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  1. #1
    Bradley is offline Senior Member
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    Default How do I get better - leg deformity and other problems

    I was diagnosed with 3-4 degrees of varus in both of my tibia. And in my right tibia about 8 degrees of a rotational deformity.

    It has taken me literally 10 years and 20 doctors and as many PT's to get that diagnosis.

    I think it's at the very least on the right track, since I've been pleading with doctors to consider that something they hadn't noticed was wrong, because nothing they said made sense of how my legs felt. But a body deformity did.

    Unfortunately, I got a second opinion by sending all the imaging and reports to another doctor I had previously seen. He acknowledged the deformities, but could neither endorse surgery to fix it nor would he say surgery was wrong. He said he has never corrected less than 5 degrees of varus.

    I'm working on getting another opinion, and I'm still leaning towards surgery, which would be an open wedge high tibial osteotomy.

    However, I wonder about one thing. My legs felt fine until about 20 years old. Not just fine, but perfect. There was no malalignment at 20 years old. I've been told once you stop growing you wouldn't acquire a malignment. I don't think I grew much if at after 20 years old. But I only noticed problems after that. And they got progressively worse after that.

    Any idea how I explain that? I have a hypothesis that the bones changed shape due to prolonged pressure applied to them due to how I sat in desks at college and at work. Slight pressure for hours at a time. Almost every day. It might be ridiculous. All the doctors say it can't happen. But all the doctors also told me there was basically nothing wrong with my legs, and they were all wrong, except for the last two. However a misdiagnosis is different than being wrong about basic physiology, IE bones changing shape due to pressure applied for long periods of time. So I'm somewhat less inclined to trust my own instinct despite the fact that I have a better track record than the doctors I've seen.

    Also my muscles have changed shape. Only my quads really. I only really noticed this some time after 20 years old. I attribute this to changing shape of bones, which would alter the position of the connection points of the muscle relative to each other, changing the overall shape. I didn't notice this until well after I stopped growing.

    I'm somewhat worried about surgery because due to the nature of how my problems have developed since I was supposed to have stopped growing, I have no idea whatsoever if it will improve my symptoms at all.

    I can't seem to find a single person who has ever had symptoms similar to time due to a malalignment.

    Any idea why my symptoms would get worse over a period of 10 or so years AFTER I stopped growing, if the problem was due to a bony deformity which supposedly was established and fixed when I stopped growing?

    And how do I figure this out so I don't get my tibia's sawn in half only to come out no better, or even worse?

    Is there soft tissue work that needs to be done too? What kind of soft tissue work would address problems that a bony deformity would cause? Are the progressions of symptoms due to soft tissue response to the deformity? What's the mechanism for these changes?

    Basically, I need guidance, and it's hard to get this level of guidance from a doctor, because they are so constrained by time, and seem to want to give superficial and simplistic answers because they just want their patients to be too trusting.

  2. #2
    Tarzan is offline Member
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    I saw your thread earlier today Bradley and to be honest I really didn't know what to say that would be of any help.

    My first thought was that it seemed a bit like the symptoms you'd expect to see in a case rickets, but as you said it happened when you were fully grown it didn't seem to fit. When adults get similar symptoms it's sometimes diagnosed as oesteomalacia.

    It seems like a mineral imbalance involving calcium & phosphorus but in cases of oesteomalacia the cause is often hormonal and it can involve vitamin d absorbtion. Sometimes it can be a thyroid/parathyroid issue causing the problems with vitamin d assimilation. So it really needs investigation from someone qualified.

    Have you seen an endocrinologist ?

    This is really out of the scope of an internet forum, but someone may be able to assist you with the muscle shortening that could result from the deformities.

    I really hope you can find someone willing to help.
    Last edited by Tarzan; 08-16-2015 at 04:54 AM. Reason: typos

  3. #3
    Bradley is offline Senior Member
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    Quote Originally Posted by Tarzan View Post
    I saw your thread earlier today Bradley and to be honest I really didn't know what to say that would be of any help.

    My first thought was that it seemed a bit like the symptoms you'd expect to see in a case rickets, but as you said it happened when you were fully grown it didn't seem to fit. When adults get similar symptoms it's sometimes diagnosed as oesteomalacia.

    It seems like a mineral imbalance involving calcium & phosphorus but in cases of oesteomalacia the cause is often hormonal and it can involve vitamin d absorbtion. Sometimes it can be a thyroid/parathyroid issue causing the problems with vitamin d assimilation. So it really needs investigation from someone qualified.

    Have you seen an endocrinologist ?

    This is really out of the scope of an internet forum, but someone may be able to assist you with the muscle shortening that could result from the deformities.

    I really hope you can find someone willing to help.
    Might anything you're talking about have anything to do with the fact that I have what I consider severe fascicullation? That's twitching of muscles. It mostly affects my calves, but it has spread a bit. It's worse after using the subject muscles more. In my calves you can actually see it. Iy looks like there are creatures moving around under my skin.

    It's something that leads to doctors checking you for neurological disorders, but I'm clear in that regard.

  4. #4
    Tarzan is offline Member
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    I really couldn't hazard a guess Brad.

    The fasciculation could be a causative factor or it could be a guarding effect from the surrounding musculature. If the neurological observations seem normal it would seem to suggest that it is a protective adaptation to the changes in your biomechanics.

    But as I hinted at earlier I'm just speculating and I could be way off the mark.

    If it was me, I'd want to know why it happened before I agreed to corrective surgery. That's not to say I wouldn't have the surgery if it was inevitable, I'd just want to have a good understanding of the causative factors before I committed to that course of action.

  5. #5
    Bradley is offline Senior Member
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    Quote Originally Posted by Tarzan View Post
    I really couldn't hazard a guess Brad.

    The fasciculation could be a causative factor or it could be a guarding effect from the surrounding musculature. If the neurological observations seem normal it would seem to suggest that it is a protective adaptation to the changes in your biomechanics.

    But as I hinted at earlier I'm just speculating and I could be way off the mark.

    If it was me, I'd want to know why it happened before I agreed to corrective surgery. That's not to say I wouldn't have the surgery if it was inevitable, I'd just want to have a good understanding of the causative factors before I committed to that course of action.

    That was basically my hypothesis.

    The deformity makes the muscles not work right, somehow, and somehow, this causes them to "misfire".

  6. #6
    Tarzan is offline Member
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    OK Brad, you've obviously had a lot more time to ponder this cause/effect relationship than myself and probably most doctors you've come across on your journey.

    Do you understand the difference between a reflexive response and a reactive response ?

    To me what you are experiencing seems like a short circuit in your reflexive responses and there could be something triggering that response.

    Often this type of short circuit is missed with the typical neurological/electrical examinations as they are mostly focused on diagnosing reactive circuits. Reflexive actions typically occur too fast for most modern equipment to detect.

    What is causing this needs investigation, but to me it seems to be a guarding type of scenario where the muscles on either side of the joints/bones are trying to keep equilibrium.

    If it wasn't happening then you could have experienced a fracture long ago. Our bones take a lot of load but balanced dynamic tension on either side take so much more force/stress that it's difficult to comprehend.

    An experienced acupuncturist might be able to help prove this point as they can switch off a reflex action with a carefully placed needle, but I can't see them doing much more than determining if it is a reactive or reflexive response.

    I really think there must be an underlying cause to your problems Brad, and to my mind it seems like a hormonal disruption of some sort or it was at the time when the problems arose.

    I really hope you can you can get to the bottom of this mate.
    Last edited by Tarzan; 08-16-2015 at 07:38 AM.

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