Almost Over the Hill Hikers
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    #137047 - 08/01/10 01:04 PM Knee surgery rehab & recovery
    moondust Offline
    member

    Registered: 08/17/03
    Posts: 22
    Loc: California
    I'm 55 and had arthroscopic knee surgery on 7/28. It's a long story, beginning with taking a fall on the trail back in October, then trying for months to convince doctors there was something wrong beyond the general diagnosis of "arthritis". I finally found the right doctor, an old (70) experienced surgeon, who immediately spotted the problem on the 6 month old MRI (detached piece of meniscus floating around). Last Wednesday he removed the large floating piece, several smaller ones, and did some sort of repair to the lateral meniscus, which I suspect had torn a couple of months ago.

    To anyone who has had this type of surgery involving the meniscus, can you recall how long it took to be able to get back on the trail, and what the different stages of recovery felt like? I was hiking hard every weekend until the knee had its meltdown. I'll be resuming physical therapy next week (I was going to PT with my general arthritis diagnosis for several months). Of course I'm willing to work as hard as it takes, but I don't want to do any more damage to my knee by stressing it too much too soon. Eventually I'll need a knee replacement, but if I can avoid damaging my meniscus any further, I believe I have a lot of miles left in the knee I have!

    Thanks for any information or advice!
    Alice


    Edited by moondust (08/03/10 02:16 PM)

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    #137108 - 08/02/10 06:26 PM Re: Knee surgery rehab & recovery [Re: moondust]
    OregonMouse Online   content
    member

    Registered: 02/03/06
    Posts: 6371
    Loc: Gateway to Columbia Gorge
    My knee injury, in which I completely tore the medial collateral ligament and both cruciate ligaments, is in no way comparable to yours. It ended up taking me about a year. Hopefully your meniscus problem will take a lot less time.

    Talk to your physician and your physical therapist. You'll have to explain in detail what your activities involve, unless one of them is also a backpacker. They may be able to give you a guesstimate, but they may want to wait a while to see how you respond to the post-surgical therapy.

    While you need to work hard at your PT, don't rush the backpacking. Between the pack, the irregular terrain and the downhills, that's a lot of strain. The PT folks will have you on a bicycle a lot. Make sure the knee is healed and that you've built up the supporting muscles first, and then start slow and work up. If you haven't used trekking poles, start now. Work on lightening up your pack weight, too.

    The only thing worse than that "arthritis" tag is when they tell women that "women are prone to knee problems and there's nothing we can do about it." I didn't have that diagnosis, since my lower leg was flopping around with no control right after my injury, but both my daughter and daughter-in-law have been told that!
    _________________________
    May your trails be crooked, winding, lonesome, dangerous, leading to the most amazing view--E. Abbey

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    #137128 - 08/02/10 10:53 PM Re: Knee surgery rehab & recovery [Re: moondust]
    DJ2 Offline
    member

    Registered: 01/06/02
    Posts: 1347
    Loc: Seattle, WA
    I wrenched my knee about a year ago. It was sudden and acute. I knew within minutes that I had injured it.

    I too was frustrated that the Drs kept focusing on the arthritic aspects of my knees rather than the acute injury (I'm a 65 year old male). Fortunately the physical therapist that I worked with simply focused on making things better and, sure enough, things got better.

    My knee injury came on the heals of a back injury so I decided to just forget backpacking for a year and build myself up. That's all behind me now and I'm good to go. You will be too but I don't have enough experience to guess when.

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    #137149 - 08/03/10 02:47 PM Re: Knee surgery rehab & recovery [Re: OregonMouse]
    moondust Offline
    member

    Registered: 08/17/03
    Posts: 22
    Loc: California
    Thanks for the responses! Good suggestions too. I have used hiking poles for years - I'd feel naked without them smile

    I'm very lucky that my PT is a hiker and PCT backpacker and he's old too (66)! (He also still runs marathons, although he hasn't tackled an ultra in a few years). He is very optimistic about getting me back on the trail, and believe me, it helps a lot to hear that optimism. He had already gotten me into good shape, concentrating a lot on my glutes so that they would support the knees properly. It did wonders for my uphill speed and stamina. I was leaving a lot of my younger friends in the dust! When my knee started to swell so much, it was not possible to do a lot of the exercises any more, especially for the quads. Now I'm waiting for the post-surgery swelling to go down enough that I'll be able to start working my leg muscles again.

    The risk of further meniscus injury is what I'm most concerned with once I'm hiking again. I think it initially tore back in October when I caught my toe in a crack coming down the North Fork Whitney trail and bent the knee almost double. That created the detached piece that I had been feeling. But the latest setback came in early May because I was negotiating some boulders and pushed up all my weight with the knee when it was bent pretty tight. It didn't hurt, but now I understand that our old fragile meniscii can't take the force any more. If I need to restrict the angle of the knee, hopefully I can wear a brace which will not let me bend it past a certain point.

    I love this forum and thanks for being here, everyone!


