Friday, August 26, 2016

Another Open Comment Forum, Jump In!

It seems it's about time to do one of these. The first two were enormously popular. Also, it's fun for me to sit back and watch everyone talk.

How's everyone doing? Summer is almost over. Was it a good one for your knees, or was the warm weather too tempting and did you try to do too much? (I realize this should be completely flipped on its head for our handful of Australian contributors, who are probably sitting inside waiting for the snow to end.)

If anyone's looking for a topic: Are there any changes in footwear that have helped you? I relate the story in the book of those special, expensive shoes I bought that were supposed to be the greatest for joint pain ... and turned out to be an absolute flop.

Or talk about whatever! Cheers.

42 comments:

  1. I am sad to say I'm not doing very well at all! I've lived with Patellofemoral Pain Syndrome for almost 2 years. It ended my semi-professional dance career and cost me 5 months of income, and it has just cost me the two jobs I had more recently, leaving me unemployed again. I have days when I think I will never get better, or that I will be completely broke before I ever get better! I am shocked to have gone from a very fit and active 31-year-old to feeling afraid of the future at 33.

    Amy

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    1. Hi Amy,

      I'm so sorry to hear that things aren't going well.

      Believe me when I say that I know completely what you're feeling.

      I am a high level figure skater with hopes of competing at the Olympics.

      I suffered a knee injury in 2011, which looked like the end for my skating career. It added another 5 years to my age....making me not much younger than you. In skating that's ancient to be competing.

      It took a couple of years to find any kind of healing, but I did heal.

      Unfortunately, I suffered the same injury again last year....this time in both knees.

      It's been a really tough go, but you know what? You can't give up.

      Amy you are not broken. You are not lost and you will overcome this.

      I have to keep reminding myself this multiple times a day.

      My past doctors and even some coaches wrote me off as damaged goods.

      You're your best and sometimes only cheerleader.

      Stay positive and remember to take care of yourself, physically and mentally.

      I had to go through 12 specialists until I found someone who would listen to me and give me a chance.

      I had to find a new coach who believes in me, and most of all, I had to believe in myself.

      I had to do my own research and learn how to decide what was happening within my own body without the help of people I thought were supposed to tell me what was wrong.

      If dancing is what you're passionate about, don't give up.

      Healing is a hard process, but it's possible. Don't let anyone discourage you or try to tell you it's not possible.

      I healed once, and I will heal again! I believe you can too.

      TSM

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    2. My experience is exactly the same as TSMs, and I'm still on the healing path. It's now over 4yrs.

      I refused to take anti-inflamatories until the last few months. Before this, I got around 50% relief from following the good advice on this blog and others similar. Dr Dyes work led me to anti-inflams to try to knock out the remaining inflamation. I've thus got the pain down another 50%.

      The real benefit of this is it has really helped me hone into what causes my knees to get worse, and what I need to avoid. Before this, they hurt so bad most of the time I could never tell what activities to avoid.

      My plan is pretty much a 10year one to get back to running consistently. Cycling would be great, but that is more of a pain trigger than running.

      I do know of one bloke who took 20yrs to be able to run again.

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    3. I would like to share my somewhat successful story in healing my knees.
      I had a partial tear in my PCL due to a childhood injury. A couple years ago I started having pain in my right knees while biking around on a random (unfitted) bicycle. I didnt pay too much attention to it because I thought it would go away on its own. A few weeks after that I started having mild pain in both knees after any rigorous activity (biking, rock climbing etc). At this point I was referred to a physio who told me that my problem was patellofemoral maltracking. For the next year and a half I went through atleast 5-6 physios who kept recommending more or less the same exercises as others. Meanwhile I was also seeing a couple sports doctors who didnt discover anything new. They did a few MRI's in the process but everything was clean. Things took a turn for the worse last December when I started having pain in both knees at rest. This was new to me as I used to have pain only after activity. It was so bad that I could walk for more than 200-300 steps without pain. I even went to a rheumatologist but my blookdwork came out all clean. That is when I discovered this blog and started reading Doug Kelsey's book on this stuff. After 6 months of slow walking and some bicycling I am now in a spot where my knees dont hurt constantly. I have now started on a program of bilateral squats on the Total trainer which seems to be helping a lot. I can get a proper workout without injuring the joints. I believe I have healed somewhat but there is still a long way to go. I dont think I will ever go back to my older activities. I am happy now just to be able to walk and bike mostly pain free.

