 Poster: A snowHead
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My left (dodgy) knee lacks flexion. If I hold my right ankle (quad stretch) my heel readily touches my bottom. But the left is some way off. I'd be very interested in views as to what is the best thing to do about this. Looking at articles on the internet most refer to "post surgery" rehab. But I've not had any surgery so I'm not sure how relevant they are to my problem.
I have a book called "Keep Your Joints Young" by physio Sarah Key. She advocates an exercise called "The Child's Squat" where you kneel down, knees together, feet apart, then sit between your feet, with a cushion (or two, depending on how tight your knees are) for at least a minute. She calls it "the exercise which people love to hate if they have bad knees". I see what she means....
It really feels as though you are doing more harm than good.
If this sort of deep flexion exercises (ie manually pushing the knee into a flexed position by main force) is really good for the knee I'm happy to continue. I don't mind pain if I think it's serving a useful purpose.  So any advice would be welcome.
I shall ask my physio next time I see him but would appreciate a range of ideas - especially from anybody with direct experience of this having to restore flexion, or any knee specialists!
Last edited by Poster: A snowHead on Tue 5-08-14 15:12; edited 1 time in total
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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I have that problem too; it's an escalation from a 9 year old MCL injury, but I have specifically sited pain on the inside of my left knee.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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pam w, fwiw, two physios have told me not to force the flex beyond where it hurts. About ten years ago, I could do those exercises with a bit of practice, but then it was just a stiffness issue: the pain now is another matter. Luckily, the flexion I have is plenty enough for skiing and (like you, I think) I only get pain after I've stopped for the day; and then RICE in the evening sorts it out sufficiently for the next day.
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You need to Login to know who's really who.
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pam w, I would be inclined to see a Physio. Essentially the question you need answered is (I believe) is there anything physically preventing the flexion or is it just tight muscles? If it is muscular then stretches and a sports massage would be helpful. If it is a physical impingement then you would want to know what and trying to force beyond could cause the physical impingement to move and become far more of a daily issue.
I could be paranoid on these things due to my issues with my knees, but a trip to a Physio won't cause any harm.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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two physios have told me not to force the flex beyond where it hurts.
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is there anything physically preventing the flexion or is it just tight muscles?
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Hmm. Those points go to the heart of what is bothering me. I am familiar with the feeling of stretching muscles and the key discomfort is really in the knee itself - fairly general, but more on the outside than the inside.
The physio I saw locally did quite a bit of work on my left quad muscle and gave me exercises of various kinds, focussing on building the strength of the VMO but didn't give me any flexion exercises (squats, yes, but those are not deeply flexed). The trigger for my post last night was having spent some time sailing, in light winds, which means kneeling down in the middle of the boat and making subtle balancing movements. I was wondering whether it was good for my knee, but it was rather sore last night - I felt very elderly and it hadn't been a long sail, just a couple of hours.
My knees do not hamper my skiing at all in the first instance (I have other problems which do that.... ) but after a strenuous week, or sometimes just a day, the bad one gets very swollen and they can both get hot. I can just hear some physio and/or orthopaedic surgeon saying "What do you expect at your age dear?". Maybe I should just accept something less than athletic perfection.
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You'll need to Register first of course.
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pam w, I hate to say it but what you have described sounds like my first medial meniscus tear. What caused it was kneeling down painting the side of our decking. I firmly believe that although that was the trigger the original damage was probably done playing hockey.
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NickyJ, I'm quite sure that the origins of my problem was an awkward twisting fall when skiing in the Cairngorms in the '80s. But I don't think I've done any specific injury recently - I've had the same kind of issues before, when sailing in light winds.
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The consultant showed me a structure of the knee and what happens when we kneel. It puts considerable force on the medial meniscus cartelage and can push some of it out of the joint. Hence why I said the kneeling painting was he trigger but there must have been some damage already there. In your case the kneeling while sailing.
I change my suggestion - go to the doctor.
Best of luck and I hope I am wrong, however that partiular injury was a straight forward arthroscopy and I was weight bearing the same day and skiing 2 months later.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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I change my suggestion - go to the doctor.
