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PKR Ligament Sprain in GoodLeg

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marieltha

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@luvcats I started CPAP (constant pressure)December 2018; changed to APAP (range of pressure) in August 2019. Doing 50% better. I return to the pulmonologist/ next week
 
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marieltha

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@luvcats Having less stiffness since adding stretches for quads, calves, hams, & glutes.
Favorite: sitting on bed or chair: little marching steps. Great before getting up : easy, not load bearing—I let the knees decide how high, and that varies.
 

luvcats

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My current focus is standing up straight to build muscle, and doing butt clenches. All my standing muscles are very weak and sad.
 

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Hello Kitty.jpeg Marie. I am just stopping by to wish you a sunny and peaceful weekend.

z-bom-fim-de-semana31.gif Izzy xx
 
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marieltha

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Thank you both!

@luvcats. Perhaps your muscles are weak, but sad? Hmmm. In a restorative phase maybe? (or better sad than angry?)

Today, I am practicing lengthening my stride my making the back leg’s step longer, rather than the front’s. Read this in on a runner’s site. Feels better actually.

@Izabel
I just visited your thread @Izabel and feel like I stopped in your lovely garden.

Have a lovely weekend!
 

luvcats

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Definitely better sad than angry. It's only to be expected after how long I spent sitting on my bum because standing hurt too much. But weakness in an otherwise straight, healthy knee is very fixable with time and care. I am blessed with a body type that adds muscle pretty quickly and likes to be strong and solid. Excellent peasant stock!
 
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marieltha

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I am showing more improvement today after switching to a different method of restoring my normal gait.

The article explains “how to take a walking stride with the best technique.” I found this online at verywellfit . If you want the link and cannot find it, PM me.
I am basically lengthening the stride of the back leg to move me forward.

I used it several times yesterday over the course of several hours in 5-minute or less practice walking sets. I also used it for my pool walking yesterday afternoon. Last night, my husband noted that I was not limping. My walking since is not perfect, but it certainly feels more normal. Less pain and stiffness in the knee ( @Jockette and @sistersinhim )

@Izabel (I wonder what your physio would think of this approach?)

@luvcats
If I use it successfully for a few weeks, I will PM it to @Jamie for her BS review.
 

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I found the article. One of the exercises that my PT has me doing is to break down the stride by doing it repetitively with one leg. So, feet together, then step forward with one leg, heel strike and shift your weight partially until the back foot is flexing up, and then step back with the same leg, shifting your weight until the off foot is starting to rock up. The repeat with the same leg. Basically, half a 'walk'. I'm finding this helpful in figuring out the problem areas and then retraining them. I'm going to add your longer back stride to this process. I have a short stride on one side and insanely tight hip muscles on the other. But it's getting steadily better.

Tomorrow I'm going to start back on the elliptical. I've always liked that machine because it enforces proper let movements. I had a habit of swinging my leg out as you did, and I find the elliptical helps with retraining.
 
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marieltha

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I’m going to try your “half a walk” as well. @luvcats
Today I added periformis stretches and more quad stretches. I’ve been stretching hip flexors, hams, glutes, and calves, but these are also tight.
I can now carefully lie facedown on the bed—being ever so cautious with the recovering RCR right shoulder. Super cautious getting up.
The easiest periformis stretch I think is to lie on your stomach on a firm bed/table, with your feet hanging over the edge. Then you just lift each leg up a tiny bit, hold a bit, and lower. Height of the lift is not the goal. Just a little lift.
Then, as long as I’m there, just a bend at the knee of each leg, pointing the toe if possible, to stretch the quad.
@Jockette this is an easier periformis stretch I think
@Izabel. Read the above from @ luvcats about the “half a walk” . I just tried it and it feels good (Thanks, @luvcats !)
 

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Good Morning.jpeg Marie

I hope you had a good weekend. We had a shower yesterday but reall desperately need rain ... lots of it. We have been in near-on drought conditions for two years and the reservoirs are pitifully low.

I have been doing my gentle exercises but honestly do not think anything will happen overnight and still cannot walk without assistance. I guess 18 months in a wheelchair did not help! But I will persevere!

