Wednesday, September 3, 2014

Tendinitis

The verdict is in!  Doctor says Elena is suffering from tendinitis (left patella).  This isn't a huge surprise, but I'm glad she saw a doctor--I wanted to rule out anything more serious.

But...how do you fix E's tendinitis when her regular method of movement is constantly pulling on her left kneecap?  If she rests too much, she gets super stiff.  If she doesn't rest enough, she will just make her knee worse.  I have seen over the past few days her pain starts earlier and earlier in the day.

So, it's the "full court press" plan.

She got an ace bandage at the doctor (I had been using Coband at home, but we ran out) and I learned how to properly wrap her knee.  Elena loves the compression, she says it feels much better with it wrapped up. 

She'll be fitted for a neoprene knee brace.  It's still pretty hot outside here, so I'm not so sure how she will tolerate it.  We'll see once we get it.  I assume she is going to love the feel of it, given her experience with compression so far.

We discussed using knee immobilizers for a while at home.  We still have her old ones...she already enjoys her stander (it's her only comfort standing up) so I'm not sure if the immobilizers would be a better choice.  The doctor assures me she can walk in them...I disagree, but we could try it (especially if only on her left knee?).

The doc said she could benefit from more flexion at her ankle, to give her less stress on her knee when moving.  Meaning, a different brace than her KiddieGait (or no brace at all).  This will be trial and error at home--not to mention, how can we work on this when she is supposed to be resting?  Finding a right balance here is going to be a real challenge.

I had mentioned patella straps that runners use--they wear them right under their knees to prevent/alleviate tendinitis pain from running.  Doc says we could definitely try it.  Now I have to see if they make them small enough for Elena (my guess is she's the size of an average 6 year old).

General rest and stretching at home.  

I mentioned that we LOVE LOVE LOVE our Dynasplint brace.  E wears it every night, she says it feels good to wear it b/c it's the only brace that she can move in, and it's a great stretch.  E normally wears it on her right leg, b/c that's the leg that is tighter.  Doc gave us a prescription for another one, so she can have both legs stretched in a way she approves.  (I am really excited, b/c this brace is expensive.)

At school, the plan is for Elena to participate at a lower level of intensity for PE and recess.  When in the school, she must use her crutches to ambulate out of the classroom (frequently she'll just walk or touch the wall, or use just one crutch).  When sitting, they'll elevate her left knee. 

I guess we do this for 2 weeks, and reassess.  Heck, it will probably take that long to get her neoprene brace!  I think tendinitis is going to be more of a reoccurring phenomenon, given Elena's general method of walking.

Thank you for your comments, especially if you have CP and have experienced knee pain.  Your experience is very valuable to me!  If you can think of any activities that might help us, please comment.  I'd especially like advice of how to be active and not aggravate her knee pain (if that exists). 

5 comments:

Anonymous said...

I take supplements to decrease swelling in my joints caused by my CP and that usually does the trick. I have also be taught aligned ways of standing and moving barefooted to increase muscle control in my ankle and it was a huge help for getting more movement at my ankle. Perhaps your PT can suggest comfortable standing and moving leg positions to increase muscle strength and improve bad tone at the ankle. I think it only works if Elena is completely barefoot because the braces decrease sensation and completely immobilize the ankle which is really unhealthy for all of her leg joints. After doing these exercises in PT I NEVER needed AFOs again. Seriously try it. Go slow and easy and give her a ton of time to learn the proper alignment since it usually takes awhile to learn the new habits but they are totally worth it!!!!!

Kim said...

D is much younger and runs more towards low tone than significant tightness, but he has been wearing Theratogs off and on this summer and it has helped his alignment so much. He never complained about pain or discomfort (aside from when outgrowing AFOs) before, but after a few days of wearing the Theratogs, did start to complain about his legs/knees occasionally when not wearing the Theratogs. I suspect his body was so used to the weaker positioning that he didn't realize how uncomfortable he was...it was just his norm.

In terms of activity, I suspect it will be harder to do at school. Frequent breaks if she doesn't already get them, warm pool time in the afternoons if you have access to one would probably also be great for her body. D seems much more fluid and comfortable after a long swim, especially when we can find warm pools - the ones at 92-94 degrees seem to work wonders for him.

Anonymous said...

"Kim" makes a good point. Once you are used to a good alignment the CP alignment becomes uncomfortable. The body tries to alert you to stay in the healthier position.

Kenzie Carlson said...

I have CP and i have some knee pain every once in a while and sometimes i wont even do anything to cause it, it just happens, its very frustrating, btu i may have some knee problems caused by my cp, i honestly dont know but i would love to find out. Lately walking around at school ive had knee collapses (knee going in majorly mid stride) and its frustrating cause i hit it on everything! I dont know how to do anything about it either so im kind of at a loss.

Anonymous said...

HI AMY I TOO HAVE TENDONITIS BUT IN MY ANKLE.. I USE VOLTEARN (SP?) FOR THE PAIN BUT FOR ME IT DOESN'T ALWAYS WORK SO I WILL HAVE TO LET THE DOCTOR KNOW, I ALSO END UP WITH SWELLING IN THE ANKLE.. I THINK THAT IS WHY IS HAS BEEN MORE SORE LATELY.. THEY ARE GOING TO FIT THE ANKLE SPINT FOR BOTH SIDES BUT IT IS TO BE USED WHILE RESTING..

WHAT CAN YOU TELL US ABOTH THE SPLINT? IS IT EASY TO ADJUST THE TENSION?

MELISSA