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Author Topic: Cheap mri? Need to go private but consultants are expensive!!  (Read 8931 times)

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Offline tanyap

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #30 on: June 15, 2008, 11:28:48 AM »
HI,
oooh - this one is hard to articulate, so ill do my best!!

Before op I had to 'think' my muscles into a contraction. After op they just do it. Before I would think 'contract quads' effectively setting them for each rep of exercise. If I didnt think it, I would end up either hurting myself cos my muscles would be slack, or suddenly contracting them halfway through the rep, so there would be a lag. Since the op I dont think 'contract quads' I think 'bend leg' and quads just follow without me 'setting' them.
They were far less responsive before the op. There was something I used to do to demo to my PT how they werent responding. I would stand, knees slightly bent and rock back and forth from leg to leg shifting weight back and forth, you could see how my left quads automatically contracted when the weight hit the left side but on the right side unless i thought 'contract quads' they would just hang there doing little or nothing.
I was still able to build them by thinking about each contraction - but obviously thats not effective in everyday life cos its not practical to think about contracting a muscle for each movement, hence I made zero progress except for the actual exercises, whereas now you can visibly see they contract themselves when my body moves naturally so even the small amount of PT I am doing is not the only exercise they get.
It was immediate for me - after op my body just kicked in and did what it was supposed to do. My OS says that my brain was blocking proper contraction when the joint felt subluxy - which was in the last few degrees of extension, but now it doesnt block it. 4 days after op, before Id started proper PT my quads were killing me - just from ordinary walking about the house - so clearly the brain was now allowing it happen.

I hope I explained that clearly - its so hard to articulate it, its like before i had no control, and now with no mental effort on my part it just happens.

But just to be reminise a bit, I can remember injury in the past where my muscles wouldnt act automatically for me and it would take some months of PT to get them doing it - in that case once the injury healed and the pain was gone the brain allowed the contractions, so to make a comparison with you - if weak muscles are causing the problem, PT WILL strengthen them and when you reach a 'critical mass' point the pain will stop happening at which stage you should be able to feel a solid difference and PT seems easier, everyday life is not a struggle and the muscles just do their thing etc....
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

Offline Roberts

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #31 on: June 15, 2008, 11:52:32 AM »
That does make sense! and I am pleased to note that if I rock side to side with slightly bent knees, both of my quads contract automatically, but obviously the bad leg doesn't like it and my good leg stays contracted for longer to protect me from putting too much weight on the other leg. That is pretty amazing straight after the op your quads contracted as normal, our bodies are clever!
My knee is hardly ever swollen now since after the cortisone injection and I've been taking natural anti inflammatories that seem to work well, so maybe my vmo is being allowed to contract now. It is definitely a different type of pain that I am feeling since the injection.
But the main thing that would ease my mind would be for my quads to feel achey like you describe from just walking around, I hope its just because my vmo wears out first and the rest of the quads aren't allowed to work hard enough, though also I wish the vmo would just feel achey instead of getting really sore as I get confused as to whether its just over worked but ultimately getting stronger, or I am harming it.

Roll on a decent physio!!!
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline tanyap

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #32 on: June 15, 2008, 12:12:41 PM »
wow - thats pretty good news about the rocking thing!!

You wont be harming your vmo - muscles dont get harmed being overworked, they just give up the ghost and wont do the job anymore!!! Then you could possibly harm your actual joint cos its unsupported. If your quads were never fully switched off (my vmo was GONE) then you might not get the achey from walking around feeling - it was new to me to have it!!

It should be getting stronger if its getting sore, is the soreness present when you contract it? A tired muscle will hurt to be used but should be ok at rest.if its getting 'pulled' on without contracting properly you could get soreness in the general area. I used to get sore in the area but no difference if I forced a contraction - thats when it wasnt doing anything much.

