My season in injuries

[Monique]

PT will get you to strengthen hips and legs in order to take off some of the pressure from the patellas. A question: were you doing squats and lunges in your ACL rehab?

I had actually stopped doing squats and lunges in January. I had patellar tendonitis (common for tendon harvest sites), and working through squats and lunges was making it worse -> limiting my skiing. I chose skiing. Predictably, I kind of fell off the wagon with all of my PT, although I do the foam roller or the plastic wand thing in fits and spurts.

Last week, I went back to the PT for the first time in months because I felt my knee was regressing. I would start the day unable to bend my knee while skiing, as opposed to it stiffening (hur, hur) over the course of the ski day. I got Graston on my kneecap (ow!) and some exercises to strength the glute med and quad, but I was told they're actually pretty strong - just not as strong as the other side.

I just saw the PT, and I am to continue these exercises - gently - plus foam roller on both the front and the back of my leg. She used Graston on both my kneecap and the back of my leg and kneecap, which was all extremely tight. So, more of that. I have more comfortable range of motion now than I did before the PT. But I'm only only lacking 1" of flexion in comparison to my other leg, and I have full extension. The 1" I'm missing is from pain in the knee, but I don't feel anything blocking or catching when I'm demonstrating flexion to the doc/PT.

I think the idea is that the tightness all over my leg is holding the patella too tight, resulting in increased friction. My hope is that two PT appointments a week for the next few week, plus of course my homework, will loosen it up and solve the issue. *fingers crossed*

Your story gives me hope

 

[agreen]

Oh, man. Me, too. It sounds like there's a non-zero chance that it could clear up with proper attention in 3-4 weeks. I don't actually understand how PT can help this, but apparently it can. If not, though, it sounds like things get murkier.

I was diagnosed with chondromalacia 15 years ago, supposedly the cause of my aching knees and popping. But this is a whole new level. Of course I can drive myself nuts wondering if I did something wrong. I stepped into the same binding earlier that day with no hint of a problem, and of course I've been stepping into bindings since December without having anything even remotely similar happen.

Fingers crossed.

Sounds like your ortho thinks you have PFS which is a tracking problem and the pop was the patella not gliding smoothly in the groove. Awhile back the PTs would focus on VMO strengthening to try and move the patella back into the groove. Then, I think the focus turned to overall quad strengthening, because it is difficult to only isolate the VMO. But the key was to strengthen the quad without a lot of flexion/extension of the knee joint because this movement is what is causing the pain. Chondromalacia is the result of the tracking problem because the patella is not gliding properly and hence wearing down or "softening" the cartilage behind the patella. Straight leg lifts used to be the exercise of choice as you can still achieve quad strength without knee flexion/extension. The above info goes back to my residency days which is 8 years ago so not sure if new treatment is being utilized. I'm seeing a different patient population now so I am not up on the latest. Good luck on your recovery.
PFS = Patello-Femoral Syndrome
VMO = Vastus Medialis Oblique (Medial Quad muscle)

 

[SBrown]

Sounds like your ortho thinks you have PFS which is a tracking problem and the pop was the patella not gliding smoothly in the groove. Awhile back the PTs would focus on VMO strengthening to try and move the patella back into the groove. Then, I think the focus turned to overall quad strengthening, because it is difficult to only isolate the VMO. But the key was to strengthen the quad without a lot of flexion/extension of the knee joint because this movement is what is causing the pain. Chondromalacia is the result of the tracking problem because the patella is not gliding properly and hence wearing down or "softening" the cartilage behind the patella. Straight leg lifts used to be the exercise of choice as you can still achieve quad strength without knee flexion/extension. The above info goes back to my residency days which is 8 years ago so not sure if new treatment is being utilized. I'm seeing a different patient population now so I am not up on the latest. Good luck on your recovery.
PFS = Patello-Femoral Syndrome
VMO = Vastus Medialis Oblique (Medial Quad muscle)

Today they are focusing a lot more on hips than on VMO, I can tell you that much. I had eight dislocations of my left patella as a kid, one full, and had to do lots of work on the leg extension machine. Now they don't do that at all, of course. (Clearly it didn't help, as my kneecap kept sliding out.)

 

[Kneale Brownson]

In the aftermath of my tibia plateau fracture stabilization (plate and screws), I had a lot of snapping in the knee. Surgeon said the tendon was slipping in and out of its normal groove and advised PT folks to show me how to use kinesiology taping. Seemed to work. Funny thing, PT used MOM (Milk of Magnesia) to coat the skin prior to taping to reduce the adhesive irritation of the skin. Let the paint dry before taping. Helped overcome my allergy to tape adhesive.

 

[Wooley12]

I was having some leg pains for a while and then my right leg stopped working completely half way down a run early this season. Luckily I've been a poor skier for a long time so skiing on one leg was familiar. Turned out it was a blocked artery at the knee. A surgeon used a roto-rooter and scooped out the crud. Lost 6 weeks of the season and with the blood thinners, every slope is a fall and you might die slope. Good thing that I never fall.

 

[Monique]

I was having some leg pains for a while and then my right leg stopped working completely half way down a run early this season. Luckily I've been a poor skier for a long time so skiing on one leg was familiar. Turned out it was a blocked artery at the knee. A surgeon used a roto-rooter and scooped out the crud. Lost 6 weeks of the season and with the blood thinners, every slope is a fall and you might die slope. Good thing that I never fall.

Yikes!

 

[Kneale Brownson]

When I blew out my last Achilles Tendon, I was at the top of Dukes Bumps for those who know Breckenridge. I skied in from there on my one good leg with the other ski doing tracers till I got to the bottom of the Colorado chair. My friend Chuck Creen carried my skis for me while I hobbled up to the locker room from there. I thought it was a torn calf muscle, but the MRI proved otherwise.

