Medial or lateral menisectomy, how much was removed?
What’s the state of the knee generally, is he knock or bow legged?
Has he seen a podiatrist? Had his gait assessed?
Menisectomy could have impacted the biomechanics, perhaps custom insoles could help if there’s an imbalance?
What sport, activity does he do? Does he do anything that strengthens and stretches, especially back and core like Pilates? What else does he do to keep his back, SI, pelvis flexible?
Does sport massage help? How is the flexibility and strength in his glutes, hamstrings and muscle balance versus quads?
How old is he? What job does he do? Back issues often go hand in hand with a sedentary job, poor posture.
Any other health issues? Has his spine and pelvis been scanned?
It maybe there’s a spinal issue, and it’s a coincidence it started following the knee op.
Maybe a fresh pair of eyes from a highly experienced physio or even a chiropractor if you can get a recommendation (their level of training varies between countries too) might be worthwhile
Good luck
Hi Vickster, love your questions.. they've made us think. Apologies for the delayed response, and sorry about the format, I struggled to add a table.
Medial or lateral meniscectomy Medial meniscectomy on the Right knee
How much was removed? 70% - April 2019
What’s the state of the knee generally, is he knock or bow legged? Pretty normal, not bowed or knocked
Has he seen a podiatrist? Not yet. Visited 2 x chiros, 2 x physios and a musculoskeletal specialist
Had his gait assessed? No, but this sounds like something we need to have done
What sport, activity does he do? Kickboxing – often 6 years ago, sporadically 3 years ago and stopped completely 2 years ago
Mountain biking – sporadically in the last year
Gym – 5 days a week, but only sporadically in the last 2 years due to lockdowns, we're still in lockdown now
Does he do anything that strengthens and stretches, especially back and core like Pilates? What else does he do to keep his back, SI, pelvis flexible? To be honest he was focusing on cardio and very little on strength, in hindsight this wasn't very smart of us as it seems like after the operation he never regained proper strength in his lower body
I've been encouraging him to try Pilates, but he hasn't yet
He tried cycling at the gym and did several physio recommended exercises, stretches and light weight-training on some of the machines for several weeks in a row, but without real progress. These focused on core and legs
For the last 2 weeks he's put effort into a new workout incorporating gluteus med/min and core strengthening. It's home based without equipment since we're in lockdown, but hopefully we can expand on that once we're out
Does sport massage help? For a little while it seems to yes, but it's short lived. Have tried acupuncture as well
How is the flexibility and strength in his glutes, hamstrings and muscle balance versus quads? Hamstrings and back have always been quite stiff, glutes and quads got pretty weak in the last 2 years. He's not very flexible at all now either
How old is he? What job does he do? 45 – In IT, so he's sitting 8 – 10 hours a day
He does try to take frequent short walks, but it doesn't always work out that way
Any other health issues? Very mild Psoriatic Arthritis. A few fingers and toes are impacted. Xrays and MRI of his back came back clean for signs arthritis
Has his spine and pelvis been scanned? Spine yes and found mild deterioration in L4 and L5
Current status The knee seems fine, although he's not really putting it through its paces at the moment so it's hard to tell if there's significant weakness around it
His lower back feels weak and stiff, seems to have pain daily for around 2 years. Might be worth mentioning that on some days (when his back feels better) he experiences coccyx pain after getting up from a chair. Like the two issues are alternating
In the last 4 weeks or so there's a shocking pain in his lower back and pelvis when performing some movements with 1 leg in the air as mentioned, and at times a radiating pain in the quad of his right leg. He's also mentioned stiffness and soreness near his hip bone, like at the site of his gluteus medius
It's sounding more and more like a glute/pelvic issue the longer we research, we're currently looking into Piriformis Syndrome, Trendelenberg Gait etc..
We'll have a Muscle Balance Assessment done at a new physio in the next couple of weeks and based on your questions we found a "Gait Doctor" which he will go see as well. And then hopefully as soon as lockdown ends (which should be in Dec/Jan) he can start on something like Reformer Pilates depending on the outcome of the two appointments
I hope we're on the right track this time around
Feeling positive, I hate seeing him in pain.
