Any Peroneal Nerve recovery stories?

[amdre]

Hey Hamish,

Ya Strating from square one can be a drag ..but you do have the upper hand this time..because you know what to expect and what needs to be done to get better.i felt  alot easier to recover from the third surgery. when i got out of the ACL surgery i was on crutches for about id say aweek ..i posted it awhile back.My ROM i got back fairly quick ..it took alittle more then a month.....i found that the stationary bike helped me gain it back faster...just kept trying to get full cosistent circles..then lowered the setting.You'll do fine you've been through it blind and recovere quick...know you know exactly how to recover again. and i hear you about an investment...lol...these braces are pretty pocket draining...but well worth it....plus my doc said he wont clear me to play again without one so its for life.

Take Care Hamish and have a good weekend

[amdre]

hey all

just updating on the progression of rehab and the therapy approaches we have been taking.
it has now been about 2 month and abit post-op for the ACL.

We have no started to increase the tempo but not the speed due to the ACL not being vascular yet.
we have introduced agility training on ladders. a ladder is laid down and i basically due football drills at a very slow and controlled pace to help retrain the motions and to retrain the muscle fibres. Dynamic warm-ups have been implemented to start getting my body as physical and active as possible before workout and training.
Water training has taken alittle twist..since i still cant run on land yet...PT(personal Trainner) has calculated the amount of steps it takes to run a 100metre dash in 11 seconds. Since water has an enormous amount of resistence the stepes must be divided by who fast i can do those running steps in the water.once that is done he can then calculate who much resistence is in the water and then tell me how many steps i must do to simulate this excersie....Yes pretty complicated ..but i understand his thought proccess. Other then the new changes the therapy is still similar to what it was before.
The Brace is coming next month then i can try running on land once again.

If you hav any ideas or differents thoughts for excersise please post them.
Have a Good Weekend all

[mom444]

Hello All,

I hope you are all doing well.

Just and update on my 3 year old daughter.  Yesterday her physical therapist experimented with Electrical Muscle Stimulation therapy...  My daughter, being only 3, was a bit confused and freaked out by it but we hope that it might help.

It looks as if some of the muscles that are controlled by the peroneal nerve, namely I guess the ones that turn the foot sort of in a bit of a sideways postiion, are still working.  However, the main ones that of course raise up the foot still need to regain their power.

Has anyone else here tried Electrical Muscle Stimulation?  I guess it is sometimes referred to as EMS?  If not, have any of your tried any type of similar therapy?  Did the electric stimulation therapy help you to regain use of the muscles and/or exercis the muscles that my have been dormant during the nerve recovery?

An early Merry Christmas, or rather Happy Christmas, to all of you!   

[amdre]

Hey Mom444,

How did she do having the Muscle stimulator on? other then being scared was she able to feel sensation and relay the sensations to you and the threapist? If you read back to some of the earlier post there are some different approaches that have been taken when dealing with Muscle Stimulation. also what kind of stimulator are they using? the one i have been most fimiliar with is a N.E.M.S unit.(neuro muscle stim) i bought a portable for 120$ canadian(ordered through the clinic) and it was used to stimulate the atrophied and "dormant" muscle that controls the dorsiflexion...Tibialas Anterior muscle which is located along the tibia or shin bone. i would have to say it helped keep the muscle alive so when i strted to get nerve reganeration i still had alittle bit of life and strength to noticable dorsiflex. The best thing i think helped me start to get my motor function back was Retraction Phase Therapy.Using the bodies natural retraction phase to help "trick "the nerve into reacting to an automaic response.(ex.If you pull your toe down past its natural sationary postion...it will retract into its original position..what the therapists did was as they pulled down i would try to meet the resistence once they felt something (or not) they would let go and assist my foot through the full range of motion.Also as i posted earlier Gravity can play another role in "tricking" the nerve into response.have her lay on her tummy with her legs bent at 90 degrees and tell her to pull down instead of up. And one last  thing i felt worked really well was trying to send signals back to the brain instead of from the brain to muscle. this was done simply with temperature changing sharp/ dull tests, pressure testing and just constant touching.

I was also wondering if she can move her toes? if she can ..which ones..usually the big toe muscle (Extensor halliucs longus)is the hardest and most stubborn one to regenerate due to its location and its tricky lumbar motor points. if she can move all her other toes it is important to start strengthening them as they play apart in the dorsiflexion of the foot. towel rolls and retraction phase and stimulation is kind of the ame as the stimulation for the tib ant.(therapist would know exactly).

Hope i was able to help you with some iof my experiences
Take care
Andre

[amdre]

Just a questions i wanted to ask about.

Is there anyone who has had an ACL recon and regained strength speed and basically all that they were capable of before the recon?if so .....what were some things that might have helped in your recovery? on my second month post op and my strength has me worried i start running next month and not sure about whether or not my knee can take it due to the lack of muscle from all the atrophy it suffered the past year.