The little white arrow points to the rupture.

 

[Monique]

When I blew out my last Achilles Tendon, I was at the top of Dukes Bumps for those who know Breckenridge. I skied in from there on my one good leg with the other ski doing tracers till I got to the bottom of the Colorado chair. My friend Chuck Creen carried my skis for me while I hobbled up to the locker room from there. I thought it was a torn calf muscle, but the MRI proved otherwise.

The little white arrow points to the rupture.

Yes, but you have skills!

 

[bgimby]

Injury from early march turned out to be still hanging around. Re-injured the same spot (outer right leg, top of boot) on my first mogul run at ABasin this week. Tried to stick to groomers but it super painful. Made an appointment with a sports medicine department and called it a season. My guess right now is that it was originally a hairline fracture in my fibula, because the symptoms fit.

Whether my leg would've been more painful than sitting inside with over a foot of fresh snow is up for debate.

 

[mdf]

I got my first post-surgery shower this afternoon. That is a great feeling!

 

[SkiNurse]

I got my first post-surgery shower this afternoon. That is a great feeling!

 

[Doug Briggs]

I just saw this thread and I refuse to post in it.

 

[Andy Mink]

That's what I'm thinking. Strap it down and go for it. It hurts like stink if I move it at all. I stumbled on the dog today and lifted it an inch or two to catch my balance. Yeeeooowww!

Well, the shoulder got much better but still hurts. Got and X-ray that shows a bit of bone or calcium deposit where it shouldn't be. Doc thinks the tendon may have torn a fragment away from the bone. MRI next Tuesday. Good news is, as we suspected, you CAN ski with only one arm!

 

[Monique]

Well, the shoulder got much better but still hurts. Got and X-ray that shows a bit of bone or calcium deposit where it shouldn't be. Doc thinks the tendon may have torn a fragment away from the bone. MRI next Tuesday. Good news is, as we suspected, you CAN ski with only one arm!

Ahh, avulsion fractures!

 

[Jerez]

Ski Nurse...

Good grief. I only just saw that you'd been injured. I'm so very sorry. Seems like you are recovering from a very bad place. Welcome back!
How on earth did they do Mothers Day without YOU?!

 

[Monique]

Ski Nurse...

Good grief. I only just saw that you'd been injured. I'm so very sorry. Seems like you are recovering from a very bad place. Welcome back!
How on earth did they do Mothers Day without YOU?!

Don't be ridiculous. She was right there! Just not skiing.

 

[SkiNurse]

Ski Nurse...

Good grief. I only just saw that you'd been injured. I'm so very sorry. Seems like you are recovering from a very bad place. Welcome back!
How on earth did they do Mothers Day without YOU?!

Don't be ridiculous. She was right there! Just not skiing.

Truth. I was the resident beach bum and "they" even trusted me to grill the food!

 

[Jerez]

Well thank heaven. I was worried the earth might have shifted it axis.

 

[neonorchid]

We'll both be back on the snow next season!

Definitely!

On Sunday, I stepped into a binding. Well, I went to step into the binding. I heard a POP and my knee started hurting. I tried to step into the binding a few times more, but no. It hurt too much and I could feel the POP coming on.

I managed to cadge a download on the lift - insisting I wasn't injured, just having a binding malfunction. If I were injured, I'd have to ride down in a toboggan. And I was not going to do that. I'd have rather tried to ski down on one leg (and no, that skill is not in my repertoire).

My knee has been poppy, swollen, and only moderately painful since then, unless the kneecap "catches," in which case the pop is pretty awful. I saw my ortho doc today. It's not a ligament. They're all in great order. He says it's "exacerbated patellar femoral chondromalacia" - he readily admitted we could use the word "exasperating" rather than "exacerbated."

When I had an ACL rupture and a meniscus tear, my doc was unfailingly cheerful and optimistic, and I never saw him look worried. Today, in contrast, he told me he was Not Happy with this development. I am to do PT for 3-4 weeks. If it's not getting better, we get an MRI and go from there.

I honestly can't believe this is happening.

Best of luck to all - I thought of your postings when reading the following:
https://www.outsideonline.com/2184466/getting-band-back-together?utm_medium=email&utm_campaign=Bodywork-05242017&utm_content=Bodywork-05242017+Version+A+CID_a61a1822c1cc5d65bf44e184ba6f0d38&utm_source=campaignmonitor outside&utm_term=READ MORE

 

[Monique]

Best of luck to all - I thought of your postings when reading the following:
https://www.outsideonline.com/2184466/getting-band-back-together?utm_medium=email&utm_campaign=Bodywork-05242017&utm_content=Bodywork-05242017+Version+A+CID_a61a1822c1cc5d65bf44e184ba6f0d38&utm_source=campaignmonitor outside&utm_term=READ MORE

I've been dealing with some of those "pain cave" techniques for my knee, believe me!

It's ... shockingly hard for me to get my right leg to do stuff. And it's weird. My right leg is plenty happy doing stuff on its own, when it's the only player. But as soon as there's another base of support (ie, my left leg), it's like my right leg disappears. The recent setback is making the misbehavior worse.

Good news, though - Graston seems to be helping, and hot yoga helps, too. Kinda crazy what I can do in a hot yoga class. Holding deep frog squats. Hero pose (with a block under my butt). I think the heat + settling time (rather than exercises where you're moving around) allows the tissue around my knee to stretch in a way that it can't under other circumstances. My knee *definitely* felt better this morning, after hot yoga last night.