Arthroscopy Arthroscopic LOA and MUA - March 7, 2022

Samsrf

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It really drives home how important resistance training is for overall health and robustness.
My PT told me It would be easier to get ROM if I wasn’t so strong and didn’t resist her smh
 
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WFD

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@CricketHip , the wall slides appear to have aggravated the tissue right below my knee, and the swelling seems to have impinged on the peroneal nerve where it crosses over the head of the fibula.

I’ve thought about the lymphatic massage and tried doing it myself, without much in the way of results. Don’t know if a professional would get better results. It may be that someone who does acupuncture could do the massage as well - I haven’t done my research yet.
 
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WFD

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@Samsrf , funny you should say that, I literally just now returned home from my GP’s office to discuss the results of my follow up blood test. Liver looks good but I do have mild anemia, which could have been caused by the mono, by diet, or some other cause. I’m going back for more blood work in another month.
 

Samsrf

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If you have to resist her I wonder if she is pushing you too hard?

For sure! She actually just called after being on vacation for a week and asked why I cancelled my appointment today. My daughter got the invite to play waterpolo with an older team so we only had 1 day notice PT said had a bunch of cancellations on her first day back and I could come in earlier. I was like “no thanks” … hmmm…. wonder why so many people canceled… I still am deciding if I should go back. I made so much functional progress this week without her - even started (slowly, using both arms) going down the stairs one foot per step & just completed a slow (25 cadence) 0 resistance 20 min spin on the bike. No gnarly pain or swelling- all within my knees comfort zone.
 
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WFD

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End of week 12 update -

The shin pain seems to be decreasing, so I am hopeful it is on its way out. This first occurred 8 and 1/2 weeks ago, and the surgeon's office said it would take "a few months" to resolve, so as far I am concerned, this nerve problem has overstayed its welcome and is due to leave.

For the last several weeks the swelling in my knee has been increasing not decreasing, and I've not really done anything to stress it. In addition, not surprisingly, the knee is feeling stiffer and my RoM is back down to 85°. This all despite the fact that the temperature of my knee has been decreasing, as measured in the morning when I get up.

This week I am going to research local acupuncture practitioners and see if I can find one that can attack the swelling.
 
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WFD

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End of week 13 update -

Exactly three months since my arthroscopic LOA/MUA and not making any progress.

Friday my youngest graduated from high school and we went out to dinner afterwards. I had to sit with my knee bent for maybe four hours and as a result I had to spend the weekend and today icing and resting my shin and knee. The swelling is up and my RoM is down to 80° as a result.

Tomorrow Tuesday I have my first acupuncture appointment and I'm hopeful she can address the swelling and nerve pain. The swelling has been gradually increasing and the RoM decreasing for about the past 5 weeks, and I'm not sure what else I can do. If the trend was flat or only a slow rate of improvement I wouldn't worry so much but it is going in entirely the wrong direction.
 

Samsrf

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I am so sorry @WFD . How frustrating. I will keep you in my prayers.
 

sistersinhim

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The swelling has been gradually increasing and the RoM decreasing
This is cause and effect. If you could get that swelling to go down, your bend will improve again. I pray the acupuncture works for you.
 
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WFD

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End of week 14 update -

Still at 80° flexion and the swelling is unchanged. The shin pain continues but at a lower level.

On Tuesday of last week I had an acupuncture appointment. The acupuncturist used a lot of needles up and down my entire leg and some were connected to an electrical device. The result was no decrease in pain in the knee or shin that day or during the following days. If anything, the pain in my shin due to the compressed nerve actually increased a bit, so this did not prove to be helpful.

On Friday I tried using a TENS unit and got similar results, except that using the machine on the shin muscle resulted in a sharp increase in the pain in the shin - not going to do that again. I'm debating whether or not to try continuing to use the machine on just the knee to see if I can get the swelling to do down.

I'm also considering using diclofenac cream (a topical NSAID) on the knee to see if that will drive the swelling and inflammation down.
 

sistersinhim

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I think trying the diclofenac cream is a good idea. It's certainly worth a try. My sister swears by it.
 

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Hi @WFD, if you haven't already tried it, while elevating you leg, massage your leg from lower leg upwards, carrying on through your thigh towards your torso. Sort of like a lymphatic massage. If unsure of what is involved, search for lymphatic massages for edema on YouTube.

With my LTKR, I religiously did that everytime I elevated - for at least the first three weeks. Even in the first few days post-op, swelling was vastly reduced vis-a-vis my RTKR (4 months earlier.)

I also did not ice after the second day and that fact coupled with the lymphatic massage while elevating did wonders in re swelling to the point that my ROM was very good even if I did no exercises at all the first week and a half.

Give it a go. It might help. If it doesn't, no harm done.

Good luck.
 
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WFD

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@glidefloss , I have already tried exactly that but seem not to derive any benefit from it.

Thanks for the suggestion though.
 
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End of week 15 update -

The shin pain has been coming and going. If I do more than the absolute minimum in activity it really flares up so I have to be very careful.

I have been using the diclofenac gel for about 6 days now and the swelling has gone down about half of a centimeter. My surgical knee is still about 3.5 cm larger than my non-surgical knee.

Despite the improvement in swelling my RoM in flexion continues to decrease - it is now down to 75°, about where it was before my arthroscopic surgery in March. This is very discouraging.

The compressed nerve in my shin prevents me from even trying any stretches than the very gentle ones I am currently able to do. My hope is that the swelling and heat will go away sometime soon, getting me past the scar tissue danger zone, and allow me to productively try to stretch this out. It may be that some of the loss of RoM is due to shortening of muscles and connective tissue - sometimes I can feel a tightness in the quad. If that is true then maybe I can reverse it with stretching.

I'm going to continue using the diclofenac gel for a couple more weeks and see if I can drive the swelling and heat down further, but I otherwise don't know what to do. The stiffness in my knee is feeling more and more like the scar tissue I developed after my other surgeries.
 
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End of week 16 update -

I've continued using the diclofenac gel but further progress in reducing the swelling is slow to non-existent.

The shin pain due to the compressed nerve had continued without any signs of improvement, then I remembered that long ago when I had a back injury (a herniated disk that impinged upon the sciatic nerve) the doctor explained that a vicious cycle ensued in which the compressed nerve causes the muscles to spasm, which then put additional pressure on the nerve, which caused more spasms, and round and round we go. In addition, the doctor explained that a badly stressed muscle can spasm on its own, without the involvement of a nerve, and when the muscle spasms it stresses itself further in another vicious cycle. The doctor prescribed muscle relaxants in addition to pain killers to stop the cycle and let the back muscles heal and the swelling to go down.

I wondered if the same thing might be going on in my shin muscle (the anterior tibialis), so I bought on Amazon some self-adhesive lidocaine pads. The pads are meant to be worn 8 hours out of every 24 so I wear them at night, with an ace bandage wrapped around the pad to keep it from getting scraped off as I toss and turn at night (which I do a lot).

I only started this two days ago and the pain is already sharply lessened and my RoM, which had been decreasing, has increased to 85° from 75°. I know this doesn't sound like much to many of you but this is an important improvement for me - if I can get it back up to 90-100° (100° is what the surgeon achieved after the surgery) and keep it there until the scar tissue danger zone is past, then I have the chance to then gain further RoM by stretching the tight muscles and connective tissue.

Lidocaine has been shown in some cases to have anti-inflammatory properties, so that may play a role as well.

So, hopefully things are looking up, and this is not just a fluke. I keep trying different things and sooner or later something has to work.
 

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