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Author Topic: arthrofibrosis, loa  (Read 13257 times)

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Offline conno11y

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arthrofibrosis, loa
« on: September 29, 2008, 02:55:45 AM »
I am excited that I get to post what may turn out to be a happy story!  Thank goodness for kneeguru and the advice to find an OS with AF experience.  I have to travel 3+ hours to see my OS, but my knee is worth it.

Brief history: I fell skiing in Jan 2008 and sprained my MCL.  My extension and flexion were both limited and I had anterior pain, medial to the patella.  A couple months of PT did not solve the problem.  An MRI showed nothing wrong, except the sprain and a bruise on my tibia.  My OS suspected a meniscus tear that didn't appear on the MRI.  In April 2008, I had arthroscopy surgery.  There was no tear, just inflamed plica beneath the patella that the OS removed.  After surgery, I was advised to 'do what I am comfortable with'.  I was off crutches by day 4 and back at work on day 6.  I had no immediate PT, no drugs, and very little icing.  I resumed PT after 2 weeks, but my ROM was still limited.  In fact, it took months to get back to my pre-surgery ROM.  When my original OS seemed puzzled by my lack of progress, I sought opinions from 3 more doctors.  An MRI showed scar tissue in my fat pad.  My currect OS says that the scarred fat pad was blocking my extension because it couldn't move out of the way to allow the femur and tibia to come together.  It was also blocking flexion because my patellar tendon was scarred down.  My OS says that surgery on a stiff knee is a bad idea.  I went into surgery stiff and came out stiff and thus got AF.  He says that the initial ROM limitaion was because my MCL healed too tightly and it should have been addressed by more PT.

I had arthroscopic surgery a week ago to remove the scar tissue.  I was worried that my tight MCL would still restrict my extension after surgery, but I am THRILLED to say that I can now pull my leg into hyperextension!!  My flexion has decreased from 129 to 75, but the OS says to only focus on extension for now.  We'll get extension, then work on flexion (without losing extension), then work on strength.  I am worried that I will grow scar tissue that will block flexion in the next few weeks, but I will follow doc orders.

I spent one night in the hospital and three nights in a hotel attached to the hospital.  I was in a CPM set at 0-30 24h/day (including sleep) and I had a cryo cuff on 24h/day to compress the leg and keep it cold.  I got up only to use the bathroom and do exercises.  I did my own PT 4X/day, including the following.  (A) 10 towel stretches: pulling the leg into hyperextension with a towel for 10 sec and then contracting the quad to try to keep the leg elevated for 10 sec.  (B) 10 quad sets: contracting the quad for 10 sec to push the knee down into the bed.  (C) 10 min on elite seat: a device that straightens the knee using straps above and below the knee - like heel props on steriods. 

Now that I am at home, I no longer have the CPM, but I still have the cryocuff.  I have added the following therapy to my 4X/day sessions.  (D) 10 straight leg raises.  (E) 10 min heel prop with 5 lb weights on either side of the knee.  (F) Prone hang as desired: lying on tummy with leg hanging off edge of bed.  (G) Standing quad sets as desired.  I am supposed to limit walking/standing to 10-15 min at a time and I am supposed to use 'good habits' when walking/standing - i.e. don't favor my good leg. 

I am taking 8 tylenol, 4 Aleve, and 2 Pepsid per day.  No stronger drugs needed.  The day of surgery was pretty good.  I woke up nauseas, but drugs fixed that immediately.  The IV pain meds worked well.  I had trouble sleeping that night because my back was killing me.  I may have a pinched nerve from limping for 8 months.  The day after surgery was the worst for me.  My back is a real problem.  I got really nauseas the 3rd day.  They say it was a reaction to the anesthetic.  I completely lost my appetite, but that has come back now.

I am optimisitic!  I can't believe that I can pull the leg into extension equal to the other leg!  I have some pain medial to my patella - I am hoping that goes away.  Swelling is present, but not obscene.  We'll see how it goes.  I'm off for another stretching session!

Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline Mookie11

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Re: arthrofibrosis, loa
« Reply #1 on: September 30, 2008, 08:37:17 AM »
Thanks for creating this post op thread. There are so many of us who have struggled with AF. It is great to hear of how others are coping with it and what is working for them. Let us know how you are doing!!!!

Candace
Who knew knees were so complicated!

Offline catwoman88

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Re: arthrofibrosis, loa
« Reply #2 on: September 30, 2008, 04:10:04 PM »
Hi Sarah,

Great to hear your progress so far after your LOA, its always so encouraging to hear that extension can be re-gained. My knee is stuck at 45 degrees lacking in extension and to say its getting tiresome is an understatement!, my other knee is so painful now as is the ball of my foot on my bad leg with me hobbling around on tip toes for so many months now due to failed AF surgeries. My knees not been straight for over 1 1/2 years now.

I know i've always been told extension is the most important thing to gain rather than flexion as the extensions needed for walking but you can live with a lack of flexion. My flexion used to come back pretty quick after surgeries so that did not seem to be a problem, extension was always the issue, but now my flexion is starting to slip to about 105 - surgery is still over 2 months away :( , but i'm not letting it beat me, i'm planning a 3 city trip into the states in November - guess my knee can't get much worse before surgery  :-\

So glad that you were able to find a great Dr to deal with your AF as we've all been to OS who know little or nothing about this condition and so end up making matters worse. I also owe alot to knee geeks site as without this site i'd been off seeing another OS and i would not even have known that AF was the cause of my knee issue. I'd have just gone with what they told me.

Sounds like you've pretty much got your exercises worked out the ones you're doing sound simliar to the ones i try and still do the best i can. Keep up the good work and keep us posted.

Lianne
Jan 2007  Pre-patellar bursitis?
Jan 2008  Scope
Mar 2008  LOA & cast
June2008 LOA, cortisone back of knee & cast
Dec 2008 Open posterior capsule release (5 other procedures done at same time) - nerve damage as a result
Aug 2010 Scope left knee - plica removed
Mar 2011 Still -35 ext loss :'(

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #3 on: October 16, 2008, 07:43:26 PM »
I'm sorry you have to wait so long for your surgery, Lianne.  I'm glad you're not putting your life on hold completely though.  Good luck to you.

I had my follow-up appointment with the OS last week (2 weeks post-op).  I can't get my leg to hyperextend using my quad (in other words, I can't do an active heel lift), but I can still pull the leg into hyperextension with a strap or towel.  Since I have maintained full extension, we have added some flexion work to my home exercises.  I'm hoping that once I regain quad strength, I will be able to hyperextend my leg using my quad.  But we won't work on strength until I have a full ROM.

My home exercise program now includes the following: 2-3 flexion sessions per day and 3-4 extension sessions per day.  Immediately following each flexion session, I do an extension session to make sure that I am not losing any extension.  I have 5 extension stretches: (A) 10 min heel prop with 5 lbs on either side of the knee, (B) 10 towel stretches with a quad set between each to try to keep the heel lifted, (C) 10 straight leg raises, (D) 10 standing quad sets with a band pulling forward my thigh, and (E) 10 min in the elite seat.  I have three flexion stretches: (A) 10 wall slides, (B) 4 flexion hangs for 30 sec each, and (C) 10 heel slides on the floor, with a quad set between each.  I have been keeping track of my flexion progress by measuring how far I can move my heel on the floor.  I am supposed to use 'good habits', including walking without a limp or bent leg.  Whenever I am standing, I am supposed to keep full weight on the bad knee in a locked back position.  Whenever I am sitting, I am supposed to have the leg fully extended.  I have to admit that this is hard.  When my leg is fully extended for more than a few minutes, I have too much pain to concentrate on anything else.  It is also hard to walk without a limp since I am so very slow.

I am disappointed with my lack of progress when it comes to flexion.  I have been bending for 1.5 weeks and I still can't get to 90 degrees.  I was at 129 degrees before surgery and the OS got my heel to my butt while I was under.  But, I haven't lost extension and that is very important.  I have some anterior pain and pressure that concerns me.  It is medial to my patella and I'm hoping it is just my MCL complaining (my original injury was an MCL sprain).  I also have some pain beneath my patella (posterior to it) upon flexion.  The OS said that my patellar tendon has shortened somewhat.  I am hoping that this pain is not the beginnings of infrapatellar contracture syndrome.

