Electronic Stimulation

**fallin** · 07-08-2008, 05:11 PM

My PT attached some patches with trailing wires to my knee to zap the swelling. Worked pretty well as I could actually see the emergence of my knee cap. Hello there little patella, I've missed you! Anybody else get stimulated by their PT?

On a less stimulating, bummer note: PT only said to work on extension by pressing knee to the floor with heel on a rolled up towel, keep icing, and move around that emerging patella. I mentioned heel slides (my ROM is about 0-90) and how wrong they feel, and he said that I won't actually wreck anything by doing heel slides. But he doesn't recommend any more exercises and I'm wondering if this is a more conservative route than I want. A reminder, I'm on day 8 right now, still on crutches (well supposed to be, but I can get around with one crutch and have occasionally taken a few steps with just a wicked limp). There is definitely still swelling and some pain, but I haven't had any pain meds since Sunday. My quad is shriveling to nothing and I can't wait to get it going! What kinds of PT activities were other maggimps doing at this stage?

**SponsoredByDuctTape** · 07-08-2008, 05:33 PM

I've been getting the "H-wave" (electronic stim) and ice at the end of PT since my very first visit. Seems they put just about every patient on the H-wave before they leave. I've also had the Ultrasound a couple of times.........and no, I'm not pregnant. It reduces swelling.

I'm 4 months out from jacking up almost everything in there - bone, ligament, meniscus - with plates and screws (the PT says "basically knee reconstruction"). I hit 122 on the flexion the other day. Not sure how much farther I will get at this point. My PT admitted the other day that he thought I would be stuck at 115 forever. My ROM has not had any big jumps as is typical with most - just slow progression (i.e. 5 degrees every couple of weeks).

Did the extension same as you for the first 2-3 weeks - prop up your foot, place a little weight on the knee, sit there for 5 minutes. Hurts like hell when you first start, but now it actually feels good after sitting in a chair for a while.

Don't worry about the lack of exercise. It's only in the last month or so that my muscles have started to come back, and now I understand why everyone kept saying "give it time." You can rebuild your muscles eventually. That's not a problem. But dealing with tight ligaments, scar tissue, etc., cannot be rushed. I'm just now to the point where I feel confident enough in my knee to actually exercise, rather than just moving it around, which is really all you're doing in the beginning.

My advice is to forget about strengthening your leg for the moment, forget about the bike and quad extensions - you'll be able to do those eventually. Take time now to make sure you don't overdo it with the exercise, and just worry about getting to the point of walking normally. Eventually, your knee will tell you when you can start pushing it a little more.

**splat** · 07-08-2008, 05:49 PM

Yo, Scott! That sounds damn good, wounded brother from another mother.
I just got back from my 1st PT visit. I was a little stiff after putting some weight on the leg and driving my meniscus crazy the last few days, so I only hit 2-85 ROM. Meniscus repairs, at least mine and prolly yours, SUCK. Insomuch as you cannot weight the leg for weeks while it is locked into a brace at zero degrees. PT just touched the joint line and sent me from laying down to sitting up straight in .00001 seconds with a resounding "Hey, that fukking hurts." He looks at me and says "My next five patients are probably walking out the door right now."

Did the electric thing and ice, pulled some measurements, but with the sensitivity I have, no exercise. I'm cool with that.
Did you accidentally weight your leg and irritate the meniscus to a discomforting level, Scott?

**Theodore** · 07-08-2008, 06:05 PM

I had to use e-stim to regain the usage of my quad... it was GONE. Stuff really works though!

**Steven S. Dallas** · 07-08-2008, 06:28 PM

I like 'em brown, yellow, Puerto Rican or Haiitian,
Name is Phife Dog from the Zulu Nation
I told you on the jam that we can get down
Now let's knock some boots, like the group H-Town.

Wait, didn't you say "Electric Relaxation"?

Never mind.

**SkiBrain** · 07-08-2008, 07:30 PM

Also been getting stimulated by PT since 1st visit at day 11 post op, but I couldn't tell if it made a difference. Have had another appt since and now just about 3 weeks post-op. I was on crutches the 1st week. During that time and before I started PT (had some difficulty get an earlier appt scheduled) I was doing heel slides, isometric quad tightening, and extension exercises with towel under ankle and knee. For PT so far I've been:

continuing to do heel slides (ROM is 110 but everything still feels really tight in there)
some stretches for my calf muscles
heel and toe raises
bridging for trunk stability
mini squats as far as I can bend the left knee
15 minutes on a recumbent bike with low resistance

Told both my doc and PT that I wanted to be as aggressive as possible about rehab since I'm moving to New York in a few weeks, but I'm still not really doing anything for the quad muscle. Hopefully that'll start at my next PT appt, but sounds like it may be a while according to DuctTape. My mobility, pain, and swelling have all improved significantly in the past week, but are all still issues. I'm taking over-the-counter pain meds and icing occasionally.

