Swelling from quad movements ?

[Boydy]

Hey Donna,
not sure what a 'subluxing' problem is, does that mean it dislocates,? or is it another name for maltraking,?  Gosh I sure hope your problem does get better before the spring, I have read so many posts (myself included) where you just keep letting them go in 'one more time' to see if it can do the trick, but some people just don't handle the after effects of surgery well, and it just goes on and on. I'm sorry I'm being so negative about surgeries,  its just one of those days,  .  Thank you for your encouragement,  ,  Let us know if you find any answers out there that might help.  I'm hoping my new brace will be my 'saviour'  !!!     
Boydy

[lilrosie06]

Its the same as maltracking. It doesnt sit in the groove properly and keeps slipping out. And it HURTS!!!! Ugh....This  has been going on since 1-3-05 when   I hurt it at work. I just wanna be able to get back to all the things I  used to do. I hope your brace helps. I have a patellar J brace. It helps some, but the kneecap still fights the brace to sublux. Good luck! And keep me updated. Thanks....DONNA

[shade]

http://www.sportsmed.buffalo.edu/info/patellarsublux.html

Hi Donna,

Sorry that things have still not happened for you.  Did you read this article by John Fulkerson, MD - it is really good and has helped me tremendously.

http://ajs.sagepub.com/cgi/content/full/30/3/447

I medially sublux and I'm now trying the tru-pull wraparound brace and it is actually working.  This is a universal brace - meaning it works for medial or lateral subluxing patella so, you can wear it either on the left or right hand side of your knee. 
This guy is pulling his left patella laterally...so, he medially subluxes like me.....


My pain has decreased tremendously and hopefully if I can now find a brace sleeve I'll get rid of the sore spots from the brace.  It really keeps my patella where it belongs and I am feeling so much better and hoping that now I'll be able to start building up the quads again.  Know that the brace is not a cure and I'll probably need more surgery like the article says, but it is nice in the meantime to get some relief. 

It really would be nice though if something like a brace could be the answer instead of surgery.  ~Shade

[KarenS]

Boydy, I really hope the brace works for you. It's not always a temporary thing -- sometimes a brace can help keep your patella in place so that you can get your quads back in shape and that will help or solve your problem. Or it could just be temporary relief (like Shade said). Don't lose hope that this will be resolved with therapy! And yes, try to get those VMOs working -- do the pillow squeezes (if you can), and turn your foot outward a bit when doing SLRs. You have to do the exercises that target it, although the quad sets work it, too (as long as it's firing, that is).

[shade]

Boydy,

Oh my, it is my PT's that kept trying to put the weights on me..... My OS says, absolutely not.....
I've had OS's in the past though that actually told me to take up running and that would fix me right up.  Ya, that would be good for a person that can barely walk without pain.  It is awful hard with all the conflicting info out there also.  You like me seem to have had one problem and then it led to another condition.  Think what happens is you have maltracking and after you try to fix it with exercises and find that exercises hurt - your choices of exercises are cut back so much that you tend to do the same things over and over and that is how we get into this overuse thing.  I could be wrong about this, but that is how it seems to me anyway.  Right now the only thing that I'm doing at all is the recumbent biking, think I've reached a point where I really am afraid to get back into the pain cycle again. 
Since I've gotten used to the tru-pull wraparound I'm feeling pretty good and afraid to go backwards again..... I went the whole day yesterday without a percocet and the only pain that I had were the sore spots from the brace (need a brace sock, I think).  Did not do much but go up and down stairs and walked around the yard and up and down the driveway, but things feel pretty good. 
Today I plan on going for a little walk and doing a little recumbent biking - fingers X'D that the spell won't be broken.  If the tru-pull brace works then it's the medial subluxation that is creating the problem and the tendinitis is secondary, which is usually the case anyway. 
Keep up with the biking and for VMO do you do the exercise where you just sit on the floor and put an exercise ball between knees and squeeze - I was told this was a great VMO exercise.  This exercise can also be done while sitting in a chair. 

