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Author Topic: Is this normal during recovery?  (Read 823 times)

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Offline Hiker girl

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Is this normal during recovery?
« on: March 12, 2013, 02:45:03 PM »
I have been back in physical therapy for a month now!  Amazingly, I am also getting my muscles to coordinate and activate while walking (I never knew there was so many muscles to activate)!

So this last week my knee cap feels like the bottom part is getting stuck in between the joint and now it is moving from side to side while in a straight leg position.  When I bend the knee it moves back in place.

Is this part of the recovery process?  If not what can I do to keep this from happening?

Rt. knee pain while hiking 08/10
Saw GP 04/11
PT 05/11  failed
MRI  clean 06/11
1st OS, nothing wrong, fired him.
2nd OS, cortisone shot 12/11 
Scope 05/12, fat pad impingement, cleaned and reshaped.
3rd and 4th OS think nerve problem
Nerve study June 2012, Femoral nerve damage

Offline kimb

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Re: Is this normal during recovery?
« Reply #1 on: March 12, 2013, 03:33:06 PM »
When you say it moves from side to side in straight leg position, do you mean if you manually move it side to side with your hand, or does it move around abnormally when you are moving your leg around?
 
My kneecap has extra laxity in it, and moves more side to side than the other (when I move it with my hands) so when I go down stairs or step awkwardly, my kneecap comes out of the groove. But that is because of my injury. If that is what is happening, strengthening the VMO part of the quad, on the inside of the leg just above the knee, will help stabilize the kneecap some. Your quad muscles are, in part, what keeps your kneecap stable so when those muscles are really week it can cause some kneecap issues. Whether what you are experiencing is entirely normal, I have no idea. These days, it's normal for me, lol.
 
I'm glad to hear things are going well in PT!

Offline Hiker girl

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Re: Is this normal during recovery?
« Reply #2 on: March 12, 2013, 04:46:12 PM »
Thanks for your reply Kimb.

When I walk it feels like it is stuck below the knee.  Last night I woke up to the kneecap out of the groove on the lateral side but slipped back in when I bent the knee.  Then the joint swells causing tightness. 

Working hard at PT and seeing other great improvements!
Rt. knee pain while hiking 08/10
Saw GP 04/11
PT 05/11  failed
MRI  clean 06/11
1st OS, nothing wrong, fired him.
2nd OS, cortisone shot 12/11 
Scope 05/12, fat pad impingement, cleaned and reshaped.
3rd and 4th OS think nerve problem
Nerve study June 2012, Femoral nerve damage

Offline Kwal57

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Re: Is this normal during recovery?
« Reply #3 on: March 12, 2013, 05:02:49 PM »
They say it takes a solid year to fully recover from minor surgeries and longer there forth. I would let the PT know about the lateral slip, and they can help you build up the medial muscle to counter the pulling from the lateral one. & who knows that might do it for you.

Good luck! :)
*Kay*
'Runners' knee > Lateral Release 3/11
Minor Meniscus tear > clip 3/11
Fall on bad knee 1/12
PT 3/12-6/12
MRI > Cartilage missing = Cortisone + PT 5/12
Arthroscopy > cartilage missing, meniscus tear, & misalignment 8/12
TTO/ACI 10/13
Healing....for now :)
instability :/

Offline Hiker girl

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Re: Is this normal during recovery?
« Reply #4 on: March 12, 2013, 06:10:04 PM »
Thank you Kawl57,

I let them know today during PT what had happened.   Brian said gotta keep pushing to build up quads. 

I am doing step ups on a 8 inch squishy step, sitting with my back against a wall with just my legs supporting me, calf raises and leg presses.  Do these build up the medial side?  Two weeks ago I felt my medial muscle for the first time since surgery in May ;D

I never imagined recovery taking soooooo long.
Rt. knee pain while hiking 08/10
Saw GP 04/11
PT 05/11  failed
MRI  clean 06/11
1st OS, nothing wrong, fired him.
2nd OS, cortisone shot 12/11 
Scope 05/12, fat pad impingement, cleaned and reshaped.
3rd and 4th OS think nerve problem
Nerve study June 2012, Femoral nerve damage

Offline kimb

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Re: Is this normal during recovery?
« Reply #5 on: March 12, 2013, 06:27:21 PM »
Wall squats (where you have your back against the wall but hold yourself, like you are in an invisible chair) are good for the quads for sure. When you do things like leg presses (check with your PT first though!) if you turn your toes outward a little, it focuses more on the VMO/medial quad.
 