    Edited by moondust (08/03/10 02:54 PM)

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    #137180 - 08/03/10 09:13 PM Re: Knee surgery rehab & recovery [Re: moondust]
    DJ2 Offline
    member

    Registered: 01/06/02
    Posts: 1347
    Loc: Seattle, WA
    "pushed up all my weight with the knee when it was bent pretty tight"

    That's just how I injured mine.

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    #137192 - 08/03/10 11:00 PM Re: Knee surgery rehab & recovery [Re: DJ2]
    OregonMouse Online   content
    member

    Registered: 02/03/06
    Posts: 6371
    Loc: Gateway to Columbia Gorge
    I understand that one of the purposes of the meniscus is to cushion the joint. With a good chunk removed, your knee will be more susceptible to shock. That's why I suggested trekking poles and a lighter pack.

    I use a knee brace on long downhills, but have found that keeping those leg muscles strong is the most important thing!
    _________________________
    May your trails be crooked, winding, lonesome, dangerous, leading to the most amazing view--E. Abbey

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    #137206 - 08/04/10 12:11 PM Re: Knee surgery rehab & recovery [Re: OregonMouse]
    moondust Offline
    member

    Registered: 08/17/03
    Posts: 22
    Loc: California
    Mouse, you are certainly an inspiration, coming back from such a severe knee injury in your 70's!

    On my last backpack (just an overnight) my pack all-inclusive weighed between 25 and 30 pounds. You wrote somewhere that you are sub-20 pounds for an overnight? Do you have your gear list on here somewhere? I am similar to you in that I am a cold sleeper and need a bit of comfort at night, and I would love to shed 5 or 10 pounds off the pack!

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    #137229 - 08/04/10 06:33 PM Re: Knee surgery rehab & recovery [Re: moondust]
    OregonMouse Online   content
    member

    Registered: 02/03/06
    Posts: 6371
    Loc: Gateway to Columbia Gorge
    I don't have a published gear list, but if you go to the home page of this site and read the articles listed in the left hand column, there are lots of articles to help you get your base weight (everything but food, water, fuel) down to 15 lbs. or less. They sure helped me, or I wouldn't be backpacking any more. There are links to a number of good lightweight (not ultralight) gear lists on Mark Verber's excellent website.

    My injury, by the way, was 23 years ago, so I was only in my 50's then.


    Edited by OregonMouse (08/04/10 06:38 PM)
    _________________________
    May your trails be crooked, winding, lonesome, dangerous, leading to the most amazing view--E. Abbey

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    #143302 - 12/13/10 05:25 PM Re: Knee surgery rehab & recovery [Re: OregonMouse]
    moondust Offline
    member

    Registered: 08/17/03
    Posts: 22
    Loc: California
    Update on knee: I was a good patient and followed orders. I didn't try to do more than my PT wanted me to, and I'm very glad I listened. My first baby hike was Oct 30, and I've been out every weekend since! I hiked 12.7 miles a couple of weeks ago, and now I'm starting to go up and down steep hills.

    The recovery was not a linear process - good weeks, bad weeks, lots of dark thoughts about never hiking again, but I'm through the worst of it. According to my PT, the knee will continue to improve for several more months as it toughens up. A week ago I went cold turkey off the Mobic (anti-inflammatory) and I'm happy to report I'm doing fine without it.

    When I get back to scrambling, I will have to do most of the climbing with my good knee, but at least I know it's doable. And you know, I'm really really happy to just be back on the trail, whatever my limitations will turn out to be! I had my 56th birthday a week ago and I told everyone my birthday present was sore quads from the Saturday hike smile


    Edited by moondust (12/13/10 05:25 PM)

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    #143491 - 12/16/10 11:23 PM Re: Knee surgery rehab & recovery [Re: moondust]
    dkramalc Offline
    member

    Registered: 09/19/03
    Posts: 1070
    Loc: California
    Congratulations on the recovery! I think you are to be commended for not trying to overdo it. I have a great deal of sympathy right now for anyone with knee problems.

    I damaged my left knee somehow in July (may have been the fall I took landing on my side when my feet slipped out from under me to the right on a muddy patch in the trail). I finished out that trip, and did another a week later, but it just felt strange (mostly stiff, with very loud clicks when I straightened it). I feared a minor meniscus tear, but when I started physical therapy in October (after I retired, I figured I had time to address the problem) the therapist didn't find any signs of one. I am still doing exercises to relieve some pain in the knee but managed an easy 10-mile day hike at Point Reyes last week which was wonderful (and didn't give me any pain). At age 55 I am finding things like this put the fear of God into me - one small slip and my hiking days could be permanently affected. According to the therapist, I should have a full recovery from this one (phew!).
    _________________________
    dk

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    #143556 - 12/18/10 05:15 PM Re: Knee surgery rehab & recovery [Re: dkramalc]
    midnightsun03 Offline
    member

    Registered: 08/06/03
    Posts: 2936
    Loc: Alaska
    DK

    It is possible that your knee clicking and stiffness could be related to a muscle spasm/knot in your lower back. Many of the muscles that move our legs originate in the pelvic girdle (attach to the pelvis), and when a muscle gets irritated it sometimes spasms at the origin (especially after a fall or odd movement). when this happens the muscle shortens a bit, and you can imagine how it could pull the entire knee out of alignment. I've written about this elsewhere, but I've had the knee "clicking" problem that you mention and was able to make it go away by massaging the muscles in my sacroiliac region.

