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Author Topic: MPFL Reconstruction - November 18, 2010  (Read 7923 times)

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Offline spurs27

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Re: MPFL Reconstruction - November 18, 2010
« Reply #30 on: January 03, 2011, 04:44:58 PM »
To echo what Sk8m8 said, you're not a failure.  You are actually doing pretty good for where you are post-op.

The sutff the PT's and OS's are asking you to do is tough, but is not excessive for where you are post-op.  For the box exercise, ask the PT if you can move it close to something that you can grab onto.  This will trick you mentally giving you something to hold onto and will give you some peace of mind when doing the execise.  Most of our apprehension during rehab is mental.  Your body can and will do amazing things if your head will let it!  Have confidence in yourself but give yourself the mental support you need to get through the execises and your body will respond!

The new brace does sound too tight.  But the reason he put you in it was to decrease the amount of support it provides so that you will use the muscles in your leg more when walking.  If it seems like it's not enough support, there's that mental block again.  You can still be cautious in the new brace but keep wearing it rather than your old one to be able to get the benfits from having a brace with less support.

Remember, we all have bad days where it seems like we're going down the wrong path.  But have confidence in the OS and PT you have.  You have had some great success on increasing your ROM.  Now it's time to build-up that muscular strength again.  You're doing great...
History:
1992:  L kneecap dislocation
1992:  L knee Arthroscopy & MCM repair
1998:  R kneecap dislocation
2002:  R kneecap dislocation
2004:  R kneecap dislocation
2007:  R kneecap dislocation
2008:  R kneecap dislocation
2009:  R MPFL recon

Offline ParisBaby

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Re: MPFL Reconstruction - November 18, 2010
« Reply #31 on: January 04, 2011, 06:51:56 PM »
Day 48

Today is a much better day. So I got the brace changed out, I took it in before PT that day and they gave me a size larger. It is still pretty tight, so I still hate wearing it but it isnt nearly as unbearable as it was.  I admit that I dont wear it as much as I am probably supposed to, but I have tried putting it on for at least 4-6 hours a day.  ;D  I consider that to be a compromise between myself and the PT.

I am excited because we had FANTASTIC weather on New Year's Eve so my fiance and I took our baby for a walk around the park, a 2 mile walk, which took us 2 hours because I was walking without my brace. This was an excellent idea since I was able to walk with the stroller so I had support in case my knee gave out and I felt good about it mentally.  The only thing I had real trouble with is that on the outside of my knee the lower knobby bone hurt. I was having these twinges like something is strung wrong and is thwacking when I walk. It is hard to describe but it feels like it is painfully twinging.  I sometimes have gotten this feeling in my hip before surgery but I have it in my lower shin muscle/ligaments, in the back of my knee and calf.  I have mentioned it before to the PT, since it has always hurt when I work on my flex, usually massage has helped fix it, but it has hurt more since I have flexed more and as I have used my knee more. I wonder if I should call the surgeon, but I feel kind of stupid since I dont know how to really describe it.  My PT says it might be my IT band and I am scared that it is my compensation methods that are making it twinge and hurt but he didnt say that was the case. So hmmm, I am unsure about this new development.

I am still at 110, it doesnt seem like my knee wants to go further, but I am able to go all the way around on the bike and I am able to keep the machine on. lol. It keeps taunting me to "pedal faster" though. So I consider that to be a win for the flex.

I have also been working on squatting down with my bad knee. I am keeping my good foot on the ground, but I am keeping most my weight on my bad leg and I do squats that way. I am getting the exercise, but I am also getting a safety foot for my head. lol. PT isnt happy with the way I am doing them, he wants me to push myself but I am happy that I am even trying to get there and I do keep trying to do them with no safety foot, but then I get all shaky and twitchy. So I will continue to bastardize my PT until I feel good about it. I havent had my regular PT person for the last 3 visits, she has been on vacation, so I dont really like this guy anyway. He doesn't seem to listen to me, and I wonder if he actually knows anything about my specific surgery and recovery. I feel like telling him, THIS IS NOT AN ACL RECONSTRUCTION, SO BACK OFF.  I have kept my mouth shut but I am really looking forward to my regular PT person tomorrow. I have missed her. :) Maybe she is my good luck charm since I havent really progressed since she has been gone. I'm Scots, I can be superstitious. lol.   

