Sunday, December 22, 2013

Happy Holidays

Best wishes from me, Congyu, Joelle and Elliot!

This is my annual "Merry Christmas" (or whatever holiday you celebrate) post.

I hope everyone out there is finding some success in healing their bad knees. What I can tell you (from my own experience) is that it's incredibly slow, and that's even if you're doing everything right.

The right attitude, and a spirit of determined optimism, help tremendously. The holidays are a good time to gather strength from friends and family and to vow to renew lapsed commitments (you know, you planned to start a movement program, but then things kind of happened, and you only half-heartedly followed through).

And, after a few guilty swigs of eggnog, you might think again about weight loss as a way to reduce knee pain.

There's a lot that knee pain sufferers can do! Damaged knees don't have to be forever. That's my message.

Well, that, and have a great week everyone. :)


  1. your book has really helped my knee, a torn meniscus, and I am anxious to avoid surgery. Sometimes however the knee collapses with a sharp pain, seemingly at the back. Will activity, walking , cycling(static bike) help this? Any advice much appreciated. Clay

  2. Of course I avoid advice, Clay, but a good question -- that I can't honestly answer. But I can tell you that, when I had bad knees (and later, even during my recovery), there were times that they felt somewhat unstable (I never feared they were about to give way, but I had a sensation that, if twisted hard enough in the right direction, they might). Now that my knees feel normal again, I no longer have those sensations. But will the same be true for you? Don't know for sure, but I think there's a good chance.

  3. Hello Richard,

    I am a new member to your Blog. First, I want to thank you for writing such an informative and wonderful book, which I could not find anywhere.
    I was able to restore one thing which is most essential in healing knee or anything else after reading your book, was "hope to heal".
    I am now staying positive that one day my knee will heals. I sent you an email to your yahoo id with my detail story and hoping if you can please reply to that.

    Making long story short, I am 47 year old female, Had an injury seven months ago in Gym working out on elliptical machine, and ever since my life has stopped.

    MRI result says that I have complex tear of the posterior horn of the medial meniscus. Tear of the free edge of the body of the lateral meniscus.

    I was able to resume walk and some normal routine work after being bed ridden for first three months.

    I had two flared up in between which got better in one week of rest.

    But, I have recent setback just two weeks ago. I thought I can start doing my quard exercise which doctors gave me five months ago, Did two minute of single leg quads exercise and felt some burring after that. Next day, I went for my normal walk, and some Christmas shopping.
    On Dec. 20th, I felt horrible burning and weakness in my knee and one bed since then. It's been two week, not much difference. Keeping leg straight and elevated on bed only helps me.

    I am planning to follow your tips and what I learnt by reading Doug Kelsey blogs about cartilage and meniscus healing.

    Right now, I cannot do even 5 min walk due to burning in my knee and weakness. It is not able bear my weight.

    Do you think this kind of flare up is something normal and it takes few weeks to get better in order to even do a slow walk? Why I became so bad in 2 min of single exercise, and then keeping up with my normal one hour walk and 2 hour shopping.
    Why I get so much burning.. I wonder what is happening inside my knee..
    I don't have any option other than resting all the time until this burning goes away and then slowly resume my walk inside my apartment. Does it soud like a reasonable approach?

    I wonder why my knee is taking so much time time to even reach to a point where I can do little walk without burning?

    Last two times, I knew it screwed up - learning swimming kicking (fist time learning swimming) and using knee a lot and second time sitting on floor on knee and knee bend for long time - but still, I did not have as much irritation or burning as I have this time. And, I was able to feel better in few days or a week.

    Do you think this kind of setbacks are common and it does not have any pattern in terms of how long they will last?

    Every morning I get up thinking today my burning will go away and I will resume my life, But it is not happening even after resting (most of the time) from last two weeks. :(

    I am feeling very low and I guess looking for some word of comfort to stay positive. I cannot even get up unless this burning and weakness in knee gets better.

    Seeing a doctor is no good since they did not do anything when I had this injury first time other than giving me print out of few quads exercise and IT band stretch.

    I would highly appreciate if you can please provide some insight and advice. Also, if you can please reply to my email then it would be greatly appreciated.

    Thank you so much for all the help and your time in doing so.


    1. Thanks for the kind words, Saroj. I usually avoid entering into e-mail correspondences about bad knees. Main reasons are twofold: (1) I really try to avoid the appearance of giving "advice" -- I'm not a doctor or physical therapist, as I've emphasized on this blog many time (2) There's a good chance that, if I respond on the blog instead, someone else may have ideas about your problem that are superior to my own.

      For instance, in your case, your problems began with a meniscal tear. I've never had one of those (nor have I read much about them, only enough to know that the prognosis for healing depends a lot on which "zone" the tear is in, and how much blood that area receives). So someone else here may have some better ideas than me on your treatment.

      A few observations: Why would you have such a bad flare up after doing some "single leg quad exercises"? I don't know what the exercises were, or how strong your legs are, or a whole bunch of other things, but -- my rather disappointing experience with the physio/doctor community has been that they are too aggressive in the exercises they prescribe. Could doing that exercise alone have been enough to cause a severe relapse? Of course. It only takes seconds to injure yourself, or injure yourself much worse.

      Setbacks are very common. My guess is that you'll have a lot more. And I wouldn't necessarily expect the burning you have now to go away in a few weeks, or even a month or two. What would I do if I were you? Doug Kelsey probably knows a lot about meniscus problems, so you may find some good guidance in his book/on his website. I'd also consider going really, really, really slow this time, in your rehab efforts. I'm very much a skeptic of "quad strengthening" and much prefer the idea of "joint strengthening" -- that is, what Kelsey advocates, which is a lot of low-load, high-repetition motion. Good luck!

