An athletes mpfl reconstruction diary

[esm87]

Hi Lucha,

It seems like you are having quite a rough time of it at the moment!

Make sure you don't leave your surgeons office without finding out exactly what's going on and how he can help you.
I understand it must be difficult not being able to do what you are used to as an athlete but maybe a couple of days of doing nothing and icing your knee as often as possible could help? My physio at the gym tells me that if i'm having trouble or have worked my knee(s) too hard. I always find it helps as it just allows everything to settle and become less inflamed and swollen.

I was just on holiday in New York for a week and walked non stop - all day every day. I am REALLY feeling it now, even more so then when i've been to the gym and worked on my knee properly.
I am giving myself a couple of days off from exercise and I feel better already.

I think your progress so far is amazing and I was always so impressed by what you were able to achieve but maybe a few days of complete rest is what you need?

Keep your chin up, I know how hard it is to think about what we used to be able to do (and took for granted!) compared to now but i'm hoping with time we'll be back to normal

Emma

[lucha86]

Hey Emma
i totally agree with you i think rather frustration does set in because we do take for granted the things we could do before and sometimes underestimate how different things can change.......
Its great that you enjoyed your holiday i do agree about the walking though when you walk a lot with an MPFL reconstruction if does take its toll on long walks.....
I have tried to ice it and have taken days off but it isnt working the only thing that works is bracing it up and that seems to hep the pain and swelling issue...... but like you said the surgeons office i will not leave until i have the answer i require........ i hope your well Emma =)

[lucha86]

day 247 - stiff knee - sublaxation - pffffff lol independent doctor
so today my knee was rather stiff all day long in went for a walk instead of going to the gym and my knee sublaxed and i fell down i was not amused to be honest it was more pffffff anything else lol
so i have decided to just swim until i see the surgeon in over 10 days time to try to relieve the knee from stress so im just rather irritated to say the least right now lol.
I feel just it comes in times you are doing great then in other times the knee refuses to do anything............
I have tried to ice it and have tried heat and the only thing that relieves the pain is with pressure, or a brace some im getting frustrated so say the least i have sooooooooo many questions for my surgeon..... because i do not have the answers..................

so i went and saw the independent doctor today as he got a call from my promotor about my knee sublaxing so i had to see him at 7pm oh joy! LOL so he decided then and there he wanted to put me in a cricket, a full leg brace...... I HATE THOSE THINGS LOL no independence and you can move with them i had that on my bad knee when i was 16 21 and 25 and i hated it lol
So he wanted to brace it up to make sure the knee was getting the best support all day ......rather than just in the gym..... so i asked him to meet me half way and i would wear the knee brace because i think by having the full leg brace would just damage all my gym rehabilitation and not help the muscle groups...... i said that to him and he said your rather intelligent i said no im an athlete that understands hows muscles works and through experience... so now he wants me to wear this brace everyday till i see the surgeon.........
ohhhhh joyyyy! lol

[lucha86]

day 248 - knee hyperextended and sublaxed again- knee feels better in brace at gym
So i got out of bed today again it was stiff i walked about another 10 steps my knee jerked back then medially jerked forward i felt my knee sublax then i was on the floor, i laughed when it happened because if i didnt i would have cried lol
so i feel my knee is performing better with the brace on in the gym right now i dont know why but its more stable and less issues on the sublaxtion front which is a good thing...... so i sad to say this maybe my independent doctor was right my knee is showing signs of medial overload as i am having a few sublaxtions........im still doing the swimming more than the gym though
 just have to wait and see the surgeon for answers........lets hope he gets my sarcastic dry humour when i try to explain to him my knee currently is like elvis prsely / herr flick from the series allo allo lol

[lucha86]

  day 249 - feelings right now

So i thought i would vent because i need to in a rather sarcastic witty way lol. So i have not been to the gym today as my knee swelled up, AGAIN! SURPRISE SURPRISE lol
today my knee has had the throbbing burning rope burn sensation going on especially when i am sitting or trying to bend it... now considering i was wrestling a couple of weeks back, and now my knee does not want to play at all... it's rather frustrating.

