Saturday, November 16, 2013

What Does the Post-Recovery Period From Knee Pain Look Like?

I’ve yakked a lot about my recovery from chronic knee pain.

But it’s been almost three years since Saving My Knees was published. What have my knees been like since then?

I’m prompted to write this because here’s how most people would address someone who “beat” knee pain:

“Glad to hear you’re doing better. Hope your knee pain doesn’t bother you too much anymore, and hope you keep improving!”

Actually ...

My knees feel fine. I cycle hard again. I ride as much as 70 miles in one day, on the weekends. I’m right there in the thick of the sprints, and plenty of times I win too. When I return from cycling, I don’t ice my knees. I don’t take a couple of aspirins for “the pain.”

There is no pain. Period.

My knees still crackle a little, but much less than before. If I drop into a deep squat and straighten up, there isn’t an awful ripping sound from my joints.

There’s no sound. Nothing.

Maybe you’re thinking, “Great, so the post-recovery period is totally smooth, no bumps, no problems.”

Nope. If that were so, I wouldn’t bother writing this post. The truth is, the post-recovery -- like the recovery itself -- is a process. I remember taking a bus from Boston to New York City for job interviews in the fall of 2009 -- a full year and a half after I quit my editing job in Hong Kong so that I could focus on healing my knees -- and my joints grumbled some on the four-hour bus ride. And they did as well after I rejoined Bloomberg and had to sit, once again, at a desk for 10 hours a day.

Around that time, there were also moments, now and then, when I felt instability in my knee joints. There were times when, descending an escalator to the subway platform at day's end, I could feel that my knees weren't 100 percent yet. Last year I had some occasional and mild burning in my knees while sitting at work (I had a little this year too, though less). I closely monitored the situation, and it never got worse. In fact, I’m pretty sure it was related to the intense cycling, because during the off-season, my knees went back to feeling 100 percent normal.

Anyway the point is simply that healing knees is a long, long process. I know no one likes to hear that, in an age of instant gratification. But I really believe it’s the right message, because it's true.


  1. Hello Richard!
    Do you use now the saddle at a position a little bit high than normal? Are you cycling hard it mean that you climb as in the past, or is better to skip climbs and ride only flat? Do you think that the run is doing badly? What about jogging?
    Thank you,

  2. Marius, I put the saddle at the proper height -- not higher, not lower. Do I climb as in the past? Well, no, but this is basically for reasons of geography: I live in New York City now, not Hong Kong. Still, the course I ride each week has a number of (small) climbs, and I have no problems with my knees when pushing hard up them.

    Your other two questions appear to be: What do I think about running and jogging for people with bad knees? I think both need to be approached cautiously; I would prefer more joint-friendly activities (cycling, swimming or pool exercises). Still, I bet someone with bad knees could get back to running or jogging, with time and patience.

  3. I'm easing back into cycling (30-45min rides, lots more easy spinning in the small chainring, no hard pushing up hills) and running (walk 1min, jog 1 min, repeat for 15-30mins). But I spent almost 12mths doing neither, just walking & swimming (minimal kicking). I've also been put on a nerve pain drug called Lyrica recently, as they think my knee pain likely has a CRPS element to it. Strangely, jogging seems to agree with my knees more than cycling still? The idea is to re-programme the sympathetic nervous system in my knees (& spine & brain). The Lyrica allows a return to graded exercise, which is now recommended as a key treatment for CRPS. But I strongly believe the 12mths of more gentle activity helped a lot, and stopped me getting the severe crippling CRPS that many people end up with. I put my bike saddle up a little (0.75cm) to reduce my knee bend a little.

    cheers, TriAgain

  4. This is amazing Richard. Either you have super-human healing ability or we are all so able to heal. I am 25 and have had knee problems for a year. Although I am going to go the other route and have surgery (I have a bunch of tissue below my knee-cap from kneeling too long...) I am inspired by your recovery. I hope to recover even half as well as you ...and I'm half your age! Keep it up Richard. Hope you stay active well into your late years with your child and all! BOL --From Chicago

    1. I like your message that it takes time. I don't know how many times with all my injuries (I guess my feet...) where I have had set-backs because of impulsiveness or a doctors prescribed "aggressive" therapy. I am an athletic looking 25 year old so they think I am Ghandi! haha But seriously being patient is so much smarter than being impulsive it's just our society rewards those/ punishes those who wait ...I don't know how many times family members/friends think I am "crazy" and "exaggerating" my symptoms bc I've had them for so long. Why would I randomly "fake" something like this? Doesn't make any sense.

      Also thank you for your blog and you being you. I know you probably don't even read my posts (who would) but I feel like in normal society I am not allowed to talk about this. From my experience, no one cares or wants to hear about it.

    2. No superhuman healing ability, that I know of. But it did take a lot of time and patience. Good luck with your surgery, and check back in and let us all know how it goes. To me, surgery is a last option, or a low-on-my-list option, but it could very well be the best thing for certain cases. Cheers.

  5. The cycling issue is interesting. A few weeks ago, I thought after 18mths, my knees were finally improving fast. I was basically pain-free for a week or two, so started a little cycling again, 3x per week, 20-30mins during the week, 45mins on Saturday. This went well for 2-3 weeks, then I did a one hour ride with some hills and bingo, my knees went backwards by at least 50%. More patience needed! The interesting thing is the supported single leg shallow knee dips & small amount of running (10mins as 1 min run/30 sec walk) recommended by my GP did not set me back - I was doing this for at least a month & my knees continued to improve. The main problem seems to be cycling - it's almost as if the pattern of cartilage damage was initially caused by cycling, which is quite likely as I used to do a lot of hard cycling.

    cheers, TriAgain

    1. TriAgain, I had the exact same experience. I was following a running re-education programme, my knees felt like I could dance and jump (which I did). I had been cycling 10mn every day, with a bigger ride of 45/50min twice a week (I don't cycle for fitness but to commute, so I don't push myself too hard but the bike is VERY heavy - over 30 pounds). All went well for 3 weeks. Then bham, I had to cycke to work and back on the same day, that's twice 50mn, and I knew straight away I would pay for it. Like you, the relapse is about 50%, not as bad as it was in the first place, but I experience burning when walking too long, or sitting for too long.
      I just had a 10mn cycle to the shop, flat route, wind in my back. No pain but my right knee feels very unsteable after.

  6. One thing I learned during my recovery: basically, you have to give up what you love and what initially hurt your knees in the first place. For me, that was cycling. A few times, as I was getting better, I tried to ride the bike again -- and it just never worked.

    My best theory was that, because cycling caused the damage in the first place (I'm pretty sure), the injury was going to be most easily aggravated by cycling. So in the end I just made myself walk away until months later. At that point, it had been so long that I'd been on a bike, I almost thought I had forgotten how to ride one!

    1. Exactly Richard (sadly because damn I miss riding.... I don't really miss running .....and just swimming gets awfully boring). And what did the knee-specialist Sports Dr tell me? Stop running, but you can ride as that is a knee-friendly, non-weight bearing activity. I quickly found out he was wrong. The cycling motion aggravates the cartilage & inflames it again, it seems to have less to do with bearing weight, more to do with the pattern of knee motion.

      I'm pretty sure your theory is right. I'm just having a hard time sticking with the program!