Saturday, February 4, 2012

Another Success Story to Brighten Your Day

Fishing through the blog's comment section each week, I never know what I'll find. Usually it's a complaint about balky knees or a plea for advice. But sometimes it's a jewel -- a success story -- and one recently got me excited enough to burst in upon my wife and 2-year-old daughter, while they were taking a bath, to tell Congyu, "Honey, listen to this."

Here's the longish story -- in full -- from someone named Ron. I'll return at the end to comment on a few things:
I wanted to let you know that I have runners knee and I am 56 years old. I have had the signs of it for about 5 years. In the beginning I can remember the movie goer stiffness. I did not know at the time what it was. I had to stop running over 2 years ago do to the pain in my left knee that seemed to come out of no where at the time. After I stopped running I figured out what I had, self diagnosis, Runners Knee.

So I did the exercises, foam roller and stretching. Sources were youtube and others on the internet. I was thinking I was getting better so I went for a run about 6 month's later. I ran about 1 1/2 miles and limped/walked for the last 1/2 mile. I was nearly on crunches the next day and it took about a week to walk normal.

At this time I decided to see a doctor and get the knee fixed. I was not getting any where. The doctor took x-rays and said the cartilage looks remarkably well and conferred with me on the runners knee diagnosis. He gave me a prescription for physical therapy. I'm thinking wow the professionals are going to fit it. They looked at the knee and did not see anything unusual. Next they iced, massaged, stretched, exercised and ultra sounded it. After 2 months of this and no improvement I got a second opinion from a orthopedic surgeon with great recommendations.

He looked at my knee and the X-Ray of it. He then had me do a couple of things and felt around and told me I had runners knee and told me to take Ibuprofen for the pain if I wanted to run. He spent about 5-10 minutes on me.

Afterwards I decided I to quit the therapy after 2 months of it. I worked on the exercises the therapist had me doing and iced a lot. Guess what after another 2-3 months no help. My knee was no better off. IT would swell if I did to much on it or had a sudden jolt like slipping on the ice or tripping and catching my self on the bad leg. I was getting bummed.

I started looking for the magic bullet on the internet, hours and hours. I finally ran across the Runners Bible, I think I paid $70.00 for it. I was desperate. I started doing the exercises, total gym mainly. Thousands of repetitions. I also gave up all the recommend exercises from the therapist. No help in first month.

I seen your kindle book. I was on the see saw about buying it. Finally I bought it. As I read the book I'm waiting for your magic bullet to fix the knee. When I finished and there was no magic bullet! I was disappointed. But the more I thought about the studies you presented and how you cured yours, eureka the light bulb went off. Its up to me to get well. I needed to move and monitor and be in the Goldie locks zone(runners bible)to heal.

Well I am a over achiever when it comes to exercising. I must have set my self back a dozen or times by over doing it. I did not keep a dairy, but had to remember several times at what I did to cause the pain a day after it happened. The pain is delayed like you said.

Walking has done the most for me. I walk our dog 2 miles every night. I have a desk job, but I will get up and walk around if I sit for a long period. I also ride my bicycle some. I have pushed to hard in the knee strengthening areas and set myself back many times. I finally got it through my thick head to back off and gradually increase the weight and volume. Slower than paint drying like you said in you book, I would say much slower than that even.

I am not cured but I am starting to run a little and am really working both legs out hard with no pain or swelling. I'm expecting to enter a 5 K in June. 2 1/2 years after I had to stop running. I have to give your book and also the Runners bible credit for my healing. I Gotta thank GOD too. I prayed a lot...:)

If I had to give anyone advice I would say create a knee dairy(I did not),get a pedometer and walk a lot also be perceptive about what causes pain and gradually increase or maintain exercise level. When in pain rest but keep the knee moving some, Know your limits and don't be a man to the point it sets you back in your progress.
(1) The first impression an unknowing reader takes from this is: "Wow, this guy really went through the mill." But if that reader has sought treatment for Runner's Knee (or chondromalacia, or patellofemoral pain syndrome), that initial reaction is probably closer to, "That sounds about right."

Because the exasperating experience above, I'm willing to bet, closely tracks what millions of other have gone through. In some significant ways it mirrors my own frustrations (they tried ultrasound on me too and one of my doctors also thought my cartilage looked good, according to an X-ray -- but a regular X-ray can't even see cartilage; the tissue's presence (or absence) is simply implied by the distance between bones!)

