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What to do if your Knee Hurts when Bending

More than a quarter of adults suffer from regular bouts of knee pain. It’s really no surprise as our knees handle a tremendous amount stress day-to-day.1-2 Scientists have found that for every pound of bodyweight, our knees are subjected to up to seven pounds of pressure when they are bent or in weight-bearing.3 If you’re here, it is because you’ve noticed that your knee hurts when bending it, is painful walking down stairs and feels uncomfortable while squatting. The fix for this really depends on the diagnosis. Below are some common causes of knee pain.  

How did you hurt your knee?

Traumatic injuries are noticeable right away and worsen dramatically the next day as pain and inflammation set in. traumatic injuries typically occur playing sports, during slips, falls, and other work-related accidents. The trauma is caused by the injury exceeding the tolerance of knee structures leading to breaks, ruptures or tears.

Knee ligaments, bones, and menisci are the most commonly damaged structures in the knee joint. Injuries to bone and connective tissue result in long term pain and will impede normal knee function for some time after the initial injury. Less serious traumatic injuries may result in only painful, superficial contusions (bruises) which heal relatively quickly. If you believe you have incurred serious knee trauma you should visit a doctor as soon as possible. If bone or connective tissue within your joint is damaged a surgical assessment could be required.

Overuse injuries typically cause knee pain that comes and goes and varies in intensity. Sometimes our favorite activities subject our knees to stressful movement patterns repetitively. Think jumping, squatting, kneeling, running, lunging type movements. Moving in this way over and over again can irritate knee structures such as bursae, tendons, and articular cartilage.

Degenerative Joint Disease (arthritis) is the number one cause of long term disability relating to knee pain. Pain often comes on slowly and over time those affected by arthritis will experience constant pain while performing weight-bearing activities.

Knee arthritis comes in a variety of forms, osteoarthritis being by far the most common. Osteoarthritis develops over a long period of time and your knee may not hurt during the early stages of the disease. Once your cartilage has worn away, bone on bone pressure develops within the joint. This causes pain as pressure is placed on the knee.

As the disease progresses, bone spurs begin to develop resulting in joint stiffness and mobility losses. Osteoarthritis is most common in people over 50 with those that are younger being much less likely to experience the disease. While age is a major influencer of arthritis progression it is only one of many predisposing risk factors to consider.

Where does your knee hurt?

  • Knee pain on the front of the joint could be patellar arthritis or patellar tendonitis. These conditions tend to hurt when bending the knee, kneeling and/or squatting. Typically the deeper the knee bend the worse it will hurt.
  • The discomfort localized to the medial or inside of the knee could indicate tibiofemoral arthritis or meniscal irritation.  
  • Nagging pain or pressure that is localized to the back of the knee could be a sign that you’ve damaged your meniscus. It is also possible that you irritated the popliteal muscle and surrounding area.

My knee hurts when bending – What Now?

1 – Managing Knee Pain

Knee pain is usually the result of inflammation – a natural response from your immune system to damaged joint tissue. Pain and inflammation are completely normal and necessary for proper joint healing. Despite being “natural” joint inflammation can negatively influence your quality of life. Your knee may hurt so much that it makes day to day tasks difficult. In such cases, reducing inflammation with NSAIDs, the R.I.C.E. method and exercise are often used to manage pain in the short-term.

2 – Professional Knee Exam

Getting your knee assessed by a healthcare professional is crucial. This is even more important if you have suffered a traumatic knee injury. A definitive diagnosis will give you peace of mind and help expedite the healing process.

3 – Getting Rid of your Knee Pain

If you are lucky, your knee pain may get better on its own with rest. However, more than likely you will need to engage in rehab exercises to overcome the injury. Physiotherapists specialize in providing specific exercises and treatment regimes that increase the strength, stability, and mobility of your joint.  

Additional Resources

Frequently Asked Questions

Why does my knee hurt when I bend it?

There are a number of possible injuries that could be causing this type of knee pain. A key thing to consider is whether the pain developed suddenly or came on slowly. Have you had a previous injury to the knee? This increases the risk of re-injury dramatically. Lastly, the location of the pain is a big clue as to the underlying cause of your pain.

How do I fix my knee pain?

The fix for your knee pain really depends on the underlying cause. For the majority of knee injuries, exercise and balance training are crucial in the recovery phase. Muscle weakness, poor movement patterns, and poor balance are often linked to those in pain. Working with a healthcare professional such as a physiotherapist, or a personal trainer can help you get started with exercises that are right for you.

What are some quick fixes for knee pain?

Ice, NSAIDs, and compression wraps can all reduce inflammation in the knee joint. It is important to remember that these treatments tackle the symptoms, not the underlying cause. Understanding why your knee hurts is crucial for long term relief.

How long will my knee pain last?

This really depends on your injury. If nothing is structurally damaged in your knee it could resolve itself in 1-2 weeks with rest. If you have knee arthritis, you may have to manage your knee pain for the rest of your life. Traumatic sports injuries requiring surgery may take up to a year to fully resolve.

References
  1. Nguyen, U. S. D., Zhang, Y., Zhu, Y., Niu, J., Zhang, B., & Felson, D. T. (2011). Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Annals of internal medicine, 155(11), 725-732.
  2. Bunt, C. W., Jonas, C. E., & Chang, J. G. (2018). Knee Pain in Adults and Adolescents: The Initial Evaluation. American family physician, 98(9).
  3. Reilly, D. T., & Martens, M. (1972). Experimental analysis of the quadriceps muscle force and patello-femoral joint reaction force for various activities. Acta Orthopaedica Scandinavica, 43(2), 126-137.

Knee Pain When Bending Knee or Leg: Causes & Relief

Knee pain when bending can be debilitating. Here’s what you need to know to get some relief from chronic knee pain.

Almost nothing will put you on your back faster than the sharp pain that comes with an injured knee. Knee pain while bending can strike suddenly, and it can be caused by any number of illnesses or injuries. Roughly one third of the patients that visit doctors for muscle or bone pain are specifically seeking physical rehabilitation treatment for knee injury and pain.

Knee injuries are very common in athletes. More than 40% of people who play basketball, soccer, or football will suffer a knee injury at some point, and more than 60% of all snow skiers. Even dancers are not immune, with almost one third suffering from knee injury or pain. Many of people who play sports will require Sports Physical Therapy at some point in their athletic career.

Whatever the cause, severe knee pain probably won’t go away on its own and calls for medical attention. Here’s a rundown on some of the common causes of knee pain while bending, treatment options, and a few tips that will guide you to a swift recovery.

Physical Rehabilitation

The first of order of business when you are experiencing chronic knee pain is to consult with an expert. There are a number of healthcare providers in the field of physical rehab that might be able to answer any questions and diagnose any problem you have. Physiotherapists, chiropractors and orthopedists all have the ability to diagnose and treat knee pain.

Anatomy of the Knee

The knee is the largest of the body’s joints. Though it feels like a solid mass in the middle of your leg, it’s actually an intricate assembly of bone and cartilage that’s held together by tightly wrapped ligaments. The kneecap is technically known as the patella, and it’s a solid disk of bone. Behind it, the thigh bone (femur) and shin bone (tibia) meet to form a hinge that’s cushioned by thick pads of cartilage.

Symptoms of a Serious Problem

Pain anywhere in this area could be the sign of a serious injury. It can come on swiftly or gradually build over days or weeks to the point that you’re left limping or rendered immobile. Signs of knee inflammation include:

  • Swelling
  • Reddening of the skin
  • The knee area feels warm to the touch

Often, a knee injury triggers this inflammatory response, though it could also be the result of an infection.

Do you have pain above the kneecap?

Above the kneecap, your patella is secured by a strong tendon that connects the bone to the powerful muscles in your thigh. Pain in this location can indicate that you’ve sprained or torn this tendon. It’s also possible, as with any pain you feel in this complicated part of the body, that the pain is referred from deeper in the joint, as with a tear in the knee’s cartilage.

Do you pain in back of knee?

Behind the knee, the flesh of your leg feels soft and thickly padded. This region known as the poplitealis home to a number of blood vessels that feed your lower leg. You can even feel your pulse in this region if you can locate your popliteal artery. Pain in this region of the knee is sometimes the result of damage to or inflammation of these soft tissues.

Do you have knee pain when bending down?

When you bend down over as if to touch your toes, you’re flexing some of the muscles attached to your knee. The pulling effect can put extra pressure on the delicate tissues of the joint, and if you have any swelling there, the pain can be severe.

Do you have knee pain when pending, without swelling?

Without swelling, local warming, or other signs of inflammation, the problem is less likely to be associated with your knees’ soft tissues and more likely to be a problem with the bone itself. Osteoporosis, arthritis, and gout can all cause crippling pain in the lower extremities with the knee being one of the more common locations for damage caused by these conditions.

At-Home Remedies

Many people delay seeking treatment when confronted with knee pain. This is totally understandable, but it’s important to note that knee pain can be caused by any number of different problems. There’s no way to diagnose a knee problem without seeing a specialist in orthopedics, and any pain severe enough to impair movement should always be referred to a doctor as soon as possible. In fact, roughly one half people with knee injuries wind up seeking medical treatment, so it’s best to not wait. It is also possible to receive physical therapy treatment at home.

Along with visiting your doctor, there are things you can do from home for less severe pain. Rubbing a balm into the skin of the knee is popular for aches that can come on with overexertion or advancing age. For acute pain and inflammation, such as that caused by a sprain, try putting ice in a plastic bag, wrapping the bag in a hand towel to protect your skin from the worst of the cold, and resting it on your swollen knee for fifteen minutes at a time. It goes without saying that if the pain persists or gets worse, it’s time to call the doctor.

Medical Options

Some knee problems won’t respond to at-home remedies. A good first step for persistent knee pain is to take the recommended dose of an over-the-counter medication such as Aleve or Motrin. Ibuprofen the active ingredient in Motrin is especially useful for this kind of pain because it acts to reduce inflammation as well as managing pain. For chronic knee pain or pain too severe to manage with OTC drugs, your doctor might prescribe stronger medication that will help you manage the pain better. Knee pain is responsible for approximately one-third of all doctor’s visits for muscle or bone pain, so modern medicine has had a lot of experience with effective treatment plans.

Surgery for Traumatic Injury

When medication isn’t enough to manage pain or restore your mobility, it might be time to consider surgery. Surgery can be indicated for any number of different injuries to the knee. One problem that’s very common among athletes is a torn anterior cruciate ligament (ACL). While this doesn’t always call for surgery, a severe tear to this ligament which holds the upper leg to the knee joint often leaves surgery as the best option.

Total Knee Replacement

Sometimes, the damage to the knee is the result of a chronic issue such as osteoarthritis. When the bone in the knee has deteriorated or the cartilaginous pads between the bones have worn away, it is sometimes necessary to opt for a total knee replacement. This procedure has evolved toward a less-invasive approach that ends with new synthetic components being inserted into the knee joint. There are currently more than 14.5 million Americans living with a total knee replacement, and more than 90% of these types of patients report a dramatic decrease in knee pain and increased mobility after surgery.

Recovery

Some kinds of knee injuries are amenable to treatment at home or by noninvasive remedies. Others are either the result of serious injury or chronic illness and have to be treated more aggressively. If you experience knee pain when bending knee components, such as the patella or ACL, or if the pain gets worse when you’re sitting or kneeling, you’ll want to try ice or over-the-counter medications. If these don’t bring immediate relief, it might be time to see a specialist. Knee pain when bending leg joints isn’t a minor problem, and it can be a sign of serious underlying issues. Don’t hesitate to talk to your doctor with any questions you may have.

Leg pain after prolonged standing or sitting: A concern?

Lately, I’ve had a lot of leg pain, especially when sitting at my desk or standing in line at the store. Should I be concerned about this new aching?

Answer From Sheldon G. Sheps, M.D.

New, persistent leg pain certainly warrants a visit to your doctor for evaluation. Leg pain can have many causes, but your description of aching after prolonged standing or sitting suggests a possible buildup of fluid in the leg veins (chronic venous disease, venous insufficiency).

Chronic venous disease occurs when the valves in your leg veins don’t work properly to keep blood moving efficiently from your legs to your heart. Instead, blood pools in your legs and feet, causing pain and swelling. The pain is typically described as a burning or cramping sensation, mainly in the calf.

Past inflammation of a vein (phlebitis) may damage the valves and lead to chronic venous disease. Poor function of the valves in the leg veins also contributes to varicose veins — distended veins visible just beneath the skin. Varicose veins also may lead to chronic venous disease.

Wearing knee-high compression stockings may be worth a try to ease discomfort associated with fluid buildup in the legs. Ask your doctor for a recommendation.

Oct. 03, 2020

Show references

  1. Alguire PC, et al. Clinical manifestations of lower extremity chronic venous disease. http://www.uptodate.com/contents/search. Accessed Oct. 1, 2017.
  2. Cifu DX, et al., eds. Vascular diseases. In: Braddom’s Physical Medicine and Rehabilitation. 5th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Oct. 1, 2017.
  3. Alguire PC, et al. Overview and management of lower extremity chronic venous disease. http://www.uptodate.com/contents/search. Accessed Oct. 1, 2017.

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Chondromalacia: Causes, treatment, and prevention

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In chondromalacia, the cartilage under the kneecap softens and wears away. This can cause knee pain when climbing stairs, for example, but not at other times.

It is also known as chondromalacia patellae.

The knee consists of moving parts, including the thigh bone (femur), shin bone (tibia), and the kneecap (patella). As these parts move, cartilage cushions them and prevents them from being worn away by friction.

However, if this cartilage gets worn or damaged, the knee loses some of this protective cushion, resulting in a painful condition known as chondromalacia.

Share on PinterestA description of symptoms and habits and a physical examination can help make clear the cause of chondromalacia.

Chondromalacia may lead to a dull pain when bending the knee or when the knee straightens right after bending it.

Activities that might cause pain include:

  • walking down hills or stairs
  • climbing stairs
  • straightening the knee while it is bearing weight

This is why the knees often hurt when a person is going up or down the stairs. This deeper movement means that the kneecap is forced to slide up and down over the femur more than usual.

If the cartilage is worn down, or the kneecap isn’t sliding in its groove, a person may feel pain as the knees bend and straighten, and the bones rub on rough cartilage. The pain may go away when walking, however, because the knees do not have to move as much.

Squatting, kneeling, or sitting with the knees bent greater than 90 degrees may also cause pain with this condition. These activities all involve deep bending of the knee.

Even a slight swelling of the cartilage can be enough to trigger pain during these activities. Some people may also notice a cracking or grinding sensation after exercise or heavy use of the legs and knees.

Symptoms of chondromalacia include:

  • pain in or around the knee, especially on climbing stairs, during intense activity, or after staying in one position for a length of time
  • crepitus, or cracking as you bend the knee

Common causes include injury, overuse, and misalignment.

Many people are surprised to find that their cartilage is damaged because they have never directly injured their knees.

