Nick's FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR 3in1 Diary

[Clarkey]

Week 4 Physiotherapy:

I am posting a day earlier then usual as I got a busy day tomorrow after seeing my PT at 9:20am and will not have any time to make use of the internet as I am going to a family fun day that have children with autism.

I did what my PT asked me to do and purchased a pair of sorbothane that cost £20 from a local running shop and removed the inner soles from my running trainers and inserted the sorbothane.

I managed to do a short run of around a mile around Droitwich Leisure Centre around the canals and playing fields as it a softer surface to be running on. I did my stretches before and after my run.

I can run but at a slow pace that is not a speed I could rejoin Droitwich Athletics Club as I feel discomfort and pressure at the bottom of my right knee that remains swollen at the bottom. Also have slight bruising along the kneecap and my right hip painful. No way can I run long distance the way my right knee is right now.

I also feel pain at the bottom of the lateral side of the right knee and really want to run at a competitive level again and will do all I can to achieve this as I enjoy running with the running club and do miss it.

Is it too soon to go back to see Mr Snow again as I already have strong quads and my quads are less knotted and tensed up since starting my physio program. Maybe I need a 3rd cortisone injection or an MRI.

In the past the two MRI's have not shown any knee problem. My sister who an orthopedic nurse said maybe need to have an exploratory scope as I had before when had my medial plica removed and fat pad trimmed.

It would be my last option and could give PT longer but feel it not going to help much with my right knee injury and like to press ahead and make some progress getting it fixed so I can run long distance once again.

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[Clarkey]

Using my iPhone to give you all an update about this mornings PT appointment I do trust my PT fully who told me he works closely with Mr Snow & to give PT a few more weeks before seeing Mr Snow again.

I am happy to do as he says till after Christmas & if my knee still not improved by January 2014 then I would like to see Mr Snow again. I may as well reveal my PT name now!

Dean has confidence with my injury that I will get back to full fitness again through doing my stretches & hope he is right as I would rather try and avoid a 2nd exploratory scope unless it is the only option left after PT & conservative treatments. I would then be ready to go under the knife if I had to in order to run again!

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[Clarkey]

Week 5 Physiotherapy:

I have increased my PT exercises as Dean has asked me to do and still unable to run and my right knee remains pretty much the same. What Dean did spot was pain while squatting on my right leg and can only bend my right knee to a certain point before feeling pain at the bottom of the knee.

The bizarre thing is that when Dean exerts some pressure on my right knee while squatting on it the pain increases with less pain with no pressure exerted onto the knee.

Been given an extra PT squatting with right knee facing outwards towards my small toe and see if it improves or not next week. What would be causing pain if pressure is added as I am not ready to run yet as my right knee does not take running too well at the moment!

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[Nettan]

You are only 5 weeks into your PT and sometimes it could takes months or even up to a year before seeing any improvement at all. Stay patient and focus on your PT.
If your knee will be good enough to run at time will tell.  All the best to you.

[Clarkey]

Week 6 Physiotherapy:

I am doing what Dean has asked me to do and doing all the stretches more regular and do wish I could say my right knee improving slowly! It not really changing much and cannot even do my volunteering  job at Droitwich Library, I am like an old man after squatting and kneeling while sorting through the books in the correct order. Feel pain and stiffness in my right knee.

Dean mentioned after next week’s PT session to try and run again! All very well and easy to say and of course I love to be able to run again. I just cannot right now as I feel pain and discomfort in my bottom of my right knee that still swollen.
Dean said I would have my right knee sorted out before Christmas and cabbnnot see this happening. It coming up to my 4th Knee arthroscopy on Saturday and was in a similar scenario pre op with members saying try and give PT longer and did and had to have my right kneecap cleaned out and was told it a but it got me back to running again.

Nettan I appreciate your support and advice and hope you are right about be patient with my PT schedule!

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[Clarkey]

Nick’s Medial Plica Excision & Fat Pad 4 Years Post Op:

Today marks my 4th Arthroscopy Anniversay on my right knee to remove the medial plica and trimming of the fat pad that was causing restrictive movement and catching in my right knee.

