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Author Topic: Injuries won't heal, doctors of no help.  (Read 3438 times)

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Offline darsemnos

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Injuries won't heal, doctors of no help.
« on: June 27, 2007, 03:34:42 AM »
I was injured about 4 years ago squatting, using too much weight with not enough warm-up after spending the whole day in a freezer. My left knee did something, like a little pop or twinge of pain. It wasn't much. I knew it was bad but it didn't seem that bad. I didn't do anything about it for 2 years, as it didn't seem like a big deal. I could still play racquetball with very rare occurrences of pain which were pretty minor and only lasted as instant and could still squat, though I could never again get in the groove squatting. It hasn't ever since felt natural to squat, whereas it did before. Two years after the initial injury it started getting bad enough that I got it checked out. After going to one doctor who was an idiot I went to another one who gave me some X-rays and discovered that my kneecaps were drifting a little to the outside. I went to therapy to try to fix that. That didn't help, or it made it worse. I'm not sure. I stopped therapy for a while, then tried it again to the same effect. Then I got an MRI and they found a small tear int he tendon that connects the patella to the kneecap. So I had surgery to fix that. They drilled a hole in the patella and put a metal post in there according to the doctor and I guess they wrapped the tendon around that. That is my understanding. I went through therapy for to recover from surgery. Surgery was July 12, 2006. Therapy got me my strength back that I lost due to the surgery, but it did nothing to improve the condition of my knee and there were additional problems that seemed to stem from the surgery that I expected to fade but did not.

(My right knee is also giving me problems, assuming due to the kneecap moving outward. The pain was starting slightly before the surgery. Nothing major, just some discomfort enough to know something was wrong. But it has progressively gotten worse since the surgery.)

Back to the left knee. After therapy for the knee I didn't do much for a couple weeks. It seemed to me that I was worse off than before the surgery, though I can play racquetball, lift, run etc. That stuff just hurts still and everything still feels very out of alignment. My left knee, which before the surgery only clicked barely noticeable by touch our sound at one point in the range of motion now does through out the whole range and itís louder and easy to feel with my hand placed on my knee. It's a bunch of clicking and popping. It's not loud, but I can feel it. Sometimes it gives one big pop when I extend my leg. That's like a couple time a day thing. My right knee also pops if I move it suddenly in a certain direction, bending it inward (obviously a bad habit that I need to stop as the knee is not meant to bend that way). So with these problems I went to the doctor again to consult him. He didnít offer me much help. Basically he said I could start doing things again, lifting lightly to start and jogging, racquetball, etc. So I went home a little pissed that he didnít really have any help to offer and basically said everything was great when I knew it was not. Then I went to another doctor who said that the diagnosis that my kneecaps were moving outward was basically seeing things that werenít there and he gave me a steroid shot in both knees. This didnít help at all. Eventually I wrote the previous doctor a hand written letter telling him I was not satisfied with the result of the surgery and heís got to give me some guidance as to how to get back to normal. So he suggested a therapist not affiliated with his practice but to whom he refers people to occasionally. This therapist said I had fallen arches and we worked using my glutes more to help that, though my glutes seem fine to me. They are large muscularly compared to my legs and everything else. Though I do have to admit he is right about my arches, I can see that with my own eyes now that it has been pointed out to me. Again therapy did nothing but perhaps making it worse. At the end of about 6 weeks of therapy the therapist asked how far I had come. He said if the level I was coming in at was 0 and normal would be 100% where am I now, at the end of therapy. I said 5, maybe 10%. And honestly that assessment was generous. I felt bad saying 0-5.

Basically I donít know what to do. I can do lot of things. Iím not crippled. I can jog play racquetball, lift, but it still doesnít feel right, and there is still pain at the point where the tendon was reattached and the right knee is still giving me problems as bad as ever.

