This is the story that I figured, one of these weekends, I'd get around to telling.
It's the story that explains why, in preceding posts, I may sound a tad bitter when I disparage those who believe in "quad-strengthening" to relieve chronic knee pain.
Yeah, I'm a little bitter -- a little angry even -- because of a bad personal experience, which showed me in convincing fashion why this "strengthen the quads" focus is pretty dumb.
Here's what happened:
I had just returned from a two-week vacation with my fiance in Tibet. Beautiful countryside, and we ambled about at a slow pace (Lhasa, where we spent most of our time, is a two-mile-high-plus city, which left us gasping for oxygen much of the time). At that point, I'd been battling knee pain for about five months. So it was still early days for my condition, you might say.
When I flew back from Tibet, my knees felt pretty decent. I even started to wonder: "Could I be cured?" (Of course now I know joint problems don't mysteriously resolve in two weeks, but in Tibet I did manage to find, by accident, a sweet spot of motion interspersed with non-stressful resting positions.)
Soon after my return, I marched into my physical therapy appointment with a big grin: "I feel pretty good," I said. My therapist responded with a broad smile and said, "It's time to hit the weights!"
Of course, I thought. This is the perfect opportunity to build up my quads, at last! For months I had been thwarted in my efforts to do so -- my knees reacted badly to the exercises that my PT prescribed. He had modified my daily exercise regimen, ad nauseam, to no avail. But my joints feel better now, I thought triumphantly.
He showed me a "safe range" for doing leg presses and seated leg lifts. For example, with leg presses, he told me to push the chair on the machine as far back as possible and to focus on doing the exercise at a nearly full extension, so as not to put pressure on the kneecap. He also showed me a "safe range" for the leg lifts.
I began visiting a gym during my lunch hour. During the exercises, my knees felt fine. My muscles would burn a little and I thought, "This is great, I'm finally getting my quad strength back." But I soon noticed something rather odd. The next morning after my little workout, I would wake up with a small, focused, intense burning in my knee joints -- a symptom I'd never had before.
My PT didn't seem worried by this, so I kept doing the exercises. Unfortunately I began noticing more of the next-day symptoms, and what's more, the overall condition of my knees took a dip for the worse. It soon became obvious that my problems were roaring back. So I stopped doing the leg presses, thinking they might be too stressful. Then, after a while, I noticed for the first time my knees were becoming uncomfortable DURING the seated leg lifts. I took this as a bad sign. Plus, I had developed a small amount of swelling in the joints.
But you know what I was thinking, in the back of my mind, this whole time? I can't give up; I need to strengthen my quads ... once my quads are strong enough, this swelling and pain and discomfort will go away ... my physical therapist must be right about this; after all he studied anatomy and went to school to help people like me and besides everywhere you look online, the advice for cases like mine is "strengthen your quads!"
Then one day I stopped kidding myself. I wasn't getting better. I was getting worse -- a lot worse. Whatever hole I had been in before had become about twice as deep. Occasionally I would leave my desk during the workday and slowly shuffle around nearby streets, just to try to relieve, a little bit, the awful burning in my joints. And that's when I began to realize that the traditional approach of physical therapy to treating bad knees -- those with chondromalacia, PFPS -- was badly flawed.
Now if there's a PT reading this, I bet that person is thinking, "Well, the problem was that your physical therapist had you doing too much! You were lifting too much weight, or lifting weights too often."
To which I would reply: I could have done less weight, and probably it would've taken longer for the symptoms to arise. But why not face the real issue: my knees were still weak. Strengthening muscles requires a lot of force (relative to strengthening joints), and one thing that weak knees can't tolerate, is a lot of force.
About that time, I began to drift away from physical therapy (until then, I had been the perfect patient, doing my stretches and exercises every morning). I began crafting my own program to save my knees, a program that took almost a couple of years, but that gave me back my knees and the physically active lifestyle that I missed so badly.
That's my story. Anyone else want to share?