MPFL repair,lateral release, Patella alignment 284 days ago

General questions about exercises, stretching, gaining range of motion, handling pain and swelling.Also braces, mobility aids, sleeping aids, shoes.
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CustomPaint89
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MPFL repair,lateral release, Patella alignment 284 days ago

Post by CustomPaint89 »

How long until i can walk at a normal speed like a regular person? How much PT is Too much? My doctor told me let pain be your guide. How long until i can lift weights like a normal person? Should i get a PRP done? Is it normal for me to be walking like a snail? I can walk 1.9 mph on a treadmill maybe 2.0 mph max comfortably

I had a MPFL repair, lateral release and patella alignment done 284 days ago. I also have some arthritis. I am a Veteran, I had my surgery done through the VA. I am 34 years old but my farther who is almost 70 can walk faster than me. I can bend and straighten my knee i think normally, that took 8 months.

I used to do endurance sports so normal for me is alot more than the average person

I do Physical Therapy 5 days a week 2 days lifting weights in the gym., 5 days of cardio 1 hour and half of walking on a treadmill and 1 hour and half of exercise bike I weigh 133 pounds. 5ft 6inches tall.
How much PT is too much? This is what i do.

Twice a week I do squats with no weight 120 reps, leg press free weight 120 reps light weight, leg extension 100 reps low weight, leg curls 100 reps low weight, thigh squeezers 100 reps low weight, outer thigh machine 100 reps low weight, calf raises 120 reps body weight. That takes about an hour, then i do a walk on the treadmill for 1 hour and 15minutes at a comfortable pace like a snail , then i do the stair climber for 15 minutes then i ride the exercise bike for hour and some change like a snail. So I do lots of PT probably too much. I don't need anyone to push me i push myself.

I do the walking and biking the same day so i do 3 hours of cardio 5 days a week. But im like a snail

Thanks opinions welcome
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Re: MPFL repair,lateral release, Patella alignment 284 days ago

Post by The_KNEEguru »

Hi @CustomPaint89
I see this is your first post. Clearly you had some incident before this surgery, possibly a patellar dislocation event/or events? If you are able to edit your 'Signature' in your 'Profile' here, you will be able to give dates/events/procedures so that others reading your post will understand the background to your issue.

It seems to me that you are determined to get back to 100%, but the sad story of patellar instability and maltracking/malalignment issues is that there are often underlying structural issues/ then maybe a big event of trauma to the patellar region/ then maybe more than one attempt at repair / sometimes even surgery to try and improve previous surgery - you mention there are arthritic changes already. Perhaps any traumatic event damaged to articular cartilage? It is all a lot for the knee to absorb, and my reading of the stories on this forum suggests very few get back to their original status.
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Re: MPFL repair,lateral release, Patella alignment 284 days ago

Post by CustomPaint89 »

Thanks for the reply i greatly appreciate your opinion.

I was an avid bicycle rider and i used to do long bicycle rides, lasting 4 hours in duration 3 times a week. Then i would do jogs 2 times a week. And i did this for years.
I started to get inflammation in my knee after rides and after runs. So went to see an orthopedic and i got a cortisone shot in my right knee. After i got the shot i went out for one of my normal long rides and And i partially tore my MPFL and some cartliage. You may no believe this but i believe the cortisone shot caused me to tear my MPFL. It can weaken tendons and ligaments so thats what happen to me. I went for ride then came back and my knee locked up and swelled. I went to the ER at the VA a few times for swelling. Months would go by before i finally got a MRI of my knee finding the partial tear and then i went through community care for surgery. No great trauma it just tore while i was riding my bike, I barely even felt it happen.

So here i am coming up on my first year 285 days after surgery trying to get some answers. You say most do not come back to how they were. Thats a bummer for me to hear. But i still have hope in my heart that maybe i will come back to at least 50%. Meaning being able to do 50% of what i used to do or at least walk normally.

I am doing all i can eating healthy, drinking plenty of water, working out and getting plenty of rest and praying.
I don't know how damaged the knee was. But i had open knee surgery It was the most painful thing i have ever experienced after the pain blocker wore off. The time lines of recovery on the internet that i read were not my reality. It took me much longer to walk then said. And supposibly you can run in 6 months yeah right. I still can't run and even if i could i would not want to stress the knee out yet. Anyway thanks again for your reply
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Re: MPFL repair,lateral release, Patella alignment 284 days ago

Post by The_KNEEguru »

That is helpful for us to understand your story.

It is indeed strange that your MPFL tore in the absence of a patellar dislocation, so I did a brief scan of the available online literature. This paper - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811746/ - "Local controlled release of corticosteroids extends surgically induced joint instability by inhibiting tissue healing" - hints that your premise might be right about the steroid being a trigger but the paper is not easy to read...

However, you might have some underlying predisposition to stress on the MPFL, such as patella alta (high-riding patella) - /KNEEnotes/knee-dictionary/patella-alta - or trochlear dysplasia (where the groove under the patella is shallow at the upper end) - /KNEEnotes/knee-dictionary/trochlear-dysplasia.
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Re: MPFL repair,lateral release, Patella alignment 284 days ago

Post by CustomPaint89 »