Anyway, thank you so much for the encouragement, I really dont know who to talk to sometimes. No one really understands unless they go through it.  This board has been a real relief for me during this process and for that I am grateful.

Happy New Year everyone and here is to 2011 being a happier more healthy and more mobile year than 2010!  :D

 

Offline LoosePatellas

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Re: MPFL Reconstruction - November 18, 2010
« Reply #32 on: January 05, 2011, 06:40:35 PM »
Thanks for all your regular posts! I'm 2.5 days out of my MPFL surgery, so it's very inspirational to hear about all the success (and hard work) you're putting into recovery. Happy New Year!
Unstable kneecaps, dislocations since age 6
1992: Arthroscopic Surgery on right knee to remove loose body
No dislocations from 2005-2010
Three dislocations in 2010
RK MPFL Reconstruction schedule for 1/3/2011!!!

Offline ParisBaby

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Re: MPFL Reconstruction - November 18, 2010
« Reply #33 on: January 06, 2011, 03:01:34 PM »
Day 50

Day 50 - A nice round number! Anyway, not much to report, other than I did talk to my regular PT about my discomfort and pain and she said it is indeed my IT band, she even found the really bad knot that was causing the twinging. So we did some massage, she showed me what to do, and it is helping.  She says that since I have been keeping that leg straight and still for so long, alot of my other muscles and ligaments have tighten and shortened, so now I have to stretch more than just my knee, so I should expect to have pain in the whole leg as everything gets stretched out.  Yippee. lol.  So massage is the key, I think and I am going to make an appointment to get a deep tissue massage next week.  I think it is about time to get some things worked on professionally.  I am still at about 110, we didnt measure on Wednesday, but I danced with the baby yesterday. I wasnt holding him but I did move more than I have moved since surgery and I was rewarded with laughs and smiles from my beloved baby boy. He is sick with an ear ache so I will turn myself inside out to make him feel better, knee be damned.  :-*

I thought I would share how I am doing with my goals too... The ones I had before surgery.

1. Ride in a car comfortably - DONE!!! as soon as I was able to unlock my brace to 70 degrees I felt so much better.

2. Start driving my car ASAP - DONE!! as soon as I was able to unlock my brace to 70 degrees and do an SLR I was able to drive. Probably about 4 weeks out from surgery.  It still hurts to get in and out of the car, I have to be careful, but actual driving is no problem.

3. Be able to walk without crutches by December 31st - DONE! - I was walking without crutches about 2 weeks after surgery.

4. Be able to walk without a brace by January 21st - I am on my second brace, hopefully at the 8 week mark I can get rid of it. My PT says it takes up to 8 weeks for soft tissue to heal, so I am planning after that no brace. I am half on and half off with the current one and I sleep without one, so this is partially there.

5. Be able to start lightly exercising on the elliptical on February 17th - I am already lightly exercising on the bike, and I have taken to walking when the weather permits. I have been restricted by my PT saying I am not allowed to do much right now outside of PT but hopefully next week I can step it up some more. I am giving myself til the end of January to really work on it. No need to do more than try for now.

6. Be able to working out (the sweaty, hard working kind) by March 1st - This is the last and final goal. Not there yet, but we will see.

So I think I am doing pretty good, in that I am making all my personal goals, I am making the OS goals.  Now if I can just get 15% of my quad strength back and get some stretching out of the way, I will be much better. lol. So the goals for January for me personally are to get enough quad strength back that it doesnt hurt to lift it, and to get stretched enough that I dont feel constant aching and pains in my back and down my thigh. And I want to get that IT band thing done. 

I am feeling optimistic.


