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Offline CGP

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Bad Left Knee
« on: February 17, 2003, 12:21:42 AM »
Here's the story;
Me, male 55 yr. old, long distance runner all adult life.
Been bothered by left knee problems. Had a stumble  Sept. 2002 while on a trail run. After a short time off the knee seemed to improve. However later was walking briskly out of restaurant when knee just seized up like there was a coat hanger stuck in behind. Feeling like I had hyperextended it. X-ray showed OA in medial aspect where pain initially began. Dr. not sure whether it's a torn cartilage. Knee has shown little improvement since. A gait analysis revealed definite weakness and 'galloping' while running. The PT pointed out there is work to be done to improve a weak VMO which is evident. The quad higher up thigh is that of a football player while VMO is that of an equestrian. The MCL appears to be lax and I think the Pes Anserinus tendon could be affected too.
Has anyone here have the same problem? If so, please reply to this post.
Arthrocsopic surgery on left knee for patella plica & partial synovectomy, Nov., 1982 No problems until June,97 stumble during relay, patella-femoral injury, PT. No problems with left knee 'til now.

Offline CGP

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Re: Bad Left Knee
« Reply #1 on: February 17, 2003, 10:29:29 PM »
Hey I would appreciate some kind of reply fronm anyone!!!!! >:(

After all it's only good manners, or is there some kind of unspoken rule for first timers to this website forum?

I really do have a big concern here about my knee and though it appears my problem may not be as bad as what I have read from others' posts I would appreciate some feedback.

I did appreciate reply from my private email to Knee Guru, however.
Arthrocsopic surgery on left knee for patella plica & partial synovectomy, Nov., 1982 No problems until June,97 stumble during relay, patella-femoral injury, PT. No problems with left knee 'til now.

Offline Linda

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Re: Bad Left Knee
« Reply #2 on: February 17, 2003, 10:36:57 PM »
Hello CGP,

When I first hurt my knee, my VMO began to deteriate. It became progressivly worse no matter what I did. i was told that it is the first thing to shut down when there is an injury, and the last to come back. despite intensive PT, it never even attempted to come back until after I had my cartilage replaced. that was in november. It is only just the last two weeks started to Flutter when I work on leg stuff that is supposed to target the VMO area. it might be that you will not be able to get much VMO until your injury is addressed as well.

Good luck to you, and keep us posted on youy progress.
Linda
LR and Chondrplasty 1/22/02, Clean-up, Chondroplasty and biopsy 6/4/02, AC Implant 11/6/02, Micro fracture and adhesion clean up 8/12/03

Offline CGP

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Re: Bad Left Knee
« Reply #3 on: February 17, 2003, 11:05:53 PM »
Thanks Linda

What is bothering me  (besides the depression of not being able to run properly and maybe that my running may be over and the discomfort from being seated then getting up) is not being able to get a definite answer from two medical personnel & from PT's whether it IS a torn cartilge. Two others, a coach down in Georgia, U.S. with whom I used to correspond & still do occasionally & Knee Guru himself believe;
>>It was as if there were a coat hanger stuck in behind my knee.<<<  this is a classic giveaway of a torn cartilage. The diagnosis that it's arthritis alone causing me problems isn't good enough as I do have the same with my right knee which has been pretty well okay.
I will be starting again tomorrow on a program to strengthen the VMO with exercises appropriate for me. Hopefully these will work out as my appointment with an OS is March 11 I was lucky to get an appointment this quick as here up in British Columbia, Canada one sometimes has to wait 6 - 10 months to get any kind of assessment. Easy for somebody to continue to hurt themselves more if they don't know what the problem really is. What may happen is I could be referred for an MRI and that may take another long period of time :(
Well of to the Rec. centre to workout

Cheers Linda

Chris
Arthrocsopic surgery on left knee for patella plica & partial synovectomy, Nov., 1982 No problems until June,97 stumble during relay, patella-femoral injury, PT. No problems with left knee 'til now.

Offline Linda

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Re: Bad Left Knee
« Reply #4 on: February 17, 2003, 11:41:22 PM »
Hi Chris,

I found the whole dianosis thing very frustrating as well. My problem was not torn meniscus, but loss of cartilage. The MRI I had did not show anything. The first OS that looked at my knee with a scope did an LR, which was a complete waste of time, and then he did not mention that I had cartilage damage. Even though he shaved on it and took pictures of it. When I finished rehabing from the LR (4 months!), I wound up worse off. I finally got smart and went for several other opinions. At that point, all the other OS's tuned right into the cartilage problem. I decided after a long research and thought process to try the ACI. So far so good. I guess my whole point here is that my problem did not show up with tests, and did not get better with rehab. I finally had to let them go in and look. I wish I had made a better chose for the guy to go in and look though. I would have saved myself that LR and that long recovery.

Good luck to you. i hope it doesn't get too long and drawn out! Hopefully you will have more luck with your VMO. I will know if I will be able to resume sports and hiking and everything else I love in another three months or so. So far so good in rehab and at the gym though.

