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Offline lucha86

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Re: An athletes mpfl reconstruction diary
« Reply #315 on: January 25, 2015, 12:13:36 AM »
An athletes return following MPFL reconstruction surgery
Ok so for me i think there are several rather important things that effect any athletes return to sport...
Confidence, belief, psychology,determination, understanding, support.............
these are the key things i believe are what helps and are key to the success of return to sport so starting with

CONFIDENCE/ BELIEF-
this a key major part, for me i felt like i had to be comfortable in my abilities to return to the sport but to also understand my limits and i could only do that through trial and error process, in any sport you have to be able to enter it feeling a sense of confidence i suppose you could call it in psychology the fight or flight response or the theory of survival rule, showing pain and fear in natural law, humans have a tendency to try to block it or not to show it or it for some people can be seen as a weakness especially in wrestling we try not to show fear.........So having the confidence and belief is a key important factor in helping you to succeed. Because in certain sports being nervous can cause un forseen situations more injuries etc.

PSYCHOLOGY / DETERMINATION
two more important key features i think sometimes whenever an athlete goes through rehabilitation we have a drive and determination to succeed due to the amount of frustration we feel, our mindsets change throughout the process, but the psychology of it is simple KNOW YOUR LIMITS, if something doesn't feel right, change it or adapt it to make it work for you rather than against you.
with psychology aspect its funny because i remember i had a match a couple of weeks back, and i lifted a person then my leg just locked stopped and the nerve pain was mental but i managed to control it mentally for a second to get myself out of the position and adapted it to make the person get down safely, sometimes pains, and sensations can get you off guard but now i try to assess it mentally to think is it a pain i can control mentally or is it a pain i need an answer for, because when you have knee surgery you will get some weird sensations, and as an athlete you need to be able to decipher what is ok, and what is new.........

UNDERSTANDING/SUPPORT
I thing theses two are the biggest important factors in the outcome if a athlete returns to their sport.
i think all athletes need to understand what changes they need to make before their return to sports by assessing all information :-X before having the surgery so athletes are EXACTLY aware of what needs to be adapted or changed for exampled with MPFL surgery i'm not allowed to land forward in case i fracture my knee cap which i was only told after the surgery when generally in the sport i do landing forward is like 50-60% of the time so i have had to completely adapt within the sport.
this is why it is IMPORTANT to ask questions about contact sport and what you can and cannot do after the surgery to the surgeon..............
 With the support aspect generally i think its best to be up front and honest with the surgeon and physiotherapist the first time you meet them tell them what sport you do to make them exactly aware what they are dealing with, to be honest i think it was hard for my surgeon as he probably have never deal with  wrestler before who can lift two men on each shoulder and throw them down, so everyone is learning lol.

 I think by being honest with the surgeon you are only protecting yourself and the surgeon so then your surgeon can make you aware of any things that might happen or need to be changed. Generally my surgeon is quite supportive and helpful in my enquiries as to be honest i am a guinea pig with this MPFL surgery lol he helps me to get mri scans which i pay for through my promoter if needed for unforeseen circumstances or bad falls etc, which is great so then i can get back to the sport asap, and anything i don't know 90% of the time he gives me an answer for which i appreciate........
Physios i think are just generally too nice with me they are good as in the medical aspect but i find by expanding my opinion base and working out with personal trainers in the gym who say to me get up dont give up and keep moving i will not see you fail compared to a physio who says well done well done bend bend bend, as an athlete i need a more pushy approach which is why i used more personal trainers than physios in my rehabilitation process and i made sure i used at least a Level 4 trainer in the gym who specialise at that level in rehabilitation............ so make sure you have the right support networks and make sure your feel you have a surgeon that is approachable if you don't as an athlete you might have a few issues along the way... but make sure you have a network of people within your rehabilitation that are well experienced and supportive with any questions you have as this will help your rehabilitation process to be quicker