I was cleared for all activity, but last week when I did just half squats and lunges with only body weight, my knee swelled like a grapefruit again. So frustrating that the most effective exercises cause such pain and swelling! I switched to yoga when the swelling went down and that seems to be going better. Warrior poses and the like are also good for quads.
 
I also made a new hiking stick out of diamond willow (we are lucky to have a huge grove of willow that is infected with the fungus that causes the diamonds, right behind my house) as motivation to stay moving and get hiking as soon as the snow melts.

Offline Kwal57

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Re: Is this normal during recovery?
« Reply #6 on: March 12, 2013, 09:49:56 PM »
One of the best things I did when recovering before was learning the muscles. I learned where each muscle was and what it was, and the best I could was to find out what it feels like to use it.

With your squishy step, you should make sure you feel like your whole quadricep region is working.

With the wall squats mentioned, I would do that, or modifications of that with a flexible ball in between my legs to have the VMO have to fight more. Please make sure you talk to your PT before trying these exercises!!! They need to know what you are doing so they can help insure a balance of the exercises.

Also ask your PT people what is supposed to work when you do each exercise. Pick their brain. I did that so much that they kept telling me to go back to school for PT. hah. It actually helped me with home rehab of my other leg. for the imbalance.

I wish you luck! make sure you talk to the PT about any other exercises you do that they do not have you doing too much! :)
Good luck! :)
*Kay*
'Runners' knee > Lateral Release 3/11
Minor Meniscus tear > clip 3/11
Fall on bad knee 1/12
PT 3/12-6/12
MRI > Cartilage missing = Cortisone + PT 5/12
Arthroscopy > cartilage missing, meniscus tear, & misalignment 8/12
TTO/ACI 10/13
Healing....for now :)
instability :/

Offline Hiker girl

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Re: Is this normal during recovery?
« Reply #7 on: March 13, 2013, 04:29:17 PM »
Ah Kimb,

Hiking is my motivation as well.  Congrats on being cleared for all activity!

Kwal57,

PT just told me to recuperate the leg for 24 hours after PT.  My gp wants me to start aquatic aerobics to get the muscles strengthened without pressure on joint.  I am still trying to straighten it actively which requires LOTS of quad strength.  My next session is tomorrow so I will begin to bug the heck out of them. 

When I do the squishy step I feel all of the quads coordinating and working together...finally!  It even works the glutes and hamstrings.  Now if it would just take off the extra weight I have gained since this injury ;D sigh

Debbie
Rt. knee pain while hiking 08/10
Saw GP 04/11
PT 05/11  failed
MRI  clean 06/11
1st OS, nothing wrong, fired him.
2nd OS, cortisone shot 12/11 
Scope 05/12, fat pad impingement, cleaned and reshaped.
3rd and 4th OS think nerve problem
Nerve study June 2012, Femoral nerve damage

Offline Kwal57

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Re: Is this normal during recovery?
« Reply #8 on: March 13, 2013, 04:34:46 PM »
aww, you guys, I have hiking as one of my motivators for recovery too!!!!! I was injured under workers comp, so I'm waiting forever!!

I am a white mountains hiker, (NH) what about you guys?
*Kay*
'Runners' knee > Lateral Release 3/11
Minor Meniscus tear > clip 3/11
Fall on bad knee 1/12
PT 3/12-6/12
MRI > Cartilage missing = Cortisone + PT 5/12
Arthroscopy > cartilage missing, meniscus tear, & misalignment 8/12
TTO/ACI 10/13
Healing....for now :)
instability :/

Offline Hiker girl

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Re: Is this normal during recovery?
« Reply #9 on: March 13, 2013, 04:55:02 PM »
Hi Kwal57,

I used to be a Sierra hiker.  I was on track to hike the 7 peaks in SoCal when my fat pad was injured on a more difficult and unstable terrain.  I haven't been able to go up the mtn in 21/2 yrs :(

