Hello All. Did anybody on here ever have a lateral release surgery? I had it and it did not help one bit. Same pain as before, so back to PT ( for a 4th time) I would love to hear peoples’ experiences with the surgery, and what ultimately helped their issue.
Thanks a ton!
You have patellofemoral pain? That surgery purports to reduce the lateral pull on the patella and thereby realign it in the femoral groove by severing very weak ligaments is structures at the lateral aspect of the patella. Bottom line is it doesn’t work. The PFP likely comes from repeated compression under load of the bone under the cartilage on the patella or femur (subchondral bone. ) Realignment therapies and surgery has fallen out of favor as the patellar and quad tendon are incredibly strong forces to overcome. PT for restoring full ROM (likely loss of flexion) and strength along with relative rest is your best bet.
Yes I have Patellofemoral pain. I agree the surgery is not the best as most people can overcome with proper PT as you suggested. However I felt I was at the end of the road after many failed treatments, so it was done as a last resort. Plus, the surgeon is very good and gave me a high success rate. It was certainly successful at wasting my time and giving me false hope!
Anyway, thanks for your input!
It was suggested to me years ago but I found out that I could release the pressure on my knees by working on my Glute Med. to take the pressure off my IT bands. My glutes were/are weak compared to the rest of my leg so the IT Band helps the legs stabilize when I’m riding. It’s easily over worked when doing this job and pulls on the knee where it attaches when it is tight. Bingo knee pain. Get some bands, start doing some bridges, clam shells, etc.
Not sure where you live, but I have been dealing with IT band issues and subsequent lower lateral knee pain for the better part of two years. Multiple stints of PT, where we focused on releasing tension in the TFL and strengthening the posterior chain would sort of work, but not really. I always felt I was on the edge of a flare up (and often was) I would take longer and longer breaks from running completely, but it seemed like the pain would come back faster each time.
I took a long break from running, began to come back very, very slowly and the last two months I’ve been seeing a doctor who specializes in dry needling with a background in both PT and accupuncture. She is absolutely phenomenal, and understands movement patterns better than anyone I’ve ever met. One session with her helped to release tension in the quad and TFL that has allowed me to run pain free for the first time in a very long time. As we continue to work together, we are finding that my actual issue may be due to a lower leg and possible ankle issue which is causing a lot of tension in my tibialis anterior and then that moves up and down the chain to my ankle and knee. The tight tfl and weakness in the glute might be a response and not a cause like we had originally thought.
So long way of saying, maybe try and find someone who specializes in dry needling/Triggerpoint release.
Thanks for the reply. I haven’t been having luck with PT. Tried several failed rounds, now into my 4th. I was also told that glut mes and hips were the likely culprit, and they needed to be strengthened. My current PT, after 2 weeks, retested my strength in those areas and says there is no longer any deficit. Yet I’m still having pain. So I’m at a loss right now.
Thanks for your response. I don’t know much about dry needling and trigger point release. However I have been to both an acupuncturist and ART, and had zero success, so not sure how much that would do for me.
I am not sure if it might just have been my practicioner. She just gets movement, and understands how everything is connected. She has experience as both a physio, and an acupuncturist, and I think that sort of east meets west approach gives her an interesting skill set. I don’t think traditional acupuncture would fix my problem. She puts the needle into the muscle that is overly tight and then kind of moves it around until it releases. I sort of see it as ART from inside the muscle.
Sorry that the procedure did not help you but I am not surprised at all…I am surprised that any competent Ortho even does lateral releases any more! That surgery does more harm by destabilizing the knee than anything else! To anyone considering it - run (or hobble) from that ortho!
Hip and lower chain biomechanics are the culprit. You do not need dry needling to fix the problem - you need a good PT that is open minded about looking at the issue from a different perspective.
I have worked in the PT field (sales rep to PT) for years and have consistently seen great results with one product - https://www.protonics.info/. I have been out of the PT world for several years and have no affiliation with Protonics but you should at least investigate it.
Yes, Lateral release is a controversial procedure. Definitely not worth it in hindsight, but at least it didn’t make me unstable.
For the Protonic, looks like a brace that holds the knee in proper alignment. Is that correct? How does it help the knee overall and long term?
Thanks for the reply. I haven’t been having luck with PT. Tried several failed rounds, now into my 4th. I was also told that glut mes and hips were the likely culprit, and they needed to be strengthened. My current PT, after 2 weeks, retested my strength in those areas and says there is no longer any deficit. Yet I’m still having pain. So I’m at a loss right now.
