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Author Topic: opinion needed re 13 year old daughter's knee  (Read 56082 times)

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Offline Janet

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Re: opinion needed re 13 year old daughter's knee
« Reply #15 on: May 09, 2005, 08:04:32 PM »
If it hurts to put weight on the leg, she can still walk with a "normal" motion while on crutches. I was instructed to do this from the first day post-op, even though I was completely non-weight bearing on that leg. It keeps the knee moving in a normal pattern, but doesn't cause the pain that weight-bearing does. People make two mistakes when using crutches. One is to take too big of a step....putting the crutches too far out in front. Keep the crutches in the same range as she would if she was walking. The second is to hold the knee in a bent back position or straight out in front. If there is no reason for keeping the knee in one position, have her practice using the crutches with a walking motion.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #16 on: May 10, 2005, 12:54:31 AM »
Hi Janet,

Thanks for writing me.  My daughter said it hurts when she trys to put full pressure on her leg when walking.  She really can't bend her leg hardly at all.  She tells me she feels pain right in the middle of the kneecap.  I phoned the doctor after hours today - the only way I figured he would talk to me and I wouldn't have to deal with his receptionists.  Anyhow, they paged him and he phoned (a miracle) and he said she was to put full pressure on her leg when walking and that it wouldn't cause further damage???  I don't know - all I know is that it's 2 months of this and I am about to hit the roof or get thrown out of the doctor's office by the next visit:)  I tell her to walk on it and she starts to cry and I feel bad.  She is tolerating the pain but is definitely in pain.  I just have to keep pushing along until some doctor tells me something that makes sense regarding a diagnosis.  Thanks again for writing.  I agree, by the way, that she has to use her leg so that it doesn't enitirely stiffen up on her as that would not be really good.  Now I'm just waiting for her to take this bone scan - does anyone know what tests there are to show muscle/nerve damage?  Oh well, it's getting late so I'm gonna sign off for now.  Have to get my two teenagers ready for school tomorrow.  Her brother is 14 - between the both of them it's amazing I am sane:) 

Hope Tuesday is a good day for all!

Hugs,
Lisa

Offline Teresa_S

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Re: opinion needed re 13 year old daughter's knee
« Reply #17 on: May 10, 2005, 01:23:04 AM »
There are many types of bone scans, and if you know which kind she is having it would be easier to explain. A tagged WBC scan requires her to go in early and have blood drawn and then it is sent to the lab, and the red cells are removed, and then it is reinjected several hours later, and then she is scanned. THE increased uptake signifies injury, infection, necrosis, etc. THere are others where she is injected and comes back in 24 hours  to be scanned. Nerve testing is generally done by emg, where multiple tiny needles are stuck into nerves for response. If you can get the exact names of tests, I will try to explain them to you. As for the pain, did he give her meds, if not, how about the family dr.Nothing that knocks her for a loop, but something that eases the pain, lets her relax, and not be on edge. Good luck, Teresa
On going instrumentation failure, chronic infection,
Arthroscopes Left 11 Right 2, MRSA, L TKR  ,  Revision, LR x5, Medial and lateral meniscus repair, Broken prosthesis
Osteochondral Fracture,untreated 6 mths. Revision new tkr 01-07 awaiting new hip and right knee
R TKR pending

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #18 on: May 10, 2005, 05:02:12 AM »
Hi Theresa,

The bone scan she's going to have on 5/20 is of her hip and knee.  She is to go to the hospital at 9:30 a.m. and they inject her with some nuclear stuff and then she is to go home and drink a lot and come back 3 hours later for the scan which takes about 45 minutes.  So, hopefully, this will either show or not show what's going on.  All I know is that she can't really bend her knee at all without pain and it looks so distorted - off to the inner side of the leg.  Feel like I'm repeating myself from previous posts.  Sorry it hurts to see her limping around on the crutches.  Anyhow, I will keep the board posted when I get the results of the scan, and see what the next step is.  Thanks again for caring and writing!

Hugs,
Lisa

Offline sparkle999

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Re: opinion needed re 13 year old daughter's knee
« Reply #19 on: May 10, 2005, 08:33:42 AM »
Hi sorry to hear she's still in pain, worry and discomfort. THis post may not help but it's worth a shot.

