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Author Topic: getting ROM back and swelling down  (Read 1958 times)

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Offline troy89

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getting ROM back and swelling down
« on: August 01, 2014, 02:17:15 PM »
Hi all,

Well my knee problem seems quite insignificant compared to some but here goes! I had a knee arthroscopy two and a half weeks ago, first week I seemed to make good progress but it seems to have slowed down now. I'm just wondering if I'm making normal progress,

ROM - close to full extension but struggling to get more than  130 flexion. This seems to be due to the amount of swelling I still have. The swelling has gone down since the op but hasn't in the last week and a half, so I'm just wondering if I'm doing enough exercises or too much?

I'm basically doing the list of exercises the nurse gave me - leg raises, hamstring curls, hip abductions, heel slides, clf stretches, step ups, all twice per day. The nurse and my gp haven't given me any advice on when the swelling will go down or when I will regain full ROM.

Basically as I don't seem to be making much progress do you think I'm doing enough exercises or am I just being impatient with the swelling?!

Thanks all!

Offline Knuckleheadz

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Re: getting ROM back and swelling down
« Reply #1 on: August 01, 2014, 02:58:08 PM »
You don't mention what the knee arthroscopy was for... meniscus repair? ACL? Something else?

I'm not expert and can only go on my own experience (I had ACL with hamstring graft).....

I am 11 weeks post surgery and still have a small amount of swelling.... Things I would be doing:

Keep your leg up after your exercises
ICE!!! ICE!!! ICE!!! especially after exercises

It took me about 3-4 weeks to get full ROM and like you it was down to the swelling making my knee tight.

No-one can tell you when you will get full ROM and full extension... everyone is different.. you just have to be patient and let nature takes it course and keep doing your exercises... Although my physio did help with some massage from the knee up my thigh towards the lymph glands in the groin which can help to reduce the swelling.



Offline troy89

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Re: getting ROM back and swelling down
« Reply #2 on: August 01, 2014, 03:33:43 PM »
Thanks for your reply,

Sorry the arthroscopy was for trimming of medial and lateral menisci and removal of parameniscal cyst, don't see my surgeon until next week so I'm basing that assumption on that was the plan anyway!

Yes I should definitely use more icing, think I'm just being impatient maybe!


Thanks

Offline Vickster

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Re: getting ROM back and swelling down
« Reply #3 on: August 01, 2014, 03:37:48 PM »
That's quite a lot of trauma to the knee despite what the small incisions suggest.  RICE and patience.  It'll likely be a few months until you are back to where you were before the op. 

Regaining flexion is less important than extension at this point, so you are getting there. 130 isn't too far off normal and thus pretty good for 2.5 weeks post op
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline troy89

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Re: getting ROM back and swelling down
« Reply #4 on: August 02, 2014, 05:26:46 PM »
Thanks, like I say I think I'm just being impatient as I have very little pain so feel I should be pushing myself further, would anyone recommend to start cycling at this stage obviously with no resistance?

Also is it normal to have lumps under the incisions? I assume this is scar tissue and will disappear?

Offline Vickster

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Re: getting ROM back and swelling down
« Reply #5 on: August 02, 2014, 07:18:02 PM »
Once the incisions are healed, massage morning and night with bio oil. Cycling, get cleared by your physio, ditto any other new exercises, activities
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Clarkey

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Re: getting ROM back and swelling down
« Reply #6 on: August 03, 2014, 04:48:14 PM »
I can pre warn you in advance that you might always have slight inflammation around the portals that has never totally gone down after my 1st scope on my right knee that I had done in November 2009. I had medial plica excision and fat pad trimmed. My swelling was caused by excessive scar tissue that I am more prone to and fluid inside the knee.

I just had a 2nd scope and I am 16 days post op that was mainly done to remove the scar tissue inside my right knee that was restricting me from be able to run.

Religiously ice your knee on a regular basis and should also elevate your leg with a cushion or rolled up towel under the knee, this should help reduce the swelling.

