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Offline cyndezu

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Has doc "botched" my knee?
« on: January 31, 2003, 03:55:51 PM »
Hi all, new poster here.
I wish you all a miraculous recovery :D
I'm 5 1\2 months post acl allo w\ meniscus repair and patella shaving.
Since surgery I have been unable to extend my leg... I have terrible pain under the knee cap, but I can extend it with help from the other leg. Also I am unable to do stairs or walk down grade in hilly TN. this also causes the same pain.
My doc tells me every month keep working on those quads! My quads have shrunk to about  1\12 to 2 inches smaller than the other, does this sound like the answer to my problem ??? Is anybody else having this problem?

     thank-you  Cindy
acl allograph, meniscus repair, patella shaving
August 23, 2002

Offline oneillii

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Re: Has doc "botched" my knee?
« Reply #1 on: January 31, 2003, 04:35:58 PM »
Hi Cyndezu,

I am relatively new here myself (post arthroscopic surg/partial menisectomy 11-06-02) but just wanted you to know that I am having the EXACT same problem.

I have gotten a second opinion, as well as seen 2 different physiotherapists. They all say it is maltracking due to weak quads.

Read back in the forum under Patello-femoral issues for more talk about quad strength/strengthening exercises. Also in the Soft Tissue Healing forum Heather M. has a post about the e-stim machine that you might be interested in.

Don't be freaked out...it just takes a really long time. If getting a second opinion helps, by all means do it. However, I have learned the hard way that you just have to go at the pace your body sets for you (in addition to doing those exercises of course).  I am now 12 weeks post op and only yesterday cleared by my OS to return to swimming. Take care, Susan
arthroscopy 11/06/02

Offline Janet

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Re: Has doc "botched" my knee?
« Reply #2 on: January 31, 2003, 04:49:48 PM »
Yes, it could definitely be from weak quads. I would guess that you had PT?? Are you still in PT? If not, you need to continue strengthening. It takes a long time to build muscle mass, and the longer your quad is weak, the harder it is for it to come back. If you don't know specific exercises to strengthen your quads, perhaps your OS would give you a script for a couple of PT sessions to learn the proper techniques.

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 cyndezu

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Re: Has doc "botched" my knee?
« Reply #3 on: January 31, 2003, 06:07:51 PM »
What!!! no freaking out? I'm afraid its too late. I have become accustomed to it ;)
I have had pt for about 5 months now with a well intentioned good hearted natzi that pushes me through exercises even though they cause pain and have left there more than once limping and suffering setbacks.
I now intend to drop out and take charge of my own rehab at the gym, at my own pace! I have my finger's crossed :-X Just the other day I taped it my self and went to the gym, it felt significently better the next day.

Cindy
acl allograph, meniscus repair, patella shaving
August 23, 2002

Offline oneillii

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Re: Has doc "botched" my knee?
« Reply #4 on: January 31, 2003, 09:52:57 PM »
Hi Cindy

Well I think we all know what happens when we push through pain...and most of us here are smart enough to know good "pain" (i.e. ooh my glutes are BURNING) and bad pain ("my joint feels like it's on fire")

I have done the same as you: cut WAY back on the PT (BTW my OS even said perhaps they were pushing too hard and I should self-supervise at gym). I got a trainer at my gym who also happens to be a licensed PT...so we will keep doing that until my Visa reaches its limit lol.

I am finding that the most important thing is patience, and not punishing my body by forcing it to do things it's not ready to do. Very tough lesson for a former athlete, but I remind myself of all I CAN do rather than focusing on what I can't...Anyway I wish you the best of luck...and anytime you want a full "freak-out" pity party session you can find me here! S
arthroscopy 11/06/02

Offline cyndezu

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Re: Has doc "botched" my knee?
« Reply #5 on: January 31, 2003, 11:26:02 PM »
Well,  could just smack myself silly :o for being sooo stupid allowing myself to be hurt but I really did'nt know what else to do... after all that initial bending for rom and being told over and over "well it's gonna hurt" dummy. I was hoping my pt knew better, I'm crying UNCLE and and moving on.
I wish my glutes would burn thats the only pain I want now, but because of the excruciating pain I'm unable to do squats :'(.
Does anybody know if I can still succesfully build my quads? I am trying to be only a little freaked out but, unfortunatly? (oops) there are many post's here about quad atrophy that are a little scary.
I use the recumbent bike, leg press (only 40 lbs.), leg curls (30 or 40 lbs.) and gobbs of leg squeezing ( hip something or other machine) at 90 or 100 lbs. There are many different kinds of  equipment available but these I'm most comfortable on.
any encouragement or suggestions would be appreciated :)

Peace and good luck to everyone,
      Sincerly, Cindy :)
acl allograph, meniscus repair, patella shaving
August 23, 2002

Offline Heather M.