Off topic, you had mentioned you were an hour away from St Petersburg. I don't know what direction but my nephew and his three sons live in Bradenton. My long-time friends go to St George's Island twice a year for a month and are there now in fact. Got evacuated on their last visit due to a hurricane. I sure do not miss the torrnados in Alabama!

Wishing you a relaxing week.

animated-cat-image-0215.gif Izzy xx
 
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marieltha

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Perseverance is definitely required, @Izabel
My cattleya finished her triple bloom for this year, but now, to my delight, has produced a second bloom pod. A lesson in perseverance there, I think.

I am amused by how often you mention something in your past that is also in mine. I lived in southern Alabama briefly decades ago. In my honor perhaps, Mother Nature delivered a record snowfall of several inches (more than in 26 previous years) while I was there. Extremely rare there. LOL. I was an outdoor runner and tennis player way back then. I prefer Florida. At the moment, I am sharing a scrambled egg with one of the crows who keep the hawk from eating the doves.

I have been discussing using a tens machine with @luvcats . I have not found it very helpful in the past. I think the placement has to be very precise. Anyway, last night, on a fluke I put the four electrode pads almost touching each other, literally on the medial knee bursa and surprisingly, it helped! It only relieves pain for a short period. It does not heal anything. So I am seeing my OS again this week now that I think it is the bursa that is still aggravated.

Continue to persevere with your gentle exercises. I will do the same.
 
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marieltha

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Update after seeing OS yesterday:

Was able to see my OS yesterday, as the right medial knee pain seemed worse, not better, despite my improvements in gait. Got a 25 minute pool walk in before going, but the knee even hurt in the water, which was new.

My OS does lots of hands on examination, as well as observation of me walking, sitting down, getting up from chairs, and more. Today was no exception, but he did begin by looking at the knee and saying it was inflamed.

Lots of specific “how does it feel when you ...” questions this time also, about both pain and stiffness. Even these questions: “how long does it take for the pain/stiffness to subside after you do x, y, z?”
He said my sinovial membranes were inflamed, probably aggravated by the ligament sprain, which is now healed. Sinovitis.
For my first time ever, though, there was fluid accumulation, which he extracted after thoroughly numbing the knee. Still felt it a bit. Shouldn’t have watched. The needle was small, but the vial to extract the fluid looked cartoonishly big (aaargh!). No visible sign of infection.
This was followed by a cortisone injection.

And a wonderful new quad stretch. I added that the stiffness and pain often goes below the knee in the front. I explained that I’d added quad and periformis stretches lying down. He was a bit surprised I was able to lie on my stomach (given the shoulder) and demonstrated this better, standing quad stretch. He demonstrated this 2x, then helped me do it:

Standing in front of a standard, knee height, padded office chair, holding on to the doorknob of the closed door on my left, my right leg bends, and I place the lower leg (front down of course) atop the chair (90 degree angle), then, most important, stand up with good posture. He had to help me put the leg up and said to start with only 10 seconds. Eventually, will be able to do longer and can then add a bit of a back arch to stretch the lower back. I could feel a much better quad stretch doing it this way!

My beloved experimented with me at home this morning to find the correct chair to use. Ended up in the great room with an upright burnt bamboo chair behind me, with its cushion removed, and me holding onto the firm back of the sectional sofa in front. Perfect 90 degree angle. I could get the leg up and off without help and could hold longer. Beloved also adheres to the “Who’s at Risk” practice, so we agreed I would do these when he is home. Can always revise a plan later.

So I’m icing and resting until Thursday or Friday, when I should be able to be back in the pool.
Feels better already and the knee let me sleep last night (AHI of 3! Five is normal, so 3 for me is nirvana).
@luvcats
@Izabel
You gave shared great exercises and stretches with me, so perhaps this quad stretch will benefit you, now or in the future.

PS Search for Sinovitis on BS shows lots of people diagnosed with it in knees and hips, before and after surgery, and before and after both total and partial knee replacements.
Just confirms my theory about the soft tissue issues being central to recovery.
 
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luvcats

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That is indeed a most excellent stretch and I've been using a variation on that for years. I have a lovely hope chest Beloved made for me that is also a perfect sitting bench. It is positioned just right to put my lower leg on it and then hold on to footboard of the bed.