Sure hope that you can find a comination of things that will work for you - think that is what it takes for some of us to find relief.  Sure hope that this cho-pat dual strap will do the trick to get you going again and give you some needed relief.  Think that is half the battle - many people just go to therapy and their problems seem to look after themselves and some of us just do not fit into those categories..... Would be nice if the physios picked up on these situations instead of sometimes creating more problems like some of us have gone through, but to get there eventually would be nice and hopefully we shall..... I do not mind the rocky ride if we can get to smooth ground eventually.....  ~Shade

[Boydy]

Karen,   the way you describe those exercises I take it the VMO are the ones on the innerside of your thigh, (they seem to be the ones that work when you turn your foot outward in the SLR, thanks for that hint,)  it helps when you know what area you are suppose to be 'targeting'.
Shade, just doing the bike, mmmmm wonder how things will go when you start introducing back some of the other exercises. It will be interesting, maybe thats the answer, give it a rest, (but not totally) then reintroduce (especially now you have your braces) other things slowly.  Maybe that has been my mistake, when I have had enough of the swelling, (and when I go away for a week holiday) I give up everything, no gym, and don't even do any floor work or stretches, just sit around visiting , eating,  and going to movies etc, (not to mention the 4 or 5 hours in the car there and back). By the time I get home the swelling is worse then ever !!! Thats why I feel I'm damned if I do and damned if I don't.    But I could be going about it wrong, if I go away like that, maybe I should try to just do some daily stretches , to keep it 'limbered up'.  Who knows, you can second guess everything till the cows come home. Lets face it, it is all just trail and ERROR, ( more emphasis on the error I think) 
I had my first walk with my brace on this morning, will take a bit of experimenting, I think, not sure how tight to pull velcro, box said firm but not tight, but half way around I didn't feel like it was working (even had some pain, which haven't had for awhile) so I stopped and pulled it really tight, and it felt much better and pain went away, but am finding it swells up quite quickly when I take it off, only walked for 15 minutes. ( I ice and elevate as soon as I get home) Will give the gym a miss for today and go tomorrow to see how it goes there. Do you find your tru-pull brace is better than the cho-pat dual strap? Do you where them on different legs? Which one is for which complaint ?  I will take my brace next time when I go see PT, he might be able to guid me on how to use it properly for my problem areas, unfortunately can't go until January, so will have to wing it until then.  By the way, they are great web sites that you are sharing with us, great info in them. Thanks. 
Boydy

[shade]

Boydy,

Well, what I've done is I've tried to keep doing something all along this journey.... for instance I was doing alot of leg exercising and biking and walking and found that the physios were wrong and I was really overworking and that is how I got into this pain cycle thingy.... Then everything was taken away for about two weeks and I do absolutely nothing but rest then slowly starting biking with knee sleeves on and then gradually started walking on a soft surface, but only went about a 1/4 mile and worked myself up.  Same with the recumbent biking, but never using tension only increasing the time and worked up to twice a day for 30 minutes..... then walking up to two miles, but then the pain all came back again - so, now I trying to start biking again with the new braces and going to be adding the trail walking very soon also to see how that goes....
I wear the tru-pull on my right leg, as that knee subluxes more than the left and the cho-pat goes on the left knee.  I also notice swelling after wearing the cho-pat but think it is because it puts so much pressure on the quad....
If you do not sublux then the tru-pull wraparound would not help you at all - it is only for medial or lateral subluxing...... meaning your patella slips out of the groove or hangs over the side while standing...... Mine is very visible whenever I stand my patella goes right over to the inside of my leg.
I've found it very hard to find a brace that helped my condition - first off I had those PTO braces from Breg and they put just too much pressure on my knees and made them ache worse, but now I know that the tru-pull is definately right for my right knee - it takes the pain right away.  Yesterday we found a brace sock and that has stopped the brace rubbing and makes the brace even more comfortable. 

look at this guys knees as he stands with his feet facing forward..... his knees are pointing inwards - this is what my knees do and this means that your kneecap is slipping in the groove or subluxing..... (also called squinting patellae).
I went to quite a few doctors and they just said this is genetic and nothing could be done about it.... Hmmmm!!  Anyway, through research you can find answers & hopefully the right doctor to help with your condition.  It is very hard to find a surgeon that is willing to help patients with these pain issues....
I'm with you about the second guessing - it is horrible to be afraid to do things and yet we all need answers and the only way to find answers seems to be by trial and error.  I call it the Catch 22....