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Re: Has doc "botched" my knee?
« Reply #6 on: January 31, 2003, 11:36:43 PM »
Cindy,

Weak quads can make your knee a disaster waiting to happen.  But it hurts too much to strengthen them, so they stay weak and you are trapped in a vicious cycle.  I was in the same cycle from June to December of last year.  I was ready to quit PT and limp for the rest of my life, but instead found a new PT and a new doctor to tackle my problem.  So before you throw in the towel on PT, it might be good to try finding a therapist who knows how to rehab knees.  PAIN is not a good thing during PT, period.  If you get sharp pain doing an exercise, your PT should stop you and find some other way to work the muscle that doesn't hurt your joint.

A personal trainer who also has a certificate in PT might be a good compromis, but make sure they are able to offer the full array of PT treatments.  Because there are a lot of things that can be done at PT--different modalities, ultrasound, e-stim, biofeedback--that can help a) target your problem areas and b) make your knee feel better so you can exercise in the pain-free zone.

You might check around for the best PT clinic, preferrably one that deals with athletes and performance enhancement as well as post-op patients.  

The only other advice I have would be to be patient.  You had major work done in there with your meniscal repair, and it's going to take a while to feel like yourself again.

Take care.

Heather  
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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Offline oneillii

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Re: Has doc "botched" my knee?
« Reply #7 on: February 01, 2003, 02:18:42 AM »
Cyndezu,

Ditto what Heather said--my trainer at the gym cannot offer me ultrasound and e-stim; I have kept on with my assigned PT for that (besides really liking her).

Girl, I can't do squats either! LOL! Please give yourself a break...FYI after 10 weeks of therapy I was able to do "mini-squats" with no pain...like I said, it is S-L-O-W

PS Have they looked at your feet at all? Apparently mine are rolling in due to extra high arches that need support...should take pressure off of that medial area and make it easier to rehab... Take care and have a good weekend! Susan
arthroscopy 11/06/02

Offline Janet

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Re: Has doc "botched" my knee?
« Reply #8 on: February 02, 2003, 06:34:03 PM »
Are you using the leg press one leg at a time? I found that when I used both legs, my weak one was just following along. I have slowly built up to doing 70 lbs with my bad leg (I can do 140 with my good one). I increase the weight by 5 lbs every two weeks or so (or if I feel I am ready). It might be worth a try.

The other thing that may help is the stepper. They actually had me do this in therapy, standing on the floor with my good leg and pushing down on the stepper with the weak leg.

The bike is a good thing to use, as is an ellipitical machine. Stay away from the leg extension machine....it is too hard on the knees. You can always do wall squats, even if you can't go down very far. Go down as far as you can comfortably and try to hold for 30 seconds.

Remember, when you are starting a new exercise, you dont' have to do 3 sets. Begin by pushing yourself just a little. Even if you can do one set of eight, it is better than not doing it at all. Good luck and keep working at it. Building quad can takes a long, long time (months and months and months).

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 cyndezu

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Re: Has doc "botched" my knee?
« Reply #9 on: February 03, 2003, 01:33:54 AM »
 ;D Thanks for the advice, your replies mean alot to me as I'm in unchartered territory, no previous injuries, first surgery ever. ( no more treehopping for me ;)
O.S. and P.T. seem a little tight lipped and we are all holding our breath hoping I get better.
Oneilli and Heather I could tell you stories that would have you runnning for the door in my P.T.  Trust me it's better this way. ;D
I was'nt really doing a n y single leg exercises in P.T. and it was becoming very hard for  my good leg, my bad one simply was'nt joining in to do 120 lb leg presses, hence another pet peeve :P
I did try the stair stepping alternative today at the gym and I think it may help :-* thanks

Happy knee's and good luck
                                  Cindy
acl allograph, meniscus repair, patella shaving
August 23, 2002

Offline oneillii

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Re: Has doc "botched" my knee?
« Reply #10 on: February 04, 2003, 05:49:16 PM »
Hi Cindy

Well after my PT session last night I think I understand what you're talking about...I limped out of there on what was supposed to be my GOOD leg. Not happy.

