Did the PT ever mobilize your patella, the knee is flexed to about 90 degrees when you are on your back. The knee cap is then moved up and down and side to side. It is not particularly nice but is is essential to have the patella move through it's fullest possible ranges when the knee is flexed. The tibia should then be moved back and forwards while the PT sits on your foot to fix it. The the tibia should be rotated on the femur at 90 degrees and at full knee flexion. A joint that does not aquire full range tends to be painfull and have some fluid. Not only that but muscles will not get stronger easily if full ranges are not present.
Last edited by james079; 06-16-2011 at 09:06 AM.
Reason: bad spell
Hi James and thanks very much for your reply and infomation.
The physio I've been seeing recently did the first 2 of what you described. I'm not sure what they were looking for so I can't comment on it. I should ask her when I see her. She thinks it dislocated and the ACL is torn.
The consultant this week did the first thing on your list but nothing else other than getting me to bend and straighten the leg as he was listening and feeling the grinding.
I'm not sure what that 3rd thing is you have listed but I'm sure it hasn't been done.
I have been told by the physio and consultant that I have abit of hyper mobility in the knees and also some other joints (I got the physio to check my sacriiliac joint in my hip as it has been painful lately as it's on the same side as bad knee - had physio on it 6 or 7 years ago for something unrelated)
I'm back to physio on Monday and will tell her what consultant has said and see what her reactions are to it. This will be my last physio with her as she said there wasn't much she could do for it as she thought it would require surgery. The consultant however said that 'when physios can't fix it they think surgery is the only option' and he said that normally with this type of blow to the knee they wouldn't even do an MRI. He is either doing it because it has been 11 months since injury or because the physio wrote a letter of recommendation to him stating an MRI should be done.
I have no idea at this stage, every opinion I get is different. I'm hoping the MRI will clear the whole mystery up.
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Have any of the doctors made mention of the cyst? or did I miss what's been done about that already?
Just as side note, for myself, I am also recovering from a car accident where I didn't know I had a neck injury. I was getting daily headaches a month after the accident. I didn't make the connection until every other possibillity for the headaches were ruled out. So, long story short: My soft-tissuse/muslce injury healed wrong and 5 months of headaches later I finally get answers/help/relief/ readjusted from the physical therapist.
How I think it may apply to you is: maybe so much time has gone by and maybe something healed wrong and perhaps they may have to re-structure your mechanics to work properly?
But don't let me influence you one way or another. I am no professional. I am just sharing thoughts related to my own experience.
My right knee is qwirky but on the mend. I still have to ice it every day and use ibuprophen or else it aches all night. I am hopeful another two weeks of ice and such will be all. I do still wear the brace when I'm very active.
Your passion for water sport inspires me.
How's that medication treating you? Celebrex?
Last edited by LessStress38; 06-17-2011 at 04:25 AM.
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Glad to hear your knee is improving. Thanks for the virtual hug
I mentioned the cyst to consultant but he never said a thing about it. Perhaps I should be more assertive in things now. I appreciate he can't tell what the problem and course of action will be until the MRI is done which is why I've held back.
Thanks for your post and telling me about your neck. I had wondered if my knee was similar in that it has healed abit on it's own but not the 'right' way.
The celebrex isn't making a bit of difference yet and pain levels have increased 10 fold from seeing the consultant (a mix of him poking at it and as it's the end of the working week the driving is agravating the knee as it moves back between accelerator and brake)
I'm busting to get back in the water again, on any level, pool or sea! The longer this drags out for with my knee the more deconditioned my muscles get so it will have a knock on effect on the fibromyalgia and pain levels.
I finally had my MRI and results. I haven't spoken with the ortho consultant yet though as I'm waiting for him to get back from holiday... here's what the results said (given to me by my GP)
"The anterior cruciate ligament is normal. The posterior cruciate ligament has an intrasubstance sprain some stage in the past.
There has been a minimal injury to the proximal medial collateral ligament of the hand.
The menisci are both intact.
There is chondromalacia patella present involving the lateral facet pateller to a lesser degree the medial facet."
So from what I can see there has been damage to the PCL and small damage to the MCL. That's not a typo on the 2nd line of the report, it actually says hand. Really instills confidence in doctors when they can't even stick to the right body part.
I know the last sentence means the cartilage behind the kneecap where the leg bones glide over is softening/thinning. I'm wondering if this is because the patella isn't tracking properly. The physio is adamant that it isn't sitting in it's groove.
From the above and after talking to the GP I'm suspecting that they aren't going to do anything (anything being surgery). The thing is that I'm now 1 year on from injury. The pain is no better, infact it is very painful most of the time. The pain made me physically sick yesterday.
I've had 2 sets of physio. The first was about 10 sessions straight after the time of injury once bruising and swelling had gone down. The second has been about 6 sessions recently over the last 2 or so months. Inbetween times I've been trying the exercises and using a static bike with no improvement or strengthening of the quad muscle.
