Overcompensation . . .

I had left knee ACL recon with PT graft on 3/17/05 and am almost 2.5 years post-op. I still have huge overcompensation issues and it is really bothering me as I sit here with a right leg that's sore to the touch after a 5000' descent hiking the other night.

Earlier this year, I had Patella-femoral syndrome and had major overcompensation then . . . I did more PT and had connective tissue work done. This seemed to help a bunch and I was able to ski pretty balanced for the remainder of the season. I feel it when conditions get tough - my left leg just ops out of the game, whether I try to focus on it or not. Mountain biking in technical terrain? Any big push leaves my right leg exhausted. Walking downhill? I can focus the entire hike on using my left leg, and my right leg soreness will actualy cause me to limp the next day.

So, I feel like my inability to use my legs in a balanced manner exacerbates the problem by emphasizing the disparity, and I feel like I'm not going to get my full power back until I can balance my legs. I do left-leg strengthening excercises still, but could probably be more focused on it.

Any thoughts? New techniques? Rolfing? Acupuncture? Back to PT? More leg strengthening? Brain surgery?

Thanks in advance - this place always seems to be pretty good with ideas delivery :D

I had a freind with a bunged ankle. Acupuncture worked really well. I think its expensive though.

The medical literature does not support the commonly held idea that the opposite lower extremity is put at risk by a chronic injury to the index lower extremity and develops a problem on that basis.

More liely this part has its own problem that needs to be checked out.

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Originally Posted by drmark

The medical literature does not support the commonly held idea that the opposite lower extremity is put at risk by a chronic injury to the index lower extremity and develops a problem on that basis.

More liely this part has its own problem that needs to be checked out.

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I don't think it's that my right leg is at risk, but rather that it's too strong and still won't let my left (injured) leg "play." I feel very imbalanced during activity, but can't seem to make my left leg engage.

Kellie I've struggled with this issue through a broken femur and four knee surgeries now. I'm guessing strenth isn't the issue for you but learning to trust the leg again on a subconcious level.

The only thing that really helped me is to focus continuously on working the weak leg. Try doing one leg hops around/over a square and in all directions to get the high speed muscle stabilization under load automatic again.

When you slip or stumble running, try to get yourself out of it with the favored leg. Take bigger strides downhill onto the favored leg (if it's strong enough)

On the bike try to ride as much as possible with only the weak leg. On off road descents, ride with the opposite leg forward than you usaully do, this will help get both legs used to new roles.

On skis I put myself in compromising situations over and over again where only relying on the weak leg can get me out, ie: left leg weak? land all your jumps in a right turn. Or plan that 'must make' turn to be a right one.

This especially solidified to me one season when I was skiing a lot of bumps and competing. I had found that after my first ACL reconstruction, taking blind airs into the bumps, I always landed to the left. I worked on it and in a matter of weeks I could land to either side spontaneously without a difference.

So, bottom line, (as you prolly know) it's more than just a strenth thing, you have to learn to trust the favored limb without thinking about it. It only comes from repetition to rebuild muscle memory.

Hope this helps.

Kellie, I think I've told you this before.... I've got the same problem. I have really bad patellar tendonitis on my left knee due to overcompensation after having PT graft surgery on my right knee. My right knee is just weaker and there's nothing I can do about it. When I lift weights, I make sure NEVER to lift them with both legs. I always do one leg at a time. This helps my right leg get stronger overall. The other solution is that I just wear a brace on my left knee all the time. Otherwise the tendonitis just kills me, but it also keeps that knee from giving out. These two things keep the tendonitis at bay for the most part. But, there is a reason why I like to ski downhill, rather than walk downhill. After 2 hours of hiking downhill my knee begins to kill me. 5000 ft descents would be painful for me to hike, no matter what.... that's why I like to carry my skis or my bike to the top ;)

i have similar issues, although maybe not as bad. someone recommended trying a cranial sacral osteopath. have to say, my inner cynic thinks this could be absolute mumbo jumbo but on the other hand spending £50 on a session isn't going to break the bank even if it doesn't work. i'll report back if i get round to trying it out

kellie-
interesting to hear this feedback from you since i've recently had the same surgery (though mine's a redo). I really think it's about keeping inflammation down so that thr right muscles can fire. If you can control that with really thorough stretching, icing and vit I, you should see some improvement. I know that sounds obvious, but in my case, I feel really strong from working out and PT, but chronic inflammation due to some hardware (which is coming out soon), is inhibiting proper function. Talk to your surgeon about this...or try a different PT?

Good luck and keep us posted!
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I think I will always be a little imbalanced due to my knee injuries. I notice it most when walking downhill in rugged terrain. I try consciously not to favor my left leg by using my right more, but it always happens that my right quads are sore after a long downhill carrying weight. Overall though, my left knee is stable and the muscles are strong enough to do what I want to do. I did work my ass off in PT after the surgery and was back on skis at 4 1/2 months post acl (patellar tendon)/meniscus/microfracture. The left knee is stable and strong but it can still get sore.

Are you the same Kellie that skied the Messner Couloir earlier this year? If so, I guess you are way stronger than I will ever be. :biggrin:

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Originally Posted by telepariah

I think I will always be a little imbalanced due to my knee injuries. I notice it most when walking downhill in rugged terrain. I try consciously not to favor my left leg by using my right more, but it always happens that my right quads are sore after a long downhill carrying weight. Overall though, my left knee is stable and the muscles are strong enough to do what I want to do. I did work my ass off in PT after the surgery and was back on skis at 4 1/2 months post acl (patellar tendon)/meniscus/microfracture. The left knee is stable and strong but it can still get sore.

Are you the same Kellie that skied the Messner Couloir earlier this year? If so, I guess you are way stronger than I will ever be. :biggrin:

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I guess that's my exact issue, and I may have to accept that it will never go away . . . my knee is stable, functional, and generally pain free (or rather, I can generally manage the discomfort and participate in my activities at a reasonably high level). I feel my right leg take over in sketchball ski conditions (heavy wet snow or breakable), and also feel it the day after a long downhill in rugged terrain (this last hike was ~5000' descent). Thankfully, I didn't have any issues on the Denali trip . . . and I bet you're still stronger than me!

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Originally Posted by Kellie

I guess that's my exact issue, and I may have to accept that it will never go away . . . my knee is stable, functional, and generally pain free (or rather, I can generally manage the discomfort and participate in my activities at a reasonably high level). I feel my right leg take over in sketchball ski conditions (heavy wet snow or breakable), and also feel it the day after a long downhill in rugged terrain (this last hike was ~5000' descent). Thankfully, I didn't have any issues on the Denali trip . . . and I bet you're still stronger than me!

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I had that problem for years. Until I tore the ACL in the other knee - since finishing that rehab they feel pretty much equal. The left one has a little more meniscus damage and therefore is more suceptible to arthritis type pain from over use or jarring stuff, and the right one is the one that locks up every now and then... so really, since I don't trust one of them more than the other, they get worked equally.

It is at least mostly in your head. The problem is, I don't know how to fix that. (I definitely don't recommend my method of "re-balancing" your legs.)