No Range of Motion (ROM) for 26 weeks in my left knee

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Originally Posted by friendsfan

im 25, i work as a healthcare assistant at my local rehab hospital (im obviously off sick)
i had my nephew on my back giving him a piggy back, i crouched down to let him off, which he did no problem, and then next thing i knew i was on the floor i dont know what happened...
the surgeon says he achieved full ROM when i had the MUA,
ive had x-rays on my knee ive had 3 different lots took, i dont know if its been skyline view.. ive also had a MRI which came back showing no real changes

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Sounds to me like you had a subluxation or dislocation and subsequent relocation and that indeed pain/reflexive contracture might be in play here. I have seen this again and again commonly in young women. p.s. the skyline is the best way to look for longitudinal fractures in the patella but it sounds like this has been cleared.

Was there any swelling at the time of injury? If so when did it occur? immediately, within a few hours, over a few days etc.

I would suggest perhaps strapping the knee to give it confidence but in the absence of any bony lesion we need to get you off the crutches ASAP as this will be making the situation worse. Can you perhaps get to a pool and do some exercise in the water when the knee might feel less apprehensive to move? :o

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Originally Posted by friendsfan

this is the best pic i can do, it doesn't look blotchy on this pic but seeing my knee i can see it

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Actually the knee does look blotchy in the picture and in fact the whole leg appears slightly swollen compared to the other. Was this taken after icing or any other work on the knee/removal of any type of brace or was this just an image of how it is?

this is after icing, this is just how my knee looks as a whole,

what do you mean by absence of bony lesion???

in my original injury it swelled straight away and just continued to swell for a few hours

Quote:

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Originally Posted by friendsfan

this is after icing, this is just how my knee looks as a whole,

what do you mean by absence of bony lesion???

in my original injury it swelled straight away and just continued to swell for a few hours

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OK, now this makes sense for why the knee is pink.

Bony Lesion: sorry just mean the various types of fractures or bony injury.

Immediate swelling - definitely not the meniscus for this. As suspected this is probably secondary to either cruciate damage or patella dislocation as these are the only things apart from fractures that will cause immediate swelling. The arthroscope would have noticed if the cruciates are damaged so my bet would be that you suffered a rapid patella dislocation and relocation without realizing it.

With this in mind any therapist should have a slightly better approach to work to regaining your range of movement and also this is why it is actually your brain being apprehensive to bending. A patella support brace would be a good place to start with the crutches to give the knee cap confidence in its position. This should then permit you to get rid of the crutches rather quickly (say over the course of a week). So chin up this is not abnormal at all, perhaps just a poor diagnosis of the original injury mechanism. :)

some of this makes sense, as for years i have said that it feels like my knee has dislocated and always gone back, (its happened on numerous occassions) but ive never sought medical advice
but when it happened this time it didnt feel like it went back, it felt like the kneecap had moved down and stayed there since..
sorry jwilso you asked about pmh i said there wasnt any but i suppose this kinda thing happening is, but because ive never seeked medical attention for it i didnt think to mention it

ive achieved a tiny bit of movement since i fell on friday, im guessing its about 10 degrees that ive gained (i need to use my right leg to bend my left leg), its very painful also, everywhere in my left leg feels so stiff... i feel as if i will tear all my leg muscles if i try to push it anymore

ive been to pain management today and the doc i saw there says he thinks i may have crps type 1, but im not showing the classic symptons, he is ordering a bone scan, and he has reffered me for accupuncture, tens unit and more physio..and he wants me to take some kinda medication

how long will you have to wait for the bone scan?what medication has he put you on?
it would probably be better if you had a different physio to the last one as they will already feel that they have tried and failed with you. will you be going to the same dept?

hes addressing the bone scan as urgent, says if it is crps we need to treat it straight away..
the medication is gabapentin which im not keen on taking..i should be starting this 2moro
yes i will be attending the same dept, i imagine i will have a different physio, they never stick with me for long..so no doubt i will have a few more..
the doc says if it is crps its stage 2 what does this mean?

type 1 crps has a known cause-eg trauma
type 2 - of unkown cause

i would try the gabapentin. youve nothing to lose. hows things going right now. have you gained any more flexion?

just found this info on another website

Stage 1


lasts 1 to 3 months
severe, burning pain
muscle spasm
joint stiffness
rapid hair growth
skin color and temperature changes

