COTH Trashed Knee + Ankle Brigade

[Graymaresrule]

[QUOTE=DutchSonofBell;6223727]
Sounds so strange but I am happy to see this blog on COTH. I had a horse riding accident almost 2 years ago. Nothing too bad as I am still here and walking. I bought a new horse last March that I thought I could ride post accident. My big problem is getting over the thought of something else bad happening. In my accident, the horse I was riding went dead on into the arena wall. I tried to turn her but honestly felt she would turn and I would be able to ditch. No such luck. I went over her head, breaking first my left wrist, then the right wrist. Started to catch helmet brim, but turned head quick to take a side blow to head and slid the 8 feet to the ground. I was between her front legs and stood as quickly as I could to plaster myself to wall to avoid trampling. Great, my left leg was hyperflexed and I pushed up. Horse did not step on me. Odd thing was the leg wouldn’t work quite right. Didn’t hurt, it just wasn’t right. At hospital I found out that I had torn off my own Achilles’s tendon in the attempt to avoid her hooves. I was put back together fairly well with steel plates and the wrists work almost as well as before the accident. Ankle is stiff and leg does not hurt mostly due to nerve damage from a previous horse accident which is why I did not feel anything when it tore. Does anyone else have trepidation in riding after an accident like this? How about after your surgeries?[/QUOTE]

My accident was non horse related but a few months after my confidence was totally destroyed by a clinician. I’ve come a long way from the point where I couldn’t even walk my horse away from the mounting block. I would just sit there and cry.

My biggest help came from Jane Savoie. Even if you don’t ride dressage sign up for her newsletter and join us on

http://www.facebook.com/#!/pages/Solve-Horseback-Riding-Fears-by-Jane-Savoie/149140361379

It’s great to get emails with “Motivation from Moshi” She has 2 books that really helped me “It’s not about the Ribbons” and “That Winning Feeling” They explained how our thoughts influence our feelings and actions and how we can change our thoughts in a positive way. She also has a DVD but when it came out I didn’t need it!

First thing I did was to rip out my mental DVD of the confidence destroying clinic, throw it on the floor and STOMP on it, any time it tried to replay in my mind. I replaced it with a mental image of me riding well…OK, I wasn’t using a tape of me, but Anne Katerine Linnsenhoff riding one of my all time favorite mares who happened to look like my mare at the time. May as well aim high.

I developed a mantra

[I]I am a strong and confident rider.

I am always relaxed and centered.

My ears shoulders hips and heels are always aligned

Sophie is always relaxed, attentive and willingly accepts the bit
[/I]
It has to be something that IS, even if you’re not there yet, not I will, or even worse, I won’t.

I have developed some defensive strategies as well. I’ve improved my riding surface so it is not slippery. I don’t try anything new if I am riding alone.
There are times I still struggle, I get tense in new situations, and right now there is something wrong with Sophie but we’ve come a long way.

BTW, you’re not alone…there are LOTS of us out there

[KBC]

[QUOTE=carolprudm;6224244]
've come a long way from the point where I couldn’t even walk my horse away from the mounting block. I would just sit there and cry.

…

BTW, you’re not alone…there are LOTS of us out there[/QUOTE]

You are not alone for sure, I had a friend over last weekend and we worked together all day, in the end I could climb up the mounting block and get on.

Doesn’t sound like much for a days work, and 2 horses, but it was a huge breakthrough for me.

[Coreene]

Sadly, a few setbacks. Must wear hinged brace all the time now except in bed and shower. That was supposed to be my last brace, but apparently my knee is loose, and so I will have to wear a de-rotation brace for a few years.

The drop foot is not getting better at all. Doctor says he does not think it will recover, PT says he thinks it will.

I was going to be off both walker and cane in four to six weeks, but now can’t use the cane at all, just walker.

Still on track to be driving in 4-8 weeks, so that’s something. And apparently I can ride in a de-rotation brace, but obviously not with tall boots.

[mp]

So sorry to hear about the setbacks, Coreene. That has to be so frustrating afterm making such great progress.

PTs know more about rehab than the docs. Fingers crossed your PT guy is right. :yes:

[Coreene]

Yes, and especially embarrassing because I started crying in PT and couldn’t stop. The knee is doing great - I have almost no pain at all - but the loose thing is frustrating because there is no magic cure, just looooooots of exercise and time.