I returned to work four days ago (3 weeks post-op).  This is a challenge.  When I was off work, I was stretching for 4-5 hours/day.  (I guess I am pretty slow when it comes to inflicting pain on myself.)  Now that I am at work, it is harder to get all that stretching in.  I am trying to incorporate some of the extension stretches at work, but it is hard to experience pain publicly.  I'm off all drugs, except an occasional Aleve when my back starts acting up.  I have some trouble sleeping from both knee and back pain. 

That is all for now.  I go back to the OS in 2 weeks!





« Last Edit: October 16, 2008, 07:47:32 PM by conno11y »
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #4 on: October 17, 2008, 01:53:09 AM »
Hi conno11y!

I'll be checking back on your thread to follow your progress. I had AF after my surgery back in October of 2007. I was stuck at 75-80 degrees flexion and was 10 degrees off of full extension for a while. My OS even talked about me getting an MUA if I didn't get my extension down to zero.  For weeks I worked with my PT and did exercises to stretch out my scar tissue and I eventually got down to a mere 1 degree off full extension. Since then I am now at 0.  I'm not sure if I have hyperextension, but as you even said, it's essential to at least get full extension in order to properly walk, etc. Right now I'm at 130 flexion. My good leg only gets about 136 flexion (I know that flexion can range from 135-150 depending on the person). It was a long road to recovery, but I'm pretty  much here. Reading your post makes me think back to when I was suffering and was frustrated, etc. I fully understand your frustration with lack of flexion progress. It took me weeks to get past 90 degrees, then 100, then 110, etc. I made tiny increments of progress. Back then I was very frustrated, but now I know that even though my progress was slow, it was still something to hang onto.

I too have pain when I bend. I had more pain a few months ago. That's because I had a microfracture repaired and a piece of meniscus removed. My OS said that my knee would always hurt in that one spot whenever I tried to bend it past 130 degrees. So even though I can't get heel-to-butt I'm still happy.

You'll see more progress.  I can tell you're a very determined person so you likely want to be up and about, able to bend fully, in no time.

I'm an elementary school teacher and went back to work 1.5 weeks post op. I was on crutches (NWB) for 6 weeks. I totally hear what you're saying about not having time to stretch. I barely had a moment to sit down. I still think back and wonder how the heck I managed to be at work for 4.5 weeks on crutches, and hardly ever sitting down.

I remember how hard it was to keep my leg fully extended while sitting. My PT told me to do that while watching t.v., and even had me putting ankle weights above my knee with a rolled towel under my ankle so that there was some pressure pushing down on my knee as I sat and watched t.v. It hurt a lot at first, but slowly it hurt less and less.

So is your quad atrophied? I think that's what you were saying since you cannot do an active heel lift). that was so frustrating for me too. It was due to my 6 weeks of being non weight bearing.

You will see progress.....slowly but surely. I'll check back to see how you're doing. Wishing you a quick recovery :)
~Nevella :D
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #5 on: October 27, 2008, 04:29:22 PM »
An update: my initial optimism is fading.  Surgery was just over a month ago and the good news is that I can still pull my leg into hyperextension with a strap.  My quad is too weak to push the leg straight on its own, but the knee feels pretty loose when I stretch it out using a strap or weights.
 
The bad news is that I have been working on flexion for 3 weeks and have made no progress.  I still can't get to 90 degrees.  I took steroids this week to see if that would help, but I see no difference.  I am confused because before surgery, I could pull the knee to 129 degrees.  Why can't I get there now?  I understand that the tendons, ligaments, and muscles have been immobile since my accident in January and thus need to be stretched out.  But if they were stretched enough to get to 129 before surgery, why aren't they now?  I don't think it is new scar tissue, because I've been doing PT everyday since the day of surgery.  Although I didn't start flexion work until 2 weeks post surgery, that doesn't seem long enough to build more scar tissue.  I still have some swelling, but it is not obscene.

Pain is blocking my flexion - mostly a stretching pain, but sometimes more sharp pain.  I stretch for hours and hours a day - it is always on my mind.  I went through torturous forced PT in the past and I think I would lose my mind if had to do that again.  I wish there were drugs that could take away the pain so that I could progress.  I've tried Vicodin, Tylenol3, and Darvon.  None worked on acute pain and they all make me sick anyway.  I would put up with the nausea if I could just make some progress.

Can anyone explain why I've had such a loss of flexion after surgery?  I know it is common, but I don't understand the reason.  Has anyone gone through something similar?

« Last Edit: October 27, 2008, 09:10:47 PM by conno11y »
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #6 on: October 28, 2008, 11:10:20 PM »
I'm sorry you are still stuck with flexion :(   And I'm even more sorry because i have no idea what could be causing it  :-\ If you  have sharp pain, then for sure you should not try to push past it.

I didn't do any flexion until 2 weeks post op and that's when my scar tissue formed. I was stuck below 90 for about a month. But i still made tiny increments.  So, are you not even progressing by 1 degree?? Do you still go to PT and they measure it each time? Even 1 degree is progress.

I hope someone can offer you some info. Maybe post your question under the "emergency" thread??? I'm so sorry.....
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #7 on: October 30, 2008, 04:55:58 PM »
I live 3.5 hours away from the OS and PT, so I only go every few weeks.  I had a PT appointment yesterday and I am encouraged that she was able to get me to 103 degrees in a torture device called a flex seat.  I got to 96 degrees on my own during a wall slide, so I am encouraged that I've broken that 90 degree barrier!  The PT said that it may take 2-3 months to regain flexion.  That seems optimistic at this rate.  She let me bring the flex seat home and I will start using it to up my self-torture tonight.  Hooray ::).

One good thing is that the majority of my pain feels like stretching pain now.  The sharp anterior pain/pressure that had me worried has faded.  As much as I hate the pain, at least it doesn't feel like I am breaking something.  My only worry now is that as I bend, I am crushing my patella into my femur and damaging it.

I wish one could measure pain objectively.  No matter how I describe it, I feel like everyone suspects that I am exaggerating.  I hate feeling like a wimp.  I know my dad thinks I should be able to power through this.  I just wish they could know how bad it is.  I wish my husband could know so that he wouldn't judge me for my daily bouts of crying.  He never says it out loud, but I know he thinks I am too sensitive.

Nevella, why didn't you work on flexion until 2 weeks post-op?  Was it because you were focusing on extension or was there another reason?  Do you have restrictions in your life now due to your knee?  For example, could you happily hike in the woods and keep up with others?  This is what I want to be able to do.  I also want to be able to return to yoga.  Of course, the first step is being able to walk without a limp.  But it would be so nice to know that at some point, I will be able to be active at will.

Thanks for keeping tabs on me!

« Last Edit: October 30, 2008, 09:57:48 PM by conno11y »
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #8 on: October 30, 2008, 10:24:34 PM »
hey you!

I didn't work on flexion until about 2 weeks post op because I had a really incompetent PT and I didn't know that I was supposed to start bending asap.  I had never had a knee injury and didn't know much about knees and rehab, etc. I just figured I could rest my leg for a week or so. My PT didn't say anything to disagree, so i figured that was fine. Well, in those 2 weeks (or week and a half) I guess lots of scar tissue built up. I wish my PT had been more knowledgable and had told me "Nevella, we need to start working on your flexion right away". My OS's person physiotherapist was too far away for me to go see (I would have to take the train and then a subway, and so I'd have to miss work twice per week.....and i can't do that....especially as a teacher.... i could not just go in later on or on the weekend to make up for lost work time, lol). So yeah, I wish I had started bending right awway. I could have saved myself a few months of painful rehab. But that's in the past for me. And it will be for you too. It will just take a while (just like it did for me). I know it sucks, and is frustrating.