Linda
LR and Chondrplasty 1/22/02, Clean-up, Chondroplasty and biopsy 6/4/02, AC Implant 11/6/02, Micro fracture and adhesion clean up 8/12/03

Offline CGP

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Re: Bad Left Knee
« Reply #5 on: February 18, 2003, 12:24:18 AM »
Hi Linda can you tell me what an LR and an ACI is?
Is there a glossary somewhere on thi swebsite?
Arthrocsopic surgery on left knee for patella plica & partial synovectomy, Nov., 1982 No problems until June,97 stumble during relay, patella-femoral injury, PT. No problems with left knee 'til now.

Offline CGP

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Re: Bad Left Knee
« Reply #6 on: February 18, 2003, 12:44:18 AM »
Found the glossary just had to look for it before asking  :-[

How much would an ACI be? I think I have heard of this type of medical procedure before.

The more I read into this website the less likely I will contemplate getting anything done unless it's to take out or repair this cartilage. If the recommendation is to take out cartilage I will be reluctant to have this done as it will probably leave more bone on bone activity. Maybe what I should do (though the kind of lifestyle, the people I see etc. running club, it's not likely I will do this) is to stay off all impact type activities and work on strengthening procedures and register for this yoga course I once looked into.

Anyway Linda the best of luck to you. After tomorrow pm I probably will be on this website again to say how my PT (physio) went. Funny how pain will drive me to these areas of the internet. :(
Arthrocsopic surgery on left knee for patella plica & partial synovectomy, Nov., 1982 No problems until June,97 stumble during relay, patella-femoral injury, PT. No problems with left knee 'til now.

Offline Heather M.

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Re: Bad Left Knee
« Reply #7 on: February 18, 2003, 01:06:17 AM »
CGP,

I strongly recommend educating yourself on the various possible diagnoses and treatment options.  And bone up (so to speak) on basic knee anatomy so that you can ask informed questions of your PT and surgeon.

For example, there are two types of cartilage that we kneegeeks refer to in our knees.  It sounds like you might have a torn meniscus (just a possibility from your description), while the ACI surgery that Linda had is to deal with damaged articular cartilage.  There's a huge difference between the two types of cartilage, and often finding what is wrong will point you in the right direction in terms of further information and treatment options.

When you see your PT, you should ask about things that can 'jam up' the knee, and these are generally torn meniscus/torn cartilage, or perhaps a loose body/knee mouse which could be a number of things--from a piece of meniscus that has torn off completely to a chunk of damaged articular cartilage that got gouged out and is stopping proper mechanics.  

As you can see, there are lots of terms and things to learn.  Good luck with your endeavor.  And be sure to ask lots of questions of your health care providers!

Hope your knee does better with some focused PT work.

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: Bad Left Knee
« Reply #8 on: February 18, 2003, 01:10:13 AM »
Hi Chris

Read your first post--sorry did not respond but you sounded so up on the jargon I thought you were getting the help you needed.

FYI I had a torn medial meniscus with no OA that barely showed up on my MRI. It was not until the Dr went in with a scope that he found it.

HOWEVER it was only a bucket handle tear--had it not been catching in the joint I probably would have left it alone and started aggressive rehab as my VMO muscle had shut down and the quad weakened considerably. I am now 15 weeks post op from my scope and still cannot run or do impact actvities. However, I am seeing improvement so I can hope  ;)

I was also a runner but backed off considerably after having my daughter 3 years ago...it was a hard choice to make but ultimately my knees are the better for it. BTW my initial injury was caused in yoga class, so please proceed carefully and always ask for assistance with poses involving your knees.

Sorry this is so long but I just wanted to chime in and say that even though you are a runner and think your legs are in great shape, there may be muscle groups that are underutilised/compromised because of your gait...this is the window where an injury can occur...however, it is also the area that, with work, may allow you to return to your sport...best of luck to you! PS Ice ice ice and NSAIDs...doesn't mean you are weak, and will speed your recovery!
arthroscopy 11/06/02

Offline Linda

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Re: Bad Left Knee
« Reply #9 on: February 18, 2003, 02:12:42 AM »
Hi again Chris,

I thought from your post that you were more familiar with the terms as well. Sorry I was not more clear. Heather posted a very good note though. My problem is probably not the same as yours as she noted, however, it is possible that you have both types of cartilage damage. Lets hope not! MRI's may or may not show the damage. There are some new things they are trying with Meniscus repair, so don't despair if that winds up being your problem.

I found that the pain that my injury caused made it impossible to rehab my quads and VMO to the point that I needed to be active. Now that they have "fixed" (we will see) my problem, that darn VMO is actually fluttering. It did not do anything before. I guess deciding on having surgery is a very personal choice, but for me the inactivity I was being forced into made it a simple choice.

What ever you decide, be sure that your OS is a good one. Having one that isn't is not only a waste of time, it can also make matters worse.

Good luck!
Linda

LR and Chondrplasty 1/22/02, Clean-up, Chondroplasty and biopsy 6/4/02, AC Implant 11/6/02, Micro fracture and adhesion clean up 8/12/03

Offline CGP

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Re: Bad Left Knee
« Reply #10 on: February 18, 2003, 09:06:38 AM »
Thanks ladies for weighing in here.