Offline lucha86

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Re: An athletes mpfl reconstruction diary
« Reply #316 on: January 26, 2015, 06:44:49 PM »
day 260- what is wrong with the surgeon ????- feeling deflated  want to cry....- indescribable- great nurse -
So today i was waiting outside my surgeons office and a lady came out and said he was miserable....
Then i thought... this is going to be interesting lol
So i went in to his office,and asked him to read the sheet of my list of positives and negatives, then i dunno what happened to him i dunno if i offended him or if he was having a bad day and his attitude changed, i really didnt know how to take him after five minutes, i dont know what i did or what was wrong with him, or if he had a bad day.
He challenged every point i made and got very defensive on some of my negative problems,and gave me an answer for each point, at some points even though i wasn't saying anything i felt he was getting very defensive and i was like in my head what have i done wrong or what's wrong with my surgeon  :-\ So some negatives i gave he said he DID'NT LIKE and he reacted to them...... but i just let him have it out because he didn't look happy at all today .......
So then he checked my knee and he said why is your knee crunching it shouldn't be crunching  he kept feeling it and saying its crunching why?? he kept repeating this several times and moving my leg up and down...by this point i just went very quiet because i thought there is no point in even trying to say anything because he's on a mission to vent lol.

So then he went onto my VMO and thats' when he lost it for me he vented and said cant you feel your VMO and the difference in contraction feel it feel it wont you!! your personal trainers are doing  a useless job, you need to change them, YOU NEED to work your VMO do you know what that is??
I thought like saying yea sorry for the atrophy considering i didnt have a physiotherapist in the first 5 weeks!!, had two major accidents in December with my knee which put me back on crutches but i thought don't do it. So he seemed to cheer up after i gave him a thank you gift, but i dont know what was wrong with him at all? He said he wanted to see me again and i said i didn't after that i just thought i was useles she said he needed to see me to check the problems as they were not good.... i feel deflated to be honest, there are other things he said which i don't want to mention but i thought to myself maybe he is just having a bad day and not to take it to heart. because he has never been like that i have never seen him like that he is normally funny and witty.........

But his nurse said to me outside your an inspiration, you have lost so much weight keep it up keep it up, your doing so well, and after having that and my surgeon i just wanted to cry because all i wanted today was positivity from my surgeon and i didn't get it .... i have two completely different outlooks and to be honest i feel even more frustrated....... considering i have done so much and come through so much and not had a well done from my own surgeon i feel deflated............i get well done from his team but not from my surgeon considering i have now lost 11 stone in excess weight, going to the gym 4 hours a day, and wrestling as well.  Maybe he was having a bad day i dont know im just confused... just want to cry so frustrated!! all i need right now is more positivity that anything with the way my knee has been acting up..

:( :(

Funny enough a friend of mine text me and said to me did you see your surgeon today i said yea, she said i had a lady moan in our shop that he wasnt happy today..... well that gave me some hope maybe he was having a bad day lol

all i want is for my knee to be good that is all, i always be nice to the doctors, because i know they get stressed out, i will work on the exercises i asked my contact on for the next 12 weeks but to honest i dunno what was wrong with my surgeon i really don't i'm in shock, i just handed him the sheet gave him the description of each negative and he was very defensive there are still some explanations im trying to understand but as he was very defensive i thought i did not want to irritate him further i dont know if he suspects something but to be honest all i want is just to have a knee that performs i will try everything to get it there.... but one think i do need is a bit of positivity,,,, i think sometimes some doctors just fear some things sometimes..........but im the type of person who just says well you tell me what to do and i will do my best to fix it and exhaust everything
« Last Edit: January 26, 2015, 10:57:50 PM by lucha86 »

Offline esm87

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Re: An athletes mpfl reconstruction diary
« Reply #317 on: January 27, 2015, 03:32:20 PM »
Hi Lucha

That doesn't sound very positive, is there anyone else you can ask to see for a second opinion?

I understand it must be a very difficult and at times, frustrating job. But for you as a patient you have not had a great experience and are not any further forward after that meeting. Especially after all the set backs you've had recently!

If it was me I think I'd ask to go back and see him or if I could see someone different, you need to find out what's really going on and how you can make it better

Offline lucha86

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Re: An athletes mpfl reconstruction diary
« Reply #318 on: January 27, 2015, 08:28:03 PM »
hey emma
i hope your recovery is going well =) i do generally believe he was having a bad day....there is one question that did bug me which i didn't asked him which was why was i signed back on to the wrestling several months ago after me lifting weight around 75 kg in front of him then he looked at my leg yesterday and said my VMO wasn't strong enough/ contracting?? strange?
But like i said maybe my surgeon was having an off day, i just feel deflated that he reacted so defensive to my queries of my negatives, all i wanted was an answer , i had never seen him like that because he had always been nice and chirpy never like that  :-\
He has helped me a lot previous to this experience which i appreciate, and been very supportive until yesterday. i think i will do the exercises as set out by my independent physio which he has added ONTO my other EXERCISES....... and see what happens at the 12 weeks point at our next consult, because i want to exhaust everything.......because my surgeon generally is a cool guy i think he was having a bad monday.....

