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Author Topic: Microfracture on 37 year old male soccer player  (Read 83160 times)

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Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #15 on: August 02, 2009, 07:55:16 PM »
Hi Scooter. I had my surgery the day before you did.

I had MFX in the trochlear groove, and MFX & TruFit plug installed in the medial femoral condryl. Since the most serious injury was to a weight bearing area my rehab is much slower than yours. I just started PT Friday. I am not completely off crutches or cane yet.  My rehab is mostly ROM work now. I am OK with slow and steady. Would rather err on the side of caution than go through this surgery again!  I have a long ways to go to build my muscles back.

I cringe when I think of the pain you must have after attempting that lunge!  :o   I would think the MFX would still be very fragile at 5 1/2 weeks.?? I'm thinking it's would also be too soon to know if it was a success or failure. What is your OS saying?

Take it easy until you see you PT this week.  This journey does try one's patience, doesn't it?   ;)

Nan

Oh, you're not kidding, Nan!  It does try one's patience, no matter how long or short the restriction period might be. 

One thing I decided was that I was going to trust my OS and any advice he might give unless he proved to be very very strange and/or incompetent ;)  So, when he told me that I was going to be full weight bearing after my surgery, I asked why, and he explained (that my lesion was in a non-WB area of the trochlear groove)  His only restriction was to keep the knee as straight as possible (to avoid the 40-70 degree range especially), and if bending the knee, to avoid "shearing" force. 

So for the first four weeks, not only did I avoid putting any force on my knee (other than body weight), I pretty much avoided even bending the knee, save for a few occasions where I "forgot" not to bend it.  It has only been in the past week or so that I have started to bend my knee, and test it in various ways.  One instance was today, doing the reverse lunge, using only my body weight.  I have also gone up stairs, again.. in a controlled and slow manner.. with success. However, I have not tried going down stairs using my injured knee, because that motion caused pain before the surgery, and for some strange reason, the fine muscles that control one's leg during that motion are so weak that I can't capably go .  (The reverse lunge same ROM and muscles as going down stairs) The only other activity I have done is ride a stationary bike with low resistance.

At my last OS visit, on July 22nd, my OS told me that I could go ahead and bend my leg, and perhaps try to test it a bit, because the clot was "attached pretty well at this point".  I took that to mean that unless I am going nuts with my knee, doing heavy weights and sprints (which I couldn't due anyway, because of muscle wasting), that I am not going to ruin the microfracture by doing a reverse lunge, or carefully going up stairs.  And if it is that fragile, then I should have been put in a brace, but at this point, it's impossible to know and futile to blame.

I am pretty frustrated, but overall positive.  I think that if this procedure doesn't work, I will still rehab my leg back to good strength while wearing a brace that moves my kneecap to track over a spot that doesn't include my microfracture area.  Then, I will contemplate the lateral release procedure, as well as the one done at Stone Clinic.  I will not, however, just "retire" from active sport; it's too much a part of me.  I will have ample time to sit on my ass when I am 70, if then.

Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #16 on: August 05, 2009, 06:40:31 PM »
Oh.. dear.

Well, it seems as if all of the optimisim I displayed in my previous posts is crawling back to me as a sussurus of pessimism, that may get worse.

I tried bounding up the stairs, and some other odd lunging motions (other than the one I described previously in this thread), and experienced the shooting pains!

The horror! Lol.. :P  I am 6 weeks post mfx as of this Thursday, 8/5, so I don't think that I was trying such things too early according to the "standard" mfx waiting period.  However, my knee is telling me differently, in a bad way.  I won't even try to jog, for fear of what I would feel.

And now, I am also experiencing something so many here have gone through, which is questioning one's OS.  I said before that I think he is a quality surgeon, and general good guy.  But now.. lol.. I called him today and explained my symptoms, and asked if I should lay off the knee, and thus not attend my first PT appointment this Friday. He summarily told me to "work through it, doing the same activities" that I had been doing, and to still go to PT on Friday.  He also told me that the pain does not indicate the mfx failed (which I believe).

So now, I am confused.  Either I trust my OS, who I still believe to be a good person and quality surgeon, or incorporate my own thoughts which are shaped by what I have read here, and on other sites (such as Dr. Steadman's).  I just don't get how his.. "workout warrior" approach to rehab can be right, since it runs contrary to what you good people have relayed.  I am of (at least) half a mind that this mfx has, or has a good chance of failing. But the other half says there is still a decent chance.  No matter.. I have to ride it out.
« Last Edit: August 05, 2009, 06:42:32 PM by Scooter72 »

Offline Marjan

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Re: Microfracture on 37 year old male soccer player
« Reply #17 on: August 05, 2009, 08:09:51 PM »
Hi Scooter.........

