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Author Topic: Quad Atrophy Definition  (Read 16453 times)

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Offline kscope09

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Quad Atrophy Definition
« on: January 11, 2010, 10:20:35 AM »
Is atrophy simply muscle wasting that can be fully recovered or is ita point of no return, whereby the muscles never recover.

Can you get atrophy in your quads if you've been weightbearing since you first came out of surgery and have been doing the exercises religiously.  I can't get the quads and calf on my right leg as strong as my left even though I've done everything I've been told.  I wonder if there is a point that they will not go beyond and that is why their not getting stronger.  I could accept this if I'd been laid up for weeks on end but I havn't been.  I've been out a lot less, but I've walked on the leg everyday since surgery, done all the prescribed exercises and have full ROM and my quadsare still weak, it just doesn't make sense.  RSD has been mentioned but I don't have the typical symptoms and I'm not in that much pain so I don't think it could be that.

I'm going to have to go back to the OS who will send me for another mri that will come back showing nothing nd be stuck at square 1 again and then have another scope, which I won't be able to recover from and do exercises that don't work.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline kscope09

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Re: Quad Atrophy Definition
« Reply #1 on: January 11, 2010, 10:22:23 AM »
Sorry, I kind of went off on a rant there.  My orignal questions was, could someone please define quad atrophy for me because I'm not sure if when people are refering to atrophy they just mean wasting in general or something specific.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Dad3

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Re: Quad Atrophy Definition
« Reply #2 on: January 11, 2010, 01:23:25 PM »
Its atrophy (wastage) due to lack of use. Plain and simple.

For instance, when you've had ACL surgery your knee sends a signal to your quads saying, "dont need you anymore" the quad "turns off" and shrinkage/wastage starts. This is how my PT described it to me before my ACL operation.
RT Knee collapsed 08/2009
MRI 10/2009 - torn ACL
Arthroscopy and MFX - 10/2009
ACL and OATS 11/2009
RT knee lateral release, mosaicplasty and medial reefing - 22nd September 2010.
Still not 100% OK :(

Offline Lottiefox

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Re: Quad Atrophy Definition
« Reply #3 on: January 11, 2010, 02:14:53 PM »
Nice description of why the quads stop thinking they need to work there Craig. It is like a switch and in rehab you're trying to both turn the switch back on i.e. the quads need to feel needed, and then when they are awake giving them the strength to contract and relax enough to do what they're meant to. Its a hideously LONG process. Many people get by in life with relatively weak quads, or imbalanced quads and hamstrings, but they manage because other things compensate and because the joints that the muscles hang onto work well enough to balance out the imbalances. When you get a lower limb issue, the kinetic chain gets disrupted and a mechanical knee problem (for example) affects the desire/perceived need of the muscles around the joint to want to work. So, anything you can do to teach the muscles to "fire" again will help how much you can then buidl strength - hence why things like e-stim machines can help with passive retraining and let you get on with different active exercises.

I'd also argue that quad strength in isolation won't necessarily be the holy grail. Yes, they are crucial for the knee but don't neglect your hamstrings and your glutes and calves and hip flexors. Stand up straight, tense your butt and watch the effect that this has on your knee position and control.

I see little point in going through another scope especially if you think an MRI won't show anything. Give your body some time to respond to the work you're doing. Perhaps think of adding in different technqiues like e-stim, foam rolling for trigger points (ITB is my big one - it has a direct effect on bits in my knee that go ouch!!) , balance exercises to make alll the little neglected muscles work as well as the big ones (stand on one leg with perfect alignment with your eyes closed - build up your time...its hard!) . Rehab is frustrating, exercises aren't the miracle cure but I guarantee without them you have a far less chance of stopping or improving any atrophy.

Lottie  :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline doublemom

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Re: Quad Atrophy Definition
« Reply #4 on: January 11, 2010, 02:57:50 PM »
Ditto - it can take very little time for muscles to atrophy, and a heck of a long time to get them back again into full working order.  When I had plantar fascia release surgery on both feet (not at the same time) I was in a walking cast boot for 4-6 weeks each, and even though I was walking around daily, because of the boot I didn't use my calf muscles properly for that time and it was amazing how fast my calves shrunk visibly.  As soon as I could walk normally again and could get back into my normal exercises, they came back, but it took a lot longer than it did to have them atrophy in the first place. 