The cho-pat helps my left leg especially up or down inclines - it takes the pain away.  Left leg gets pain over and under the patella tendon with walking.   
My right leg is a different story though - it did nothing to help with the medial subluxation & therefore was not enough brace for my right leg.

Karen,
You are so right, guess I just don't explain things very well.  Some people have great success with finding the right brace & doing the proper exercises through PT & being able to return to normal activities without having surgery, and that is great!!
Unfortunately, there is a percentage of people this will not work for & it's mainly because their condition was left untreated.  I have read this over and over and it really bothers me as I know I am included in this category -  If you have a problem for a long period of time & it goes untreated - it takes much longer to correct the condition as other problems compound the original condition....
No one should give up!!  There are answers out there & although it is difficult sometimes there are surgeons that are willing to take on tough cases & willing to help patients with pain-cycle conditions. 
I feel better today that I have in three years.  This new brace has given me pain-free walking & more of a lifestyle.  Don't know what is in my future, but know that this Dr. Fulkerson article & his brace have changed my situation and I'm very pleased with the results to date.  Maybe it is a permanent fix, maybe not!!
Don't think it should be this hard to find answers, but in reality it is sometimes.
Hope everyone has a great day...... ~Shade

[KarenS]

If you have a problem for a long period of time & it goes untreated - it takes much longer to correct the condition as other problems compound the original condition....

Yes, insert me into that category, too. It forever amazes me that "knee experts" tend to blow off these chronic conditions that develop, instead of hammering into our heads that we need to do something about it ASAP instead of trying to "rest it away." I now know that the longer someone walks around with severe quad atrophy, the more and more likely they're going to develop additional problems. GRRRR... Don't get me started. 

[Boydy]

Hi Shade & Karen,
Shade I can't believe you were, so far down the recovery trail just to go back to square one again ! That is what I am scared about, (trying not to look to far ahead & be all negative etc) but I too have been a lot further down the road ( I was even managing to do some leg extentions in my daily gym work outs ) but all came crashing down (for no apparent reason) and went back to the daily swelling etc. That is the hardest part of all, everyone commenting on how well your walking now and, "gee you must be getting better, your not even limping now !!"  Then the next time they see you your back to walking stiff legged at a snails pace and limping around !!    "What happened, they say"       (IF ONLY WE KNEW) !! This is why I can't get my life back, just when I start thinking that it is getting stronger, and I might start to look for a job, it backslides, I'm just not game to go and take the risk of putting my knee under anymore strain, ( I don't know how you other people are managing to go to work, or look after  a young family !!!) I had to give up my job a year ago, there is no way I could stand ( or sit for that matter) for longer than two hours at a time. Most jobs that I know of,  that is exactly what you would have to do.  How do you all cope !!!    And my children are all grown up, (actually my son (22) has just left home this morning to go and work in the big city. So now just my hubby & I at home. I have been bawling like a baby all morning!      So really I am very spoilt and have the time to concentrate on my knee, exercise, ice , elevate as often as I need too. Maybe thats the problem, too much time to focus, might need something to take my mind off my troubled knee.    OK,  enough waffling on, thanks for listening, depressing day for me, missing my boy tremendously already, (its only been 3 hours) think I need some chocolate !!!   
Boydy

[KarenS]

Boydy, I'm sorry you had such a bad day. Does it make you feel any better that I was crying last night, too? (I'm sure it doesn't!) Don't feel like you're spoiled because you have more time to work on your knee problems. It's depressing whether you have kids, or a job, or whatever else! And I think you hit the nail right on the head: When you have too much time to spend thinking about your knee problems, it does make them seem (and feel!) worse. Seriously, I'm convinced of it! If I go out for the night with friends, or go to a party with family, I don't even notice my knees much -- whereas, if I had been at home, I would be obsessing over them practically every single minute. It does become an obsession! And I don't know about you, but the more I worry about something that ails me, the worse I feel physically. So, long story short, maybe you *should* try to do something to take your mind off it. I know it's hard when you're limited by where you can go and what you can do that involves walking/standing. But surely there must be something...?? (I've been thinking I need to find something, too!)

