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Author Topic: Physical therapists & Microfracture  (Read 2249 times)

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Offline crumblingknee

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Physical therapists & Microfracture
« on: October 21, 2006, 11:07:41 PM »
   From:      neil
   Subject:    Re: Re[2]: Knee Geeks
   Date:    October 21, 2006 5:56:51 PM EDT
   To:      cookie

Hi,

Thanks for your detailed reply. It is great to hear from you.

Thanks also for the warning about pain & your description of the delicacy your PT is showing. I am working with my second PT since my operation in August 2006 & am developing concerns. She has really been pushing me to expand my range of motion which is at 120 degrees or so, up from 90 degrees, which was my limit 2 weeks after the operation. The thing that is troubling me is this move she does where tries to bend my knee up to expand my range of motion. My knee was sore from the last treatment on Monday & on Thursday she pushed again. I had been giving some hints about pain issues during the session but she did not bite. I have been getting back into working so I am focussing on work now more than recovery & I think I failed to exercise adequate supervision of my treatment. Anyhow as of Friday morning I was very sore & by Friday evening I was limping. Things are better as of Saturday but I am very concerned. I think if there was no injury to the "patch" from the microfracture that was more luck than anything else. My next session is Monday & I am planning to clear up this failure to communicate. Since I am in some pain I may be less than diplomatic! A few things are bugging me here. 1) I am concerned that my present PT and 2 other PTs previously I have dealt with before are all on the aggressive side, all work for the same hospital, & all seem to have poor listening skills. I am giving a lot of thought to saying 3 strikes, you're out, & simply switching to a new hospital for my PT. 2) Even if I am able to back off this particular PT from this particular stretching movement, she might try something else that is overly aggressive & cause me more problems. 3) This hospital, as well the vast majority of PTs I have encountered elsewhere, seem way to insurance driven. If you are given a 60 day benefit for PT by your insurance carrier (my benefit is 60 days), you are deemed recovered, whether or not you really are. For someone recovering from microfx, the recovery period is way beyond 60 days. 4) I am really distressed by the poor communication between my doctor & my PT.  I picked the hospital presently providing my PT because my doctor does his operations there & has an office there. I had hoped that would encourage PT-MD communication if not supervision. At my last session, my PT said that everything in my knee that required fixing was fixed. I was not aware that was the case & am not all sure that to be true. At the very least I had a menisectomy on a different part of the same knee, meaning something is wrong somewhere else. I also get grinding on the outside of my knee on a site which I believe is unrelated to either operation but has been a source of trouble in my opinion. (My surgeon has operated on my knee twice but not addressed that issue except to say it is chronic). Anyhow I am pretty upset by this situation & would welcome your feedback & the feedback of our fellow knee victims.

I think you are wise to not let your knee get sore. Your recovery sounds like it is safe & steady, which is the way to go.
Neil

On Oct 19, 2006, at 12:05 PM, All Mountain Construction wrote:


Neil,

I started going to PT 1 week after surgery. I also had a lateral
release at surgery and she's being very careful to make sure I don't
develop any scar tissue. I've been going once a week and basically
working out and she's been massaging and stretching things a bit too.

I've been working on my foot, ankle and hip mostly - strengthening
those a lot. I'm working my quads and hamstring as much as possible
too.

I'm in business for myself, so I had to stay working and not stop much
when I had surgery. Luckily I have a partner who is great. I'm a
contractor and we build new homes and a few remodels. At least I can
go at my own pace. Plus, one of the remodels I'm doing now is on my
doctor's and PT's house..... (One of our crew recently broke his collar
bone and my doctor took care of him too.)

In the last week or so, my leg has been getting a lot better and
faster. I've made sure though to never allow the defect area to get
sore in the least.

Apparently, since my defect area is so large and since at 6-8 weeks,
it is only meant to be partially filled in in smaller defects, my
doctor will probably be gradually increasing my range of motion in the
brace until the 12th week.... So I won't be "liberated" quite yet.
However, I remove the brace every evening I'm home and I'm simply
careful to not bend my leg too much. My leg is plenty strong for that.
I also do a lot of exercises at home without the brace on:
1. single foot toe raises
2. single foot rolls
3. pillow under knee and then flexed to straight leg raises with 3 lb
weight on ankle
4. stand on bad leg and swing good leg across front
5. stand on bad leg and rotate good leg around as far as possible from
side to side
6. band around ankles and side step in circles both ways
7. legs on big ball and do bridges both straight legged and bent
8. lift foot up behind me
9. raise thigh and let foot dangle

There are others too, but I've got to get some stuff prepped for the
seminar we're giving tomorrow on skiing. I do all exercises until I
can't do them any more - until fatigue....

I'd be really careful NOT to get your knee sore by the end of the
week. You need to take it easy and make sure you allow that
microfracture to fill in and not be damaged. Pain at this point is NOT
good.

More later.


Cookie
« Last Edit: October 21, 2006, 11:11:12 PM by crumblingknee »















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