However, chondromalacia can result from other factors, not only an injury or accident.

The most common causes include:

Excessive use of the knees: This can result from running, jumping, or any activity that requires heavy use of the knees. Chondromalacia is often called “runner’s knee” for this reason. It occurs in people of any age and is common in young, active athletes.

A kneecap that is out of alignment: If the kneecap is not in the proper position, the cartilage will not be able to protect it from rubbing. Some people are born with a misalignment of the knee that can cause this issue.

Weak muscles in the thighs or calves: The leg muscles help support the knee and keep it in place. If they are not strong enough, the knee may slip out of alignment. Even a slight misalignment can gradually wear down the cartilage and cause pain over time.

A knee injury: An accident, fall, or blow to the knee can throw the kneecap out of proper alignment, damage the cartilage, or both.

Chondromalacia is more likely to develop in:

  • athletes and others who put strain on their knees through exercise and other activities
  • adolescents, due to a temporary muscle imbalance as the body grows, which normally corrects over time
  • women, as they tend to have less muscle mass around the knee
  • people who have a previous knee injury, such as dislocation
  • those with a tight hamstring, flat feet, difference in leg length, or joint laxity
  • people with patellar hypermobility, where the kneecap moves more than it should

It can also be a symptom of arthritis. It can be made worse by activities such as climbing stairs, squatting, jumping, cycling, skiing, running, sitting with the knees flexed for a long time, or a combination of these.

Another cause is muscles that are not balanced. Strong thigh muscles combined with weaker calf muscles can also push the kneecap out of place. Similarly, strong outer thigh muscles and weak inner thigh muscles can cause misalignment.

People who have knee pain or symptoms of chondromalacia should see their doctor. Early treatment can prevent further damage to the cartilage and alleviate pain.

Lifestyle remedies

Typically, noninvasive treatments for chondromalacia are successful. They include:

Low-impact exercise: Walking and swimming are good options to strengthen the legs and keep the muscles strong without stressing the knee. It can also enhance mood and sleep quality.

Orthotics, or shoe inserts: These can support the foot arch, if necessary.

Avoiding activities that cause pain: Many people must avoid stairs if climbing them causes pain. Instead, they should do exercises that are comfortable. This may help avoid further damage to the cartilage.

Diet: Following a varied diet can ensure a balance of nutrients and help maintain a healthy weight. Excess weight can damage the knee cartilage and put stress on the knee joint.

Sleep hygiene: Get enough sleep, as this will help reduce pain and fatigue.

Pain relief: Over-the-counter pain relief medication, such as ibuprofen, can help control discomfort.

Knee support straps: There is a lack of evidence that these are of use. Some people have reported adverse effects, such as discomfort and abrasion. One review of studies, published by Cochrane in 2015, in calls for further research before recommending these devices.

Orthotics and knee support devices are available for purchase online. A doctor can advise you on whether or not to use a knee support device.

Professional help

Share on PinterestPhysical therapy can help strengthen muscles and prevent the problem from worsening.

If a physical examination reveals a muscle imbalance, certain exercises may help balance the muscles and put the kneecap back in alignment.

If the outside of the muscle is stronger than the inside, for example, a health professional may recommend exercises to strengthen the weaker muscles.

A physical therapist works with patients to perform special exercises and stretches. They will suggest specific exercises, depending on the cause of the problem and the muscle that needs strengthening.

Exercises

Depending on the underlying cause of the problem, a health professional may recommend a series of exercises.

Examples of exercises to stretch and strengthen the quadriceps muscle include:

Semi-squats: Stand with the feet hip-distance apart and bend the knees to 40 degrees.

Step-ups: Put one foot on a 10-centimeter (cm) step, then the other foot, then step down with the first foot and then with the other.

Straight leg rise: Sit with the legs straight out in front, raise one leg and lower it slowly, then do the same with the other leg.

Sitting leg lift: Sit on a chair or bed with the feet on the floor and the back of the knee against the chair or bed. Slowly raise and lower each leg in turn.

Do each of these 3 times and rest, then repeat 10 times.

After doing these each day for 6 weeks, your health worker may recommend increasing the difficulty.

Other exercises may be recommended to stretch other parts of the body.

Medications and surgery

Ibuprofen or naproxen may help relieve pain and inflammation in the cartilage.

Surgery will only be necessary if the pain is severe and other treatments have not helped.

This may involve removing the rough surface of cartilage to reduce pain. The surgeon may also be able to release tight tendons and ligaments. This can help to align the kneecap.

Without treatment, chondromalacia can lead to patella-femoral arthritis. This occurs when the cartilage gets severely worn away by damage.

Once the cartilage is lost, it cannot grow back. In severe cases, the bones may directly rub together. If this happens, the pain may be debilitating, and the person may feel it while resting.

A healthful lifestyle, combined with exercise, is good for the knees and all the joints. It is important not to ignore knee pain. Pain during certain activities may be a warning sign of chondromalacia or another condition.

Some people wear kneepads when gardening, scrubbing floors, or other activities. Shoes with proper support are also helpful for the knees.

Keeping both feet in alignment can help the leg muscles remain balanced, and quality shoes can help absorb shock from walking and running.

People who have a diagnosis of chondromalacia can still lead healthy, active lives.

Early treatment can help prevent further irritation or damage to the cartilage. With proper treatment, many people get relief from pain and can do many of their favorite activities again.

6 Common Causes – Howard J. Luks, MD

 

Pain in the front of the knee or anterior knee pain is widespread. Do any of these scenarios seem familiar to you? You come to a stairway and cringe at the thought of having to walk downstairs.  You love to run, but the pain you have when running downhill has taken the joy out of running. If you’ve been sitting for a while, the thought of having to get up is becoming too much to bear.  While I could say “you’re not alone,” that’s not very comforting.  You are here for answers. Let’s see how we can help educate you on why the front of your knee hurts so much.  

Pain in the front of the knee – or anterior knee pain can affect people in all age groups. Approximately 25% of people will suffer from pain in the front of their knees.  I have seen teenagers who can longer participate in sports, and I have 70 years olds who can no longer walk downstairs without fear of their knee giving way.  Why is our kneecap or patella so prone to bothering us like this? 

The cause of anterior knee pain might vary based on your age, level of activity, and your chosen sports. We can see people who are inactive and suffer from pain in the front of the knee, and we can also see people who are highly trained and disciplined who are suffering from pain around the kneecap.  

In the majority of cases of anterior knee pain, we do not find anything wrong with your Xrays or MRI scans.  That has led to a significant change in our approach to anterior knee pain over the years. 

You want your pain to go away.  I get that!  Let’s review some common and not so common causes of pain in the front of your knee. 

While our studies may show no abnormality is present in most knees, a few of you might have something show up on an X-ray or MRI.  That’s more often because no one over 35-40 has a “normal” knee MRI.  Therefore, understanding the muscle imbalances and potential structural causes of anterior knee pain is also very important to know how to treat it. 

Anterior knee pain is particularly common in young women and many runners. 

The symptoms of anterior knee pain vary … some of you might have very mild pain, while some of you might have very severe pain. Some people feel a burning pain around their kneecap; others will get a sharp stabbing pain in their kneecap.  

Most of you will notice that the front of the knee hurts when arising from a seated position, or when walking up and downstairs. Some will describe it as a burning pain. Others might feel clicking or popping. Sitting for a long while will typically be very uncomfortable. If the pain in the front of your knee worsens, your knee may start to feel like it wants to give out, or your knee might begin to feel unstable.  Having a knee that feels unstable is alarming.  

Many runners with severe anterior knee pain (PFPS) will no longer be able to run, especially downhill. Running downhill is more stressful than running uphill.   Our heart might ache running uphill… but the front of the knee is under a tremendous amount of stress running downhill. As we will cover, committing to a long term strengthening program is critical for most runners. 

Is the sound that my knee makes bad? 

As we reviewed in a popular post about the sounds that our knees make, we discussed that the majority of these sounds are not mechanical!  That means that you are not bone on bone or grinding away the insides of your knee when you bend it.  Yes, these sounds can be annoying or even embarrassing, but they are rarely dangerous. The most common cause of this grinding sensation or sound is actually due to inflammation of the tissues inside the knee.  You do not need cortisone or “lubricating” injections to treat these sounds or sensations.  

 

The most common cause of anterior knee pain is often felt to come from a muscular imbalance or a particular pattern of weakness.  This will be the case for the majority of you reading this.  At least that’s what we think is the most common cause.  We have come a long way in evaluating runners and other people who present with pain in the front of their knees.  They often show the same findings when we use high-speed cameras to videotape them while running or walking.  Now, this might be a chicken vs. the egg thing.  Right?  Which came first, the weakness pattern or the pain?  We like to think it was the weakness that came first. We are still working on proving that.  

If you are a runner or cyclist, etc then your training may influence your anterior knee pain.  If you train too hard, too fast, you are at a higher risk of developing anterior knee pain.  Try to keep your training at a continuously progressive pace. You should be slowly increasing the load, distance, or speed over time. Try not to increase your “load,” eg. distance, speed, etc more than 10% per week. 

We also know that a program geared towards correcting an abnormal pelvic tilt, or glute weakness can improve anterior knee pain.  This is especially true in runners, hikers, and long walkers.  We discuss these treatments in a little more detail down below.  Video examples of some of the exercises you can perform can also be found at the bottom of this post.  

Now, some people are found to have a mechanical or structural issue that might be contributing to their pain in the front of their knee.  The following bears repeating early and often. Keep in mind what we already said.. the vast majority of you will have kneecap pain, or a runners knee because of a muscular imbalance or weakness patter– not because of something that showed up on your MRI.  Based on age at the time of presentation, and the common diagnoses we see at that age, I have broken it down into three distinct groups who suffer from pain in front of the knee.

Before you read this, it is worth repeating… the majority of you will not have the issues that I outline below.  The majority of you will have pain due to a gait abnormality or muscle imbalance. We all feel the need to have a specific label for why our knee hurts.  Anterior knee pain due to muscle imbalance just doesn’t cut if for some of you; you want something more specific.  I understand that.

The point I am trying to make is, if you assign the cause of your pain to a specific structural finding or something that your MRI report mentioned, then you may have difficulty getting past that and buying into the PT or exercise strategies that have been shown to work.    

  • Chondromalacia:  Chondromalacia is likely a very early sign of arthritis.  It involves the “softening” of the cartilage under your patella (kneecap).  As the cartilage softens, it is thought that it irritates other tissue in the knee with certain activities. I’m not convinced that this is a common cause of anterior knee pain. Chondromalacia is very common, even in people with no pain.

We find chondromalacia in so many people at the time of surgery for other things, such as an ACL tear. And those people rarely have pain in the front of their knee. So it is not entirely clear why some people might have pain due to chondromalacia, and others do not.  Surgery is rarely needed.

 Physical therapy for lower leg, hip, and pelvic strengthening is often successful at limiting your discomfort. Compression sleeves might help minimize the pain too.

  • Plica:  A plica is a normal tissue found in 25% of knees.  In some patients, the plica tissue becomes thicker and irritated.  This will cause pain on the inner side of the patella or kneecap.  Most people with pain due to an irritated plica will notice improvement with a period of activity modification, and over the counter medications.  Injections can be useful in some cases.  Surgical removal of the plica is sometimes needed… but only after all other treatments fail.

 

  • Patella tendonitis: Patellar tendonitis is a common cause of pain in the front of the knee.  It is a common overuse injury in sports requiring jumping and quick sprints. Patella tendonitis is common in jumping sports participants and is often referred to as a Jumper’s Knee.  

The pain of patellar tendonitis is in the front of the knee just below the kneecap or patella. It is often very tender to touch. Patella tendinitis can resolve with a period of rest, followed by intensive physical therapy. PRP injections or surgery can be considered in rare situations if your pain does not improve with at least 4-6 months of physical therapy. Surgery is rarely needed. See this post on patella tendonitis for more information.

 

If you have patella instability, then your patella is not gliding in the groove in the front of the femur the way that it should. The patella can be tilted, or it could dislocate out of the groove entirely. Physical therapy can be useful for certain individuals. Patella braces might also be effective in a few individuals. Other patients might eventually require a procedure to “realign” the patella, so it doesn’t dislocate or pop out of its groove

  • The patella fat pad: Some of you who have pain in the front of your knee will have inflammation of the fat pad under your patella tendon. Your MRI might have shown fat pad edema or fat pad inflammation.  The radiologist may also use the term fat pad impingement.  The fat pad is only starting to gain attention now. It seems that the fat pad can be a cause of anterior knee pain in a decent number of people.

  

We will cover the fat pad in its own standalone post within a few months.  Most people with fat pad impingement will improve with a long period of observation.  We can try injecting the area with cortisone for persistent pain.  Surgery to remove a portion of the inflamed fat pad is occasionally useful in recalcitrant cases that do not respond to activity modification, anti-inflammatories, injections, and PT.  

A hallmark of the runner’s knee is that we often find nothing structurally wrong on the exam or an MRI. Contrary to popular opinion, pain in the front of the knee from running is not usually due to arthritis or a plica. Softening of your cartilage, or chondromalacia is also not necessarily a common cause of anterior knee pain.  Why is that? How can this hurt so much, and my imaging studies are normal ??  

Being treated for anterior knee pain can be very frustrating.   The pain is very real- no one will deny you that.  The issue I am trying to convey is simply that the cause of your pain cannot often be easily labeled on an X-ray or MRI.  Bone scans are also rarely effective at revealing why we have pain in the front of the knee. 

We will cover coping strategies for anterior knee pain in a second… but it should be clear that surgery is rarely indicated, and it has been shown in many studies that a structured exercise program is equally effective.  

This and many other papers reveal that surgery is no better than structured exercise.

Many runners will present with an MRI which shows a meniscus tear – but we know that a meniscus tear is NOT the cause of pain in the front of your knee. So don’t have that knee arthroscopy.  Most of those meniscus tears in runners can safely be ignored. We now believe that hip/core weakness, leading to excess inward rotation of the femur (see image below), is potentially a common cause of PFPS.

If you look at the diagram below, it shows how your pelvis and hip strength contribute to your kneecap (patella) position, which could cause anterior knee pain. Furthermore, surgery is seldom indicated for a runner with pain in the front of their knee. Physical therapy, which focuses on hip strengthening, core strengthening, and stability, can alleviate PFPS symptoms in most runners. Most runners with pain in the front of the knee do not need to stop running if their pain is minimal. As I mention just below, there are some changes that you can adopt to lessen the pain you experience.  