I'm glad your pain is no longer the sharp pain. So if it's stretching pain, you just have to slowly push a bit more each day. I remember those days.

wall slides rock!! Those are what helped me. Do you have one of those swiss balls?? That worked wonders for me. I'd sit on it and hold on to a table or chair with one hand and then slowly rock forward, keeping my bad leg bent as far as i could and my good leg extended. then i would just gently roll forward on the ball, even just 1 degree past where i could go without pain. I hope that makes sense. Have you tried to swiss ball/stability ball. i went and bought one from my local Walmart.

yeah i hated when people just didn't understand the pain. I know lots of people have high pain threshholds. My fiance would have pushed so hard past the pain and he wouldn't have taken as long as I did to recover. But i'm a baby, lol. I don't like pain either. I never cried at PT, but many times I was near tears, or sweating from pushing so hard, lol.

Yes you WILL be active again :) I still can't sit cross-legged. I just get so busy during the day that I dont' always do my quad strengthening exercises. I still need to build up a bit of my quad muscle. But i'm still much better than I was before. I can run, etc. But I guess my goal should be being able to sit cross legged. But I'm happy with what i can do now. the only restrictions now would be that I can't sit cross legged or squat completely/kneel completely. But I don't need to do that for work, and I don't want to. My OS said that I'm at a great spot for my way of life. If I was a gardener or something, I'd need to be able to kneel. But i'm a teacher, so I'm okay with being able to walk freely, run, etc. I don't have a limp or anything. so I just have to maybe try to push my flexion to 138 (i can get to around 133 and my good leg to 137 i think), and getting my quad back as strong as the other one. that's all. I won't try soccer again, or sports where I pivot, just because it's not worth it to me to have to go through all of this again.

I think i limped until early June. So that was 7 months post op! It was partially that i was so used to it, and my one quad was weak. but now i have no limp. So don't worry, your limp will go away. I got so tired of people saying to me "you're STILL limping??", lol.

ok, gotta go. keep pushin :)
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #9 on: October 31, 2008, 04:32:47 PM »
Hi Nevella,

I do have a ball and I will give that a try.  The flex seat is terrible, but I think it is helping.  Thanks for the encouragement!

Sarah.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #10 on: November 13, 2008, 04:54:00 PM »
Just a little update: the flex seat is great.  It's painful and I hate it, but it is bringing results.  Being strapped into the flex seat lets me push harder than I can with a wall slide.  I previously had a flexionator by ERMI and I think that was a better piece of equipment (more comfortable and easier to track progress), but the flex seat is good too.

I've been monitoring my flexion progress by measuring how far I can pull my heel towards me using a strap.  I mark my heel location when my leg is extended and and then when my leg is bent.  My heel-to-butt measurement would (hopefully WILL) be 75 cm.  On the day I started flexion work (5 weeks ago at 2 weeks post-op), I pulled the heel 29 cm.  Before getting the flex seat, I was stuck around 36 cm.  But, I've been working with the flex seat for 2 weeks and yesterday I got to 47 cm.  If I can gain 1 cm/day, I could reach full ROM in a month!

I can still get hyperextension if I put a strap around my foot.  It is stiffer than it used to be and the stiffness seems to be directly correlated with how much flexion I've achieved.  I have to stay diligent with the extension work.

I still limp and my lower leg hurts when I straighten (could be my fibular head?).  But, I am encouraged by the flexion increases, however slow.  I do need to focus more on proper walking.
« Last Edit: November 13, 2008, 05:00:03 PM by conno11y »
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #11 on: November 17, 2008, 12:27:09 AM »
I had a bad weekend and am fighting negative thoughts.  I lost a few cm on flexion and I don't have an explanation.  I can see a (new?) bulge near my patellar tendon and I think its scar tissue.  Everyone says that extension is the key to walking without a limp and my PT thinks it's so great that I can pull into extension with a strap.  But when am I going to see a functional improvement?  I am so sick of the knee pain and back pain and leg pain.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #12 on: November 25, 2008, 10:41:28 PM »
I feel like I should delete this whole thread since it was so much more optimistic to start.  I can still get hyperextension when I pull a strap around my foot, but it isn't as easy as it used to be.  I can't get hyperextension using my quad and I can only stand with a straight leg right after I've done my stretching work.  I'm limping badly and my back is messed up as a consequence.  My passive flexion is past 90 degrees (I'd guess maybe 105), but I can't get to 90 actively.

When I work on flexion, I have an aching pain down the lateral side of my shin bone.  That seems new and it seems to be linked to the back pain that I also get during flexion and extension.  When walking, I often have pain at my fibula head on extension.

I feel like I could do so much more rehab if I could just block the pain.  I'm not taking any meds, but I don't think this is the type of pain that meds can help.  I have Vicodin and Tylenol3 and Celebrex and Darvon and Aleve and Ibuprophen and Tylenol and Aspirin in my cabinet.  The narcotics make me sick, and I don't think they help anyway.  Anybody have a favorite drug?

I guess I'm having a blue day (week, month...)

Sarah.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #13 on: December 01, 2008, 09:39:58 PM »
Hi Sarah,

Firstly, I'm so sorry that I've neglected your thread.  I can't fix my KG notifications so it shows me all of the threads I've ever posted on (so I can't easily tell when a new post has been made).  I guess that's my fault for posting on so many peoples' threads, lol.

I'm surprised nobody else has been posting here. 

I read in your other post that you're measuring flexion in terms of cms.  Over here I'm used to it being done in degrees. So i'm trying to imagine what degree of flexion you have. 

Unfortunately I don't know what a fibular head is.  So i don't know what you might be experiencing.  I remember the stiffness and the limping with my injury. Definitely frustrating. And the loss of flexion.  But you seem to be getting there. Slowly but surely!! :D Yay!!!

My favourite drug, lol, was Motrin IB (super strength). I took 2 of those and it helped my pain at physiotherapy. It also didn't make me sick.  But everyone is different.  I hope you find something that works, because pain sucks when working on flexion (I know!).

I don't know what the pain down the side of your shin bone could be. I had pain in my knee, but that was where I had the microfracture repaired (and it was normal). I hope you figure out what it is.

Do you see an OS again soon??

Hey, if for some reason I don't post for a while, send me a message, k? Also, if you pop by the thread that I share with my buddy Lenore, you'll meet lots of people and just get a few laughs, and some encouragement. I try to stop by that thread daily (or every other day).  You're going through a lot and so you should be around people more (in a thread that is more active). I just don't want you to give up on KGs.  There has to be someone here going through what you are (and know what you mean by the type of pain you're describing).

i'm gonna go find the link to my thread and post it for you, k? drop on by :D

i hope tomorrow is a better knee day :D
~Nevella :)
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #14 on: December 01, 2008, 09:42:09 PM »
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #15 on: December 10, 2008, 06:16:35 PM »
Hi Nevella,

Thanks for the response.  I will try ibuprophen again and see if it helps.  The problem is, when I am on drugs, I can't drink and wine is my favorite pain killer these days.  ;D  It has been 2.5 months since my surgery.  I went back to the clinic on Friday for some PT.  It had been 6 weeks since my last PT session.

Extension: The PT said my extension was alright.  She said that enough time has passed that I shouldn't be making any more scar tissue.  If that is true, it is comforting.  I have been very worried about losing my extension.  I still need to warm up for gravity to pull the leg straight while sitting.  I can pull the leg into hyperextension using my arms, but I can't get there using my quads.  I still walk (limp) with a bent knee.  I am hoping this will improve when I regain some quad strength.

Flexion: 6 weeks ago, my flexion was at 96 degrees during a wall slide and 103 degrees in the flex seat contraption.  This time my flexion was 112 degrees while pulling on my leg with a towel and 120 degrees in the flex seat.  I can only get my knee to about 90 degrees using just my hamstrings, but I also hope that will improve with strength.  I like that 120 number.  I was at 129 before surgery, so I am making some progress.  I still shift my hip when I go upstrairs and I can't go downstairs at all.

Patella tracking: My patella catches when I bend my leg.  The OS said that my patellar tendon has shortened by a few mm.  This has me worried about patella baja.  But, oddly, it seems that my patella gets stuck up (proximally) when I bend my knee.  I have to push it back into place with my hand.  I am hoping that is improves as my flexion improves.  It simply must improve for me to have a functional knee.

