Return to normal walking?

[Catrin]

I'm just curious how long it has taken those of you who have had a scope and lateral release to return to normal walking?

It's been 3+ months now, flexion and extension is all good, pain is basically gone, but I just CANNOT walk normally or at my old fast pace. I tried this morning and felt like Frankenstein with one leg wanting to go faster and the other knee having obviously reached the limit. No pain, just a mechanical thing.

Hopefully I just need more patience, but it would be helpful to learn if others have gone through this, thanks!

[Pax]

I know I had a different procedure, but like you my flexion and extension are in the range to allow for a normal gait... but it just won't do it! My knee feels like it's wants to do what it's supposed to do, but I just can't get right and left into synch.

[Catrin]

Oddly enough, my flexion and extension are much better than before the surgery. I honestly don't know if I should just be thankful, but then when I'm out walking around downtown it's hard to ignore how differently I walk compared to those around me.

[Pax]

Oddly enough, my flexion and extension are much better than before the surgery. I honestly don't know if I should just be thankful, but then when I'm out walking around downtown it's hard to ignore how differently I walk compared to those around me.

It may be that it feels weirder to you than it looks to others. I was lamenting my "spastic" walk to my honey recently, she said "it must feel weird to you, but to an observer you just have a slight limp".

[emily_in_nc]

Totally different surgery, but when I had my pelvis put together again and had to relearn a normal gait, it took a loooooong time. Gradual improvement probably over a year. And even once I walked normally or felt like I did, it still felt a little strange from time to time. It takes a long time to get to the point where you just walk and everything is back in sync and even longer to get to the point where it becomes so automatic and normal that you don't even think about your surgery or the fact that your two sides are "different".

[Catrin]

That's good to hear Pax and Emily. I've had friends tell me that from the outside it looks as if the opposite sides of my body aren't in sync - apparently it doesn't look like limping. They say it doesn't scream attention to itself, unless someone is watching me in particular. This morning I tried to walk closer to my normal speed to the office and it was SO strange, it really felt like that knee had a mechanical barrier - but that doesn't mean it DOES. Very frustrating, and yes, I am a little afraid that this is my "new normal". Sigh, I need to try and put it out of my mind - but it is so hard to do that since I am literally incapable of walking at my old (fast) pace. I feel like I've had to give up so many of my old activities and I was hoping that I could at least be walking normally by know and use that for exercise. Kettlebells are great, but it is good to have more than a single fitness activity. I can hike, but very slowly as WR can attest to :-)

Thanks for listening to me vent, and the information is very helpful. Back to trying to be positive about all of this. The pain is MUCH better than prior to the surgery so that is a thing to be positive about :cool:

[ny biker]

What does your doctor say?

When I had ankle tendon surgery many years ago, the recovery was very slow and gradual, with stiffness and pain lingering for months. Most of my "friends" thought I was faking it, but my doctor and others at his office assured me that everything was normal. About a year after the surgery, I realized that I hadn't felt any felt any pain during everyday activities in a while. But I still needed to be wear shoes with really good arch support for years after that to avoid pain when I was doing lots of walking.

Somewhat similarly, I know someone who just had shoulder surgery, and she expects full recovery to take a long time. I don't recall exactly what she told me, but it was at least 6 months, possibly more.

In a way this can be overwhelming, because it's hard to be patient while things heal. But it's also reason to be hopeful, because you haven't necessarily reached the point where it won't get better anymore.

[Catrin]

Good point NY Biker, I saw my Ortho a couple weeks ago and he didn't seem all that interested in hearing about it. Maybe because there is little that can be done right now outside of time. I've another appointment with him in 2 weeks and I suspect he will release me at that time. Workman's Comp doesn't care so much about athletic performance...

Sorry about your ankle surgery, I had major ankle/foot surgery in 2004 and it took close to 3 years before I could walk without thinking about it...I guess I AM expecting a bit too much to be recovered after only 3 months and one week :o

[emily_in_nc]

Sorry about your ankle surgery, I had major ankle/foot surgery in 2004 and it took close to 3 years before I could walk without thinking about it...I guess I AM expecting a bit too much to be recovered after only 3 months and one week :o

Definitely. And since you mention that you haven't even been released from your ortho yet as well. When I was 3 months out from my surgery I had just stopped using crutches and had a big limp. I continued going to PT for strengthening and gait work for awhile after that, and then the rest of it, I was on my own. You certainly need to give it more time and stay positive!

