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Author Topic: Swelling from quad movements ?  (Read 4949 times)

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Offline Boydy

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Swelling from quad movements ?
« on: December 18, 2005, 09:31:31 AM »
Can anyone shed some light on my query. I think I have narrowed my problem down to Patella-femeral Maltracking. So from what I can gather, does this mean every time I weightbear on my knee, because it is mis aligning, that is what will cause me pain if I do certain things, (squats, extensions). Now if I don't do those things but just do simple slow walking,(which doesn't cause me pain) is that enough friction to cause the swelling that I have daily ??  And has anyone had this sort of experience, even if I am having a so called good day, and there is minimal swelling, I can make it swell up by just standing still and rocking slightly & gently (without lifting my feet off the ground) shifting my weight from one foot to the other. I only have to do this about 5 times and it just puffs straight up. (Swells above the kneecap). I watch my legs when I do it and I notice that my quads are flexing as I do this, (I don't go around doing this all the time, it is something that I have done a few times to show PT and OS what I am talking about )  ::)     ;)  .   Just wondering if anyone else has such sensitivity to swelling when trying to work those quads. I know they are all supposed to be connected some how but it just seems that as soon as I try to work my quads my knee swells instantly, but that is the only thing I'm told that will help my knee, is to get those quads working again, but they won't work if there is swelling.   SEE MY DELEMMA    :o      ::)    Any one in the same boat  ??? Boydy
Arthroscope to repair meniscus tear, 10/04
Arthroscope for Lateral Release & repair another medial meniscal tear, 2/05
"Time heals all wounds"
Gosh I sure hope so !!

Offline shade

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Re: Swelling from quad movements ?
« Reply #1 on: December 18, 2005, 11:47:56 AM »
Boydy,

As you know I'm no doctor, but sure sounds like tendinitis..... Do you use ice on your quad/patella tendon daily?  Just wondering because this helps.  These ice bags are very convenient to use.


If you are not swelled you can use hot water bottle to loosen up muscles and the heat soothes the muscles.  Sometimes I'll do an ice pac, then wait ten minutes and change to a hot water bottle. Another thing you can do is elevate your legs as much as possible, this helps with swelling.
http://www.footsmart.com/Ailments-Knee-Tendonitis.aspx

http://www.physioroom.com/injuries/leg/patellofemoral_maltracking_sum.php

Hope your cho-pat dual strap comes in soon and will relieve some leg stress so you can get out walking again.  Also, hope you can find a surgeon that will treat your condition.  Good Luck.  ~Shade
« Last Edit: December 18, 2005, 12:31:37 PM by shade »
July '05 (RK) - LR/debridement
Mar '06 (RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07 (LK) - LR + Fulkerson TTT

Offline Nettan

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Re: Swelling from quad movements ?
« Reply #2 on: December 18, 2005, 01:44:48 PM »
Not easy to get around it then Boydy. Maybe you need to have other exams then a OS to see why this happens, if there's any other condition behind it.
I don't remember if you have done that. Just a thought.
I wish I had a clue how you can work around it. Does same thing happen if you work with completely straight knee ?

HUGS NETTAN  8)
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline stgiles16

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Re: Swelling from quad movements ?
« Reply #3 on: December 18, 2005, 01:46:40 PM »
Boydy , I am in a similar boat. My knee swells every evening (sometimes during the day) and it swells when I try to do quad exercises. It also hurts alot when I do quad exercises which means that my muscles are not growing even if I work thru the pain. I just got this speech from my OS and his PT this week. It is a vicious cycle that I dont know how to stop. I am really frustrated withthis too. If you can figure out an answer, please share, I will bet that there are lots of us out there.

missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline shade

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Re: Swelling from quad movements ?
« Reply #4 on: December 18, 2005, 02:02:15 PM »
Missy,

Know what you mean - I'm in this pain-cycle thing and so is Karen S & probably many other people out there.  It is a very hard cycle to break as I've been learning and with the help of bracing and pain killers, knee injections etc.  it has to be broken or you will never get the quads strengthened.  This is quite scary.....
Everything we have tried so far hasn't worked so I'm down to trying to go for a walk when I feel good and recumbent biking without tension.  Tried using a stationery bike and can't stand the pressure it puts on the knees, so had to purchase my own recumbent bike....
Had really hoped that the knee injections would have done the trick, but that did not happen, now I'm hoping the bracing will help get me moving enough to strengthen the quad without further setbacks. 
I've learned to stop everything and rest, elevate and ice if I get pain.....
Good luck Missy, let us know if you find anything that works for you....  ~Shade
« Last Edit: December 18, 2005, 02:04:02 PM by shade »
July '05 (RK) - LR/debridement
Mar '06 (RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07 (LK) - LR + Fulkerson TTT

