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Twisted and Torqued (it seems) PLEASE HELP!! (swollen knee and pelvis problems)

Question: Twisted and Torqued (it seems) PLEASE HELP!! (swollen knee and pelvis problems)

I am a 45 yo very fit woman. My right knee remains quite swollen (size of baseball) for the past 8 months after 2 arthroscopic surgeries (1st -meniscus tears June 2011; 2nd one - lateral release of knee cap 12/11 -- which was questionable if needed but orthopedist was trying to figure out why the swelling didn't go down after the first surgery).
My knee continues to be quite swollen, even as it was prior to any surgery. My orthopedist has run numerous labs on the synovial fluid and no disease process has been found whatsoever. Anti-flammatories (pharmaceutical and enzyme) have not helped at all. The swelling also has not been helped by physical therapy, exercise, ice, elevating the leg, compression hosiery or shoe orthotics. All tried faithfully for the past 8 months.
Now I am wondering if there is some structural problem going on beyond that of the swollen knee causing limping. What is happening is that now my pelvis feels as if both twisted side to side, as well as torqued front to back! Symptoms besides the swelling are: I have pain that goes from the outside of my right hip across the back of the leg down to the back of the right inner knee. When I walk it feels like my right thigh is sort of swaying side to side and not stable. There is also fatigue in my right lower calf and achillies. I have pain in the area of my ishial tuberosities on both sides which I feel strongly upon rising from a chair and when bending over. There also is fatigue and pain in the area of the left psoas muscle. And, pain in both hips when rising from a seated position. If that isn't enough, there is pain and and severe tension in my right shoulder between the area of the spine and the scapula. I feel that my gait is off and my body seems both twisted and torked. Socks ride down in my shoe only on the right side. There are more symptoms but these are the ones that are daily now.
By the way, after the last surgery in December 2011, there was no swelling at all in my knee UNTIL I began to be weight bearing and walking without crutches. My surgeon and physical therapist do not have any answers as to the reason for the ongoing swelling. It sure is causing major problems with daily living and fitness activity.
Can you please offer some suggestions on what might be going on? Does this sound structural? Can a knee be chronically swollen from structural problems? Also any other thoughts as to possibilities you may have. Many thanks in advance.

Answer:

This from Steve in our Facebook group, 'Use the lymphatic drainage that hamstring pumping does very well. The effusion will probably return but it could start the process of drainage. Our supine get some to hold your ankle getting them to resist both your flexion and extension movement for 15-20 reps.'

Answer:

lellelady
Steve, I very much appreciate your response. I am not sure how to do the "hamstring pumping" you mention. I also couldn't find anything specific online. I understand that someone needs to hold my ankle and resist flexion/extention, but what is my corresponding action to be? Am I trying to flex and extend against the resistance? Thanks so much

Answer:

How long did you wait before you started your weight bearing programme? Did all the early range of motion exercises go to play prior to weight bearing?

Answer:

Hi,
Was wondering, was any other damage (apart from meniscal tear) discovered on investigations i.e. perhaps osteoarthritic changes, patella fissures or ulcerations? I would assume not, but these may be reasons for the ongoing swelling in the knee.
Does the swelling worsen with activity or does it remain pretty much constant? Do you have pain in the knee on activity? Some of the symptoms that you describe may be compensatory issues arising from your knee problem. To discount systemic causes, it may be useful to get a full blood count done (even tho' the synovial tests were negative), to discount any inflammatory processes (NSAID's are not always effective) & a thyroid function test as a an alteration in thyroid function can lead to swelling, fatigue & muscular pain.