Because i have my independent doctor telling me i think our reconstruction was done too tight and this is why you have the medial overload. But then when you read journals its very hard to get an MPFL RECONSTRUCTION right...

lets be honest from my surgeons point of view i can understand he was think yea got a patient who throws men above her head and throws them out of a ring, then her knee reconstruction has to be tighter to cope with the demands of the sport..........
BUT THE QUESTION i ask myself is when is too tight too tight??

Then i consider what i am doing at the gym twice a day working upper and lower body to maintain my body form as an athlete, but also as part of making sure my leg is at the best it can be in full strength...
I work with Pt's a physio and a sports massage therapist, who are all just as confused as me .... i have had a suggestion from the physio to say it has been too tight from the beginning and my PT and my sports massage therapist have noticed my knee reacting differently since my accident.......

Sometimes too many opinions can be rather confusing lol

As an athlete i generally don't want to take any form of painkiller because i need to be aware of biofeedback and what my body is alerting me too, but currently with a PMT knee lol which keeps swelling up when it likes to do, shooting pains down from my knee to foot, and rope burn pain in my knee at night and while sitting...... im beginning to think something is not right as i have near enough exhausted every possible idea....
i Generally try an meditate to try to block the pain, or use a hot water bottle, ice or arnica.........

I do believe the cold weather has played a major part cause sometimes when i go and walk outside my knee gets so stiff it gets difficult to walk for long periods of time..........

Mpfl reconstruction has the ability to give a normal patient their life back in day to day terms and a security term, if the case of an athlete there is still so much for surgeons to learn from..... because i feel what sometimes is surgeons forget our careers we put into their hands because its our last option... so we will constantly be frustrated throughout the rehabilitation process ......... but then as athletes we forget that sometimes we cannot always be invincible sometimes change is inevitable... in terms of to adapt in the sport.....to protect ourselves/.

[lucha86]

day 250 - ice and hot water bottles galore
so i have been going inbetween ice and heat to lessen the stiffness in my joint and it seems to be helping a little today but fingers crossed if i do it for a couple of days i can start gyming again i went swimming and that was fine, im just getter rather bored and annoyed that my knee is in control right now ...........

[lucha86]

day 251  easing swelling -  knee MPFL reconstruction...........

1) Cryocuff- This was the best £120 pound i had ever spent a machine with a brace that keeps you knee cool post surgery, and keeps the swelling at bay in the first 12 weeks...........

2) Sauna/ Hot showers- I have noticed in the colder temperatures i have been turning more to heat than ice to relieve the joint of stiffness and swelling, i find by staying in the sauna in my gym, or a very hot shower after every workout seem to relieve the pressure and throbbing and swelling of the joint..........

3) Hot and cold techniques- yes sound bizarre but i have found when my knee has been temperamental
   and doesnt take to one type of relief.... i use both i got taught this by my sports massage therapist as an extra back up for when cold techniques does not work on the knee..........

4) Arnica gel - generally alot of marital arts use this but i have found it effective during matches and post matches to relieve muscle pain in the knee or swelling............

5_ Sports massage therapist- Yes they can be expensive but your knee will feel completely different by the end of the massage and the muscles will not have any tightness..............

[lucha86]

day 252 - knee hyperextending - still swollen -off gym with flu -
so my knee has been overextending, and hyperextending, it is still swollen and considering i have been off the gym for the last few days as i caught the flu and bronchitis and currently banned from the gym by my GP,  and feeding myself medication im currently doing nothing with my knee so in a way the positive thing with the flu is my knee is still swollen and stiff even without exercise so then it shows that i cannot be overdoing it at the gym and there must be an underlying cause such as weather or tightness of ligament, even getting out of bed has just be irritating because its so tight....... so the positive with the flu is that it shows im not being over excessive on my joint in the gym as it is still swollen post a few days rest........ and its still throbbing and painful to sleep with..............
OH THE QUESTIONS I HAVE FOR MY SURGEON LOL!!!!