I worked out yesterday. Did some deadlifts, 3 sets of 5 with 135 and front squats, 3 sets of with 95lbs and today the point where the tendon was reattached is sore (Not good sore, like it was a good workout, but a sore that tells me something is wrong). That will probably go away soon. But Iím coming up on a year since the surgery and things have seems to reach an equilibrium at a point I am very unsatisfied with. Surgery genuinely seems to have made things much worse. I donít know if I have any recourse against the doctor. Iím not out to go after him but maybe I am entitled to some compensation, at least to cover the continuing search for helpful help. Any one know anything about that? Do I have any recourse? But that is not my primary concern, though I would prefer not to keep spending thousands of my dollars to fix this. My biggest concern is getting back to normal and if I have to take the financial hit to do so that is fine.

I donít know. This just sucks a lot. The doctors and therapists donít seem to have a clue. I want to consider some alternative therapies, like non-western techniques, acupuncture, qi gong, maybe yoga. Maybe these things will help things get re-aligned so my legs feel normal and stable again and the left knee can heal. But I donít know where to start with these things. I am cleaning up my diet to give my body the best resources to build from. I wonder how significant poor diet played in recovery. Maybe that was the only real problem all along. Itís possible. I guess time will tell as I improve that.

Any ideas anyone?

Offline Nettan

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Re: Injuries won't heal, doctors of no help.
« Reply #1 on: June 27, 2007, 06:52:16 AM »
Sometimes even how much the docs tries they can't make us come back 100%. That is sad and no fun.
Sometimes after surgery we have to struggle very long to come back as much as possible.
Maybe after this injury the facts are that you never will be 100% again.
I would try see some sportsmed if you haven't done that, to see if that can give you something.
Also work on your muscles as much as you can. But be careful with anything that makes you more sore.
I doubt that your knee like deadlifts.
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 Silkncardcrafts

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Re: Injuries won't heal, doctors of no help.
« Reply #2 on: June 27, 2007, 09:34:37 AM »
Hi there,

It doesn't sound as if your patellofemoral problems have ever been addressed properly. I have had patella instability for over 12 years now and know how frustrating it can be.

I would strongly encourage you to go and see a good sports physician that will be able to diagnose your problem correctly and refer you on to a physio that specialises in patella problems. In most cases physiotherapy is tried first before considering any type of surgery. It is really important that you go to a physio that specialises in knees, particularly patella problems. The rehab needs to be very specific for this problem. I find it annoying when a doctor will just try quick cures. These sorts of problems can take a while to treat and recover from. Whereabouts are you based ? I know of some good sports physicians in Melbourne, Australia and London, UK.

At this stage I wouldn't be rushing off to try other treatments. You need to get down to basics.

You are fortunate that you can still keep fit and active. I am waiting to have more knee surgery for medial patella instability and aren't able to play any sport at the moment. However, I can still keep active which I'm happy about.

Good luck with it all. :D
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline darsemnos

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Re: Injuries won't heal, doctors of no help.
« Reply #3 on: June 27, 2007, 10:12:44 PM »
Hi there,

It doesn't sound as if your patellofemoral problems have ever been addressed properly. I have had patella instability for over 12 years now and know how frustrating it can be.

I would strongly encourage you to go and see a good sports physician that will be able to diagnose your problem correctly and refer you on to a physio that specialises in patella problems. In most cases physiotherapy is tried first before considering any type of surgery. It is really important that you go to a physio that specialises in knees, particularly patella problems. The rehab needs to be very specific for this problem. I find it annoying when a doctor will just try quick cures. These sorts of problems can take a while to treat and recover from. Whereabouts are you based ? I know of some good sports physicians in Melbourne, Australia and London, UK.

At this stage I wouldn't be rushing off to try other treatments. You need to get down to basics.

You are fortunate that you can still keep fit and active. I am waiting to have more knee surgery for medial patella instability and aren't able to play any sport at the moment. However, I can still keep active which I'm happy about.

Good luck with it all. :D

I did actually attempt therapy twice before getting surgery to no avail. I'm in the US, on the east coast. Virginia if you know the state.

I can stay kind of active, but I think I need to give any significant leg work a rest for a while until I can get some good help. I'm going to contact a chiropractor and see if they can do anything for me. I've been to four orthopedic/sports medicine doctors and four bouts of physical therapy with three different therapist. None of them has been of significant help, except "fixing" the tear with surgery, which I actually regret having had done at this point. I was much better off before.

