Dear Drs. Ferguson & Stoll:
Believe it or not, this is a "summary" 3-month report. When I started it was too long and I did not want to overload Dr. Stoll's BB with too many personal details.
I have been doing reasonably well. After a substantial improvement in the first half of May, I have had minimum improvement in the last 2 weeks and maybe even some deterioration. In the improvement department the pain going up/down steps has decreased as well as the pain when getting up from a sitting position, HOWEVER, I started to get some pain in walking (like at the office & home). Sometimes the pain is in the knee, but many times it is below and above the knee (maybe at some of the muscles around the knee).
After a review of the last few weeks, my earlier postings and your replies, I think I have been committing again some of the sins of the past. Too much exercises (45 min/day), but this time with the encouragement and recommendation of my Chiro # 3. I just took a 2 day exercise break and the knees felt much better.
During these 2-weeks of discouragement I searched the net several times and landed in a page from Activator Methods. There they had the summary of an article describing a successful treatment of my same condition (tear in the posterior horn of the medial meniscus) and a list of chiropractors that use their instrument, with a couple of them close to where I live. A link to the summary of the article is below (if the link does not work just go the www.activator.com page and follow directions).
I had a free consultation with one of these "Activator Certified" Chiropractors (I will call him Chiro # 4 although he has not worked on me yet). He did a quick check on my back and knees, told me that I needed several adjustments in my bad knee and asked me when was the last time they were adjusted. He was surprised Chiro # 3 was not adjusting my knees.
KNEE ADJUSTMENTS. From the first time I went to Chiro # 3 I showed him your (Dr. Ferguson) recommendation of adjusting my knee (...familiar with anterior media tibia and external tibia) to the correct position. He said that my knees were in "good shape" and needed no adjustment. He said that all that was needed was to stretch and strengthen the quadriceps and the hamstring muscles and pass some current (2-electrode) to promote healing. Last week I told him of my disappointment and that I was about ready to quit him. So after talking for a while he told me he COULD ADJUST MY KNEES (even if he thought it was not needed). He also had an Activator Gun and he used it a few times (although he is not "officially certified" on it) . Boy, after he adjusted my knees they felt real good. I felt like if I was "WALKING ON AIR". I wish he had done this since I started going to him in early May. His adjustments were different to those Chiro # 1 used to do. Chiro # 1 just pulled and pushed the whole legs, while Chiro # 3 pushed around the knees (both front and back) in several places.
So Dr. Ferguson, after all of the above I have these questions:
1. Can an experienced Chiropractor know how bad your knees are just by BARELY passing his hand around the knee? Chiro # 4 did this while I was lying on my stomach. He said my bad knee needed the 6 to 8 adjustments (or there were 6 to 8 things wrong with it) while the good knee only needed 2 adjustments (or only 2 things wrong with it). He saw me the day BEFORE Chiro # 3 adjusted my knees.
2. I remember from your initial recommendations you thought once/week adjustments to the knees should be OK. Chiro # 4 indicated that if I went with him and he did 6 to 8 or more adjustments he would need to see me 3 or 4 days later. Is this frequency really needed?
3. I usually put a cold pack for 20 min on ea. knee after the exercises. Will heat may be more desirable sometimes? I would think circulation will be more improved with heat than with cold.
I have no swelling visible to the eye.
4. I got a copy of the full Meniscus Repair article
In Reply to: Torn Cartilage -- Drs. Ferguson & Stoll posted by Antonio on June 07, 1998 at 13:22:12:
I'm a bit confused as you said "He was surprised Chiro # 3 was not adjusting my knees." and then made the comment "He saw me the day BEFORE Chiro # 3 adjusted my knees."
1. By "passing his hands" around your knee, it depends. These problems are so common and follow such a similar pattern that just a few movements to test the restriction are all that are usually necessary. There are a standard set of orthopedic tests that should be performed but primarily the problem IS very easy to detect. The 6-8 adjustment advice is probably correct. As well as the other knee.
2. Sometimes, especially with active people such as yourself, the frequency of treatments does need to be increased. I usually see someone like yourself a couple times the first week and then once a week for 2-4 weeks and if it's not improved by a GREAT deal then it's time to refer out.
3. Neither heat or ice is "necessary". Ice helps keep down the swelling that occurs in the joint and reduces the pain. With your amount of activity you may NEED the pain(I mean that in the kindest sense). Pain is a great limiter of activity and may result in you actually getting better faster. The heat DOES improve the circulation and can be used with some success but should always be followed with 15-20 minutes of ice. If you alternate hot and cold after activity it will act as a pumping mechanism for the knee. Always start with, and end with ice. Acute injuries and "flare ups" are almost never improved with heat alone.
4. I would appreciate a copy. RR#1 Box 121AA, Cynthiana Ky 41031
5. No contraindications to ace bandages that I can think of as long as they are not too tight, don't keep them on for more than 6 active hours or 2 inactive hours, and never sleep in them.
As far as the steps go, just minimize as much as possible.
It has been my experience that the adjustments are what get the results(as you have seen). I'm not sure WHY you are getting "the run around". Not having seen you personally I can't make any significant judgements but I do sympathize with your situation.
