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Offline Jakem

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Elite Seat Question
« on: March 07, 2007, 06:39:06 PM »
I found a guy who will rent me the Elite Seat for 150 dollars for 30 days.

As some of you know I had a severe extension deficit of 20 degrees.  Dr. Minas did a LOA 18 months ago which got me to 0 or -1 (1 degree of hyperextension).  My good knee is -6 (6 degrees of hyperextension).

Even though I am jogging now and doing barbell squats with heavy weights, my "bad leg" is gaining strength yet always lags 1" behind my good leg.  I believe this is due to lack of full hyperextension.

My question to you is based on any experience with the Elite Seat, do you think it can help me get a few more degrees of hyperestension?  Also, if it can, will I just lose all I gained after the 30 days if I don't continue using the thing for the rest of my life?

Offline QBknee

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Re: Elite Seat Question
« Reply #1 on: March 08, 2007, 01:38:10 AM »
Jake,

I think the elite seat can help improve your extension some, but I think you will need to continue to use for up to a year.  I know you know all of the other extension exercises (hanging weights with ankle proppped, prone ankle hangs). 

Dan
5/90 - Microfracture, 11/02 - ACI harvesting scope, 09/03 - Bone graft-Scar Resection -10/27/03 - Manip w scope 2/2/05- Posterior Capsular Release, Anterior Interval Release/staph infection, 3/14/05 wash out scope 12/11/06- Scar resection, lat/med releases

Offline jeepannabell

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Re: Elite Seat Question
« Reply #2 on: March 08, 2007, 05:51:47 PM »
Hello Jakem.  I think the Elite Seat will help you get there.  I personally could not believe how much better it worked for me than any other extension excercise.  Will it maintain after you stop using if??  I don't know, that's a great question...one I've been wanting to know the answer for.  I have been using mine for 15 months now and my knee has gotten a little bit worse over the past several months despite daily use of the Elite Seat, but if your knee is going to develop more scar tissue and impede extension (which is the case with mine) then it is going to happen no matter what.  The Elite Seat just makes it harder for the scar tissue to grow and when it does, it "crunches" it down...like a trash compactor :) 

Anyway, I think you would be suprised by how much you could gain, although I am not sure if it will allow for much gain in hyperextension.  If you are already straight the mechanism of the Elite seat makes it sort of hard to really hyperextend.  I was like 30 degrees bent going into it and got to like 8 pre-op just from it.  It works really well to get you straight (or, in my clase closer to straight).  So, I don't know if that helps you at all, or if I just confused you more.

Good Luck,
Anne

Offline Jakem

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Re: Elite Seat Question
« Reply #3 on: March 08, 2007, 06:32:58 PM »
I think you seem to be saying that the elite seat doesn't go into hyperextension.  That is not what I have been told and I hope that is not the case as it would mean I wasted my money.  I am already at 0 degrees or mayby even 1 degree of hyperextension.  I want to get to 6 degrees of hyperextension like my good leg or even 3-4 degrees would be great.

Also, I am not producing anymore scar tissue.  What I am concerned with is that if I do gain some hyperextension over the next 30 days, will it be lost after I stop using the Elite Seat or will normal activities including walking, stretching, jogging and weightlifting keep what I gained?

Offline mee

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Re: Elite Seat Question
« Reply #4 on: March 10, 2007, 03:06:52 AM »
Hi Jake,

The elite seat will provide hyperextension.  I'm at about -1 or 2, not equal to my other leg, but really happy with it.  I used it for about five months post-op, and just used stretching and active heel lifts after that.  I may have lost a degree since then, but I don't think so (I don't measure it anymore).  I guess the question about keeping the extension gain depends on why you lack the full hyperextension.  If its tightness in your posterior capsule and other structures, then it seems to me that the gain will stay once you get it stretched.  But keep in mind that all your other muscles and soft tissues have accomodated into your present state. 

Seems to me that it's worth a try, just to see if you make the gain.  Maybe you can make progress with it and then just maintain the extra extension with less drastic measures.

Good luck,

Mary
Dec 1999  RKnee - ACL tear while running on treadmill-weird, I know!
Jan. 2000  RK ACL Recon
July 2000   RAnkle peroneal tendon repair (decade-old injury)
April 2001  RK scar debride
Sept 2005 RKnee debride & fat pad removal
July 2006 RKnee - full ROM, rehabbing sloooowly

Offline Jakem

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Re: Elite Seat Question
« Reply #5 on: March 10, 2007, 03:39:33 PM »
Hi Mary,

Wow, it sounds like you are doing great, especially considering where you were.  I am glad to hear that. 