Coping strategies for runners with anterior knee pain:

  • A shorter stride: a shorter stride allows you to control your pelvic drop better. 
  • a higher cadence (number of steps per minute): This also minimizes your pelvic drop and other gait abnormalities. 
  • Avoiding hilly terrain until the pain has lessened.
  • Progressive, intelligent training.  Consider using apps such as HRV4 and TrainAsOne. 
  • Patella taping: See the video at the end of this post. 
  • Orthotics or shoe inserts:  These have been shown to work in more than 50% of you.  
  • Prevention: Keep your glutes/ hip abductors / core strong. See the exercise videos at the end of this post.  
  • Osteoarthritis (OA): Arthritis of the patella causes pain because the cartilage under the kneecap has worn out. Arthritis, which only involves the patella in your knee, is more common in women.   Physical therapy can be very effective in the early stages of osteoarthritis of the patella. Read more about the treatment of early arthritis. Injections and over the counter medications may have a role in some patients.  In some situations, when the arthritis is severe, a patient will need to consider a replacement of the patella or a total knee replacement if the arthritis is elsewhere within the knee.

Pain in the front of the knee is usually treated successfully without surgery.  Many of you will respond to physical therapy, which should focus on your hips, yes, your hips and pelvic muscles as much as it focuses on your thigh muscles.  Runners who focus on a strengthening program might– repeat — might have a lower incidence of anterior knee pain. 

When will my kneecap start to feel better? 

One broad caveat to keep in the back of your mind.  Many of you are thinking that a few weeks are enough time to start to see improvements with treatments such as exercise or physical therapy.  Sadly that’s not going to happen.  It is not unusual for it to take 3-4 months before you start to see significant improvement in your pain.  Furthermore, it is not uncommon for it to take 8-12 months for a complete resolution of your symptoms.  This is important — I wouldn’t want to seek a surgeon’s consultation because 4-6 weeks of therapy and exercise left you with persistent pain.   

Down below.. under coping strategies, we list a few things to try that can calm down your pain while we give the exercise time to work.  

Examples of Leg Exercises: Learn from an expert so that your form is accessed and your risk of injury is lowered.

 

There is no easy surgical solution for anterior knee pain.   

The mere fact that there are likely to be ten or more described surgical techniques to try and treat pain in the front of your knee should give you pause.  That usually means that none have been very successful, so we keep trying new ones.  Surgery for anterior knee pain has not been proven to be more effective than a proper exercise program. 

Drilling:

Some procedures have drilled holes into the patella, thinking that excess pressure may have been the cause of pain. Did it work for some people? Maybe… but with that pesky placebo thing, we always hear about, we don’t know because this procedure was never tested against control or sham.  Besides… having holes drilled through your patella might cause it to break if you fall on it or if you are hit in front of your knee.  

Burning:

One prolific Spanish author wrote about burning the tissues around the patella.  We call that a denervation procedure.  That’s because when you heat the tissues, you will fry the nerves to that region.  The thought behind this procedure was that the patella is fed by nerves that could easily be burned using an arthroscopic approach.  This procedure was also never evaluated against a control group or a sham group- so we just don’t know if it works. 

Cutting: 

Surgeons have been performing a procedure called a lateral release for decades.  It has long been felt that a tight tissue on the outer side of your knee may be responsible for causing pain in the front of your knee.  For a while, it seemed like everyone was offering this procedure to most patients with anterior knee pain or a runner’s knee.  We have learned a lot over the last few decades.  We can safely say that there is very little role for an arthroscopic lateral release as an isolated procedure in the management of anterior knee pain.  

Moving:  

Far too many of you are told that your patella doesn’t track well.  What your doc or PT is referring to is that the kneecap sits in a groove on the front of your thigh bone or femur.  That groove is called the trochlea. The patella should theoretically sit perfectly in the center of that groove — but there is a ton of normal variability that exists.  Do real cases of patella maltracking occur? Sure, however, it’s not nearly as common as many believe it is.  And once you’re told that your kneecap doesn’t track well… it’s hard to get that thought out of your head.  Words harm.  

To improve your patella tracking, we can cut small pieces of bone around the knee and move them around.  We call this procedure a tibial tubercle osteotomy.  Don’t get me wrong, this procedure has a huge role in managing people with a kneecap that dislocates– but the role of an osteotomy in managing straightforward anterior knee pain is much more limited.  

Non-surgical suggestions for alleviating pain in the front of your knee.  

Many people with anterior knee pain get some relief with the following coping strategies :

  • A Knee Compression Sleeve 
  • An Ice compression sleeve
  • Taping has been shown to be effective at minimizing pain in the front of your knee.  See the video below on how to tape the knee for a runner’s knee or painful kneecap. 
  • Insoles or foot orthotics. No, don’t spend $1000 on orthotics from a podiatrist, consider the OTC brands.  If they do work, feel free to continue them on a short term (6 weeks) basis.  

Physical therapy is effective in managing the pain brought on by most causes of anterior knee pain.  Your PT will focus on your hip muscles and strong thigh muscles. 

Some of the exercises we use include: Wall sits, Squats, lunges, knee extension, bridge (single leg) and so on.  Many of these exercises can be adapted or changed to accommodate a knee that is very painful.  This is also a situation where patella taping and orthotics might be useful to calm the knee down and allow you to start an exercise program.  

Is surgery ever needed for anterior knee pain? 

In some cases of patella instability, where the kneecap dislocates often we need to consider surgery to reconstruct the ligament which holds the patella in place.

In cases of severe arthritis of the patella, we occasionally need to consider a joint replacement if you do not respond to a compression sleeve, injections, activity modification, and physical therapy.

Patella tendonitis or a jumper’s knee will usually respond to activity modification and physical therapy.  It is not unusual for your recovery to take up to 6-8 months.  If the pain remains severe, there has been a recent interest in trying PRP injections to “regenerate” the patella tendon.  It is still controversial whether or not PRP injections are useful.  Surgery, although rarely needed, can be very useful in severe cases of a jumper’s knee.

Many of you are afraid to exercise.  Yes, some of you may have pain with a few of these exercises.  You can start with quadriceps isometric exercises, or simply don’t go too low with the squat, lunge or wall sit until your strength improves.  Most of you will find that after doing these exercises 3 days/week for two weeks that your pain will start to improve. As I mentioned previously, this is a program that can take 6-12 months to fully correct the weakness pattern that led to pain in the front of your knee.  So stick with it.    

Squat: I like the variations that this group throws in.  You do not and should not start with 100 if you are just starting out.  

Chair Squats are the place to start if you don’t have the strength or confidence. 

Wall Sits: A great quadriceps exercise.  This video is a little mechanical, but it contains the dos and don’ts of how to perform a wall sit.  

Reverse Lunges:  Easier than forward lunges.  Don’t lunge back further than you can handle.  That distance will get further over time.  Focus on your front knee so it doesn’t wobble back and forth.  

Planks: This video includes a good description of the proper technique, and it gives you 10 different variations to try. 

 

Hamstring bridge exercise.  If this is too easy you can rest a barbell across your pelvis, or a kettlebell on your lower abdomen. 

 

 

Disclaimer:  this information is for your education and should not be considered medical advice regarding diagnosis or treatment recommendations. Some links on this page may be affiliate links. Read the full disclaimer.

Causes of Knee Pain When You Straighten Your Leg

A knee injury such as “runner’s knee” may cause pain when the leg is straightened.

Image Credit: lzf/iStock/Getty Images

It’s a runner’s greatest fear: You’re training for an upcoming race and completing more and more miles each week. The pain in your knee begins as a little itch but becomes more difficult to ignore with each run you finish. Before long, you’re in the doctor’s office because your knee hurts every time you straighten your leg.

Unfortunately, knee pain is a common issue among athletes and can be sustained through either overuse or direct trauma. Whether your knee pain is dull or sharp, make sure to consult a doctor before continuing your training schedule.

Read more: Exercises to Help Loosen a Stiff Knee

Common Causes of Knee Pain

Knee pain can come from a variety of direct causes, whether it’s sprinting downhill or even kicking a ball. However, the most common cause of knee pain is usually doing “too much too soon,” says Tyler Nightingale, DPT, a physical therapist with Bespoke Treatments in New York City. A rapid increase in activity or repetitive performance of a new movement can result in tissue overload, causing swelling or pain.

If you’re feeling pain while straightening the knee, it’s probably due to cartilage or joint surface damage between your larger leg bones (the femur and tibia), says Nightingale. When you extend your knee, contact between these bones increases, which can cause painful pressure. This damage is usually the result of an injury.

Here, we’ll break down the most common injuries that cause this type of knee pain, which can be categorized as either overuse injuries or traumatic injuries.

Read more: 12 Exercises That Are Safe to Do With Knee Pain

Knee Overuse Injuries

Tendons are strong bands of fibrous tissue that connect muscle to bone. Pain in the patellar tendon (patellofemoral pain syndrome) — which attaches the bottom of the kneecap to the top of the shinbone — can occur from repetitive knee movements, especially jumping and climbing stairs, according to the American Academy of Orthopaedic Surgeons (AAOS). A common form of this syndrome is runner’s knee, which is caused by overuse of the tendons through the repetitive motion of running.

Overuse knee pain can also be caused by a muscular imbalance in the quadriceps muscles, according to the AAOS. When the knee bends, it relies on the quad muscles and quadriceps tendon to keep the kneecap within the trochlear groove (think of this like the pathway the knee should follow). If your quads are weak or imbalanced, that might cause the knee to track abnormally through this groove, resulting in pain.

The severity of the pain determines the best treatment method for either injury, but it is typically advised to begin knee pain treatment with the RICE method, according to the AAOS. RICE stands for rest, ice, compression and elevation. However, if pain persists after you’ve iced your knee several times a day, rested properly and taken other precautions, it’s a good idea to visit your doctor. He or she will most likely recommend physical therapy or orthotics if the pain can be treated non-surgically.

Traumatic Knee Injuries

One common form of traumatic knee injury is a meniscus tear. Each knee contains two small pieces of rubbery cartilage called menisci located deep within the joint, according to the AAOS. Your menisci act as shock absorbers between the two main bones of the knee — the femur, or thighbone, and the tibia, or shinbone.

Meniscus tears are common injuries that typically result from exercise or other physical activity. Sometimes this injury can feel like a “pop” in the knee and cause stiffness when straightening. Knee swelling may occur, especially with tears caused by an acute injury. And part of the torn meniscus sometimes catches between the bones, causing locking of the knee.

Tears of the anterior cruciate ligament (ACL) are another traumatic knee injury that may be the source of pain while straightening the knee, according to Nightingale. Often, these injuries are sustained by athletes that play high-intensity sports like soccer, football or basketball where the player rapidly changes direction, stops and starts frequently or experiences direct collision, according to the AAOS.

Unlike many overuse injuries, an ACL tear cannot heal without surgery, according to the AAOS. Typically, a surgeon must rebuild the ligament and stitch it back together in order to restore stability to the knee. After surgery, patients typically follow a physical therapy program to help regain strength and motion of the knee before returning to any physical activities.

Read more: Can I Do More Damage Walking on a Torn ACL?

When to See a Doctor

If you are experiencing sharp, shooting or throbbing knee pain that prevents you from putting full weight onto your leg, it’s best to see your doctor right away, says Nightingale — especially if you sustained the injury traumatically through a fall or collision. Symptoms like locking or catching of the knee are also common signs of a more serious injury and a red flag that you should consult a doctor ASAP. Any chronic knee pain lasting more than a few days should be assessed as well.

[Online Knee Injury Symptom Checker]

If you are experiencing knee pain when walking, knee pain when bending, knee pain when resting, or are hearing popping/clicking in your knee, etc., it may be a minor concern or indicator of a serious issue. 

Knee pain is usually caused by traumatic injuries, repetitive motion injuries, long-term wear & tear, or tissue disorders. Below are injuries that are common causes for knee pain, but it is best to enter your symptoms into our Knee Pain Diagnosis Symptom Checker to gain a better understanding of your injury. 

Common Knee Injuries

  • Meniscus tear: a tear in the cartilage in the knee. The knee often becomes unstable and the forces of weight-bearing concentrate onto a smaller area of the tibia, leading to arthritis. 
  • Ligament tear: a tear of any of ligaments in the knee: PCL, MCL, LCL, and the most common ACL (anterior cruciate ligament). 
  • Osteoarthritis (OA): osteoarthritis, or OA, is characterized by cartilage damage that, over time, exposes the underlying bone. Rubbing against the exposed bone produces symptomatic pain, inflammation, swelling, and stiffness.
  • Patellar dislocation: a patellar dislocation, or kneecap dislocation, is usually caused by either direct trauma to the knee or from a sudden twist or pivoting of the leg. A dislocation occurs when the patella shifts out of its normal position in the front of the femur. 
  • Osteochondritis dissecans (OCD): a disease in which localized osteocartilaginous separation at the level of the subchondral bone causes damage to the protective articular cartilage cover, subsequently producing pain and swelling. If untreated, this can lead to loose bodies in the knee. 
  • Bursitis: an injury or inflammation of the bursa, the tiny, fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body.
  • Baker’s cyst: an accumulation of fluid in the back (posterior) of your knee.

90,000 Leg pain

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct prescription of treatment, you should contact your doctor.

Pain in the leg – the causes of the appearance, in what diseases it occurs, the diagnosis and methods of treatment.

The legs perform supporting and motor functions, taking on the entire weight of the human body and at the same time allowing it to move easily and smoothly.

The slightest asymmetry in the ligamentous and muscular apparatus of the trunk and legs quickly leads to the development of pain syndromes.

Many vascular pathologies also affect the condition of the legs.

Varieties of leg pain

The nature of the pain is determined by the severity of the pathological process and the type of tissue that is affected by inflammation.If the pain is caused by diseases of the veins, then it has a pulling, breaking and bursting character. Muscle pain with myositis (muscle inflammation) is characterized by significant intensity, which increases with exertion, and weakens at rest. In addition, reflected pain arising from radiculopathies (radicular syndrome) is possible. For arthrosis, arthritis is characterized by dull pain, aggravated by walking. With gout, in addition to severe pain, there is a significant deformation of the joints.

Possible causes of leg pain

Leg pain can be the result of trauma – bruise, fracture, tendon sprain, muscle rupture.So, sprain of ligaments and tendons happens with a sharp movement in the joint, a fall, accompanied by varying degrees of damage to the fibers of the connective tissue.

Most often, stretching occurs in the ankle or knee joint when jumping, running, playing sports, as well as with unequal leg lengths, when wearing improperly selected shoes or shoes with high heels.

Stretching is accompanied by severe pain on movement and swelling.With prolonged and slight exposure to a damaging factor, it is possible to form microtraumas, the symptoms of which appear gradually, which complicates the diagnosis. Microtraumas include tendonitis (inflammation or tissue damage) of the calcaneal (Achilles) tendon, plantar (plantar) fasciitis, often called heel spur. Rupture of a muscle occurs when it is severely and abruptly contracted or hit and is accompanied by hemorrhage and the inability to step on the leg.

