Re: No tracking problem.....

[Guest guest]

This, I find, very hard to believe and if I were

you I get a second or third opinion or from a

physical therapist who's Ph.D. in biomechanics.<br><br>The

knee's cartilage doesn't just deteriorate unless you

have something like arthritis or <br>gout where all

your joints would be affected. And the fact you've

gona though so many <br>surgeries should be a flaring

warning sign something is wrong with your mechanics,

either in daily activities or exercise. I mean obviously

something is being repeated to incur this pain?<br><br>It

should be noted that several orthos have told me my

tracking is fine, perfect when they see walk or squat, and

it is, but my injury happened while cycling where it

took a computerized 3D motion analysis to find the

problem. Just because your knees look fine doing one

motoin doesn't mean they're screwed up doing another

motion.<br><br>Also the fact you keep getting these surgeries

concerns me. If they're not helping, and it sound like

their not, why keep going into the knee to scrape

cartilage away where you get the orange peel effect?

[Guest guest]

This reply is for bucko902000.<br><br>I'm a

cyclist, too, and I'm intrigued by the 3D motion analysis

that you mention. Where did you have it done? What did

it tell you about your biomechanics, i.e. was the

problem related to your equipment, technique, or was it

just the way you're put together? In any case, it

sounds like a really cool way to diagnose exercise

related injuries.<br><br>Thanks.<br><br>Tony

[Guest guest]

Healthsouth should very well be able point you to

one their clinics which have this method. I got mine

done at Healthsouth and another place which was

sold.<br><br>The method of 3D motion analysis is computer

animation in a very rough regiment, like stick figure

theater.<br><br>What they do is put little reflective balls on all

your joints and place two or three cameras on

different but equal axis in the room and while filming you

in action they strobe you. The media is then

imported into special software which only sees the

reflective balls. The end result is you look like stick

figure in motion and because all your joints are seen by

a straight line it's easy to see any mechanical

abnormality. Also the lines have rotation figures so even if

something isn't seen a numeration will state if there is a

variation between the joints. Also the animation can be

seen from any angle, top, bottom, side, diagonal to

view abnormalities.<br><br>I could write a great deal

about how my CP came about. My problem wasn't so much

equipment or technique but massive muscle imbalance. My

mechanics were finally accurately analyzed by a Ph.D. in

biomechanics who told me my mechanics had developed into the

most complex case she had seen and it would take while

to write. But, trying to make it short, several docs

told me initially to work my VMO which would usually

be ok for most but was something I didn't need to do

and helped caused a muscle imbalance since my vastus

Lateralis was already weaker in relation. In essence my leg

was flaring out while on the upstroke, not down,

where many think the most stress occurs. Also weaker

than my vmo were my rectus femoris and hamstring,

pretty much anything that helped flex the leg was

screwed up. I was also given some popular floating cleat

and shoes with the thought they would help. They

didn't. These shoes and pedals made the problem worse

since my <br>mechanics were already missed up. Those

shoes and pedals are good if your mechanics are ok but

not if you need help like I did. I've since gone to

fixed cleat.<br><br>When I read/hear people going to

orthos or PTs where they treat them like text book with

the idea that medicine is an exact science, which it

isn't, and keep doing the same thing with the result I

shake my head because I went though the same thing for

years. There were numerous times I almost went though

surgery because I thought it should help, they wouldn't

do it unless it helped?<br><br>But I obviously got a

perspective that some if not many experience that being

chondromalacia is nearly entirely effected by mechanics; after 9

months from my injury I was able to ride again and I

mean really train where oddly the one thing I could do

for hours with no pain was intense hill work. I'm

talking 16% grade climbs that last one to 1 1/2 miles. I

would go up and down for hours which baffled me because

flat terrain with big gears would incur pain. Nobody

really knew what I did for such a turn around where the

docs thought it was the vmo exercises but it wasn't

that, it turned out I had inadvertently strengthen my

hams and Lateralis by walking a great deal with

weights. It was exactly what my legs needed, an open chain

exercise which equalized my muscle strength. Only problem,

it took years to realize that doing those vmo

weren't the cure but problem, at least for me.<br><br>I

would stress if someone keeps getting the same results

from the same doctor or PT then change for God's sake

change because you may never know what's really causing

your problem. In fact there were two orthos where one

wanted to do a lateral cut and another wanted a open

knee re-alignment, neither which I needed.<br><br>If

there were huge monster pieces of advice I would give;