This time last year I was doing really well to such an extent was ready to take part in my very 1st Half Marathon in March 2013 by taking part in the 2013 Droitwich Half Marathon. Training was going well and was averaging a pace of 6 minutes 40 seconds a mile doing a 9 mile circuit 3 times a week in just over an hour.

January 2013 was a cold month in the UK with snow and ice on the pavements. It was like walking on an ice rink and was walking along the pavement and slipped onto my right knee and the side of my right hip. Both hip and my knee was bruised and the bottom of my right knee swelled up.

I thought rest would do the trick and my right knee did not improve and had no choice and had to pull out of the Droitwich Half Marathon. I ended up seeing an OS specialising in soft tissue injuries of the knee Mr Snow.

His conclusion was that my right knee injury was a pre existing injury and the fall onto black ice just speeded up the process. I had very tight muscles and a tight IT band that was contributing to the knee pain and swelling.

I have so far had a CT guided Botox injection into the top of my right leg muscle near to the groin into the tensor fascia lata followed by PT. It should hopefully release the tension in the tight leg muscles and IT band.

I am into week 7 of my PT and my physio has given me mainly stretching of the quads and ITB as well standard stretching and squatting.

My physio said to try and do some running and I would if I could as right now as soon as I try to run feel pain at the bottom of my right knee and discomfort and my running pace is too slow to re join Droitwich AC.

I am being told keep doing my daily PT schedule I have been given to do by my physio. So far I am not seeing any improvements and would like to have my right knee sorted out by Easter 2014.

I have been told I should avoid a 2nd Arthroscopy on my right knee if possible as it a risky and do know any surgery is a risk. The last surgery was a slow recovery but at least it got me back running to full capacity again. Many professional runners seem to be fine after more then 1 scope on their knee.

Getting to a point now where it been almost a year and PT so far not making any difference and have only one option left now to go back and see Mr Snow as it is starting to annoy me now.

My friends that live in the Spa Town of Droitwich are joining Droitwich Running Club and pleased for them it just hurts to see them be able to run and I cannot as my right knee is being stubborn to treatment so far. I am now feel like an outsider as former Club Member and now look’s like I will not be able to do the Droitwich Half Marathon in March 2014.

I do know I have PFPS and maltracking in my right knee that remains swollen at the bottom of the knee with some fluid that explains the swelling at the bottom of kneecap.

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[Clarkey]

Week 7 Physiotherapy:

I saw Dean this morning and doing everything he has told me to do so far, he has told me to try and run a few times before seeing him again next week and even my right knee is painful while running to run through the pain!

I not had a MRI since 2008 that's coming up to 6 years and a lot can happen during that time period. I would love to run again if I could and do try my very best to try and run. I just cannot get the pace as my right knee does not feel right with pain and instability while attempting to run. Pain is at the bottom of the kneecap, which is where I am getting the swelling.

I will try and run even if the right knee hurts and do not like how everyone makes out I do not really have a knee problem? I have done 13 years of manual labour on a golf course and prior to that did a lot of gardening work from early childhood onwards lifting heavy objects as well as running.

To then say there is nothing wrong with my right knee is narrow minded. My last right knee injury they did an MRI, injections and then finally an exploratory scope. I was hoping to compete in the 2014 Droitwich Half Marathon as they are already making reservations that will go quickly.

Maybe I am reading into the situation wrong with Mr Snow, Dean and members on KG saying PT will fix my right knee problems? No one can predict how my knee right problems can be resolved just give their personal opinions.

If I cannot do a simple task sorting out books at Droitwich Library due to my right knee feeling double its age when I kneel and squat, will be 35 a week on Monday. 10 years membership on KG Bulletin Board this coming Monday 25th January.

My right knee pre op just over 4 years ago felt better then it does now, of course I want avoid surgery if possible. I just like to see Mr Snow again and maybe a cortisone or another form of injection or none surgical treatment as well as PT might make  some progress into rectifying my right knee injury as PT alone not helping.

I did not want to come across as winging just had enough now of being forced back into running again when I physically cannot. I would love to run again if I could!

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[Clarkey]

Week 8 Physiotherapy:

I know Dean doing his best and means well and has been helpful with his advice and still thinks I can push my right knee to it limits. I been told to do at least a 15 minute run a few times a week even if the knee hurts just try and ignore the pain while I am running.