Interesting observation from Oneillii about leg muscles being in shape but not really functioning. Probably the balance between quads & hamstrings and flexibility as well.  

>>there may be muscle groups that are underutilised/compromised because of your gait...this is the window where an injury can occur...however, it is also the area that, with work, may allow you to return to your sport..<<<

In my case I have tended to be heavy on my feet while running even though I'm not that heavy in weight. This is certainly noticeable while on the treadmill where I have been going lately. Hopefully the above copy/paste will be an answer for me.

Cheers

Chris
Arthrocsopic surgery on left knee for patella plica & partial synovectomy, Nov., 1982 No problems until June,97 stumble during relay, patella-femoral injury, PT. No problems with left knee 'til now.

Offline oneillii

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Re: Bad Left Knee
« Reply #11 on: February 18, 2003, 06:15:17 PM »
Hey Chris

Glad my post was helpful...FYI I tried strictly treadmill/walking at first in an attempt to wake up the VMO, but the other muscles compensated...are single leg squats part of your routine?

My PT has my standing on a half-circle of foam roll (i.e. about 2.5 feet long and maybe 6 inches wide) on one leg and doing a very slow squat and raise up.

You can really feel the VMO kick in in that last 10 degrees or so of extension. I still can't run though  >:(

BTW I'm sure you are paying attention to your gait when you run...i.e. heel first then rolling onto the toe area...I also ran "heavy" on the front of my foot, which really compromised the knee. Arch supports may also help you...good luck and please let us know how you are doing!
arthroscopy 11/06/02

Offline CGP

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Re: Bad Left Knee
« Reply #12 on: February 18, 2003, 08:34:29 PM »
Hi Oneillii

Yes, one-legged squats are a part of my regimen. However presently these are hard to do as the pain/discomfort is on the medial side the same I get while running like you on t-mill these days), though I can run but probably shouldn't be. :-/  I feel a little bit of discomfort on the elliptical trainer though I can push the elliptical to the max. Also I can use the stairmaster though I was advised to stay off this. Cycling for me is fine though last few days I get this stiffening up feeling over where the pes anserinus tendon is located when I get off the bike & straighten my knee to walk. I was always a mid-foot striker while running and it was always noticeable to others when I was younger I had a high knee action.
This coach I used to deal with maintains that my problems are due to a weaker left glut area, hip flexors & maybe my core (abdominals) need work. Posture could be contributing to my knee problems.
One really good strengthening exercise I used to do (can do this but seems to set my knee back) is the balance & reach. Bend forward as an ice skater, lift one leg back & diagonally & hold for 2 sec. & repeat for a set number of times.

Will be seeing PT this PM and will see what exercises he will have for me which are appropriate at this time.
Arthrocsopic surgery on left knee for patella plica & partial synovectomy, Nov., 1982 No problems until June,97 stumble during relay, patella-femoral injury, PT. No problems with left knee 'til now.

Offline oneillii

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Re: Bad Left Knee
« Reply #13 on: February 19, 2003, 01:02:13 AM »
Hi Chris

I am surprised you are still running with pain...I can't bring myself to do it, but then I hate the treadmill. If I can't be running outside I don't want to run at all.

You might not want to hear this, but I turned to swimming when running started troubling my knees. It is not the same feeling at all but it does have its own appeal.

Posture for me has been key, and my trainer is working on that along with gait. I am sorry to report, though, that the medial side where the injury occurred still feels compromised. At this point I am somewhat in denial and in the "bargaining" stage of "Just let me dance like I used to and maybe run occasionally..." Unfortunately it doesn't work that way...compared to what others on the board are going through, I feel a bit greedy  :-[

Please continue to post, especially exercises that seem to help. I hope you at least can return to running on a part time basis... Susan
arthroscopy 11/06/02

Offline CGP

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Re: Bad Left Knee
« Reply #14 on: February 19, 2003, 03:30:11 AM »
Hi Susan

Got back from PT (gait analysis guy) Was given 3 different exercises the King Deadlift (one legged squat), the step up on a bench (one leg) and the Swiss ball hamstring curl which really uses the abs, glutes & the hamstrings. Actually all 3 bring the glutes into play.

These are to be done as such;

30 reps. (5x6) or (3x10) whichever is possible or comfortable.

I'm back there Thur pm.

I'm also not to run for awhile :(, avoid the leg extension apparatus, go easier on the elliptical etc. Guess maintaining basic conditioning is a real concern and I'm always one to 'see how much running I can still do' while combining it with other activities to make up at leasdt one hr. cardio per day. Guess this was a bit too much at this time :( and like I said pain drives me to websites to seek out answers, solutions etc. It doesn't always seem to come from Dr.'s ::)

I have prescription Naproxen tablets though I always try to not use these but my knee has been particularly sensitive and I want to get it as painfree as possible.


Cheers Susan

Chris

Arthrocsopic surgery on left knee for patella plica & partial synovectomy, Nov., 1982 No problems until June,97 stumble during relay, patella-femoral injury, PT. No problems with left knee 'til now.