year old daughter's knee
« Reply #9 on: May 05, 2005, 12:00:38 PM »
good luck xxxx
Nikki Michel

Age 20
Jan 2005 - dislocated right patella

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #10 on: May 07, 2005, 12:56:08 AM »
Hi,

Well here's the scoop - Took her to doctor today as you know.  He asked her how she was feeling and she said "not so good".  She told him her hip hurt and about the pain in her knee.  He asked her to show him where it hurt and she pointed to the middle of her knee.  He said he was going to take some special xrays of her hip and knee but then after walking out of the office to get one of the girls for the xray he suddenly came back and said he wanted to do a bone scan instead to look for small cracks in the bone.  So we are scheduled for a bone scan on May 20th (first date the hospital had) for right hip and to rule out fracture in right knee and see why she is hurting.  When I asked him what does he think, he said "She injured herself really bad" well - duh as we say in the states why didn't he figure that out over a month ago?  I didn't ask for the records yet as I will have the scan done and see the results - plus, the office manager was really "rude" and I told her she was "rude" when I asked her for notes for my daughter's church confirmation retreat which has physical activity and I was trying to get them to schedule an appointment for the scan that fit my job time.  Sorry I got off track talking about that woman (smile) but boy we were glaring at each other:)  Anyhow, what do you know about bone scans?  Do you think that is a good idea?  I saw on this site the name of a doctor in N.Y. but don't know if I can use her health insurance to go out of Pennsylvania.  I'm a little stressed to say the least so bear with my rambling.  I do telemarketing work all day so guess I'm in talk mode or guess type mode right now.

I better sign off before I write a novel:)

Love and hugs,
Lisa

Offline John1

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Re: opinion needed re 13 year old daughter's knee
« Reply #11 on: May 07, 2005, 09:23:59 AM »
Good luck to your daughter. I'm sorry to hear that you had such a bad experience with the office manager.

It's good that the doctor is finally taking things seriously. I wouldn't be surprised if your daugther had a torn or partially torn ACL. I just read that partial tears are more dificult to diagnose with an MRI. Also, if the patient is tense and in pain, it's hard to perform the manual test to determine if the joint is loose from a tear. And you've said that a boy fell on her leg, which could have easily torn a ligament. Hopefully the bone scan will show something or not and the doctor will be able to come up with a better diagnosis. If not, maybe he knows another doctor that can make the correct diagnosis.

Good luck,
John  :)
4/12/05 Arthroscopy: plica removal and medial femoral condyle microfracture (2 cm^2)
11/9/05 Arthroscopy: complete removal of plica, removal of scar tissue on fat pad behind patella tendon and on medial side.

Offline sparkle999

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Re: opinion needed re 13 year old daughter's knee
« Reply #12 on: May 07, 2005, 06:03:35 PM »
A bone scan will show all sorts of extra stuff.

It seems to be the way these OSs are that they try to say it will all get better with PT and then really start listenening only when the PT doesn't work. A similar thing happened to me and after weeks of PT not working he was like a different person who was willing to listen and take some action. Hope the bone scan gives you some answers. It's frustrating all this waiting around, especially when you don't want her missing school or social activities. I'm a teacher and I hate missing school and social activities too. My OS decidied to do a scope which I have on Monday and I'm hoping for some answers after that.

Good luck to you and your daughter
xx
35 y/o
ACL rupture
loose body under kneecap
impaction fractures
injury 19th march 2005
scope 9th may
recon 24th october 05

Offline nikki michel

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Re: opinion needed re 13 year old daughter's knee
« Reply #13 on: May 08, 2005, 12:15:33 AM »
ahh well at least you have both been taken seriously! - thank god for that!!! she knew something was wrong and its about time these doctors started listening - instead of assuming they 'know what the problem is'.....

bone scans are excellent, unlike an MRI - which shows water, ligaments, muscle etc a bone scan is much more specific to the area thats causing her problems - hopefully this should show up whats causing her pain and they can quickly sort it out - for her sake - believe me i know how she feels!!!! it took my doctors 6 weeks to listen to me when i requested a 2nd MRI scan!

and what is it with doctors receptionist and office managers???!!! in england you cant make an appointment with your local doctor without the nosie receptionist asking you "the reason for the appointment" - gossip queens i tell ya! (sorry im now drifting waayyy of the subject!)

but im glad all's well - or at least is better than before, keep us all posted! give her my love! xxx

Nikki Michel

Age 20
Jan 2005 - dislocated right patella

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #14 on: May 08, 2005, 11:34:02 PM »
Hi,

Thanks for all your input regarding the bone scan.  Guess I will just have to sit tight and wait till May 20th to see what it shows.  We just got in a little while ago from the Mall.  Her leg is really hurting her.  The doctor never told us if she should put weight on it with the crutches or not to.  I forgot to ask him.  He probably will say she should go by how she feels.  He doesn't say much - he has a monotone personality if you know what I mean - very emotionless.  I just think that if she doesn't move it, it will stiffen up but then if it's an injury I know nothing about if it would get worse to use it - I'm a little confused here.  To those of you in England or U.K., do you celebrate Mother's day as we did today?  In any case, I wish you all and/or your moms a happy mother's day!   And to Jen I couldn't reply to your message so hope you are reading this - yes we are in Pennsylvania but up in the Poconos - a long drive to Philly and other parts.  Besides, I don't think her health insurance covers too much.  In any event, I am just going to wait for the bone scan and then take it from there. 

Hope you all have a great week and thanks again for the messages and support.  Hey, they should have a knee-geek get together and we could all meet:)

Hugs to all of you!
Lisa and Heather