Andi
2000 R patella dislocation
2004 - Soccer injury - LK medial and lateral meniscectomies
2007 - Dx patellar tilt, lateral subluxation, grade III chondromalacia
5/13/08 - RK medial/lateral meniscectomies & patellar chondroplasty
4/6/2010 - RK TTT/LR scheduled

Offline Cosmicsnuffle

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Re: Quad Atrophy Definition
« Reply #5 on: January 11, 2010, 05:58:11 PM »
....Skinny little thigh and chubby knee courtesy of 4 months left knee with only 30o ROM and PWB at best. 2inches lost of quad/thigh girth (and I'm only little!) and have a superb jelly calf despite being religious about what little PT I could do.

Lottiefox recommended the STIM (Neurotrac) which I've purchased (Sports XL) - I haven't had it for long enough to see a significant change in muscle mass but it has certainly been good for working on tension/pain where the muscles have been fixed in a certain position for long periods.... if nothing else it feels great!

:-)
Oct 04 - torn meniscus
Dec 05 meniscal trim and debridement
Sep 09 torn ACL, kissing contusions, knee locked 30-60o
Jan 10 ACL stump debrided, lateral parrot beak meniscal tear trimmed
May 10 ACLr (Hamstring)
Aug 11 mfx (focal lesion lateral femoral condyle)
Jun 14 100k walk London-Brighton 28hrs

Offline jt801

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Re: Quad Atrophy Definition
« Reply #6 on: January 11, 2010, 06:23:54 PM »
My left quad began to atrophy BEFORE i had my first surgery in '99 for lateral release. I did several months of PT trying to strengthen the muscles to improve the tracking of my patella but had no results, thus the surgery was performed. In my case, the volume of muscle never came back in 10 years but the strength of the leg eventually returned to more or less what it was before the problems started.
12/99 left knee lateral release and plica removal
1/09 right knee chondroplasty and microfracture LFC

Offline kscope09

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Re: Quad Atrophy Definition
« Reply #7 on: January 11, 2010, 06:40:56 PM »
Can cycling help your quads?  I've had one pt say it can and another ssay it can't.

Also, what other muscles can cycling help?
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline kscope09

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Re: Quad Atrophy Definition
« Reply #8 on: January 14, 2010, 03:07:21 PM »
I think my quads aren't too bad, their not shrunken on the right leg, but the calf muscle is a lot smaller and nowhere near as defined.  What is the best exercise for the calves?  I stand on tiptoes and slowly lower myself down, but it doesn't really help.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline fraud_ninja

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Re: Quad Atrophy Definition
« Reply #9 on: January 14, 2010, 05:31:51 PM »
It takes a long time to regain back muscle that is lost...much longer than anyone ever thinks it would take.  I had ankle surgery in September and after 3.5 months in a walking boot my calf muscles were shot.  My quads also atrophied during this time.  In the two months since I have been without the walking boot I have worked religiously to get my right leg stronger.  Its coming, slowly, but its coming.  I think we expect it to come back sooner than it ever does.  Best advice, just keep working it.

Here are some things I do at the gym for my quads:
1.) Walk on the treadmill at an incline.
2.) Do the bike or elliptical, but turn up the resistance as much as you can tolerate.  It should be a good workout, but you should not have pain.
3.) Squats, lunges, step downs.  There are so many things you can do here...the key is don't do it if you have pain.  You can add to the challenge by holding 5-10 pound weights in each hand.
4.) Fitness classes such as pilates and yoga are great for this.

In general I do not use any of the machines at the gym.  They are unnatural movements and they isolate your muscles too much. 

For my calves I do the following:
1.) Stand with my heel hanging off of a stair.  Raise all the way up and all the way down.
2.) Walk on my tip toes.
3.) Stand on my tip toes.
4.) There are ramp incline settings on the elliptical that target your calves more than others.  The really low inclines and the really high inclines are good for the calves.
5.) Use flippers while swimming in the pool.

Again, its a long process.  You'll think that you have plateaued but just keep working it.

My right calf is still noticably smaller than my left.  When I got the boot off there was no muscle at all.  I have been able to build back up the basic muscle and it has some definition to it.  Now I need to work on bulking it back up...which will probably take a very very long time.
12/26/02 LR R
10/26/06 TTT R
1/25/07 TTT L
12/17/07 TTT revision, MPFL recon R
2/7/08 TTT revision, MPFL recon L
3/24/08 screw removal R
4/30/08 screw removal L

Knees are fixed, training for a triathalon.

9/21/09- Right ankle reconstruction

Offline kscope09

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Re: Quad Atrophy Definition
« Reply #10 on: January 14, 2010, 11:42:11 PM »
Thanks for the help with suggessions.  I'm definately going to get a bit more aggressive with my calves and hamstrings.  When the snow and ice go I'm going to see my pt about expanding my exercises and if he gives me the same of squatts again I'll be looking for a new pt, one that does e-sttim.