Fallin, sounds like you're doing well and I would just keep following your doctor's and PT's orders. However, if you are feeling really good, confident, and want to try to do more, it may be worth mentioning to the PT and see what he/she says.

**SponsoredByDuctTape** · 07-08-2008, 07:45 PM

Originally Posted by splat

Yo, Scott! That sounds damn good, wounded brother from another mother.

Did you accidentally weight your leg and irritate the meniscus to a discomforting level, Scott?

No, I haven't really had any meniscus pain at all. I was really careful with it when in the non-weightbearing stage. Although about 4 weeks after surgery, I slipped on a wet bathroom floor on the crutches, landing on my braced leg. All I can say is the brace probably saved me from re-breaking it.

I also have the benefit of being a wee lad. The surgeon said that if I was heavier the injuries would be a lot harder to come back from.

You definitely need to give the meniscus time to heal. Like I mentioned earlier, the muscles will come back eventually. The meniscus....not so much.

I've also been on a Glucosamine pill diet since about a month after surgery. I have no idea if it's helping or not, but it can't hurt.

**splat** · 07-08-2008, 08:26 PM

You pretty much nailed it with that. I do not want to screw this up, so when I get any weight-bearing on the leg, I freak, and justifiably so, based on the pain that erupts. PT has been in the operating room and seen my doc do these repairs, which is cool. Like everyone else, he says I got the best mofo for the job. All I gotta do is hold my end up. I'm 3 weeks post op (1 day apart from the Brain) with another 3 or more, possibly, on crutches in this brace. Feel lucky, Nat!

Which brings to mind...you really get fresh eyes about the tribulations of people who bear the burdens of disability long term, eh?
Like when some dickhead slams a door in your face or little things like that.

**Noonan** · 07-08-2008, 09:12 PM

Originally Posted by splat

Which brings to mind...you really get fresh eyes about the tribulations of people who bear the burdens of disability long term, eh?
Like when some dickhead slams a door in your face or little things like that.

I can't agree more with Splat. Spend some time on crutches and you learn to appreciate how hard it is for people with a real long term disability. Suddenly the grab bars in the john are much more useful then just hanging the newspaper over. And the electric powered door openers are suddenly pretty cool instead of just being a toy for the little bratty kids to screw with.

As for the e-stim my PT did it for at least the first month. His motivation was to get swelling down more than fire the muscles. I did used to crank it up so my vastus medialis was sitting there visibly twitching - at least it made me feel like it was getting some exercise.

I also had e-stim with acupuncture after I was around 1 month post op. My guy jabbed a needle pretty deep into the joint capsule then hooked me up to the juice. It was only a 9V battery I felt it more then the e-stim at the PT. The deeper stim seemed to get out some deep swelling that really help with ROM. Needle felt like shit going in, but it worked.

**splat** · 07-08-2008, 09:24 PM

Originally Posted by Noonan

I also had e-stim with acupuncture after I was around 1 month post op. My guy jabbed a needle pretty deep into the joint capsule then hooked me up to the juice. It was only a 9V battery I felt it more then the e-stim at the PT. The deeper stim seemed to get out some deep swelling that really help with ROM. Needle felt like shit going in, but it worked.

I went to an old Chinese master of acupuncture in LA after I crushed my shoulder body surfing on Kaanapali beach. He drilled more steel into me than Black and Decker would have. Right into the socket. My buddy had to hold my shoulder, pin it down on the table, cause the rest of my body was flailing around like a perch on the dock.

**Noonan** · 07-08-2008, 10:11 PM

Luckily I didn't have that fun acupuncture experience, but it wasn't exactly like TV where there are a couple of little needles just under the skin.

Me "Um...is that supposed to hurt" Doc "Maybe a little stick, what's it feel like" Me "Kinda like it's on fire" Doc "Oh, well that's not right, let's try again" After he reinserted it was cool.

He also stuck a bunch of needles in my opposite shin while I was on my back. Then he goes, OK flip over so I can work on your hamstring and put your leg on this bolster. Uh.. there are needles in my leg. Oh don't worry about them, they'll be fine. The guy worked magic but was the most layed back person in existence.

**fallin** · 07-08-2008, 11:09 PM

Originally Posted by Noonan

I can't agree more with Splat. Spend some time on crutches and you learn to appreciate how hard it is for people with a real long term disability. Suddenly the grab bars in the john are much more useful then just hanging the newspaper over. And the electric powered door openers are suddenly pretty cool instead of just being a toy for the little bratty kids to screw with.

I completely understand this sentiment. Tonight I went to the grocery store and used this:

What a good time that creature is. Just don't ever go backwards or it makes a screechy beeping noise that everyone turns around and looks at. What a pain it must be to have long term mobility problems.