      Dont lose hope. With the right level of activity I believe anyone can heal their knees!

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    4. Bloody physios and patella tracking. That whole profession needs to give itself a good uppercut when it comes to anterior knee pain.

      They remind me of the 40s and 50s when some doctors thought smoking was good for you as it was relaxing.

      Delete
  2. My problem is chronic pain in my left knee from a running overuse injury that started a year and a half ago. I'm happy to say that after a major setback after trying to do a run before my knee was ready, I am doing much better. The reason is two things that surprised me: TECAR therapy and laser therapy. I know the clinic studies do not yet show a lot of objective evidence for their effectiveness, but they made a dramatic difference for me. Now that the pain is under control, I feel a lot more optimistic about a potential full recovery. Another breakthrough is that it's become clear to me that the pain is concentrated on the INSIDE of my knee. One or both of the MCL and medial patellar ligament seem to be involved, possibly indicating that this is primarily a soft tissue problem. A new MRI indicates that my MCL is thickened due to traumatic stretching, so that's a further clue (it didn't say anything about chondropathy or osteoarthritis). Now I'm equipped with much more information when for when I go back to see my orthopedist in a couple of days. The physical therapy he had me doing previously for five months didn't help, and probably made it worse. So I'm curious what he's going to recommend this time. One thing I'm definitely going to ask him is if the problem may be an MCL bursitis or a plica. All along I assumed (because that's what I was told) that the pain was coming from the patellofemoral joint itself and the cause was patella maltracking, but that just doesn't seem to fit my symptoms.

    S.A.

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    1. Update:

      My orthopedist sent my MRI images to a radiologist specialist, and the radiologist detected what he believes is a medial meniscus tear. Evidently it was missed by two previous radiologists because it doesn't present the "classic" signs of a tear. This diagnosis is consistent with my symptoms and makes a lot more sense to me than "patella maltracking." My orthopedist thinks I should consider a partial menisectomy (surgical removal of the damaged part of the meniscus).

      Has anyone ever had this done? What was your experience? Did it help?

      I have three concerns. The first is that it's unclear to me why, if the meniscus lacks nerves, does a meniscus tear hurt and how will surgery help? The second is that removing even just part of the meniscus can lead to premature osteoarthritis. And the third is that one of my most persistent and frustrating symptoms is inability to tolerate prolonged sitting with my knee bent. My orthopedist says that's not a symptom of a meniscus tear. Is that always true? Anyone want to share any insights on any of this? Would love to hear your thoughts.

      Pax,
      S.A.

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    2. http://www.ncbi.nlm.nih.gov/pubmed/24369076

      https://www.painscience.com/articles/knee-surgery-osteoarthritis.php

      Probably shouldn't because meniscectomy didn't do any better than sham surgery in a controlled study.

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    3. This is the same anonymous who said you probably shouldn't get the surgery. I"M NOT a doctor, surgeon or any kind of medical professional. I just came across the study that meniscectomy did no better htan sham surgery.

      BUT maybe the surgeon knows something that makes you an exception or maybe you seek a second opinion at least.

      Note, again i have no medical credentials.

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    4. Hi. Thanks for your reply. I keep hearing about that study and it makes me nervous. I'm meeting with the surgeon next week and I'm going to bring it up with him and see if he can offer any insights. If he can make a persuasive case that surgery has a good chance of helping in my case I'll consider it, otherwise I'll hold off.

      S.A.

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    5. I had a medial meniscus tear which happened very suddenly while doing an easy little run. It caused considerable pain and was causing the knee to 'lock' sometimes. The loose piece was also rubbing on the end of my femur cartilage and causing damage there. After a month I had surgery (despite my GP indicating I wait 3-6mths to see how it healed on its own), but that precipitated a downward spiral for both my knees (though I suspect the surgery was just the last straw which caused a loss of homeostasis which was on the verge of happening anyway).