(2) Finally Ron gets on the right path (with Doug Kelsey's The Runner's Knee Bible, and I'm proud to say, an assist from Saving My Knees). And he's getting ready to run a 5K in June. Which is how long after he had to stop running? A few weeks? A few months?

Nope. Two and a half years.

Which is why I think it's so important for people to rethink their time horizon for healing. Get on cartilage time, as I say. If you expect to be back competing in your favorite sport after a few months, you're setting yourself up for disappointment.

(3) Setbacks, setbacks, setbacks.

Healing is not smooth. Healing is not linear. Every week will not necessarily be better than the preceding one. You will screw up -- I guarantee it -- and your knees will let you know when you do.

If you're smart, you'll learn from the setbacks. If you're not, you'll shrug and say to yourself, "I guess my knees will never get better." And if that's your approach, guess what? They won't.

It's very hard to stay within what Doug Kelsey calls "The Goldilocks Zone" (I refer to the same thing as the "sweet spot" of movement -- not too much and not too little -- and have seen it referred to more technically as the "functional envelope.") Nobody hands you a manual that says, "Right now your knees can do x steps daily, then you should increase that by 1,000 steps every two weeks." You have to figure that out.

(4) Why do you have to work so hard?

Well, look at Ron's experience with the orthopedic surgeon who came with "great recommendations." He spent 5 to 10 minutes on Ron and recommended Ibuprofen (an over-the-counter anti-inflammatory) to combat the pain from running. First, setting aside whether trying to run through pain by using medication makes sense (I would say no, no, and no again), look at that number -- 10 minutes -- and really think that over.

How much time is 10 minutes? That's about the length of a coffee break or a water cooler chat about the Super Bowl.

Now, I don't mean to denigrate surgeons. They have hard jobs and see a lot of patients. But in 10 minutes even the most brilliant surgeon can't extract enough information to understand the complexities of what's going on with your knees -- and these complexities hold the key to your getting better.

What a good surgeon will do: inspect the joint, bend your knee, and ask you "Does this hurt? What about this?" as he probes. But once he determines there isn't an obvious overlooked problem, and you really do have the kind of nagging knee pain common to cartilage damage, he's gonna kind of shrug.

What else can he do?

Once the damage is bad enough, and you need some kind of surgery just to make life tolerable, he figures he'll see you again.

Again: this isn't meant to be an indictment of surgeons. Because at this point, a surgeon isn't who you need anyway. You really need two people on your case. One is a smart physical therapist who believes that knees can heal (not just that muscles can get stronger), and knows how. The other -- more important -- is yourself.

P.S. I'll throw open the comment section below to Ron and others who want to ask him questions (assuming Ron checks in regularly, and I think he does). People always want to know more about success stories. All yours, Ron!


  1. This definitely did brighten my day. Thank you so much for sharing this! I'll try not to be too much of a WOMAN to the point it sets back my progress. ;)

    The knee journal is so hard for me. I am not a methodical person/mind like Richard. I will try though.

    I'm going to rededicate myself to walking! :) I love walking, anyway.

  2. I have been walking 2-3 miles a day now for about 4-5 months, so far I dont see any difference. But I am trying to be patient, as you say. I do have a desk job that requires a lot of sitting down and doing research - so that's not helping either. I am now learning how to swim(though at41, that's taking some time ESP. Breathing part). I would love to change my lifestyle and run/bike everyday at some point... Hopefully I'll see some success like Ron and you one day

  3. Hi Anonymous: Getting better demands not only patience, but the right program for your knees, with a graduated increase in intensity over time to strengthen them -- that's what I believe anyway (it worked for me, though slowly). If you think you're in a rut (believe me, during my recovery, I felt that way more than once), you might try Doug Kelsey's The Runner's Knee Bible -- it has more specific types of exercises you can do. Maybe 2-3 miles of flat-stage walking for you isn't the best program. Easy cycling? Cycling is great for bad knees, I think, as long as your range of motion is adequate. Here's Doug's book:

  4. What if your not able to increase anything because the pain or signals stay the same, at a certain kind of effort. Should you increase anyway and hope for the best? (And thus take the risk of having another setback)

  5. This is a very tricky thing to navigate. I might try going slowly, very slowly, then gradually increasing the load, and see how my knees react. It might be worth trying to work with a good physical therapist who will try to measure your "load tolerance" a la Doug Kelsey, then try to build from there.