And then I think of my friend Judy, who had a cough that turned out to be stage IV lung cancer and is now dead, and I realize how fortunate I really am. :sadsmile:

[Chief2]

See if you can get a drytex hinged brace for the warmer months, Coreene. It will make a big difference in your comfort and frustration level. I get mine at www.betterbraces.com. Once the heat gets climbing upwards, the neoprene brace makes me sweat like a water fountain, and then my frustration level soars. Put on the drytex, and I stay cool in the hottest weather.

Wishing you all the best for a good recovery! :yes:

[red_mares]

Resigning My Membership!

I think it’s time to resign my membership here!

I had the last PT session yesterday… he was going to have me finish Thursday, but when he heard I’d spent the day in dress heels…“You’re Done.” YEAH!

I just can’t believe the difference. Just over 2 months ago, I was struggling to do darn near anything, go shopping, go to the barn, whatever. It boggles my mind that something that took a year of my life was so easily fixed. I know things happen for a reason, but I’d sure like to hear God’s logic on this one.

Here’s the funny part - I still have some peroneal tendonitis issues. When I brought this up to the OS last week, he suggested that I ask my PT for some exercises to help it. Hello, I’VE DONE EIGHT MONTHS OF PT! Do you really think they’ve been holding out on that one magic excercise that will fix it in all that time? (PT confirmed he hadn’t:) )

You know what has helped - dress shoes. My feet don’t hurt if I wear high heels. Wrap your head around that one.:lol:

Coreene, I lost it a couple times at PT last year too. The frustration and (I won’t say depression, I’ve got a clearance to keep) just got to me.

[KBC]

I saw the surgeon yesterday, and he is going to operate on my knee YIPPEE, trim up the tear in the meniscus, a good amount of debridement, and hopefully good to go. I will need replacements, but I’m hoping that this will buy me a few more years.

Now to start the great wait, 4 to 6 months, is the estimate

[BackInTheSaddle74]

NEVER TOO YOUNG FOR TKR

just scheduled bilateral TKR for early August. I am 55. Been pushing it off for too many years as local ortho thought I should wait til I am 60. but after a tibial plateau fx 4 yrs ago -non surgical, thankfully - the PT at that point thought I was overdue then for TKR.

I trashed both knees, hips and neck in a horse-crash when I was 45. Also did all the “little” fixes, that didn’t work. At 55, I found a surgeon willing to turn me bionic. When I expressed surprise - I had been told I was “too young” and “too fat” to have replacement surgery, he told me “Had you been a 230 pound, 25-yr old linebacker, we’d have replaced that knee the day after you trashed it.” It’s very true that there is a terrible prejudice against women when it comes to this surgery.

Since then, I have had three hips and three knees, the last knee (a revision) at age 71. A year later, I got back on a horse and have been riding for the last three years. I do both trail and dressage - the latter to teach my horse obedience and flexibility for the trail. I have ridden a variety of horses during my training, and yes, I can post without trouble. However, my daughter took pity on me last year and got me a very smooth Missouri Fox Trotter and I’m having a ball.

I plan to celebrate my 75th birthday this fall doing a competitive NATRC ride.

[PaintedCash]

BackInTheSaddle74 - Wow! Your story is very inspiring!

I guess I should check in/join the club… I’ve got troublesome knees… I’ve always had knee dislocation problems, but in 2007, really did a number (was squatting down putting on a standing wrap - stood up and my patella tried to jump out of my knee!) and have had major trouble ever since…
On my left knee, I had a lateral release and medial plication in March 2011
Right knee:
Lateral release and medial plication April 2007
Lateral meniscus repair October 2008
Lateral meniscus repair March 2010 (after being kicked by a horse)
Lateral meniscectomy August 2010 (repair failed and my leg was locking in flexion)

Then last fall I really tore up my right knee… Knocked off cartilage, had loose bodies, deep marrow bruising… So in December 2011 I had a scope and biopsy, and March 9 of this year has a lateral meniscus transplant and ACI (Autologous chondrocyte implantation - they grew my healthy cartilage cells, then shaved down the hole on my bone, made a pocket, and injected the healthy cartilage) to avoid a knee replacement (I am only 29!).

I have been in a wheelchair or on crutches since then, nonweightbearing, and am 6 weeks post-op. My shoulders and elbows are so sore! I see my surgeon Monday actually to talk about starting to put weight on the leg, which is supposed to happen somewhere around 6 and 8 weeks. I am really freaked out right now though, since I haven’t gotten very far in PT. I go twice a week, and the past 3 weeks I have been stuck at about 90 degrees flexion. When the therapist pushes further, I’m left moaning and crying.

Crossing fingers my surgeon won’t be too upset at my flexion as of now… But I am sure really to start walking/driving!