Back: I have lower back pain when I do my stretches for both flexion and extension.  I also have pain that radiates down my shin bone.  The PT said that I am probably pinching a nerve in my back that correlates with my shin.  It limits my PT and really irritates me.  I think the only thing that will fix my back is to stop limping... which requires my knee to get better... which is hindered my dang back.  Sigh.

The PT added some strength exercises (step ups, step downs, biking, knee extension) to my home exercise program and I will return to PT in 6 weeks.  I will see the surgeon at that time and have some Xrays.

I know everybody heals at a different rate and I have to be patient, but this recovery is so much slower than I expected.  I thought I was prepared to be patient, but gaining less than 2 degrees per week seems insanely slow.  I feel like the success stories that I have read on this site moved much more quickly.  Can anyone provide insight/opinions about the rate of recovery?  Did you regain flexion more quickly?  Did you regain it this slowly but still end up OK?
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #16 on: December 22, 2008, 06:00:04 PM »
I'm still not walking correctly - I don't have a straight leg on the strike-down and I don't bend my leg enough as I pick up.  I think the lack of flexion is actually more detrimental to my walk than the lack of extension, contrary to what I have read.  My patella gets stuck and makes my bending painful and uncomfortable.  How do I know if I am damaging the cartilage beneath my patella?  I try to ignore it during my home PT, but I know that my worries about grinding away that cartilage inhibits my rehab somewhat.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline chelseagirl

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Re: arthrofibrosis, loa
« Reply #17 on: December 22, 2008, 07:59:58 PM »
Hi Sarah,

Are you still monitoring this thread?  I hope so, because I just read it for the first time and wanted to try to compare notes with you-- sounds as though we're experiencing similar things!  It made me feel so " not alone" to read your struggles with gaining flexion!

I had a lateral meniscus repair (bucket handle tear) back in mid- November 2008.  So now I'm about 5.5 weeks post-op.  I feel like I've been through some sort of PT hell since then.

Right now I can push myself at home to get to about 70 degrees flexion, and my extension is about -5.

I can't figure out why I can't flex the knee more!  I've been doing my exercises at home religiously (heel slides, straight leg raises, mini-squats, heel raises,etc), but I can't seem to get to 90 degrees, which is where I am supposed to be at about 6 weeks post-op (in a few days).  So, I am behind.

When I do the heel slides, I have the usual tight feeling.  This doesn't bother me.  It's the sharp pain, usually under the kneecap, that bothers me.  And I get a sharp-like pain on the lateral side of the knee, where my primary scar from the lateral meniscal repair was done.  It's like there's a brick wall that I can't push my knee past.

Could this be arthrofibrosis (AF)?  I'm really at a loss as to how to get my flexion back.  I just had to fire my PT because, when I asked him what was the problem, he said "You just seem to feel pain more than the average bear."  I almost cried, it was so hurtful!  I don't think I'm hyper-sensitive to pain (no one has ever said anything like that to me before).  I am more than willing to work hard at PT and no one wants to get my knee to flex more than me!  But there's "good" pain and "bad" pain and I think I can tell the difference!  I can work through the bad pain-- it's the sharp pains-- like someone is stabbing your knee-- that make me stop in my tracks.  I can't seem to "work" past this!  I'm seeing a new PT on Wednesday (Christmas eve), so hopefully I can get some understanding rather than judgment.

I'd like to hear more about the pain you experience.  When you pull your knee up in a heel slide, do you feel like you just hit a brick wall and your knee won't bend any more?  This is how I feel.  Is this the scar tissue, or is something wrong in there?  When you really push your PT, do you have incredible pain at night? (I do).  It keeps me awake for hours.  I don't know if it's a good sign or a bad sign, though.

Anyway, if you've managed to improve your flexion, I'd sure love to hear that, too! (and how you accomjplished it).    I hope so-- some encouraging news would be very welcome right now!

Best wishes to you and your family over the holidays,

Chelsea

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #18 on: December 27, 2008, 09:03:25 PM »
Hi Chelsea,

I'm glad my post may have made you feel a bit better.  Here is some encouragement: the stabbing sharp pains that I had after my surgery went away.  I don't have a specific reason for why they went away, but I am relieved that they did.  When I complained about them to my PT, she kept telling me, "You just had surgery.  You're going to feel weird things."  This was not a comforting answer because the pain was shouting to me that something more serious could be wrong.  But, it looks like my PT was right.  The sharp pains are gone.  The pain I have now is an intense stretching pain/pressure upon flexion.

Are you getting heat or swelling in the knee?  If you are, make sure that you elevate and ice the knee.  Keep it from being angry as much as possible.  Ice after every PT session.  I think the pain after PT that keeps you awake is not a good thing.  Can you try to elevate the knee while sleeping?  When I had pain that woke me up, my OS gave me some oral steroids.  I don't think that they helped me, but maybe they would help you.  Inflammation is bad for scar tissue formation.  Does the OS have you taking any NSAIDs?

The comment from your PT was probably not meant to hurt you, but it is very hurtful.  I have learned from this experience that nobody can know another person's pain.  Perhaps your PT has never experienced this level of pain.  The PT after my first surgery was the more painful than I thought I could bear.  I never knew pain could be that bad and I always worried that people thought I was just being dramatic.

Have you tried wall slides?  I have had more success with them than heel slides.  My first slide will be pathetic, but after 10 slides, I can get better flexion.  I also have a flexion device that holds my knee at its maximum flexion for 10 min.  That device works for me too. 

Since I have to travel to see my OS, I won't have a new flexion measurement until Jan 20th.  I am making slow (very slow) progress.  I measure how far I can pull my heel during a heel slide and I now can move it 8 cm further than I could on Dec 5.  That isn't much, but at least it isn't getting worse.

Have you seen your OS since your surgery?  What does he say?  Can you get your PT and OS to talk to one another?

« Last Edit: December 27, 2008, 10:04:09 PM by conno11y »
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #19 on: December 28, 2008, 06:55:54 PM »


Right now I can push myself at home to get to about 70 degrees flexion, and my extension is about -5.

I can't figure out why I can't flex the knee more!  I've been doing my exercises at home religiously (heel slides, straight leg raises, mini-squats, heel raises,etc), but I can't seem to get to 90 degrees, which is where I am supposed to be at about 6 weeks post-op (in a few days).  So, I am behind.

When I do the heel slides, I have the usual tight feeling.  This doesn't bother me.  It's the sharp pain, usually under the kneecap, that bothers me.  And I get a sharp-like pain on the lateral side of the knee, where my primary scar from the lateral meniscal repair was done.  It's like there's a brick wall that I can't push my knee past.

Could this be arthrofibrosis (AF)?  I'm really at a loss as to how to get my flexion back.  I just had to fire my PT because, when I asked him what was the problem, he said "You just seem to feel pain more than the average bear."  I almost cried, it was so hurtful!  I don't think I'm hyper-sensitive to pain (no one has ever said anything like that to me before).  I am more than willing to work hard at PT and no one wants to get my knee to flex more than me!  But there's "good" pain and "bad" pain and I think I can tell the difference!  I can work through the bad pain-- it's the sharp pains-- like someone is stabbing your knee-- that make me stop in my tracks.  I can't seem to "work" past this!  I'm seeing a new PT on Wednesday (Christmas eve), so hopefully I can get some understanding rather than judgment.

I'd like to hear more about the pain you experience.  When you pull your knee up in a heel slide, do you feel like you just hit a brick wall and your knee won't bend any more?  This is how I feel.  Is this the scar tissue, or is something wrong in there?  When you really push your PT, do you have incredible pain at night? (I do).  It keeps me awake for hours.  I don't know if it's a good sign or a bad sign, though.

Anyway, if you've managed to improve your flexion, I'd sure love to hear that, too! (and how you accomjplished it).    I hope so-- some encouraging news would be very welcome right now!