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I think you've convinced me, NickyJ. I did go to my GP some weeks ago and she suggested I see a sports physio. The consultation with him and the exercises I've been doing have, I think, corrected the VMO problem which was a short-term issue, triggered by the extreme swelling I'd suffered following the off-piste skiing in Les Deux Alpes. My VMO is now firing away beautifully, not footballer-standard, but as good as my right leg.
The GP did say that if in 6 weeks the problem still existed, to go back and she would refer me. I'll go and see the physio again and see what he has to say - I wouldn't like him to think I'd gone back to the GP because he was no use. But clearly he can't deal with a structural problem with the knee, such as you describe, rather than the musculature.
I'm not in the least bothered by surgery in itself but I do feel that it should be a last resort in knees! But an arthroscopy would be OK - my OH had two, both very straightforward, both successful. I've been paying for BUPA since he died, on the basis that I need to be as self-sufficient as possible when it comes to health matters, so would be able to get the op quickly if recommended.
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pam w, good news re your VMO. What ere you doing that improved it?
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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pam w, Problems with the knees due to kneeling in light winds is a widespread sailing issue. Over the years I have seen many Laser/Phantom sailors forced to move into Solos due to the kneeling problem. As far as I know they don't end up having surgery but put it down to old age.
A Musto skiff sailor did do a bucket tear of his meniscus cartilage due to kneeling downwind, though.
Having only skimmed this thread I think your sailing problem is par for the course and you need to treat yourself to a new boat. Have you looked at the new RS Aero  , though that might still require kneeling. Ironically one of the best boats for singlehanding that has a nice thwart for sitting on in light airs is the classic Mirror. Fibreglass with a Bermudan rig, might be worth a thought. Ideal for grandchildren too.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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holidayloverxx, I was told to do 200 "tenses" of the muscle each day, and have pretty well managed that. The thing is, it did fire, it was just pathetic. So I was able to make contact with the muscle - which I know can be very difficult or impossible after surgery. Have also been doing squats etc
cad99uk, you might just be right but the Topaz was new last season (well, it was second hand, but new to me). Not heard of a fibreglass Mirror with Bermudan rig - having now looked it up and read a (very positive) review I suspect it would be far more expensive.
I've made an appointment with my physio tomorrow. The thing is, I would be prepared to accept that it's just old age and wear and tear but my right knee, whilst hardly in 21 year old fettle, is heaps better than my left - two like that would be great!!
My physio treated the GB sailing team - has endorsements from Ben Ainslie amongst others and is a Senior Instructor so he will get the picture!
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You know it makes sense.
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pam w, I spent a few months recovering full flexion in one knee after a minor MCL injury last season. Even though there was still enough range to ski I wanted full range back if possible, to reduce the chance of injury when full range is unexpectedly called upon. Disclaimer: that is my own thinking, not a professional opinion, and remedial actions I took may not be advisable in all cases and could potentially cause further injury.
Actions included hands-on physio sessions weekly or bi-weekly, daily stretching to see how far it would go before resistance, deep massage in various locations around the knee to relieve stiffness or inflamation before stretching again, plus daily icing. I find stretching after massage usually gets further without discomfort. My physio also advised not to push past the point of resistance or pain, so I was quite careful about that, and eventually got as far as sitting on my heels again without discomfort.
I guess the above won't work when there is an obstruction within the knee, e.g. meniscus tear, but I'd say it's worth asking your physio if there are actions you can continue by yourself on a daily basis.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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balernoStu, thanks. That all sounds v sensible - will ask the physio tomorrow. cad99uk, I do like the look of that GRP Bermudan Mirror but I only have room in my garage for one boat. Can you recommend one with super sharp leading edges on the foils to slice through the bloody weed?
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Poster: A snowHead
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pam w, No solution to the weed problem I'm afraid. But can't the Mirror go in your sailing club dinghy park.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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cad99uk, the dinghy park is over-subscribed; there's a waiting list. Besides, my garage is closer to the water.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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pam w, So if you have only room for one boat then the Topaz will have to go and be replaced by the Mirror.
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You need to Login to know who's really who.
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cad99uk, or maybe I can get my knee sorted out!
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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pam w,
The restriction is either in the knee or in the muscles around the knee ( most of the time)
If you can fully flex your knee with your hip bent right up then the problem is likely the muscles that are too tight. For that you'll need physio .
If with hip fully flexed the knee is still restricted then it is in the knee.