    2. Hi Richard,
      Thank you so much for your reply. I checked for your reply earlier for few weeks and then I though you may not reply.
      I have read Doug Kelsey "knee bible" and all blog post to learn more about minscus tear..
      This time the flare up is so bad that I am on bed from last 6 weeks. Taking Anti-inflammentary from last 2 weeks and still cannot walk more than 2 minute.
      Walking few steps few times for less than a minute is also making my knee burning.. and it feels like some num (dull) , very unconfortable sensation which spread around in fron of my knee cap and all the way in thigh or leg bone with few step walk.. Not sure what this sensation is all about... It is very uncofortable..It feels like some fluid is spreading around or millions of insects or Ants are crowling inside my knee.

      Richard, did you have this kind of symptom or any idea what it could be.. I am looking for some word of hope that it will go away or slowly heal. Do you think it will take few months?

      I know I need to do slow and frequent walk otherwise my joint will become more weak, but the problem is that the moment this dull senstion starts spreading inside my knee, I feel so horrible uncoformtable that I have come stay in bed... Not sure how to get out of this death sprial ?

      I tried contacting Doug and he said he is not taking any patient. He is my last hope but not sure what to do if he is not taking me..

      I cannot even do his furniture sliding drill becasue even that brings that uncoformtable dull pain in my knee.

      Any feedback or word of hope would be a great help Richard.

      God bless you for your help

      Do you think

  4. You do sound like you're in a tough spot, Saroj. If there is swelling in your knee, you may have to get that down first. I did write a post "How Is It Possible to Exercise Without Pain When Pain Is All You Know." You may find it interesting:

    I'm not sure that, in your situation, I'd be too worried about the "death spiral" though. That's something that plays itself out over many months. You sound like you're actively dealing with an injury that you need to get on top of.

    I know you're not keen on the doctors you've seen, but honestly, if my knees were in that kind of shape, I'd redouble my efforts to find a really good doctor (or physical therapist) who can actually examine me. You may need some new tests to see what's going on inside the bad knee.

  5. Hi Richard,

    Thank you for your reply. I wish I had seen it bit earlier, but I was so tense and worried with my situation that my mind is not working straight most of the time.

    I did see a one more famous orthopedic dr. here in Palo alto medication foundation (bay area). I saw another orthopedic and he diagnose 2 problems in my knee

    – 1) Meniscus tear in posterior horn of medial and lateral meniscus (injuery happened 9 months ago, I was functional up until this recent flare up 6 weeks ago.. 100% bedridden.)

    Dr. is saying to do a surgery where they clean / cut meniscus with camera. I have heard in your book and from Doug blog not to take route of surgery, but these horrible symptom and no relief with resting, I am not sure what route to take? Felling very stressed with this whole thing.

    Dr. does not believe in PRP injection, but Doug does..

    2) This second dr. said I also have chondromalacia. whereas first dr. told this as patellofemoral pain.

    This time with this flare up, I also got horrible burning around my left knee cap which also has meniscus tears.

    Since I was doing little walk with right knee (for bathroom etc.), I think it put lot of pressure on right knee too and from last 2 week I am having little tingling or burning upper right cornor of my knee cap. Scared to death what if this knee will also get burring around knee cap or same issue?

    Can you please advice, suggest where should I start? Should I wait until this flare up is bit settled before going for PRP?
    Is it advisable to take PRP with such a bad flare up?
    Should I go for surgery directly without thinking of PRP because of acute symptom - but again no guarantee that I will feel better after surgery and how much pain I will have? – or not?
    Richard, do you know if you also had burning around kneecap or even behind the knee. This will give me some clue as what is going on with Knee.
    Where is this severe burning coming from? What I need to do to calm this down? Resting from last 6 week and aleve has not helped much.
    Is chondromalacia. and patellofemoral pain terms are same?

    I am ready to do or pay anything to get out of this death spiral

    Richard, do you remember burning in behind your knee or around kneecap? The only think which give me some relief is sitting on bed with elevated legs.

    I have extreme burning behind my knee and under my knee cap. taking “aleve” from last one month.. Not much improvement. My knee cannot even tolerate less than 1 min walk
    Also, I am planning to go to India since I have no family here as alternative, Richard, did you travel in plane when you had this acute burning, is it something manageable with straight legs? I mean do you think air pressure will cause more burning etc.?
    Any help on answering these question or providing some feedback as where should I start from will be a great help Richard. God bless you for all the help you have given to me.
    Your book is my Bible and only hope, I just read it over and over again every day in the time of depression or desperation to get some help.
    Many Thanks

    1. Sorry to hear that things are still not good. Yes, I had a lot of burning around my kneecaps, so there's a similarity, but again, I didn't have a torn meniscus. And I'm not sure what it takes to rehab one of those, if it's the kind of tear you have. To be clear: I'm not opposed to all and any surgery. I just view it skeptically for the kind of problem I had. Still, there are situations where surgery probably is the best option. Maybe that is your situation.

      Also, yes, sitting for a long time on a plane will probably cause discomfort -- but you might be able to get a prescription for anti-inflammatories before you fly.

      Anyway, Saroj, I can sense you're intensely frustrated and desperate right now. I don't mean to minimize this blog, or the good people on it, but if I were you, I would look around me -- to my friends, to doctors, to actual people in my life who can help in some way. Even if I confidently told you, "Do this and do that and do this other thing too," your best advice right now won't come from a stranger on the Internet who isn't even a medical professional. I think you need the best doctors helping you, and your best friends helping you get through all this.

      The best thing I can say now is don't give up; everything will get better. :)