Best wishes to you and your family over the holidays,

Chelsea

Hi Chelsea,

I check on here once in a while.  I have recovered from my surgery (I had a scope in October of '07) but I had some similarities to you.  I was stuck at about 75 degrees a few weeks post op.  What had happened to me was that I developed excessive scar tissue (arthrofibrosis). you should post your question on the Arthrofibrosis thread/room.  Anyways, I felt what you did. It felt tight, but also a pain at the side of my knee where the piece of meniscus was removed.  To make a long story short, it took me until around June of '08 to get my ALMOST full flexion back (I'm at around 133 now, and my full flexion on my good knee is around 138). My OS is happy with where I am (I no longer have to see him or go to PT, not since June) because I am happy. If I try to push past around 130, I get that sharp pain. I'll always have that pain b/c the piece of meniscus wasn't able to be repaired. It had to be removed.  At one point my OS told me that my progress wasn't enough (this was maybe 4 months post op, so you shouldn't worry too much right now), and he said I'd need an MUA if I didn't get my full extension back and improve a lot on flexion.  I think at that point I was at 100 flexion and -10 extension.  Well I worked hard to fix that.  I did lots of wall slides, but also I got one of those swiss balls (giaint exercise balls) and sat on it and would roll slowly forward as far as I could, bending my bad knee. then I'd hold it and then push back. And repeat. Between that and the wall slides (I would put weights on my ankle so help push my knee down a bit), my flexion stopped being "stuck".  I was there (where you are now). I was afraid that I'd never get past 80 degrees flexion.  But i did. It was slow going, but I did it.  For extension, I would have weights on my ankles and lay on my stomach with my leg hanging off the bed. It hurt like heck, but slowly my extension improved and stayed that way.

Anyways, I dont' have much time to post. If you want more info, send me a message and then I'll send you my email.  But I'd seriously consider posting in the AF room as well. It sounds like you might have it.  My OS told me that sometimes younger people (some older people too, but it's more common in younger, athletic people) have scar tissue that builds very rapidly. So that's what happened with me.  Can you oscillate your kneecap a lot? Or does it feel stiff/stuck? I could barely oscillate mine back when I had AF.

there are also some great AF articles on here by I think Dr. Noyes. If you can't find them, let me know and I'll try to see if I have them saved somewhere.

Take care!

~Nevella
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #20 on: December 28, 2008, 07:00:43 PM »
Chelsea,

Here's the link to the AF room:

http://www.kneeguru.co.uk/KNEEtalk/index.php?board=9.0
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #21 on: January 11, 2009, 12:39:33 PM »
Hi Sarah,

I haven't been on here in a while. How is your knee doing?
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #22 on: January 13, 2009, 01:32:29 PM »
An update: I went on vacation to Puerto Rico.  I decided that I don't know if/when I will recover and I need to try to live my life despite this knee problem.  My husband had to carry more than his share on the trip but, fortunately, he seemed OK with that.  We went to an island because I can swim and float pretty well.  The walking was still an issue: I am so slow and I have to stop sharply when my knee randomly doesn't line up correctly.  The trip would have been better if I were healthy, but I had a great time anyway.  It lifts my spirits to see that I can still travel.  I just have to be more slow and patient.  And then I have to be even more patient.

I can still get full extension when I am warmed up.  I'm beginning to like the elite seat now - it is less painful and it is effective. 10 min on it gives me a bit of hyperextension.  I still cannot do an active heel lift using my quad.  My patella does not shift proximally when I contract my quad and I can't push my patella proximally during mobilizations.  That is a problem.

I am still working on flexion.  Since my PT session 5 weeks ago, I have increased the distance that I can pull my heel towards my butt by 9 cm (to a total of 58 cm).  I don't have the trigonometry skills to convert that distance into degrees of bending, but my healthy heel moves 75 cm to my butt.  I'll see the OS next week and we'll measure it. 

My walking is still poor.  Two days ago, right after using the elite seat, my husband said that I walked normally at the store.  I was concentrating very hard, but apparently, I looked good!  Too bad it only lasted a few minutes.  But it is a good sign.  But will I ever wake up with a straight knee?

I still can't go down stairs at all.  I can get upstairs, but not normally.  My quad doesn't look as atropied as it used to, but I don't see a functional improvement.  Maybe I am just not noticing improvement because it is very gradual?

The OS will take X-rays next week.  I am worried that I have worn away the cartilage behind my patella.  Will that show up on an Xray?  I know my patella is pulled down too hard into the joint.  I am hoping that by working on flexion, I can stretch the patellar tendon out.  I'd love to see my patella shift proximally.  But, it has been nearly 4 months since my surgery and that feels like a long time.  How do I know if I have IPCS, patella baja, or patella alta?  What is the difference between ICPS and baja?  Can you have any of these and still have a fully functional knee?

Sarah.
« Last Edit: January 13, 2009, 01:35:19 PM by conno11y »
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #23 on: January 21, 2009, 05:07:19 PM »
I went back to see my PT and OS yesterday. 

Flexion: After warming up, I pulled my leg to 130 degrees.  While in the flex seat contraption, the leg was at 135 degrees.  This is 15 degrees more than 6 weeks ago, so that is progress.  135 degrees sounds great of course, but it is a bit misleading since that is my maximum flexion under good deal of pain and strain.  But, I will keep working and I hope to have 135 without strain some day.
 
Strength: They measured my leg strength and it was pathetic.  My injured leg is only 46% as strong as my healthy leg and can only press 89 lbs.  No wonder I can't walk down stairs: I weigh more than 89 lbs!  So I have a lot of work to do.  I'd like to get the injured leg to 90% of the healthy one.  But, I am actually comforted by this news.  I was concerned about my complete inability to walk down a single stair, but if strength is my only problem, it should be fixable.

Pushing on the leg press was painful.  I often have pain under the proximal area of my patella while bending my knee.  When I pushed on the leg press, this proximal pain radiated around the patella and the entire circumference of my patella hurt badly.  I am worried that I am damaging the cartilage on the back of my patella, since my patellar mobility is so limited.

They took Xrays and said that my knee looks like it did before surgery, except for some osteoporosis from disuse.  I take this to mean that there is not a narrowing of the joint space and I have not worn my cartilage yet.  So I can't explain the patellar pain.  I still have to push my patella distally when I bend my knee.  If I bend extremely slowly, I can increase the chance of not having to push the patella down.  But the patella isn't tracking properly on its own.  My OS said that this may improve as I stretch out my patellar tendon by working on my flexion.  I really hope that he is right.

Home PT: Focus on maintaining extension by using the elite seat and towel stretches, 2X/day.  Improve flexion using wall slides and the flex seat, 3X/day.  Work on strength by biking 30 min, knee extensions with 3 lb ankle weight (this scares me due to the patellar pain) 3X/day, step-downs building up to 100, 3X/day.  Good habits throughout the day: stand on the injured leg and walk normally.

I'm going to start to try to sit on my heels.  I am so excited by this prospect because it would mean that I could return to yoga!  To start, I will place a big folded pillow between my rear and my calves.

So, to summarize, my biggest problems now are my scary patellar pain and my lack of strength.  I still wake up with a bent leg and have to stretch it out to get full extension.  I still limp and can only walk normally immediately after stretching out.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #24 on: January 22, 2009, 12:06:18 AM »
Hi Sarah,

Sorry I haven't been on much. Since going back to work in early january, it's been busy busy. I wish I had a job where I was in an office setting so I could easily go on KGs to check on ALL of my friends. But I often only have time to go on the thread I share with my friend Lenore. So, just know I do read your posts, but sometimes find it hard to reply to you (and a few others that I follow).

That's great you're at 135 flexion. But yes I know what you mean about wanting to get there without the pain and strain. I'm finally there now (without pain/strain), but it took a long time. Part of it is that I don't keep up with the at home exercises (i haven't needed to go back to physio since last July. But I dont' always do my exercises on my bike and with my ankle weights, etc). But I'm gonna join the local gym next week so that will help. I'll go with my boyfriend so that will help motivate me. And it will help me lose the 15lbs i've put on since my October '07 surgery. No more excuses, lol!

