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Author Topic: arthrofibrosis, loa  (Read 13256 times)

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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