All i want is to wrestle, be happy, have a good working knee that doesn't feel like the ligament is rubbing on bone or painful to sleep with, or feel grating behind the knee cap, i just want it to be sorted and im a happy person, placid generally and very sarcastic but i'm not asking for much just for my knee to be ok
i appreciate doctors are under pressure and the stresses they have but, i need a bit of positivity and support right now and someone to say hey it's gonna be ok and explain a plan which i dont have =( rather than defensive

Offline randoknee

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Re: An athletes mpfl reconstruction diary
« Reply #319 on: January 27, 2015, 08:29:36 PM »
Hi Lucha,

The tough thing for those of us who are sophisticated consumers of orthopedic services to remember is that, our ortho surgeons, who we're trusting to put our f'd up knees back into perfect working order are themselves human and by definition imperfect.  Everybody, even doctors have crappy days.  They have professional and personal lives and you never know when someone has a bucket of unpleasantness dump on them.  It can be tough to compartmentalize the bad stuff and always remain cheerful and supportive to everyone around us.   I grew up with a dad who was a surgeon and remember vividly when he'd come home after a really bad day.  I suspect (and hope) you just got him on one of those days.  If you like and trust your doc I'd say give it some time and another try.  Do look around the exam room and make sure there are no hammers, meat cleavers and bone saws lying around though. ;).   I hope everybody has a better day and follow up appointments.  Dan
12/08 L patellar tendon rupture (mush) -ORIF  -  8/10  fx of L patella  - 8/10 ORIF L Patella 9/10  dx patella alta  - 2/11 dx "delayed union" - 6/11  L knee scope / HW remvd.- 6/13  R Knee Scope - 11/13 R knee PFA - 6/14 Left knee PFA - 10/14 L Knee TTO- 11/16 L patellar tendon repair & augment

Offline lucha86

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Re: An athletes mpfl reconstruction diary
« Reply #320 on: January 27, 2015, 08:41:26 PM »
hey dan
i know what you mean i use to teach doctors English on the side out in Latin America where i use to wrestle and i remember the surgeons would come to the starbucks to learn English big black eyes lol they always wanted americanos or expressos lol and tired and stressy after 12-15 hour shifts lol, and i know how much under pressure they are as doctors and that why i give doctors and nurses and their secretaries  gifts now and again for their help as i know the pressure they are under, and sometimes i have seen how bad patients shout at them and i feel so bad for them. I think for sure my surgeon did have a bad day, and he does go the extra mile every time and thats why i do trust him and thats why i will do the exercises and see if it helps..... due to the comments of the patient and i had never seen him react like that, and he has helped me a lot,   luckily enough dan there is no meccano sets lingering around in his room lol  many thanks for your comment =)

Offline lucha86

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Re: An athletes mpfl reconstruction diary
« Reply #321 on: January 28, 2015, 04:37:47 PM »
Hey guys so after  264 days this is  where my diary ends. I don't feel that I can write anymore that would be if benefit I hope that all the information has been useful to you all  I hope it has taught doctors physios and patient about mpfl surgery  alike ..........

I wish you all the best good luck everyone it was nice to talk to you all  :) buena suerte con mucho gusto :)))

Offline Leenie

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Re: An athletes mpfl reconstruction diary
« Reply #322 on: January 28, 2015, 05:34:02 PM »
Lucha, I can honestly say that your diary has helped me immensely. I'll be sorry to see you go, but best of luck with your recovery and beyond!

Leenie

Offline patriciapatella

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Re: An athletes mpfl reconstruction diary
« Reply #323 on: January 31, 2015, 10:08:40 AM »
Thank you for this wealth of information on MPFL, lucha. I've been a follower of your diary and I thank you for replying to my questions in my own diary. It has become a very good reference for me in my own recovery. I pray that your knee becomes better, dear. Best of luck, lucha!