[Catrin]

He wanted to release me a month ago but I keep complaining about my gait :-) I've been on my own for PT for 6 weeks now. I'm starting to wonder if I am going to need to get extra PT for my gait, but it doesn't fit into my budget I'm afraid, so I just walk as much as I can.


Definitely. And since you mention that you haven't even been released from your ortho yet as well. When I was 3 months out from my surgery I had just stopped using crutches and had a big limp. I continued going to PT for strengthening and gait work for awhile after that, and then the rest of it, I was on my own. You certainly need to give it more time and stay positive!

[Blueberry]

He wanted to release me a month ago but I keep complaining about my gait :-) I've been on my own for PT for 6 weeks now. I'm starting to wonder if I am going to need to get extra PT for my gait, but it doesn't fit into my budget I'm afraid, so I just walk as much as I can.

Talk to your ortho and see if he'll try to get workers' comp to authorize more PT. Gait issues can cause all kinds of issues later - (hip, back) so better to try to deal with it if you can! Lots of orthos in this area will be somewhat of an advocate for you with workers' comp - can't hurt to ask!

[Catrin]

I will ask him about that directly, good point. I've been trying to be patient and do try hard to make lemonade, but I do wonder. Thanks!

[Catrin]

Thanks Muirenn! I don't currently have a gym membership. I just train with my KB group (no access to thier other equipment) and my KB herd at home. I hike as much as I can, and there has been much improvement in all but my gait. That is what had me wondering.

Thanks for the comments everyone!

[emily_in_nc]

I think Sheila makes a great point. I would think spinning would be excellent rehab for your knee if there's a reasonably priced gym you could go to for that. Other than that, the PT for gait could be a bit helpful (although I didn't find it to be anything special). And time, lots of time. That's the hardest part of it all -- the patience!

[Catrin]

I had my coach watch me walking outside today and his jaw dropped. It isn't obvious over short distances like when walking across a room but outside is a different story. He said that it's obviously a motor control problem, my GOOD knee is almost collapsing as I try to walk normally because my bad knee doesn't appear to bend much, and this causes my hip to do odd things. My Ortho's assistant told me today that I should be pretty much back to normal by now as far as walking is concerned and he is going get back with me on this, hopefully they can get some gait training approved. This wasn't THAT major of a surgery.

I'm glad I asked my coach outside to watch me walk - I wanted to make certain that it just wasn't some minor thing that felt more than it was.

[Crankin]

Good call, Catrin. Do you have a video to show the ortho? I hope you get the approval for the gait training.

[Catrin]

Good call, Catrin. Do you have a video to show the ortho? I hope you get the approval for the gait training.

Sadly there wasn't enough light for his Coach's Eye on his phone to record my "walk of shame". The interesting thing is I've been VERY consistent with my PT exercises, but as Rick said, those are mainly for ROM and not so much for the eccentric loading involved in walking. I do weighted exercises with ankle weights, leg raises, and bench squats but obviously that hasn't been enough. Flexion and extension are both great - but there are apparently other pieces in this puzzle. It feels like I'm still wearing a brace - which I never used more than 4ish hours a week.

Hopefully they will approve it - my "Active Release" specialist (who has done close to miracles with my neck, shoulders and hips) is also movement specialist and he may be able to advise me on things I can do if the gait training isn't approved. We will see what the Workman's Comp folks will approve. :o

[ny biker]

I think PT should be about more than range of motion. You might want to consider the possibility that the therapist isn't good at their job. I wasted months with a bad one, made very little progress until my doctor sent me to a different one.

You should find someone to video you while walking in a well lit area to show the doctor. And stress to him that you are not recovered -- you cannot walk. If it's not addressed now, you will develop all sorts of other problems with your knees, hips and back and you probably won't have that treatment covered by worker's comp.