Yes, I figured the elite seat goes into hyperextension. 

I am not sure why I am not at full extension.  It may be from small amounts of scar tissue that grew back in the immediate weeks after my LOA in the fat pad area and behind the patella tendon, but then again it may be just from shrinkage of all the ligaments, tendons and muscles in my leg from having a 15-20 degree extension deficit for so long before I had the surgery to remove all the scar tissue.  If that is the case, I think the eltie seat may help.  The evidence seems to suggest that the Elite Seat is superior to the Dynasplint and JAS and the other techniques such as weights strapped on the knee, towel pulls and pushing down with heel elevated and prone hangs with weights. 

Don't get my wrong, I am doing well at -1 degrees, but I want to squeeze out a few more degrees so I can build muscle in this leg equal to the other leg.

I will let you know how it goes.

Offline Jakem

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Re: Elite Seat Question
« Reply #6 on: March 15, 2007, 12:33:26 AM »
Well, I got my elite seat in the mail today and I used it for the first time and the results were amazing.  This won't mean anything to people who have never had an extension deficit, but those who have, will know exactly what I am talking about.

After using it one time for 10 minutes and I was able to hyperextend my knee such that for the first time I could stand with my quad completely relaxed for the first time in 3 years.  Of course it tightened up a little an hour later but I am starting to think if I can get this result with 1 use, then 30 days of 5 times a day I may get a permanent improvement in hyperextension.  I will keep you posted.

Offline mee

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Re: Elite Seat Question
« Reply #7 on: March 15, 2007, 02:24:20 AM »
wooohoooo!  That IS exciting, Jake.  It's pretty cool, isn't it?

Good luck,

Mary
Dec 1999  RKnee - ACL tear while running on treadmill-weird, I know!
Jan. 2000  RK ACL Recon
July 2000   RAnkle peroneal tendon repair (decade-old injury)
April 2001  RK scar debride
Sept 2005 RKnee debride & fat pad removal
July 2006 RKnee - full ROM, rehabbing sloooowly

Offline rjs1956

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Re: Elite Seat Question
« Reply #8 on: March 15, 2007, 10:00:16 PM »
How would you compare the elite seat and the DynaSplint?
1970 patella dislocation
1/1/07 stage 4 petallfemoral osteoarthritis bone-on-bone
1/1/07 petallfemoral bone bruises "kissing lesions" quarter-sized
1/2/07 bruises bleeding into knee cavity, swollen, immobile
1/18/07 surgery to remove blood, swollen immobile, fibrosis starts
4/9/07 LOA Dr Folk

Offline Jakem

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Re: Elite Seat Question
« Reply #9 on: March 15, 2007, 11:47:11 PM »
They both work, as I have used both.  However, I would say the Elite Seat is superior.

Of course the key with the Elite Seat, JAS and Dynasplint is to use them immediately after you have the scar tissue cut out.  That is when they are most effective.  I used the dynasplint after my LOA and the surgery combined with the dynasplint got me from a 15-20 degree extension deficit to 0 degrees or 1 degree of hyperextension.

I am now using the Elite Seat nearly 2 years after the surgery so it won't be as effective.  My goal is to gain 2-3 degrees more of hyperextension.  It is a modest goal, but that is all you can expect so long after surgery.  Still going from -1 to -4 will enable me to build the quads back to the size of my good leg.  Anything less than full hyperextension will impede your ability to develop maximum strength in the quad.  Why is strength so important?  The more strength in the quads, the better your patella will track properly and hence less pain from the chrondal defects on the bottom side of the patella and trochlea.  Once you get scar tissue that creates an extension deficit, you will incur damage to the chrondal surfaces.  So you need to cut out the scar tissue, then use an extension device to get full extension.  You need to get near full extension within 2 weeks of the surgery or your are generally screwed.  You have more time to work on flexion.  Then you have to strengthen the quads so the patella tracks better so the defects will hurt less.

Keep in mind, even if you get full hyperextension, if you quads are wasted and you fail to strengthen them, even small patella-femoral defects will hurt like a son of a gun until you build muslce back enough so that the patella track ideally.




