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Author Topic: arthrofibrosis, loa  (Read 13259 times)

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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)
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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!