[Catrin]

I think PT should be about more than range of motion. You might want to consider the possibility that the therapist isn't good at their job. I wasted months with a bad one, made very little progress until my doctor sent me to a different one.

You should find someone to video you while walking in a well lit area to show the doctor. And stress to him that you are not recovered -- you cannot walk. If it's not addressed now, you will develop all sorts of other problems with your knees, hips and back and you probably won't have that treatment covered by worker's comp.

Good idea NY Biker, there just isn't enough space at the office to show them that it is like and I will see what I can arrange to make that happen. To be fair to the PT, she did have me on the treadmill and THAT looks fine - because I was holding on and supporting myself. My gait is much better with a cane, oddly enough - probably because it's helping out my good leg a bit more than I knew. The knee wasn't normal for a very long before the surgery and while I did walk normally, it could be that my body had made certain compensations that no longer work with my patella finally being in the "right" place. It really feels like there is now an internal physical impediment in that knee - like an internal brace - and I had ascribed that to nerve "stuff" and recovery.

Thanks again everyone!

[ny biker]

To be fair to the PT, she did have me on the treadmill and THAT looks fine - because I was holding on and supporting myself.

That might be a big cause of your problem. When I was in PT for the ankle they emphasized normal walking on the treadmill, without limping and without holding onto anything.

[Catrin]

I was afraid of falling, the knee was less stable then...and I was only on it for a couple of minutes at each session. Hopefully this is just an unconscious habit from my body trying to protect the knee rather than something else.

[Catrin]

I saw my Ortho yesterday and we discussed all of this. He didn't seem happy with my physical therapist and said the range of exercises she had given me were too narrow in scope and, despite all the work I've been doing, the knee has stiffened. He is sending me to someone outside of the workman's comp system (if they approve it), to a movement/athletic/PT specialist he works with for a one-time visit. The plan is to give me a movement screening (I assume this is the FMS but time will tell), and then give me more appropriate exercises to work with on my own.

I don't think there will be any further formal PT, but really, all I need is to know what to do and I'll do it. I do hope we can reverse the stiffening, but frankly, I still move a lot better than many with a stiff knee. I have noticed my plantar fascitis on that side has been flaring and it HAS to be from my uneven gait. Ugh.

[Pax]

Glad you're getting to see someone who might actually help.

Something seems to have turned a tiny corner with my leg, over the last four days I walked a mile each day. Today I'm tired and sore so I'm resting... but I'm done waiting for it to get better. I'm joining a gym again and going to start working out (with a few modifications).

[Catrin]

Glad you're getting to see someone who might actually help.

Something seems to have turned a tiny corner with my leg, over the last four days I walked a mile each day. Today I'm tired and sore so I'm resting... but I'm done waiting for it to get better. I'm joining a gym again and going to start working out (with a few modifications).

Good for you Pax, I'm glad you came up with something that seems to be helping. I've considered using a cane for my longer walks on pavement (I use a hiking stick on the trails) as I seem to walk more smoothly with the cane, but I will wait and ask this specialist I hope to see next week. I can't TELL that I use the cane for more than stability, but I must since my gait seems better with it. I'm firing up my gym membership back up here pretty soon and the kind of exercises they recommend may help me decide which of the two gyms I'm considering. I can do a LOT at home with my kettlebell herd and Jungle Gym suspension system but I need more indoor options since I can't hike in the winter.

Tomorrow is supposed to be 58 degrees here, I'm off work and not about to go near a store the day before Thanksgiving - so am considering a hike tomorrow to go along with my usual kettlebell workout.

[Catrin]

So I saw the specialist yesterday, and the problem is one of two things. Either the tightness is deep inside the knee joint - and thus permanent, OR it is a combination of tight superficial tissues over the knee, weak quad and crazy-tight hip flexors. He did give me some things to do in hopes that it's the latter of the two. The FMS screening was...interesting. It IS the one I thought, and I know what I've previously done on that screening. It was all rather embarrassing.