6 weeks out from MFX surgery is still very early.  Most OS's will tell you that "recuperation" is 6 weeks, but that's just the recuperation from the surgery (ie, expecting most of the swelling to go down, etc).  At 6 weeks the clot is fairly well "attached" but it has not "ripened".  It was explained to me that the cell organization at this point is very disorganized and therefore has little strength or "cartilage like" characteristics.  As it matures, the cells will settle in an organized matrix that becomes as strong as possible.  This can take up to a year!
In the meantime when that spot is "in use" it will be tender and result in fairly scary bone pains.  Bounding up stairs is probably too much force on the knee.  Good exercises should be of the type that never have both feet off the ground at any time. Wall squats, BOSU ball balance, hip flexor exercises, and when you feel up to it, elliptical training are good ways to stay in shape.  Swimming is excellent (don't use a "frog kick") and any kind of water aerobics is good.
I'm 10 months out and still recuperating.  I've started doing more and more stuff, but everything needs to be brought into the picture at a rate that would have frustrated me years ago. 
I believe most OS's are very capable, but from having had two MFX surgeries, I've gleaned a lot on just how long this rehab takes and it's one of my pet peeves that OS's call it 6 weeks, when it's actually closer to 6 months.  Oh sure, you'll be getting around just fine in a while, but the pain, irritation, muscle aches and stabbing medial pain will go on a lot longer than 6 weeks.  So, go slow.......don't overdo, it's not a "no pain no gain" situation....

Good luck and hang in there....

marjan

Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #18 on: August 06, 2009, 02:43:42 AM »
Marjan, as usual you are a voice of reason, and also a calming influence.  I appreciate the advice.  Sometimes we need the voice of others to help keep a level head. 

In the meantime, I will continue to follow your long-running thread in this forum.  Am glad to hear that you are getting about with your dogs Boomer and Sneakers. and making it to agility trials, at this point.

I will continue to update my progress.

Offline Scooter72

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another update
« Reply #19 on: August 17, 2009, 03:32:27 AM »
So I am in my 7th week post-op (my surgery was June 25th.. for details, please refer to the original post in here).  I just had my first PT appointment last Monday, and I want to throw some random thoughts out here...

  I always seem to have a little to moderate swelling on the knee. The "moderate" swelling usually occurs after exercising it.  It's not painful, with an exception; I am still missing a small amount.. maybe 8 degrees of flexion in my ROM.  When I approach that limit, a pain starts. (BTW, this area is not in the range of the mfx site)  While that may seem insignificant, it's going to be a problem if I ever get back to a sporting activity, which was the point of this surgery.  My PT also seems to think it's trivial, and sort of blew it off.  However, I am sure there will be times when I land awkwardly, for whatever reason, and reflexively bend my knee to the full. 

 Despite my physical therapist's optimism upon my initial evaluation last Monday, he is still starting me out basic.  He has me doing body-weight squats, where I touch my butt onto a chair and then come back up in a controlled motion.  I do calf raises, using the injured leg, as another exercise.  And the final exercise is weird.. I lie flat on my back, bend my knees, squeeze my butt-cheeks; do a plank while keeping the soles of my feet off the floor (thus using my heels to contact the floor); once in the plank position, extend the leg that is not injured, and then reverse the steps until lying flat once again.  The PT stressed that I do all of this last exercise in a step-wise manner, as I described.

 Aside from the above PT prescribed exercises, I also ride the stationary bike at light resistance, 2-3x/week, and use a wobble board every day for ia few minutes at a time.

 My PT is against leg extensions on a weight machine, due to the force placed across the patella, I think (?)  He also advised me to avoid stairs, for presumably the same reason.  And in general, he advised, "if it hurts DON'T do it!"

  With the above said, of course, I have tested myself.  I find that I can casually go up and down stairs. At this point, only pain occurs with going up stairs, and it is mild-moderate, depending on the day, and how I choose to go up the stairs.  In other words, I vary the angle, position and force exerted on my affected knee and corresponding foot.  No pain going down stairs, but it is not smooth, because the muscles that control such motion are weak.

