MCL tear and PT

[Pax]

Started PT on my right knee yesterday for the new MCL tear (it's the knee I've had five surgeries on already), the PT was excellent! He disabused me of the notion that I was NOT having a knee replacement in the future, he calmly pointed out that that assumption might be unreasonable given the degradation of the joint to date. In the past when I told the ortho doc I didn't want the surgery I'd get a shrug and "okay", nice to hear something a bit more definite based on the evidence.

We're working on strengthening the leg so that the time I've got before the surgery can be active time. He's a big fan of staying active so he wants me on an exercise bike (with no resistance for now) building up to 30 minutes, then we'll add resistance. And I got the okay to get back into the pool (gently).

I am sore today!

[OakLeaf]

Good luck, Pax.

FWIW, when my mom had both knees done a few years ago, her ortho told her that it's better to have the TKA before you're completely immobilized. What he said is that people wait until they've become way deconditioned, which makes the rehab much harder and much less effective.

The surgery was hard on her, but she made a fast return and never regretted it for a minute.

[Pax]

Same thing this new PT said, "hit it from a position of strength, don't wait until you're housebound and weak".

[Trek420]

Same thing this new PT said, "hit it from a position of strength, don't wait until you're housebound and weak".

Same thing that knott says.They see patients who are really active, but have some pain and decide to just have it replaced. Others wait too long to have the surgery. Let it go too far and you can't do the pre and post surgery pt. I've got coworkers who had TKA but won't do the training or make the life style choices to keep active. It's not a magic bullet, you gotta do the work. You'll do fine.

What's his opinion on orthotics?

http://forums.teamestrogen.com/archive/index.php/t-20374.html

[Helene2013]

Sorry you have to go through another surgery.

I remember prior to my ACL surgery (about 10 years ago) I was very active, but I kept a custom brace on for safety. I still then competed with my dogs in agility, still in-line skated, etc. Post-op was easier, but still painful. I remember how PT would "hurt" me and telling me it was normal as she needed to work on that post-op to avoid a stiff knee. But I was back on track within a few months. PT had said then, no matter who you are, an ACL reconstruction takes 6 months to heal and to take you back to where you were, or better. Whether you are just me or an athlete. Healing (inside) takes the same time. It's also how you see things before, during and after.

My knees will trouble me forever and I've learned to deal with this. I'm still in PT (was there last Tuesday), no more crutches, can walk on that leg but leg needs reinforcement in order for knee to perform better and safer. So now I have about 45 minutes per day of PT to do. And in no time, I will be back to harder training. For now, I just enjoy the little I'm allowed to do. In my case, I try to hard to avoid another surgery. Surgeon, then, had said this is the type of surgery you can't have too many times. So I am extremely careful.

Good luck and have fun working out until then!

[Pax]

Same thing that knott says.They see patients who are really active, but have some pain and decide to just have it replaced. Others wait too long to have the surgery. Let it go too far and you can't do the pre and post surgery pt. I've got coworkers who had TKA but won't do the training or make the life style choices to keep active. It's not a magic bullet, you gotta do the work. You'll do fine.

What's his opinion on orthotics?

http://forums.teamestrogen.com/archive/index.php/t-20374.html

After he tested the leg for strength he stopped and just put me on a basic strength program, the leg is so weak it can't support my weight independently anymore. In two weeks (after I do all my exercises) he's going to reevaluate to see what's next.

One interesting thing... found out my left leg is .5 inches shorter than my right.

[Pax]

Wow, the exercises are so simple, leg raises with the quad isolated, side leg raises, quad sets, and hamstring stretches... and they kick my butt. I had no idea how weak my leg had become; explains why my left leg has been hurting so much, it's been doing a lot of extra work.

[Catrin]

Wow, the exercises are so simple, leg raises with the quad isolated, side leg raises, quad sets, and hamstring stretches... and they kick my butt. I had no idea how weak my leg had become; explains why my left leg has been hurting so much, it's been doing a lot of extra work.

Hang in there Pax, and am sorry to read that there is another surgery in your future. Hopefully it will be the last one! It does sound like your working with a good PT.

[Pax]

Thanks, Catrin. It's a process, but it sure is slower going than I'd like. I seem to recall this being much easier/faster when I was 25. :D

[Pax]

Had my follow up appointment, managed to straighten my leg to within three degrees of straight (from 12 degrees previously) and I'm a lot stronger!

He added in ankle weights and modified squats (body weight only, up and down from a chair).