      If I had my time over again, I'd have backed right off on exercise and given the knee at least 6-12mths of conservative treatment before opting for surgery.

      If your knee is not locking, I'd definitely be avoiding surgery for now and going conservative.

      OSs love to operate - because they get paid to do so. They are in denial about the fact that many major structural problems in the knee can resolve themselves with care & patience (wish I'd known that 4yrs ago. I thought surgery was the only option).

      Removing a piece of meniscus also increases your chances of future osteoarthritis - ESPECIALLY if you don't allow yourself sufficient healing time after surgery (see video below). I got really bad advice on this front from my surgeon following my surgery.

      Watch this:

      https://www.youtube.com/watch?v=jGLisqHx8sM

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    6. Yes, TriAgain, but I am under the impression that Dr. Dye opted for surgery for his meniscal tear. Have to see the video again but as far as I can recall during that surgery he found out about his Chondro 3rd Grade. Surgery or no surgery from what I gather you have to somehow find a way to slowly move the joint into balance anyway. And that may take a long time of very very gentle movement. Maybe more than a year. Did Dr. Dye say he achieved complete clinical silence after 2 years following the probing into his knee without anesthesia!?

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    7. I agree that trying conservative treatment, like physical therapy, first is preferable. But I did almost six months of physical therapy for my medial knee pain and it didn't help. And doing nothing didn't help. Evidently, whatever is causing my chronic medial kee pain is not something that can be resolved with stretching, muscle strengthening, or rest.

      S.A.

      On another topic...Dr. Dye had surgery for a meniscal tear? Can someone give me the reference for that?

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    8. Just pay attention to what the man himself says in the video S.A. I find it for you - it is around minute 8 in the link. So he states also that it took him 20 months to get back into homeostasis after the surgery.
      Why do we have to figure out those things and time frames on our own in a voluntary network for sharing research and data like this blog and not in the medical facilities that are maintained with public money?
      Cheers,
      S.

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  3. Hi everyone,

    A couple weeks ago I decided to try treating the underlying bone marrow edema.

    It's the only thing from my MRI findings that I haven't actively tried treating yet.

    My issue is focal cartilage thinning and some fissuring to a specific spot of the cartilage on the femoral condyle on both knees. It's a very small spot of damage seen on the MRI film in the same exact spot on both knees.

    I believe it's due to a new brand of figure skates I started wearing the year my pain started. The blades were not mounted properly, causing my knees to take more load on the inner part of the joint.

    Logically if my cartilage can't actually produce pain, and all of my other tissue (surrounding cartilage, meniscus, tendons, muscles etc) are healthy, the bone surface under the damaged cartilage must be where my pain is coming from.

    This may not be news to any of you who have done the research, but it's a new path for me to take.

    Basically the steps I'm taking are the same as treating inflammation, except I'm focusing a lot more on strengthening my bones by taking supplements and eating specific foods, while excluding certain foods also.

    If anyone has tried this please please share any insight. I'm always up for learning a thing or two.

    Until then, heal on, friends. Heal on!

    TSM

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  4. TSM, your approach is very much similar to how Racer-X (my online friend Ed in the US) dramatically improved his knee problems (he would probably not say cured yet, but compared to mine they are). An anti-inflammatory (and anti-fungal) regime.

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    1. Hey TriAgain,

      Thanks for the response!

      Do you know what Ed's actual injury is? It would be interesting to know.

      Check out the post I just made below. It's a bit of an "aha" moment for me right now.

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    2. As I recall, Ed had a defect on the back of his kneecap causing pain, went in for exploratory surgery and the surgeon decided to do a cleanup (ie. shave some cartilage off the back of the patella to smooth things out) which Ed was not expecting. Ultimately, this resulted in both of Eds knees imploding (constant pain/burning etc) to the point he could hardly walk.

      Same happened to me after a meniscus trim, though in hindsight I think my knees were on the way down anyway as a result of patella cartilage damage & heavy training, and the timing of the meniscus tear was incidental, but the subsequent surgery was the last straw which accelerated up my demise.

