Dr. Ivan Edwards, D.O.

Recovery from paralysis, following a stroke, depends on three factors:

Location
a) the location of the impacted part of the brain or spinal cord that the stroke is associated with. If, for example, the stroke arises in the motor area of the brain versus the sensory part--the paralysis will be more pronounced and longer lasting

Rehabilitation
b) Rehabilitation would be critical to restore recovery. If one does not participate in rehabilitation, the paralysis would persist or evolve into spasticity and contracture--and into more serious disability.

Compliance with treatment and therapy
3. Failure to comply with the appropriate treatment and therapy would limit the appropriate recovery from paralysis.

What you have is patellar instability. It happens when the patella "de-tracks" out of the trochlea groove, specifically, a patellar tracking disorder

This condition most commonly affects women.

It occurs from a twisting mechanism with the knee in extension, or with encounter of a direct hit to the knee cap.

Some of the proven ways to prevent the knee for popping out of place is to do the following:
a) taping or bracing - to prevent the de-tracking mechanism
b) orthotic device - to stabilize the tracking mechanism over time
c) quad strengthening - to support the appropriate tracking mechanism

Repeated subluxations (incomplete pop outs) or dislocations (complete pop outs) can further be assessed via imaging, to ensure that no ligaments or tissue destruction have occurred to precipitate the repeated dysfunction.

It all depends on your age, comorbidities, and prior level of health and endurance.

It can take up to 6 months, following the illness, for the patient to regain strength (1). Generally, it is safe to postulate that the length of time it takes to regain one's strength after having COVID-19 depends on the severity of the illness one went through.

Source
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833295/

Rehabilitation, after stroke, is highly individualized from one patient to another. It is NOT a one fit all treatment modality.

Stroke rehabilitation is best attained in a facility staffed with therapists and a Physical Medicine & Rehabilitation specialist, practicing stroke rehabilitation since not all physiatrists practice stroke rehabilitation.

Stroke rehabilitation covers critical areas of mobility, ADL tasks, speech, cognitive, and medical management of stroke sequelae that encompasses issues like headaches, pain, depression, and bowel/bladder dysfunctions.

Here are some generic guidelines for stroke rehabilitation that would form the basis of a sound rehabilitation course in a patient who has had a stroke:

a) Promote mobility:
• exercises whose goal is to enable a patient develop in and out of bed mobility.
• motor-skill type exercises - for muscle strength and coordination.
• constraint-induced therapy - to use affected paralyzed musculature.
• Range-of-motion therapy - to minimize contracture formation.

b) promote ADL/self-care tasks:
• engage in basic ADL task re-training.

c) Promote speech, cognitive and emotional functioning:
• Therapy sessions for speech, cognitive disorders (memory, processing, problem-solving) - including swallowing and eating.

d) Manage spasticity

e) Manage bowel/bladder dysfunction

f) Manage conditions that increase risks of having further strokes

g) Manage post stroke depression (can occur after one has had a stroke)
• Monitor and treat.

h) Manage post stroke pain
• Monitor and treat central and peripheral pain as well.

Multiple causes can precipitate knee pain: joint/bone issues, soft tissue disorders, bursitis, injuries, ligament tears, etc. Self-diagnosis, via google search, will help you. Seeing a right doctor will. The best thing to do is go see a doctor, preferably a Physical Medicine & Rehabilitation specialist (a doctor who specializes in bones, muscles, nerves, brain, spine issues).

An entrapment type neuropathy. It can be either a distal entrapment mono-neuropathy like carpal tunnel syndrome, or a proximal nerve root entrapment, aka a radiculopathy. Go see a PM&R specialist specialist.

Participating in walking and performing pelvic floor muscle exercises (for strengthening) are recommended after prostate surgery, i.e. Kegel exercises.

A Physical Medicine and Rehabilitation (PM&R) specialist. First call/ask if the specialist does musculoskeletal medicine--since PM&R specialists do a variety of
muscle/joint/nerve/pain work.

Frozen shoulder, also known as adhesive capsulitis, is a common condition that results in the loss of the normal range of motion in the affected shoulder. It can be painful, rigid and disabling. It generally affects women more than men (in the age group of 40 to 60). Left untreated, a frozen shoulder gets worse and ultimately results in the disability of the affected shoulder. You should see a physiatrist (a PM&R specialist) who can assist you in treatment and send you to the right therapist for continued care.

Physiatrists are specially trained in the complex area of musculoskeletal issues; they have expertise related to issues and matters of bones, muscles, tendons, ligaments, nerves, rehabilitation and pain. Like any other specially, however, not all physiatrists treat back pain--since the specialty Of Physical Medicine & Rehabilitation is broad. Some physiatrists treat brain issues (like TBI non-surgically); some treat spine issues (like spinal cord injuries non-surgically), while others can treat neurological issues from carpal tunnel, neuropathy, spasticity to MS and Parkinson's disease.

Overall, all physiatrists are trained to improve and/or restore function in a patient with painful syndromes, injury, illness, and disability.

A physiatrist who treats back pain is highly trained in the appropriate diagnosis and treatment of the condition, including what physical or occupational therapy is required to provide the best outcome. So, seeing a physiatrist will ensure that you are getting treatment form a well trained specialist, who is also providing the best oversight to your rehab course.

Seeing a physiatrist ensures that you will get holistic care in the treatment of your back pain. If holistic care is what you seek, then go see a physiatrist!

A physiatrist who treats low back pain would have the expertise to do the following for you, if needed:
a) NCS/EMG studies to assess what nerves have been affected in your disease process.
b) Peripheral joint injections (in treatment) for any joints or parts co-existing or contributing to your overall back pain. .
c) Trigger point injections for chronic myofascial (soft-tissue) pain associated with your back pain.
d) Execution of modalities, such as heat, cold, manual manipulation (in the case of an osteopathic trained physiatrist), relative to treatment of your back pain.
e) Execution of ultrasound guided injections, interventional spinal injections and other procedures, such as prolotherapy, platelet rich plasma injections, and autologous stem cell treatments (for those trained in these areas), relative to diagnosis and treatment of your back pain.
f) Management of pain and associated conditions using various medications and narcotics - physiatrists that treat pain syndromes, of note, have expertise in pain medications and spasticity medications.

You should see a doctor, specifically a physiatrist--a PM&R specialist--who treats pain syndromes, if the following scenarios arise:
a) you develop worsening pain over a span of a few days
b) you develop fever, chills, or malaise
c) you develop bleeding, fluid drainage of any kind, warmth, redness or a wound of any kind
d) you develop a mass or growth