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Author Topic: Quad feels tight constantly months after surgery  (Read 876 times)

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Offline Mvparetti

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Quad feels tight constantly months after surgery
« on: February 07, 2019, 05:13:37 PM »
First time posting, I had arthroscopic surgery in sept/2018 after a knee injury at work. The surgeon did the following: interval partial lateral meniscectomy, synovectomy, lateral release, debridement of Hoffa's fat pad and had to clean up tons of damaged cartilage under my patella that was damaged from dislocation. I was on crutches for 5 weeks after surgery due to quad weakness. I was unable to hold weight on my right leg and once I could I walked slow due to my knee buckling backwards if I walked to fast. I was in PT the entire time and slowly my leg woke up. Since day one I complained that my quad felt tight and was always told thatís normal it just needs to strengthen. Every Doctor visit I complained.... we tried injections at the portal sights to break up scar tissue with no relief. I can not walk for any real length of time without my quad feeing like it is going to explode and having occasional cramps down the medial side of my patella. Hereís the wierd part, if I squeeze my thigh about 3 inches above my quad if releases the tightness I feel. I showed this my doctor at my last visit and he looked at me like I have 7 heads. Every professional Iíve talked to seems confused as to what could be causing this feeing. I feel like someone is holding a tournaqette over my quad and the top of my patella. It is very painful and feels like my skin is going to explode or rip open, but it doesnít look visibly swollen. Iím getting discouraged and can not have this be my life. Iím an RN and unable to work due to this pain and restrictions.  And itís only tight when Iím using the muscle (activates is what I like to say)....when Iím laying in bed or sitting I donít feel it.

I had another MRI on Monday that showed only this:

1. Findings compatible with lateral meniscectomy. No definite evidence of recurrent lateral meniscal tear identified.
2. Small joint effusion.
3. Chondromalacia patellar cartilage with chondral fissuring medial and lateral patellar facets.
4. Hoffa's fat pad edema can be seen with patellofemoral impingement.
5. Lateral patellar tilt.

Has anyone else ever experienced anything similar to this???  I feel like Iím crazy.

« Last Edit: February 07, 2019, 05:18:01 PM by Mvparetti »

Offline PwordsB

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Re: Quad feels tight constantly months after surgery
« Reply #1 on: February 08, 2019, 11:55:21 AM »
I've had very different knee surgery to you, but since my last operation in August, I have had quad issues.  My surgery involved a fairly large open wound, so I have a large scar down the medial side of the thigh, ending at the knee joint.  My quad issues don't quite match yours, but they're not far off.  It feels like extreme muscle cramp when I'm doing certain motions, and if I carry on, it does start to feel like my leg is going to fly off sometimes.  Now, I do have a titanium plate underneath the muscle in question, which could potentially be causing some of this discomfort, but that's unlikely.  So I started seeing a well qualified sports therapist (someone who has studied for years and genuinely understands the body, not someone who's done a three week cause in how to act like you're a therapist).  He immediately thought that the scar tissue could be causing it.  He applied pressure to the scar in various places and we tested what difference it made. 

For example, I lay down face up on the bed and lifted my leg up (straight at the knee) against his hand for resistance.  When we turned my toes outwards (meaning that raising the leg applied more emphasis to the vastus medialis, which is where my pain is), I could barely lift the leg against his hand and the pain was massive.  Then he applied pressure to the scar and we tried again.  Immediately, I had more strength and less pain.  After a minute of prodding, I still had that improved function even after the pressure wasn't being applied.  Since then, I've been doing my own little massage of the scar for a few minutes a day.

The fact that you've said you've felt similar relief to what my therapist and I found is a good thing.  It means that, if you're lucky, it really is just the scar causing this for you.  It can be the physical presence of the scar limiting space and movement within the knee/leg, but also the neurological connection being disrupted by the scar, which my therapist said can kinda feel like a foreign object to the brain, meaning it stops trying to move the tissue around it.

So, before worrying that it's not going to improve, give that a go.  It's slow progress for me, but quite clear that it is slowly improving since I saw the therapist.

I hope that helps.  Good luck.
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18