I located a patellofemoral pain expert on Twitter and emailed her. She has the best article on why some ACL reconstruction patients may develop patellofemoral pain. I wanted to know if she had any more articles on this combination of ACLR and PFP (she didn't say if she did). Basically it has to do with bone swelling that changes the loading of the knee. Elevated water content levels in the patella may lead to increased pain which further inhibits quads and alters loading after surgery. I also asked if she had A) any case studies for ACLR patients who started a year late but still had good outcomes, B) any case studies on ACL + PFP or know of success stories. She did not unfortunately have any written up (didn't say if she knew of success cases, maybe that was careful wording on her part). She did say 20% of her clients are PFP or fat pad pain post knee surgery, so that shows that it's not that uncommon. She also said it sounded like I was past the worst of the pain - I had never thought about it that way! Yes, I need to remind myself this more often! Things were a lot worse a year ago. She said she would be happy to host my story on her website once I am all better. I will need to be my own success story! She encouraged me to keep going. I love when people write me back. The first week of 2019 was kinda down in the dumps for me. I think knowing how much more rehab I have kind of hit me, while also being happy that I've completed a year of rehab at the same time. I know I'd snap out of it, usually takes a week. I decided to start cataloging and relistening to my favorite podcasts (and find more podcasts) - the kind of podcasts that really turn your attitude around or change your perspective. People who went through pretty hard times but are thriving or at least have a heck of an inspirational story to share. Educational podcasts on injury and recovery. I can tell it's helped too. My wrist follow up appointment is next week for the TFCC tear. They wanted me to come in instead of going 9 weeks in the brace. More on that next week! It also happens to be on my 700th day of ACL recovery. I usually like to celebrate these big 100 dates with something I know I can do. My reason is that physical milestones are much less frequent at this stage but dates come regardless of noticeable progress! Trying to think what that would be right now with snow on the ground. Getting in some good knee rehab sessions. Always hitting at that safe but sore line but not a flare up so far. Below graphic and caption is from Dr. Caleb Burgess DPT, OCS, CSCS. 🔥Pacing & Graded Exposure🔥
. 💥 In most cases, if we "overdo" it during a specific activity, our body will produce pain before any tissue damage occurs in order to alert us to make a change so that it doesn't get to that point! This pain is usually short term and diminishes quickly . 😣 When you've experienced persistent pain with specific activities (> 3 months), many times your pain threshold becomes lower with that task as your body becomes more sensitive in an effort to protect you from what it believes may cause you injury . 🤔 In this case, the process is a little more complicated. As you perform the activity, the body produces pain well before any tissue damage can take place ("Protect by Pain" Line) . ☝️ However, in order to desensitize the body and tolerate more of this activity before pain occurs, you must learn how to find your Baseline, which could be referred to as where you are "SORE BUT SAFE". This is the point where you feel some pain but it decreases following the activity in a predictable and controlled manner. . 🚨 You want to avoid pushing yourself "too far, too fast", however, as this may cause a "FLARE UP". A flare up is a period of intense pain that is more severe than normal, with no set pattern and lasting hours to days. If you have a flare up, it's important not to freak out! A flare up still occurs before "Tissue Tolerance" (the point where tissue injury actually occurs), so just because the pain is intense does not mean that you have injured yourself . 🔥 The goal with Pacing and Graded Exposure is to SLOWLY do a little more of your chosen activity on a daily, weekly, or monthly basis (it's highly individual). YOU know you're body best, so figure out a progression that's right for you, and STICK TO IT! . 💥 An easy phrase to remember is: 👉🏼 "To It, NOT Through It" . 👊🏼 This helps to remember to push yourself TO the "Sore But Safe" line (which should increase over time) without blowing THROUGH to the "Flare Up" line . 💯 The process takes time but if you are patient and positive, you can eventually return to the activities you love and enjoy 😉 . ❤️ SHARE with someone in pain who could benefit from this strategy!
0 Comments
Leave a Reply. |
AuthorA 45 year old active female who tore her ACL in January 2017 (at the age of 40). Reconstructive surgery in February 2017 with bone-patellar tendon-bone autograft. Archives
November 2022
|