I seem to be doing a little better with my home exercises + my person at the gym...my OS has already suggested that I back off from the "formal" PT so I may take his advice this week. I sure don't want a repeat of last night.

FYI my trainer is not having me do the leg curls because she says the knees can kind of get in on the action and get injured. She's having me work the hams by putting my heels on one of those exercise balls, lift the pelvis, and curl in to 90 degrees of flexion. I'm doing 3 sets of 15...trust me they WORK.

Also, are you still doing the isometric quad sets? You know, where you press your leg into the rolled up towel? That is the single quad exercise that has given me the fastest and most pain free results. A lot of PTs think that we're "past that" because it's been a while since our surgeries, but in my case it's a case of I have to crawl before I can walk! Anyhow, I'm still doing them and it helps tremendously.

Lastly, I haven't even gone to the stepper yet because weightbearing still irritates (though Janet's exercise sounds like the first I'll try). I'm doing sprints on the bike...boring but quite effective.

OK hope things are going well out there in TN...I think I'm flying through Nashville on one of my first trips back...unfortunately I never get much time to explore but lots of my co-workers live there. It sounds so beautiful! Hope you're well, Cindy! Susan
arthroscopy 11/06/02

Offline Netty

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Re: Has doc "botched" my knee?
« Reply #11 on: February 10, 2003, 06:57:12 PM »
Hi there,
quad weakness is my forte. I had my first of 3 surgeries exactly 3 years ago and I had them all done in 18 months.The 1st thing to go was my quads and on my bad leg its still noticably weaker. I still cant hop even 1 inch off the ground on it. They take months to build up so dont expect too much too soon. Ive been back trying to play tennis and softball for the past 3 months in my hinged brace and even all that effort hasnt improved the quad. As all of my surgeries have been failures so far, Im putting it down to the fact that the knee is fixed properly so that means I'll never be able to build it back up. I think the surgery has to be spot on before the muscles can recover fully. Oh well, Im just hoping my life will never depend the strength of my quads. Netty
Broke the cruciate and damaged the medial and lateral ligs playing softball.Hammy ACl recon Feb 2000(failed).Hammy ACL recon Aug 01(failed).Medial repair and Lateral loop Dec 01(failed).Still unstable

Offline The KNEEguru

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Re: Has doc "botched" my knee?
« Reply #12 on: February 10, 2003, 09:51:00 PM »
Welcome to the bulletin board. I trust you will get the help you need from our fantastic supporters.

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Offline opal

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Re: Has doc "botched" my knee?
« Reply #13 on: February 11, 2003, 07:04:15 PM »
Cindy,

I agree with everything everyone else said and only want to add that after TTT, my PT used electric stimulation in conjunction with straight leg lifts, quad sets, etc. for 8 weeks before we went onto any kind of gym activities. There were no exercises included until AFTER my quad had strengthened!!!  Yes, a weak quad is a disaster waiting to happen.
7 arthroscopies on both knees since 1991; many torn menesci and plica syndrome; TTT 5/23/02 for maltracking patella.  Screws removed on 4/16/03!!!

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Re: Has doc "botched" my knee?
« Reply #14 on: February 11, 2003, 07:07:26 PM »
Cindy,

Opps, hit post instead of continuing.  I'm sure that you continue to do your passive exercises at home...don't stop.  It can take a long time for that VMO/quad to come back.

After the 8 weeks of e-stim and exercises, I returned to my OS and his comment was, wow, look at that quad move; it has great definition.  This after 9 months of weak quad due to patella problems.  Don't despair and don't give up...it can come back, but you must be patient and persevere!

Keep on keepin' on!

Opal
7 arthroscopies on both knees since 1991; many torn menesci and plica syndrome; TTT 5/23/02 for maltracking patella.  Screws removed on 4/16/03!!!