  Today, I went to my father-in-law's house for dinner. He has a nice, plush backyard.  I took a soccer ball and started to dribble at a light jog, with only mild cutting.  To my surprise, I didn't experience any pain, until I cut a little bit too hard, at one point, which gave me a bit of the old "shooting pain" under the knee cap.  I stopped all activity for the day, immediately, and iced the knee down.

  So, upon reading all of the aforementioned parts of this post, you may think I am optimistic. I would classify my feeling as cautious optimism.

  I also want to re-iterate to all who are considering or have had mfx.. unless your name is "Wolverine", and you happen to have adamantium claws, tailor your diet to heal.  Eat the blueberries and cherries.  Eat the fish.  Get a good cod liver oil supplement.  Get the Cosamin DS and use it. (Remember that almost every other chondroitin/glucosamine supplement is not going to work). Take high doses of vitamin D (while under a physician's supervision) I strongly believe that I am advancing properly due to such measures.

 
« Last Edit: August 17, 2009, 03:42:02 AM by Scooter72 »

Offline chariotson

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Re: Microfracture on 37 year old male soccer player
« Reply #20 on: August 18, 2009, 09:56:07 PM »
Hi Scooter,

I'm a 42 year old soccer player, I had microfracure of the medial femoral condyle on October 7th 2008, which was a 12 mm tear. They said the rest of the cartilage was in good order.
This was most certainly the weight bearing region and so did the full 6 weeks NWB. I never cheated much to the suprise of my PT.

To cut a long story short, I first hit the soccer field again (in a match) in May this year about 7 months post op. Scored my first goal in early June (header of course).

I do still get some pain, but its quite minor, but I don't overdo it and tend to only play once per week, the rest of the time I'm in the gym. I actually had some knee cap pain up until July this year, but after coming back from vacation found that has totally gone now. I tend to agree with you if it hurts don't do it, but there comes a time, that you do have to push it, for me it was the 6 month mark.

I kind of expected to be limited more in the game, but I find that I've not lost any speed or motion at all.

Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #21 on: August 18, 2009, 10:47:07 PM »
Hi Scooter,

I'm a 42 year old soccer player, I had microfracure of the medial femoral condyle on October 7th 2008, which was a 12 mm tear. They said the rest of the cartilage was in good order.
This was most certainly the weight bearing region and so did the full 6 weeks NWB. I never cheated much to the suprise of my PT.

To cut a long story short, I first hit the soccer field again (in a match) in May this year about 7 months post op. Scored my first goal in early June (header of course).

I do still get some pain, but its quite minor, but I don't overdo it and tend to only play once per week, the rest of the time I'm in the gym. I actually had some knee cap pain up until July this year, but after coming back from vacation found that has totally gone now. I tend to agree with you if it hurts don't do it, but there comes a time, that you do have to push it, for me it was the 6 month mark.

I kind of expected to be limited more in the game, but I find that I've not lost any speed or motion at all.

Awesome. What a great story, because it shows that even "older" athletes can come back from this procedure, and perform at their previous level.

So what is your experience with soccer?  And how do you think your injury came to be?  I feel as if playing too much on turf, and taking too many rough tumbles, caused my injury over a long period of time.

Offline chariotson

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Re: Microfracture on 37 year old male soccer player
« Reply #22 on: August 19, 2009, 05:20:50 PM »
Mine was a couple of incidents, I had no real knee trouble before the first incident.

Take a seat and get comfortable :)

It all came about when we had a game, and the other striker missed his second penalty in a row, so I said to him I would take the next. That week I was on the field and decided to practise a couple, and on our field the grass is too long and even worse on the penalty spot. I went up to take one, and stepped funny in the long grass in the run up, I shoot with my right and injured the right, so it was simply the step before the plant to take the shot.

I just felt a pop in the knee, it hurt a bit but not much. I even took a few more shots before I decided to rest it. Next day I sent an email to our manager (this is amateur O40, nothing special), and said I'm doubtfull for Sunday. But by Saturday it seemed alright and I played the game, with no ill effects. During this time I was playing indoor and Wed and outdoor on Sunday. So I played a few more games, before I really hurt it.

I can only assume that this initial injury was a crack in the cartliage, is that even possible. I played on it with no pain, and forgot about it.

Then I did it, played another game and had a ball come over me that I could not reach and kind of landed funny, and the knee exploded. I assume at that point that the crack became a hole in the cartliage, with the cartliage floating around the knee. I didn't play again from June 08 to May 09

Although knew that MRI was needed I gave it a coupld of months, before I did the right thing and saw the specialist.

Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #23 on: August 19, 2009, 10:04:57 PM »
Mine was a couple of incidents, I had no real knee trouble before the first incident.

Take a seat and get comfortable :)

It all came about when we had a game, and the other striker missed his second penalty in a row, so I said to him I would take the next. That week I was on the field and decided to practise a couple, and on our field the grass is too long and even worse on the penalty spot. I went up to take one, and stepped funny in the long grass in the run up, I shoot with my right and injured the right, so it was simply the step before the plant to take the shot.

I just felt a pop in the knee, it hurt a bit but not much. I even took a few more shots before I decided to rest it. Next day I sent an email to our manager (this is amateur O40, nothing special), and said I'm doubtfull for Sunday. But by Saturday it seemed alright and I played the game, with no ill effects. During this time I was playing indoor and Wed and outdoor on Sunday. So I played a few more games, before I really hurt it.

I can only assume that this initial injury was a crack in the cartliage, is that even possible. I played on it with no pain, and forgot about it.

Then I did it, played another game and had a ball come over me that I could not reach and kind of landed funny, and the knee exploded. I assume at that point that the crack became a hole in the cartliage, with the cartliage floating around the knee. I didn't play again from June 08 to May 09

Although knew that MRI was needed I gave it a coupld of months, before I did the right thing and saw the specialist.

Sheeeesh.. yeah, that sounds about right.  What a bad way for it to occur.. taking penalties on a crap pitch?  Eh?  Achh...

You did almost exactly what I did.. kept playing on it until the pain wouldn't allow it.  I played on my knee with pain for months before I couldn't take it anymore.  And even then, it was another few months before I got the proper diagnosis. 

So how competitive is your O40 league?  Any ex-college or pro's in there?

Offline chariotson

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Re: Microfracture on 37 year old male soccer player
« Reply #24 on: August 24, 2009, 02:22:34 PM »
Mine was a couple of incidents, I had no real knee trouble before the first incident.

Take a seat and get comfortable :)

It all came about when we had a game, and the other striker missed his second penalty in a row, so I said to him I would take the next. That week I was on the field and decided to practise a couple, and on our field the grass is too long and even worse on the penalty spot. I went up to take one, and stepped funny in the long grass in the run up, I shoot with my right and injured the right, so it was simply the step before the plant to take the shot.

I just felt a pop in the knee, it hurt a bit but not much. I even took a few more shots before I decided to rest it. Next day I sent an email to our manager (this is amateur O40, nothing special), and said I'm doubtfull for Sunday. But by Saturday it seemed alright and I played the game, with no ill effects. During this time I was playing indoor and Wed and outdoor on Sunday. So I played a few more games, before I really hurt it.

I can only assume that this initial injury was a crack in the cartliage, is that even possible. I played on it with no pain, and forgot about it.

Then I did it, played another game and had a ball come over me that I could not reach and kind of landed funny, and the knee exploded. I assume at that point that the crack became a hole in the cartliage, with the cartliage floating around the knee. I didn't play again from June 08 to May 09

Although knew that MRI was needed I gave it a coupld of months, before I did the right thing and saw the specialist.

Sheeeesh.. yeah, that sounds about right.  What a bad way for it to occur.. taking penalties on a crap pitch?  Eh?  Achh...

You did almost exactly what I did.. kept playing on it until the pain wouldn't allow it.  I played on my knee with pain for months before I couldn't take it anymore.  And even then, it was another few months before I got the proper diagnosis. 

So how competitive is your O40 league?  Any ex-college or pro's in there?

Our top league has some very good players, but I'm playing at a lower league level than that, serious but fun.

worse thing about my penalty is that there was no keeper, just a practise shot. I think its just a fluke, I could have done that running for the bus

Offline Greenfire083

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Re: Microfracture on 37 year old male soccer player
« Reply #25 on: August 25, 2009, 03:11:26 AM »
Hey Scooter72!

I just had microfracture this last Friday.  I went in for a menisectomy and the doctor discovered a 4mm hole in my cartilage.  I was told afterwards to begin putting weight on my leg as soon as it was not painful for me to do so and that I would not need a CPM.  I was confused at first from reading a bunch of other post op instructions that told people to be NWB for at least 6 weeks and here I am already off the crutches.  I was told not to bend deep or use stairs.  I am glad I was finally able to find someone else who was told to stop using the crutches ASAP!

My doctor is very well respected and considered a perfectionist.  Have heard nothing but great things from him, but it still worried me not finding any other cases with people being WB as soon as possible.