Time scale varies for each individual my swelling took 18 months till I just had swelling around the portals with the type of surgery I had done after my 1st scope. Some patients take longer than other for their swelling to calm down and reduce back to normal size again.

Good luck with your recovery.

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RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline troy89

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Re: getting ROM back and swelling down
« Reply #7 on: August 04, 2014, 12:19:22 AM »
Thanks for your reply,

Good to hear other peoples experiences as I've found the nhs /my surgeon far from helpful in what to expect afterwards; 10 days back to work, four weeks back to light sporting activities - the first wasn't achievable and the latter doesn't seem to be! He made it out to be such a relatively insignificant procedure!


Offline Vickster

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Re: getting ROM back and swelling down
« Reply #8 on: August 04, 2014, 07:25:54 AM »
It's hard to predict how someone will react to the surgery and what they do after the op (in terms of RICE etc), so the surgeon gave you a ballpark (perhaps based on what the surgeon thought you were expecting.  Almost full ROM at 2.5 weeks as your initial post was quite good. 

I should think at 4 weeks most could do light gym work, static cycling with minimal resistance, swimming assuming the portals are healed.  I think after my second scope I was back on the static bike in 3 weeks :)

Have you seen a physio? Probably privately as I don't think it's standard on the NHS after arthroscopy unless there's an issue

We all recover at different rates, you need to be patient ;)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline troy89

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Re: getting ROM back and swelling down
« Reply #9 on: August 04, 2014, 11:42:33 AM »
Private physio definitely the next step for this week along with more RICE!

Has anyone used the KT tape? I've read one review about it being really helpful but I can't find much more on it. It's supposed to work by dilating the lymphatic vessels. Obviously a sports physio is the way forward but just wondered if this would be worthwhile between sessions.

Offline Vickster

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Re: getting ROM back and swelling down
« Reply #10 on: August 04, 2014, 11:48:46 AM »
Kinesio tape?  Really needs to be applied by someone who knows what they are doing, i.e. physio.  After a scope you could well have swelling for 3-6 months at least.  My knee has been puffy since injury, that's nearly 5 years ago and I've had no surgery for 4 years nearly.  Are you also taking anti inflammatories? Doing ankle pumps, heel slides to help the fluid?  Massaging the portals with bio oil if healed?
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline troy89

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Re: getting ROM back and swelling down
« Reply #11 on: August 04, 2014, 12:15:55 PM »
Yes kinesio tape, I'll ask my physio about it.

Thanks for your help, I guess I just wanted to know if it's normal for the swelling to remain and as it seems to be I'll just find the best ways to manage it :)

Offline Vickster

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Re: getting ROM back and swelling down
« Reply #12 on: August 04, 2014, 12:26:15 PM »
See if the physio can do lymphatic drainage massage. Ultrasound can help or acupuncture. But only 3 weeks out I wouldn't worry, think what your knee has been through. Also did you still have swelling from the injury? That won't go immediately either
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Clarkey

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Re: getting ROM back and swelling down
« Reply #13 on: August 04, 2014, 12:44:52 PM »
If you are able to afford to see a private physio my advice is to see a sports physio rather than standard physio as NHS physios seem to only give you some exercises to do back home, gym or at the swimming pool.

I am not too happy with my present NHS physio that not had much experience and think I will go back to see my private sports physio who more realistic and knowledgeable about getting back to a competitive level in sports. I trust him 100% that does a proper assessment giving me sound advice as well as massaging the knee and muscle and breaking down the scar tissue by doing friction massage therapy around the portals.

I have seen a number of NHS physios over the years that are not as contentious as private physios, you will be getting what your monies worth going private.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline troy89

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Re: getting ROM back and swelling down
« Reply #14 on: August 04, 2014, 06:37:07 PM »
Thanks nick that's definitely good advice!

I had little swelling before to be honest as the injury was 7 months ago and I stopped playing sports after it, just a small amount over the lateral side where I had a parameniscal cyst.

Hopefully as you say massaging from a physio will help :)















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