My quad is still not as strong as the other leg. Again, it's my own fault. PT can't help me. I have to do the squats at home every day to get it back to 100%. But at my job i don't have any time to sit or do exercises, and by time I get home, i'm exhausted from a long day with kids, lol. But i still have trouble going DOWN stairs. I usually have to hold on to the rail. So my leg likely isn't as weak as yours (I remember back when i couldn't go down stairs at all, so I know what you're feeling now), but it still isn't 100%.  But at least you know that it's just the strength and once you get that back, you'll be able to manoevre stairs again.

Wow, your home PT regime is amazing. And you stick to it? Good for you! That's where i fell short. I couldn't stick with it. I hope goign to the gym will change that.

Oh wow, so you're almost able to sit on your heels? I call that Heel-to-Butt. I still can't do that, but I haven't been pushing myself to get that last little bit of flexion. My OS said i dont' need it for what I do every day, and since I get so much pain from where i had the microfracture and the piece of meniscus removed, I don't need to get full flexion. But i know if I pushed it and tried the pillow thing like you do, i'd get there. I don't do yoga, but it wouldu be nice to be able to sit cross legged and to knee.

I hope your patellar pain improves. Did you say you take meds for the pain at all? Or does it only hurt a lot when you do the leg presses?

ok, i have to get going. talk to you soon :)
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #25 on: January 22, 2009, 06:05:12 PM »
I think I should clarify - the home exercise that I listed is what my PT prescribed for me.  I thought it might be helpful information for others.  That program is my target and I wish I could say that I do it all everyday, but that would be a lie.  I am trying my best.  I didn't try kneeling last night.  I think I am afraid to find out how bad I am at it.  But, I plan to do it tonight.  Maybe I will surprise myself! 

I can't wait to go back to yoga.  I know it would help my back and my leg muscles.  I suspect it would help my brain too.  I was no yoga expert by far, but I was reasonably good at all the beginner poses to which I was introduced.  And the last time I did yoga (over a year ago), I left with a high that lasted all night.
« Last Edit: January 23, 2009, 03:40:25 PM by conno11y »
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #26 on: January 23, 2009, 10:47:25 PM »
Hey Sarah,

That information will be helpful to others.  It was great of you to post it.  I think a lot of us can relate to not keeping up with our prescribed PT at-home routine.  It's just not fun, lol.

My fiance and I just joined the gym together, so i'm excited. Not only will it help me lose the 15 lbs i put on after my surgery (and have been too lazy to do anything about it), but it will also help me get my quad back to 100%.

I don't think I'll be able to ever do yoga.  I tried it once, but right now I can't sit cross-legged (with my flexion). Maybe one day (after i build up my quad more and then it doesn't feel weird when I bend it).

ttys!
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #27 on: February 23, 2009, 05:38:09 PM »
My flexion progress has slowed.  In the last four weeks, I have only increased by 5 cm in the distance I can move heel towards my butt.  But, 5 cm is more than nothing.  I haven't been as committed to my PT as I should be.  I am ashamed of that and I am exhausted.  I work on my knee everyday, but I haven't been as regimented with my routine as I was previously.  I know I'm not doing enough strength work.

I have seen small signs of improvement.  I can do flex hangs now!  They used to be terribly painful and my quad would fire throughout to protect my knee from pain.  Now I can do the hangs without firing my quad.  I do worry that this means that I am reaching the end of my flexion range.

Today I was able to bend my knee and cross my foot over the opposite knee/leg to get a nice glut/lower back stretch.  Oh - that felt SO good!  It has been over a year since I have been able to really stretch that area.

I want more ROM and I want it quicker and with less pain.  I think improving strength will help daily living.  It is so hard to do strength training when there is pain in my knee.  I see the PT again in a week.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #28 on: February 23, 2009, 11:56:19 PM »
Hey there!

i hear ya about not being committed to PT. I still have a bit of quad atrophy, over 16 months after my surgery. I just don't find the exercises exciting, so i put it off (plus i get busy at work). But i know i have to make time. And yeah i remember the pain too. But it truly pays off when you get past the pain and you are actually at a good flexion. what are you at now? in terms of degrees? even 5cm is still an improvement. and at least you know you can do better (so that's a good thing :)).  Keep truckin' along and keep me posted, ok?

congrats on being able to bend your knee and cross your foot! :)
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #29 on: March 03, 2009, 08:41:33 PM »
Thanks for keeping track of me, Nevella.  I saw the PT yesterday.  I had progress in flexion and strength!  I can still pull the leg into hyperextension, but still only after it is warmed up.

At maximum strain/pain, I pulled the knee to 143 degrees with my arms.  My PT said that she doesn't think I will reach full flexion, but I am not ready to give up!  I LOVE that number - 143!!  I feel like shouting it.  I wish I could tell my past self that I would get to 143.  I don't have anything close to 143 cold, but I'm hopeful I will get there one day.

My injured leg can now press 125 lbs (36 lbs more than 5 weeks ago).  My healthy leg presses 210 lbs now, so I have 85 lbs to go.  I'm adding leg presses at the gym to my PT.

My walk is still impaired.  I don't push off my toes properly and I hitch my hip, partly out of habit and partly because my patella feels out of place when I bend my knee while walking.  I will work on that.  I have seen functional improvement.  I can pull my foot back to let people walk by at the movies.  I used to have to stand up.  I can also get into the back seat of a car without a big production.

New PT protocol: wall slides and flex seat everyday, elite seat and towel stretches everyday, strength routine a few days a week.  Strength routine: leg presses with reasonable weight only within comfortable range of motion, side leg raises, step downs with 4 inch step, knee extensions.  I will have to watch to make sure that my strength work doesn't hinder my ROM due to pain and swelling.

Onwards!!
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #30 on: March 08, 2009, 01:05:56 AM »
Good for you! wow, I don't even get 143 flexion on my good leg, lol! But I know that a "normal" adult flexion can range from around 140 to 150.  My good leg only gets to about 137 flexion. So getting my bad one to 133 is good enough for me, lol.

I tried doing the leg press but it causes my bad knee to sort of pop and hurt. So i have stopped doing those. there are many other exercises i can do to strengthen my quads. I think i'll save the leg press for when my quads get a bit stronger.  also, because i had a microfracture and a piece of meniscus removed, i'll always have pain in one part of my knee, and i think the leg press aggravates it.

so what have you been up to besides PT? how's life?  did i already add you to my Facebook?

ok, gotta go. Star Wars is on and Martin wants me to watch it with him and the kids :D
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #31 on: April 01, 2009, 04:38:44 PM »
I pulled my heel 72 cm towards my bum yesterday!  I don't know what degree that is, but when I could get it to 66 cm, I was at 143 degrees.  I'm hoping I can get to 73 or 74 cm by next week, when I see my PT.  My healthy knee moves 78 cm (150 degrees).

Using 2 large pillows between my calves and thighs, I successfully kneeled on my heels for a minute.  It was not comfortable, but I cling to the idea of returning to yoga someday.  I still limp and drag my leg somewhat - mainly because it is faster and easier to do so.  I know that is bad, but people at work say I am getting around better.

I still have trouble going upstairs and can't go downstairs at all.  If I push distally on my patella while going downstairs, I am fine.  This worries me.  I thought that my problem going downstairs was simply muscle weakness - something that can be overcome with exercise.  But, since I can support my weight to go downstairs if I push on my patella, it seems that the problem is the mechanics of my knee. When I start to bend my knee, my patella gets caught and feels like it will dislocate if I bend further. 

My patellar tendon was shortened from the lack of use when I had AF, but I don't think that explains my problem since a short patellar tendon would pull my kneecap too low, right?  I'm wondering if maybe my problem is actually that the patella is too tight laterally.  I know this is a relatively common problem that can be addressed by strengthening the VMO.

Anyone know how I can determine if my patella is too tight laterally?  Anyone know how to selectively strengthen just the VMO?

p.s. Nevella - will this get you to my facebook page - http://www.facebook.com/profile.php?id=639128812&ref=profile?  Did you know there is a KneeGeeks facebook page now?
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #32 on: April 10, 2009, 04:51:54 PM »
I had another PT appointment on Wednesday.  I usually leave PT pumped up by my progress... not this time.  She measured my strength and said it had not changed since my last appointment 5 weeks earlier.  I don't understand how that is possible, since I have been going to the gym and using the leg press.  It is deflating.