Thanks for your reply
My patella may have dislocated then went back in place. One doctor thought so at least. I saw a total of 3 doctors before i got my surgery. Va doctors then community care doctors. But i am not sure if that actually happened or not
My current doctor did not diagnose any conditions that may have contributed to my injury. As far i know i have a normal knee. But i would have to ask him. I see them tomorrow.
My knee is stable now tight at times but stable. He tightened up my mpfl and then loosened the other side with the lateral release. That is as far i understand. I don't get alot of pain or swelling anymore. I would say the knee is functional for regular task like getting around, going to the store, taking a shower etc... But i don't have my regular speed everything is snail speed. It could be worse so i thank god for that but i am not how i used to be not even close.
In my case would you do a PRP? What are the potential issues with trying a PRP?
I am hopeing that a PRP would give me a boost in healing. Get me back to be more normal. I wouldn't do it otherwise or if the risk are too great.
I am still praying for a healing as well.
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Re: MPFL repair,lateral release, Patella alignment 284 days ago

Post by The_KNEEguru »

From this paper https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445108/ one reads that "despite the widespread use of PRP in muscle strains, tendinopathy, and ligament injuries, and as surgical adjuncts to rotator cuff repair, ACL reconstruction, and meniscal and labral repairs, research on its clinical efficacy is still in its infancy.....Although there appears to be sufficient data to warrant continued clinical study of PRP as an adjuvant to healing, its clinical role is not yet defined."

I doubt that it would do any harm, though, in your case.
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Re: MPFL repair,lateral release, Patella alignment 284 days ago

Post by CustomPaint89 »

Is it normal for me to have fatigue still in that leg? When i ride the exercise bike the leg i had surgery on gets tired easily after about 45minutes and fatigue persist for almost 20- 30 minutes after i get off the bike. I ride for 90 minutes but i split it up 45 and 45 or 60 and 30. It seems strange to me that the entire leg would fatigue meaning my quads and calfs get fatigue, i can feel the lactic acid building up in the leg like a burn. I used to do 4 hour rides so that worries me a bit. Hoping by summer i can do rides outside. That is my sport biking witch i should be able to do I would think even if i had several surgery's. I can leg press almost 200lbs and i only weigh 135lbs, i can leg press 180lbs-170lbs 20-25 times for several sets. So my leg muscles don't seem to be weak. I can leg curl and leg extension well too. I don't lift heavy on purpose too protect the knee. I would have even bigger and stronger legs by now if i could lift heavy. I started lifting after i got hurt so its still new to me. Can't wait till i can squat with weight. And lunge and maybe do do dead lift. anyway i see my doctor today
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Re: MPFL repair,lateral release, Patella alignment 284 days ago

Post by CustomPaint89 »

I saw my doctor today and he assured me that it would be a year and half before i would see a full recovery. My right knee quad is still a bit weak even though it has grown a bit. So there is hope that more time will heal me back to normal. Wow thank god
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Re: MPFL repair,lateral release, Patella alignment 284 days ago

Post by CustomPaint89 »

My doctor suggested that i train in the gym 3 times a week. Is this too much? As i explained i have been training 2 times a week in the gym. My workout targets every muscle in leg. Don't know if i can do my routine 3 times a week. I also do the cardio 5 days a week for an extensive amount time.
My concern is the squats and leg press I do 240 reps between them both that would be 480 reps combined per week. so i would step that up to 720 reps per week seems like alot to me i would have to back down the reps i think to train a third day. Don't know if hitting the gym a 3rd day would yeild a strength gain or land me an injury. Guess i have to experiment witch for me is scary.

How strong is the graft? How much can the graft take vs a regular MPFL? Any physical therapist on here that maybe can give me a few pointers. I have been training by myself insurance won't cover anymore PT plus the PT never seemed to challenge me enough. I was a endurance athlete so doing high reps helps me fatigue. While lower reps won't fatigue me enough.
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Re: MPFL repair,lateral release, Patella alignment 284 days ago

Post by annamivivan »

Today, my doctor reassured me that it would take about a year and a half for a complete recovery. Although my right knee quad is still somewhat weak despite showing some improvement, there's hope that with more time, I'll fully heal back to normal. I'm grateful for this progress.
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Re: MPFL repair,lateral release, Patella alignment 284 days ago

Post by CustomPaint89 »

CustomPaint89 wrote: Sun Feb 18, 2024 4:22 pm How long until i can walk at a normal speed like a regular person? How much PT is Too much? My doctor told me let pain be your guide. How long until i can lift weights like a normal person? Should i get a PRP done? Is it normal for me to be walking like a snail? I can walk 1.9 mph on a treadmill maybe 2.0 mph max comfortably

I had a MPFL repair, lateral release and patella alignment done 284 days ago. I also have some arthritis. I am a Veteran, I had my surgery done through the VA. I am 34 years old but my farther who is almost 70 can walk faster than me. I can bend and straighten my knee i think normally, that took 8 months.

I used to do endurance sports so normal for me is alot more than the average person

I do Physical Therapy 5 days a week 2 days lifting weights in the gym., 5 days of cardio 1 hour and half of walking on a treadmill and 1 hour and half of exercise bike I weigh 133 pounds. 5ft 6inches tall.
How much PT is too much? This is what i do.

Twice a week I do squats with no weight 120 reps, leg press free weight 120 reps light weight, leg extension 100 reps low weight, leg curls 100 reps low weight, thigh squeezers 100 reps low weight, outer thigh machine 100 reps low weight, calf raises 120 reps body weight. That takes about an hour, then i do a walk on the treadmill for 1 hour and 15minutes at a comfortable pace like a snail , then i do the stair climber for 15 minutes then i ride the exercise bike for hour and some change like a snail. So I do lots of PT probably too much. I don't need anyone to push me i push myself.

I do the walking and biking the same day so i do 3 hours of cardio 5 days a week. But im like a snail

Thanks opinions welcome
Recently had an issue and had to lower the exercise bike duration down to 1 hr. I added in weight lifting 1 more time a week so now im going to lift 3 times a week again light weight lots of repetition
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