However, I took my poles out and walked (pretending to hike) about a quarter mile on a very slight incline last Saturday.  That was satisfying.  All this nonsense with my knee is cramping my outdoor life style.  My hubby climbed Whitney without me...which was a blow.  But it is done on a lottery system so who could fault him for having a great time :-\ 

Nice to meet up with hikers on here.  And may we all be able to get out and do what we love to do very soon!
Rt. knee pain while hiking 08/10
Saw GP 04/11
PT 05/11  failed
MRI  clean 06/11
1st OS, nothing wrong, fired him.
2nd OS, cortisone shot 12/11 
Scope 05/12, fat pad impingement, cleaned and reshaped.
3rd and 4th OS think nerve problem
Nerve study June 2012, Femoral nerve damage

Offline Kwal57

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Re: Is this normal during recovery?
« Reply #10 on: March 13, 2013, 05:02:48 PM »
nice! yeah, I've been away for 2.5ish years too. there was a point that I could go up and do the small 30m hikes in an hour. but I couldn't imagine it now...:/ my patella doesn't track right regardless of my quads getting stronger. so I'm looking at a TTO & ACI. basically making a better track for the cap.

There are some neat waterfalls and random springs that are so pretty in the white mountains. :) I was lucky enough to go on 4-5 hikes before my knee business. :)
*Kay*
'Runners' knee > Lateral Release 3/11
Minor Meniscus tear > clip 3/11
Fall on bad knee 1/12
PT 3/12-6/12
MRI > Cartilage missing = Cortisone + PT 5/12
Arthroscopy > cartilage missing, meniscus tear, & misalignment 8/12
TTO/ACI 10/13
Healing....for now :)
instability :/

Offline kimb

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Re: Is this normal during recovery?
« Reply #11 on: March 13, 2013, 07:16:51 PM »
We hike mostly in northern MN, but will hike anywhere we happen to be! We have a kid who is kind of at an inbetween age, he is 4.5, so too big to carry in a backpack anymore, but too little to hike too far. But we go on shorter hikes to picnic at waterfalls and then I'll go with my husband, or my mom or my sister, or my older boys on longer hikes. We have some really high traveled trail hikes, and some much longer backwoods hikes as well.
 
I only injured my knee this past December. Bowling of all things. Considering how much hiking and kayaking and skiing we do, I'm astounded that I injured my knee bowling, lol. I am a bit nervous for my follow up in a week. He said it'll depend on my ROM (which is 100%) and my strength whether he would recommend surgery for the slipping kneecap. I do not want to give up hiking for the summer and the fall, so I am thinking if he recommends it on seeing if I can just be careful and wait until later in the fall, but I also worry about the knee because it slips even on the stairs. The last thing I need is to be 14 miles in the woods with no cell service and have my knee dislocate on a rocky climb or something.
 
So frustrating to be away from what you love! I hope you both can get back on the trail soon. There are a lot of things I'd be willing to give up to keep my knees healthy but hiking is too much a part of who I am. I can't imagine not being able to do it. Sad you had to miss your Mt Whitney trip! I hope you will be able to do it in the future. 
 
We are lucky to basically live in the woods. Even though I cannot right now do a long hike, I can walk out my backdoor and be in the woods, so I can take short walks, or snowshoe trips on the lakes and stuff at least.

Offline Hiker girl

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Re: Is this normal during recovery?
« Reply #12 on: March 15, 2013, 03:34:23 PM »
Kimb,

I hope your visit with the OS turns out fine or at least surgery can be delayed :-\  However, it would totally be a problem to have an issue with your knee out in the woods.  I had to hike down the mtn when I injured my knee.  Total agony!  I finally sat on my butt and scooted down until I got to the river! 

It sounds so lovely where you live.  In fact it is a beautiful state. 

May we all hit the trails soon.

I had PT yesterday and asked Brian if we could specifically work on VMO.  He said I was a good month out from that and that my muscles and knee joint have been so fluid logged for so long it will take longer.  So I guess working out with lots of patience will be my lovely Spring goal ;D

Rt. knee pain while hiking 08/10
Saw GP 04/11
PT 05/11  failed
MRI  clean 06/11
1st OS, nothing wrong, fired him.
2nd OS, cortisone shot 12/11 
Scope 05/12, fat pad impingement, cleaned and reshaped.
3rd and 4th OS think nerve problem
Nerve study June 2012, Femoral nerve damage