[lucha86]

day 253 -  knee very stiff - trying to describe tightness - feelings on mpfl reconstruction
so today my knee has been very tight and stiff but again the temperature has dropped again so i rather suppose i have to accept this in the winter periods lol...
It took my a while to describe the sensation when i row, go on the stepper or bend my knee to an excessive point...... rope burn was the nearest i could describe but after sitting down with my physiotherapist i was trying to exactly describe it in another way as in a law of physics so when i see my surgeon he can understand so friction of bone and ligament , rubbing, was the only way i could describe it as i barley have a voice my physio therapist helped me to write down the questions for my surgeon so then if my voice fails lol i can give him the sheet to make sure every question i have is answered..........

I appreciate the fact that being a wrestler there has been no research on high martial arts with MPFL reconstruction surgery contact sports so my surgeon is just as much in the dark as i am but if he does not know an answer i will ask him to say he does not know, because otherwise im trying to seek an answer for a question where there is no answer for it due to lack of research etc....

I am proud to say i returned to wrestling before 4 months post mark when generally the lower contact sports is 6 months and high contact sports is 9 months it proves to the medical profession that the impossible is possible with the right determination and thinking outside the box with the rehabilitation aspect........

 I have had COMPLICATIONS THROUGH mpfl reconstruction which did rather frustrate me ...
However the one thing i wanted to do through this whole process is see what works and doesnt work pass it onto my surgeon so then that way things can be learned and patients can have answers to questions in the future where sometimes i did not..........It is rather funny because i know when doctors don't have an answer their smile say your name and move onto another subject...

 because i think they feel by them not having the answer does not make them look good, but as some people who have had mPFL reconstruction can understand that especially in the uk as its still rather new surgery half of the doctors dont have a clue lol...... they look very blankly at you or just smile and offer you painkillers if you have a problem or refer you back to the hospital .... a never ending cycle where in the end your just best treating yourself through trial and error because doctors fear the whole liability issue if they touch you because they do not know what MPFL reconstruction is but surely its a doctors ethical duty to make sure a patient is comfortable or just to look and see if something looks ok?.......  But surely orthopaedic doctors are aware that even us as patients know there is little information on MPFL reconstruction so we are in the dark just as much as them and surely some honesty would be best for the patient ??

One thing i have learnt is with MPFL reconstruction is that now i will treat myself and not go to a GP because i still feel it will be a couple of years yet until general doctors will feel comfortable checking a MPFL reconstructed knee, they are comfortable treating acl, mcl, and pcl reconstruction but as one GP told me  "Whats that?" ive never heard of that in 12 years as a GP." lol

[lucha86]

day 254
be afraid my knee has been ok during the day expect for sleeping which is a plus wohooo!!!

[lucha86]

day 255- knee throbbing but not as bad as it has been
so im still having the issues sleeping but the knee is having its good days and bad days and i suppose with the change of weather you have to accept it comes with the territory........ today it is still swollen but  i suppose you rather have to work with it rather than against it, i suppose we are all not invincible lol

Im hoping to start the gym again tomorrow........ so fingers crossed =)) 

i just want to get rid of the stiffness that is the rather frustrating part lol

[lucha86]

day 256 MPFl reconstruction surgery for a standard patient v athlete......my opinion

So for me as athlete i though further into this today and i thought about how MPFL surgery can have its benefits and problems for me as an athlete in a very high contact sport......

To be honest i think a lot of us athletes do think we are invincible until something proves us otherwise, because when i was training to be a wrestler over 10 years ago, we always got taught mind over body, go through the barriers, never feel defeated by an obstacle, never show pain to an enemy etc.

MPFL changed this whole ideology for me lol. I still remember an 80 year old lady who had a knee replacement next to me walking the next day, and i thought time to get out of bed, and i physically couldn't and it frustrated me that i was telling my leg to move but the quadricep wasn't functioning due to atrophy from the surgery, which shows how important it is to research what your having before you have it lol Even the matron was amused by my frustrations as i was trying every way to get out of bed it looked like the great escape she said... but i must admit the pain was incredible, i cannot even to this day describe the first two weeks, expect i was drugged up like dory out of finding nemo to give myself some dignity and normality...........