I did 10 minutes today on the treadmill and said my running looks fine. It was ok up to a certain speed then the pain kicks in that not as bad when I do actually run outside. I try to run on a softer surface if I can and just cannot seem to force my knee as it is limiting me to a low speed. If I try to increase the speed pain increases at the bottom of my right knee and ankle seems to take most of the pressure.

Dean says I am a lot more flexible now, I know PT can take a while and will please him for now and follow what he tells me to do. If my right knee is not improving by January will ask to see Mr Snow again.

I had this problem with my last injury with my last PT on the NHS that there nothing wrong with my right knee when all along there was when Mr Green had done an exploratory scope just over 4 years ago.

I want to be back to full fitness by spring 2014 as I am finding it hard to do my voluntary jobs of working at Droitwich Library and helping out with a weekly Year 9 school gardening project in Worcester as my right knee is painful to kneel and squat on if I do it for too long.

Would be nice to my right knee at least looked at by Mr Snow. My right knee injury is coming up to a year and not seeing any improvements yet.

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[Clarkey]

Week 9 Physiotherapy:

I have be patient enough now as it now nearly coming up to 1 year since my fall on black ice and getting a bit fed up with the negativity I am getting with members and Dean thinking they know my right knee is ok and not been damaged in any way.

I am not going to keep on doing PT for months and months, so I far I have not seen even a slight improvement since seeing Dean. No one can stop me seeing Mr Snow again and presume I do not have a knee injury by listening to newly qualified PT that more concerned to save the NHS money with the cut backs rather then send a patient back to the OS.

I am going back to my private PT as the NHS PT’s are a waste of space and do not know what they are talking about to force me to run through pain. This is poor advice if I have not had MRI scan since 2008. I would rather go on swimming, cycling and the gym rather then running. If you have swelling and fluid at the bottom of the knee, the last thing you should do is go running.

I am not going back to Dean again as he giving me poor advice that could ruin my right knee forever thinking he knows it all when he not an OS. This is a common problem in the UK that NHS PT’s are big headed not wanting to refer a patient back to the OS, to save money on the NHS.

Also annoyed with members on FB KG saying give PT more time when they do not live with my knee problems that could ruin my chances of getting two gardening jobs in the spring as my right knee is restricting my kneeling and squatting. My sister with 25 years experience as an orthopaedic nurse on the NHS says now the time to see an OS again, and running is bad advice.

Boils down again to me having Asperger syndrome, as you all think it in my head!

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[vickster]

Good luck with whatever you decide to do Nick

[Clarkey]

Thanks Vicky,

I apologise about yesterdays post was just I am just a bit annoyed at the time it is taking to sort out my right knee problem. 1st they had a delay seeing Mr Snow a delay having my Botox injection and an even further delay having PT after Botox injection. Then to top it all off get given bad advice from my current PT who is forcing me to run when I cannot.

PT’s are too over rated by patients as all they seem to do is hand out a sheet of PT that's clearly not helping my knee problems and have been doing PT for long enough now thank you so cannot be stopped from seeing Mr Snow again. Mum said the same she was handed a PT sheet by an NHS PT and left, she has arthritus in her knees.

No two knees are the same and cannot compare one injury from another as each patient knee problems are different. The NHS could save money by not asking me to attend the gymnasium every week, as they are making me feel small by making out I do not have knee injury. This is very unprofessional approach towards their patients satisfaction to put money before the health of their patients. I am not alone as many patients with knee injuries receive the same treatment as I am getting on the NHS.

Will take out private health cover once I find full time employment as my experiences with the NHS has been negative since injuring my right knee again in January 2013. I have lived all my life in the UK worked full time 13 years so entitled to get treatment on the NHS without everyone making me feel guilty for using their services by thinking PT will solve my right knee problems, I do not think it just a tight ITB causing the pain.

