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Author Topic: PT pain levels  (Read 1843 times)

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Offline amoler

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PT pain levels
« on: August 23, 2011, 05:15:53 PM »
Nothing ever seems to go according to plan. Anybody have an opinion on exactly how bad PT is supposed to make you hurt? I have an MCL spain, two meniscus tears and an "old" break that nobody has given me information on how old.  I spend two weeks of the past month on crutches, then the last 3 weeks limping very badly. I have loose floppy tissue in my thigh because I've lost so much muscle in the quad. I was sent to physical therapy in the pool and told to do 20 reps each of about 2 dozen different exercises. Today, I can barely walk (my quad feels like it has a full blown cramp), and my knee totally gave out on me trying to get out of the tub and dumped me. (Good thing I have a well padded behind) Is PT really supposed to make me hurt this bad? Thoughts ? Your experience?
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline smillie

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Re: PT pain levels
« Reply #1 on: August 24, 2011, 05:09:29 AM »
No. that's the short answer

The trick with PT is to get results without irritating your knee to a harmful extent. Communicate with your PT. They need to know that it was too much. When you are doing the exercises, if it is really painful, communicate that then so adjustments can be made. In my experience, sometimes the pain comes during PT and sometimes it comes a few hours afterwards. So if you are getting too much pain afterwards, then let them know so adjustments can be made. In the mean time, ice ice ice.
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline Kimberly 77

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Re: PT pain levels
« Reply #2 on: August 24, 2011, 03:31:50 PM »
I agree, you shouldnt be feeling so much pain after PT. A little soreness and a bit increase in pain is normal but if it is to the point you say then I think you are doing too much too soon. Your Pt needs to be informed about it so they can make adjustments. My Pt would do this certain bending exercise with me, she would get up on the table and force my knee bent from the front and it would hurt so bad during and then after I would swell and my knee would be hot to the touch. So she changed it up and had me lay on my stomach and then would push my knee bent from that direction, it hurt much less during and after. Sometimes you just need a different position or a different routine all together.
Right leg amputee.
Osteoarthritis in left knee.
Medial femoral condyle defect, arthoscopy 8-2-10
Grade 3 defects, patella, medial femoral condyle, tibia scoped1-12-2011
Physical theraphy and awaiting microfrature 2-1-12

Offline amoler

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Re: PT pain levels
« Reply #3 on: August 24, 2011, 05:15:05 PM »
Now I have a new utterly ridiculous problem that I don't understand. Twice this morning when I was walking across a level floor it felt like all the muscles in that leg were firing out of sequence (best way I can think of to describe it) and it almost completely gave way. I managed barely not to fall but this is totally creepy. Any theories on what could cause this?
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline smillie

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Re: PT pain levels
« Reply #4 on: August 25, 2011, 03:39:01 AM »
It sounds like your muscles were over-strained or exhausted yesterday so there is weakness today. When I played softball, I played catcher sometimes which is very exhausting for all of the quads muscles. The day after a double-header, my leg would feel all out of sorts because those muscles were spent and they felt weak and felt like they weren't cooperating with each other. You can also get that feeling when your muscles shut down which can be due to irritation and swelling. But probably you are just feeling the results of over-doing the exercise and your muscles just need a couple of days to recover. I always thought they felt worse on the second day than the first, so they could get worse before they feel better.
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline Kimberly 77

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Re: PT pain levels
« Reply #5 on: August 25, 2011, 08:14:46 PM »
Again I agree:)
Right leg amputee.
Osteoarthritis in left knee.
Medial femoral condyle defect, arthoscopy 8-2-10
Grade 3 defects, patella, medial femoral condyle, tibia scoped1-12-2011
Physical theraphy and awaiting microfrature 2-1-12

Offline amoler

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Re: PT pain levels
« Reply #6 on: September 30, 2011, 09:35:07 PM »
I'm back to agonzing pain at PT again. Pain so bad I stood in between the dang parallel bars with tears running down my face. The PT people just shrugged and said they didn't know why it hurt so bad. The ache runs from mid calf to mid back with a nice dagger of pain in the medial side of my knee. The chick, PT asst person, offered to kill me. No actually I'm not really kidding. Apparently reading my chart to notice that dexamethasone is one of the things I absolutely positively cannot take is too much trouble. She offered to ionphoresis some into my leg. ???
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline Kimberly 77

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Re: PT pain levels
« Reply #7 on: September 30, 2011, 09:52:45 PM »
So sorry Pt is not going well for you. I had about the same experience as you, my Dr. suggested a unloader brace and more PT at my last appoint. I decided to forfiet on the PT and have ordered the brace. I think I have a mechanical block in my knee cap and lots of scar tissue which is making it too painful for me and also keeping me from getting anywhere with flexion and extension, so until that is fixed I am not going to put myself thourgh any unwanted pain. I wish I had a answer for you but all I can say is it might be time to schedule a follow up with your ortho.
Right leg amputee.
Osteoarthritis in left knee.
Medial femoral condyle defect, arthoscopy 8-2-10
Grade 3 defects, patella, medial femoral condyle, tibia scoped1-12-2011
Physical theraphy and awaiting microfrature 2-1-12

Offline smillie

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Re: PT pain levels
« Reply #8 on: October 01, 2011, 04:32:42 AM »
Amoler,
I'm sorry you're having so much pain again! I was just on the phone with my mom who has been having horrible pain from her back down to her lower leg like you describe. There is a good bit of sciatica in it, I think. She just started PT and they said that it is stemming from her back (probably a bulging disc) and it evidently has made her hamstrings so tight that she can't even extend her leg all the way. If she had been having knee problems, I think they would have been distracted by that. She said that today (her second PT session) they put the electrodes on her back and laid her on the big moist heating pads and got her back to relax and then she did all the exercises for her back and legs with the e-stim in place. Everything finally loosened up and she feels so much better tonight. She hasn't really slept in about 7 weeks, so this is a pretty big deal. I say all this just to ask, are they checking your back and doing anything beyond your knee? I know you have a lot going on with your knee, but it sounds like you've got something else going on too.
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline starpolisher

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Re: PT pain levels
« Reply #9 on: October 04, 2011, 07:39:00 PM »
I am so very very sorry to hear what you're going through.  Honestly it makes me cry to read your description.  I had a similar experience when I lived in NY.....with arthrofibrosis.  I often would scream when the PT would really put a lot of force on my knees to make them bend!  The problem was I still had the scar tissue and it wouldn't remain pliable that long....I would have to continue to endure this therapy in order to walk.  It was short lived.  It wasn't until I went to Indiana and then I saw they didn't believe in causing so much pain!  They didn't believe in it....in my case they felt (and I agree) that this tremendous force was causing more scar tissue to form.  I do exercises to a point where the threshhold of pain begins and then I am not supposed to cross that line.  I have a very different problem from you and my Astym treatments are limited to certain conditions. 
I wish I could be helpful but I don't know enough about your condition.  It was a layperson ... another patient who asked what was wrong with my legs and asked me to please call her therapist who did Astym.  It turned out to help me a great deal!  But I hope someone sees what you are going through and what you have and can chime in here and help you!  I had my conditions with very painful PT for 6 years!  I am better.  I do wish you the best and really hope you will find an answer.  It is sad that so many orthopedics seem totally lost as to how to help so many conditions. 















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