Does a Tens machine do roughley the same thing as e-stim?  Is it as thourough.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline fraud_ninja

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Re: Quad Atrophy Definition
« Reply #11 on: January 15, 2010, 03:58:48 PM »
In defense of your PT, squats are one of the best things you can do to build back up your quads.  There are so many variations to squats and you can add to your challenge level by holding weights in your hands.  I do squats every time I go to the gym.

There are different schools of thought involving e-stim for building back up muscles.  The more into fitness I have gotten the more I would want to get away from using e-stim.  An e-stim machine specifically isolated one specific muscle and forces it to contract.  In my opinion you are not training the body or the brain to contract that muscle in a situation where you would really use it.  In theory, you are never going to use that one muscle in a totally isolated situation.  This is just my opinion so do not take it as anything valid.  All I know is that the more I have gotten away from isolated muscle movements and focused on entire muscle groups...the better I have been able to build back my muscles.
12/26/02 LR R
10/26/06 TTT R
1/25/07 TTT L
12/17/07 TTT revision, MPFL recon R
2/7/08 TTT revision, MPFL recon L
3/24/08 screw removal R
4/30/08 screw removal L

Knees are fixed, training for a triathalon.

9/21/09- Right ankle reconstruction

Offline Lottiefox

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Re: Quad Atrophy Definition
« Reply #12 on: January 15, 2010, 07:51:30 PM »
I'd agree on the e-stim machine not taking the place of functional strength/balance training. using muscles in everyday actions is THE best way to build them up and develop optimal function - hence why I love free weights and not weights machines as they force you into one position and isolate too many muscles. Free weights on an uneven surface (gym ball, power plate etc) - now you're talking! BUT - I think an e-stim can help if the muscles have "forgotten" how to fire - to me they bridge the gap between the inability to get a muscle or its group working and then using it effeciently. E-stim is helping me use my quads a bit more effectively, although they are still weak as ****. When my husband had patella issues e-stim for 3 weeks got his quads firing and he was then able to do PT properly and start doing exercises tailored to his sport - golf.

Ninja have you ever come across Vibram 5-Fingers footwear? A trainer friend of mine swears by them for promoting natural movement and muscle usage - he lives in his and has different ones for running, weights etc. I'm not sure my bumpy feet would fit in them!

 ;D
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline jenbas01

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Re: Quad Atrophy Definition
« Reply #13 on: January 16, 2010, 06:14:51 AM »
Hi Everyone! I am new to this site and this posting on quad atrophy really caught my attention. I had Patellar Realignement Surgery on Dec 7th.. I had 3 screws put in the tendon, a lateral release and of course putting that knee cap in place.. I am going into week 6 post op and I am in an immobilizer and crutches. I have such quad atrophy and have not been able to get it to fire. This in turn is causing all sorts of issues with trying to do PT. I cannot even lift my leg yet and just walking in the immobilizer is very difficult. It is like my leg is jello and keeps jolting when I walk almost like a buckle. I do my PT excercises but am very apprehensive at PT and very scared. I went to try and put pressure on my knee and stand up the one day, the entire kneecap locked up and got very tight. I feel so scared and just want to know that I am going to be okay. They keep telling me at PT that the things that are happening are normal, but I am so scared that I will never walk again. I wish I never had this surgery! Ever!
Any advice would be great, especially if someone has had this type of surgery since it is not very common.


Offline Cosmicsnuffle

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Re: Quad Atrophy Definition
« Reply #14 on: January 16, 2010, 05:19:51 PM »
Hi jenbas01 -

I'm a relative newbie to this site and to knee injury, terminologies and recovery.... I haven't had the same surgery as you but hopefully my words and limited experience may be of some comfort.

Being scared is natural (I've learnt), especially when things aren't going as well as you expected - regretting the surgery when you can't see an end is natural too but knees seem to be notoriously slow in their healing - listen to what your PTs are saying, and take a good trawl around this site to see what others have experienced..

If your PTs seem to think that everything is on track then try to relax into the timescales they are giving you, there will be a light at the end of your tunnel :-)
Oct 04 - torn meniscus
Dec 05 meniscal trim and debridement
Sep 09 torn ACL, kissing contusions, knee locked 30-60o
Jan 10 ACL stump debrided, lateral parrot beak meniscal tear trimmed
May 10 ACLr (Hamstring)
Aug 11 mfx (focal lesion lateral femoral condyle)
Jun 14 100k walk London-Brighton 28hrs

Offline Lottiefox

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Re: Quad Atrophy Definition
« Reply #15 on: January 16, 2010, 06:04:14 PM »
Hi jenbas01 and welcome,

I can't offer any specific advice on the surgery you've had but I know the scared feeling and the worry that things aren't as they should be - and I've not even been under the scapel (yet!!). Listen to what your PTs are saying and take your time - knees are SO slow to show any progress and healing, it seems to take forever and as soon as the muscles get used to not working the whole walking concept seems impossible - BUT you will get better and I am sure you won't regret the surgery. Both of my patellas track incorrectly - you've made a brave and right decision to get yours sorted and when you're back and walking and the little fella tracks straight and true....wooohoo!! We'll expect photos!!!