Offline LoosePatellas

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Re: MPFL Reconstruction - November 18, 2010
« Reply #34 on: January 06, 2011, 03:09:03 PM »
Congratulations to you! I am just a  few days post-op, so an optimistic post like this really helps brighten my day. My major milestone today was that I slept a full 8 hours last night, the first since my operation. (I of course woke up for a few min for pain meds)
Unstable kneecaps, dislocations since age 6
1992: Arthroscopic Surgery on right knee to remove loose body
No dislocations from 2005-2010
Three dislocations in 2010
RK MPFL Reconstruction schedule for 1/3/2011!!!

Offline ParisBaby

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Re: MPFL Reconstruction - November 18, 2010
« Reply #35 on: January 12, 2011, 06:08:05 PM »
Congratulations LoosePatellas! Seriously, a good nights sleep is nothing to sneeze at when you are coming off a surgery like ours! I felt like I didnt get a good night sleep until I could unlock my brace a little, but I am a side and stomach sleeper so I just couldnt get comfotable enough.

I went to visit my OS today, my 8 week appointment. It went well, he seemed to be optimistic about my progress. He said that I need to get my flexion to where my other leg is by the end of the month. Let me just say... my other leg is pretty flexible! lol. I used to be able to sit with my legs folded under me and then lay on my back. So my good knee touches my butt pretty easily so he wants me to get there with my bad leg.  I am laughing but I think I can do it. I made it to 120 degrees in PT which is not at my goal but we have really been working hard of getting strength versus flexibility back.  So I will work on it but I really want to work on stability and strength more.
I also asked him when would be a good time to get pregnant again. I am not looking to do so any time soon but since I gained a TON of weight with my first (think 70lbs), I am assuming worst case and I need to know my knee can support that kind of weight again, ecspecially since falling is not an option when you are pregnant. He said I should wait at least another 2 months. Other than that, he basically moved my knee cap alot, my right one is in really tight... my left, not so tight. I asked if that means I need to have surgery on the other one and he said as long as it isnt dislocating then I dont, but if it does cause me problems they can just do the same procedure. I dont know about y'all but I DO NOT want to do this again. This is HARD WORK!  :D. and I am done with having knee problems after I get this fixed. This is it! Done, Finito, Finis!  I want to wear 4 inch heels and not have to worry about anything like knee problems. I want to walk down a flight of stairs in said heels and feel confident about not hurting myself. I want to be able to push a box with my foot and not have my knee dislocate. All of those things are worth this procedure, so I guess I just talked myself into another one. hahaha. Can't argue with myself!
Thanks for the posts Sk8m8... I find other people's stories just as inspiring and honestly, it is nice to know other people have my struggles too. It really helps me think that I can get to the next goal or degree. We can do it, it just might be a little scary and painful at times, but like I said before, what is the alternative?

Offline Kmcsmiles

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Re: MPFL Reconstruction - November 18, 2010
« Reply #36 on: January 12, 2011, 08:40:32 PM »
It sounds like you are doing great meeting your goals!  I laughed when I read how you want to be able to wear heels and not worry about your knee dislocating.  That is exactly heat I want, even just a 1 in heel!  I had my mpfl reconstruction in September.  The more I started to move around the more the rest of my leg hurt-behind my knee, on the side, etc.  My pt said the quad and hamstring attach by the mpfl which causes pain when you start to move, and all the other muscles, etc need to get used to moving again.    I agree massage really helped and after a few weeks of moving around that pain went away at least.  I hope your recovery continues to go well!
12/20/89: diagnosed hypermobility joint syndrome
88-96 numerous checks/mri's on knee pain
91- left knee dislocate
93-96 rt and lt knee lateral release, plica removal
12/09 dislocated rt knee
09/10 rt knee mplf and lpfl reconstruction
06/11 rt knee repair nerve damage and ligament
10/10 MUA
6/11 r

