Question: Muscle loss after an injury. How to get my legs back?

[snow addict]

So I injured my knee two weeks ago. For a change it was a left knee (all past mishaps occurred in my right knee) and the injury wasn't even on my "shopping" list. The moment I knew I blew my knee and got over the fact that I was missing my ski clinic a I kind of wished for mild MCL which I had before few times. Turned out I dislocated patella. Ligaments intact, tendons in a good state, meniscus absolutely fine. There is some cartilage damage as it happens with this sort of injury but it's not extensive and doesn't require a clean up. The only concern my Dr. had was that apparently I have a shallow groove in which patella sits and my Dr. was very surprised that I lived till almost 40, skied for 9 years, had XC and ice-skating background (started at 4, meniscus and ACL prevented me from selection for competitions and after I recovered "double Axel" became a swearing word for me) and it hasn't happened before. Supposedly I might have just as shallow groove in my right knee. I went to see a specialist yesterday who pretty much sent me packing and told to come back in three weeks because he wanted "to see a good healing", meaning full length brace + crutches for another 2-3 weeks (I've had them for 2 weeks already), then "we talk" and told me not to think about skiing till March.

So as I got over the shock of the injury I thought I could live with that. But there comes another shock. My knee is healing quite well, I can feel it. The swelling is gone and it's not wobbly anymore generally, only when I take off the brace, I guess because it's been locked all day in this weird straight position. When I get up in the morning after not wearing the brace, it's much better. However, when I look at my legs my left leg is noticeably thinner than my right leg. Basically no quads at all and I had pretty good ones. I also lost all the weight it took me so much effort to put on. I was 122 pounds at Christmas and I weight 112 now, and back at UK6 after gaining a full size in about a year. I literally can brace my left mid-thigh with two hands and my fingers will touch. How on Earth I am going to turn my skis with this legs in a month time? And I expect it to get even worse in 2 weeks....

I've been reading extensively about knees last couple weeks. Went through TGR forums which convinced me there is absolutely no way anyone can talk me into having any sort of surgery on my knees unless it's a life-saving surgery or I can be given a 100% guarantee of a very fast (say 8 weeks) recovery. (That's if I have a surgery in July - I can't lay myself off for any sort of time till then with work commitments). And the stories I read indicate something like 6 months recovery post-op AT LEAST. I don't want to jeopardise my next season - I am planning and plotting to take ALL January off next year to make up for the loss of ski time this season. I also understood that to prevent my kneecap from popping out again I need strong quads and hamstrings. Which I will get by December - I don't have any concerns about that. But I HAVE to ski THIS season and they are disappearing and I am afraid I will have none in three weeks time. And I will need them in March.

So any tips for a fast quads build-up? I am reading MarzNC thread, which has awesome information and is very inspiring, but she had time to get the strength... Any Divas had the experience of getting their strength back in a shorter time? Overall fitness is a lesser concern to me - by now I walk on crutches almost as fast as I did without them, same distance takes me maybe 5 min longer (in the beginning what previously had took me 20 min was taking about 40, but now it's down to 25 if I get traffic lights right), so I guess I am not doing top badly in this department. I am taking 2 weeks over Easter.. And I can stay away from moguls this season. But when I look at my legs I realise that with these I can only go straight on bunny slopes... Any Divas had the experience of getting their strength back in short time? Sorry for the long rant, but it just sits in my mind and doesn't let go...

 

[skibum4ever]

Some years ago, I skied about 6 weeks after tibia plateau surgery. I spent a lot of time on a stationary bike and that seemed to help both my knees and my quads. The elliptical is another machine which really seems to strengthen my quads. I'm a machine person but I'm sure a good PT can give you the most effective exercises for your situation. Good luck; I feel your desire to get back on skis again this season.

 

[contesstant]

Yes, PT is in order. I do hope they prescribed some for you? I have dislocated my left patella twice. The first time it was out for about 30 minutes until they could pop it back in in the ER. The 2nd time, my daughter sat on it, it popped out and stayed out but I was able to relax my quads and it slipped back into place. Neither time did I suffer any swelling or great pain so I was back at activities in no time.

Anyway, not to bore you but I am familiar with this injury and for PT, it's all about the glutes and hamstrings, not just the quads. For the quads, it's all about slow and controlled exercises that allow you to control the tracking of the patella through the range of motion. Please to get to PT ASAP as it's an easy injury to deal with (in my experience) and you should be back at it in no time! Be patient and don't worry too much--if you were strong before, it'll return quickly.

