Rehab after knee op

[mclidst3]

Hello, I had a knee arthroscopy last summer after a couple of years of knee pain. It turned out I had inflammed synovial membrane and the surgeon trimmed some tissue away.

I had a 6 week physio course to get me walking again after the op but since then I am struggling with knee pain and limited movement (due to pain). My knee also clicks a lot!

I don't know whether the original problem has returned (maybe a biomechanical probalem that caused the pain originally), or if the pain is due to my knee/leg being weak on that side. I have tried excercising to strengthen the leg but I am limited in what I can do due to the pain. My injured thigh is noticably less defined on that side and smaller, particularly the vastus medialis.

I did the excercises the physio gave me after the op which helped to an extent but the strength still hasn't returned. Other excercises I can do are leg extensions but with only about 20 degree extension (machine), and I have done light squats to shallow depth (full depth squats hurt, as do large range of motion leg extensions)

I am a semi-pro rugby player so need a good level of leg strength etc. but I haven't been able to play since the op. Any suggestions as to how I can strengthen my knee/leg, and if anyone can suggest how to prevent synovial membrane inflammation(knee suppport etc), that would be great.

Thanks,

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[physiofixme]

Sounds to me like you might be suffering from patellofemoral syndrome as a result of muscle weakenss following the surgery. (you may want to google patellofemoral syndrome) Rehab is to engage in quads strengthening in the form of squats (leg extensions can cause further problems due to the stress they put on your kneecap so i'd avoid these) Also strengthen hamstrings and butt muscles. Stretches for your iliotibial band also helps. You may want to look at taping your kneecap so that you can perform squats pain free and therefore get on with the strengthening. You should be able to find a lot of this stuff online. If not I'll see what I can do...see how you get on.

[mclidst3]

Thanks for the reply - really useful. Should I be only excercising when it is pain free? I normally stop if/when it starts hurting but should I keep going?

Regarding taping the knee, I had thought of that but read somewhere that it stops the quads engaging properly when squatting - any truth in this?

Should I stop running as well until the quad is strengthened? I haven't been doing much just enough to stop me getting too fat! and I always stop if it hurts. I'm not sure if this is hindering the recovery process though...

[physiofixme]

If you are just taping your kneecap (called patellofemoral taping) It's not going to inhibit your quads from working - in fact quite the opposite: It may help to stimulate your VMO (inner quads). You shouldn't do exercises with pain, but I'm hopeful that once you tape your kneecap you'll be able to do the squats pain free.

The same theory goes for running - don't do it if it's causing pain. Taping your kneecap could allow you to run painfree. If not then try cycling, swimming or aquajogging for fitness. If you can run painfree with the tape then do so but build up slowly and stay clear of hilly terrain for a few weeks.

[mclidst3]

Great, thanks. Is there a particular method of taping that will stimutate my VMO? (I had a quick look on google and there seemed to be a lot of different ways to do it...)

I've just done some squats, they were pain free up to about 90 degrees - any deeper than that and I get knee pain. Should I stick with shallow squatting or tape it up and go deeper?

Thanks again.

[physiofixme]

Try this link

Patella Taping - McConnell Taping - PhysioAdvisor

[gailflorence]

I had repair of a tibial plauteau fracture 3 1/2 months ago, 11 wks non weight bearing, been in PT 2 month but the thigh muscles remain week and the knee somewhat unstable. What generally is the recovery time to full activity?

[Montague07]

I think you should go with some thigh muscle exercises.These exercises may help you a lot to reduce your recovery time.Choosing thigh exercises that are right for your unique goals and situation. Doing this will give you the results you want but it can be a tremendous challenge to get it right.When it comes to your thighs remember that to actually visually see results, you need to do thigh exercises that not only tone, firm and strengthen you thighs, but also burn the fat.Here is one good exercise:

Lie on your side with the upper leg crossed over your lower leg, keeping a good range of movement in your lower leg, as it's the inner thigh muscles of the lower leg that will be worked.Keeping your knees and toes pointing forward smoothly lift lower leg to a position of about 45 degrees, focusing on using the muscles of your inner thigh to perform the exercise.Lower again under control and repeat. Swap onto the other side and repeat this exercise for your inner thighs again.Ankle weights or resistance bands can be used to make this exercise harder, alternatively you may decide to hold in the upper phase for 2 - 3 seconds, and avoid letting your foot rest on the floor during the lower phase.

[PhysioAdvisor]

I would strongly recommend seeing your physiotherapist for identification of any contributing factors to the development of your knee condition and for appropriate treatment following knee arthroscopy. Knee Stretches and Knee Strengthening exercises are certainly an important component of rehab and should be guided by the treating physio.

Hope that helps and good luck,