1 find out how the tracking became out of whack. 2.

find an aerobic open chain exercise which doesn't hurt

the knee and do it religiously. Keeping myself active

in some order but not ignoring the degrees of pain

has been vital.

[Guest guest]

Hi bucko,<br> Thanks for your reply. I so much

agree that I felt it had to be linked to some type of

biomechanics but I've seen four different OS's in Reno and

they all agree that everything looks fine. I'm two

weeks post op from my scope, he removed my plica which

he said was enlarged/inflammed and scraped some more

roughened cartilage. He too said the patella tracks fine

and said the next progessive surgery would be high

tibial osteotomy - Scary! I'd walk thru fire (we all

would) to be normal again, or even walk around without

pain/grinding. The hard thing for me is not to feel like I'm

drowning in this, I don't feel like I'm me anymore. I'm

not, I can't do the things I've always done. I'm

afraid because I'm only 33 and nobody wants to replace

knees until your 60. I do think I'm going to just leave

the knees alone - I will have them go in to access

the damage in my right knee cause I want to know and

I have some popping that might be the plica. I have

had my right shoulder begin to grind so I'm sure the

docs are correct that it's osteo arthritis, not much

can be done.

[Guest guest]

Everyone knows your frustration including myself.

It's difficult to believe something so small, the size

of dime or smaller, could cause so much trouble.

Although something doesn't sound right with your problem

because the knee it's self is hardly if ever the cause of

a problem but a symptom of something wrong below or

above the knee because that's where the motion is

beginning. The knee is simply amplifying the mechanics of

those articulations so when something is wrong it ends

up at the knee. If you don't find out the cause your

destined to keep going to the OS out of frustration where

they'll keep scraping your cartilage.<br><br>btw, I had

five OSs and even more PTs look at my knee before it

was correctly analyzed. In fact no OS ever saw my

problem but the PT who's Ph.D in biomechanics. I was in

your boat and made sense what-so-ever because I kept

asking myself, " how did this happen? " Several people

told me what they're telling you and it made no sense

then where you situation makes no sense now. I'm 31

and I've had CP for 10 years and remain as active

when I first had it and never had surgery, never had

it scoped but had it MRI many times instead. They

can look at you in the office but I've learn that

doesn't mean anything unless their looking at your

Q-angle or weak inner quad. But as for checking your

mechanics accurately you need to go into an environment

where you can re-create the motion that caused your

pain otherwise I don't think it means anything. You

need to re-create the fatigue of your muscles during

that motion or you won't get an accurate

analysis.<br><br>My concern is if you don't need surgery, depending

on you level of activity, then the cure maybe worse

than the disease. If I were you I would get the

mechanics of your legs checked out by someone know their

stuff and not just in an office visit. Either your

Q-angle is askew or your leg's muscles need work, one or

the other. Either you generally getting arthritis.

And if you go into surgery without finding which of

these is the culprit you'll be going into dangerous

cycle where you can't go back.<br><br>Unless your pain

is beyond your threshold I would take a step back

and not let your frustration get the best of your

judgment. Take some time and find an activity where you can

move your legs without pain. In fact the first thing

my OSs told me when they first thought I had CP was

to get moving as quickly as possible. Reason being

the cartilage gets it's nurishment by the compression

of the patella, femur and tibia within the synovial

fluid. The more your remain inactive the more likely

you'll develop arthritis.<br><br>Also popping doesn't

mean anything unless you feel your patella coming out

or painful otherwise it's nothing to be concerned.