The first two weeks of MPFL reconstruction is the hardest as an athlete you are fighting a lot of frustrations as a standard patient and also you want your independence and dignity back and some sense of normality
But i suppose for athletes its alot harder to accept you have to rest, when your in the gym normally twice
a day and then currently sitting on your backside and twiddling your fingers or sleeping, you become irritated .

But for an athlete with MPFL reconstruction i had so many time frames to get back, to get fighting again,
but then again i think we forget sometimes the body has ways of teling us when something is not right.
In my time with the NHS i could not get a physiotherapy appointment for at least 5 weeks after the surgery
So through some insurance i had left, i got a wrestling physiotherapist i had through my promotor to help me get moving as well as a personal trainer who visited my house everyday she is not just a personal trainer anymore she is a very good friend of mine.......

But my body had other ideas, leg swelled up to triple the size, blisters everywhere, hot to touch, and my foot was so swollen i could not even get a slipper on my foot i had only a flip flop....... again as an athlete i broke a cardinal rule- listen to your body lol. My surgeon could not fathom what was going on with my leg just sheer silence from him, and he kept saying its not dvt correct you had it checked, and i had it checked. so he believed there was a bleed somewhere, but the physio i hired believed it could have been a mix of athrofibrosis and compartment syndrome.

So ended up with a big red letter which you know in the NHS means you screwed or its an emergency surgery lol. By this point as an athlete i was getting more tired and irritated that my body was no reacting the way it should and i had the pressure of time frames.....But i was forgetting the general rule that everyone heals differently my athlete stubbornness or competitiveness to be the best was forgetting the basic rules of healing and rehabilitation which as athletes we are generally use to ....

So after the MUA, and hiring more help to get my knee back on track by post four months, i was back on track signed off for the wrestling which generally is 9 months for high contact sport as you fly out of rings into chairs etc lol.....But it took time for me to adapt  and change my moves as my surgeon said to me after the surgery your not allowed to land on your front or you could fracture your patella i though and why didnt you tell me that before the surgery lol

As an athlete you have to be aware of so much more and your falling techniques and look out for yourself more, sometimes i do find my knee locks during matches or i have the rubbing friction rope burn sensation on the bone with the new ligament but i try and just get on with it.... i dont believe taking painkillers and painkiller is effective for the body or to understand what your body is trying to say you can and cannot do. I think all surgeons or doctors who read this who do MPFL reconstruction should make any athlete aware of flexion loss risk or patella fracture risks BEFORE the surgery as in high sports like wrestling where the risk of fall is 90% these are great things that can change important moves or changes to adapt within out sport.......

I think MPFL reconstruction is great for standard patients as in daily life it is great for me..... but there is still so much to learn for athletes with MPFL reconstruction because every sport has its different pivot and motion techniques where as an athlete we will need to adapt those to suit the reconstruction to work with it rather than against it... Every athlete has the capability to return to sport with n MPFL reconstruction it is down to the help they receive the right information and answers being given and also, i do think though
some doctors need to be more approachable or think outside the box when it comes to MPFL reconstruction as a patient we are just as confused as the doctors due to lack of research and information on MPFL reconstruction the only one who has given me the answers is my surgeon or his student or my independent doctors gp's dont know what it is lol MPFL reconstruction it is so specialised that it is a process or trial and error and thinking outside the box , without my physios and personal trainer giving me new techniques different exercises compared to the standard ones then i would be in a totally different situation....

