Only good for a week 'syndrone'

[KarenS]

Hey, Boydy, I love to write, and I have been a copyeditor for the past 10+ years! And I think I've heard that Heather is a writer, too (?) We probably *could* write a book! I think "From the Depths of Hell" would be a good name for that sort of book! LOL!

I'm so glad the piddly pool noodle did some good while you're waiting for the big guns!

Shade: I don't know what's going on with those dents -- although it could be atrophy...? Do your ITBs feel tight? How about if you press into the bands and rub -- does that hurt? It seems like ITBS is a popular problem amongst the long-term sufferers on this board.

So, is this thread our offical "meeting place" now? I feel like I belong to a club! Maybe we can call it Club Gimp. 

[shade]

Karen,

No, it does not feel tight.  It is very painful at the end near the knee.  I can stick my fingers right into the dent - it is like a trough up my leg - lateral side right leg. 
OMG - Please tell me it is not more atrophy...... 
All this biking and walking that I've done in the past 6 months post-op - hope it is not more atrophy - that would not be good.....
Well, Karen if this is a club - don't think I want to be a member - like the people - but not the ITBS......

[KarenS]

Shade, I'm sorry if I made you feel down. I was referring to our thread here ("Only good for a week syndrome") as our "club"! I don't want you to be a member of the ITBS club along with everything else you're dealing with! I actually was trying to make you laugh -- it's been a long day, so I guess my wit leaves something to be desired!

I have dents, too -- aren't they normal?

[stgiles16]

Shade, that dent is just a normal part of the body. It does NOT mean that anything is wrong with you. I have always had those and so does every other person that I have seen unless they are greatly overweight. It is definition between muscles. Everyone has them.

missy

[Boydy]

Hi girls,

Shade I did that test and I also have that dent, it is also on the inside of my thigh as well, (actually both sides concave inwards when I tighten my quads). I thought this might be natural as well, so I did the same test on the other leg and it doesn't 'indent' , 'concave' (whatever you call it) at all. ?  Is that what muscle atrophy is, noone has ever said 'those words' to me, they just tell me my quads are 'pathetic' and 'abnormally weak'.   .  Maybe you will get some answers from your OS,  Is this a new one, or just a follow up ? When do you go to see him ?
Keep us posted . Will be interested to see what he says.

[KarenS]

I don't think that's atrophy. Like I and the others said, I think it's a natural "dent." But if it hurts at the bottom I would be suspicious about the ITB. I think you should mention it to someone to find out for sure.

[shade]

Karen,

Read your post, you did not make me feel down.  I also was trying to make a joke.  Guess it is Friday and I'm just tired.  'Club Gimp' might be the right name.

Missy, hope you are right - it is not the same as the other leg though.  I can put two fingers side by side in the dent right up the outer part of my leg for 6 inches - then the leg is solid again.

[misshilde]

Hey Shade, you're supposed to have a"dent" there ...it's supposed to go all the way up your thigh if you're in shape..that's muscle tone..good for you..means you don't have too much fat in that area....

hilde

[Heather M.]

If I'm thinking of the same 'dent' that you are, it is where the quad muscles turn into the quad tendon, then attaches around the top of the patella.  So it's perfectly normal, if you have some muscle definition, to have an indent.  Strangely, I lost mine with my lateral release--because the top of the LR cut can extend all the way to the bottom of the quads where they come into the quad tendon...at least if you have an "extreme" lateral retinacular release, as I apparently did.  So anyway, there are several reasons that area could be sore--for those of us with LR, it is the top of the incision that split the lateral retinaculum and released it.  So this is a surgical site, at least, and it may also have a significant 'chunk' of scar tissue as result of the procedure.  There are also lots of nerves in the area, as well as a lot of soft tissue with a good blood supply...blood usually means pain potential. 