Best estimate I have for riding has been August-ish, and I’m not about to cheat… I have ridden early in the past, but these have been smaller surgeries. This is the big one and I don’t want to mess around Luckily my horse is very quiet, short, and forgiving, so once I start riding, I won’t be chancing too much.

Good luck to everyone with these problems, knee stuff is really rough! Also, I am a surgery veteran, and an a MRI/x-ray tech by day, so if anyone has any questions, don’t hesitate to ask

[Jingo-ace]

a guarantee of premature osteoarthritis…

a guarantee of premature osteoarthritis…

Why does this not surprise me… AFTER-THE-FACT - of course, my knee surgeon removed the cartiledge of the left medial menescus… ya think, he would have put something IN there, like a rubber gasket. for shock absorbtion… but knowing how many knee surgeries he does EVERY WEEK??? Sigh, I am on-track for a knee replacement someday soon… grrrrr.

Now, I guess I go with the joint injections until I can’t stand the pain anymore.
J

Following info is from the Knee boards:

http://www.factotem.org/library/database/Knee-Articles/Knee-anatomy-physiology.shtml

"Menisci: these are two crescent-shaped pieces of tough cartilage that reside between the articular-cartilage-coated ends of the femur and tibia at the knee. (They appear edge-on in Figures 3, 4, and 5.) They serve to cushion the joint against impact-type loadings (some people compare them to shock absorbers in this regard), and distribute compressive and shear loadings across the vulnerable articular-cartilage surfaces. Also, they assist in joint lubrication and cartilage nutrition, and they contribute to overall joint stability. Clearly, the menisci are extremely important in their role of protecting the weight-bearing surfaces of the tibia and femur.

Meniscal tears very commonly occur in conjunction with ACL tearing; the medial one is more often torn than the lateral one. (One reason for this has to do with the stresses on the medial compartment being greater than in the lateral compartment.) In the past, surgeons would often completely remove torn menisci. Such surgery, known as menisectomy, was a guarantee of premature osteoarthritis. Although surgeons know better today, it is interesting to note that the importance of the menisci is something that was, from the viewpoint of biomechanics (which is more a physical science than a biological one), entirely obvious long before the first surgeon took a scalpel to the knee.

Today, when confronted with a torn meniscus, most surgeons simply recommend to trim away the torn portions. However, many meniscal tears are in fact amenable to repair via careful cross-suturing. (Much ground-breaking research in this regard was done by Dr. Frank Noyes; some medical-journal articles on this topic can be found here in the Knee Library.) Regrettably, because (in many countries, including the United States) the health-insurance billing codes for meniscal repair are the same as the billing codes for partial menisectomy, and also because meniscal repair takes several hours and menisectomy takes minutes, most surgeons have an obvious financial incentive to recommend the partial menisectomy.

Note, too, that a loss of even a small portion of a meniscus can engender huge increases in compressive and shear loadings on the articular-cartilage surfaces. So, it means absolutely nothing if a surgeon says “don’t worry, I’m only trimming away a quarter of your meniscus”…when in fact, even though 75% of the meniscus is left, the removal of the damaged portion (which, because it was injured, is probably what was biomechanically the most essential anyway) might easily bring a quadrupling of compressive and shear stresses on the articular cartilage. So, the surgeon’s sweeping “don’t worry” statements are nothing but empty reassurances. (And, of course, the patient is the one who will be dealing with the pain of premature osteoarthritis, not the surgeon! Furthermore, if a surgeon says he/she will remove a certain percentage of your meniscus, how is this percentage being measured…on a surface-area basis or on a volume basis? The menisci are shaped as crescents: thin at the centre of the knee, and thick at the edges; this is what enables them to cup the ends of the femur nicely.)

Remember that each and every time an ACL-deficient knee is allowed to give out, further damage occurs to both the meniscal and articular cartilage. Such damage invariably brings aftereffects that are both cumulative and permanent, and which increase the spectre of premature osteoarthritis…and which complicates future attempts at surgical repair. "

[dreaminOTTB]

Posted here once, but it’s been awhile.

Coreene - Sorry to hear about the setbacks.
red mares - congrats on making it through PT!

Just had surgery about two weeks ago. Removal of screws from knee and ankle in the right leg (rod stays in). No PT prescribed, partially due to insurance issues. It is needed/recommended, but not available due to insurance restrictions. Able to walk and lightly ride, but with pain. Daily pain management is not fun, but I try to remember what it USED to feel like.

Best wishes to everyone.