[Helene2013]

That is good news.

[OakLeaf]

Yay! Hope it's not too painful.

[Catrin]

Very good news!

[Pax]

Oak - it hurt a lot at first, now it's just exercise. The only thing that still hurts a bit are the ones where I try to bend my knee a little further, there are structural changes in the joint that make that endeavor kinda miserable.

[Helene2013]

See Pax, because I have little cartilage left in knees and squatting the normal/safe way is causing too much pain, my PT told me to do them the way it does not hurt which is bending more forward. That way I can squat down almost to do a perfect chair. It still works my quads, etc. There is always a work around to help you.

[Pax]

Helene - Yup, it's so exciting to be able to do squats again.

[lph]

I don't have anything useful to add, but I wanted to say that this makes me smile every time I see it on my post list ("it's so exciting to be able to do squats again "). I know just how you feel! And I don't even do squats! :-D

[Pax]

Thanks, lph!

At my last appointment I think my PT caught on to the fact he'll have to be careful what he suggests since I tend to then go 100% full on. :p An athlete can get old and overweight, but at heart we're still those young fit athletes of yesterday.

[Catrin]

Pax I am glad things are easier! I've a problem squatting as well, and I am carefully avoiding having it looked at since it is an intermittent problem
Have fun squatting!

[Sky King]

I learned that if I am going to do any type of squat (I don't do many) I have to stick my butt way way back - I suppose that is the same process as bending forward at the waist before squatting. Same with side lunges - I focus on where my behind is and then bend the knee. Yes, nothing worse for a bike riding female than not being able to squat (IMO) Makes it tough out on those lonely roads

[OakLeaf]

Yeah, I can't squat properly either.

Yet.

I'm determined to keep working on my body, whether I get there or not I'll keep working. I've got major mobility issues in both ankle dorsiflexion and lumbar extension, but the more I both learn and work, it seems that both are really traceable to the feet, and particularly the big toe. Little by little ...

[Catrin]

Let's all keep working at it :-) I try to balance out what to ignore and what should get medical attention. I do have a cranky knee, and I've got to be careful with lunges, but I keep at it. I don't lunge so deep that it hurts - which means it isn't near as deep as it once was...but that is life. Sky King, are you bending forward or doing a hip hinge instead? Different ways to get there, but stick with what works!

[Pax]

The MCL is really feeling better and I'm getting stronger... but there is a deep knee pain that won't go away, I'm starting to think I may have torn the medial meniscus as well. *sigh* Oh well, that will heal or not, I'll just keep on working and see how it goes.

[Pax]

Okay, something is definitely wrong, my knee feels like its full of broken glass, straightening it is torture, and putting weight on it is getting more painful by the day. Guess I better call the docs office tomorrow.

[Helene2013]

ouch. boy do I feel for you right now. Make sure you are not getting a baker's cyst either. It could happen too from such injury. You don't want to add to your tear. no way.

[Pax]

ouch. boy do I feel for you right now. Make sure you are not getting a baker's cyst either. It could happen too from such injury. You don't want to add to your tear. no way.

Already have a lovely HUGE Bakers cyst. I won't be surprised if they try to convince me it's time for a replacement.

[Helene2013]

wow. You are in trouble heuh! Hopefully something can get done before things get worst. Sending good vibes your way. +++++++++

[Pax]

Thanks, Helene. You too!

[Catrin]

Okay, something is definitely wrong, my knee feels like its full of broken glass, straightening it is torture, and putting weight on it is getting more painful by the day. Guess I better call the docs office tomorrow.

Oh my, hang in there!

[OakLeaf]

Oh Pax, so sorry you're having so much trouble. Healing thoughts headed your way!

[Pax]

Got the appointment set with the ortho doc for 12/9, I'm going to ask for an MRI, it's time to see what is actually going on inside the knee.

[Helene2013]

More than time! Let us know how it turns out.

[Pax]

More than time! Let us know how it turns out.

Will do.

This thread was huge help in figuring out when the pain changed, good info to give the doc.

[Catrin]

Sending good wishes your way!

[Pax]

Really appreciate all the good thoughts; this thing is knocking the wind out of my sails a bit. Getting very tired of the pain after two months.

[Crankin]

Good luck, Pax. You'll be ready for the spring.

[Pax]

The broken glass feeling is fading since I stopped doing squats. There's still pain and some limping, but the awful super sharp pain has passed, thankfully!!

[Catrin]

So glad you found something to mitigate the pain for now. When is your MRI?

