Lateral release

[snapdragen]

Anyone here have one, or know anything about it?








//sigh. My new hobby is having surgery once a year.

[KnottedYet]

Please don't.

There are so many other options, that unless you have exhausted all of them it really isn't worth it to have a lateral release.

I've seen young athletic women have them, but since the original problem that caused the lateral structures to get tight (especially the IT band, it feeds into the retinaculum) wasn't addressed, they ended up right back where they started.

[Possegal]

I've had one and my knee is a world better. However the PT that had worked on mine before the surgery (patella dislocation) and then worked on it after the surgery, commented that I was the only successful lateral release she and the other PTs there had seen. Given that, had I talked to her before the surgery, not sure if I would have had it. But 1 yr post-dislocation I was not able to run more than 1/16th of a mile without pain and couldn't walk up and down steps normally. So I may not be the average LR patient either.

[snapdragen]

Parts of my kneecap have no more cartilage, my kneecap is way out of alignment. I don't have much of a femoral groove, that's where your kneecap lives. So my right kneecap is trying to escape and make it's way to the side of my leg. I can't go up or down stairs without pain -- it was bags of fun when our elevators went out at work, I'm on the fourth floor.

For now I'm doing PT, NSAIDs, and probably cortisone injections. Doc thinks these are just band aids, eventually I will need surgery. Even with all of this, he's pretty sure that down the road a few years, I'll need a knee replacement.

Oh well. At least he's not making me quit Team in Training....just have to avoid hills.

This is kind of what my knee looks like.

[TxRider]

Frequent lurker, infrequent poster here.

... had chronic dislocations all throughout high school & into college. I tried less invasive measures, but finally had the first surgery about 18 years ago. It worked well, but then I started having trouble with dislocations again about 10 years ago, so had a 2nd lateral release. (The other knee never really had the same problem, but now I have issues with the IT band on the other knee.) Have had no more dislocations since the 2nd surgery, but looking back, wish I had known more & maybe could have avoided the surgeries altogether.

Both times, recovery was pretty easy for me, but I was diligent about doing all of the exercises that were prescribed starting the day after surgery. I wasn't actively cycling at the time of either surgery, so don't know about time to return, but played a lot of sand volleyball & thought I was ready to go back after about 4 weeks (unfortunately, my doctor nixed that & made me wait until 10 weeks post-surgery).

Good luck if you have the surgery & hope you heal quickly!

[ef2204]

I had a lateral release done on each of my knees within a year of each other - and was unable to walk at the time that I had them done. I was very active (field hockey, swimming, etc), but overweight at the time which likely contributed to my knee problems as well. They were done about 12-13 years ago and I still have problems with my left knee, but the right one is great. I also now weigh 40lbs less at 33 year old.

My journey with cycling started about 3 years ago and included meeting with a physical therapist/bike fit professional who was immensely helpful in reducing knee pain/stress. The fine tuning of cleat positioning, saddle height & position can make all the difference in avoiding knee pain.

After having had this surgery, I would recommend putting it off as long as possible. The body is never the same after having it altered by the hand of a physician. While it may solve some problems for you - it always creates other challenges and sensitivities. Good luck with making a difficult decision (if you haven't already!).

[Zen]

I don''t understand why they just don't do the knee replacement?

[snapdragen]

I don''t understand why they just don't do the knee replacement?

They only last 10 years - or so I've been told.

[snapdragen]

Thanks ef2204, I am going to do my best to postpone this until I have no other options. I start PT in a week or so, then I'm going to meet with a trainer and see if she's willing to work with me to strengthen my legs (and the rest of me). My goal is to finish a half marathon in November - most likely my last.

[OakLeaf]

They only last 10 years - or so I've been told.

What difference that makes really seems to be a matter of regional philosophy. So you might get a second opinion.

I guess I'm somewhat relieved to hear it from you, rather than thinking it was just the way they do things where I live, where medical care is generally dismal. My mom had bilateral TKA two years ago at a really top-notch hospital - and although she's in her 70s, we specifically talked about that question (more in relation to some of my young former clients than anything), and the attitude of the doctors there is that you do it when the patient needs it, not when the hardware needs it; and if it needs revision in 15 years, then you do it again.


(And my mom is back to her birding - not entirely with her doctors' approval - which is why she had it done to begin with.)

[Trek420]

I start PT in a week or so, then I'm going to meet with a trainer and see if she's willing to work with me to strengthen my legs (and the rest of me). My goal is to finish a half marathon in November - most likely my last.

Sounds like a good plan. I think you're right about the expiration date on joint replacement. I considered toe joint replacement (no kidding). After multiple consults considering what my options would be in 10 years when that fails (pick a sport or shoes and fuse the joint to match that) decided to work on the joint ... and the rest of the bod instead.

With the right PT and training here's a toast to you conquering your half marathon and many more.

[ef2204]

Snapdragen, From what I know about the lateral release, there are two things that are accomplished with the surgery. First, releasing the tendon on the outside of the knee cap keeps it from pulling out of place and therefore gets rid of the grinding feeling inside of your knee when you bend it and causes the irritation. Second, it gives the docs a chance to clean out the inside of the knee socket and remove/repair the shredded tissues caused by the knee cap pulling up and out. The pictures from the inside of my knee before and after show a dramatic change.

I did learn in the process that "over-strengthening" the muscles on the inner-thigh side of your quads (I'm forgetting the correct muscle name) immediately above your knee can counter act the tight tendon on the outside of your knee (which is what pulls the knee cap up and out of track). Women are particularly prone to problems with this injury because the width of our hips emphasize the strength of the major quad muscles and we don't focus on strengthening the other supporting/balancing muscles. By super strengthening the inner quad muscle, you can help bring the balance back - perhaps without surgery. Running builds the muscles on your outer quad, so find an activity or exercise that will balance that strength if you can. I would recommend that you try everything you can to work that inner-quad muscle to avoid having surgery. I have found Pilates classes (on the reformers) to be a huge help with building strength in the underlying/supporting muscle groups.

During PT to recover from the surgery, they also teach you to completely relax your leg and put your fingers on the outside of the kneecap (almost under it where the tendon connects) and push the knee cap towards the inside of your leg - flat across the top of the knee socket. In the recovery stage, it keeps tight scar tissue from forming where they released the tendon, but might also help you now with lengthening the tendon (and perhaps helping to avoid having to release the tendon). After having the lateral release, I can pick my knee caps up and move them side to side.

If your PT is worth their credentials, he or she should be VERY supportive of your desire to try strengthening before surgery - it might take months to a year to see improvement. At the very least, it will put you at a better fitness level going into the surgery, if needed, which makes recovery easier. Best of luck to you!

[KnottedYet]

VMO - vastus medialis obliquus
It's the tear-drop shaped critter you see bulging out on the inner side of the thigh above the kneecap. It shows up very nicely in sprinters, they have honkin' VMOs.

Lots of VMO-specific exercises out there. When you find one that looks good to you, rest your fingers on the belly of the VMO to be sure you can feel it kicking in.

And ask someone to check your body mechanics to figure out what made you tight laterally in the first place. (anterior pelvic tilt, internally rotated hips, knee locking, over pronated feet, etc.) Wide hips allow women to get away with some sloppy mechanics, but we pay for it later.