[shade]

Hi Boydy and Karen,

Think you are right. 
I agree - that is the reason I ended up on this site to begin with.  I tried taking time away from my knee by delving into PC games that took a long time to play, ones where you developed the characters etc like Diablo or Neverwinternights or Morrowind.  If you don't like these strategy games you can play online puzzles or scrabble type games.  Also, you have to try to get out each day, even if it is just walking around your yard or going to have a tea or coffee with someone..... It all helps.  Original fall for me was almost ten yrs ago now.  I fell off my horse & landed on both knees & one arm.  Then had fall in house three years ago & that is when the limping and the subluxed patellae began.
What I've learned is that you definately have to find hobbies, movies, friends, pets, or tv.  Whatever works for you.......
Sorry about your boy moving away for work, but it eventually happens to all of us. You'll feel better soon.....
I can't really relate to this idea about if you don't think about your knees they don't hurt as much but, maybe because my patella was always in the wrong place, I felt my knee with each step. Think getting your mind off the knees is a great idea though.  You just have to try to maintain some sort of lifestyle through all this so that your knees don't take over. 
Guess that is why I've been so surprised, but delighted with my turnaround just because of a knee brace - hope this will happen like this to both of you also.  ~Shade

[Boydy]

Karen & Shade,
thanks for the support & encouragement girls, , I am feeling much better today, I received a big newsy email from my daughter, and a lovely big phone call from my son when he arrived at his destination. So all is well in that department. (Karen hope your not so sad today, hope something has cheered you up as well   )   Maybe in the new year we will both find incredable jobs, I'm thinking about something 'half days', so that if it does play havoc with my leg it won't be so bad as having to deal with an aching leg or pain & swelling for a whole day. I just remember what it was like when I was working all day on my bad knee, by the time I got home it was ssoo swollen, then to have to turn around and take clothes off the line and cook tea as well aarrgghhh !! (yes, I'm one of these women who do EVERYTHING inside the house, hubby does OUTSIDE ) he works very long hours so that is the way it always has been. So it suits me fine, to be 'just' housewife for awhile, but I'm afraid we got used to living a lifestyle with two wages & a bit hard to break those 'spending habits'  . Don't get me wrong I do fill my day in quite well, I have a little puppy, and I do like to take her out for outing most days, & my house and cupboards have never been so organised and tidy    But it is the money side of it, I really will feel better when I can get some sort of income, (I like my holidays, especially now we have no kids at home, this is suppose to be  'our time' ) Fingers crossed for the New Year.
Shade, I was going to ask you if your brace restricts you from bending your knee. I wore mine to the gym yesterday and because it has about an inch strap that goes aroung the back of the knee it was a bit hard doing the exercises, even the recumbersome bike was hard to do, and the leg curls as well, the brace sort of stops you from bending your leg , (great for just walking , but I really need the support for the gym work)   Does this happen with yours ??
Boydy

[shade]

Boydy,

No, do not find either the cho-pat or the tru-pull wraparound give any problems with doing my biking or walking.  I'm not doing any other exercises and especially not leg curls.  I've really rested my legs this time and only introducing the biking and walking until further notice after the middle of January......

Have you tried using a knee sleeve or just an ace bandage while doing your PT..... Might work better for you......

[Boydy]

Shade,
yes I used to use the knee sleeve for PT and that did work well, might have to go back to that and just use my brace for walking. Is there a particular reason you aren't doing anything else besides walking and bike ? Has that been suggessted to you by PT or are you going by your gut instincts that this is the right move for you? Do you do any floor stretches or quad sets at home as well? Sorry about the 20 questions, but just trying to get a grip on what works for everyone,( and also what different PT are advicing people)  I am not game to do any less then I am because I am ssssooo scared of losing anymore quad strength, which I feel will send me backwards even further.
Boydy

[KarenS]

It definitely will, Boydy! My new motto is, if nothing else, do the quad sets! I seem to be able to add more and more every few days, and I do see more muscle when I flex. Yay! So, as "wimpy" as quad sets may be, they definitely do *something*!