Offline spurs27

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Re: MPFL Reconstruction - November 18, 2010
« Reply #37 on: January 13, 2011, 04:59:05 PM »
Sounds like you are over the hump, Loose.  Now just a matter of building-up your strength!  Congratulations on your progress...
History:
1992:  L kneecap dislocation
1992:  L knee Arthroscopy & MCM repair
1998:  R kneecap dislocation
2002:  R kneecap dislocation
2004:  R kneecap dislocation
2007:  R kneecap dislocation
2008:  R kneecap dislocation
2009:  R MPFL recon

Offline ParisBaby

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Re: MPFL Reconstruction - November 18, 2010
« Reply #38 on: January 20, 2011, 03:53:59 PM »
Day 64

I am pretty optimistic today. I am able to hobble up the stairs like a normal person and have been for about a week. I can't carry anything and I have to really concentrate on making my knee hoist me up, but it can be convinced to do it. (btw, I talk like my knee is a seperate entity from the rest of my body, which is how I consider it these days, since it won't listen to commands from my brain and doesn't do what I want it to, when I want it done.  :o).  So I am happier, plus with massage my knee pain has been getting better. It still can twinge and feel really painful after walking around in this snow (you have to walk VERY carefully and plan every step) but I am feeling about 75% normal these days which is a BIG GIANT improvement over the last couple months. 

The things that still bother me are:
1. I still get pain if I sit with my knee bent for too long. I have to straighten it or move it alot more and sooner than my other knee. I am talking like crippling pain where it feels like I have a ligament charley horse.
2. I still get pain walking, again on the side and behind my knee.
3. I still have pain when I do a SLR or try to lift my knee using quads and knee strength.
4. I am having alot of pain in my hip and quad from being unflexible for so long.
5. I am unable to bend past 125 because of said quad and hip flexor pain. How ironic is that? I could probably bend my knee more if my darn quad wouldnt hurt so much! lol.

I am hoping that these things get better with time. I am really happy about the stair walking, and I am working on trying to figure out how to go down the stairs with both feet too. That will be a real milestone.  I am able to step down backward, like off the step but actually facing down the stairs I am too scared of the height and the possibility of falling. Mental blockage, again.

All in all, I am happy with the results of this surgery, as I twisted my knee the other day in PT trying to get off one of the machines. I am talking the kind of twist that would have normally popped my knee out in the past, but it just hurt, like a stretch or a pull. I didnt feel any looseness or any sliding of the knee over. It is hard to describe the degrees in which the knee dislocates but I am assuming that people on here know what I am talking about since we are all intimitely knowledgable about knee dislocations.  I think that two months is not so bad to be feeling paritally normal, I will be happier of course when I am much more normal and can work out and such but I feel I am so close to actually being able to.  The OS said I can start the elliptical, if I get another 15 degrees and I am past week 10. So hopefully I am at 135 degrees by the end of January and then I can get on the ellipitical machine.  I am already able to do the bike with a 3 resistance and I am lowering the seat to a 4 setting for right now, which was a normal setting for me before. So happily, the bike is getting easier, and I dont even need to heat up before I do it.  It doesnt even hurt at first to do the bike, before it would take a couple minutes to warm up and stretch my knee out before I could really start going around and getting some speed.  So improvements yes, it is harder to measure now, but I measure it in normalcy of my life, rather than degrees on my leg. lol.
 

Offline ParisBaby

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Re: MPFL Reconstruction - November 18, 2010
« Reply #39 on: January 20, 2011, 04:07:59 PM »
Kmcsmiles - Sadly, most of my reasons for this operation were all superficial and petty. lol.  I LOVE wearing heels, the higher the better, and I have several pairs of heels that I have spent the last 10 years wearing happily. I have worn ballet flats/trainers/Ugg boots/ugly old man slippers exculsively now for about a year, even since the injury that put me over the line.  I feel frumpy. lol.