A decent physio is going to do wonders for you - your motivation is inspiring!!
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

Offline Roberts

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #33 on: June 15, 2008, 08:30:00 PM »
Ok not the achey from walking around feeling, a better way to describe would be the muscle soreness you get after you have been on a long run, the ache you get the next day when you can tell that the muscles are exhausted but will be fine in a day or two, thats what I'm missing. When I feel that I'll know I'm back to normal.
I was really scared that I had done bad to my vmo yesterday, it just suddenly twinged and gave up, very scary. Luckily today I am able to walk on it a bit but now its painful again as the dog was desperate for a walk so I walked back and forth on the edge of the park throwing a ball, limping around in the rain - what a sight!! lol.
Its sore as I sit here but I think thats because its reached its limit, I don't think it is sore at rest normally, its only when walking, so hopefully it is still alive.
I think the sports dr has scared me by saying I had to be careful in the 1st 10 days after the injection as it could tear easily and then I'd be in big trouble, so as he said I had micro tears at the vmo attachment I keep fearing that the pain is these tears getting bigger.
I must get sports massage too as I must have lots of scar tissue. Tanya and Kirsty have you had sports massage, or trigger point accupuncture?
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline tanyap

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #34 on: June 16, 2008, 09:06:48 AM »
I know what you mean - youre missing the same muscle soreness I was missing. Not firing on all cylinders yet Id guess.
I havent had either sports massage or acupuncture - but all these things are worth looking into.

Any update on getting a decent physio for yourself?
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

Offline Silkncardcrafts

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #35 on: June 16, 2008, 10:05:39 AM »
Hi Robert,

No I haven't had sports massage, but dry needling which is not that dissimiliar to accupuncture. I've only had it for my shoulder and peroneal muscles and really helped. It targets the trigger points and helps release the pain. Ask the sports doctor about it.

Once you get some guidance from a good physio I'm sure you'll feel much better about it.
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 Roberts

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #36 on: June 16, 2008, 11:02:17 AM »
yeah dry needling, thats what I meant, I had it once in my glut med and it loosened it up in 2 sessions, quite impressive.

I've just got off the phone to the nhs physio secretary and it turns out that the hospital forgot to refer me and eventually did it 7 weeks later (after I rang) and the waiting list has gone up from 10 weeks to 16 :o. I'm still getting a private physio but I want to stay in the system on the nhs instead of them trying to sign me off all the time so a physio will be ringing me back to see if they can forward my appointment.

I see the sports dr on the 24th so I have no physio till then.
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline Silkncardcrafts

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #37 on: June 16, 2008, 11:05:29 AM »
Unfortunately that's the NHS for you. They are a bunch of turkeys !!!

You would be much better off with a private physio that knows what they are doing. Not long till you see the sports doctor anyway. Who are you seeing ?
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 Roberts

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #38 on: June 16, 2008, 11:16:26 AM »
I know, they are awful, I only want to stay in the system because I know if my knee doesn't get sorted a private person will send me for an mri and they cost lots so I want the nhs physio to be available to refer me back for an nhs one. But I keep wondering if its worth the hassle and it will probably take another 6 months so probably not but its worth a try, I think, hmmm.

I'm seeing Dr Mike Bundy in London, he is the one that did the cortisone injection and thinks it is just wear and tear under the knee from the weak muscles, so I hope its just that too. He wrote a letter to guide my nhs physio but I think I'll be seeing him before I see them! I should have asked for a physio recommendation on my 1st appointment with him, bother.
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline Roberts

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #39 on: June 24, 2008, 10:35:16 PM »
Hi there  :)
I have eventually met up with nhs physio again, this time it is a new man and he was surprised to see that I had already done 6 months of physio with them already, but he said he would try and help me too. He taped my knee to try and get the vmo to fire better and is going to do some acupuncture this thursday and teach me how to tape myself. I have been doing 3 straight leg raises twice a day and so far so good.

I saw the sports dr in london today also and he said I should now try some aggressive physio as the cortisone injection hasn't helped enough. He said my vmo has gone to sleep and I need to activate it again. So I've gone back to that thread you gave me a link to tanya to have a re-read as it is definitely what I should be doing. He also said I should get the physio to do electrical stimulation of the muscle - would this be the same as the knee estim thing you had Tanya?
I have to increase the frequency of low grade vmo strengthening exercises and expect pain, but try not to make it higher than a pain level of 5 out of 10.

He then said if I don't make any progress I can come back to him and he will do an autologous injection where he takes blood from my arm and injects it into the vmo tendon to encourage healing. I'd not heard of that one before!