She measured my flexion and I only got to 145 degrees.  That sounds great, but it is 5 degrees shy of normal and it marks only 2 degrees improvement in 5 weeks.  My cold flexion is nothing close to 145.  She said I still have full extension, but with a 'hard end feel'.  I never feel like my leg is fully locked straight.

The real problem is that my kneecap rides too high when I bend my knee.  This is why I am still limping (it has been over a year now) and why I can't go down stairs.  Stretching my patellar tendon by gaining flexion was supposed to help, but it has not.  My PT is confused, since my patellar tendon is shortened and it pulls my patella distally during rest.  I have limited patellar mobility in the proximal/distal direction.  There is nothing we can do to fix it and I am terribly depressed that I may limp the rest of my life and walk down stairs like a baby.  Will I ever be able to consider hiking again?  Will I ever return to yoga?

She gave me a tight band to wear proximal to my patella.  It helps me walk better and I can hobble down the stairs when I wear it. But it is not a cure - it is a temporary fix to make me more comfortable.  I am hoping that wearing it will at least help me build strength since I should favor my healthy leg less when I wear it.

This has been such an emotional roller-coaster and I just want off the ride.

Sarah.
« Last Edit: April 10, 2009, 04:54:01 PM by conno11y »
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline MartinsGirl

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Re: arthrofibrosis, loa
« Reply #33 on: April 20, 2009, 10:56:10 PM »
Hey there,

sorry I haven't been on much. I only come on KGs every few days, and just for a few mins, so I usually only post on the thread I share with my friend Lenore. I got your facebook link and requested you as a friend. Im' on there a lot more often.

yes there is a Facebook group for Knee Geeks. It's called "We are Knee Geeks".

I'm sorry you're going through such a roller coaster.  I'm surprised that you're not happy with 145 flexion. For me my good leg (non op) only gets to about 140. and my op leg has only been able to get to 133. I guess I'm satisfied b/c I don't want to do any sports or anything like that again. my OS said if I'm happy, he's happy. I just had a bit of AF, but I got past that and now I just have to strengthen my quad (i have been lazy) and maybe push for more flexion). 

So what is the next step for you? More surgery? PT? Sorry it has been a while and I confuse some of my KG friends' injuries and surgeries. It just seems like you still have that patella problem, but do docs not know how to fix it? I know knees are super complicated (i hate mine sometimes, lol). I hope you do not have to suffer much longer.  xoxo
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #34 on: April 22, 2009, 04:21:25 PM »
I would be happy with 145 flexion if I could get there without warming up and pulling on my leg with all my might.  My knee probably gets to only 110 or so before it starts signaling my brain to stop bending.  This means many everyday activities are still somewhat uncomfortable and working out is certainly inhibited. 

My kneecap riding too high is my real problem though.  Even if it could be addressed surgically, I can't face another surgery - at least not for a long while.  The recovery is just too hard.  It took months of rehab and tears after the last surgery just to regain the crappy flexion that I had going into surgery.  I'm so sick of all this.  I'm hopeful that regaining strength will help the kneecap learn its place.  My PT didn't say that would happen, so I don't have much reason to hope.  But, what else can I do?

At least I've started to lose the minor amount of weight that I gained after my accident last year.  That is one bright spot and I'm about halfway there.

Sarah.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #35 on: May 04, 2009, 09:41:51 PM »
Odd thing happened on Saturday: out of the blue, I lost feeling on the back of my thigh (posterior/lateral) from my rear to the back of my knee.  It isn't completely numb, but it is altered and feels dull and strange.  I have been wearing the band proximal to my patella on and off throughout the day for weeks.  I took the band off, but no feeling returned.  It has been 2 days.  I'm guessing a nerve is being pinched in my back.  I'm not terribly worried about it yet, but I would like to have  that sensation return.  What is strange is that it popped up out of the blue.

I tried yoga again on Thursday and Friday.  I am nowhere near as advanced as before the accident, but at least I made it through the video.  I can't do my favorite: child's pose.  I will probably never be able to do that nice, relaxing, refreshing pose since it requires heel to thigh.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #36 on: May 15, 2009, 09:55:33 PM »
I saw the PT again and got some better numbers than last time.  She measured my flexion (at max pain/strain) at 149.  That is hard to believe because I still can't get heel-to-butt.  But, there has been some improvement.  I am going to work harder at trying to kneel.  I can kneel with a pillow between my thighs and calves, but only for maybe a minute.  I'm going to start timing it and increasing my time.

My total leg strength improved from 125 lbs to 146 lbs on the leg press.  My healthy leg can press 200, so I still have some work to do.  We measured my quad and hamstring separately for the first time.  My hammy has full strength!  My quad has only 45% strength compared to my healthy leg.  So, I have a lot of work to do, but I am looking at this optimistically.  If this is how it feels to be 55% deficient, imagine how much more comfortable I will be when I reach less than a 10% deficit.

I've been wearing a tight band above my patella to push it downwards.  It helps my gait tremendously.  I look like a normal person when I have it on!  Unfortunately, I am becoming dependent on it - I still hitch my hip and don't bend my knee fully while walking without it.  I think the band around my leg is contributing to sciatica and causing some swelling in my knee.  But I wear it anyway because it makes me more comfortable and I think it is most important to develop better walking habits.

I can't run at all, but I am going to start to try on a treadmill.  The PT said that she doesn't think I will achieve a comfortable kneel, but I'm not giving up yet.  The body is amazing and I can't believe I am still healing 8 months after my last surgery.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #37 on: June 23, 2009, 06:33:35 AM »
I saw the PT and OS again.  Extension is still tight, but can get hyperextension when warmed up.  My flexion is at a tight 150 degrees with maximum pressure and pain.  I still can't kneel, but my OS thinks I will be able to someday.  My PT is less convinced.  I'd really love to be able to do yoga again, so I will keep trying and be patient.

My biggest complaint is that I can only hobble downstairs.  Both weakness and mechanical issues are contributing to that problem.  My total leg strength measured at ~165 lbs (~85% normal).  When isolated, my quad had a bigger deficiency - maybe 50%, I can't remember the measurement.  So, I need to keep working on strength.  I'm hoping that strength and time will one day let me anonymous on the stairway again.  I hate the attention that hobbling down the stairs brings.

I did manage to take a 7 mile bike ride on a real bike in the real world.  That was a victory!  I had to be careful and I was slow, but it wasn't bad at all!  Other progress: I can hold a heel lift if my knee is warmed up!  I can grab my heel from behind while standing for a nice quad/hip flexor stretch.  I ran on a treadmill for 2 minutes, but stopped because it felt bad.  I can hobble awkwardly downstairs even without a strap above my patella.  Many people have commented that I no longer limp.  The truth is that I do limp, but it goes away when my knee warms up.  I no longer have numbness down the back of my thigh.  I can sit in a loose cross-legged position.  I'm working on wearing my patella strap less often.

New problems: my knee had two consistent pops.  When I push into full extension, I almost always get a small pop in the center of the knee.  It doesn't hurt, so it doesn't concern me deeply.  The more alarming pop is one that occurs frequently while I am trying to walk.  My patella seems to get stuck and I can feel pressure building and a need to pop the knee.  Once it pops, my gait improves.  The pop is often painful (but not excruciating) and it feels like my lower leg is twisting when the pop happens.  It does not feel good and it is not something that I want to deal with forever.

I'd like to run again someday.  My PT said that would take months of dedication.  She said I would have to start trying to run and it would feel bad for a while, but with time it should get better.

It is interesting to watch my expectations and desires increase as I recover.  There was a time when all I wanted was to be able to walk again.  Then I wanted to be able to climb stairs.  Now that I can basically do those things, I want more.  I want yoga, I want running, I want stairs, I want pain-free.  So... I will keep working and waiting and hoping.