If the problem is in the knee you need a diagnosis from a knee specialist to establish what the cause is ( ligaments, arthritis, meniscus)
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You'll need to Register first of course.
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I saw the surgeon (name of Andy Cossey) this morning. He showed me my MRI pictures and what he described as a "nasty" tear in the meniscus. He showed me on the scan but of course it didn't mean much to me! He said that was consistent with the symptoms I've described. Most of the time the knee functions fine but under pressure - particularly skiiing but also walking in rough terrain, it doesn't cope well and twisting is particularly dodgy. I was sailing at the weekend and once or twice when I needed to get myself in a stable position to work a winch it refused to cooperate and I had to shift around into a position where the knee was content. We were not racing, fortunately, so my tardy winching wasn't a problem. It's hardly life-threatening but I think it probably makes sense to have the tear repaired. At 67 I don't expect perfect knees but if my left could become as good as my right (ie both a little swollen at the end of a hard days skiing and responding to ice, rest and gin and tonic) I'd be content.
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Ooh, not sure if that's good news for you or not...but at least you know where the problem is coming from! Has he advised you get it tidied up?
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Well I have been attending knee physio exercise classes in my local hospital, and have a load of specific exercises to do at home. Guess I am going to have to incorporate this routine into my life from now on considering the pounding my knees have had over the years.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Has he advised you get it tidied up?
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No. He said that if it didn't interfere with everyday life he'd suggest leaving it alone. It doesn't interfere with everyday life if I potter around shopping etc and it can cope with controlled exercise such as squats though I sometimes get a twinge of acute pain if I twist - not doing anything gnarly, maybe turning over in bed. But walking on uneven ground seems to irritate it, and skiing anything other than gently can give rise to a lot of swelling. It's for skiing, really, that I'd get it done.
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pam w, difficult decision but, given how much you love skiing and walking..............
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Pedantica, +1
If you reasonably want to ski for another 10yrs + then worth thinking about it. Hopefully Jonathan Bell will spot this...
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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I have been slightly alarmed by some accounts of recovery and rehab - google. Being off driving for a week or so no big deal and happy to do rehab exercises but talk of recovery taking many months made me wonder. My OH had two tidying up arthroscopies and was skipping round in no time and I was skiing 12 weeks after fracturing my pelvis. Couldn't ask surgeon this morning. I had two kids with me and they were getting slightly disruptive. Will obviously ask him but other am interested in other experiences.
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You know it makes sense.
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Sounds a difficult choice, and hope your surgeon appreciates what is important to you.
| pam w wrote: |
| ... I had two kids with me and they were getting slightly disruptive. Will obviously ask him but other am interested in other experiences. |
No help for the rehab question, sorry, but I do have plenty experience trying to get things done in the company of two disruptive kids 
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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| NickyJ wrote: |
| pam w, I hate to say it but what you have described sounds like my first medial meniscus tear. What caused it was kneeling down painting the side of our decking. I firmly believe that although that was the trigger the original damage was probably done playing hockey. |
Sounds like it is very similar injury. Are they actually proposing a repair? With mine they trimmed away the offending tears causing the issue. I was weight bearing the same day, and skiing 3months later. Yes you will need to work on physio exercises afterwards, but it was pretty straight forward and as you are physical fit from the sound of things, it strikes me as the best bet. Good luck
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Poster: A snowHead
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| pam w wrote: |
| I have been slightly alarmed by some accounts of recovery and rehab - google. Being off driving for a week or so no big deal and happy to do rehab exercises but talk of recovery taking many months made me wonder. My OH had two tidying up arthroscopies and was skipping round in no time and I was skiing 12 weeks after fracturing my pelvis. Couldn't ask surgeon this morning. I had two kids with me and they were getting slightly disruptive. Will obviously ask him but other am interested in other experiences. |
Success in surgery is all about "patient selection", by that I mean that if your surgeon is skilled at identifying who will do well from an operation and only offers surgery to those he/ she thinks will do well results will generally be good.
The problem occurs when surgeons don't " select" and give same advice to everyone or they advise people to have surgery that in reality may not work for that patient. The factors to take into account can be vast but certainly activity level is a crucial one often overlooked.
These days it can seem that decisions on when to operate are based in a scan. Nothing could be further from the truth.
Jonathan Bell
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