[ratherberiding]

[QUOTE=BackInTheSaddle74;6251694]
just scheduled bilateral TKR for early August. I am 55. Been pushing it off for too many years as local ortho thought I should wait til I am 60. but after a tibial plateau fx 4 yrs ago -non surgical, thankfully - the PT at that point thought I was overdue then for TKR.

I trashed both knees, hips and neck in a horse-crash when I was 45. Also did all the “little” fixes, that didn’t work. At 55, I found a surgeon willing to turn me bionic. When I expressed surprise - I had been told I was “too young” and “too fat” to have replacement surgery, he told me “Had you been a 230 pound, 25-yr old linebacker, we’d have replaced that knee the day after you trashed it.” It’s very true that there is a terrible prejudice against women when it comes to this surgery.

Since then, I have had three hips and three knees, the last knee (a revision) at age 71. A year later, I got back on a horse and have been riding for the last three years. I do both trail and dressage - the latter to teach my horse obedience and flexibility for the trail. I have ridden a variety of horses during my training, and yes, I can post without trouble. However, my daughter took pity on me last year and got me a very smooth Missouri Fox Trotter and I’m having a ball.

I plan to celebrate my 75th birthday this fall doing a competitive NATRC ride.[/QUOTE]

:yes: this gives me hope!

[ratherberiding]

PaintedCash - hugs for you

Jingo-ace - thanks for that info

[Donkaloosa]

Tomorrow I’ll be 12 weeks post-surgery — a TKR that replaced the partial knee replacement I’d had for 8 years. I’m amazed at how little pain I have now — and it’s muscle pain, not the original arthritis pain that was so bad. I’m good enough now that I’m back to training all 3 dogs and have sent in entries for 3 one day shows and a 3 day show, plus have worked the FIRST Regionals and start FIRST Championships on Wednesday — where I’ll be on my feet for long, long hours each day. And I know I’ll survive — with a little pharmaceutical help, I admit! I chose to quit riding several years ago, but I am glad that so many people have continued to ride. If we ever get together, we need to compare scars!

[PaintedCash]

Donkaloosa - wow, that is great for 12 weeks post-op! Good luck and don’t forget the advil

Jingo-ace - I was in the same boat of sorts, and aggravated when I saw my surgeon last year and he recommended I see a specialist and look into a meniscal transplant. He had removed around 50% of my lateral meniscus in 2010 after a failed repair attempt. I was 27! So I was not surprised when I basically knocked a chunk off my cartilage where I was missing a meniscus. I really knew better when I had it removed in the first place, but after my knee locking in place (scary!) I was just thrilled to have that “fixed” that I wasn’t looking at the big picture.

Depending on your age, a replacement may not be your only hope… Also, I see you’re in CA - if you’re in SoCal I know a few great cartilage docs - 1 in SD who is one of the best in the country, and also my surgeon at UCLA.

Good luck

[Equine_Adhesive]

I figure I might as well join the brigade, I’ve already read through the entire thread, and ya’ll scare me with what you brave souls are going through, but unfortunately I’m here to join you.

-Athletic accident early 2010 = torn hamstring, meniscus tears, MCL strain, plica syndrome. This went undiagnosed for EIGHTEEN MONTHS of sheer pain, with docs telling me I was crazy/negative MRI proved there was nothing. Went thru PT and cortisone shot, got to where I could ride (flatwork) but wasn’t able to do other sports without re-injury. Finally:

-Mensical debridement + plica removal summer 2011. I was told afterward (other than “oh I guess the MRI did not pick up any of that”, and I quote: “Your knee looks beautiful and will not give you trouble any more.” Surgeon did note lax ACL. Did the appropriate PT, which enabled me to finally fix the hamstring problem (before I was too limited to rehab the hamstring). I resumed FULL SPORTS, including: hiking in backcountry terrain, cycling, running, swimming, riding (slowly returned to jumping, was planning to return to racehorse riding), kickboxing (non-sparring), even bouncing on large trampolines. I had some discomfort here and there but stopped thinking about my knee as things returned to “normal”.