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    3. Hi Tri

      Have seen the thread and am thinking about a response that touches on inflammation and arthritis: peer reviewed articles, what I did, etc. Don't want to do more harm than good, as I believe the school of an ounce of prevention (Bedard, Dye, Ingraham and Kelsey) aka "the envelope of function" is worth more than a pound of cure, at least at this point in time when prevention in those other arenas is so vaguely defined.

      As for my surgery, it's generally part of my "white whale" of cartilage I choose not to pursue any longer... Dr. Dye sums up my surgical experience well in his video that's linked here. Was scheduled for a "sport-med" patella shave to address a slowly healing patella catch and woke to discover my medial femoral condyle had been shaved (which wasn't bothering me, but started to post-op and is OK again), and that I had been given a lateral release, which I think did a lot of damage and that I spent a lot of PT time on. Enough said.

      So I continuing to improve. Cycled up Mt Shasta to where the road ends this summer, my first time in 6 years. No problem, no knee pain.

      I still do experience inflammation on occasion (tingling) in both knees, for no apparently reason: it's not exercise induced, or related to the barometer or stress and isn't painful. If I rest, usually a good nights sleep, often an hour with my legs up and I'm OK again. It doesn't stop me from being active. BTW, I can run, but I try not to as running does feel like too much pounding still.

      Give me a few weeks to think about a response.

      Racer-X

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    4. Looking forward to it Ed.

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    5. I want to thank everyone for sharing stories and info!
      I'm too looking forward to read your summary, Racer.
      I read some of your posts throughout the years and really appreciate the input and now this good news.
      What is your opinion about your long journey - do you think you were able to repair the cartilage or you slowly managed to move the joints into homeostasis, while the existing hardware is more or less the same?

      Warmly,
      Sveto

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    6. Hi Sveto,

      Dr Dye has a detailed article where he gets scoped without anesthesia and establishes that cartilage isn't "innervated" (doesn't cause pain), but that other "intraarticular" (inside the joint) structures do. He did feel mild-moderate pain on a condyle and mild pain on a part of the patella called the "odd facet" when probed, but concluded this was due to thinning cartilage exposing nerve in the underlying bone. I'm way over simplifying a lot of complex info here...

      So my thinking is that I have restored (mostly) tissue homeostasis and that an absence of inflammation has reduced irritation and pain with non-cartilage structures in my knees. I like to think in the absence of inflammation that my cartilage is slowly healing too, but homeostasis first has to be reached, with cartilage being slow to heal, even in knees without inflammation. I do remember how much sharp pain and noise I had in my knees just a few years ago. Subjectively it felt like my cartilage was gone and in tatters. 5 years ago there were grade 3 findings on my M.F.C., across the patella and a defect on my trochlea.

      I am not a "knee expert," I'm just an average guy healing his knees one day at a time and I don't want to give anyone false hope. I take it one day at a time, probably do too much and still live in fear of a relapse and am hyper-vigilant "listening" to my knees. Also, it is hard for me to write this, as I am an experiment of one, feel vulnerable and don't want to hex myself or harm others by saying too much.

      Racer-X

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    7. I reckon you are pretty close to the mark here Ed with what also happened to me. While no doubt I had (still have) some patella cartilage damage, the main source of my pain was (still is) loss of tissue homeostasis & hence inflammation, which can still be flared up so easily.

      What I've never fully understood about your journey (despite our exchanges which have been such a huge help and source of inspiration to me) is, did you ever reach a point where you backed off everything so much that you became pain-free, then started ramping things up? Or did you always have some background pain/sensation, but gradually ramped things up to where you are now?

      This is one thing I've never done - just stopped everything except perhaps walking (blame exercise endorphin addiction of more than 25yrs).

      I've gained a lot more function, strength & pain reduction, but the demon is still well and truly there (e.g. I type this after a 6hr drive to Bathurst which has stirred things up again).

      Cheers mate

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    8. Tri raises an interesting question. I asked something similar Richard after reading Paul Ingraham's book where he seems to suggest that after a flare up you ought to go to a pain free zone and then push gradually from there. However, if you have an acute injury or messy surgery, you can easily discover this to be somehow a dreamy suggestion.