The extensive list of diseases of the vessels of the legs is headed by varicose veins of the lower extremities (varicose veins) . Its causes are hereditary factors, obesity, hormonal disorders, improper lifestyle, pregnancy. With this disease, the saphenous veins expand, and their walls become thinner. A syndrome of chronic venous insufficiency develops, which is characterized by a decrease in vascular tone, changes in the vascular walls and a decrease in blood flow in the veins.The first complaints of a patient with varicose veins are directed to the appearance of telangiectasias (spider veins) and reticular varicose veins (vascular networks). Then edema occurs, which is accompanied by a feeling of heaviness and distention in the muscles.

The severity of symptoms decreases with walking, and increases with static loads. Late manifestations of the disease include persistent edema, pigmentation, eczema, varicose ulcers.

Thrombophlebitis is characterized by inflammation of the venous wall and the formation of a thrombus in the lumen of the vessel.Most often, blood clots form in places of narrowing or confluence of veins – tributaries of the small and large saphenous veins and perforating veins. Throughout the inflamed area of ​​the vein, the skin turns red and becomes hot, there is swelling of the limb below the formed thrombus, there are burning sensations, bursting and pain. Thrombophlebitis can develop in highly convoluted veins, with an increase in the number of platelets in the blood. However, the most common cause of thrombophlebitis is varicose veins of the lower extremities.

Vascular thrombosis – the final stage of thrombophlebitis, accompanied by sharp pain in the leg, severe edema, discoloration of the skin to bluish-purple. Particularly dangerous are deep vein thrombosis, which can occur when the patient is in a supine position for a long time (after surgery, stroke, etc.). In this case, the formation of a thrombus threatens with blockage of large veins of the lower extremities, and in case of its separation and advancement with the blood flow – pulmonary embolism.

Quite often, the vascular cause of pain in the legs is obliterating atherosclerosis of the lower extremities .This is a slowly progressive disease, which is characterized by a thickening of the inner walls of the arteries of the lower extremities due to the deposition of lipids on them (in violation of lipid metabolism) and the proliferation of connective tissue.

Decreased blood flow below the area of ​​atherosclerotic plaque formation leads to muscle and subcutaneous fat atrophy, pain (especially when walking), and the legs become cold to the touch.

The final manifestation of the disease can be the development of dry or wet gangrene of the fingers and feet.

Diseases of the musculoskeletal system are always accompanied by pain in the legs. So, with diseases of the spine (osteochondrosis, intervertebral hernias, radiculopathies) pinching of the nerve roots leads to shooting pains over the entire surface of the leg. Pain in this case can be accompanied by burning and numbness of the limb.

The defeat of the joints of the legs occurs with arthritis and arthrosis . In this case, the pathological process extends to the entire joint, including cartilage, the superficial part of the bone, ligaments, synovium and muscles.The result is the destruction of the articular cartilage with the formation of cracks and the formation of bone growths. Most often, this process affects the knee joints. Symptoms of arthritis include pain, stiffness and limitation of movement, crunching sound when moving, and change in gait. The pain increases with walking and standing for a long time, and subsides at rest.

With long-term pain syndrome, synovitis develops – inflammation of the joint membrane with accumulation of fluid in the joint capsule.At the same time, the pain intensifies and does not stop even at rest, there is a long morning stiffness in the joint. In the later stages, deformation of the joint occurs. The disease can develop as a result of infectious and autoimmune (gout) processes.

Pain in the leg can cause degenerative changes in the hip joint – coxarthrosis . If earlier this disease occurred mainly in elderly patients, now it is significantly “younger”.

The cause of damage to the hip joint is a violation of its blood supply, excessive load due to overweight and improperly selected shoes, curvature of the spine, a genetic predisposition to dysplasia, systemic diseases (collagenosis) and infections.

Symptoms of coxarthrosis: pain, restriction of movement in the hip joint and change in gait. After rest, patients begin to move with difficulty, and with prolonged walking, the pain intensifies, which is manifested by lameness.At rest, the pain subsides.

Erysipelas (erysipelas) is the most common infectious cause of leg pain. The disease is caused by hemolytic streptococcus, which can penetrate through damaged skin. Hypothermia, varicose veins disease, diabetes mellitus contribute to the development of pathology. As a rule, the disease begins acutely, with chills, a sharp rise in body temperature to 38-40 ° C, headache.

After 1-2 days, local manifestations of erysipelas appear, which are characterized by clear uneven foci of redness.

The affected limb is swollen. Soreness of the lymph nodes, burning sensation and distention in the leg are noted. Bubbles with transparent contents are possible.

Muscle tissue disorders that can cause leg pain include myositis (muscle inflammation) and fibromyalgia (a complex disorder accompanied by musculoskeletal pain). The latter disease is diagnosed by doctors by the method of exclusion, since it manifests itself with a number of symptoms: chronic widespread symmetric pain, stiffness of movement, depression, sleep disturbances and the presence of characteristic pain points.Most often, the disease is diagnosed in women aged 25-45 years.

Diagnostics and examination

X-rays are required to diagnose fractures in trauma.

Diary of a broken leg | alexmak.net

No, I didn’t break my leg again, fortunately. It’s just that last week (March 14) was exactly one year since the day I had a bad skiing, and I decided that I needed to write a small update on how the leg recovery is going on.At the same time, I decided to collect all my posts published last year on this topic on Medium, and put them out as one blog post. (Yes, as one very witty reader wrote to me, it’s time to move the blog from the Apple tabs to the Health tabs).

Moreover, the story with the leg was only the first stage of my medical adventures last year, and for me this is a kind of closure of gestalts. So I exported all the posts from Medium, imported them into WordPress, put them together as one long read, tweaked the text a bit to make it more readable, and here’s my graphomaniac result.I hope you find it as interesting to re-read as it was to me.

By the way, you can read the notes of another equally lucky guy – Artyom (aka Yura) Rosnovsky, who in his Medium account talks about the same fracture and medical troubles with his leg in America.

Beginning
Once we went to France to ski … by the way, someone asked me “why France and not the States?” Oddly enough, but skiing in France is much cheaper than in the States, even taking into account more expensive air tickets.And everything is cheaper: accommodation, equipment rental, ski passes, food (it is also much better and tastier), and so on. Not to mention the fact that skiing in the Three Valleys is much more interesting and varied than, for example, in Vail, Colorado. Well, in general, this was our seventh time in Les Menuires, we are already used to it there and we all know. We usually arrive in Geneva and in 2.5 hours of absolutely charming surrounding beauties we reach the resort. In short, France as a whole rules.

Le Menuir’s main square (view from the balcony)

And on the third day of skiing (6 days were planned in total) I fell and broke my leg.

Wide smile. I don’t know yet that I’ll break my leg in an hour.

I am falling completely out of stupidity, on a simple and flat section of the blue track – I wanted to stop and show the brother and wife who were following me which lift we had to get to next. So I started to turn around and slow down sideways … but then everything happened so quickly that I’m not sure if I remember the details correctly. It seems to me that some of the skis caught the snow with a piping, I stumbled, lost my balance and began to fall.Instinctively, even though I was driving sideways, I turned to face forward, and the ski remained across the track, and here, apparently, my leg could not stand it. In general, in theory, the ski should have unfastened (the right one was unfastened), but for some reason this did not happen, and as I fell I heard a crunch coming from my knee (damn it, I still have this crunch in my ears). Having already fallen and felt the pain, I realized that this time everything was worse than in the previous falls, when I was stretching my ligaments, but I did not want to believe in the worst yet.

With the help of my brother who drove up, I unfastened the second ski and somehow sat down on the slope. The leg, of course, hurt like hell, and it was difficult to bend it. But I continued to amuse myself with the hope that maybe everything will work out. I also remember that I thought, “Well, I shouldn’t have taken the knee corset, which I have left from the last time with ligaments.” After a minute of keeping the snow on my knee for cooling, an optimistic thought came to me “ so, well, for today I have probably already skated “. After another couple of minutes, focusing on the pain, I calibrated and thought “ or maybe I skated before the end of the vacation.”And after a couple of minutes I thought “ maybe if I get up, it will somehow get better and I can at least reach the end of the slope to the apartment ”. When I tried to get up, I realized that I still needed transportation downward: my leg bent by itself and the pain was simply unbearable.

The wife went to the nearest ski lift to call the rescuers. About 5 minutes later, Uncle Tomas came downstairs with a stretcher, who asked questions, felt my leg and said that for a simple dislocation of pain it is too much, but the X-ray in the emergency room will tell me for sure.

In general, with the help of my brother, he dragged me onto a stretcher and we rolled down. It was the most painful 10 minutes of sledding in my life, because every push gave me a sharp pain in my leg. He brought me to the emergency room, which was located on the -1 floor of the building where we rented an apartment, and I managed to think “ well, now the plaster will be screwed on and I am hobbling up to the 10th floor in the elevator. I will sit all day on the balcony, drink hot wine and sunbathe in the sun “.

In the emergency room, I was transferred from a sled to a gurney and immediately brought into a room with an X-ray machine. I had to take off my shoes, pants and thermal underwear, so for the next few minutes the emergency room was filled with my groans and screams “ fuuuuuuck ” … according to the results of the X-ray, the dude from the first-aid post dumbfounded me with the fact that a) my knee was broken (I already understood this), and b) to fix it, you need to go to the hospital and have an operation. In short, with this “successful” fall I deprived myself not only of skiing, but even sunbathing on the balcony with hot wine.Well, fuck …

An ambulance was ordered at the first-aid post to transport me to the hospital, and it was supposed to arrive in 1.5-2 hours. In the meantime, since I was still in great pain, they decided to give me a pain reliever. Since everything in my body is not very simple (I’ll tell you somehow what’s wrong there – upd As you understand, here I meant my story with the kidneys), then morphine acted as an anesthetic: a specially trained nurse came and put on an IV and sprinkled morphine there.Feelings, of course, yeaaaaa…. But, by the way, I just didn’t like these sensations and I would not want to repeat them, although it helped to reduce the pain.

Apparently, under the influence of adrenaline and drugs, I woke up with a desire to change everyone, so I tried to give out all sorts of valuable instructions to my relatives – call the insurance company, what should I bring to the hospital, and so on. Fortunately, they mostly ignored my CU and made everything much more correct and organized. They paid off the emergency room for X-rays ( 150 euros ), with the nurse for morphine ( 120 euros ), and also sorted out the insurance guarantee for the payment of transporting the body from the slope ( 462 euros .I’m wondering, is it somehow considered “per meter” that such an exact amount is obtained?). In short, without them it would all be much more complicated, and I am very grateful for their help (and I am still tormented by remorse that I “broke their vacation with my foot.” My brother’s wife, for the first time, decided to try skiing on this trip, and it was we who persuaded her for a long time. She even managed to like it, so I hope that this minor incident will not scare her away).

X-ray at the first-aid post

In the meantime, an ambulance arrived.By the way, this seems to be just a commercial minibus that specializes in the delivery of injured people to hospitals. In about an hour and a half and 320 euros , two French handsome men, who practically do not speak English, not only took me to the hospital, but also managed to draw up the necessary papers and take my card to pay for the “delivery”. So I went to a hospital called Center Hospitalier de Bourg St Maurice . I was glad that almost all such cases were brought here from the nearest ski resorts, so their experience and specialization were understandable, and it would be difficult to find a better place to fix a leg in the area.

This is how I remember the mountains

I was unloaded in the corridor of the emergency room, and the nurses who periodically ran through, whenever possible, tried to ask me some questions and fill out the appropriate forms (by the way, the language barrier with the French did not float before me, but here I felt it in full measure). The leg was still painful, but I decided to refrain from painkillers as much as possible. In order not to lie in the corridor all the time, I used a technical trick – I said that I needed to go to the toilet, after which I was taken to a separate (temporary) ward with duck .An hour later the doctor came, asked more questions, then after an hour and a half I reached the X-ray ultrasound (where they checked that the internal organs did not suffer during the fall – upd here I was just about what they were checking if everything was fine with the kidneys), and then they rolled another knee for CT. After these procedures, I was again returned to the same room with duck , but somewhere around 8 they said “so, we need a room, let’s go back to the emergency room”. After that I was left in the corner of the emergency room behind a special curtain while the documents were being processed.

In the hospital emergency room corridor

To help you understand the timeline better: I fell at approximately 12.30 . I was brought to the hospital at about 4.30 , and at about 8.30 I was taken to the “normal” ward in the surgical department. Considering the workload of the hospital with people with broken limbs, in principle, a good result. At the same time, no one could tell me exactly when my operation would be: Wednesday or Thursday, which resulted in an interesting mess on Wednesday.

In the ward where I was brought (in total it is designed for two people), there was another neighbor who broke his hip while skiing. He had an operation with a joint replacement, and they promised that he could leave the hospital almost on the day of the operation. This neighbor, who spoke a little English, came in handy when he relayed various instructions in French to various nurses that had been given to me by doctors and other staff before. The ward itself is very comfortable, measuring 40 meters, with bedside tables, electrically adjustable loungers, TVs on the wall and regular nurses visiting you.Since at that time dinner time had passed, and I had not eaten for a long time (I fell just when I was driving to lunch), they warmed me some instant potatoes in the form of mashed potatoes, and gave it with a piece of ham. The staff was inclined to believe that the operation would be on Thursday, so they did not forbid eating, and the anesthesiologist generally insisted on drinking more. At night, the nurse came almost every hour and asked if I needed painkillers (I refused – I love to suffer). And then, at about 2 o’clock, apparently, a new shift came, and on the sly, while I was sleeping, I connected paracetamol to the dropper.

Such is the “supper”

The next day (Wednesday) the French mess was taking its toll because the staff gave me conflicting instructions about food and drink. For breakfast they brought tea with a crouton (although the neighbor had a bun, I saw it!), And then to the questions “ so can I eat or drink? “one staff said” yes, eat what you want! “, and the other” no, don’t eat, you have operation “. Since I wanted to finish the operation quickly, I thoughtfully decided not to eat.Around 12, a lumpy anesthesiologist rushed into the ward, who had previously said “ drink more and eat what you want ” and asked “ did I eat something? “. He clearly sighed with relief when I said that apart from crackers, I had eaten nothing, and announced that the operation would be at 3 o’clock in the afternoon.

Preoperative breakfast

All sorts of orderlies and nurses ran around me, finally they took me out of the remnants of ski equipment, and then a sad orderly came, then all the time leaving somewhere and at the same time repeating the phrase “ ay cam backing “.He said that I would need to wash and disinfect myself, and I had to do it myself somehow with the help of a basin of water, iodine and rags. (This orderly, by the way, looked a lot like Podrick Payne):

I somehow mastered this process, then it was the same sad orderly who shaved my broken leg (it turns out, shaved legs are so beautiful! It’s no wonder women do this to themselves all the time. Now I can’t decide whether to shave the other leg – upd I decided to leave the natural cover anyway).The orderlies and nurses continued to run around, both to me and to a neighbor, at that time my family still came to visit me, and at the same time in the ward they first repaired a tap with hot water, and then a door lock, local Shpuntik . And all this 15–20 minutes before the operation; I hope this description conveys well the state of the madhouse around.