I read somewhere on here that in knee recovery you sometimes don't have to even think in terms of weeks (certainly not days!!) but monthly chunks...so perhaps look back a month, and then in another month look at how far you'll have progressed. Its hard work without doubt. Try not to lose confidence from the wobble you had when you put weight through the knee - give it time, deep breath and try again. And this forum is a mine of information of support. I never realised there were so many of us with wonky knees!!!

Good luck with everything  :)

Lottie  ;)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline jenbas01

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Re: Quad Atrophy Definition
« Reply #16 on: January 17, 2010, 04:54:35 PM »
Thank you all for your wonderful words of encouragement! It is much needed. Especially when those around you are getting frustrated, yet they are able to walk around! It is so hard to sit here sometimes and watch family up and walking around, going about there daily everyday lives.. you start to wonder if you will ever see the light of day! I have had extreme anxiety with all of this.. I do well for a bit, then something happens and sets me back.. then I get an overwhelming fear and am so scared to just get up on my crutches.. my palms sweat, heart races.. then when I do walk on them my good leg starts to wobble and shake because of the anxiety, which in turn causes the bad knee/leg to freak out because it is not being supported. I wake up every morning thinking I am up and walking, and then look down at my brace and cry! They say that a positive attitude is everything in recovery.. I have good days and bad days. Taking off this brace and actually walking seems so far away, since just walking with the brace and crutches is a hurdle right now. I dont want my anxiety to hold me back.. Any thoughts on how to overcome fears right now would be helpful.! Thank you all and I am so glad I found this site for support! You have all been so wonderful!

Offline Cosmicsnuffle

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Re: Quad Atrophy Definition
« Reply #17 on: January 17, 2010, 10:11:24 PM »
jenbas01...

the beauty of this site is that you know you are talking to people who can empathise from experience, who understand your fears and frustrations without judgement.
I've had mornings where I've gone to leap out of bed and realised (luckily before it's too late) that it's not possible without crutches. I've had dreams where I'm back to "normal" (if I ever was  ;) ).

The fact that you acknowledge that you have good days and bad days is a start. Look out for triggers and be prepared to allow yourself extra space emotionally when you need it. Be prepared to ask for help (whether from those around you, or on the KGforum). Understand that it will take time (seems to be a recurring theme in my posts at the moment...which means that I must be finally getting that message into my head too!). Find things you CAN do - use your experiences to help others here.....
Make sure you keep exercising/stretching your good leg too!

...and when you feel most down ....   stop and smile .... or "fake it 'til you make it"  as my Taekwon Do instructor used to say about my reverse turning kicks!

Hugs  :-*



Oct 04 - torn meniscus
Dec 05 meniscal trim and debridement
Sep 09 torn ACL, kissing contusions, knee locked 30-60o
Jan 10 ACL stump debrided, lateral parrot beak meniscal tear trimmed
May 10 ACLr (Hamstring)
Aug 11 mfx (focal lesion lateral femoral condyle)
Jun 14 100k walk London-Brighton 28hrs

Offline Lottiefox

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Re: Quad Atrophy Definition
« Reply #18 on: January 17, 2010, 10:15:57 PM »
jen,

I'm sorry you seem to be having such a tough time. Its horrible when you see everyone going about normal life and you're stuck in your brace etc - BUT it isn't forever. You've made a huge choice and a positive decision to get your knee stronger and better so that one day you'll be doing all of those things you crave at the moment. I think when you've chosen to do something rather than it just "happening" e.g. after an accident, you are bound to have days when you wonder what you've done. I would suggest you perhaps start your own thread down on the Patella-femoral section of this forum - there are LOADS of fabulous people on there and some will know exactly what you're going through and can be a bit more specific in their advice on your particular surgery.

In general though try and trust your PTs. Try and do some deep breathing and perhaps learn some relaxation technqiues to help recognise the anxiety cycle and try and break it so you can make a bit more progress. Anxiety is a bummer - its in your head but it isn't - as your body also responds physiologically and as you describe your legs shake, your heart races, your palms sweat - COMPLETELY normal! When we were cavemen that response kept us safe as we needed to react to bears trying to eat us! Good days and bad days are normal. Remember them all, but watch how the good ones start to out number the bad ones....