Sk8m8 - I bet we would do it again, escpecially once we see how fantastically this operation will turn out.  ;D Yeah, my current employer would probably fire me, even though I have only taken off one week of time, but the PT is twice a week and I think it annoys my boss that I have obligations that I have to take care of. Not to mention that fact that we are self insured here and I just cost the company about $50k. and I have only been here since May. So from an employer standpoint, I am an annoyance.  But you know what, I care because I want to do a good job, but I dont really care. I am going to do what I have to do and if they (my employer) doesnt like my choices, then I will find a new job. I put this operation off for about 10 years, cause there was never a "good" time to take off work. Well my knee decided for me, and frankly I feel stupid I didnt get it done sooner.  I have been through 2 employers in those 10 years and neither one of them deserved my waiting. My arthritis and dislocations meant nothing to them and the fact that I have lived in pain received no extra compensation or recognition, so my mindset for now is f-'em. I need to do what I have to do and bully for them if they dont like it. (Obviously I have saved up a little nest egg so that I wont be living on welfare if I do get fired and I have some time to find a new job, and that has afforded me a small sense of relief and freedom).  Look at it this way, they would fire me in a heartbeat if it was good for the company, and I have too look at  myself as my own company. I have to do what is for the good of the company.  ;)

Offline LoosePatellas

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Re: MPFL Reconstruction - November 18, 2010
« Reply #40 on: January 20, 2011, 05:51:37 PM »
Parisbaby:

So stressful to have to worry about workplace insensitivity! Luckily, since I work on a college campus, there are long breaks - but in a week and a half the semester starts and I'll have to hobble around campus again. I'm really hoping it's done snowing for the winter!

Also, congratulations on having the elliptical in sight! That's a big one!

As for heels - my knees have always been so bad that I've never been able to wear them, but I wonder/dream that I might after full recovery!
Unstable kneecaps, dislocations since age 6
1992: Arthroscopic Surgery on right knee to remove loose body
No dislocations from 2005-2010
Three dislocations in 2010
RK MPFL Reconstruction schedule for 1/3/2011!!!

Offline ParisBaby

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Re: MPFL Reconstruction - November 18, 2010
« Reply #41 on: January 24, 2011, 06:00:51 PM »
So I went to PT today and I felt really well rested and awake so I was ready to work hard. I took some asprin before my session and I think it helped me push it further than I have been able to in awhile because I was able to get to 134 degrees of bending. Which makes me really happy. So I am going to push for another 10 over the next week, so I can be that much further in my goal. I think my limit is 155? I am not sure what the flexion is on my good leg, since I never thought to measure it  but I will ask on Wednesday when I go back to PT.  We also did another exercise at PT which was the quad weight machine. This is the one where you sit down, put your shins behind the bar and lift your legs out straight. It works the front of your quads. It hurt so bad. It hurt to lift it and it hurt to lower it. Right smack dab on my knee cap, it hurt, sharp pain. I think it is from me not using that motion in a long time, but man oh man she had me do 2 sets of 10 and I think it took me about 5 minutes for that. I was not supposed to use my good leg unless I needed to and the weight was at 10lbs. It really hurt. I am assuming that is going to be my new exercise to get over.  It used to be the bike, then it was the stairs... I am good on the bike, the stair step thing is okay, I am not great on it but it doesnt hurt. 
I had a good hour massage on Friday and man did it feel good. She bent my knee enough and really worked on my sciatica and my IT band pain. I felt really good but also sore like she massaged deeply. She also worked on my knee cap, massaging it like I am supposed to, and working out the scar tissue all around the knee cap. I feel she did a good job and am going back in a couple weeks, just as a maintenance. Plus I got the gift certificate for Christmas so I might as well use it for the next couple weeks. :) 
All in all, I am feeling more confident walking, I can now walk at a semi-normal pace, and I am very stable, except for the occasional twinges on the side and back of my knee that draw me up short. I am very scared of those but I am hoping as time goes on, they will go away.
I heard an interesting thing today in PT... one of the OS people said that for every 1 pound of extra weight you are carrying it is 5 pounds of extra pressure on your knees.  So since I gained an extra 70lbs during my pregnancy, it would explain why my knees suddenly gave out on me.  I am still carrying around 15 extra pounds from my pregnancy since I couldnt work it off due to the injury but wow! I suddenly saw the damage I did to my knees and am thankful they carried me through that time so well.  I am excited to get back in the gym and get this weight off so I can give me knees a 75lbs break. lol. 