Preparing the leg for surgery

Exactly at 3 o’clock I was taken to the operating room.

Part 2
In the first part, I forgot to say what, in fact, I broke – the knee is a complicated mechanism.If I’m not confusing anything, this is a “tibial plateau fracture”, and this type of fracture even has its own Wikipedia page. Roughly speaking, this is when the femur, which is on top, crumbled a part of the lower (tibia) bone on impact with a twist. This is called “out of luck”. Also a warning: at the end of this part there is a photo from the #Unsead series, so be careful there!

Unfortunately, they are not allowed to enter the operating room, so the operation process will be without a photo.(Although, I must say, when I found out that the operation would be without full anesthesia, I wanted to arrange a live broadcast from the operating room). There I first lay in dressing room # 1, then another half hour – in dressing room # 2, where I was given anesthesia. Moreover, due to some peculiarities of my body (upd This, of course, is also about the kidneys), it was decided not to do the operation under full anesthesia, as was originally supposed, but under epidural (spinal) anesthesia – the doctor pronounced both of these terms, I don’t know which the term is more correct in this case.In short, some liquid was injected into my spine and after a certain time I stopped feeling the lower half of the body, but at the same time remained conscious and heard and felt everything that was happening.

It seems to me (here the feeling of the passage of time is rather blurred), after about 15–20 minutes the anesthesia worked, the surgeon came and began his action. This, by the way, is a very strange sensation, when you seem to feel touching your leg, and you understand that there is not just “touching”, but something is being cut, drilled, etc., but there is no pain.I “felt” well how the surgeon held the scalpel to open the skin, I remember how the pins were inserted into the bone and how the last “threaded” bolt was screwed in, which secures the plate holding the crumbled bone. Towards the end of the operation, it seemed to me that pain began to appear, which I informed the staff about, and after that I don’t remember anything. Perhaps I finally fell asleep, or they just hit me on the head so as not to be distracted, but I did not hear how the cut on the skin was collected with paper clips, and I already woke up when they kicked me and said, “ well, what’s up here? Go already, give “.No, in fact, they said, of course, not so rudely, but they informed me that now I will go to the intensive care unit (because I need additional supervision – upd, yes, of course, in connection with my history with the kidneys).

The intensive care unit is a department with 4 individual wards, which is assigned a team of nurses and nurses around the clock, as it seemed to me, in the amount of 4 people. They monitor the condition of patients, dispense medications, measure vital signs, ensure the circulation of ducks, and so on.Since I was drinking dinner that evening while in the operating room, the nurses “muddied” me with the same “instant” dinner with mashed potatoes and ham, but by then I was again hungry enough to enjoy even this dinner. In bed, they hooked me up to a dropper, pulled a heart rate monitor on my finger, glued three sensors for monitoring the cardio system on my chest, and screwed a pressure monitor on my left arm (by the way, it turned on according to some algorithm every few hours, and on the first night I almost died several times from a heart attack, when this crap suddenly began to squeeze my hand and measure the pressure).

I am right after the operation. There were some problems with Wi-Fi, so they connected me directly to the Internet with wires.

That night, by 11 o’clock, the anesthesia finally released, my leg began to hurt, and the nurses immediately began to offer me morphine. I refused, agreeing to start with paracetamol. After an hour and a half, it became clear that paracetamol did not help much, and the nurses again began to offer morphine, but I continued to refuse, so they brought some kind of mixture in sugar.But she also did not help, so the leg was still covered with ice. At about 2 am I still gave up from the unabating pain and agreed to morphine, and the nurses happily injected me with it, so I managed to get some sleep. “A little” – because at 6 in the morning they had a shift, and the old shift had to take my blood for analysis, and the new one – to make sure that they were given a still relatively living body. By the way, about the body – after the operation, the leg was not enclosed in a plaster cast, but in a special corset, which can be conveniently unbuttoned if necessary, but at the same time fixes the leg rigidly at all the rest of the time.

Corset

For breakfast there was traditionally tea (you can choose coffee), and a bun with jam. With breakfast, the nurse brought the pills and said that the operation went well overall. During the day, all the routine with measurements of vital signs continued, a change of bed (two nurses deftly do this right under the lying patient), and they also took me to an x-ray to see what was going on with my leg after the operation. Many saw this photo, I actively grabbed it on the Internet:

Obviously they have no problems with screws

In profile it looks like this:

It’s funny, when they brought me for an x-ray, there was an old woman lying next to her on a cart, who had already been x-rayed, and now they had to take me to a CT scan.The old woman also went skiing successfully, but what was more interesting was that she was from Britain, and we exchanged a few phrases in English with her. At that moment, I experienced some incredible relief from the fact that at last I can speak with someone not in broken simple phrases, supplementing them with gestures, but in normal English, and, which is also important, the person understands me, and also answers so that I understand everything. Somehow, this feeling of the language barrier with the French covered me at this moment.

Lunch (it is served around 12.30) this time I caught it, so I was able to fully appreciate it:

Can he be called healthy? Not. But tasty – you definitely can!

Something, but feed for slaughter. That same day there was a supper (around 6 pm):

It is hard to see, but a tomato cut in half with a thick cutlet is inserted in the rice.

Sorry for the large amount of food photos, but what else to do in the hospital after surgery, when the fun is over and the recovery routine begins? On that day, there was another funny story when, apparently, the head of the hospital came and muttered something in French with the staff.From his gestures and intonation, I understood that he had asked something from the series “ and who is this? “, they answered something, and this manager was like this:” ahhhh, le American! “. I could not stand this, and I had heard that the French do not treat the Americans very well, so I hastened to assure him that “ but, but, ah uh, American! Ah uh ukreinian! “. The doctor’s face really instantly brightened, and he asked me in English: “ So you are not Donald Trump? “. “ Of course, I’m not Donald Trump, yopta! ”, I assured him, and the manager, satisfied with this answer, left.

On that day, a physiotherapist came and told me more about the injury itself, about the operation, about the recovery process, and also brought crutches and taught me how to use them. Actually, the most important thing about the process that I needed to know: at least 6 weeks of no weight on a broken leg, and after that, at least 6 more weeks – light loads. That is, crutches for the next 12 weeks are my best friends, so when we bought them (they were given a prescription and had to be bought at the nearest pharmacy), I called them “ Abbott and Kostyllo ”:

Typical forearm crutches, very inconvenient to use

Looking ahead, I want to say that when I arrived home, I ordered other crutches on Amazon, which turned out to be much more convenient.On the same day, a surgeon came to visit, who, apparently, operated on the leg, who said that “ operation is OK, the bones are weak, they must be protected, no weight on the leg ” (upd Yes, the bones were weak due to kidney problems). By the evening, armed with crutches, I grew bolder and demanded to be escorted to the toilet (I had to push the IV after me). Two nurses said that they were not ready to take on such responsibility, and brought a special chair-portable toilet into the ward.I said that I would not do anything in THIS, so the compromise was the decision in which they took me to the toilet in this chair.

More or less the night passed, and on Friday I should have been discharged. Traditionally, at 6 in the morning, the night shift took blood from me, and the day shift began at 8, some of its regular procedures. Since I had to be discharged, after changing the bed I was told “ sit in the chair ”. A couple of strokes to the stupidity of the French:

  1. I was seated at the sink and told to wash.The nurses changed their bed and rushed off with the words “ if you need something – call ”. All is well, but the washbasin did not have any button to call them. So after I washed, I sat for another 15 minutes and tried, waving my hands at the window opening in the door, to attract attention to myself, until they noticed me.
  2. Then, when I was seated in a chair, I was also told “ if anything – call ”, not taking into account that the call button is actually on the other side of the bed, and I cannot reach it.It’s good that I didn’t have any urgent requests.

One of the most popular questions I got during the broadcast from the hospital: Who is paying for this whole carnival? (in other words, do I have insurance?). I had insurance, specially bought for the trip – I needed to get a French visa, and there insurance is a mandatory document. The insurance was purchased online from Tokio Marine HCC, and we called them almost as soon as the incident occurred.Moreover, when it came to paying for “sledges” from the slope to the first-aid post, they faxed a payment guarantee for this amount (462 euros). Unfortunately, it was not so easy with the hospital. First, they sent the payment guarantee to the hospital by e-mail using the Cisco Secure Mail service, and the hospital administrators (not those who are IT, but those who are just responsible for working with patients) immediately exploded from this. There comes a link, which, in order to open, you still need to register, then confirm the registration and only then, having logged in, see the letter.Somehow I persuaded me to send a payment guarantee to my address, and I was able to get the letter itself from this system, after which I ran into another problem: although the letter was addressed to the hospital, for some reason all that the same coverage amount is 462 euros. Several calls to the insurance support service did not give me any results, they told me that the hospital should provide them with a detailed report on the procedures performed so that they can then review this report.

In short, we decided for ourselves that we will pay the amount of the bill from the hospital ourselves, and then we will apply for compensation to the insurance company for a refund (this is the second option, how to deal with the insurance company). So after several phone calls with insurance, I decided not to waste time on them that day. Moreover, they brought dinner:

I could not identify vegetables in a garnish for fish

At about 5 o’clock in the afternoon, a family arrived by car to pick me up from the hospital.A nurse from the intensive care unit brought a large envelope with various papers and more, among which were:

  • X-rays of the leg after surgery
  • postoperative doctor’s report with information about what was operated on and how, with what anesthesia, etc.
  • recommendations for the further use of medications (in particular, pain relievers and blood anticoagulant injections)
  • prescriptions for necessary medicines
  • Letter to the airline stating that I am allowed to fly on an airplane
  • exemption from work (“to lie for 6 days and not work for 3 months”.Obviously they can afford it in France)
  • discs with X-ray images and with CT-recording (where in general there is a very cool 3D reconstruction of the destroyed knee)

Now the most interesting thing is the cost. What was done on the slope, I have already listed in the first part of the story. The hospital stay from Tuesday lunchtime to Friday lunchtime, including the operation, cost € 3255 , and the operation itself cost € ,700 . In addition, the following was added to the expenses:

  • crutches and leg corset ( 110 euro)
  • prescribed medications ( 67 euros)
  • Well, there are all sorts of little things that patients buy – slippers, new pants to fit on the corset on the leg, oranges-apples.

So, having paid the bill from the hospital, we got all the documents in our hands, they gave us a chair to drive me to the car, I somehow climbed up there and we left somewhere around 6 pm (I just barely made it to dinner at the hospital, unfortunately!).
Then there was a very painful flight home and a new epic, this time with American doctors, but more about that some other time. Considering that I still sit at home and when I’m not working, I’m fucking bored, there is no need to hope that my graphomaniac talent will suddenly subside.And nothing more interesting in my life still happens because of this leg, so I will, if possible, chronicle it.

PS. As a bonus, the photo might not be for the faint of heart. Today I went to the dressing, and finally saw how beautifully the braces hold the seam on the skin.

chpok-chpok-chpok 28 times

In short, take care of your legs when you are young, and then take care of it too. They will still be very useful to you. However, take care not only of your feet!

Part 3 – Transportation
I also decided to talk about how I got home from Europe (to America) with a broken leg – perhaps my advice will be even more useful than the previous two parts, where I mostly complained about life and told, how they fed in a French hospital.

Air travel is a topic that is already not very pleasant, if you cannot afford to fly in business class and hang out in business lounges, and with a broken limb, a flight can even become quite a torment. We had a flight Geneva-Porto-Newark , with a total length of almost 10 hours, and we wanted to make it, if not comfortable, then at least not painful. (A separate part of the story was that my wife had completely different tickets for another day and with a different airline, so I had to strain and find tickets that allowed her to fly with us at least part of the way.Therefore, she got tickets Geneva-Lisbon-Porto-Newark , and already in Porto she joined us. As it turned out later, this was very correct on my part and allowed me to significantly alleviate future suffering).

The flight from Geneva to Porto was operated by Swiss airlines and from Porto by Tap Portugal. I don’t know how they divided tickets among themselves, but I communicated with both companies in parallel and could not get an intelligible answer from them about how I could upgrade my ticket.At some point, they rolled out something about 2 thousand dollars for a business class, but then a toad stepped on my throat – after all the hospitals and so on. I no longer wanted to throw money around. Theoretically, this money in the future could be knocked out of the insurance company later, but I was not sure of the success of this enterprise, so I did not want to risk my money. So I limited myself to two things:

  1. I asked TAP in advance to arrange a wheelchair for me to get to the plane
  2. When checking in online for the Porto Newark flight, I paid for seats with extended legroom

By the way, everything was not easy with a wheelchair.I communicated with TAP support via Twitter (hanging on the phone while waiting for an operator via international roaming is still a pleasure comparable in pain to a broken leg), and when I wrote to them “ help with the chair ”, they first sent me to the page “ medical assistance ”on the airline’s website. There were listed various conditions in which a seat may or may not be provided, as well as a bundle of certificates that must be provided before the flight. I wrote to them “ dudes, you do not understand.I’m not dying, I just need a regular wheelchair from the check-in desk to take me to the plane, and then I’m myself, ”after which they confirmed to me that there would be such a chair. Also, being taught by the fact that Swiss and TAP are somehow not friends with each other, just in case, I asked Swiss support for a chair at the Geneva airport, too. The Swiss support answered me that “ and we see that our colleagues from TAP have already ordered for you”, and I relaxed. But, obviously, the synchronization between the companies still failed, so both at the Porto airport and at the Newark airport I was met not by one, but by two chairs.

Closer to the waste bins

Then everything was quite simple. In Geneva, I hobbled to the front desk on crutches and was checked in. During the registration process, the young lady asked a question that I did not pay much attention to: “ can I walk up the stairs? “. I honestly said that not very much. After that, she told me that I could get my seat (together with the accompanying person) in the “special assistance” department in half an hour. There was a waiting room where you could wait for a chair.There I showed my landing to a special registration aunt, and she immediately sat me down in a chair. After some time, a special man appeared who took my chair and took me to the plane. First, we went through the “for crew” security checkpoint, where I and the chair were contacted for dangerous items. There was no passport control as such, because the flight, in fact, is an internal one in Europe. Therefore, immediately after the security control, we went … to the airfield.

Wow ”, I thought, “ will he get me across the field to the plane now? “.

Everything turned out to be even more interesting. We drove up to a special truck that had a cab for transporting such “immovable” passengers. We got on the elevator platform and climbed into the back of the truck, sat down in the chairs in this cab and drove to the gate.

Real estate transportation

At the gate, the accompanying man took our passports and boarding passports with his son, and went inside the gate. There he apparently scanned us, returned and we drove further across the field, already to the plane.On the left side, a ladder was attached to the plane, so we approached the plane from the right side. The cockpit rose and “sucked” to a separate entrance on the right side, the escort knocked there, the door opened, and we were invited aboard. It was very unusual to get on the plane this way.