I'm impressed by your progress on your diary Tanya. And Kirsty that really sucks that you had a car accident and its set you back, life is mean sometimes. I had a car go into the back of me the other week and the driver just looked at us and then drove off, a police car chased them, it was quite exciting, but now stressful as there is lots of paperwork and a damaged car :(
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline tanyap

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #40 on: June 25, 2008, 09:07:11 AM »
Hi,
Im so sorry to hear you had a car accident too!!! All the crazy drivers must be out this past week!

Whats happening with your VMO sounds suspiciously similiar with what happened with mine. Yes, the muscle stimulation is the same as I had - I actually bought a home one to use twice a day (you can rent them too), it was expensive to buy but in Ireland you can claim back the tax on medical stuff so I just did it. Here is the one I bought:
www.kneehab.ie

They tend to have different looking ones in physio practices - but the principle is the same.

Also you should touch your vmo with your hand when your trying to contract it - it sounds mad but touching it while its contracting will help it start firing. What you have to remember here is that the neuromuscular connections have broken down due to dead nerve fibres (wasted muscles mean that the nerve fibres die off) so you need to work backwards with it, MAKE it contract, that will send messages back to the brain, the brain will think 'oh Ive got a muscle here, I better grow some nerve fibres' and it will then start re-opening the neuromuscular pathways.

Be prepared for no progress for ages though, I did 2 years of physio - no result. Went to a new physio, got new exercises, got the e-stim etc... and it took 4 months for it to start firing by itself - i knew when it happened, I woke up one day with lots of shooting electric type sensations in my VMO and I just knew that was it waking up.

It WILL happen, it just takes time, hard work, a good physio and a lot of patience!!

1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

Offline Roberts

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #41 on: June 26, 2008, 07:26:57 PM »
Hi, my mother in law has a slendertone machine, I assume I could use this to stimulate my vmo? I saw the nhs physio again today and he wasn't too interested in the sports dr recommending that he used one on me. Instead I had 7 needles stuck around my knee, I looked like a pin cushion!

When you say to touch the muscle whilst it contracts do you think thats why patella tapiing works, because I've read how the tape doesn't actually align the patella any better and they aren't sure why it works, maybe its because the muscle can feel the tape?

Its all very interesting. I can't tape at the mo because my skin has reacted and is starting to blister, mmm lovely.
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline tanyap

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #42 on: June 26, 2008, 08:28:35 PM »
Hi,
For e-stim whats important is the trigger points of the muscles. A slendertone is perfect for stomach muscles because the electrodes are aligned to deliver the electricity to the trigger points of the stomach muscles. I dont think itd work for your VMO - that link I gave you, thats set up to deliver to the quad trigger points. You can get manual placement electrode ones (theres one in the argos catalogue), and you need to learn how to place the electrodes for those.

Some PTs are not too interested in e-stim. Mine thinks its good to encourage muscle firing, but once they fire thats it - throw it away!

Yeah I reckon thats exactly how it works - its a constant 'reminder' to the muscle to contract and it doesnt provide any real support (a little maybe). I think you can get hypo allergenic tape - reactions are common to it alright.

Ultimately all you can to is hypertrophy a muscle to make it grow - that means over using it in a controlled manner every single day, over and over, consistent exercise, consistent use. But its so important to make it actually fire, cos the body will just compensate anyway it can.

I would think e-stim would be good for you, not your mum in laws slendertone though!

1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

Offline Roberts

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #43 on: June 26, 2008, 11:58:12 PM »
It's an old one where you plug in the wires attached to circular pads so I can place them wherever I like. I tried it earlier and stuck 2 going up the vmo muscle and when I turned it up high it was doing big contractions, it was quite unnerving to watch!
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline tanyap

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Re: Cheap mri? Need to go private but consultants are expensive!!
« Reply #44 on: June 27, 2008, 09:14:32 AM »
Oh that might work actually - apologies - i thought it was the belt type.

You should google 'vmo trigger points' and get some info on correct placing. Read up about it in general because its important how the contraction is produced and for how long to use it etc...... (consistency is key!!!)
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app















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