- Kristine
MPFL Diary <-- my MPFL blog

1998 - first experienced bilateral patellar subluxations
1999-2014 - multiple dislocations every year
12/01/2014: MPFL recon of right patella
1/18/2016: MPFL recon of left patella

Offline lucha86

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Re: An athletes mpfl reconstruction diary
« Reply #324 on: February 01, 2015, 01:36:36 PM »
Thank you all got your kind words I will still see how everyone is doing on the board this is my final update
I now have an independent physiotherapist 20 years experience she is very good and she worried about the state of my knee".......
1) over stiffness In the joint wants to manipulate the joint more because it's too tight
2) vmo slight atrophy which she said is to be expected since had no physio 5 weeks post surgery
3) she believes the ligament maybe too tight due to the symptoms I'm describing but she wants to build the vmo abit more then reassess the joints new ligament  mpfl
4) she said I SHOULD HAVE NOT have been signed back on to wrestle as knee is showing distress and my ankle is rolling out wards

So I will keep going on but not with the diary but I will check others peoples diaries to see how you are all doing :)) Emma Leenie and Patricia good luck in your recovery i will leave you a message now and again on your diaries
« Last Edit: February 01, 2015, 07:13:51 PM by lucha86 »

Offline esm87

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Re: An athletes mpfl reconstruction diary
« Reply #325 on: February 03, 2015, 03:38:12 PM »
Hi Lucha

Please keep us updated on your recovery :)

I wish you all the best!

Emma

Offline lucha86

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Re: An athletes mpfl reconstruction diary
« Reply #326 on: February 06, 2015, 12:14:37 PM »
Thanks Emma hope all is well

Offline lucha86

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Re: An athletes mpfl reconstruction diary
« Reply #327 on: February 12, 2015, 12:03:41 AM »
Final follow up!!
Do I have been to the new physio therapist so so far as a round up
1) crunching of knee and knee cap is still sublaxing and misaligning and should not be happening it semi dislocated in front of her......
2) should not have been signed back on to wrestle
3) knee and ankle are working against each other knee is going one way ankle is going the other
4) put into ballerina tiptoe points weird flexions to test need movement pain and flexion, she wasn't amused by the stiffness lol
5) she thinks I have slight nerve damage ( well to be expected I suppose so many nerves around the knee I signed the paperwork) but I told her I deal with it mentally when it happens in matches
6) failure to have physiotherapy in first weeks of surgery was the biggest issue......especially being an athlete
7) swelling of the knee is a concern for her......

So she said most of the groups of my muscules are ok she wants to strengthen one group see if that helps if that doesn't help then it's not my issue she said lol  but she has her concerns with the crunching when I'm walking and flexing

So I got rather frustrated at certain points when I could not describe what I feel is going on inside so she went out of her private office got a knee model and smiled and said well now you can :) and she said show me and I tell you what I showed her the motions I feel when I walking the crunching of the kneecap with the bone behind and the issue if the movement and do you know what she is the first one to let me describe it visually it's hard enough describing what you feel after mpfl reconstruction I think doctors should use these tools more and models because then it's better for the patient to describe the problem :)

She said to me sometimes doctors forget with people within the martial arts their knees are put under the most amount of stress compared to other sports, so these athletes are more aware of their joints and motions because of the stress out under them.....

I then said to her well explain to me why I managed to lift two men one on each shoulder and chuck them down previous to these issues because my surgeon doesn't believe me  .... Some doctors forget the following She said you had two falls which didn't help but again in wrestling your use to taking hits and pain falling onto cement wood the body will adapt and it will through adrenaline and the mental ability to overcome pain which you have built but now your body is saying something is wrong your body will stop if there is an issue for a valid reason and a lot of your problems concern me and I can see these problems I work with athletes daily so I know when something isn't right"........

She also told me to rest which I did and my knee swelled up she wasn't happy about that lol so how am I currently feeling lol I dunno just I suppose I want to laugh because I'm just confused now just want a working knee that's all lol .... So will carry on with the physio and see what happens in the next few weeks this is my last update Peeps :))

Offline lucha86

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Re: An athletes mpfl reconstruction diary
« Reply #328 on: February 25, 2015, 10:49:40 PM »
the final conclusion of MPFL reconstruction  AND ATHLETES OPINION
I wanted to right this as a final evaluation of an MPFL reconstruction

So for me i believe KEY is movement is the first couple of weeks and making sure you have a physiotherapist available or complications could occur. I did not have a physiotherapist till at least 4 weeks post surgery... in some cases on this board i have seen some people have physios within the first week i suppose it is dependent where you are in the uk...............