Interior for the transport of real estate

The flight itself, although it was short, was accompanied by very unpleasant pains in the leg, and we must pay tribute to the Swiss staff, they helped to make this flight as comfortable as possible.The first two rows of the plane were allocated for “business class”, but there was only one passenger, and therefore, some time after takeoff, I was offered to transfer there. I was able to fully stretch my leg and put it on the seats, and this helped me a lot, because in the first days after the operation, the leg was swollen a lot. It’s a shame this flight was so short.

Swiss mimimi

When we arrived in Porto, after all the passengers had left, I was greeted by a burning man named Alberto, who happily sat me down in a chair and rolled through the terminal to the transfer point, periodically patting me on the shoulder.We very quickly passed the border with him, and he drove us to the gate, where the next flight was supposed to be boarding. He left me in a chair and ran away on some important business, saying that when necessary, he would definitely return. Meanwhile, having flown in from Lisbon, my wife joined us.

After almost no additional control (which is usually present before American flights) and some incomprehensible delay in the start of boarding for about 40 minutes, we were brought up the sleeve to the plane, and from there I was already digging to my seat 11A.It was that same extended legroom seat, the first row just behind the business class, with really increased legroom. Since I bought these places for all of us at the last moment, I had 11A , son 11D , and my wife 11G , but after certain “tags” with replanting neighbors (a complicating factor was a young Hasid, whose dad was not against him somewhere and transplant, but an important condition was that a woman could not sit next to him), we were able to sit down so that my wife and I sat in places 11A and 11B , that is, next to.This, probably, helped me to survive on this flight.

Me and my friends

The problem was that this extended legroom was just a tiny bit lacking. That is, in a normal situation, with healthy legs, it would not be critical, but in a situation where I needed to keep my left leg as extended as possible, but at the same time so that it did not rest against the wall, I was missing a couple of inches. Therefore, I had to keep my leg slightly diagonally (putting a backpack and bags with pillows and blankets under it from below), but this was not enough for a comfortable sitting.It was then that the wife sitting next to me came in handy (she came in handy before, with support and all that), but in a situation with chairs and a lack of legroom, I especially appreciated the opportunity to change places with her and keep my leg diagonally slightly under the other angle. These replacements plus the pain reliever helped me to survive the 7.5 hour flight (although if the plane flew not at 700 km / h, but 900 km / h, then the flight could also have been much shorter). To enhance the discomfort during the flight, one can also add the fact that the toilet closest to me broke down during the flight, and I had to waddle further, which, of course, did not make my life easier for me in my situation.

On arrival, we were also greeted with a seat, which could be accessed after all the passengers had left the plane. But we passed the border without queuing, because we were taken in a chair to a special counter with a border guard, reserved for crews and real estate like me. Then the accompanying man helped to find the luggage (thanks to the Swiss, who stuck “Priority” tickets on it back in Geneva) and took us to the exit. Then the family rushed to get a car from the parking lot, and I waited for them at the exit until they arrived and took me away.Getting in with a sore and stiff leg, even in a compartment with its long doors, turned out to be even more fun, but I was so close to home that I almost didn’t care.

In any case, during the flight, I did not regret at all that I had agreed with the airlines in advance about wheelchairs, which significantly helped speed up and facilitate travel around the airports, and yet I regretted a little that I had saved on the upgrade to business class in TAP. which could possibly reduce the amount of suffering on the flight.It’s amazing that all these additional services with seats and deliveries to the plane cost nothing to the passenger. BUT! I want to say that although it is pleasant to go around the line at the border and go through it quickly, because “you are in the chair”, but when choosing “in a chair out of line” or “standing with a whole leg in the queue”, I would not hesitate to choose the latter …

Part 4 – 2 weeks
Today I went to the local orthopedist for another examination, where he announced a clearer timeline of the process:

  • Until May 10 – crutches and no weight per leg
  • Until the end of May – still crutches and gradual small loads on the leg.

From such injustice, my graphomaniac talent experienced another attack of hard work and demanded to write something else about the leg. And since I still sit at home most of the time (and, in fact, I will continue to sit until the end of May), then to sublimate me into texts is not to resublimate.

Do you know what is the hardest thing in this situation with the leg for me? Loss of mobility. Moreover, as a local one – even walking around the house on crutches is quite difficult for now; and “global” – the lack of the opportunity to get into the car and go on business or even just somewhere, wherever the eyes are, simply infuriates.Yes, the family happily (for now) takes me wherever it is necessary – to donate blood there, for x-ray or to the doctor, but it is precisely the inability to control my own movement, and the need to synchronize it with others terribly enrages.

In the first two weeks I was ready to give anything for the opportunity to sleep on my side; I usually like to sleep on my side, but here I had to sleep on my back all the time. Now that the leg has begun to heal, you can contrive and lie on your side for a while. Therefore, in the first place came this desire to sit down and just go somewhere, without any goal.Drive, squeeze the clutch and enjoy the road. But it seems that this will not shine for me yet.

PS this morning we went to donate blood. I took out my phone … I thought and hid it back: since for me the opportunity to get out into the “outside world” is now not common, I decided to just enjoy the views around. And I got such pleasure from this seemingly trifle …

Part 5 – 3 weeks

In addition to the loss of mobility, with a broken leg you still lose a lot of independence (although, probably, the same loss of mobility can be classified as “independence” as well).But this is manifested in so many daily examples that I wanted to tell you separately.

No, fortunately, I can go to the toilet myself. It’s not as convenient as without crutches, of course, but you can get used to it. True, with a broken leg it turned out to be more convenient to do everything while sitting, because when you try to pee while standing, it turns into some kind of selective yoga: since you are standing on one leg, then all the muscles in the lower body are tense, but in fact, just certain muscles it would be nice to relax at this moment.

Washing-shaving-brushing teeth is also quite successful independently, but taking a shower already requires additional help. For this business, I bought a special stool, which is placed in the bathroom, then I need to sit on this stool (which, as it turned out, is not so easy to do with one leg over the side in the bathroom), remove the corset from my leg, and then pull it on my leg special protective cover. I also bought this on Amazon, such a special “condom” for the leg, with a tight elastic band in the hole, it stretches to the middle of the thigh and closes the wound and dressing with high quality.Moreover, it is impossible to pull this “sock” on the heel by yourself, you have to attract outside help. Well, then, while sitting, you wash from the hose as it goes.

Speaking of leg pulling. Since the left leg does not bend well and because of the pain it is also impossible to bend towards it, pulling clothes on to your feet is also a quest. In principle, I somehow mastered the “throwing” a seine on my leg, and then somehow pull it higher (talking about the fish), but with the left toe so far I have to ask for help.The same, by the way, applies to shoes on the left leg, it is very difficult to pull it on your own leg, although, it should be noted, now it at least fits: in the first week and a half, the leg was swollen and was almost as thick as a ski boot.

Food is a separate topic altogether. It would seem a trifle: take something from the refrigerator and put it in the microwave to heat it (there is no talk of cooking food yet). But, when your hands are busy with crutches, you can’t jump from the refrigerator to the microwave with a saucepan in your hands.Therefore, when someone is at home, I usually ask for help with food, and when I stay on my own, I have to get out. Unscrewing basically consists in using a trolley on wheels, where you put food from the refrigerator, then push it where necessary, there, for example, you put it on a plate, heat it in the microwave, then take it back, and then you have to take it back to the table on a trolley.

Sitting, by the way, is also quite difficult for now, and this applies not only while eating, but also, for example, work: it is very difficult to maintain a leg in one position for more than half an hour.You begin to shift it back and forth, but after another half an hour or an hour it finally gets tired and you crawl onto the sofa to lie down a little and relax. But you still have to work, so you drag your laptop with you. But you can’t carry it in your hands – crutches, so the same cart comes to the rescue as for food – you put a computer on it and push it in front of you to the place of bedding.
Not to mention such an important part of everyday life as combing the hair of cats. I used to put cats in the bathroom and scratch them there, now, because of my legs, I can’t do that.I entrusted this task to my son, but it seems to me that neither he nor the cats have the patience for such a thorough process, as I had, so the wool at home has become even more, and I blame myself for this too.
But not by single losses, of course. I feel that the vestibular apparatus, with the need to often balance on one leg, has pumped very well. Perhaps this will help avoid other falls in the future.

Part 6 – 4 weeks
Last week the doctor removed the second batch of braces from the incision (I promise, this time without a photo!) And we can say that the most boring period of recovery of a broken knee has begun.The pain, as before, seems to be almost nonexistent, except for some particularly careless movements with a turn of the leg, but it is still impossible to transfer weight to the leg, so you have to move only on crutches (and so on for a month and a half, until the end of May ). In general, I have learned to overcome some distances on crutches, although it does not bring me pleasure. But sitting at home is also not fun, the awl in the priest affects:

I also took off the bandages and bandages from my leg, now in the mornings and evenings this is a good reason to look at the scar and groan, feeling sorry for myself and my leg.I can’t wait for the warming so that you can walk in shorts and scare others with a scar.

The most unpleasant part is the loss of flexibility in the knee and muscle atrophy in the leg. Therefore, for the next many weeks, physical therapy is shining for me, with the development of the joint and the restoration of muscles. (Although, of course, with the mechanics in the car, I have to recover some of the muscles quickly enough when I can drive. You can even go to New York on Friday to speed up the process and knock about in traffic).

I do all sorts of exercises for contraction and stretching of muscles, it is not painful and not difficult, but with the knee it is worse, bending the leg causes quite painful sensations.To simplify the process, the doctor gave me a special device, which I call an “exoskeleton”: you insert your leg there, and the device tries to bend it at the specified speed to the specified angle. Formally, the thing is called OptiFlex-K1 Knee CPM, where CPM stands for Continuous Passive Motion.

In short, about once every 25-30 seconds, this thing bends the leg, and then unbends; you can specify the starting angle and the angle to which to bend. (Here you can watch an almost entertaining video on how it works).I started from 55 degrees, now I have brought it to 73. My wife jokes that by the end of the warm-up I will be able to participate as a dancer in River Dance:

Well, the muscles are weakened, you can feel it in simple tasks such as rearranging the leg, for example. Also, I am still afraid to walk up stairs with crutches. I seem to have learned to climb upward more or less without losing my balance, but going down still scares me, since the loss of balance is fraught with falling on the injured leg, and I would like to avoid this. And at night, even under crutches, cats love to get confused, they have long passed the phase of fear of these sticks and they love to rub against them.

Since I almost stopped using the leg brace and started developing flexion, the big progress for me is that I can now fit with my leg in the front seat of the car. I think another week of recovery and it will be possible to try to steer on an automatic transmission – I really miss the ability to drive myself.

And the global conclusion is still the same: to be able to walk is good, to break legs is bad. Take care of your feet and more!

Part 7 – 5 weeks
As I wrote last time, the most boring period of leg recovery has begun, when nothing special happens except for the gradual restoration of leg function.Recovery consists of the exercises that I do, plus the passive flexion of the leg on a typewriter, which I also wrote about last time. There is some progress there: if I started with bending the knee at an angle of 55 degrees, now I have already brought it to 93 degrees. By the next visit to the doctor (April 27) I expect to bend my knee at least 270 degrees Fahrenheit.

I no longer use the corset, but I still cannot step on my foot and it will be impossible for a long time. The leg is still swollen in the area of ​​the knee and the foot, but I read on the Internet that this is normal and with such injuries, the swelling can last from three to six months (FML!).But by improving the bendability of the leg, I have already mastered the independent pulling of socks and shoes, which is good news.

But the most important breakthrough for me happened yesterday, when I was finally able to fit behind the wheel of a car and drive from the store to the house (10 kilometers). I felt like some kind of drive addict, I got such pleasure from the process. In fact, such a charge of pleasure passed through the body that it reminded me of the sensations from the injection of morphine, which I was given in the emergency room, only without the unpleasant “blow” of the injection.Climbing into the driver’s seat still requires a little patience, because the leg must be bent more than it allows without unpleasant sensations, but when you are already sitting behind the wheel, everything is very comfortable and, in general, the thrill of driving. Yes, so far only a machine gun, the mechanics still have to suffer, but it’s still great. 4.5 weeks of abstinence without a rudder – it was very difficult for me. Well, and a separate bonus is the return of at least a partial independent “mobility”.

Yesterday we also went to visit, and since yesterday we had a sudden heat (+ 30C), we had to put on shorts.It turned out that the scar was already in a fairly decent condition and none of those present fainted from the sight of it. The holes around the scar are, of course, funny, but the incision itself heals perfectly, thanks to the doctors. I hate crutches anyway, but there is still no way to get away from them. But until May 10, as an intermediate deadline, there is already relatively little left, and there it will definitely get even better, which is what I wish for you!

Part 8 – 6 weeks
Basically, when I was discharged from the hospital, they said that there was no weight on my leg for 6 weeks, so I could already slowly start stepping on my foot.But my local orthopedist believes that you need to play it safe, and therefore insists that for another two weeks you need to additionally save your leg from weight. Well, okay, of course, he knows better.

But I got bored and exported Health data from iPhone. After some manipulation of the data in Excel, it turned out to count about 87.5 thousand steps and 40 miles of distance traveled since March 15. I don’t know how correct a watch with a phone is in general counting steps-distance when you move on crutches, but for a one-legged (or three-legged?) Not a bad result, given that I don’t like to walk at all.

two observations: 1. it is interesting that skiing is somehow converted into steps, and 2. I don’t understand where 300 steps on the day of the operation (March 15) came from.

After reaching an angle of 105º on a knee-flexor machine, I realized that passive flexion was not enough for me anymore, and I needed to switch to active (muscles from passive flexion are not being worked out at the required level). So I scored on a typewriter and just every day I try to bend my leg as much as possible (well, I do other exercises too), so in general, the leg is gradually being developed.At least for me, the progress is noticeable in that now, in order to climb into the driver’s seat, I do not need to completely push it back.

By the way, about the driver’s seats. Yesterday, for the first time in a long time, I climbed to sit in the Camaro. Climbed (it turned out to be easier than in Makan), started the car, sighed at the sound of a normal engine. I tried my left foot for the grip, but realized that it was too early: the grip is very tight, to squeeze it out, the foot movement is not enough, you need to move your whole leg and apply a solid effort for this.And this means weight on the leg, well, plus this requires the rectus femoris muscle, and it seems to have atrophied the most in the left leg. So you need to wait another two weeks for the doctor’s signal, and in general, consult with him how much you can / need to rush with such a foot movement, and then start developing the muscle back.
On the good news – the insurance company from which I bought travel insurance has finally blown up. They immediately said – “a month to consider an application for an insured event,” and I submitted the papers on March 24th.Today a letter came from them that they did not receive part of the bills that I poured into the system, but at least the most important bill – for hospital stay and surgery – they received and approved its payment, so this amount is sent check me. For the rest of the positions, they asked me to send them invoices, which I did, so we’ll see.
In short, it all fits together a little bit. I want it to be faster, but this is not really my case, so in addition to the muscles of my left leg, I develop patience, this is also a useful quality.