Thinking back I finally realized that the PT from workman's comp paid far less attention to flexion than anything else as she considered it functional and while I should have questioned her, I didn't and followed her direction. That, in the end, is the problem, and hopefully I can loosen up all that stuff. I may well, however, go back to the cane for long walks on pavement as he thinks there is still stability problems due to all of this. I will certainly use it on icy walks from the parking garage to work as I just cannot afford to fall again. I've new boots that will help in snow and ice but still...the thought of falling sends chills down my entire body as you can imagine.

[Pax]

Catrin, so sorry you're still dealing with all of this!

Couple of stability suggestions for icy mornings, I bought and wore these my last three winters in Illinois and they were lifesavers! http://www.amazon.com/Stabilicers-Original-Heavy-Traction-Cleat/dp/B009ZPVZRI Strap them on over your boots and you could tap dance on ice; our mail carrier wore them and I figured if they worked for an eight hour outdoor job they should work t get me to and from my office.

Also, maybe try hiking poles instead of a cane? Mine came with cool rubber non slip tips and they seem to offer better stability than my cane did.

[Crankin]

I second the traction devices. I started with Yak trax, but after 2 pairs that broke, I bought Ice Spikes. I need them to walk down my driveway! But, they are also useful for hiking, when there is not enough snow for snow shoes.
I hope it's #2 that is the problem. You are too young to be doomed to a life of knee pain.

[Catrin]

Thankfully there is next to no pain. The problem is my gait and the very consistent feeling of restriction in the knee. It really feels like there is an internal brace.

My Uggs (http://shop.nordstrom.com/s/ugg-australiaakadiaboot-women/4030067?cm_mmc=Google_Product_Ads_pla_online-_-datafeed-_-women%3Ashoes%3Aboots-_-1110733&amp%3Bcountry=US&amp%3Bcurrency=USD&mr%3AreferralID=db6d27dd-9b78-11e5-b7e1-005056946dac&gclid=CjwKEAiAs4qzBRD4l-2w7qOoqEMSJABauikXHkzHceoTjpq6hcq2eXKRKcUIXqpCdTCTgD-Q2sXV2BoC91vw_wcB) are AWESOME on ice and snow, but if the winter turns out to be bad this year I will certainly try out the stabilizers, thank you! I noticed that individual replacement cleats are also available.

I also found a pair of $40 snow boots at Costco that will really help for those times when there is a lot of snow between parking garage and office (about 3 blocks). Did I mention the Uggs are awesome? I've also a pair from an earlier generation of this model with the same footbed that I purchased 6 years ago that still look almost new! They aren't inexpensive, but they last and there is something in the footbed material/how they are made that seems to almost grip the ice.

As far as the cane is concerned, I'm trying not to use it at all as my quad needs strengthening. I'm not aware that I actually put any weight on it, but I've noticed my gait lasts longer when I use it. I appreciate your input on hiking poles, I am going to hold off on those until I can determine if this is permanent or not. They aren't inexpensive, but more importantly, I want to unload that quad as little as possible. All bets are off when I hike though, I've a cool hiking stick for that, regardless how short the hike might be.

[Pax]

I ordered a box of replacement cleats when I got mine, but three hard winters and I still didn't have to replace any, that and the sole is vibram so they are super well made.

[Catrin]

Saw my Ortho yesterday. Home exercises for 6 more weeks and then he will release me
It is what it is, hopefully not permanent but I don't think he can do any more than he has.

[Pax]

That "it is what it is" place is hard to get to. I'm there as well and will just keep doing the best I can and hope to see improvement.

[ny biker]

Saw my Ortho yesterday. Home exercises for 6 more weeks and then he will release me
It is what it is, hopefully not permanent but I don't think he can do any more than he has.

I hope the exercises work. Are they for quad strengthening? Did they give you stretches for the tight hip flexors?

[Catrin]

Just exercises for knee flexion, which is odd now I think about it. I will need to do my own research. The problem is I can't tolerate kneeling or lunging and all the hip flexor stretches I know of include one or the other. A lot of my kettlebell work does involve the quads so that helps.