Thanks Everyone
Andre

[mom444]

Hey Mom444,

How did she do having the Muscle stimulator on? other then being scared was she able to feel sensation and relay the sensations to you and the threapist? If you read back to some of the earlier post there are some different approaches that have been taken when dealing with Muscle Stimulation. also what kind of stimulator are they using? the one i have been most fimiliar with is a N.E.M.S unit.(neuro muscle stim) i bought a portable for 120$ canadian(ordered through the clinic) and it was used to stimulate the atrophied and "dormant" muscle that controls the dorsiflexion...Tibialas Anterior muscle which is located along the tibia or shin bone. i would have to say it helped keep the muscle alive so when i strted to get nerve reganeration i still had alittle bit of life and strength to noticable dorsiflex. The best thing i think helped me start to get my motor function back was Retraction Phase Therapy.Using the bodies natural retraction phase to help "trick "the nerve into reacting to an automaic response.(ex.If you pull your toe down past its natural sationary postion...it will retract into its original position..what the therapists did was as they pulled down i would try to meet the resistence once they felt something (or not) they would let go and assist my foot through the full range of motion.Also as i posted earlier Gravity can play another role in "tricking" the nerve into response.have her lay on her tummy with her legs bent at 90 degrees and tell her to pull down instead of up. And one last  thing i felt worked really well was trying to send signals back to the brain instead of from the brain to muscle. this was done simply with temperature changing sharp/ dull tests, pressure testing and just constant touching.

I was also wondering if she can move her toes? if she can ..which ones..usually the big toe muscle (Extensor halliucs longus)is the hardest and most stubborn one to regenerate due to its location and its tricky lumbar motor points. if she can move all her other toes it is important to start strengthening them as they play apart in the dorsiflexion of the foot. towel rolls and retraction phase and stimulation is kind of the ame as the stimulation for the tib ant.(therapist would know exactly).

Hope i was able to help you with some iof my experiences
Take care
Andre

Thanks Andre.  Your input helped a lot.  Again, because she is only 3 it's hard for her to explain what she feels in her leg.  We have to put things into a 3 year old's perspective which is a bit challenging for us.  I think it is the NEMS unit that you mentioned. 

I'm glad that I am able to dialogue with some of you who have direct experience with all this.

My next concern is maybe to move her to another physical therapist who is more experienced with helping people with this type of injury.  Because my daughter is only 3 we are required to take her to the PT dept at the local Children's Hospital.  I wonder if I can maybe find a physical therapist who normally deals with adults but who has more experience with peroneal regenration.

[amdre]

Hey Mom444,

From what i noticed..not to many theapist know how to approach such an injury Mainly because its out of there expertis.nerve damage is pretty rare and without the ability to actually rehab it they kind of just wing it and let time tell...it will be a search but finding someone who is proactive is a must.At the beging stage me and my school therapist went searching for answers and we were introduced to a sports medicine doctor on a pro team just to ask questions about different approaches. usually they are very busy but they are usually open to public and it could be a good route to find information...once you get the info needed it can be carried out by your regular therapist. usually the info given is just outside of a therapists level of training i guess you can say. some of the things he suggested were making sure i wasnt lacking any vitamins minerals or nutrients in my diet....so i had to take blood tests to see how healthy i was and if  i lacked somewhere i had to basically top up  on it.(his theory was "the more healthy you are the better chance for recovery") also he said (dont qoute me) ... maximizing your oxygen levels was needed to insure better regeneration  ..this was done with a hyperbaric chamber. im not referring anything i have done  ...but there are plenty of options ...we just need to find out who knows them.

I guess what im trying to say is find someone who knows all the ingredients to normal recovery(changes in the body,key contributers in healing red blood cells oxygen,amino acids etc...) and apply them to this injury with the therapist. 
I wish you all the best and i know things are gonna wokout
Andre

[mom444]

Thanks Andre   I hope things work out for my little girl.  It's so upsetting to see your child injured.

I was wondering what a Rehabilitative Medicine specialist could do.  We had a Rehab Med doctor do her EMG and so far out of all the other doctors we had seen it seems like the Rehab specialist knew the most about this type of injury.

All of this is new to me and confusing.  Would a Rehab Med person do anything a PT wouldn't do?

[j_smi001]

Hello Mom444

I have sent you a personal message.  I cannot answer your query regarding a rehab med as I don't think we have those on the NHS.  I hope that you see some improvement soon in your daughters condition.  Children do adapt so much better than adults but of course it is more difficult to explain what and why things happen.  Does your daughter have hydrotherapy?  I am a great fan of this type of treatment and convinced most of my improvement has been hrough this type of therapy.  You take care and Bless you good.

[mom444]

Hello Mom444

I have sent you a personal message.  I cannot answer your query regarding a rehab med as I don't think we have those on the NHS.  I hope that you see some improvement soon in your daughters condition.  Children do adapt so much better than adults but of course it is more difficult to explain what and why things happen.  Does your daughter have hydrotherapy?  I am a great fan of this type of treatment and convinced most of my improvement has been hrough this type of therapy.  You take care and Bless you good.

Thank yoiu j_smi001 for your sweet personal message!  I tried to reply but it would not let me so I am replying personally here.