 

[MaineSkiLady]

Familiarity here as well, but to rx would be foolish -- you've got to get a hands-on pro to evaluate and prescribe. Yes - the quads lose it FAST. The good news: they come back fast - and strong! There is hope! Promise.

 

[snow addict]

Yes, PT is in order. I do hope they prescribed some for you? I have dislocated my left patella twice. The first time it was out for about 30 minutes until they could pop it back in in the ER. The 2nd time, my daughter sat on it, it popped out and stayed out but I was able to relax my quads and it slipped back into place. Neither time did I suffer any swelling or great pain so I was back at activities in no time.

Anyway, not to bore you but I am familiar with this injury and for PT, it's all about the glutes and hamstrings, not just the quads. For the quads, it's all about slow and controlled exercises that allow you to control the tracking of the patella through the range of motion. Please to get to PT ASAP as it's an easy injury to deal with (in my experience) and you should be back at it in no time! Be patient and don't worry too much--if you were strong before, it'll return quickly.

I think mine popped back in place immediately or almost so. But I was told to immobilize for a month until we can talk about PT... I have a feeling - because I wasn't in great suffering and swelling disappeared fast - that had it happened in the off-season I would probably be going back to activities around now.

Thank you, ladies, for encouragement, will try to find a gym close to my house. Hopefully I can still walk when I finally can take this thing off

 

[pinto]

I dislocated my patella 8 times, but it was back in the 80s, and they did things differently. (Immobilized leg for a month or more, talk about quad loss.) Then the focus was on the VMO (part of quad on the inside of leg), but now they are working more on hip abductors to keep control of the patella. Definitely you need the quads back, but for prevention, do a lot of research (and see a physio) about the hips' role in this.

 

[contesstant]

You would have known had it not popped back in! It is hideous when it doesn't. Your doc is clearly more conservative than the hospital I was at. Walter Reed Army Medical Center is where I was--they gave me a brace and sent me on my way! I went to my doc on my own. I was back at it two weeks later. Can you go back to your doc or get another opinion?

 

[snow addict]

Ladies, you are fantastic! I really thought I was some kind of a freak, especially when I was told that I had shallow grooves so that should have been a common injury to me... I have an appointment on the 19th. I'll stick with my ortho for now as we are not talking about surgery or anything drastic yet but on 19th if he keeps putting off my return to skiing I will be going for the second opinion definitely. I feel that one more week and this brace will be doing me more harm than good and I keep forgetting my crutches everywhere I go, they are basically a PITA.

 

[snow addict]

Some years ago, I skied about 6 weeks after tibia plateau surgery. I spent a lot of time on a stationary bike and that seemed to help both my knees and my quads. The elliptical is another machine which really seems to strengthen my quads. I'm a machine person but I'm sure a good PT can give you the most effective exercises for your situation. Good luck; I feel your desire to get back on skis again this season.

Thank you! You should have seen the snow! I am heartbroken I am missing it... 2 feet in day and a half and more on its way this week. Why, or why couldn't I injure myself in April?

 

[HeidiInTheAlps]

Hey Snow Addict....

I am counting on a meet up with you! We can avoid the moguls, they're nasty on even the best of knees!

But you gotta be there!!! 23 Feb to 2 March are our planned Haute-Nendaz/Verbier days... I'm sorry I don't have any medical advice to be useful, I can just do the cheerleading bit....

 

[snow addict]

This should be doable. I am in Verbier 22-24 and 28-3. Hopefully I might be even fit enough to ski some blue runs by the 3rd. Ditching brace and crutches this Friday, I just can't see any benefit any longer and want at least to start walking independently to get some fitness back before my appointment on the 19th.

 

[HeidiInTheAlps]

Snow Addict - -

I believe, you know your body better than anyone else, doctors included. I think when you've done your research, and matched those data points with your own personal history, and your intuition and sense of what is right and good for you, you will make the fastest possible recovery.

Of course it gets tricky for me, I have crossed my intuition with wishful thinking...that didn't turned out so well... I say that as something for you to check yourself with - -

But, having read what you've written thus far, I think you are capable of ascertaining what you are capable of, and managing it such that you don't hurt yourself, only help yourself.

My very unprofessional, non-mediacl opinion.