My wife has seen PT’s from AZ to Ohio with various issues over the years. Everyone one of them will take our money but only one or two of them could actually identify real root causes. It’s actually crazy when I think about the success rate that she’s had with various PT’s. My suggestion would be to try and nail down a PT that is actually worth their salt.
I had the surgery 30 years ago - it sort of helped. I wasn’t really able to run long distance before surgery. Could after but had to wear a knee sleeve to keep swelling down (for 20 years). Now all is good. Guess it might have helped a little?
I’m glad it seemed to help you! Was your issue just patellofemoral pain or did you have other stuff going on? Also did you have any crepitus after surgery? Thanks
I’ve had it in both knees. First one was in 2016, second one was almost exactly 2 years later. Both have been successful.
I tried PT before the first surgery and my Dr. admitted that he almost never recommends the surgery. But, he said that, anatomically, mine was one of the worst he’d ever seen and the MRI showed pretty severe bone bruising from the misalignment. Before the surgery, I was to the point I really couldn’t run more than a few steps. Due to articular cartilage damage discovered during the surgery, the Dr. did a microfracture at the same time as the lateral release. Because of the microfracture, recovery was pretty slow (as I couldn’t put any weight on my knee while bent for 3 months). I eventually worked up to running fairly solidly, including a fairly competent-for-me half marathon.
But right as I was starting to feel like I was really getting back, I started to get the same pain in the other knee. It was eerie how similar the pain was. With my right knee (the first surgery), I first noticed a quick sharp pain when moving my legs after sitting on the couch with my feet up that initially didn’t bother me at all running but progressively got worse. With my left knee, I first noticed the quick sharp pain when I bent my knee turning over in bed. Dr. said that the MRI for the second knee was so bad that the radiologist posited I had a really bad condition that I can’t remember the name of, but based on the experience with the other knee, my Dr. was pretty certain it was the same issue. I took it a bit slower jumping into things after the second surgery. But I started running really consistently a year ago and am now running more than I ever have before. I’m up to 30 mpw with basically no pain.
I was skeptical going into the surgery based on things I had read online. But I think I was one of the few cases where the surgery really was warranted.
I’m glad to hear it helped! Where did you have the surgery done?
Thanks
Salt Lake City
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I had that surgery in 1990 and now am 58. I played basketball extensively back then and nothing else but weights to be in shape for basketball.
It’s what got me into cycling thankfully. I never had pain, just swelling and discomfort.
My hindsight is it did not help much and could have been avoided with proper therapy involving strengthening and core work and balance exercises on the Bosu or wobble board.
I was a worse case for recovery (the Dr. indicated) with it taking 6-7 months and I had a lot of pain under the knee cap after. Perhaps he shaved off too much cartilage during the clean up after slicing the ligament so the knee cap could track better. I bombed the biodex test several times during the initial 4 months.
I even developed problems with my other knee during the first rehab from doing leg extensions most likely. I worked with a different therapist and she put me on a good strength program, told me to wear the knee sleeves at night (that sucked) and after 3 months both knees calmed down. I realized after that the surgery could have been avoided (my opinion). I found out years later the Bosu and core work also helped and the balance exercises helped with everything. I am still playing some basketball in the Winter but mostly cycling year round. I dabbled in some short hilly trail runs this summer to have hiking with a backpack fitness and found it did not bother my knee. The basketball bothers it some due to the change of direction and start stop movement so the end is near on that sport, sadly. I would speculate I have a sloppy knee from the clean up and damage prior.
To conclude with the other responses- if you find the right strength program it may cure up. I would focus on quads, hamstrings, core, hips and the balance stuff for ankles and stabilizing.
It’s a long solo ride to recovery, that is for sure. I would guess it took a full year before things were better. My left leg is still smaller than the right midway up the quad.
Rob
My current PT, after 2 weeks, retested my strength in those areas and says there is no longer any deficit. Yet I’m still having pain. So I’m at a loss right now.
2 weeks? I’d give it some more time.
Yeah. I had been doing some home exercises for about a month prior to starting this new PT so I could have improved somewhat but it still seems surprising that my muscles are no longer weak at all. Especially considering the surgeon said it could take 4-6 mos of dedicated PT!
Yeah. I had been doing some home exercises for about a month prior to starting this new PT so I could have improved somewhat but it still seems surprising that my muscles are no longer weak at all. Especially considering the surgeon said it could take 4-6 mos of dedicated PT!
I guess nothing is impossible but if your glutes and hips were weak, slim chance they are going to come around with 2 weeks of PT. FWIW, the way I’m understanding this is: you went to PT; you were told your glutes and hips are weak and causing you the knee pain; you do PT for 2 weeks and are told your hips and glutes are no longer weak/imbalanced. I’d look for a second opinion.