Even my coach, who is highly effective, educated and knowledgeable, can't think of anything more I can do for hip flexors that I'm not already doing. At his suggestion I will attempt hip bridges tonight. I'm already doing several versions of the Bretzel and a half Turkish Getup (unweighted currently).

[Pax]

Are you swimming? Kicking laps with a long slow kick (like you do when scuba diving) does a nice hip flexor stretch.

[emily_in_nc]

Catrin, I had to do a lot of hip flexor strengthening on my right side after my pelvic fracture back in 2005. That side is still weaker than the left, as when I do a lot of stairs or uphill hiking when I haven't been, I'll get sore in my right hip flexor but not the left. One of the stretches my PT suggested for when my hip flexor was sore was to lie on the bed (but it's gotta be a fairly high bed) on my back, in a normal position (head on pillow end, feet towards the foot board, but lie close to the edge with the leg to be stretched to the edge of the bed (since it was my right leg I needed to be on that side of the bed, in other words). Then dangle that leg off the bed until you feel a stretch in the hip flexor. You have to be careful not to let your back arch, but this stretch was good for me without requiring a lunge or putting any pressure on the knee. Hope I've explained it adequately!

[ny biker]

Catrin, I had to do a lot of hip flexor strengthening on my right side after my pelvic fracture back in 2005. That side is still weaker than the left, as when I do a lot of stairs or uphill hiking when I haven't been, I'll get sore in my right hip flexor but not the left. One of the stretches my PT suggested for when my hip flexor was sore was to lie on the bed (but it's gotta be a fairly high bed) on my back, in a normal position (head on pillow end, feet towards the foot board, but lie close to the edge with the leg to be stretched to the edge of the bed (since it was my right leg I needed to be on that side of the bed, in other words). Then dangle that leg off the bed until you feel a stretch in the hip flexor. You have to be careful not to let your back arch, but this stretch was good for me without requiring a lunge or putting any pressure on the knee. Hope I've explained it adequately!

Oh I like this. Sometimes I get hip or leg pains after I've been sleeping a while and I need to stretch to make them go away so I can get back to sleep. This is something that I won't hardly have to wake for. :D

[Catrin]

I tried this hip flexor stretch when I woke up this morning, nice! Thank you!

[emily_in_nc]

I tried this hip flexor stretch when I woke up this morning, nice! Thank you!

Oh good, I am glad you were able to follow my description. It's much easier to show than to tell! It's one of those stretches that doesn't seem to do a lot unless you're really tight or sore in the hip flexor area, but when you are, it is helpful.

Funny, I had to do it this very day myself as my right hip flexor is very sore today after yoga yesterday. I had not been to practice for nearly two weeks because a trip we took, so yesterday's lunges and boat pose took a toll. I am a little sore in the shoulders, but mostly in that weak right-side hip flexor.

[Wahine]

The hip flexor stretch Emily suggested is great and bridging with something to squeeze between your knees is great too. The idea is that whatever you are squeezing keeps your hips in neutral alignment, a yoga block works well. These both help with hip flexor tightness. Here's another (https://youtu.be/yhCKRCXmge8), more neutral example of the same stretch.

I've tried to find a video to illustrate an exercise I have my patients do where they walk with a theraband wrapped around their leg all the way up to the waist to facilitate normal gait, but I can't find one. I may have to make a video myself. eeeeek. It's really hard to teach patients in person, I'm not sure it's possible to describe. You take a really long piece of firm (blue or stronger) theraband. Step on the band at the half way point. pull the band tight +++ and cross it in front of the ankle. Pull the band tight +++ and cross it behind the knee. Keep pulling tight and cross it in front of the hip, then tie it around your waist. With the theraband on like this and walking around, it will help you relearn how to coordinate your muscle activation patterns to bend appropriately when you lift your foot to step forward and also to activate the extensors when you're standing on that leg.

[Catrin]

The hip flexor stretch Emily suggested is great and bridging with something to squeeze between your knees is great too. The idea is that whatever you are squeezing keeps your hips in neutral alignment, a yoga block works well. These both help with hip flexor tightness. Here's another (https://youtu.be/yhCKRCXmge8), more neutral example of the same stretch.