      Thank you for your reply, Racer. I can understand your cautious wording. I examined this article of Dr. Dye some time ago. I was just curious where you stand in the debate whether cartilage can heal or not.
      We may not be "knee experts" but as some lady put it in another similar space for sharing - "here I learn much more than talking to my doctors". And it is true, at this given time it seems that the anecdotal information and evidence is much more of use than much of the official medical practice in many respects. That makes extracting information from people who are going or went through this crucial.

      I am much interested in your line of thinking about the autoimmune trace in your problem. Especially, what you have written before about mold triggering knee pain. Some months ago I definitely experienced great worsening of my inflammation when I got to my village house where there's a lot of mold. I just stopped going there and improved. If you do not mind, drop me a line at skolibarski@gmail.com and I'll write you a short email with some fungal and immune musings and questions.

      Cheers,
      S.

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    9. Sveto, I agree entirely with your view that places like this blog are a much better source of learning than most medicos.

      I sent the link to Dr Dyes video to 4 of my medicos. No response from any (though my OS did ask my wife how my knees were going when they met in a social setting). The other day I went to my physio to get some more sticky pads for my TENS machine and she admitted she had not watched it, but assured me she would.

      Their modes of operation just don't fit with people going through the nightmare which is chronic knee pain, and I suspect they are scared to learn/admit that they really have no idea what is going on, and that the solutions they have on offer are bunkum...or worse.

      To resolve this knee problem, you have to become immersed in it for the long haul, and the modus operandi of most medicos does not fit that model. Largely they are hit and run operators.

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    10. You are spot on about the time frame not fitting the ideology behind the current medical practice, TriAgain.
      Also I feel that medical science&knowledge nowadays is moving way faster than what most educational institutions and hospitals can incorporate in their practice. In an ideal world every year or two doctors should be having some educational session and re-training. How can you expect someone to be in touch with current knowledge when s/he graduated 20 years ago when Q-angles and maltracking patella were all to blame and lateral release was prescribed like aspirin.

      By the way, what is the outcome of your 30-day experiment with anti-inflamms? And did you get rid off the the catching of the patella after riding your bike that you mention some time ago? It took me 3 months of iron discipline to calm down my knees a bit so both my patella are almost not catching anymore, which is a huge relief. I thought that there was permanent structural damage causing the catching. In my experience thus far it is clear that the knees are trying to heal themselves if you give them the right laod&frequency of movement. However, the speed is mind blowing. Also I do not know if there are limits to healing after certain damage or it will just take forever to get them on track.

      Best,
      S.

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    11. Hi Sveto

      I definitely got pain reduction from the 30 days on anti-inflams, and my GP now wants me to persist on them for another 2 months. The catching has also largely disappeared.

      Problem is, I'd added some walk/run sessions around the same time I started the anti-inflams. I asked him if I should continue with the running and he said yes, as it was good for my mental health (which it most certainly is). As I got fitter, I pushed the running a little more and I suspect that may have set me back a bit and caused my healing to plateau.

      The bottom line is I should probably do 6-12mths of entirely avoiding anything which is suspect for my knees, but mentally I struggle to do that.

      I agree with your last few sentences. I think the cartilage can slowly heal, but you've got to calm down the synovial lining etc inflammation first and I have not been patient/consistent enough in doing that even with the anti-inflams. I also think my GP does not understand that concept, though in his defence he is trying to balance my knee recovery with the mental side of my exercise addiction!

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  5. I have discovered a class of knee injury called an insufficient fracture.

    Affects the medial femoral condyle weigh-bearing surface and typically is seen in women.

    It's not a traditional fracture of the hard exterior layer of bone, but affects the spongy layer and bone marrow inside of a bone.

    Treatment is conservative rest and analgesics (pain killers.)

    The injury is usually overlooked as something else because it mimics other common injuries.

    Healing requires no weight-bearing, and typically takes 4 weeks.

    Researchers found their patients were not healing because the basic act of walking was inhibiting proper healing. They simply needed to take the load off of their knees for awhile.

    Once they paid attention to specifically taking the load off of the joint, their patients recovered.