Thanks for your input on getting help from someone who specializes in knees. That's a good idea. Though the problem is probably not limited to my knees, given the fallen arches.

Offline Silkncardcrafts

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Re: Injuries won't heal, doctors of no help.
« Reply #4 on: June 28, 2007, 02:08:08 AM »
Hi there,

I really don't think a chiropractor is going to help you.

You are better off seeing a good sports physician that works with an elite sporting team. That way they are likely to be in the forefront of different sorts of treatments. If you contact the American College of Sports Medicine (www.acsm.org) or the American Society for Orthopaedic Sports Medicine (www.sportsmed.org) you should be able to find someone good. The things you want to find about the doctor is what experience they have in working with athletes, whether they belong to a sports medicine organisation and what qualifications they have. A good sports physician will also be able to tell if you have a problem with your arches too.

Also, how long did you try physio each time ? For patellofemoral problems you need to give it a good 6-12 months to find out if it's really going to work. There are no quick fixes for this problem. Make sure you see someone that specialises in knees, particularly patella problems.

It can be easy to go and see a lot of different people, but you are better starting with the basics first.

Good luck !! 8)
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline jathib

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Re: Injuries won't heal, doctors of no help.
« Reply #5 on: June 28, 2007, 02:09:45 AM »
Stay away from chiropractors. They have no business touching your knees. Will probably make them worse.

Offline darsemnos

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Re: Injuries won't heal, doctors of no help.
« Reply #6 on: June 28, 2007, 04:11:56 AM »
Hi there,

I really don't think a chiropractor is going to help you.

You are better off seeing a good sports physician that works with an elite sporting team. That way they are likely to be in the forefront of different sorts of treatments. If you contact the American College of Sports Medicine (www.acsm.org) or the American Society for Orthopaedic Sports Medicine (www.sportsmed.org) you should be able to find someone good. The things you want to find about the doctor is what experience they have in working with athletes, whether they belong to a sports medicine organisation and what qualifications they have. A good sports physician will also be able to tell if you have a problem with your arches too.

Also, how long did you try physio each time ? For patellofemoral problems you need to give it a good 6-12 months to find out if it's really going to work. There are no quick fixes for this problem. Make sure you see someone that specialises in knees, particularly patella problems.

It can be easy to go and see a lot of different people, but you are better starting with the basics first.

Good luck !! 8)

I did the therapy for a couple months at a time each time. I got ZERO improvement. If anything therapy made things worse. In my mind therapy has failed and I would like to look elsewhere.

What are the basics anyway? Depending on their specialty different people will think different things are the basics.

The doctor I had for most of the time and who "performed" the surgery was a member of AOSSM and he was on the US olympic team as a doctor, but he doesn't seem to be any good so far.

Offline darsemnos

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Re: Injuries won't heal, doctors of no help.
« Reply #7 on: June 28, 2007, 04:12:27 AM »
Stay away from chiropractors. They have no business touching your knees. Will probably make them worse.

Why do you say that?

Offline Silkncardcrafts

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Re: Injuries won't heal, doctors of no help.
« Reply #8 on: June 28, 2007, 09:59:50 AM »
Hi there,

The doctor you have seen sounds like he is an Orthopaedic Surgeon and not a sports medicine doctor. As I said before you are better of seeing a good sports medicine physician/doctor.

Also doing physio for a couple of months isn't enough. You really need to give it at least 6 to 12 months.

Some suggestions would be to use an exercise bike in a gym and perhaps try clinical pilates. They have both helped me immensely.

There is no quick fix for patella problems.

Good luck !!!
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline jathib

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Re: Injuries won't heal, doctors of no help.
« Reply #9 on: June 28, 2007, 01:50:32 PM »
Stay away from chiropractors. They have no business touching your knees. Will probably make them worse.

Why do you say that?

Chiropractors like to adjust things, mostly backs. But they are not medical doctors and some of them think they can cure just about anything. You don't want them grabbing onto your patella and trying to adjust it. Besides being painful they will probably destroy your knee in the process by tearing something.