[lucha86]

day 257 things i have learnt in process of MPFL reconstruction surgery with rehabilitation through the weeks and what to expect for patients to undergo this surgery in a funny witty way lol

week 1-2
1) make sure you dose up on painkillers, on the correct hour and dont miss them or the pain will be crazy
2)Sleep will be an issue you learn to expect if after the end of week 1 i called it the stormy weeks
3)Make sure you try to keep the leg and joint moving as early as possible
4)when having showers have something solid on the floor so you dont slip or a stool
5)cryocuff becomes a GOD rather than your ghd hair straighteners as it eases the pain and swelling lol
6)tears frustration and lack of independence will cause outbursts to pre warn you lol
7)anti clotting injections in the stomach they sting like wow but stops the risk of DVT no pain no gain lol
drain out the pain with your ipod touch or ipod, with George ezra, amy winehouse, one direction or adele, coldplay, u2 or nickelback really helps lol

weeks 2-4
1) Frustration tiredness and tears its a part of the process let it out even if it end up being your surgeon or physiotherapist you say it to lol
2) next time my physio or doctor say how did i feel i sarcastically replied you try having three holes drilled into your kneecap femur and your hamstrings ripped out and then see how you feel i got a laugh from them lol
2)Sleeping movements starts to increase as it becomes more comfortable
3) Frustration with VMO sets it to do full leg raises, its a pain but it will happen, its actually funny when you tell your leg via your brain to lift it and it won't but and the time its frustrating
4)Physios and the word "bend" and "time" becomes a common frustrating theme lol just keep going lol
5)Jumpy legs start to happen due to nerves healing and nerve pains that stop you in your tracks...
mentally just control it or use the right pain killers
6)Dry skin- ah very common around the knee Vaseline intensive care was my saviour lol
7) sutures sticking out of skin?- wrap some cling film round your knee to protect it in shower
expect your knee to feel a little weak if you have no brace like i did expect your knee to feel wobbly and be careful when walking it can feel like it will dislocate it is because your muscles are weak at that point

weeks 4-6
1) recovery process seems to speed up, you will notice the leg becomes more responsive
2)stiffness getting in at out of bed, very common the physio said it can last up to 6 months post surgery.
3)sleeping becomes more flexible and easier...
4)no painkillers by this point, maybe one if your knee is tired about physio or a stressed workout.
5)sticking out sutures finally dissolve yes i can finally have a normal shower wohooo lol
6)swelling starts to settle lot quicker

weeks 6-9
1) the bike oh how it frustrated me lol - turning the wheels of a bike is hard to do as the knee cant due to the atrophy then you watch people in the gym and it frustrates you more this is normal it will happen just keep trying i got frustrated when the physio was like we will try another day i was like no we try it now but know your limits people lol
2)need starts to feel more secure less wobbly due to the atrophy post surgery
3) the feeling of freedom and independence is fully back as you have the ability to do more
4) frustration can set in when doctors as you to explain how you feel some pains with MPFL you cannot describe and when you do doctors look and just smile expect this lol
5)finally running by week 9 wohooo!!
6)knee is still stiff and tight but work on rehabilitation and swimming to build on this..........

weeks 10 -12
1) swelling nearly gone
2)sleeping no longer an issue as the swelling has settled but still stiff getting out of bed and sitting
3)some things can become frustration in the gym because you the muscle groups wont allow you to do them keep doing and use that frustration as a drive to succeed =) its hard but worth it
4)can run now but still feels stiff
5)swimming just keep swimming just keep swimming is a key tool to flex the joint
6)feeling normal...........

[lucha86]

Mpfl reconstruction photo

[lucha86]

day 258 - independent doctor questions - knee still stiff - but im still going in a rather positive sense.
So i went for a check up with the independent doctor, before i see my surgeon in the next few days, he said he was still NOT HAPPY with my knee and still wants the surgeon to check it, he thinks the joint is stiff for a specific reason... tightness ......

my knee has been feeling like is rubbing inside i just cant describe the feeling expect it feels like friction and it has still be swollen so im just getting on with it

but then he also asked me to write, about an athletes return to sport about how i managed to wrestle again considering the surgery i have had done, can rather make huge impacts on my sport so i said i would write it up and i would also place it on this diary..... i think sometimes doctors fail to understand with athletes