"Activator certified" refers to a technique that uses the "gun" you speak of. The use of the gun/instrument is not limited to those who practice this specific technique. Not being "certified" in that technique is not a strike against the person who uses one. It's sorta like me saying I am certified to plant corn. Well that doesn't mean the next fella can't drive the same type of tractor.
It's obvious to both you and I that the adjustments help. Your knee needs to be adjusted and maintained in that position to let it HEAL in that position. The more it stays rotated the longer the ligaments are stretched. Imagine a shoulder that dislocates. If you put it back and it dislocates again but wait to correct it again then you are going in the wrong direction.
It sounds like chiro #3 can DO the job but may not have a full grasp on his capabilities or has limited experience in these sort of cases.
If it was my knee I would forget the electrodes, limit excercise to some walking, and get the adjustments. The whole "stretch and strengthen" of the surrounding muscles is REHABILITATION. You rehabilitate AFTER you have a handle on the problem. If you came to me with a sprained ankle and I told you to run a mile to strengthen it, you would think I was nuts(and you would be right). After this problems is corrected, and you learn to quit letting your toes point out while sitting and lying down, then you can start to strengthen the surrounding muscles. The Vastus Medialis(medial head of the Quadraceps) will be a key area to make sure it gets as much work as the other areas. NOT MORE.
I'm so frustrated I could spit. If you have anymore questions or need clarification please let me know.
In Reply to: Re: Torn Cartilage -- Drs. Ferguson & Stoll posted by David Ferguson, D.C. on June 07, 1998 at 23:09:17:
Dear Dr. Ferguson:
Thank you very much for your quick response.
The confusion comes because I saw Chiro # 4 (the "Activator Certified" Chiro) on Wednesday June 3. This was a free initial consultation. The next day I saw Chiro # 3 and told him that I was disgusted and about ready to drop him. Chiro # 3 then adjusted my knees for the first time. When I saw Chiro # 4, Chiro # 3 had never adjusted my knees.
The full article will be in the mail tomorrow morning. Let me know what you tink about it.
Chiro # 3 is also on vacation this week, so I will not get any adjustments until I am back from my ""vacation"". I am not 100% decided to continue with him or give Chiro # 4 a chance. Chiro # 4 does not use regular current like the other Chiros but "electrical acupuncture". If I go with him I will probably ask him to skip the acupuncture and concentrate on the knee adjustments. By now I have some experience on this and I can ask the Chiros to do what I want.
I have to study your reply more carefully. It has quite a bit of good information which I have to digest. Between your reply and the full article I am sending you I think I will be able to get this problem under control.
The tought of going to see you have crossed my mind several times. My wife is from WVA and we used to go there once or twice/year. We go now less because her relatives have been dying and there are not too many left. From there, Charleston, to your town will only be about a 3-hr ride. Maybe next time we go there I can take a jump to see you. (Hopefully to celebrate my recovery).
Well Dr. Ferguson, this is all for now. Again, thank you for everything. I wish I could help you with something someday.
Regards,
Antonio
In Reply to: Torn Cartilage -- Drs. Ferguson & Stoll posted by Antonio on June 07, 1998 at 13:22:12:
Dear Antonio,
I am enjoying just sitting back & watching Doc Dave's recommendations work. I have little to add here & more to learn.
Is this "Activator" an electromagnetic device? You will note that professional athletes have been using devices like this for years. How do you think they come back so fast from stuff that would lay someone else up for 10 times as long? Professional athletes were the first segment of our society who realized that Chiropractic was essential for a complete rehab program.
Thanks for sharing.
Walt
In Reply to: Re: Torn Cartilage -- Drs. Ferguson & Stoll posted by David Ferguson, D.C. on June 07, 1998 at 23:09:17:
Der Doc Dave,
I can empathize with your frustration. I feel like that with fully half of the people who write for information on this BB.
I didn't know you were from Cynthiana. There are some wonderful friends there who have developed a public bird sanctuary on their extensive acres. I cannot recall the name of the facility but you really need to make contact with them. Tell them I suggested you call & give them a big hug for me.
They are Martha & Bill Wiglesworth, at Box #336, Cynthiana 41031. Phone 234-5382. Martha did full time volunteer work in my office (for a year) trying to spread the word about a holistic way of approaching healing to her influential friends. She came to me & volunteered her services after she began to hear of the good work I was doing. Bill has developed a very effective retroversion therapy that gets at the deep psychosocial causes of many chronic conditions (It only takes about an hour; progress that takes years with conventional psychological techniques.) One of the crimes of our age is that he has not been able to get this technique out into general practice. He demonstrated it on me & my staff one weekend when we were invited to have a 3 day retreat at their site. I can personally vouch for its effectiveness. He has no credentijals or training---he just figured it out all by himself.
You-all would hit it off famously. It never hurts to have influential friends in your community.
I continue to marvel at the help you are being to people here on the BB
Namaste` Walt
In Reply to: Re: Torn Cartilage -- Drs. Ferguson & Stoll posted by Walt Stoll on June 09, 1998 at 09:06:55:
An "activator" is a type of hand held adjusting instrument that imparts a high speed, low aplitude thrust to correct misalignments on a more accurate vector. Used correctly, it can gently do the work of manual manipulation with as good if not better results.