I have been unable to put full weight on the knee now for 7 weeks (had arthroscopy yesterday with good news!) One of the things Janet was saying is what my PT advised. I'd had the crutches set to the wrong height and was leaning when walikng. Once set to the right height, she showed me how to use the crutches so that it didn't affect my gait. That was to put equal weght on the crutches, take small steps and really concentrate at allowing the foot to (very very lightly) roll from heel to toe along the floor to keep as normal a notion as possible. If you do it properly it looks like there's nothing wrong with the knee and that is when your gait is normal.

I don't know if this helps and please don't get hacked off with people giving advice that she just can't do. I know what that feels like but hopefully we'll ALL find something to help her soon. I'm hoping the bone scan will show stuff up.

My OS was surprised when he did my scope. He thought I was developing arthofibrosis, but it turned out all the blockages were where stuff had stuck to the snapped ligament and the cartilege that had broken off. They do get the wrong idea in thier heads sometimes.

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

Offline trekker05

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Re: opinion needed re 13 year old daughter's knee
« Reply #20 on: May 10, 2005, 01:10:37 PM »
Hi;

     Let's try a SLIGHTLY different approach to this problem.  The problem with a lot of doctors, and unfortunately, therapists, is they depend too much on x-rays, MRI's, CT scans, etc.  If nothing shows up, they don't know what to do!  I'm not exactly sure  what type of injury she has and how it occured, but let's assume that the bone scan comes up negative.  Nobody seems to have looked at what her muscles are doing.  Irrespective of what initially occured, she has already developed muscle imbalances, guaranteed!  Are there any muscles that are in contracture, i.e. spasmed?  These will not show up on tests, but if she is having this occur, it will inhibit Range of motion, movement, and affect normal joint balance and patellar tracking.  The great thing about these issues is that they are correctable with the proper work.  Why is it that everybody seems to jump on the surgery bandwagon?  All you are doing is further disrupting the knee!  Find someone who is knowledgeable in manual therapy, muscle balance, trigger point or muscle release techniques, and corrective exercise, have them do a TOTAL BODY kinetic chain evaluation, and work with them!  And if the doctors can't find anything on any of the maging tests, don't settle for anyof those waste of time surgical procedures! 

Offline trekker05

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Re: opinion needed re 13 year old daughter's knee
« Reply #21 on: May 10, 2005, 01:30:56 PM »
Hi again; just found your original post.  Sounds like she had what are colloquially known as "squinting kneecaps."  This is a sign of what is known as Patellofemoral Syndrome.  It is a tracking problem that can be aggravated by overuse, injury, impact, etc.  She may have had this before the injury....it is NOT normal by any means!  Some of this may have corrected as she grew up; unfortunately, she had the injury.  Based on what you've said, it sounds like she may have a case of femoral anteversion and tibial torsion.  If your doctors or therapists don't know these terms, they're not worth the ink on their degrees!  Apparently the impact caused trauma to muscles or other structures stabilizing the kneecap, and as the trauma weakend the structures, part.  muscles, over time, they finally were not able to overcome her mechanical imbalances and her patella dislocated.  Do what I mentioned in the previous post.  Too bad you're not in Southern California.

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #22 on: May 10, 2005, 11:39:54 PM »
Hi Sparkle, Hi Trekker - Sparkle thanks for the post.  First I really hope they now know what to do for you since the scope.  These doctors - I tell you can drive you nuts.  Good luck with your doctors.  Supposedly her crutches are at the right height according to the physical therapist we went to before we were told to stop therapy.  We just have to wait for the bone scan and God knows what next.  Trekker - I'm going to mention the terms you wrote - anteversion and tibial torsion and see if they know what they mean.  If he orders her back to therapy after the bone scan, well first I'm going to try and see another doctor up here and then mention what you said Total Body kinetic chain evaluation.  I do agree that surgery is the very last thing I would want for her.  From a lot of the posts on this site I noticed that so many people have more problems after surgery.  She never had any tracking problem growing up.  This all occurred right after the injury - about 1 week after the injury the maltracking was noticed by her.  It definitely was the impact that caused all of this.  You wrote "trauma weakened the structures, part. muscles etc.  What does the abbreviation part. stand for - partial?  You sound very knowledgable about all of this. 