Offline stgiles16

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Re: Swelling from quad movements ?
« Reply #5 on: December 18, 2005, 02:31:40 PM »
Shade, my OS wants me to come down there and stay for two weeks to do intensive therapy , 5 hrs a day. I dont see how that is going to break the pain cycle but it might just show him what I have been trying to explain all of these visits. The thought of leaving my kids for 2 weeks sucks though and just the thought of the pain terrifies me.

missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline shade

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Re: Swelling from quad movements ?
« Reply #6 on: December 18, 2005, 03:04:50 PM »
Missy,

I'm with you on that one, but the reasoning might be for his PT's evaluate your pain levels and find a treatment program to accomodate you - so you can do exercises without pain during and afterwards.  They have not been able to achieve that with me yet.  If I can do the exercises without pain about three hours later I can barely walk due to the pain.   It is so very hard when you feel that no one is getting it - that is how I felt for so long, but even if they understand that you are trapped into a pain-cycle it is still hard - trying to find a way to exercise & not create pain while exercising or afterwards.  That is where everyone is having such a hard time with me.  Heck, I'm still taking percocet to get through the day and I'm over 5 months post-op..... Yikes!!  that sounds awful......
It would be hard leaving for two weeks though, I agree.   To tell you the truth it makes me cringe thinking about you doing this, but they might find out what is going on and maybe will be able to devise a plan of treatment that will be beneficial to you.  I'll keep my fingers X'D for you - if it was me I'd go for it, just because I've been seeking answers for three years now and would jump at any chance to get back to a more normal life...... Well, if I could jump.....  ~Shade
July '05 (RK) - LR/debridement
Mar '06 (RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07 (LK) - LR + Fulkerson TTT

Offline stgiles16

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Re: Swelling from quad movements ?
« Reply #7 on: December 18, 2005, 03:52:05 PM »
Shade, I will go down there for a week first to see if it is helping but the thought of leaving my family is not a good one and I am soooooo afraid of how much this is gonna hurt. Like you, I hurt everytime that I do exercises, shoot, I hurt if I shop for a couple of hours and I love shopping. I am really frustrated right now. The expenses are a little frightening too. Yikes, hotel bills, new deductable on insurance, that will be one pricey trip.

missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline Nettan

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Re: Swelling from quad movements ?
« Reply #8 on: December 18, 2005, 04:03:12 PM »
I'm like you...doing excercises aggravate all of the pain...so for me it's totally up to me how much I do. No phys nowadays or OS will give me a level. So when doing watertherpay sometimes i'm only in there not doing any special, depends on how the day is.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline shade

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Re: Swelling from quad movements ?
« Reply #9 on: December 18, 2005, 04:15:07 PM »
Missy,

Think a week is a good compromise..... It's very hard when your surgeon does not live nearby, I have that problem also. 
We plan on another roadtrip in the new year, around the middle of the month - seeing if the injections worked or not, but since I've found no real relief yet - sounds doubtful that they are going to start working now.....
It does become very expensive and with motel rooms in the mix - very expensive. 
Good luck, Missy..  ~Shade
July '05 (RK) - LR/debridement
Mar '06 (RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07 (LK) - LR + Fulkerson TTT