Offline ParisBaby

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Re: MPFL Reconstruction - November 18, 2010
« Reply #42 on: January 31, 2011, 09:22:16 PM »
Back at PT again... On Sunday, I worked out in the pool, did the bike for 30 minutes and some weights. My knee hurt all weekend. On Saturday, we moved boxes and I went up and down the stairs many times and I was trying to paint baseboards. Plus I tried to do the Just Dance game on my neices' Wii. I think I overdid it but I was just trying to be normal and active and get my knee back in shape.  So in PT today, it was killing me and I have to say I am still in some pain today. I might take it easy over the next day, but it is supposed to have a ice and snow storm, so that is going to be tricky.  Nothing new to report, I went backward in some flexion to 131, but oh well. I am trying to go to PT twice a week for over an hour,  sleep train my son, get our house ready to show, work full time, plan my June wedding and get some sleep at night. I am dead on my feet most days, so I am thinking that this is all I can take on.
I am very tired so I should probably be working on my knee a little more, so maybe I will do that tonight.

Offline ParisBaby

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Re: MPFL Reconstruction - November 18, 2010
« Reply #43 on: February 09, 2011, 06:28:45 PM »
So today was not a good day. I had my 3 month evaluation with my OS today and I am not where I need to be. No the dr was not happy... he is putting me back on pain killers in order to make me try to bend more and work out more.

My range of motion is not good, I haven't increased more than 10 degrees in the last month and I still haven't regained strength in my quad, which is putting stress on other parts of my knee and my hamstring. It is causing me pain and I am damaging other ligaments.   So over the next 6 weeks, he needs to see more improvement and increased range of motion, otherwise we need to talk about next steps, during which he used words like MUA (Manipulation under Anesthesia) and sports therapist (not the physical kind, but the mental kind).

So not a good visit, in conjunction with a painful physical therapy and a long wait for the OS, which made me about 2 hours late for work, is stacking up to be a tough day so far.

I didnt think it was that bad and I can't beleive that we would be talking about being put under for a mere 15 degrees but I guess that range of motion is important. Plus I am very discouraged today since I feel like people keep saying I need to try hard, and I feel like saying that I have been trying hard. I mean, I get up at 5:30am to go to therapy, I let them torture me for about an hour and a half, I go to work , where I sit all day and my knee is killing me, I work extra hours since I came in later, and I rush home to try to see my child for at least an hour and a half before he goes to bed. I mean, what more can I do? My baby already screams like I am a stranger to him, he doesnt even recognize me right now because I am always gone before he wakes up either at PT or at work. It is just frusterating, I can't keep all these balls in the air and I probably have been letting my recovery slip. So I guess there is nothing to do but get up earlier, try to work out more, stay up later doing exercises and hopefully it will get better with time. I am just discouraged and upset that this isnt over yet. 3 months is a long time to be in pain and to work hard and see no results.

Offline ParisBaby

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Re: MPFL Reconstruction - November 18, 2010
« Reply #44 on: February 24, 2011, 10:08:48 PM »
So I have been swimiming every Saturday or Sunday and it is a good exercise for not hurting my knee. I am concentrating more on trying to use my quad muscle. I am going to therapy twice a week. They have really been working hard at bending my knee, and on Monday we got to 140 degrees, after some major massage and alot of pain on my part. My quad does not want me to bend my knee. I am going to really concentrate on stretching this weekend, and I want to get to 140 on Monday, but easily, and with so much pain.  I feel like I still have a long way to go on strengthing my quad and trusting my knee not to buckle under me for no reason, it did it today and I caught myself but it is not trustworthy yet.  I will do my exercises tonight and hopefully I will start to see an improvement.  I am somewhat discouraged but hopeful that this can still be salvaged. My OS seems to be very hopeful as well and says that the numbers tell him that the recovery rate on this surgery is fantastic and that I should be able to get back to where I want to be. I just have to stay positive.