    MNS
    _________________________
    YMMV. Viewer discretion is advised.

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    #143674 - 12/20/10 02:00 PM Re: Knee surgery rehab & recovery [Re: midnightsun03]
    dkramalc Offline
    member

    Registered: 09/19/03
    Posts: 1070
    Loc: California
    Hi Andi,

    Thanks - I'll try that approach as well. As luck would have it, I have a massage scheduled tomorrow (midway through my Nutcracker run - playing in the pit always makes my back and shoulders sore), so that may help.

    The PT diagnosis is that at least right now, my quads are too tight (though I've improved that significantly over the last several weeks). The clicks do seem to be related to tightness, and go away after a bend or two, unlike the clunks. She thinks the clunking may be due to scarring along ligaments or something at an injury site, so that as I flex/extend the knee there is a clunk similar to if you were pulling a knotted rope through a notch, and that with time the knot will wear away.

    There's also some weakness along the outside; when I do one-leg squats on the left side, the knee goes inward rather than straight forward unless I really pay attention and make it behave. It's all improving, albeit slowly, which is a big relief to me.

    Debbie
    _________________________
    dk

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    #143700 - 12/20/10 07:27 PM Re: Knee surgery rehab & recovery [Re: dkramalc]
    midnightsun03 Offline
    member

    Registered: 08/06/03
    Posts: 2936
    Loc: Alaska
    Well, it does sound like it is muscular then, with muscles tight and pulling unevenly (or unequally) and thus pulling the knee out of alignment. I had a great chiropracter in CO who explained how having two muscles, which are supposed to work equally, instead pulling at different strengths can throw a joint out of alignment. In my case he was talking about my jaw, and how the muscles that are attached to the spine and help open the mouth are supposed to have equal pull strength. But for me, because my neck vertebrae were out of alignment the muscles pulled unequally, resulting in TMJ. He aligned my nect and the residual TMJ that I had (it had also been treated by another form of eastern medicine - a form of shiatsu called Sugi) went away. I do have some jaw degeneration due to way too many years of active TMJ so it still clicks, but I can open and close my mouth all the way without using my hand to physically manipulate it now. Now that I've been studying anatomy again in great detail, I can see exactly why it is so important to make sure all of our muscles are kept in optimum condition. We have alot of muscles, but not really much redundancy. Fascinating really.

    MNS

    P.S. How many shows do you have to play?
    _________________________
    YMMV. Viewer discretion is advised.

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    #143761 - 12/21/10 04:17 PM Re: Knee surgery rehab & recovery [Re: midnightsun03]
    dkramalc Offline
    member

    Registered: 09/19/03
    Posts: 1070
    Loc: California
    12 shows total (in past, more economically sound years it was in the 20's for us). But SF Ballet does 30, so I can't complain too much (those musicians look like Night of the Living Dead by the end of the run!) - besides, it really is great music, and the kids who come are adorable to watch. I love seeing them come peer down into the pit, dressed up in their best little outfits.
    _________________________
    dk

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    #146196 - 02/10/11 12:10 PM Re: Knee surgery rehab & recovery [Re: moondust]
    Pitterpatter Offline
    member

    Registered: 02/08/11
    Posts: 15
    Loc: California
    My knees were pretty much destroyed when I was 18 in a freak accident. I've had several operations on both, they've been partially reconstructed, I have lots of hardware in there. Both feet were broken, too, and I had a head injury that left me 3 weeks in a coma.
    Then at 33 I broke my back.
    I am now in my mid forties, and although I still deal with pain on occasion, I can backpack anywhere, do yoga, swim, lift weights, I even got a black belt in taekwondo at 39 years old.
    The key, for me, was to never stop moving, but to be patient and careful, work things up gradually.
    I have kept my weight down to alleviate pressure on my joints, and kept my muscles strong and flexible to protect them.
    Listen to your body is my best advice.
    Pay attention to the cues it gives you with dull aches, swelling, sharp pain etc, adjust your activity and intensity accordingly.
    I live relatively pain free now, unless I am tired or the weather changes. Gotta love being a walking barometer!
    Time is your best friend, though. The older we get, the longer we take to heal so respect that, but keep moving... gently at first.
    One key element is to condition your core to rock solid: with a strong core, you don't lose your balance and catch yourself on your leg, which could hurt if you do a wrong move. You also don't compensate with your lower body so your step is sturdier and more supple. That helped me a lot.
    Good luck!

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    #146591 - 02/17/11 10:10 PM Re: Knee surgery rehab & recovery [Re: Pitterpatter]
    Tango61 Offline
    member

    Registered: 12/27/05
    Posts: 931
    Loc: East Texas Piney Woods
    Man, I'd love to see you go through the airport security!

    That would be a hoot!

    "Yes, I'm SURE I've taken everything out of my pockets!"
    _________________________
    If you think you can, you can. If you think you can't, you can't. Either way, you're right.

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