    The injury appears only on MRI scans, and only Dr's familiar with the injury would be able to discern it.

    This is the first time I have found any study or mention of injury focused on the medial femoral condyle, which is the issue I have.

    The symptoms and suspected cause line up perfectly with my MRI findings, medical history and lifestyle.

    My next step is to actively rest and eliminate all unnecessary weight-bearing for a few weeks.

    I'll update this post in the future at regular intervals to help others keep track.

    Keep healing, friends!

    TSM

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    1. Upon further reading, I think stress fracture better suits what I'm experiencing.

      Insufficiency fracture suggests my bones were weak, which I don't think is the case.

      I'm still going to limit weight-bearing for a few weeks.

      I'll update next weekend.

      TSM

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    2. Here is an update as promised.

      Went in for a bone scan about 2 weeks ago. I have an appointment with my Physiatrist scheduled for Oct 5 to get the results.

      While doing my scan, the attendant must have consulted the radiologist and decided to send me for an x-ray of both knees.

      While getting the bone scan, the attendant allowed me to look at the screen while the images were being taken.

      I could clearly see the bright areas in the spots where I'm feeling pain in my knees, which confirmed what I already knew....obviously there's something wrong in that region that an MRI didn't pick up.

      I had to be a bit more assertive/aggressive with my Physiatrist to get refereed for the bone scan done because he wasn't convinced I could have a stress fracture. His reasoning was that it would show up on an MRI. He's an excellent physician, though, and I don't hold it against him. He has been the only person capable of helping me at all.

      I have stopped trying to treat inflammation because it wasn't doing anything for me except making eating proper foods difficult. I actually feel better now since going back to my regular diet (including dairy, occasional honey, regular carbs, occasional treats etc.)

      I've stepped up my intake of supplements to promote bone strength like calcium magnesium, vitamin C, vitamin B, Vitamin A and some Lysine.

      I'm hopeful that when I get my results next week it will come back positive for a stress fracture. Sounds crazy to want that diagnosis, but it's a treatable injury that can heal.....unlike some mystery pain that no one can seem to put a finger on.

      If you're having joint pain without any clear diagnosis, I suggest the bone scan. It's unfortunate it wasn't in the first steps to help create a full diagnosis picture, and It appears the scan isn't a primary go-to for some specialists. Maybe it's a regional thing? Not sure.

      I'll update again after my appointment.

      Until then, let's keep healing! Don't give up hope.

      TSM

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    3. TSM, if you can update later, it would be interesting to find out what exactly your doctor says the bone scan shows and what he/she prescribes to fix whatever's wrong.

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    4. Hi again,

      Here's what my doc says about the bone scan......it's inconclusive for a definitive stress fracture.

      Hearing this was a little painful. Anyone dealing with knee pain, or pain in general, understands emotional distress comes with the territory.

      There is a very bright side, though.

      The scan did reveal a low signal in the bone in the areas I'm feeling pain in, which means there's a verified and obvious disruption in the bone directly beneath the former cartilage injury.

      I say "former" because the recent x-rays taken show that my joint space is actually in better shape than it was a year ago. The radiologist says that my "joint spaces are well preserved and no arthritic or destructive changes are apparent." There has been improvement with the cartilage, at least whatever the x-ray can show. That's really interesting and incredibly encouraging.

      So the bone is showing signs of disruption, but my cartilage is no longer showing signs of distinct injury on x-ray. Not sure what it would show on MRI, but I've been suspecting for months that the problem was the bone anyways.

      One of the theories for a negative stress fracture finding is, because I've undergone 3 rounds of prolotherapy and 2 rounds of PRP (platelet rich plasma therapy,) the fractures may have actually healed. That doesn't explain the lingering pain, but the pain is 95% better now after treatment than it was even 4 months ago.

      My physiatrist can't figure out what's wrong so he suggested I go to another specialist in my region. He broke up with me haha, but for the most honorable reasons.

      I have decided that, at this point, if medicine can't tell me what's wrong, I have to be smart, use my research skills and apply what I've learned to my situation.

      I'm also going to keep relying on how my body is feeling. My instincts and personal observations of my own body have served me well to this point.