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[vickster]

Nick - one warning, pretty much NO insurance company will cover your knee as it is a pre existing condition.  Normally, they have a 5-7 year exclusion period (or longer)

Unless you can pay  many '000s a year for the cover.  You'd be better putting the premium money in a savings account for a rainy day...unless you might want to cover other conditions in the future

You might be best off going back to your private physio or finding another

[Snowy]

Also annoyed with members on FB KG saying give PT more time when they do not live with my knee problems that could ruin my chances of getting two gardening jobs in the spring as my right knee is restricting my kneeling and squatting...Boils down again to me having Asperger syndrome, as you all think it in my head!

I think this is quite unfair, Nick. You've been asking for advice and the people who have taken the time to answer you have given you their genuine and thoughtful opinions based on their own experiences. I have never seen anyone on KG suggest that your knee problems are all in your head, or be anything other than helpful and sympathetic.

I understand that you're frustrated but if you ask for honest opinions, you need to be prepared for the fact that sometimes they won't be the same as your own. And that's fine - it's your knee, you know it better than anyone, and you have to make the choices you feel are right for it. But don't turn on people for responding to your requests for feedback, or for having a different opinion on whether or not physiotherapy is worthwhile. It might help to remember that everyone who responds to you is coming from the same place, which is the hope that you're able to resolve your knee problems successfully.

[Nettan]

PTs do what they can. OS's are no Gods. As I have told you before, you need to give it more time. A PT can't exactly tell 100% what works or not nor an OS. Why do you think your OS sent you to PT ? Because he believes this Will help you. Noone think It's in your head. Sometimes or even often dodgy knees are tricky to solve and sometimes we have to live with Them the best we can. But giving in after this short time It's not a solution.

[Clarkey]

Week 10 Physiotherapy:

Hi All,

Thanks for responding back and was in the wrong to have ago at members of KG who were only giving me good advise and to running down the NHS and my PT Dean was childish of me. I was just touchy about my current right knee problems and apologise.

This time last year I was training to compete in the Droitwich 2013 Half Marathon in the 1st week of March. I was happy with my average pace of 6 minutes and 50 seconds per mile and was running 3 times a week a 9 mile run around Birmingham more scenic routes. My best time was just under 1 hour 9 miles and my fastest lap was 6 minutes and 2 seconds in 1 mile. I have kept a record to prove these time with a running app I had on my iPhone while running.

https://www.runtastic.com/en/users/nick-clarke-3

I saw Dean this morning and said I really like to run again and trying my best and even if I go at a slow pace with not too much knee pain it hurts afterwards. I was volunteering at Droitwich Library after a 10 minute run and 30 minute swim and was going up and down the stairs in the Library that hurt the bottom of my right knee. I even got a stabbing pain as I was going up the stairs and not comfortable when kneeling and squatting, sorting out the books on the shelves in the correct order.

I really loved my long distance running and would run if I could and now Dean think it is best to go back to see Mr Snow. I would rather not have to see him again  and know PT takes time, I have not seen any slight improvement yet, it is getting slightly worse with the colder damper weather.

Dean thinks the next stage is to arrange to have an MRI scan done 1st then see Mr Snow for the results. I hope he does spot a problem and can fix it even if it meant a 2nd scope at least then I know it may be sorted out. I know surgery is a gamble and a risk. I can still carry on doing PT that may sort out my right knee. If it does not then at least I am on the waiting list.

Just having other personal things to sort out to become a support work for children with Autism and was snappy as have been offered a part time job in the Spring as a leader of a Asperger syndrome gardening team at the autistic charity shop I help out at.

Worse case scenario is PT does not solve my right knee problems and need a scope and then will lose out on my 1st paid job since walking out of work after being bulled by the Golf Course Manager in June 2013. I cannot forgive him still for making come into work the 3rd week after surgery when I had a sick note from my GP as my recovery took a while and had to have a cortisone injection to calm the right knee down. I ended up having to have 6 weeks sick leave in the end as coming in too soon prolonged my recovery period.

I thought I would be ok to compete in the 2014 Droitwich Half Marathon and can cannot as the speed I am doing is slow and cannot speed up as I am getting pain at the bottom of my knee and remains swollen at the bottom of kneecap. I also get pain in my ankle, I feel all the pressure is exerted in my ankle, so cannot run right now.

Will be glad to see the back end of 2013, sorry if I offended any members on KG. We say things we do not me when we are upset about something as I did not think I would be back to square one again so soon after last the 1st scope.

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