You will see light at the end of the tunnel. The tunnel is quite long unfortunately with knees, i had no idea how complicated they were, and that doesn't help anxiety! Be patient, try and relax and visualise that day when you're free of that brace, and things will come. Do as much as you are able with PT, look after your other leg and knee too and kep it strong. Trust your rehab team, eat chocolate cake, and don't be afraid to cry sometimes. (Lottie's 3 step plan for recovery  ;))

Take care x :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline jenbas01

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Re: Quad Atrophy Definition
« Reply #19 on: January 20, 2010, 02:40:42 AM »
Thank you Lottie and Cosmic! Both of your replies were wonderful to my soul! Coming here after a long day of tears and fears is a wonderful relief! I feel so much support and that is exactly what I needed for this process! It is easy for those around you to say just lift your leg up.. its not hard. And you are thinking, I am trying but it wont lift!! ha ha

You are wonderful people and thank you again for your thoughts! I will check out the patella section of this forum and see if I can find someone who has had this surgery.. I know this quad will get stronger, it has too!
Bell well!
Jenbas

Offline Cosmicsnuffle

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Re: Quad Atrophy Definition
« Reply #20 on: January 20, 2010, 11:12:39 AM »
Hi Jen

Glad to give back a little  :).

Your experience of "just lift your leg" made me chuckle. I went to physio for the first time on Monday... "just roll onto your tummy on  the couch and rest your toes down, then straighten your legs and lift your knees off the couch".... I couldn't even roll over... and laughed and laughed (defence mechanism!).... after several minutes I managed to get my toes to the couch (technically) but they were there in spirit and not really in body.... as for the knee straightening...hahahahahahahaha!

...but I know what I'm aiming for, and as the football-that-is-my-knee recedes to show some bony definition life will get easier and one day I'll wonder what all the fuss was about.

Hope you got some useful replies in the patella forum

XX

Oct 04 - torn meniscus
Dec 05 meniscal trim and debridement
Sep 09 torn ACL, kissing contusions, knee locked 30-60o
Jan 10 ACL stump debrided, lateral parrot beak meniscal tear trimmed
May 10 ACLr (Hamstring)
Aug 11 mfx (focal lesion lateral femoral condyle)
Jun 14 100k walk London-Brighton 28hrs

Offline likewoa2007

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Re: Quad Atrophy Definition
« Reply #21 on: November 20, 2010, 06:30:31 PM »
I have quad atrophy myself.  I had knee surgery twice this year. (May 25, 2010) (Oct 20, 2010).  What have you done to help with the quad atrophy? Has it gotten better?  Hope so.  Were going down stairs ever a challenge since you had quad atrophy?

Thanks
Tom

Offline kscope09

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Re: Quad Atrophy Definition
« Reply #22 on: November 20, 2010, 06:53:35 PM »
Mine are a lot stronger than sicne I started the topic, but not what I need them to be, so I'm still working at it.

I  found that a good exercise was to do slrs but to hold them for a long time.  I can do about 4 minutes on the left leg and 6 on the right and by the time you have to put your leg down it is shaking like craxy and the muscles are having to work.

I still do my squatts 2 0r 3 times in a day as well as heel raises for my calfs and I practrice as often as I can to stand on one leg.  I've been given lunges but I hate them so if I do them I do it very lightly.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline coral 251

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Re: Quad Atrophy Definition
« Reply #23 on: November 20, 2010, 09:19:32 PM »
Hi every-one
Just thought i would chip in with my two pennyworth.
I had a patella fracture, it was in 3 pieces, displaced,and needed surgery,i was in a cast from ankle to thigh for 7 weeks,being non weight bearing in that time,once the cast had been removed i had only 20 degrees ROM,and could only do heel slides, and had to have a further 2 weeks non weight bearing with this being the only exercise.

I think you can now imagine what my leg looked like,i had only 5 physio appointments,and reached full ROM,with that the PT discharged me, saying that i was ok,i was far from ok, my leg strength was crap,all he worked on was rom, and nothing else.
I knew every-thing was far from ok,so i did a bit of research myself,and subsequently discovered this amazing site,with lots of support, help, and advice,so now i feel i would like to help others, as i myself have been helped.
It was with sheer determination and constant gruelling exercises, that i have now gotten to the stage i am at,

The key factor is to exercise little and often, your body will tell you if you are overdoing it,take every-ones tips on board, but also remember, that we are all different, our bodies heal differently,and re-act to surgery differently, so what may work for one person may not work for you, so listen to your OS, your PT, and your body.