Originally Posted by Noonan

As for the e-stim my PT did it for at least the first month. His motivation was to get swelling down more than fire the muscles. I did used to crank it up so my vastus medialis was sitting there visibly twitching - at least it made me feel like it was getting some exercise.

Mine twitched too!!! Biggest movement it's seen in awhile.

**Noonan** · 07-09-2008, 12:04 AM

I motored around the store in one of those a few times. That's also an eye opener regarding disabilities - people are complete jackasses - they bump into you and walk right in front of you. Sure was fun to drive around - wish it went faster.

As for the stim - I figured the movement would have to good - if nothing else it would help flush out some swelling - which is really the idea of the stim i think.

**FredsTrees** · 07-09-2008, 07:11 AM

I never used eltric stimulation or a Physical therapist for that matter my L acl repair. The first two weeks were 3 home workouts a day, with stretching (Heel to butt things called cannonballs) and simple strength stuff, like stepping up on a 4 inch plate with one leg. Each included a 30 minute bike rides 3x a day. I walked the day of my surgery and never used crutches. I was driving by Day 7. Sounds like i am bragging a bit...Ode to Dr. Mark.

So there is always a level of aggressiveness you can shoot for, you just have to make sure you have the permission of your doctor. I have found that PT's arent always the best source for what you can and can not do, follow the protocol of your doctor to the T.

**Woodlandclown** · 07-09-2008, 03:40 PM

i didnt have the electric stim.

he maybe having you focus on extension for a reason. I was using the CPM machine for a week and a half, so I wasnt really doing heel slides. I started them somewhere around day 10-12. I should have kept better notes.

Fredtrees - I dont think you had a meniscus tear fixed, so that maybe why you were off crutched so quickly. I know Dr. Mark treats those repairs as if they didnt happen, but that doesnt make sense to me and I aint buying it. he obviously hasnt tried walking on a repaired meniscus that is healing. Its pretty painful. and when you finally get off crutches, still painful.

Awesome you used the cart! I was too ashamed--I hobbled around on crutches like a dumbass.

**splat** · 07-09-2008, 04:55 PM

apples and orangutangs

**SponsoredByDuctTape** · 07-09-2008, 05:35 PM

Originally Posted by splat

apples and orangutangs

Breasts and boobs?

BTW, anyone noticed the tags for this thread? "Rabbit vibe" and "vibrate setting" tagged to an "electricronic stimulation" thread.........interesting.

**SkiBrain** · 07-09-2008, 05:44 PM

Originally Posted by splat

I'm 3 weeks post op (1 day apart from the Brain) with another 3 or more, possibly, on crutches in this brace. Feel lucky, Nat!

Been thinking of you and wishing you the best Pat!

I'm surprised at how fast 3 weeks has gone by. May the next 3 fly by even faster for you so that you can finally be crutch-free! I do feel very fortunate that they didn't have to do much to my meniscus. That was one of my big fears before heading under the knife, but luckily they just had to clean it up a bit.

I overdid it a little doing my PT exercises yesterday. Am channeling my stress and frustration with trying to figure out my upcoming move to New York into exercising. Not the smartest thing to do and I need to be more careful.

**FredsTrees** · 07-10-2008, 06:48 AM

Originally Posted by Woodlandclown

i didnt have the electric stim.

he maybe having you focus on extension for a reason. I was using the CPM machine for a week and a half, so I wasnt really doing heel slides. I started them somewhere around day 10-12. I should have kept better notes.

Fredtrees - I dont think you had a meniscus tear fixed, so that maybe why you were off crutched so quickly. I know Dr. Mark treats those repairs as if they didnt happen, but that doesnt make sense to me and I aint buying it. he obviously hasnt tried walking on a repaired meniscus that is healing. Its pretty painful. and when you finally get off crutches, still painful.

Awesome you used the cart! I was too ashamed--I hobbled around on crutches like a dumbass.

I did not have a meniscus tear, and Dr. Mark does not treat it the same from what i remember, pretty sure it was a 3 week restriction, not sure to what level...

I had trouble getting full extension since pre surgery i did very little prehab. So focusing on getting early full extension is really good advice....trust me it gets way harder later on to improve it.....

**FredsTrees** · 07-10-2008, 07:49 AM

Originally Posted by FredsTrees

I did not have a meniscus tear, and Dr. Mark does not treat it the same from what i remember, pretty sure it was a 3 week restriction, not sure to what level...

I had trouble getting full extension since pre surgery i did very little prehab. So focusing on getting early full extension is really good advice....trust me it gets way harder later on to improve it.....

I thought I would post this link to another group of ACL repairs on a Motocross and BMX site.... the screenname CaptainKnobby had a meniscus and ACL done 4/25/08, he lists his protocol and progress....

http://www.thumpertalk.com/forum/sho...d.php?t=654041

I post under the screenname Racer Chaser....