Part 9 – 10.5 weeks
Hooray, finally real progress! Approximately 2.5 weeks ago, the doctor allowed partial weight to be transferred to the leg, and yesterday, after looking at a fresh X-ray, he said that it is possible to start transferring the full weight to the leg. True, so far I’m still with crutches, on the sly, but it’s 3-4 days until I get used to it. Then you can switch to a cane instead of crutches, and in a week you can even try to walk at home without a cane! I wanted, of course, on this occasion to buy some kind of cane, where there is more gold and with some kind of snake’s head, but nevertheless common sense won out.

So in 3-4 weeks, it may be possible to completely get rid of walking aids. Even carrying a lot of weight on the leg is still scary, not to mention walking without crutches – in 10 weeks the body has completely forgotten how to do this. Yes, and purely psychologically, it is simply scary to step on the foot, because it seems to heal, but “what if what will move?”. So you need to change something in your head first.
But this is only part of the progress.Also, the doctor finally allowed me to ride a mechanical box. So far, I have recommended a little bit, to avoid sudden acceleration and deceleration, to avoid the highway and rush hour, but generally allowed! Soon, soon I will be fully enjoying my V8 again!

And I also went to rehabilitation therapy, this week I have already been twice. The therapy includes a whole bunch of different exercises, mainly with your own leg weight, but there are a couple of slightly more difficult ones. There was also a whole 5 minutes of the bike, during which I understood very well where I still lack flexibility in my leg.Well, one of the exercises is electrical muscle stimulation with electric current to accelerate recovery. However, I am not complaining, because I really want to recover as soon as possible and start walking normally. And in July I’ll start, perhaps, a swimming pool.

In short, definitely good news, which is what I wish for you!

Part 10 – 11.5 weeks
On Monday I started walking with a cane. I was looking forward to this moment, thinking about how I would throw off my crutches and flutter freely, waving my cane … but it didn’t work, it turned out to be much more difficult than I expected, and not even in the place where I expected.

First, the leg was not physically ready for such loads; It’s one thing to jump on crutches, moving my legs and even thinking that I transfer most of the weight to my leg, and quite another, when there are no crutches – the leg is not yet ready for such loads. Secondly, the psychological moment turned out to be even stronger than the physical one: the fear of transferring weight to the leg, as it happens during normal walking, turned out to be very strong: “what if something can’t stand there? Well, you never know. ” And thirdly, the most painful thing when walking was in the ankle.Not only did she do nothing for 11 weeks and did not experience any stress, she also does not really bend the knee when walking, and the load on the ankle increases significantly. Well, in general, when walking with a stick, I feel some kind of unnatural distortion, and I’m sure this only increases the pain in the ankle.

On the first day it really upset me: I thought how fun I would ride on three limbs instead of four. (Well, it hurt like hell.) But since I am very motivated to start walking normally as soon as possible, I force myself, overcoming the pain, to continue walking and, if possible, correctly rearrange my left leg when walking.This seems to help, as yesterday I was able to walk much more and with less pain than before. Plus, during physiotherapy, they knead my muscles with electric current and align the joint (by pressing on it, it’s also quite painful), so it gets better a little.
It’s funny that no matter how the ankle hurts while walking, this does not in any way affect the sensations when driving mechanics. The quadriceps in the leg revived a little and this, apparently, is enough to squeeze out the grip without painful sensations.However, getting in and out of the car with a cane, all the time I feel like Biff from Back to the Future 2, where he was walking with a cane, and then, getting out of DeLorean, he lost the head of the cane:

In general, traditionally: take care of your feet and not only your feet! Head too!

Part 11 – 13 weeks
Today “turns” 3 months (or 13 weeks) since the day I broke my leg while skiing. Well, but I finally went!

It seems like just recently I finally threw off my hooves crutches and switched to a cane, but less than a week later I realized that walking without it is even more comfortable for me than with it.Yes, I limp thoroughly, from time to time something crunches in my knee, I walk much slower than I walked before (or, for example, I walked on crutches), there are still a lot of painful sensations in my ankle, but I can already walk on my own, without aids … It is very difficult to describe how much delight this causes: when your hands are finally freed and you can do something with them, instead of, for example, holding onto crutches, it’s just a thrill. It would seem that such a completely simple and inconspicuous little thing, but it radically changes the quality of life for you.

I continue to do physical therapy – all sorts of exercises aimed at returning to normal “range of motion”, that is, the maximum indicators of flexion and extension of the leg. So far, there is still room to improve these indicators, but riding a stationary bike almost does not cause pain. The most interesting thing about physiotherapy is “torture with electricity”, that is, electrotherapy of muscles, and the most painful thing is “alignment” of the leg, when the physiotherapist presses on the leg from above, trying to give it an angle as close to 180º as possible.At first I asked them what kind of exercise it was, in which they again tried to break my leg, but then I got used to it. And I also uncovered the bicycle that was stored in the garage and began to wind a little circles around the house: in general, I do not like a bicycle, but now the circumstances are such that I have to. It’s funny that I found that with a broken (or, more precisely, healing after a fracture) leg, I often walk more per day than I walked before the fracture, and even stand-goal per day in Apple Watch I do much more often.

And it turns out to drive the car quite well. The quadriceps femoris has already recovered enough that even the tight Camaro clutch pedal can be squeezed out without problems, so that “car mobility” is almost completely restored. “Almost” – because in order to get in and out of the car you still sometimes have to grunt, especially if the long door cannot be fully opened in the parking lot or garage, but you can already drive without any discomfort.

As soon as I “moved” my legs, I immediately wanted adventure and even go skiing! Although I understand perfectly well that this does not shine for me for several years: first, everything needs to heal well (one and a half to two years), and then, if I am really going to ski again, I will still have to remove the plate and pins, and again wait until everything heals there (although the recovery after the removal goes, as the doctor says, much faster and not as painful as after a fracture).Therefore, for now, there will be adventures of a different plan. Since I wrote that I already feel confident with the clutch, I signed up for the track day in July, since I no longer have the strength to hold on. Pocono Raceway, here I come!

I think that with this post it will be possible to close the topic of regular updates of the “diary of a broken leg”, because it is unlikely that something interesting will happen in the near future. Rather, it is simply a gradual improvement in walking quality, along with a “straightening out” of the leg.Thank you for reading my whining and complaints, I hope I convinced you with their help that you need to take care of your feet (and not just your feet).

Part 12, it is a year later, it is also Epilogue
So, if you have read this far, then, first of all, you are a great fellow! (However, if you’ve read all this before, and just scrolled the article to this point, then you are great too).
Those who regularly read my blog know about my kidney story, when I first had my kidneys removed and then had a kidney transplant from a donor.This story greatly affected the leg, both before and after the fracture. Firstly, if it were not for my diseased kidneys, then, most likely, the leg would not have broken, but there is no need to regret it now (although the nephrologist hinted before skiing that you need to be more careful with the bones). And secondly, due to the operations in September and October, and the recovery period after them, I was generally not up to the leg and its recovery, so now, a year later, I can say that the leg has not fully recovered. In terms of regaining muscle strength, I would say that recovery was somewhere around 90 percent, and ellipsoid and bicycle exercises are actively helping me in this recovery.

The situation is worse with flexibility. If the broken leg is similar to the right leg in extension, but in flexion, I would say, recovery has occurred by 80 percent. This is expressed in the inability to fully bend the leg 180 degrees (for example, so that, sitting on the mat, the thigh touches the lower leg). More precisely, now I almost can, but so far it is very painful. When I started developing the flexibility of this joint a month and a half ago, an angle of 45 degrees remained between the lower leg and thigh, so there is definitely progress, I just try to do it without unnecessary haste.Now it’s almost possible to sit on bent legs, so I’m pleased with the progress. Feels like, as I understand it, the main problem is in the tendon of the quadriceps muscle and the patellar ligament, which have stagnated a little during the period of inactivity. Nothing, we can handle them!

I still don’t risk running, and, by the way, I don’t want to, but I’m very good at walking. True, in the knee sometimes while walking there is something crackling, crunching, but I hope that as the flexibility improves and the load on the muscles increases, this will go away.I continue to load the muscles on the ellipsoid and (when the weather permits) on the bike. I suddenly really liked the bike, so I plan to actively pump this skill when the normal spring finally arrives.

Sometimes the place where the plate is installed aches, and I wonder if I ever want to get rid of it. In any case, I am not in a hurry with this question yet, because I do not want to return to the hospital in the near future, operations, recovery, that’s all. Plus, some of the medications I take after kidney transplants have a side effect of weakening the bones, so it may be for the best if the plate remains.Although I hope that perhaps medicine has a way to check the condition of the bones without drilling, for example, a sample from it, and this can be found out without unnecessary intervention. And even then I will think about it (although I will not hide it, I would have gone skiing already!)

You can’t scare people with a scar, if you cut through them in shorts – the scar is quite well tightened up and is almost invisible under the layer of vegetation. This, by the way, gives me hope that the scars from abdominal operations will also heal well and will be less noticeable.

This is such a leg (the original photo from March was lost, so I had to remove a new one in November 2018)

To summarize … But what is there to summarize? Breaking your legs is bad, recovering them after that is not easy, but if you treat it as a temporary difficulty and an adventure, it helps to cope with difficulties. In addition to optimism, family and friends help us to cope with difficulties, for which I am very grateful to them. Take care of yourself!

90,000 Numbness: limbs, finger, arm, leg become numb

Causes of numbness

Numbness is a sensation that occurs in certain areas of the skin.The most common companions of numbness are tingling, chilliness, burning, and constriction. These symptoms, for the most part, turn out to be signs of such diseases:

  • migraine;
  • osteochondrosis;
  • the presence of intervertebral hernias;
  • Circulatory disorders in the arm or leg;
  • diabetes mellitus;
  • are signs of a deficiency of vitamins, trace elements and excessive consumption of alcoholic beverages;
  • transient ischemic attacks, which involve one arm or one leg, one or another part of the body, and possibly all limbs;
  • compression of the nerve in the narrow areas where it passes, in the areas of the wrist, elbow, groin, ankles, tunnel syndromes are formed;
  • Nerve damage due to joint deformity.These are rheumatoid arthritis and other diseases;
  • multiple sclerosis;
  • Certain inherited diseases that are associated with nerve damage.

People who experience attacks of numbness often ask themselves the question: what is the right thing to do – see a doctor or wait until the symptoms go away on their own. In fact, if numbness attacks occur frequently enough, it is imperative to see a doctor. Moreover, if, in addition to numbness, pain, awkwardness, weakness, or loss of sensitivity occur, and also if a violation of coordination of movements appears with numbness.In addition, a visit to a neurologist is mandatory if you cannot tell the difference between cold and warm water.

Numbness of the extremities (numbness of the extremities)

Numbness of the extremities is a very unpleasant sensation that occurs when a nerve is pressed for a short time, when a person takes an uncomfortable position for a while. When you change the position, the numbness disappears within a few minutes. But if a change in posture does not help to get rid of this sensation, and it arises quite often, this should be taken as a signal that one should consult a doctor.

Numbness of the extremities may indicate the presence of arterial vascular disease (most often in the legs). This disease can cause inflammation of the inner lining of blood vessels, the formation of obstruction in the arteries (Raynaud’s disease, obliterating atherosclerosis, stroke), and impaired blood circulation. This can result in partial gangrene of the limb. Numbness of the extremities can occur due to nerve injury, which is caused by diseases such as: tunnel neuropathy, osteochondrosis, carpal tunnel syndrome.

Hand numbness is a very common disease. It is caused by the compression of the nerves that supply blood to the median nerve. In the case when timely treatment of this disease is not performed, its consequences can be very negative. At first, the disease manifests itself in numbness of the fingers, then palms, hands, over time, it can turn into pain that occurs at night, then it can appear in the morning. Later, the pain appears during the day, and is especially aggravated by raising the arms up.

Numbness of the limbs can be caused by the following reasons:

  • Uncomfortable lying and sitting posture. In such situations, after numbness, a tingling sensation occurs, which disappears when the position is changed;
  • pinched nerve caused by spinal problems, such as osteochondrosis;
  • due to carpal tunnel syndrome. In this case, the first, second and third fingers of the hand usually go numb, as the middle nerve passing in the area of ​​the hand is squeezed.

Prolonged work with a computer mouse is often the cause of this disease. First, the fingers are numb, then a tingling sensation comes, turning into severe pain;

  • lack of vitamin B12 in the body. This vitamin is included in the metabolic processes of nerve fibers and its low content in the body causes not only rapid fatigue and general weakness, but also leads to impaired sensitivity, heart rhythm disturbances and irritability;
  • Raynaud’s disease.This disease is manifested by paroxysmal circulatory disorders of the arteries, which, most often, appear in the area of ​​the feet and hands. The onset of the disease can be caused by stress, hereditary factors (they consist in the peculiarities of the structure of the nervous system), intoxication (nicotine and alcoholic).

Young women who have suffered from hypothermia, infectious diseases, overwork or prolonged exposure to the sun are most susceptible to this disease.In addition, young women who work a lot with computers, as well as pianists, are at risk. With Raynaud’s disease, not only numbness is felt, but also rapid freezing, as well as the acquisition of a blue tint to the fingers in the cold and during excitement. Most often, the disease affects the second, third and fourth fingers and toes.

If you do not pay enough attention to such symptoms and do not treat, the disease can affect other organs (chin, ears, nose). The arms are affected first, and later the legs;

  • obliterating endarteritis.This disease affects arterial vessels (most often of the lower extremities). Due to significant vasoconstriction, blood circulation is impaired, accompanied by a feeling of numbness, as well as cooling of the limbs. The progressive disease leads to the complete overlap of blood vessels, resulting in gangrene;
  • neuropathy. This disease affects the nerves. It is caused by metabolic disorders or intoxication. Symptoms characteristic of this disease are: itching, tingling, burning, tightness in the toes and hands, and on the protruding parts of the foot.Patients often describe their sensations as “stiffness.” There is a manifestation of spontaneous pain. Neuropathy is also characteristic in diseases such as rheumatoid arthritis, diabetes mellitus, multiple sclerosis, and so on;
  • ischemic stroke of the vertebral and inferior cerebellar arteries. Often, numbness of the extremities is associated with this disease;
  • There are cases where numbness of the limbs occurs due to hyperventilation, accompanied by rapid and shallow breathing in a state of anxiety or fear.

Numbness of the extremities and is a symptom caused by bending of nerve bundles or blood vessels, with an uncomfortable position of the body, impaired blood circulation or more dangerous diseases, which have been described above. Numbness is a change in the sensitive function of the limbs, often accompanied by painful sensations and tingling sensations.

The consequences of numbness of the extremities can vary significantly: from disturbances in blood circulation and up to gangrene of the extremities (partial).These effects depend on what caused the numbness. However, regardless of the reasons, if numbness occurs frequently, this means that the work of blood circulation and blood vessels in the limbs is impaired. This implies that there is a risk of dangerous diseases and you should consult a doctor in order to diagnose the disease in time and prevent its development.