Stage 2


lasts from 3 to 6 months
pain which becomes more intense
swelling
decreased hair growth
nails which are cracked, brittle, grooved, spotty
softened bones
stiff joints
weak muscle tone

Stage 3


irreversible changes to skin and bone
pain is continuous
muscle atrophy
severe limited mobility
contractions of muscles and tendons (limbs may be twisted)

which stage do you feel your in?

if im really honest with myself i'd say 2, but i cant even admit i have it....
if i have this is it possible to get my mobility back to normal?
no ive not gained anymore flexion its just way too painful to try and push it more,

have a look at this useful website. i dont normally like some of the American websites as they are usually advertising something but this has some really good advice. take a look. hope its useful.

http://artzoo.com/health/print.htm

thankyou, it is very useful and it explains a lot
i wish i never went to that pain clinic, i could still be in complete denial.. anyway i suppose i'd better admit it

ive got an appointment today for a tens fitting on october 8th, what is a tens fitting?

a tens machine is a modality that can help reduce pain. some people do find them extremely effective. they are a small box that can clip on your belt. they then connect electrodes to it that pass a small electric current through the area affected. it effectively intercepts the pain signals and blocks them off. if it works for you you may not need so many painkillers and it may allow you to exercise

i dont like the sound of that, but thanx for explaining it to me

its not as bad as i probably made it sound. hope it works for you:)

im sure it will work, if that doesnt something has to, otherwise they can take my leg

try and be possitive. RSD/CRPS does improve, but it takes a long time and a lot of effort and physio. have you got the TENS?

i havent got a long time i have a life to live and a job i need to get back to..
my mum bought me a TENS machine today i dont know where to put it though, i dont go to the hospital for the TENS until OCT 8TH
ive started the gabapentin today its making me feel spaced out and my dose is being doubled next week, then doubled again the week after, that should be fun

11/2 hrs every day for 9 weeks is a lot to ask someone to do. also RSD pain is different to post-op pain.

did the TENS not come with instructions on how to use it. its not rocket science. i would get it out and give it a go. it couldnt make you any worse by the sound of it.

i think that you will have to prepare yourself for a long recovery period im affraid.

yes it comes with insructions im just not sure where to put the pads as my leg is so sensitive

im no expert with TENs by any means but i gues that you couldeven apply the electrodes at your lower back if your leg is too sensitive as the pain signals have to travel through this area. worth a try ??

what do you think will hapen with work? can you afford to be off long term?

i have a meeting at work tomorrow to discuss my sick leave, i dont know whether to tell them about the crps or not....
the occ health doctor has said im unfit for any kinda work so they cant even offer me a alternaitve post...and i cant afford to be off sick long term i wish i had some kind of time scale 3 months? 6 months? a year or more? the worst part is not knowing.
i will try that with the TENS later

i bet that you could do without that extra stress right now. good luck for tomorrow

thanks, yer i cud do without that extra stress but i have to try to be positve, and realise that whatever will be will be..
can i take a moment to thankyou for all the time you've spent with me it has helped me

no problem. glad to help. wishing you a speedy recovery

ive been for the meeting at work...
the outcome of this is when i next see the occ health doc on oct 30th if he says im still unable to work, they are going to dismiss me on the grounds of ill health, talk about kicking me when im down.
my opinion in this is it isnt giving me very long to tryto recover as i dont start treatment until oct 8th
ive also got a appointment for a 2nd opinion for orthopaedic this is 19th oct, its a another hospital so a fresh set of eyes on the job

thats bad news sorry to hear that. how long have you worked there? are you in any kind of union that can support you?

ive been there 2 years, yes im with unison but im not sure that they would be able todo anything

at least if you do lose your job ,in a way it might take some pressure of you.
surely you will be entitled to some benefits to help financially

did you try the TENS ? if you can tollerate it the electrode placement suggested by altohealth would be the best to try.

yer im entitled to some benefits, but its only a fraction of what im used to living on...
i tried the TENS with little effect, going to force myself to tolerate it on my knee a little later, as its been quite a good day knee wise

hope it works for you

ive used it on my knee, and now my leg just keeps going into spasm, dont know whether this is good or bad

dont know to be honest. dont have the intensity too high though. should be a comfortable tingle feeling when on

ive used the TENS again today and once my leg stopped going into spasm, my leg felt different, it didnt feel as vunerable, painful and heavy as it usually does

great. some progress maybe!!!

i hope so, even though the relief lasted about hour, its the best its felt in nearly 29 weeks,

any relief after this long is a possitive. keep going