Truth is, there are some problems that are so complex that even doctors are at a loss. Sometimes the best you can hope for is a tolerable amount of pain. Not all surgery is successful and this is not always the doctor's fault or the patient's. It just happens. If your doctor has given up then find another one. There are thousands of them out there, one of them might be able to help you. But don't expect your knees to ever be perfect. That's just not going to happen.

And stay away from chiropractors.

Offline Silkncardcrafts

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Re: Injuries won't heal, doctors of no help.
« Reply #10 on: June 28, 2007, 11:56:58 PM »
Hi there,

I totally agree with jathib. Stay away from chiropracters for knees.

A lot of specialist sports physicians and knee surgeons still struggle in understanding patella problems.

There are lots of doctors out there and am sure there will be one not far from you that can help you.

Good luck with it all.
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline kimmyxs

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Re: Injuries won't heal, doctors of no help.
« Reply #11 on: July 01, 2007, 05:13:47 AM »
Sadly, you will probably always have that feeling that something just does not feel right, especially when you can feel the clicking and popping in you knee.  In all likelihood in additiion to the patella tear, you have damage to the cartilege itself.  My patella has been debrided twice and I still hear and feel the clicks and pops, but they are not painful.  Once you have damages the knee or the ligaments and cartiledge around the knee you are asking for future problems and pain.  It is after all the main weight bearing joint in your body. 

If you have ssen a recommended OS or sports guy, I would think that you are on the right path.  They cannot fix everything.  They try to do therapy to build up muscle rather than doing surgery.  The quad are the main component of a stong knee and if they are weak - especially the VMO, surgery often isn't successful.  Many OS ask that you work to build up the muscle and lose weight before doing surgery to help guarantee the succsss of the surgery.  Often other factors arise after surgery.  In my case my quads were really strong and I had patella alignment issues that allowed the patella to discloate (hence hated squats and lunges becuase I was always afraid of a dislocation).  When I had my last dislocation, my quad tensed and snapped the patella.  I will never, ever be the same.  My second surgery in six months was to remove the screws in that patella because they were catching in the muscle and then a VMO advancement (a VMO graft) to hold the patella in place along with a LR to loosen the lateral side.  6 months later that surgery seems successful, but there are no guarantees.  I am crossing my fingers.  I will never be able to jog or run again, but I can still do other things. 

I finally back in the gym, although I would never do a deep squat because it causes problems in the knee.  I cannot use a treadmill, I cannot do breaststoke (the kick is damaging as well).  I can ride a bike (although I think my OS was frown upon true mountain biking because we stand on the pedals causing pressure on the joint).  I warm up well and use ice immediately afterward.  I can no longer play tennis, but I gave that up 13 years ago when my knees aches for days a set or two.  I can still bowl, golf, walk, bike, etc.  I can skydive, hike (but no backpacking) but I limit hiking to hills and nothing steep. 

I understand the frustration and the depression of the dark days.  Give PT a try for 6 months.  Do the exercises as shown and do them diligently - just like you do your strenght training.  Ask them if the weights you are working with are the problem or is the depth of the squat.  Do you have tendonitis in the pateller tendon.  That hurts like hell.  Work on quad strength, especially the VMO it is that supportive structure.  Most of all, we wish you the best.  Aging and losing seemingly a part of yourself is hard.  I was sad to find out that backpacking that I did in my teens and twenties as well as riding motorcycle trials contributed to my current issues with joint damage itself, but I would never,ever have given up those trips up and down the grand canyon.  Twenty years later, it is hard to think that I am no longer the spring chicken I was. 
6/03/89 - First Knee Cap Disclocation
7/05/89 - Returned to work
6/17/06 - Tramatic Knee Cap Dislocation and Vertical Fractured Patella
6/28/06 - ORIF - Screws - no wires
8/24/06 - Ditched the brace - start PT
9/20/06 - First spinning
1/15/07 - screw removal, LR , VMO Advanc  & patella cleanupl















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