it was the 26th of March when i had the op,so it will be exactly 8 months post-op on the 26th November.
So, here are my results to date,i can walk almost normally,little to no pain anymore,climbing stairs no longer an issue, though still need the handrail for support,though not to literally hoist my-self up as in the early days,in fact all in all, feeling quite "normal"now, just one or two hardware issues, but hopefully i can have that removed in march/april time,and these should be rectified.And the leg strength is now returning, and getting stronger day by day.
It has not been easy, and has been a long hard journey,but now i can see the light at the end of the tunnel, so stick at it, and you will get there.
I feel so proud of myself having come so far, and having had no professional help or advice, so if an "oldie "like me can do it, so can you.
So i wish ever-one of you a speedy recovery,and send you my best wishes.
Kind regards.
                      coral.
PS. this link may help you.
http://www.ehow.com/how_2313283_strengthen-quad-muscles.html
and
http://www.physioadvisor.com.au/8290850/quadriceps-strengthening-exercises-vmo-strengthe.htm
« Last Edit: November 20, 2010, 11:51:10 PM by coral 251 »
23/03/10 displaced patella fracture 3 pieces right leg
26/3/10 had op,2 pins & figure of 8 wiring
full cast ankle to thigh 7 weeks.
18/5/10 cast removed xray showing hairline crack
26/7/10 walking unaided,full rom
31/10/2010.6 months post-op check,bone not healed,harware cant be removed

Offline likewoa2007

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Re: Quad Atrophy Definition
« Reply #24 on: November 20, 2010, 09:29:11 PM »
That is good to hear that your qauds have progressed.  Were going down stairs ever a challenege due to the weak quad?  Did going dwon stairs improve over time or were they never an issue?

You do squats 2 to 3 times a day?  With weights?   I thought squats with weights should be done once per day every other day?   Unless your dooing sum without the weights?

How many SLR do you do holding them  for 6 min?

Thanks for the info!

Offline coral 251

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Re: Quad Atrophy Definition
« Reply #25 on: November 20, 2010, 09:46:59 PM »
Yes,stairs were my biggest problem,it was just last week that i finally conquered that,but i am led to believe by every-ones comments, that the stairs are the last thing to be able to do.
The exercises i do are, riding a stationary bike for about 3 minutes at a time on high tension, about 10 times a day,swimming, water aerobics,the exercises shown on the link i placed on my last thread, and SLR's,very low squats(butt to heels), and thats it.......Arnie eat your heart out.
My email address is displayed so if any-one needs any exercise sheets, feel free to e-mail me, and i will glady pass them on,
 Kind Regards.
                          coral
« Last Edit: November 20, 2010, 10:03:01 PM by coral 251 »
23/03/10 displaced patella fracture 3 pieces right leg
26/3/10 had op,2 pins & figure of 8 wiring
full cast ankle to thigh 7 weeks.
18/5/10 cast removed xray showing hairline crack
26/7/10 walking unaided,full rom
31/10/2010.6 months post-op check,bone not healed,harware cant be removed

Offline kscope09

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Re: Quad Atrophy Definition
« Reply #26 on: November 21, 2010, 08:36:29 AM »
Arrrggg!

I never said I used weights, never never never. NO WEIGHTS.

I go to 90 degrees ver very slowely, concentrating on using the vmo to help lower me down smoothley.

The SLRs are usually about five at a time about twice a day. I'll hold up my leg for a minute and do that 4 times on the last one I hold it as long as I can.
« Last Edit: November 21, 2010, 08:42:51 AM by kscope09 »
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline likewoa2007

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Re: Quad Atrophy Definition
« Reply #27 on: November 23, 2010, 04:48:28 AM »
Hi

When you first suffered from the quad atrophy, did it make you ever want to wear a knee brace?  I'm debating on getting one due to my job but wasnt sure if it might keep the quad from not strengthening  right. like maybe it might feel as though the brace is going to keep it from getting stronger.

What do you think and did you have a brace?

Offline kscope09

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Re: Quad Atrophy Definition
« Reply #28 on: November 23, 2010, 10:28:46 AM »
I definatley agree that if you wear braces or elasticated bandages too much your body will rely on them.

For me they've been like a safety blanket and it is hard to ween off them.  I wear simple tubigrips to give my knees some extra support when out and aobut, especially when walking around on ard pavements to help reduce impact and shock.  Then when I'm inside will will just slide them down, like when I'm at work.  If I ever get back to my Karate them I'll get a proper sports brace but that may or may not ever happen.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline anniehine

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Re: Quad Atrophy Definition
« Reply #29 on: November 23, 2010, 10:26:40 PM »
Hi likewoah, I'm 9 months post op now and still have issues going downstairs so don't worry.  Even if I'm walking down the road and theres a small curb I slow down a bit, I'm getting better at that though though :-).