Offline Boydy

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Re: Swelling from quad movements ?
« Reply #10 on: December 18, 2005, 09:46:28 PM »
Hi all,  this time difference is wierd, so many conversations happen, while I'm sleeping.  ;) 
Shade -  Funny you should say Tendinitis, that is what my PT is saying, OS says Maltracking,  ::), but after reading those great sites you gave me, it sounds like both of them.  :-\ . Yes I do ice EVERY day sometimes two or three  times, (plenty of time on my hands now I'm not working) I use a wheatbag that I keep in the freezer, (very similiar to your picture) I even take it away with me. I have the same thing with the bikes, Stationery is a no go, I can only use recumbancy bike. Yes, I am holding out for my brace, thought it would have come Friday, but didn't, so am thinking TODAY is the day, hope it helps. Is yours still giving you success,? hope you are feeling a bit better, shook that bug, and getting back into it, have to be good for xmas.
Nettan - Yes I have had quite a few opinions, have seen 4 different OS and the last one 2 weeks ago also sent me to a Nuerologists (saw two of them) to rule out muscle or nerve problems, one was concerned by my muscle responses to stimulie, and sent me for Brain and spinal cord MRI's (was testing for MS etc) & fortunately these came back all clear, so back to square one. As to your query on straight leg, do you mean straight leg raises ? If you do, then yes it does still swell if I do them,  the weird thing is , it also swells if I have acupunture or have it massaged ( when they find those lumpy sore bits and massage them out  :o   :'(   that really kills. Weird when it is my thigh they massage and my knee swells  ???.
Missy - That sounds like a good thing to do if you can manage a week at least,  I've often thought, I wish the PT or OS could see me the next day after they have got me to do all those things in their office, because after I have been for a visit, my leg takes about a week to settle down !!! I don't think they beleive me when I tell them, so one day I went back in the next day to show him (PT) and he was dumbfounded, so then he just gives in because its in the too hard basket. (All 5 PT have done that,) that is why I have to do what you guys seem to be doing as well and just going by your own instincts and trying to work out your own programs. (With a lot of helpful advice from this site, and listening to people who have the same sort of symptoms). Whew , sorry this is so long, but there is a lot to cover.  :P
Boydy













Arthroscope to repair meniscus tear, 10/04
Arthroscope for Lateral Release & repair another medial meniscal tear, 2/05
"Time heals all wounds"
Gosh I sure hope so !!

Offline shade

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Re: Swelling from quad movements ?
« Reply #11 on: December 18, 2005, 11:28:52 PM »
Boydy,

I do agree that you can have both...... Know that the rehab for maltracking usually leads to tendinitis.  I know for a fact that my patella is medially subluxed because the new brace that I have the tru-pull wraparound really pulls my patella over to the groove and my knee feels much better now, but as soon as the brace is off the patella subluxes again......
When patellofemoral pain due to maltracking is associated with patellar tendinitis, both pathologies need to be addressed.

It is very strange we are from all over & none of us can find physios who seem to be able to treat our conditions properly.  I've been to several therapists and they all try to slap weights on my ankles and look at me like I'm crazy when I refuse...... Then they think I'm difficult..... Argg!!

http://www.physioroom.com/injuries/leg/patellofemoral_maltracking_full.php

Hope your brace arrives soon.  I'm wearing two braces right now - fun, fun, fun.....  Think I'm over the bug now, feeling better each day.  Will start walking on the trails again soon and will let you know how it goes......

PATELLA MALTRACKING
The normal patella should track in the groove of the femur in a relatively straight manner.  There are varying degrees of malalignment and tracking.  In some cases the patella may tend to track more to the side of the knee or actually be tilted as it goes back and forth in its groove.  On occasion it may actually come partially out of the groove, which is called subluxation.  Some patients have a positive “J-sign” in which, in full extension, the patella tilts and is pulled strongly to the side of the leg.
The tracking of the patella can be influenced by different things.  Most of it is influenced by the anatomical shape of the knee.  The following can all contribute to the maltracking of the patella:  shallowness of the femoral groove, the angle of the knees (knock-knees), rotation of the hips, foot positioning on the floor (pronation or flat feet), weakness of the quadriceps, and the shape of the patella.

Treatment
Treatment for this emphasizes quadriceps strengthening.  The middle muscle of the quadriceps, called the vastus medialis obliquus, or VMO, is the muscle that is focused on to try to balance the patella in its motion.  Occasionally, taping can also help with this.  If conservative measures are not helpful, surgical treatment is reasonable.  Rebalancing the kneecap by opening some tissue on the outside of the knee can be done arthroscopically.  Occasionally tightening the medial structures can also help.  In most patients, this type of surgery would be all that they would need.  In some patients with a significant problem and with patella subluxation or dislocation, a more extensive realignment procedure is sometimes used.