I can't squat or kneel. I can walk a mile with a compression bandage but it is then agony and feels very unstable. I haven't been able to swim since the injury and that alone is killing me.
What really annoys me is that when I told the ortho about not being able to walk far or swim he said it was a lifestyle choice! What the hell. So because my GP practice doesn't want to pay for arthoscopy then my life will have to be sitting in a chair, taking pain meds and getting fat?
The GP was very unhelpful and said he would just prescribe more Celebrex at double dose. I told him I didn't want to be on them indefinitely and he just said surgery wasn't the answer. He also said the thinning wouldn't lead to arthritis which is also incorrect going on the advice of several friends I have in medicine.
The physio thinks they should do the arthoscopy and flush out the knee at the very least. I have a feeling I'm going to be fighting an uphill battle with this.
Oh geez.. that's a long post! Typing this out has really made me angry about being fobbed off.
Last edited by FurryPaws2011; 07-20-2011 at 02:18 PM.
Thanks for posting back Jane, I really appreciate your input.
The physio talked about taping it on the 2nd visit but it never happened.. would that be a permanent thing? Or what would it do? Keep the kneecap in place while I work on strengthening the muscles around it?
I just feel at a loss as I have been doing the exercises and the static bike and nothing is getting better, the muscles or the pain.
When I was at PT, my knee was taped a few times. Just a kind of strong medical tape stuck on my knee, like a band-aid, only very snug. I left it on for a few days, then it peeled off. It seemed to help significantly, at least in the short term.
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Thanks, I'll mention it when I next see her. She actually didn't want me paying to go back now as she can't do much else in way of physio.. put she has listened, understood and explained things in a way doctors haven't so I'll go back once more to see about taping.
Based on what you have described in your posts, I think you need to have arthroscopy done (no matter what the doctors say). I had patella tracking problems in both knees several years ago. I had a scope and an open lateral release (at the same time) on each knee. My left knee was operated on in 2008, and my right knee was fixed in 2009. I have not had any tracking issues since the surgeries. I am very surprised that the doctors are saying that surgery won't help.
Hope you're all in relatively good spirits, if not in good health!
I thought I'd give an update in my circumstances..
I was discharged after I had the MRI back in July without explanation and GP was sent a letter recommending more physio (at that stage I'd had a year of it already which wasn't helping).
So, I went back to the GP and asked to be re-referred back to consultant. Again I was sent to ICATS which is not an orthopedic consultant but an intermediary like a physio or GP specialising in kness. I had the appointment about 2 weeks ago and the ICATS person was a physio.
They explained in more detail what is going on with my knee (multiple issues) and also examined it themselves. The things I knew already from the MRI was that the ACL, MCL and cartilidge is/was damaged. I also knew the patella wasn't tracking.
The ICATS physio told me that although it isn't it the MRI report that my kneecap, from her examination, is slightly rotated and it is kind of bouncing of a fat pad underneath the knee which is why it feels unstable and is hypermobile.
She did a test to prove it by pressing her thumbs either side, just under my knee. It was excruciating. I hadn't had anyone do this test before! So this is called Hoffa's syndrome, along with all the other injuries.
So I'm going back in January to have injections into the knee and then taping. She told me exercise to build the muscle hasn't worked so far because the kneecap is so out of place and it can only work if it is taped... However, I am concerned that if conservative treatment doesn't work I will be left with this problem eternally as she said it wouldn't be a case for surgery. Surely after 18 months of pain, swelling, physio and not even able to walk far is reason enough to at least try?
I don't mind trying injections and taping first though I was told by a friend who works in muscle therapies that the injections are short term and can cause more problems with the 'junk' they leave in the joint area...
I don't really know what to do anymore! Passed from pillar to post with no resolution, all I seem to be offered are short term anecdotes..
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PT for my Rt. knee
Third injection today (and last)
They told me in PT that my upper thigh muscle wasn't responding properly to strength training because my knee cap kept leaning off to the right...thus the taping....
(I really liked the taping btw and kept it on for like 5 days I think, now my knee seems to stay better for now)
I had fallen and caused a divot in the cartilage under the knee cap, like a pot hole, thus the injections, to fill the gap?
I asked the PT about the shots and she said they go well for mild to moderate cases. For persons not candidates for surgical routes.
We will see. I really want to resume my elliptical usage! The ortho doc said I must wait a week from today.
Also, they ordered a stretchy small knee brace for when I do resume more activity to keep my knee cap tame until my muscles start kicking in better!
As for pain, I was getting clicking, swelling from it, ie - the pain. Before was throbbing at night. Now there is nothing to speak of hardly. Sometimes an ache that is passing. Lol...maybe that's just cause I just had the shot today!
Anyways, I was glad to get your update and I wanted to share. Please feel free to ask me anything in addition to what I mentioned that may concern you. Take care.
Less Stress 38.... I wish u all the best. I am also facing similar. 2ys post accident. Bakers that has grown from 3cm at 1month post accident to 8cm in June of this yr. I am going to ask about the test you had. How are you doing now? <3
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