You may also be sore there because of scar tissue alone.  Sometimes when you have adhesions in one spot, the skin will suck down (like one of my incisions--when you push on it, the skin puckers down or dimples); I would think this would cause some pain around the area--tightness, pulling, soreness, or outright OUCH.  Or the pain could be because of some quad tendinitis, neuroma (damaged chunk of nerve tissue), ITBS (another form of tenditis or overuse syndrome), or even mal-tracking patella that goes laterally and has damaged cartilage or soft tissue in the area.  Lots of reasons.  If it feels much better when you rub it, then perhaps it's soft tissue related?  And the IT band goes right down the lateral aspect of the knee.  Myo-fascial release should help a lot of this is the case.

Good luck.  And don't worry too much about the difference in the appearance between a leg that's had an LR and one that hasn't--it pretty much changes the appearance and definition of the muscle because the tension on the bottom of the quad of the operated leg has been released...that's the whole point of the surgery as a matter of fact.  If you haven't had an LR done, maybe the change is due to scar tissue or serious atrophy?  That's something to consider.  Lack of function, or inability of the quad to fire properly because it's entangled in scar tissue, for exmaple, will cause the muscle to shrink and change in appearance compared to the other leg.  So don't fret too much, hopefully it's just a normal (but really annoying) consequence of the procedures we've all had.

Heather

[shade]

Heather,

Contracting my quads and watching them move - the area I'm talking about is just lateral to the quads, so I'm thinking it is the ITBS.  The explanation of adhesions in one spot, the skin will suck down might well be what is going on with my leg.  I'll definately mention this on my next appointment & see if this is the problem & what should be done to help.
Thanks for the information, Heather.  Good explanations.  I'm just so hoping that this has nothing to do with ITBS because I've been doing so much biking for my rehab & reading biking should be avoided with ITBS problems sends a shiver down my spine.......   
Aren't knees wonderful.  ~Shade

[KarenS]

Shade, try not to worry for now. My recent PT wanted to get me on the stationary bike (I'm assuming with no resistance, but who knows with these crazy PTs), and she knows that I have ITBS. It's good that you're not using the bike, though, until you see what's what. The recumbent bike is okay for people with ITBS, but only later in the recovery, I believe, once the band is loosened and calmed down.

On another note, my acupuncturist discovered something else I've been doing wrong all this time -- quad sets! I had a feeling after I explained to Boydy how to do them that I was doing it wrong -- I'm sorry, Boydy!  What I explained to you were short-arc quads. I don't think you're supposed to do short-arc quads until you can perform a good quad set, and now I know why! I cannot do a quad set very well AT ALL.

When I went to acupuncture a couple of days ago, I was on the verge of a meltdown and was having a very hard time holding it together (just wasn't feeling well and hadn't been for a treatment in almost three weeks because she had been on vacation). So, my acupuncturist, bless her heart, went right into therapist mode (and I mean physical *and* mental therapist mode!). She examined me thoroughly again, showed me how she wants me to massage my thighs twice a day, and had me show her the exercises I was doing. As it turns out, I was doing 80 reps of those short-arc quads and was getting barely any benefit from them because my quads weren't firing correctly. In fact, where I've only been feeling good off and on, I had been sitting a bit more than usual, and she found that the muscles in my right leg (the leg that's worse) is now WEAKER! I was so upset to hear that! But I guess I should just be glad that I found out what I'm doing wrong. I have a VERY hard time getting my quad to contract when just doing a regular quad set. It's so much easier to flex your foot and lift the bottom of your leg while contracting the muscles (particularly when the muscles are not firing correctly!  ). She told me to start working on the quad sets immediately, and that I should work my way up to at least 100 a day (obviously not right away -- especially since I can barely perform 10 wimpy ones and my legs feel tired from that  ). This is so ridiculous that I've been examined so many times by all different people and *14 months* later, I'm finally told that I'm doing the simplest exercise incorrectly. Grrrrr...