Hope everyone has a great evening.....  ~Shade
« Last Edit: December 18, 2005, 11:31:49 PM by shade »
July '05 (RK) - LR/debridement
Mar '06 (RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07 (LK) - LR + Fulkerson TTT

Offline KarenS

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Re: Swelling from quad movements ?
« Reply #12 on: December 19, 2005, 12:26:35 AM »
Shade, I read the information you posted, and I'm so disgusted right now (not at you -- just in general!  ;) ). Deep down inside, I feel that the LRs I had years ago to correct patellar tilt in both knees set me up for this horrible experience I'm having. It's far from a "simple" surgery and it changes the mechanics of your legs. I couldn't push my self to do much rehab after those surgeries because, sort of like now (but not nearly as bad), some of the more advanced exercises seemed to make my knees feel irritated. (And now I realize that it probably was because I still had some inflammation in there and my kneecaps were maltracking a bit, which causes pain -- same as what's going on now!). So I just backed off the exercises and walked to exercise my legs. I was lucky that eventually I did get most of my quad strength back, but I was told by my therapist that after knee surgery, most people never get back 100% of their quad strength unless they are very aggressive with their rehab. So I think my quads have a tendency toward weakness to begin with...add that to the "miserable malalignment" I have, and add that to the fact that I was working out like a maniac at the gym without a stretching program, doing the same type of exercises over and over instead of working all muscle groups...and there you have a huge, unbalanced, atrophied MESS, named Karen. ;)

Anyway, I'm just ranting a bit. It just annoys me when I read about how "cut and dried" they try to make LRs out to be, and they really are a big surgery. I still feel that in my case it needed to be done because nothing else was working therapy-wise, and I wanted to kiss the ground my surgeon walked on when I was able to walk around like a normal person once again with no pain. But now I'd like to slug him for not warning me that I needed to be very careful in my rehab and to stick with it until I could do it pain-free. I think I entered this recent knee problem at a disadvantage because of that. I honestly thought I was going to get through the next 50+ years without more than a peep or two from my knees. HA.

And with that, I'm off to bed. (I'm sorry, Boydy, for highjacking your post! I'm grouchy because I felt really good today and attended a Christmas party...only to end up with that weird sore area on the inner portion of my knees on the way home. What IS that?!? I sure hope the OS I see next week will give me an answer -- and I'm praying it's nothing to be worried about. :( )

Offline lilrosie06

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Re: Swelling from quad movements ?
« Reply #13 on: December 19, 2005, 03:43:29 AM »
Boydy, I have a subluxing problem, and any use of my quad causes pain and swelling. I cant squat, kneel, and have to be real careful on stairs. If my condition doesnt get any better by spring, my OS is gonna do a patellar reconstruction. You are not alone. Hang in there...

DONNA
LEFT KNEE INJURY-1-05
SCOPE 4-05, LR 1-07, TKR 6-07, MUA 7-07, REVISION 10-07, INFECTION CLEANOUT 11-07, REVISION 4-08, EXPLANT 2-09 ANTIBIOTIC SPACER PUT IN, AND PICC LINE FOR 6 WEEKS
REPLACEMENT 5-09

BACK IN PT NOW....HIP AND FOOT PAIN, POSSIBLY SCIATIC

Offline Boydy

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Re: Swelling from quad movements ?
« Reply #14 on: December 19, 2005, 03:49:56 AM »
Hi Shade,
OK,  I'm starting to get the drift of all this now, seems important to get the VMO in working order, any ideas on how to do this if I can't do leg extentions or squats, lunges. When I looked it up that is what was recommended. Will the VMO muscles get stronger by just doing a few quad sets and a few leg presses (no weight).??  Because (like you)  everytime I see PT or OS they insist that I will not get anywhere just doing the things I am doing.  Even this new OS I saw last said," strap those ankle weights on and sit in front of the tv at night and work your way up to 100 lifts " !!!      :o  Don't you just feel like slapping them !!  I know that for some patients that may be some good advice,  but just once I would like to go see someone that has an incling into what my knee is all about, and just say, "most cases this is what you should be doing, BUT, in your case we will have to do this instead !!!  ::)
Yay, I just picked up my brace, have gone up and down the stairs a few times and it feels good, so far. Test will be at the gym tomorrow, and when I take the dog for a walk,  then the real test will be the next day, (see if it swells up) !!  Bugger it if it does,  at least I might be able to do a few more activities with it on, (without limping)  and start to do a few more social things, sick of being left behind all the time because I can't do this or that. Especially over the holiday season.  Fingers crossed, I will let you know how it goes.  :D  Thanks for all the info it has been a good read. I need to have as much knowledge as I can to do this right.
Karen S -  go for it , I don't mind sharing, anytime,  we are all in the same boat !!!  ;)
Boydy
Arthroscope to repair meniscus tear, 10/04
Arthroscope for Lateral Release & repair another medial meniscal tear, 2/05
"Time heals all wounds"
Gosh I sure hope so !!