Is there enough information on MPFL reconstruction for a patient i would say it needs to be improved, i did feel throughout my journey it was a case of trail and error to integrate new moves to help my knee, because i did not have the information available to me at the point of time,  i appreciate doctors are still learning about the surgery but i think in the recovery process especially of an athlete .......

MPFL reconstruction to think those  who have had it would understand sometimes the strange sensations you get are weird but normal, and sometimes it can be rather hard to describe it what i will say is to expect it to be hard to do a straight leg lift in the first few weeks, numbness, shooting pain dry skin, sleeping in weird yoga positions lol just to be comfortable leg jumping randomly while sleeping, frustration tears it is all part of the process and be aware that when you have had this surgery for the first couple of weeks anything to sit low in is very hard and uncomfortable ,,,,,,,,,, but it is worth it to stop the dislocations
The first few weeks are the hardest but then it rapidly improves. I will say if you have to have an MUA it doesnt hurt and it will help you to move so dont be afraid of it =)

As an athlete..... well you have to understand a wrestler before you understand why we think the way we do..... we are trained not to show fear or pain or it is seen as a negative we turn our frustrations into power and use it as a positive we are stubborn of nature and highly competitive if you tell us not to do something we will lol we get taught mind over body........

For me this surgery has pushed me to so many extremes lol that i don't think many wrestlers or people in martial arts could cope with lol The first few weeks i was throwing my crutches around because i lacked the independence that i had before the surgery having to rely on others was a problem for me luckily enough my family were very supportive and understood me....

getting back into the wrestling was unique i had to adapt my back my landing position my pivot techniques, in order to not land on my front as my surgeon said i could not free fall forwards on my stomach as a wrestler that is hard to do considering you are constantly falling generally........... forwards........... i managed to do 12 matches  then my knee was having problems for me it was rather frustrating because i managed to do the 12 matches and my knee was not coping crunching, slightly weak VMO which is no surprise due to the physio reasons.... but you keep going as an athlete and block the pain that is what we do that is what we are trained to do......

 i lost one of my brand contracts due to failing to keep going in the wrestling the question i would consider for athletes with an MPFL RECONSTRUCTION  is consider the type of sport you do and how much you fall on your knee cap or kneel because it could cause problems within your sport, before you have the surgery. I have had some people say should i retire i say no i want to continue and work on making sure my leg is strong..... some doctors i believe do underestimate the pressure athletes are under when it comes to return to sport or when you get complications after return from sport from a reconstruction which is rare......

In a normal patient mode i believe the knee reconstruction is a good option for day to day life to stop dislocations, for an athlete it is down to the individual and the sport and if you can adapt within your sport to not damage the reconstruction........

I am proud of myself the weight i put on before the surgery due to not being able to exercise i have lost 11 stone in 9-10 months during the time of the knee surgery and returned to the sport in 4 months but now at post 10 months i have been suspended from the sport due to the knee being insufficient in contact sport, i suppose its swings and roundabouts but i hope i have proven some doctors wrong that you can return to sport post 4 months after mpfl surgery and it can change your life and that to have belief in a patient to achieve everything they can the human body is fascinating in many ways but anything is possible.......... i would say to every patient for an mpfl reconstruction it is better to try it that keep living in the dark with constant dislocations of the knee but also remember every patients recovery is different and unique.......................

I now wait with baited breath to see if these exercises work to help me return to the sport =)) it is my last hope or my 6 pairs of boots will gather dust ......


Offline lucha86

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Re: An athletes mpfl reconstruction diary
« Reply #329 on: March 09, 2015, 09:37:45 PM »
an update......
So with the physiotherapist she is pleased that my VMO IS hitting back and showing more stability and that my leg is looking more stable.....  im doing every exercise she has set me but i have had a few setbacks..........
she said i have very bad noise of crepitus in my knee and i said i feel like its rubbing and burning inside this she said i need to go back to my surgeon about that....
My knee has dislocated twice just by walking but have managed to pull it back into align, my physio had her concerns that it was doing it when i walked rather than in impact exercises,
so now im having to use specific banding to keep the knee cap aligned to try to see if more advance exercises will help it further out of any colour it is bright pink so you cant miss it lol
My knee is also still semi dislocating due to the hyperlaxity but i have to expect some of that.......
My physio has said if it sublaxes or dislocated i must rest it and not do anything with it and ice it to reduce the swelling for the first 48 hours............so its a case of twiddling my fingers and giving in and going back and forth lol if i dont laugh i would just cry lol















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