Numbness of hands (hands go numb)

The most common reason for numbness in the hands is the compression of the neurovascular bundle by connective tissue, as well as muscles.This beam is used to nourish and innervate the muscles. There are seven places where pinching can occur. After diagnosing, the doctor can identify the affected area and eliminate the compression of the vessel or nerve. In cases where numbness of the extremities is associated with abnormalities in the functions of the spine, the doctor will also determine the site of the lesion and take action to eliminate it.

Numbness of fingers (fingers numb)

Numbness of the fingers, or carpal tunnel syndrome, was not common and almost never occurred until the 1980s.However, since that time, the number of people using computers began to increase rapidly. Daily use of a computer keyboard is a significant risk factor in the development of this syndrome. But not only people associated with computers are at risk of this disease, it also includes joiners, painters, seamstresses, that is, those people who have to make the same type of movement with their hand every day. In practice, carpal tunnel syndrome occurs when, after exertion, tendons swell, thereby compressing the nerve that is responsible for the sensitivity of the palm, middle, index, and thumb.The nerve and tendons pass through the same rather narrow channel. Such compression of the nerve with swelling of the tendon, leads to tingling, numbness, as well as throbbing pain localized in the area of ​​\ u200b \ u200bthe fingers. Pain and other symptoms of this syndrome are often more felt at night or in the morning. Lack of timely treatment can lead to the death of the muscle responsible for the movement of the thumb. As a result, a person will not be able to bend his thumb, as well as clench his hand into a fist.A large number of people, in such a situation, have to change their profession. Statistics show that women are more susceptible to carpal tunnel syndrome. The most common age at which the disease occurs is 40-60 years.

Numbness of the legs (numbness of the legs)

Numbness in the legs is a very common symptom in people of working age. This manifestation of the disease causes a large number of inconveniences and concerns. In this case, the concern is not groundless, since impaired nervous sensitivity is a sign of a serious illness.According to statistics, 90 percent of leg numbness is caused by spinal problems: intervertebral hernias, osteochondrosis, and so on.

The spine is responsible for many functions in our body. The normal functioning of the legs and arms is also under the responsibility of the spine. In the legs, pain can occur as a result of changes in the lumbar spine. The frequency and nature of numbness can be different, depending on the reasons for which they have arisen.
Intervertebral hernias can compress the nerve roots, thereby causing a reflex spasm of tissues, as a result, the patient’s legs become numb, a feeling of “cottoniness” appears, there is pain, a feeling of “creeping”, prolonged standing, sitting, head tilts, coughing, and so on. further lead to increased pain.Less often, the occurrence of numbness is caused by osteochondrosis, or other systemic diseases (for example, diabetes mellitus).

Osteochondrosis is a disease that progresses for a long time and can be accompanied by various clinical manifestations. To determine the causes of numbness in the legs, often additional examinations should be performed. In order to clarify the diagnosis, an X-ray of the spine, namely its lumbar spine, is used, MRI and ultrasound are used.

In order to establish the cause of leg numbness, additional research methods are often required.To clarify the diagnosis, use MRI, X-ray of the lumbar spine, ultrasound.

Usually, before the numbness of the legs occurs, the patient experiences other symptoms of diseases associated with the spine, such symptoms may appear even at the age of twenty and be in the nature of chronic lower back pain. If medical care is not provided on time, the disease will continue to progress, despite the fact that the pain disappears over time, leaving behind a feeling of stiffness in the spine, then various pains in the legs appear.

If the cause of numbness is radiculitis, hernia, osteochondrosis (in 95% of cases), then it is very important to timely help a specialist who can find out the causes of the disease, as well as take all measures to prevent its development. Our clinic offers high-precision diagnostics of diseases, as well as their effective treatment.

Numbness of toes (numb toes)

There are many reasons for numbness in the toes.For example, various metabolic disorders, radiculoneuritis, can lead to numbness of the legs. Also, osteochondrosis of the spine, accompanied by a narrowing of the intervertebral clefts, disorders in the vessels, tuberculosis of the spine, and, sometimes, the development of cancer, also belongs to similar reasons.

Oncological diseases lead to numbness of the fingers due to the growth of a tumor outside or inside the spinal cord, pressure is created, which in turn causes numbness. This process does not carry the danger that a person will not be able to walk.However, if the numbness is caused by the development of a tumor in the legs, then the risk that the person will quickly develop disability is very high.

If numbness is caused by osteochondrosis – the loss of the ability to walk can occur, both rather quickly and develop slowly – it all depends on the degree of damage to the spine.

Obviously, if you feel numbness in your legs, you should immediately consult a doctor. The doctor must conduct all the necessary examinations and, only after that, make a diagnosis.It is impossible to make a diagnosis based only on the patient’s complaints.

It is impossible to delay referring to a specialist, since it is a well-known fact that the earlier the treatment is started, the more effective and faster it will be.

90,000 Causes of Muscle Pain – How to Get Rid of Muscle Pain

Muscle pains (myalgia) are muscle pains that can occur not only when stressed, but also at rest. Painful sensations of a pulling or spastic nature can be localized in one part of the body or in several at once.

Causes of muscle spasms after exercise

Discomfort due to pain in the shoulder, lower back, neck or other parts of the body is a common occurrence when playing sports. Myalgia is often experienced by beginners who try to do a lot of exercises as soon as they get started. Experienced athletes are also susceptible to it, drastically changing the training plan.

The causes of muscle pain in such cases lie in small breaks in muscle fibers. Due to microscopic wounds, a constantly increasing painful sensation arises in them.An intensive recovery begins in the body: protein is intensively synthesized and hormones are released.

The discomfort disappears after 2-3 weeks, when the athlete enters the rhythm and correctly draws up a training program. But if the pain in the back and shoulder or in another area is sharp and throbbing, the cause may be an injury, so the athlete should consult a traumatologist.

Types of myalgia

  1. Fibromyalgia. They arise in ligaments and tendons, and appear in the occiput, neck, and lower back.Often manifested in women due to stress and men due to overload at work or in the gym.
  2. Myositis is an inflammation of muscle tissue. It occurs due to injuries, heavy physical exertion, complications after the flu. Such muscle pain in the legs, arms, trunk is localized, increases with movement and is aching in nature. Most often, a leg or arm is required to be treated in a hospital setting.
  3. Polymyositis. Serious illness. A person may have severe pain in the neck, shoulders, then the pain passes to the pelvic girdle and legs.Sometimes it leads to muscle dystrophy.

Muscles ache during pregnancy

While waiting for a child, most women experience muscle soreness. Moreover, if before pregnancy a woman was not engaged in maintaining physical fitness, then they manifest themselves more strongly.

During pregnancy, muscles can hurt in various areas:

  • back – due to the load of the enlarging body;
  • abdomen, due to painful muscle sprains;
  • lower back – due to increased stress from increasing weight and natural displacement of internal organs;
  • legs – the causes of leg pain are the same, pain is accompanied by cramps in the calves, which develop at the beginning of sleep, at night or in the morning;
  • breast – under the influence of changes in hormonal balance, increased blood circulation;
  • vagina – under the influence of changes in venous hemodynamics, increased vascular load, decreased elasticity of muscle tissue.

Child’s muscles ache

Myalgia often manifests itself in children due to a lack of vitamins, calcium, magnesium in the body. It may be due to the fact that the child’s bone skeleton is growing, and the muscle tissues do not keep up with it and are stretched.


If the child not only has pain in the legs or arms, but also has a fever, swelling appears, an urgent need to consult a doctor to find out the cause of the disease. Your doctor will prescribe treatment for muscle pain.

Treatment

Treatment for muscle pain depends on the cause, so it is important to make an accurate diagnosis.

Muscle pain in the back and other areas is treated with the following methods:

  • drug therapy;
  • physiotherapy exercises;
  • physiotherapy procedures;
  • manual therapy.

To avoid such problems, you should follow the rules of prevention: a healthy lifestyle, balanced diet, moderate physical activity, an ergonomic workplace, exclusion of smoking and alcohol abuse.

Date of publication: 21.09.2017 |
Date of modification: 05/26/2020

How to pump up your ass without squats if your knees hurt

Today on the agenda
a very sensitive topic for girls, like training for sore knees
joints or ligaments or how to pump up the ass without squats and give the buttocks
round shape.

Why do knee injuries occur

Large number
girls suffer from this problem – 90,015 pain
in the knee joints or ligaments .Injury problems arise primarily from
because of the pain threshold, which is different for all people. There are strong people, they have
high pain threshold, there are weak people – they have a low pain threshold. The strong
people are injured more often than weak people because they feel
heroes and are ready to lift, sit down more than their ligaments are ready to withstand.

People who are more than
attentive to their health, so-called “hamsters” injuries occur in
because they are afraid of everything and protect themselves.Eventually arises
an objective situation when you need to strain and this voltage falls on
unprepared ligaments and muscles, respectively, injury occurs.

To manage your
trauma and understanding them, you need to learn how to manage your pain threshold. Need to
know what your body is ready for right now: warmed up, not warmed up, degree
fatigue

Is it possible to swing the ass and engage in
sore knees 90,720

Engage, of course,
need to.It is necessary to understand the methodology of how to deal with the overloaded and sick
joints and ligaments. The basic principle is to touch the pain. What it is?
After any injury, there is a limitation in the amplitude of the exercise.
There is a certain part of the movement that is painless when squatting, then
comes to a state where it hurts to move.

Meaning
regeneration of the ligament and joint is to increase the metabolism in
injured part
.This is done by touching
pain. You make a movement, you come to pain and back. During the multiple
touching pain, the joint heats up, increases metabolism
in this place. Actually, this is the beginning of the regeneration process.

Majority
women lead a sedentary lifestyle
, and when they stand, then
stand like horses. This refers to the position of the joint. Woman bends back
legs, and when this happens, the hips relax and the ass hangs.Of this
it is not recommended to do it.

More on the topic: How to squat with a barbell

Example
fitness bikinist Arina Modest, we will show how to pump up the buttocks without squats , and the athlete herself
share a set of exercises for pumping priests, which is minimal
engages the knee joints and keeps the muscles of the buttocks and thighs in good shape. it
the technique that the girl followed and studied for about six months –
recovery exercises.After all, a fitness player
suffered a knee injury as a result of negligence, and she had to look for ways
return to normal training.

Pump Your Ass Without Squatting – Complex
exercise

Cardio on ellipsoid

And we will go hiking
training. The first exercise will be a regular warm-up, that is, cardio. Training apparatus
for warm-up – this is an ellipsoed or a bicycle with a reclined back, when the pedals
in front of. Percussion exercises such as a jump rope, treadmill are best removed.How you do cardio is very important. With sore joints, if you
want to pump up the gluteal muscles of the ego should be performed with special features. At all
sore knees in some form accompany pumping
gluteal muscles, and squatting is not necessary
. Why?

In this situation, all
the load is shifted from the knees to the buttocks, from the knee joint to the hip joint.
The butt is pulled back, and with your feet press on the heels, and not the socks that are not
should look out for the knees.Plus, you can tilt your torso forward a little.

Circular motions around the fitball

Second exercise,
which will keep your quads in good shape and not engage the knee
the joint is the revolutions around the fitball. The exercise was invented by Arina herself. Instead
fitball can be any object + support.

What happens. IN
the upper point of the amplitude, the leg is delayed in a circular motion, and the quadriceps
in suspense.Perform it in 3 sets of 20 times.

Pelvic Raises

Go to more
popular exercises that focus on the gluteal muscles. Options
there are several pelvic lifts: with a weight, from a step, on a fitball. With sick
joints, the girl recommends starting with easy options – lifting the pelvis by
rug.

Knee joints in this
do not worry about the situation. Lie on the floor, take on a little extra weight
on the stomach, rest our feet and raise the buttocks.Many people think that it is
useless exercise. Nothing like this. Need to do it right – at the top
squeeze the gluteal muscles to the point of amplitude. This rule applies to all exercises.
when training the gluteal muscles without a squat and with him.

Can be complicated
exercise and put one leg on the other. How it’s done? Simulate a pose
“Lotus” and rise as follows. All these isolation exercises are not
have a certain number of approaches
and repetitions.The girl does not recommend dropping below 12 reps and a minimum of 3
approach.

Platform Press

Impossible
pump up the buttocks without basic exercises. It doesn’t have to be squats
,
instead of them there can be lunges, bench press
platforms, deadlift
. All this can be done with injured knees.

In this exercise, it is important to
put your legs as high as possible. This exercise is basic and not repetitive.IN
In our arsenal, we have fewer basic exercises than a person with healthy knees.
It is in this exercise that you can put relatively large weights and turn off your knees.
when driving. Arina Modest says that there are no knees in the exercise at all
feels, although they still hurt her.

Again, all the equipment goes
from the heels. Even before removing and starting the car in action, simulate
a kind of “crush” in the heels. Do 15 reps in place, like a burn, and
squeeze your buttocks.And only then remove the weight from the retainer. Do not forget
breathe correctly, always exhale while strengthening.

More on the topic: How to pump up your buttocks in the gym?

Perform the exercise
in order to minimize the use of the knee joint, it is necessary to do on a partial
amplitude. So your buttocks will burn and the ligaments will remain intact.
knees. It is not necessary to lower the platform low, it is necessary to control the movement.

Deadlift on straight legs

Another basic
exercise and replacement squats for pumping the buttocks – deadlift on straight lines
legs.All basic exercises are recommended to be done with a belt. Not worth it
overpay for steep belts, you can buy a regular corset orthopedic
belt. Holds the waist and lower back very well.

No dead thrust
the load on the knees is not even close. We start with small warm-ups
scales. We put the legs quite close to each other, narrower than the width of the shoulders. Going down
and only at the bottom point we bend our knees, take the ass back, bend
back.All the load goes to the heels, in the upper position we squeeze as much as possible
buttocks.

Leg Raising

This exercise
it is logical to perform the finishing move at the end of the workout. Its a huge plus that
the load goes exactly to the target groups. If during the deadlift we use and
lower back, and hips, then there is an emphasis specifically on the buttocks. That, how to pump up the ass without squats is to perform leg breeding
in this simulator.

Source of all photos: YouTube channel of Arina Modest

Do exercises
good in the drop-set, that is, without stopping the exercise, throw off the weight from the projectile,
and continue to work to failure, hammer in the gluteal muscles.First rep
start 25-20 times. We do not count the next repetitions and do it to failure, throwing 1
pancake. We tilt the torso forward, bent the back, lean forward. After
we do not sit on the chair, we got up, walked around and stretched our legs.

Instead of output

We hope that this
training will be useful for you and not traumatic. What did you understand, how you can pump up your buttocks without using
squats
when knee pain is felt.All the exercises that showed
the girl, both basic and isolated, performs herself throughout
six months, the girl has not been doing for a long time already
squat due to an injury of
in the knee joints, but shakes his ass further and
keeps muscles in good shape.

.