Next appointment in 2 months!
« Last Edit: June 23, 2009, 06:37:12 AM by conno11y »
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #38 on: July 21, 2009, 06:59:31 PM »
Things are slowly improving - ridiculously slowly.  I ran for 5 minutes on the treadmill.  I should be able to increase that, but it doesn't feel good right now.  I tried to get a heel-to-butt kneel going for an extended period of time.  I didn't reach heel-to-butt, but I must have pissed off the knee because my extension was lagging for a week afterwards.  I think it is finally back now.  That was disturbing.

I have daily popping.  The pop is needed to have free walking and flexion.  I haven't figured out a way to force the pop yet.  I am at the mercy of luck.  I just keep walking until the right combo happens and it releases.  The pops sometimes hurt, but they usually increase my function.  I'd like them to stop because they are certainly not normal.  They are more disturbing than the normal occassional pops that I get in other joints.  The knee feels like it's twisting as it pops.

Overall, I shouldn't complain.  I can walk and run a bit.  I went sailing and biking this weekend without much trouble.  My knee is on my mind frequently, but sometimes I forget about it when I'm sitting.  I'm hopeful that this will all be a memory someday.

I wrote a letter to my first surgeon.  I want him to know what happened to me.  I told him that I find it unforgivable that he left me for 2 weeks post-surgery without physical therapy or even instructions for home therapy.  He knew I went into surgery without full ROM and when he didn't find anything to explain the problem, he should have known that I would be high risk for AF.  I want him to remember me when he cuts into his next patient.  I wish our medical system had a way to scorekeep.  I wish it were easier for patients to evaluate doctors.  I'll never have another surgery without somehow finding a certifiable expert. 
« Last Edit: July 21, 2009, 07:06:34 PM by conno11y »
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #39 on: July 23, 2009, 07:12:29 PM »
I ran 10 minutes on the treadmill yesterday.  I tried not to favor my healthy leg, but I know I favored it... the healthy quad is more tired than the weak one today.  The run didn't feel great, but I'm pretty happy with 10 minutes!  I should back off and use the eliptical... but I really want to feel normal again.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #40 on: August 10, 2009, 11:56:33 PM »
I just had my (hopefully) last PT appointment!  She said I had minor swelling and my extension was tighter than previously.  I made some gains in strength - not as much as I'd hoped, but that's nothing new.  On one strength test, my injured leg was at 85% compared to the healthy leg.  On another strength test, it was only at 65%.  I'll keep working on that. 

My PT suggested laying off my attempts to get a heel-to-butt kneel going.  It definitely pisses off my knee and it probably caused the swelling.  She emphasized that I NEED my extension to walk properly and avoid wearing down the knee.  I really want to be able to kneel without pain so I can return to yoga.  But, I won't push it.  I'll keep trying, but I'll be more mild and I'll use my cryocuff and the elite seat afterwards.

So - I need to gain strength and function, but I am on my own.  No more 8 hour round-trips for PT for me!  I've got this idea that someday I'll be able to do a sprint-length triathelon with this knee... we'll see what happens.  My husband is interested in training for that, but I need to be able to run normally before I can start that.  I think I could do the bike and the swim right now.  I can't do breaststroke (yet), but freestyle isn't bad.

Anyway - that's my story!  I am so pleased with my surgeon and so grateful that I found him and his clinic.  Things could have ended up so much worse.  I'm guessing I've got a couple years before I feel normal, but I think it will come!
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #41 on: October 15, 2009, 07:12:11 PM »
I ran for the bus the other day... and caught it!  A full half-block of running for a purpose makes me feel less broken.  It hurt and I wasn't sure I wouldn't end up flying face-first onto the sidewalk, but I did it.

I've had to use the elite seat a few times a week to regain extension.  My knee is tight and I limp if I'm not stretched out, but not badly.  I don't think the limp is noticable to others after a few steps.

Maybe I will have the courage to return to a yoga class this week?  It has been nearly two years since this knee took me out of that.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #42 on: November 05, 2009, 05:42:22 PM »
I actually touched heel to butt a week ago while kneeling!  It took a lot of warming up to get there and it hurt (wasn't anywhere close to comfortable), but there was definite contact.  I don't care where my flexion finally ends, I just want the end point to be non-painful.  Over a year since my last surgery and I'm still making progress!

I need to work on strength...
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #43 on: June 23, 2010, 08:30:04 PM »
An update: I'm doing well!  I can't say that I'm progressing anymore, but I am not regressing.  I don't do specific PT to rehab the knee anymore.  I can use a rowing machine (major knee bending there), but running for exercise doesn't feel good on the knee.  I can't kneel comfortably on my heels, but I have been to 2 yoga classes and kept up reasonably well.  My affected leg is weaker than my healthy one, but all-in-all I'm really happy with the progress.  I have mild pain under my patella when I flex my quad sometimes and I am worried that will be a bigger problem as I age.  Using my hand, I can feel a lot of crackling when I bend the knee.  Pops are more infrequent.  I want more flexion and I work on that sometimes, but the extreme bending pisses the knee off and results in more pain for a while.  I had to slow down a couple weeks ago after a 3 mile walk because some pain randomly flared up.  But - there are hours that pass in a day when I don't even think of my knee.  Dr. Shelbourne and his staff are my heroes!
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline kcknee

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Re: arthrofibrosis, loa
« Reply #44 on: June 24, 2010, 03:12:30 AM »
I'm glad that you are doing so well. I had read your story before when I was trying to figure out what was going on in my leg. I was diagnosed with AF after my 3rd surgery, but suspect that it started after my 2nd, the ACLr. Right now I am seeing a fellow from the Steadman-Hawkins Clinic and am desperately trying all the nonsurgical treatments to get the inflammation to calm down and get my extension back. Unfortunately nothing seems to have a lasting effect.

It is good to see that you were able to get back to a more normal life that isn't completely focused on your knee. I'm still in the stage where if I try anything beyond daily living my knee/leg gets really hot and I start losing more extension. The fasciotomy that I had for for compartment syndrome last December seems to be trying to scar over again also.

Please keep posting your positive updates to give those of us in the early stage of AF hope. It helps a lot to see that a normal life is possible.

Kristin
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #45 on: September 23, 2010, 07:25:11 PM »
Two years since surgery and I'm still happy!  I still think of the knee everyday, but there are hours that pass when I don't.

I've been going to yoga again and doing OK!  I still can't get heel to butt, which makes kneeling difficult, but I can do reasonable version of child's pose, my former favorite.  My hamstring on my injured leg is much looser than on my unaffected leg.  My hamstring really compensated for all those months when I could not bend my knee.  I'd like more symmetry, but I can't get the hamstring on my unaffected leg to stretch out (yet).

I'm working on strength with leg presses.  If I put my hand over my knee while I press, I can feel nasty crackling, popping, and whooshing.  These are not present in my unaffected knee.  In general, I don't have much pain.  There is pain under the kneecap sometimes, but I can live with it.

On to year 3!
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #46 on: November 30, 2011, 05:53:09 AM »
Three years since surgery and things are great!  I had a baby this year and my knee barely affected my pregnancy at all!  I can't kneel comfortably, but I can do everything else that I want.  I think having this little baby will be good therapy too - since there is a good deal of squatting involved!
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!

Offline markrthq

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Re: arthrofibrosis, loa
« Reply #47 on: October 23, 2012, 01:20:04 AM »
Sarah,

Do you still monitor this thread? I am in a similiar situation with you and very frustrated...I recently had surgery with Dr. Shelbourne 6 weeks ago.

Offline conno11y

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Re: arthrofibrosis, loa
« Reply #48 on: January 23, 2013, 11:55:16 PM »
Hi Mark,

I didn't get your post until just now... I hope you are doing better.  Still looking to talk?

Sarah.
Jan 08 MCL sprain, skiing
Feb 08 MRI OK, ROM 13-127
Apr 08 Arthroscopy: plica resection
June 08 AF diagnosis, due to lack of post-op care
July 08 MRI: fat pad scar, ROM 9-115
Sept 08 Arthroscopy: LOA, MUA, medial/lateral release
Oct 08 ROM -5-90
Mar 09 ROM -5-143 (max strain/pain)
Sept 09 Success!