At times it can mean your lateral muscles are tight

but that's about it.

[Guest guest]

It's nice to talk to people who do understand the

frustration. I actually had to activate insurance thru my work

because my husbands told me they would not pay for me to

see yet another OS. I had to wait for open season to

activate my own insurance and then got in to see the one

who did my latest scope. Mainly I wanted to know what

the heck was going on inside my knee. I asked him

about my Q-anngle and said it was a little high but no

biggy. I'm being seen in Reno Nevada - maybe a bigger

city would have more options. I am swimming (which I

don't really dig on but it's impact free) and riding a

bicycle but have curtailed all things I loved doing like

jogging, water skiing and playing tennis. Walking and

everyday activities now cause me some pain and grinding.

Emotionally this has been very hard but I'm glad I'm alive. I

pray I never get where I can't walk as I am doubly

blessed to have degeneration in BOTH knees. I'm going to

have this doc scope the right just to see what's going

on, MRI's show absolutely no damage whatsoever which

is why five different OS's have told me basically

" you're crazy and nothing is going on with your knees " . I

asked this doc what my options are as I'm only 33 and

what if in five years I'm limping around - he said the

next step would be osteotomy but I don't think I'm

ready for that until I absolutely HAVE TO. Truthfully

I'm just so damned tired of knees, knees, knees. I

can't remember a time that I didn't think about them.

I'm saddened that I can't be the person I walways

thought I was, ie active! It really is a disability - I'd

like nothing more than to go back to jogging and

playing tennis every Sat and Sun but my body won't allow

me even though my mind screams GO. Well I've rambled

enough I guess the point of my post is I wish I had the

financial freedom to see the " best " docs and physio's but

how does a person even know if they are seeing the

best? We will be moving this summer to Virginia and I

was wondering how would I be able to pick out the

" articular specialist " there. Any insight?

[Guest guest]

I know how you feel. I've seen 3 OS's and one

consultant rheumatologist who all waggle my legs and say

there's nothing wrong with me. X-rays normal. MRI was

taken yesterday... wonder what that will show. If I

don't use my mag wraps I end up in excruciating

constant day-long pain and they all seem to think I'm

imagining it...! It's crazy. I know I'm not imagining

ANYTHING!<br>Joe

[Guest guest]

I don't know why they even bother with taking

X-rays, they don't show a thing! what I mean by that is :

plica won't be seen, cartilage degenaration, tendons

and inflamation. All an X-ray is good for, is to show

broken or dislocated bones. I've heard that from a doc

before. MRI's are the best because they show everything

that is happing in there. I think these doc's just

don't have the time of day to do a proper diagnosis,

here in Canada, doc's take 5 to 10 min with you and if

it takes longer they start looking at their watch,

and leave in the middle of a question. It happend to

me so many times...clinics are full of people and

doc are trying to see everyone, they are overbooked

which results in mis-diagnosis.<br><br>Good Luck

Joe<br><br><br>Kat

[Guest guest]

That's not entirely accurate. The OS would get an

xray to tell if the patella isn't lined up with the

femur which is quite easy to see with all the angles

the xray provides. Also it can show if larger defects

in the cartilage or meniscus exist. Additionally for

larger tendons, if tendonitis exist, would show on an

xray because the extent of build up with calcium.

[Guest guest]

Hi, I read your post. I was wondering if you

could explain what an open chain exercise is/ walking

with weights. <br><br>Thanks.<br>K.<br><br>Also, did

the biking help your knees? It seems that I started

having all my problems once I started biking. My knees

would get stiff and then after a few revolutions, it

would go away. After several bike rides of 15-20 miles

on a level surface, my knees became stiff as soon as

I got off the bike. I'm scared to get back on one,

even if it's just to warm up on a stationary bike.