If your pool is configured cooperatively, you can stand in front of a pool ladder and kick your foot up onto a lower rung and then lean into the stretch that way. I don't always get my knee at a perfect 90 degrees, but the stretch feels great anyway. And in the pool, the risk of falling is minimized, because if you fall, you're just wet!
 
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marieltha

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Great idea about the pool! @luvcats
No ladder (tropical lagoon), but a nice spot facing the spa wall (easy to hold on) with my lower leg on a step behind me.

My OS said to rest and ice for 2 days after my injection and draining for sinovitis on Tuesday. So, being a good member of the ODClub (just read @Macknit’s thread), at the dot of 48 hrs yesterday, into the pool I went. He did say I could try it late on Thursday, but to listen to the knee. I wore the AquaJogger belt and did a lot of the walking in the deep water with no impact. I set my timer for 30 minutes (usually 45+), but the knee marched me right up and out at 15.

I just felt like I was getting too stiff and thought the rest of the body would benefit, which I believe it did. I iced and elevated after showering, after dinner, and at bedtime. And for the first time in months, I left the bed set with my feet elevated above my head when I slept. Felt really good.

This morning, my knees are still tender, but both are the same, normal size again.
 
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Update: A week since the draining for sinovial tissue inflammation and fluid (sinovitis) and a cortisone injection. Slept without medial knee pain from the first night after this treatment. It has taken the full week, however, for the knee to feel more normal. As I said previously, this was my first experience with the draining, and this medial inflammation. So I did not rush it.

Nice normal-sized, matching knees again. No more medial knee pain. Went from 8 Tylenol a day to zero from the day after. Sleeping without any knee pain.

Continuing to work on the gait, though, which is still not normal. The quad, hamstring, and lower back stretches and calf massages are helping. Back to walking in the pool daily.
 
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I just saw your post about the sinovitis... I guess there is always a unique issue that is bound to happen in such a complex joint....I'm glad to hear it is going so well for you!!!

It has been hard to relax and wait, when even the smallest walk causes my knee to swell. I plan to search this on BS,too (just because I'm curious.)

It sounds like you have a lovely place to do your water therapy....:)
 
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marieltha

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My OS’s 24/7 surgical RN called me yesterday to followup on my sinovitis treatment. Such a wonderful service to be able to talk with someone like this.

She cautioned me on overtaxing it too soon after the draining—who me? Evidently, the fluid accumulation is a normal reaction of the knee to the aggravated synovial tissue and joint. So, if I ask it to do too much too soon, the knee will produce fluid again. We want to stop/avoid that cycle, she said.

I have noticed some scrunching and occasional popping when I bend the knee, which I have not had prior, even though the pain is gone. She said the knee implant may pop more as it had been cushioned by that fluid and may miss it, so to speak.

She wants me to ice,elevate, stretch, and go a bit easier on it this weekend. Then, we will talk again on Monday and she will decide if I should see the dr sooner than scheduled, just to make sure there is no more fluid accumulation.

And, LOL, I think the knees are just fine now without any Tylenol, but the shoulder (5 months since RCR surgery) seemed to speak up last night and say, “Hello, no one asked me about stopping the tylenol. I think I’d like some tonight if we plan to sleep.” So I took 2 at bedtime and slept without pain.
 

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Hello, no one asked me about stopping the tylenol. I think I’d like some tonight if we plan to sleep.
lol
Right? Oh, my knee feels great, it's this other thing that really hurts. lol It's always something it seems.
 
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marieltha

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Yesterday, I took 2 Tylenol during the day, and iced and stretched more, and did not walk in the pool. I love walking in the pool, so it took an effort to not just go in for a bit.

Perhaps I was doing a bit too much too soon, as I did not need the Tylenol at bedtime. I think I may have overdone the shoulder resistance the last time in the pool as well, as the shoulder did not hurt last night or so far today.

I decided to err on the side of caution, though, and will see the OS Thursday to check on the knee. It does not hurt, and it looks normal, but it feels bigger inside than the other. Might be fluid? Better to know for sure.

Still working on the gait. So far, the addition of the half step exercise that @luvcats shared, the core and lower back stretches and strengthening exercises, and the standing glute stretches and exercises have helped the gait the most.
 

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