I am at the gym alot trying to work on those quads, VMO, hamstrings, glutes etc etc.  Do you use an exercise bike?  I'm on one for about 20 minutes and then every 5 minutes do 30 secs of standing up cycling, it REALLY works your quads and my physio tries to get me to do them as much as possiible. Its absolutely knackering but you can feel that burn! I also use the leg press alot at the gym. I used a tubigrip too while my quads were badly atrophied but unless you're really bad I wouldnt recommend to use one..it won't inhibit your quads strengthening though.

Good luck, we'll get there in the end  ;)
Left knee started dislocating at 7 years old
Hypermobile
Arthroscopic scope April 2009
Trochleoplasty at 28 years old (10.2.10)
Did 1st SLR 1.4.10 WHOOP!!
Walked through house without crutches (12.4.10) very pleased with myself!!

Offline kscope09

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Re: Quad Atrophy Definition
« Reply #30 on: November 23, 2010, 11:23:22 PM »
It's good to hear from you Annie and I'm very glad your doing well, keep up the good work.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline likewoa2007

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Re: Quad Atrophy Definition
« Reply #31 on: November 24, 2010, 12:03:11 AM »
Hi Annie.  Well that is good that there are others of us out there that experience these symptoms following a major knee surgery.  I'm working on my VMO, hamstrings, glutes, quads just like you.  I use the exercise bike but not often.  I use the exercise bike everyother day for  like 10 minutes.  I use the Eliptical machine more.  I use that for 20 minutes or so everyother day.  The Elyptical machine works your quad, cavs, hamstring, glutes etc.   My goal on the eliptical is to be able to bump it up to 30 minutes in a few weeeks everytother day.

I do sqauts every other day. I do them at the gym with 10 pound weights in each hand (20 pounds total) for 3 sets of 10.   I also use the leg press when at gym to.  Later that day at home i do squats with no weights.  another 3 sets of 10.  so roughly 60 squats every other day.   My paln is top alternate lunges with squats every 2 weeks to change things up so the routine isnt dull to the muscles. 

My personal trainer is having me do more strengthning exersices but those are done every 3rd day.   One of the exercises is squeezing a exercise ball in between my quad and inner thigh muscles.   That I think is helping too. 

Do you keep up with your Straight leg raises?  If so do you use ankle weights and how many do you do on a basis?


Thanks.  It was nice hearing from you! Keep in touch!

Offline anniehine

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Re: Quad Atrophy Definition
« Reply #32 on: November 24, 2010, 09:23:39 AM »
Hi guys, thanks for your good wishes :-)

I haven't been doing SLRs for a while to be honest, I should start again doing them 4 ways to try and help my VMO  ::) The eliptical machine freaks me out a bit, I think because it extends the leg right out which is when I have the least confidence in it..I've been using the stepper though which my physio has me doing a range of different step types-deep and long, quick and shallow etc. I can jog and skip on the floor now but can't build up the confidence to do it on the treadmill so I just do fast walking and hill walking!! :-)  I HATE squats, my crunchy knee makes me feel sick when I do them and if I go down too low my knee really hurts...but I do try to do some!  Lunges are horrible too.  In fact, writing this makes me realise I'm not doing some things I really should be!

I will definitely try the eliptical tonight I think! I'll let you know how it goes!  Take care knee pals  8)
Left knee started dislocating at 7 years old
Hypermobile
Arthroscopic scope April 2009
Trochleoplasty at 28 years old (10.2.10)
Did 1st SLR 1.4.10 WHOOP!!
Walked through house without crutches (12.4.10) very pleased with myself!!

Offline likewoa2007

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Re: Quad Atrophy Definition
« Reply #33 on: November 27, 2010, 07:30:12 PM »
So for all of you going down stairs the right way took like a year or so from your surgeries?  Like for me I cant carry anything going down stairs.  I always need the railing. I guess once the quad sarts to grow stronger that is when you mastered the stairs okay?


Offline kscope09

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Re: Quad Atrophy Definition
« Reply #34 on: November 27, 2010, 08:54:48 PM »
With me it was taking forver to ge the quads working, even when I did the exercises every day and it genuinly hurt to go up stairs and down was unthinkable.  When things go on and on your confidence goes and it is ahrder to get it back again.  My problem with downstairs was the feeling or even phobia that my leg would not bend properly and I would fall forward, and probably if I tried too early it might of happened.  Even now I look at a flight of stairs and think, "OK now take it easy," but once I can get into a rythem it gets a lot easier.  Last week I did 4 flights both up and down with very little pain, this was on the Friday and again on the Sunday and it was a real confidence boost but I still don't think I could run up and down them like I used to, 2 0r 3 steps a time.

