Forums Knee ACL surgery creates increase stability = leading to pain?

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    • #71288
      AvatarOrlando Rosado
      Participant

      I am looking for some brainstorming from the community, all thoughts are welcome.

      Client has been a long time high level athlete, collegiate for many years then turned to competitive cycling the last 5 years.  Turns out she’s had a wrecked ACL (torn/or non existent) for the greater part of the past 20 years.  18 months ago, she was “convinced” to have ACL surgery, and repair some medial meniscus tearing and microfracture of medial femur head.  Since the surgery, she has gone thru the basic ACL rehab program, however is dealing with specific pain on the lateral femur/fibula/tibial tuberosity aspect of the knee and ant Tib – in fact just basic walking is creating significant pain now.  Current DX is chronic popliteal/ITB tendonosis.  
      I am interested in the thought process that others might have in regards to this issue.  Is it possible that despite the normal joint/joint model, stating hip=mobile, knee=stable, ankle=mobile, that in this instance due to the strong movement pattern of 20 years with a less than optimal ACL stability, that the ACL surgery has created increased stability that has resulted in a different movement pattern and thus resulting in the current pain syndrome?  
      If this is the case, i’m trying to decifer how far back I need to go to work on coordinating the proper movement pattern with the new found knee stability.  Any and all thoughts are welcomed and greatly appreciated. 
    • #75850
      AvatarAnonymous

      Sounds like there would be changes in movement patterns following the surgery.
      Have you looked at mechanics, position, standing, sitting position?
      Unlearning habits and creating new movement patterns
      Start at the bottom level and rebuild all movement patterns it may take some time in the beginning, however, it will translate across.

    • #75852
      AvatarTom Matchinsky
      Participant

      Box squats at or slightly above parallel are crucial with anyone coming off knee surgery to get them in the habit of loading the hips properly and taking any shear moment off the knee. She needs to keep the shins as vertical as possible. Soft tissue work should revolve around the TFL in the hip and cleaning up any stiffness in the quads and hamstrings as they feather into the IT band. Voodoo floss above and below the knee, don’t go directly over knee cap.

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