Thankfully this whole ordeal has not caused my daughter too much emotional or physical pain.  She for the most part has been going on being an active and happy toddler.  She flops her foot when she walks and occasionally trips a bit more easiily but she still somehow manages running around and can still play on the jungle gym at the playground!    She occasionally complains that her lttle foot brace hurts her but she is okay for the most part.  They are now making her a foot brace with dosiflexion assist. 

She has a very long and very deep incision scar on the back of her leg from the surgery.  Hopefully it wll fade as she ages.  Strangely enough she did not have a lot of pain directly after the surgery.

I think I will start looking into other therapists after the Christmas break.  I don't want to insult her PT by saying that we want to go to someon else but I think her PT will understand.  We are in the US so we are on my husband's health insurance and sometimes they are restrictive as to where you can go. 

I just have to mention again how thankful I am and how blessed I feel to have found this board.  Prior to this I had no contact with anyone who had been through a similar ordeal.

Thank you for your thoughts and prayers.  I am thinking of and praying for all of you too. 

[amdre]

Hey Everyone how are things? hopefully recovery and life is going well.

Just blogging.

Its been 1 year three months and 5 days since the injury
one year three months since the first surgery and
2 and a half months since the ACL surgery.

today the knee feels stable ...lacks strength and reflexively im still alittle slow. i have full extension but when i reach my max ...the "fat pad" seems to have some scar tissue surrounding it still ...from the surgery which im hopig will subside with massage and "Mobs".Walking is fine but putting pressure doesnt feel the greatest( mainly lifting weights)...its hard to explain but i just do not feel confident with alot of pressure....not sure if its because i have been compensating for so long with my good leg or just "Normal" ACL surgery pains. It almost feels like everything i do (weight baring) my good leg automatically takes the load.Really trying to even this out but to me it seems like i need to put more pressure or weight then one leg can handle so my left has to kick in.....im sure my therapist would differ.

 the nerve feels good as well....i still have the tingles and cold rushes ......almost as if ice is being poured down my leg. not sure  if this still symbolizes healing at this stage in recovery ..but im guessing it cant be a bad thing since there has been consistent improvement.
still do not have EHL response trying hard to get a reaction .....we know there is juice following there just not enough and it seems to be to difficult to assist this function with stimulation.The other four toes are working hard to strengthen and are showing improvement just not at the same pace of the Tibialas Anterior Muscle....but im sure they'll tag along. Numbness is spotty.....on the top of my foot i have numbness here and there and when the numb spots are touch it feels awkward almost like a higher level of sensitivity. the outside of my leg feels better as well...near the peroneal tendon when i run my hands up and down a trail on tingles follows my touch pattern...not sure if this is a good thing or bad ...but i do it anways just to get a sense of feeling back to the tendon and leg.

Quads Quads Quads..these suckers have taken a massive blow this past year and are doingalright with strengthening...these muscles are by far the hardest ones to retrain and strengthen i feel especiallly when you cant do leg extension.It almost makes me regret all those days i was in the gym and skipped the leg ext mahine to do squats. And last just some input on the ankle....it has been dangling fo clse to a ear and now that i can move it it feels so tight. every movement feels like a stretch and no matter how much i stretch ...it  still feels like that. i m guessing it just needs to get back in the habit of movement since it went thorugh a hibernation phase. Well that about somes up the way my knee leg and ankle feel since the injury.

I probably wont be on for the rest of the week or weekend so have a good weekend everyone.

[amdre]

Happy New Year Everyone and Good Luck with Recovery for 2007!

[stabso]

Happy New Year!

I've been reading this forum with interest and even though I don't have a knee injury, I do have full on drop foot as a result of compression of the L5 S1 root nerves by a massive disc rupture.
I had a discectomy (removal of ruptured part of disc) to relieve the pressure on the root nerve on Nov 8th and the back is now doing fine.

What I have been struggling to get my head around, is the foot drop/nerve damage and how to best promote healing especially as I was shocked to be given only a 10% chance of recovery and no physio specific to foot drop.

Anyways, I guess what I'm trying to say is, I'm glad I bumped into this forum and I hope as a "spine" guy, you "knee" guys don't mind me showing up now and again.

[fire535]

Good luck with your foot drop.  I am glad you got some relieve from your surgery.  Nerves take time to heal.

[j_smi001]

Firstly Happy New Year to all and let 2007 be a good year for nerve recoveries.  Welcome to stabso and fire535, foot drop is foot drop no matter where it originates from and if we can help eachother along a bit with either advice or words of encouragement when needed then that is good.  I have gained great comfort from this thread.  Initially I felt so alone and in complete disorientation until I started to learn about the condition and how others were managing with it. 

My physio has requested nerve conduction tests for the sciatic and peroneal nerve to assess their function.  I suppose I am getting near the 12 month mark.  Although now I have my Toe Off splint I am quite happy as there is very little I can't do.  I am lucky in that  have had some recovery in my foot and so remain very positive.  Just need to get past the HTO in March and hope you will all be there to help me through that.

Heard a great quote today, Never argue with an idiot ... they drag you down to their level then beat you with experience.