I also noticed that with going downstairs you've got to let yourself go so that you go down in a relaxed manner.  I'm still fairly tense when I do it but when I've done a few steps I hve a rythem going and it seem s to work.

Also, with me I live in a bungalo so it was good for rehab in that I could get around the hosue OK but because I didn'thave to use steps I wasn't preactising them enough, so I started going to places where I knew there were good even steps to pratice on and a banister on both sides.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline likewoa2007

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Re: Quad Atrophy Definition
« Reply #35 on: November 28, 2010, 01:32:02 AM »
I have just a few more questions.  What type of knee surgery did you have and when was the surgery? 
Also were you ever doing single legged squats?  I told my PT who suggested it and there is no way. My quad is just to weak and when I tried it has to much patella pain

You think I'm doomed to never rebuilding the quad because of it?

I do squats with both legs
I do leg press one leg
I do leg curls (hamstring) one leg

The other day I ride the bike for 25 minutes in morning and around 25 minutes on the Eliptical machine 2nd half of day


I hope that workout is benficial to rebuilding.  I find it hard to beleive that as the years go on from the surgery that the quad wont get stronger.  It has to you know


Offline Vickster

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Re: Quad Atrophy Definition
« Reply #36 on: November 28, 2010, 09:28:18 AM »
Have you tried swimming?  I found 800m of front crawl 3 x a week through the summer strengthened my legs (when I wasn't allowed to use the gym)

Do you cycle with as much resistance as you can bear?  Have you also tried the crosstrainer and stepper machine - low impact but good for legs.   Also, the leg press?
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline likewoa2007

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Re: Quad Atrophy Definition
« Reply #37 on: November 28, 2010, 07:19:51 PM »
When I ride the Eliptical Machine I have reistance and ramp up.   However when I cycle my bike that I use doesnt have resistance.  I've heard just riding the bike is as good whether you use resistance or not. Swimming I'm not to good at.

Offline Vickster

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Re: Quad Atrophy Definition
« Reply #38 on: November 28, 2010, 07:26:10 PM »
The bike is good for ROM, but surely, unless you have some degree of resistance, you aren't working the quads as hard - I can definitely tell the difference in my thighs (and knee) depending on the level?  How about physio exercises like leg raises, glute bridge, wallslides - I find the latter make my quads work really hard and burn.  Are you seeing a physiotherapist regularly to discuss and tailor the exercise programme?
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline ElSquinto

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Re: Quad Atrophy Definition
« Reply #39 on: November 28, 2010, 07:26:32 PM »
I'm not convinced that treatment of muscle atrophy is as simple as people are making it out to be here.

A case in point...

A have a very good friend who was a seriouis competitive figure skater for about 15 years.  She eventually progressed to performing advanced triple jumps (thankfully her knees and hips remain intact to this day - a happy state of affairs that she attributes to her decision to leave the sport when she turned 18).  Like all figure skaters she had her preferred direction of rotation - whcih led to her favoring a certain side when falling to the ice.  The cumulative effect of several years of using the same arm/shoulder to help cushion her fall led to lax ligaments in her right elbow and resultant muscle atrophy.  She can try to exercise it all she wants - but she immediately experences fatigue/cramping/soreness around the joint.

There's nothing neurological at work in her case - the bones are simply not held together well and it is not possible to again build muscle around their joints because they cannot bear training loads safely.  She's been looked over by several orthopedic surgeons - all acknowledge the problem; none dare operate on it.

I am not a doctor but it seems reasonable that if a patient undergoes a procedure like an osteotomy there's all sorts of problems with the ligaments holding the bones together and tendons that hold the musches to the bones.




Offline likewoa2007

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Re: Quad Atrophy Definition
« Reply #40 on: December 07, 2010, 01:54:47 AM »
Were you doing single leg suquats when you had your quad atrophy? 
What kind of squats were you doing to build your quads up?

Offline lizt

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Re: Quad Atrophy Definition
« Reply #41 on: December 21, 2010, 05:42:56 AM »
Hi everyone
i read with interest all the post on quad atropy,cos i too have this after 7 weeks in an immobiliser brace,with a broken patella.
I understand very little about the subject cos my os doesnt tell me anything or answer my questions,so maybe someone here can help me.
Why do we need to build back up the quad muscle?I am able to walk now Kind off (not very well or great distances)
Does the lack of quad muscle have an effect on my ROM cos thats what im struggling with cant get knee to bend.
Thanks