I'm assuming the tear in my cartilage came from soccer just like my torn meniscus.  I play indoor about 2-3 times a week and on an outdoor team.  I know when I did the meniscus tear, but still not sure what happened with the cartilage.  Just glad the doctor was able to find it before it got any worse!

As I said earlier, I am only a couple days out of surgery and walking without crutches with a little limp.  I'm afraid of rushing it and messing the surgery up.  Just wanted you to know that there are others out there who were told to get off the crutches as soon as possible!

Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #26 on: August 25, 2009, 05:42:23 AM »
Good to hear from you Greenfire!  Yes, I am glad others have had the same recommendations with weight bearing, as I.  So you play soccer too? Well, let me in on what your level of play is, and whatnot!  I love the sport, as does chariotson.  So you played 2-3x/week on turf, eh? Well, that is becoming a recurring theme; I did the same, and I can't tell you how many times I landed on my knees as the result of hard collisions.  Let's not mention that playing on turf puts a lot of stress on the patella, in the first place. 
Greenfire, you will experience a lot of ups and downs, even within the first two months (which is where I am at).  You may have limited range of motion, when you (get clearance to) test it.  Just post here, and I will try to answer in a timely fashion.  As has been mentioned by many others, it's a mental battle, as well as a physical one. 

A question for Greenfire and chariotson.. either one of you have a favorite professional team that you follow?

Offline Greenfire083

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Re: Microfracture on 37 year old male soccer player
« Reply #27 on: August 26, 2009, 03:26:55 AM »
Well I played in college with the club team there, and a few of us moved to the same area so we play together now in both indoor and outdoor leagues.  Typically we try to play at the highest level that the league offers.  Living in the states, there just isn't the interest in soccer as other sports, but when I get a chance to watch league play I love watching the EPL and have to say that Man U is my team there! A lot of my boys that I coach favor teams such as Barca and Real Madrid(I'm a teacher/coach).  What about you and what level do you play at??

I'll keep you updated with the progress!  Hope all is going great for your rehab!

Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #28 on: August 26, 2009, 04:00:19 AM »
Well I played in college with the club team there, and a few of us moved to the same area so we play together now in both indoor and outdoor leagues.  Typically we try to play at the highest level that the league offers.  Living in the states, there just isn't the interest in soccer as other sports, but when I get a chance to watch league play I love watching the EPL and have to say that Man U is my team there! A lot of my boys that I coach favor teams such as Barca and Real Madrid(I'm a teacher/coach).  What about you and what level do you play at??

I'll keep you updated with the progress!  Hope all is going great for your rehab!

I started seriously getting into the game, when I was 30, and have loved it every since.  Before that, I had only played as a child.

The leagues I play in vary widely with the experience any player may have.  There are ex-college all-americans, and newbie's and/or people who will never be good, but love to play.  I really enjoy playing against the best (in my age group, obviously) because it's such a test.  For example, there's this guy in one of my leagues who was a 4-time collegiate all-american for a prominent NCAA Division I program, who plays forward.  He is almost impossible to stop due to his combo of size, pace and ball skill. But I get a rush out of competing with him nonetheless.

As for "soccer" in the states.. it is slowly catching on.  The survival of MLS, and the fact that ESPN has now picked up the EPL are some of the signs.

Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #29 on: September 01, 2009, 02:20:27 AM »
I went to see my OS last Friday, and he told me to go ahead and start jogging, and also to do leg extensions with as much weight as I can tolerate.  The problem with this advice was that it directly conflicted with what my PT wanted me to do.  So, I went to my PT immediately after (seeing as how his office is down the hall from my OS's office), and conferred with him.  He hesitantly agreed to go with the OS and allow jogging, but was non-commital with allowing leg extensions. 

So a few days ago, I went for a jog.  It hurt at first, producing the "stabbing under the knee" sensation.  But after a couple of minutes, the pain diminished to barely noticeable levels.

The next day, I jogged again, and there was no pain.  I broke out into a sprint, with some pain, but nothing significant.  Note, I have not tried to do any cutting.  Just jogging/running on a flat surface, for short amounts of time.

I still have problems with doing "step-downs" using my left leg (microfractured knee) to support my body weight, because for whatever reason, I still have pain when bending it around the 25 degree mark.  It's not only pain, but also lack of strength.  As a substitute exercise, my physical therapist has me doing wall-squats, with my left leg positioned forward moreso than my right.

I am pleased with my progress thus far. 















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