I've tried to find a video to illustrate an exercise I have my patients do where they walk with a theraband wrapped around their leg all the way up to the waist to facilitate normal gait, but I can't find one. I may have to make a video myself. eeeeek. It's really hard to teach patients in person, I'm not sure it's possible to describe. You take a really long piece of firm (blue or stronger) theraband. Step on the band at the half way point. pull the band tight +++ and cross it in front of the ankle. Pull the band tight +++ and cross it behind the knee. Keep pulling tight and cross it in front of the hip, then tie it around your waist. With the theraband on like this and walking around, it will help you relearn how to coordinate your muscle activation patterns to bend appropriately when you lift your foot to step forward and also to activate the extensors when you're standing on that leg.
Thanks Wahine, I was trying to picture it from your description. I do have a yoga block at home so can add that to my hip bridges. Interesting, yesterday I was back at my gym and I tried the ArcTrainer for 15 minutes at an easy level to see if my knee would tolerate it. That's the only cardio - based machine that my knee has tolerated the most, all other elliptical-type machines are torture. It is just different enough and I noticed for the first time that something about the stride carry-through is stretching my hip flexors. I need to be cautious as not to overdo it but that's hopeful. I just need something for cardio that doesn't involve kettlebells. I can, and do, use them for that but I need to balance it out so I don't really blow my shoulders out.

My coach is meeting me Friday for a lengthy screening to determine exactly what I can do at the gym without impacting my various broken bits. Outside of being a kick-azz kettlebell competition coach (who is still competing at 69), he has also specialized for a long time on the "aging athelete" and how best to work around "stuff" to meet goals. He calls it like he sees it. I just want to stay active and regain some of my lost fitness and strength since my most recent injury. It's frustrating as it seems my range of activities seem to keep shrinking but I won't give up!

[Pax]

I tried this hip flexor stretch when I woke up this morning, nice! Thank you!

I tried it today,it worked great! Thanks, Emily.

I noticed since I started using the ellipticals at the gym my hip flexors get really tight.

[Catrin]

Do they have an ArcTrainer Pax? Those do work differently, at least they seem to for me

[Pax]

Do they have an ArcTrainer Pax? Those do work differently, at least they seem to for me

No, it's a small family owned gym, they don't have too much outside the basic elliptical/treadmill/exercise bike. It is kinda fun though, I couldn't use an elliptical before the knee replacement.

[Catrin]

No, it's a small family owned gym, they don't have too much outside the basic elliptical/treadmill/exercise bike. It is kinda fun though, I couldn't use an elliptical before the knee replacement.

Progress is always a good thing! The Cybex ArcTrainer is really the only machine I can use without knee or hip pain and I've tried them all (both pre-and-post surgery) - it does things differently though I couldn't explain how. It doesn't hurt any of my body parts and that's a good thing :cool: Thankfully it's a HUGE machine so there is no way that I could be tempted to purchase a used one for home. Why yes, I've considered it :o It makes me feel like I can run - though I cannot. I'm unsure if I literally could run to save my life, though I would assume that the mind would overpower the mechanical problem if that should be necessary, at least I hope so!

[emily_in_nc]

I tried it today,it worked great! Thanks, Emily.

You're so welcome! :)

[Catrin]

There seems to suddenly be a big improvement with my knee/walking. Not saying it's perfect, but much better. Perhaps time was all that was really needed. Hopefully that will work for my neck as well...

[Pax]

Congrats!! I had the same thing happen (at about the 8 month mark). Couldn't see a reason for it, it just started working better... our bodies are so weird, aren't they?

[Catrin]

Congrats!! I had the same thing happen (at about the 8 month mark). Couldn't see a reason for it, it just started working better... our bodies are so weird, aren't they?

Yes they are! I no longer feel like there is an internal brace, though my IT band is getting tighter no matter what I do... perhaps my leg needs that? I don't know, but I'm not complaining :cool:

[Crankin]

That is great news, Catrin.

[emily_in_nc]

Good news both Catrin and Pax!

Happy New Year and hope for even more healing.

[ramonhines]

I have also suffered from the same situation and it took nearly 4-5 months for me to recover properly .