Thanks Sparkle and Trekker for writing.  All this information helps me try and sort things out for myself as these doctors aren't any great help.  Can't wait till they do this bone scan, which I have a feeling will show nothing.  But ya neva know:)  The doctor never mentioned anything re muscles except therapy when we did go mentioned strengthening the muscles which caused her pain sometimes all night into the next day.  That's why we stopped therapy re doctor's orders.  Though I don't have too much faith in this doctor right now.    Speak to you later.  Have to finish cleaning up dinner dishes and then sit down with my kids and watch American Idol:)

Hugs,
Lisa

Offline cat

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Re: opinion needed re 13 year old daughter's knee
« Reply #23 on: May 11, 2005, 12:08:25 AM »
This is an example of 'squinting patella'-.
 

cat
"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

Offline jillo

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Re: opinion needed re 13 year old daughter's knee
« Reply #24 on: May 11, 2005, 02:20:49 AM »
If she's in that much pain I wouldn't make her walk on it.  Teenagers are pretty tough and I can't imagine sh'es making it up.  My personal experience has been that doctors do not give nearly enough credence to a patient who feel that walking on an injury is NOT a good thing and that there is something very wrong.  Find another doctor, at least for a second opinon.  Maybe try a trauma specialist?

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #25 on: May 11, 2005, 04:41:28 AM »
Hi Cat,

Gosh the knee facing me in the picture you sent on the right (guess it's the left knee really) looks very similar to my daughter's.  Just curious what do they do if it's squinting patella?  Thanks for the picture!

Hugs,
Lisa

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #26 on: May 11, 2005, 04:47:10 AM »
Hi Jillo,

I agree teenagers are very tough.  I know she's not making up the pain.  I tell her to try and walk on it and then I say don't walk on it if it hurts too bad.  I don't know what to tell the kid.  She is on the verge of tears so much as she is getting tired of having to walk around in school on the crutches and wants so much to wear short skirts for the summer.  I just keep telling her it will get better but it's going to take time until we figure out the problem.  Wish the doctors could walk in her shoes for a mile and see how they feel!  And I am definitely going for another opinion and another etc. until something makes sense to me.
Thanks for your concern.

Hugs,
Lisa

Offline trekker05

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Re: opinion needed re 13 year old daughter's knee
« Reply #27 on: May 11, 2005, 12:00:25 PM »
CAT, thanks for posting the picture so "Upset Mom" can see what I'm talking about.  Upset Mom, part. means particularly (muscles).  Sorry about that. The issues your daughter has are reversible with the proper therapy.  Typically people may be able to "ride out"  some of these types of issues early in life until trauma, certain activities, etc. create a stress that magnifies the imbalances.  There is a good chance I could alleviate a good deal of your daughter's pain, if there are no imageable injuries, within 5-10 minutes; however, dealing with the imbalances that predisposed her to this would take longer.  As I said, however, it IS reversible.  Try to find someone who can release/relax her IT band; then take a look at whether her Rectus Femoris is hypertonic or too tight.  That might work in relieving a lot of her pain.  By the way, that condition your doctor mentioned that she might have...never heard of it.  That doesn't mean it doesn't exist, but.....?  Maybe someone else can tell me what it is.

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #28 on: May 11, 2005, 10:07:19 PM »
Hi Trekker,

I think I spelled the condition wrong - probably still will - he said patella femoral syndrome.  Anyhow, wish you lived next door so you could alleviate her pain:)  And it is definitely encouraging to know that it IS reversible.  I hope an pray you are right.  My guess which is completely uneducated in this area is that they most likely will send her back to physical therapy.  If they do I will write down your comments and mention them.  Thanks for writing.

Hugs,
Lisa

Offline morgan515046

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Re: opinion needed re 13 year old daughter's knee
« Reply #29 on: May 15, 2005, 04:18:24 PM »
hi my name is morgan and im 14 almost 15 and i went to the doctor to and he told me that physical therepy would help and i would be better in 3 to 4 weeks but when i went (been going for 2 weeks) 4 seessions and they told me that i need to bend it and that i was tensed up but im not it is that i am in alot of pain. so jsut to let you know im in the same situation as your daughter and im here if she ever needs to talk about it cause i think im going through the same thing

best wishes
-morgan-
« Last Edit: May 15, 2005, 11:35:16 PM by morgan515046 »
*14 years old*

3/29/05 Track hurdle incident
7/6/05 surgery for menisectomy
8/9/05 Possible RSD???
10/11/05 Patella Tendonitis from not rehabing all the way.

VOLLEYBALL ROCKS!!!