[Pax]

So glad you found something to mitigate the pain for now. When is your MRI?

Doc appointment is next Tuesday, IF he'll order the MRI it's probably a week to ten days past that to get on the schedule.

[Helene2013]

Wow. That long to get an appointment?

But I can understand. Here if we go public, it can easily take a year to get it through hospital. But if you go private, you can get it within a few days, or even same day (like I did my leg ultrasound and knee xray last Thursday). Xrays are free but the ultrasound was $160. Luckily I have insurance that covers this. An MRI for knee is about $800. Not cheap.

[Pax]

Here a lot of people have copayment issues and they need to have things done before the end of the year for others they need to wait until the first of the year... makes December and January a really difficult time to get an appointment.

[Blueberry]

For an ortho in my area, that's a pretty good appointment time. My local hospital runs off site MRI's - so when I needed one last summer, I was able to schedule within the week. Getting back in to see the doc to get the results, on the other hand....

[Crankin]

Wow, I've never had any trouble scheduling an MRI, either at the hospital or an outside place. I guess that's one advantage of living in the medical capital of the world. Too much choice. And, I don't even go into Boston for my care, like some of my snooty friends. Sure, if I need a second opinion, which has only happened once.

[Pax]

Wow, I've never had any trouble scheduling an MRI, either at the hospital or an outside place. I guess that's one advantage of living in the medical capital of the world. Too much choice. And, I don't even go into Boston for my care, like some of my snooty friends. Sure, if I need a second opinion, which has only happened once.

I'm looking forward to that in FL. Living here in the middle of nowhere, we have great care, but they haven't expanded enough to accommodate the huge aging boomer population.

[Helene2013]

My friend needs to see an orthopedist for a thigh issue. Doctor gave her a reference paper (required to see specialist) and she called and there is a 2 year waiting list...when they take new patients. On the other hand, if you go private, you cough out the $ and you can see one rapidly. Or if you truly have good connections (like I do) I can see one quickly, if needed. But you need to be ready for him (he's not wasting anytime) - have all tests, etc on hand. We have excellent hospital system here, but the problem is not enough generalists, even less specialists.

[OakLeaf]

I'm looking forward to that in FL.

Choose carefully, though. (And also be aware of the irony in my saying that, since with all my third-party exposure to local practices, I have a history of choosing terrible care for myself ...) Health care in Florida generally has a very bad reputation. I know more than one person who flies back North when they need health care. It's not just the availability of family caretakers, it's also the quality of the practitioners, that causes a lot of people who retire to Florida, to move back "home" when their health declines.

Good luck at the ortho's.

[bmccasland]

I had an ACL repair to my left knee a couple of years ago, and a couple of years after my bike wreck. The MRI was done shortly after the wreck, but the surgeon in New Orleans said I could walk with it (which I could), and we could postpone surgery. Then I moved here to the PNW, had trouble on non-flat ground, saw a sports medicine surgeon.... who looked at the MRI and wondered what took me so long to have surgery?

So Pax, how's your opposite hip? I found that walking around on a bum knee threw my gait off enough that now I have trouble with my right hip.

I would say, get the MRI, and surgery. Don't wait. And do ALLL the exercises your PT gives you.

[Pax]

My other hip has hurt for a while. After five surgeries on my right knee since 1974, my poor left knee and hip have borne the brunt of my weight. Coupled with that it turns out my left leg is a half inch shorter than my right so my gait has been a mess for a long time.

See the otho doc tomorrow morning, I've decided if he suggests the total knee replacement, I'll listen and give it some thought. I mean how many surgeries can they do on one knee before it becomes and exercise in futility?

[Helene2013]

It's true what you say Pax....about hips hurting. I too now have my left hip more sensitive because of the weight bearing on that side when my right knee was injured. PT is working on it but it is normal when you compensate a lot. PT said it was misaligned some. Oh well.... the love of aging. haha

Good luck tomorrow.

[Pax]

Got good news (sort of, but I'm happy) from the orthopedic doc this morning. My knee is still good enough to NOT need a joint replacement yet!! The most recent injury is going to be treated by either arthroscopic surgery or shots, depending on the amount of damage showing in the MRI next week.

It still means a possible sixth surgery on that knee, but not the horrifically painful total knee!!!

[rocknrollgirl]

That is great news. keep us posted on your progress.

[Crankin]

Great news, Pax.

[OakLeaf]

Yay! Good luck with the MRI.