Return to normal walking?

[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.

[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-Or.../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 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.