Anyway, I am *so* happy that my acupuncturist is back to work. She really worked on my ITBs and my quads on Thursday, and I've been sore as heck ever since. I feel like someone beat up my thighs. But I'm happy to have that feeling because I know she did something to help. She also helped to calm me down, because I think it was written all over my face that I'm at the end of my rope. She insists that although she knows I'm very uncomfortable, she feels that it's just been a long recovery as it sometimes can be with certain people, and she feels strongly that all that's going on here is not something severe enough to worry about. She told me again that she has dealt with people with very similar problems in the past, and she's not really surprised that it's taking a long time to sort it all out. Although, she did say that she felt I was going to be "all set" last September when I was almost completely better...but that my extremely weak legs couldn't handle the sudden increase in activity and is the reason for my backslide. She started stimulating my quad muscles again, and once again my legs feel stronger. I'm so mad, though, because that strong feeling was really beginning to stick around for longer and longer periods before she went on vacation. I think three weeks without the needling set me back a bit. Oh, well. She said that in China, when people are stuck in this sort of rut (legs need exercise because of atrophy, but exercise causes pain because of atrophy), they have acupuncture every day to stimulate the muscles, to get them to the point where they are strong enough to get them "over the hump" and able to exercise more. But, of course, in China that is the usual method of treatment rather than an alternative one, so the insurance pays for it. Pretty soon I am going to consider moving to China. LOL!

Oh, and I'm still waiting for that guy to call me about coming over to fit me for that knee sleeve with the EMS. Man, everything seems to take so long to get going! I'm sure everyone feels that way, though. It's a lot of hurry up and wait with rehab.

[shade]

Karen,

Glad that you have a good accupuncturist, they can be awesome. 

Probably a big part of my problems - the therapists here just don't know what to do.  The equipment used for PT here is very limited & totally out of date.  Anyway, I have my recumbent bike & hopefully will manage to get this chondral lesion to settle down enough so that I'll be able to get back to biking & walking again.  I keep trying to go out for a little walk each day, but I can't get very far without this lesion getting irritated - it is very discouraging & frustrating, but hopefully will be resolved with time.
I've really considered going to a gym & have found a good physio there, but he won't touch me until I have papers from the surgeon.  He is worried about the chondral lesion pain I'm having, he has no problem with me wearing the tru-pull brace for the medial subluxation, which is a change. PT's allow kneesleeves while exercising, even though my patella displaces medially whenever I stand.  Duh!!  Anyway, if I can find something to help with this lesion I'm really thinking I'd like to go see this guy & see if he could help.  He is very expensive but uses all the best equipment & knows his stuff - guess you get what you pay for.  Don't think insurance would cover, but could try.....
I'm back to doing only the manual exercises like the straight leg raises & heel slides.  That is something that I was shown how to do & think I'm doing right.  It's frustrating going backwards, but that is just how this knee beast works.........

Acupuncture done by someone taught traditionally is just so different.  They use the long needles & it really gives different relief as they penetrate further and are usually left in from 15 to 30 minutes.  The PT's here only have the basic training & can only use the tiny needles.  Glad you found your acupuncturist......
Maybe they'll get the brace fit soon.  Know about the hurry up and wait attitude..... Hmmmm!!
Hope tomorrow is better than today......  ~Shade

[KarenS]

Yes, those needles really do get right in there. She goes pretty deep for my ITB, and if she taps it in too quickly it hurts like the dickens. It looks like she's going in pretty deep for the quads, too. I didn't even know anyone used those short needles for acupuncture, but then again I've never had acupuncture anywhere else than from this woman. She does everything very traditionally.

I really hope the pain from your lesion lessens more and more with time. I would think that, like everything else, there's a good chance of this with the more you can build up your quads. I know, I know...it's easier said than done. I would think that doing your little walks (and stopping as soon as you get pain) is a good thing, and hopefully the more you do it the farther you can go, even if it's only 30 seconds longer each week. Hey, it adds up over time, right? Hang in there...