Offline Jakem

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Re: Elite Seat Question
« Reply #10 on: March 16, 2007, 12:01:59 AM »
The whole scar tissue causing extension deficit causing chrondal defects causing pain and loss of quad strength and poor tracking is all part of the ugly vicious circle of arthrofibrosis.  Most of the people who post here are caught in this devastating circle at various points.  There are stories on here that will bring tears to your eyes.  What makes it so difficult is that you got to get the scar tissue cut out within 3-6 months or you will get the chrodal defects.  Most of us end up waiting too long based on poor advice from doctors who are ignorant on how to treat scar tissue.  Once you get the defects, you are in a tough road.

First you got to get the scar tissue cut out, then you have to get full extension (within 2 weeks) and then flexion.  This alone is extremely difficult. 

Even if you make it past this point, your quads will be mush, which means your patella will be tracking horribly so the defects you got will hurt a lot.  So you need to gain strength, but that is tough to do because of the pain you are in from the defects and unless you gain the strength, the patella will continue to track poorly and your defects will get worse.  Hence the vicisous circle.  There are probably 50 regular posters and 1000 lurkers who are all caught in this ugly merry-go-round.


Offline JaneB

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Re: Elite Seat Question
« Reply #11 on: March 16, 2007, 04:02:19 PM »
Hi Jakem,
First, it's good to hear you are doing so well and JOGGING!

I am in a somewhat similar boat; I find myself doing worse this year than last because of patellar maltracking.  The PT says it's because my VMO (and other quads) on my operated leg are too weak.  I agree.  He also says the IT band is too tight and needs stretching.  I also lack a few degrees of hyperextension compared to my other leg but I've maintained the extension and flexion gains since surgery so that I'm in the normal range and SO much better. I'm about 145 flexion and -2 extension. I've been skiing and riding again; I'd say it's about 90% .  I was at about 15% before the surgery, as you know, and in constant pain.

I do have increased pain because of the maltracking (I think).  I also have a grade II chondral lesion on the medial tibial plateau.  I don't know if that causes pain or not.

How does the few degrees of less hyperextension contribute to weakness in the operated leg?  My PT claims it doesn't...but I am worried.  I occasionally have a brief but intense "stabbing" pain laterally, above the  kneecap. 

JaneB
t
ACL repair 3/04
arthrofibrosis developed ROM 125/-10
LOA \anterior interval release/chondroplasty 12/04

Offline Jakem

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Re: Elite Seat Question
« Reply #12 on: March 16, 2007, 06:48:35 PM »
Hi JaneB,

Like you I got near fully functioning ROM.  However, as my activity level increased, like you, I got patella tracking problems with the medial trochlea defect (caused by the scar tissue) hurting.    Leg extensions were impossible.  One leg presses worked for a while but still trochlea pain.  Finally, I did something crazy, I started doing regular barbell squats.  I started very light weight, just the bar and it did hurt at first.   I did it every 3 days, one set of 12 reps with feet about shoulder width apart and pointing slightly outward.    I added about 2.5 pounds each time.  Soon quads became much stronger.  As they become much stronger, the patella tracked better and the trochlea pain decreased.  The stronger I became the less pain. 

Then I noticed I had added about 2" of muscle to the left thigh but the good thigh kept gaing size and remains 1" larger than the bad leg.   I believe this if from lack of full hypextension, so hence I got the elite seat to get a few more degrees of hyperextension.

Another thing that is critical is taking glucosimine/condroitin/MSM.  The stuff definitely works.  I don't think it grows real hyaline cartilage, but it does fill in defects with fibrocartilage. 

So for me it was the combo of glucosimine and doing barbell squats for strength.  I realize it won't work for everyone but it may for you.

Offline Jakem

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Re: Elite Seat Question
« Reply #13 on: March 16, 2007, 06:55:14 PM »
I also had IT band problems and stretching completely eliminated the problem.

I do the first stretch shown on the link below.

http://www.nismat.org/ptcor/itb_stretch/index.html

Offline Jakem

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Re: Elite Seat Question
« Reply #14 on: March 17, 2007, 05:21:53 PM »
Today is the 4th day I am using the Elite Seat.  I am a little less optimistic it is going to help right now.  After I use it, I do get a few degress, probably to about -3 or -4 compared to -6 for my good leg.  However, after a an hour or two I am right back to 0 or -1.  So it may be just compressing the residual scar tissue which then rebounds after an hour or two.  This is the problem with using one of these devices so long after surgery. 

Of course it is still early so I will stick with it for 30 days, 5 times a day, 10-15 minutes a pop and see if it works.  However, my initial enthusiasm has waned.















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