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Offline Natalie.D

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Need Ideas...
« on: September 04, 2006, 01:14:42 PM »

I have grade IV OA, just had microfracture done on LFC and on underside of patella and I'm trying to rehab from this, problem is I had a car crash 2 weeks after the microfracture and bashed both patellas off the dashboard, now I cannot progress with my PT because of patella pain, the only thing I can do without major pain is SLR, does anyone have any ideas on what other exercises I could try that would not aggrevate the patellas?  My PT has discharged me as I cannot do the exercises and has referred me to try some hydrotherapy but it seems this will take a good few weeks before I can get a session and I don't want to lose the small amount of quad strength I've got left.  Any ideas/suggestions?

Dislocations since age 12
Trochlear Dysplasia
TTT, LR, MR L knee 95-Success
TTT, LR, MR R 02-Success
Screws out
Partial tear ACL
Severe end stage OA
4 Debridements
Partial Meniscectomy
Failed Microfracture
11mm Defect LFC
Bone Spurs, Kissing Lesions

Offline Jaci

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Re: Need Ideas...
« Reply #1 on: September 04, 2006, 10:01:10 PM »
Hello, Natalie,

I have an entirely different knee issue, but similar problems with patella pain when I do most quad strengthening exercises. My knee cap grinds due to altered joint mechanics from arthrofibrosis, much of the cartilage is rubbed off my patella and trochlea. I can do quad sets and SLR with marginal irritation. I recently started doing them with e-stim to get better contraction, thus more development of the quads/ VMO. I use an e-stim unit at PT and TENS at home, I just set it to the longest burst and rest interval. I do hundreds of SLR and quads sets this way.

At one point I was able to do very light presses on a leg press machine (less than 10 pounds) and using a very limited arc of motion (about 15 degrees) in which I did not straighten my knee completely. Did a lot of experimenting with my PT before we could find a range of motion and weight that didn't bother my knee. We started by having me just press with slightly bent knees against resistance of a leg press machine, had to use a bit of weight to keep from accidently lifting, but I was able to get pretty effective quad using from this method.

We also found ways of tricking my quads into working by doing exercises that are completely unrelated to knees, such as wall push ups, and arm abduction and adduction using a theraband hooked in the door. What the exercises did was cause weight-shifting that automatically induced the quads to contract. They work best if you can fully weight-bear, but I've even done the arm ones while on crutches. I know it sounds a little weird, but they really did help.

I hope you can get into hydrotherapy soon.

Best wishes,

« Last Edit: September 06, 2006, 03:34:21 AM by Jaci »
10/03 Twist injury
12/03 Menisectomy- tears ACL, MCL, & LCL missed by OS
Arthrofibrosis ROM 38-68
3/04- 4/08 Multiple scar tissue procedures:
6 scopes w/LOA, AIR, LR, chondroplasty, synovectomy, bone spur & plica removal
3 insufflations, many injections
Chronic AF, patella infera, IPCS