[Boydy]

Karen, OK now young lady, you are going to have to tell me all over again, I'm afraid I get confused pretty quick these days,     Which ones are the short arc quads sets that I'm not supposed to be doing, and how does the other ones go that I am supposed to be doing,    This Acupunturist of yours sounds like she sure knows what she is doing, (is she Asian,? they seem to have the best knowledge and incredible 'healing hands')  It sucks that all these wonderful practitioners have to go on holidays ( how dare they !)  I can't wait until Tues when my myofacial massage therapists goes to town on my leg,  oouucchh !!  I don't know about this ITB, I have looked it up numerous times, but am still a bit confused about where it actually is. ( Told you,!!  my hubby is convinced the more surgeries I have the more my brain whittles away with confusion    )  All I know is my leg gets very tight in certain places up the outside of my thigh, ( mostly just above where they did the LR ) So I think that is what Heather was talking about.  That is the spot I have been concentrating on with the pool noodle, and have found it to be a great realease ( for a few hours only, but anything is better than nothing).  Isn't it sad that we all seem to having some bad days at the moment, Karen, especially when you were at the stage where you could actually get up and DANCE, and in HEELS!!! ( I think I got that right, didn't I ?)   That must at least give you some encouragement that you can get back to that stage eventually, did it once , you can do it again, (sometime in the future)  .   It has been  16 months since my 'fatal' dance night, ( that is how all this started for me). I love dancing, and I have missed it sooo much, to go out or to a party and not be able to dance just about kills me.  I get sooo bored, ( I'm not one for just sitting around drinking and talking ) So my social life for the last year and a half has been very dull, ( or maybe I just am very dull and had better learn the art of 'wonderful conversation' )   
OK, this has turned into a  "Dear Mabel'  letter, ( this site tends to do that to me) 
I think it is that empty nest syndrone, really kicking in lately,!! 
Definately have to get myself some sort of job this year or I will go insane focusing on this damned 'thing' the whole day. Goes like this........... Should I do another set ?  Have I done too much today ? Should I just give it a rest ? Is it too soon to add that other excercise I was told about ?  OMG, which thing made it swell like this !!!  Damed, I was able to go up the stairs sooooo much better yesterday !!!  WHAT WENT WRONG      
I bet this sounds familiar 
OK I'm going before you all think I have really lost the plot.!!!   
Have a happy day !
Boydy

[KarenS]

Should I do another set ?  Have I done too much today ? Should I just give it a rest ? Is it too soon to add that other excercise I was told about ?

That made me laugh! Oh, yes, that sounds SO familiar! I'm sure lots of us on this site have these thoughts going through our heads most days.

Okay, it's not that you shouldn't be doing the short-arc quads, but I did read somewhere that the first thing you should do -- and keep doing until you are doing it WELL -- is quad sets. If you don't perfect the quad set, you won't be doing the short-arc quad right, either. And you don't want to waste your time thinking you're doing so great because you can do so many reps when you're not working the right muscles! So, here's the deal. A quad set is when you contract your quad muscles ONLY -- they are the only things moving. Don't flex your foot, and don't raise the bottom of your leg (as I mistakenly told you previously). Hold for a few seconds and release. You have to really concentrate on those muscles to get them to move. I know that sounds weird, but I was even taught that at the gym for back exercises and it does work! (Lots of back exercises have you pulling/pushing weights with your arms, and if you don't concentrate on using your back muscles, your arms are what's getting the workout!) So, the acupuncturist showed me on her leg how when she contracts her quads, the kneecap moves upwards towards the thigh. So she had me focusing on getting the kneecap to move up, and that really helped get me to isolate the right muscles. It's very easy to start using your butt muscles during quad exercises, and you don't want that.

The short-arc quad is what I described before: flex your toes up while pushing your knee down into a rolled-up towel while flexing your quads, and raise your lower leg a bit until it's in line with your upper leg. Hold for a count of three.

Oh, and yes, my acupuncturist is Asian. She came here from China a couple of years ago, after having worked for ten years at an orthopedic hospital that deals in Traditional Chinese Medicine. She is the ONLY person who's examined me who has been able to make sense of what's going on with me, and the only person who has given me good advice. If not for her, I would still be crying every night on the couch (now it only happens after I've danced in high heels -- yes, you got that right, Boydy! ).

So, I hope I cleared that up! Have a great night.