-Jan. 2012 I was jumping my horse, he bucked and threw me forward. Felt instant discomfort, thought I should get off and check (horse needed to be lunged, anyway). Slid to ground and knee buckled. Took a week off riding, resumed riding w/o stirrups for next 7 weeks. Went to see sports med doctor (surgeon was booked for 2 months out from even there), who intentionally tweaked my plica (to show his rotation student) for AT LEAST 60 SECONDS OF AGONY on more than one occasion. Then he wrenched my knee hard- I have no idea what he did. But since that appointment (5 weeks ago), I have been unable to go up or down stairs, walk properly, or do ANY sports or really ANYTHING.
Subsequent MRI = negative (same as one pre-surgery).
For first 3 weeks after appt, had lots of laxity in knee.
-Then I went to see an ND and I started prolotherapy, because I don’t know what else to do. Insurance is not covering it, but I am desperate. I am also starting Hyal. Acid/MSM/Gl/Chon supplements + fish oil, and I do 30-60 mins of PT a day, plus hot + cold therapy. ND noted laxity in my MCL and ACL. The injections into my MCL hurt like a bitch. I started to walk better 8 days after my first prolo session, but it was probably due to literally NOT getting off my ass for those 8 days. My session #2 is next week.
-I have an appt with my surgeon (finally) in early May. But I don’t want to have surgery again with no diagnosis! And under a year after my first. I was talking to a friend who has a history of knee problems and she told me they don’t tell you this, but you don’t come back 100% from surgery and each one brings that down, and athletes in particular are very prone to reinjury and lifelong problems.

I am now very depressed, selling my horse, and have trouble foreseeing my future in athletics. I see myself as one of those crippled people when they are older. I don’t understand how my pain and limitations can be so enormous when I am young (under 35) and ON PAPER, have a more functional knee than some other people who are actually doing a lot more than I can! All I can do at this point is walk on level ground for a few blocks and back. THAT’S IT. The moment I try more, I am back on my butt for days that turn into weeks. I cannot walk up or down (particularly down) any hills. I cannot walk briskly. It is not like I walk normally and then that degrades- my walk is slow and it is easy for observers to tell I am in pain. (People at the barn like to tell me I am too young to walk like that…I am sure they mean well but it hurts to hear them say that to me. It’s not like I choose to have this problem.) I am just starting to take some stairs, but it is very, very slow. Before my app’t with the sports med doctor, I was scaling stairs no problem, riding w/o stirrups and had just taken then back, and I was swimming! What should I do?

I am desperate for a solution. =(

[Jingo-ace]

Thank you Painted Cash for the info on some other knee drs. I just had the first of the three Euflexxa injections into the joint yesteday… and damn, it HURT. I can take ALOT of pain, but I guess I’m turning into a wimp. I am NOT looking forward to the next two injections!!!

Yeah, I really need to look for other alternatives too. I wanna e RIDING when I’m 93, not sitting in a rocker waiting to die! Grrrrr…
J

[Coreene]

Five months and one day post-injury, and I am taking the cane to the office and using it for like half the day. A cane makes me use a whole new set of muscles, and that aches, but it’s all cool.

EA, are you wearing a brace?

[Equine_Adhesive]

Coreene - I was thinking about getting the freedom leg brace that a poster on here linked to, during my worst times of non-weight bearing hell, because I also could not use 2 crutches (I injured my arm attempting to ride a green horse with my bum knee, assuming I could because I did before and it went ok…YES, I know I am stupid. No more.) But I waited it out. Then I looked into other braces but feel like I do so little activity that I would need one if I was doing activities. Regular walking on level ground is OK, if I keep it short distance (from car and back, etc.).

I do have some good news - I seem to have “good days” and “bad days” now, which makes me think this is a sign of healing? I used to just have mostly bad days and nagging pain all the time, and any fresh pain would last days and weeks to resolve. I don’t know if prolo is responsible for me now having some good days this week. On my good days, I was able to walk freer, without pain-- not a fast walk by any means, a moderate walk, but a WALK. You know what I mean. No hesitation when my leg swung and landed. And when I sleep, I can curl my leg up a little, whereas before I would want to stuff a pillow under it and it was uncomfortable. I started doing some exercises (straight-leg) in the pool. And I noticed that in my PT, my leg is stronger w/ better ROM, but of course my ROM should be better since it’s been 2+ weeks since I had a 10cc injection.

Today is a “bad day”, as I am stiff and sore- but not as much as 2 weeks ago on a “neutral-normal” day. But I did my PT, decided to not attempt any stairs, and ate spinach and oranges and bananas with pb for breakfast (lol). My next prolo appointment is next week, and the week after that I see my surgeon. I DO feel a LOT less instability since prolo #1. So we will see. I have no idea if it is working or not, but I have no other choice but to try.

I’ve also lost 7 lbs since my re-injury, not sure if that helps (I was not overweight to begin with and am petite, so 7 lbs is a lot for me). Looking forward to when my msm et al. supp’s arrive.