      If I had just gone along with the initial half dozen diagnoses of "patellofemoral pain," I would still be strengthening my quads, hamstrings and hip muscles with no end in sight.

      The bone scan is evidence that my hunch is right, the bone is the only verified pain causing agent seen on imaging. Bones heal!!

      Because of that, I'm going to focus on treating my bone with supplements and proper foods, and low-impact exercises that keep the joint active without putting more strain on the area.

      Based on my research, I'm taking the following supplements:

      Vitamin A
      Vitamin B complex
      Vitamin C
      Vitamin D
      Vitamin E
      Bromelain
      Calcium Magnesium
      Curcumin (turmeric)
      Chondroitin sulfate
      Davil's claw
      Glucosamine sulfate
      Ginger
      Lysine
      MSM
      Zinc

      I'm going to cut out major inflammation inducing foods, mostly added sugars and saturated fats.

      Exercises will be done in the pool, also anything laying down that doesn't involve joint loading.

      I've considered using crutches to completely go non weight-bearing, but I've been noticing that resting actually makes my knees feel sore. Not painful, just a dull soreness.

      The lack of a clear diagnosis may seem like a failure to understand what's wrong, by my instincts were actually right about the pain coming from my bones, which had been initially doubted by my doctors.

      To me I'm in a much better position now to heal and go back to training.

      Cartilage damage may be be an issue, but it's not what's causing the pain. Remember that.

      Tried to include links to the research I've been reading, but for some reason it won't allow me to.

      I'll update again as soon.

      Until we speak again...keep healing and don't lose hope.

      TSM

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    5. Interesting, TSM. It does sound like the bone scan turned up something. And it makes sense you'd see "signs of disruption" in the bone before evidence of a fracture.

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    6. Quick update as promised,

      Since my last post my range of motion has improved quite a bit and I have no pain doing single leg bends at various angles.

      I still have some pain, but it is much less noticeable now than it was 4 weeks ago.

      As I mentioned in a previous post, the bone marrow edema hat showed up on both the MRI and bone scan has been my focus.

      My plan of attack has been treating a bone bruise, which can take many, many months to heal.

      My goal is to return to skating by January 2017 without any pain, which right now seems very likely.

      When the pain started last year it was an 8/10.

      After prolotherapy and platelet rich plasma therapy treatment this summer it was about a 3/10.

      Right now I'd say I'm at a 1/10. Next step is pain free!

      I'll update again soon.

      Take care, and keep healing!

      TSM

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    7. Re: Figure Skating. I've just discovered this website after trying to fix out my knee problem for nearly a year now. (Grade 3 fissure in patellar cartilage, frayed meniscus, Baker's cyst, bursitis, tendinosis in several places around the knee, uneven muscle firing in quads, and probably some other stuff, too). I had a PRP injection 11 months ago that took my knee out of immediate crisis, but it's been tough recovering and occasionally I've had setbacks. I'm pretty much done with doctors and PT and have been doing my own rehab program. I could go on and on but I won't right now.

      I'm an adult figure skater and have missed it terribly and was resigned to never skating again after having enjoyed skating 2-3 times weekly for the past 30 years. But the knee was feeling better and I was able to jump on and off a Bosu ball sideways and also manage on a Reebok balance board (to simulate skating edges) without pain so I recently gave skating a couple of tries, tamely and tentatively at first. This third time I clearly overdid it and set myself back at least a month by my estimation. No pain other than a couple of twinges while skating but the next two days I was limping and a week later I still have some pain in the knee and in the lower hamstring tendons. (I might have a blade setting problem too.)

      On the positive side, my hip and leg exercises enabled me to do stuff (jumping off to do a waltz jump easy) but my joint was unprepared for the stress of edges and of rocking back and forth on the blade at an angle. I haven't given up, but if I go back to skating I will limit my initial skating times to 10-15 minutes no matter how good I feel, and I will wait to see how I feel the next day before stepping up the amount of time. Skating is just so different and unlike other activities (which is why it's fun!)

      Good healing wishes to all!





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    8. Hello!

      Another update!

      I'm happy to say I no longer have knee pain while doing single leg bends/squats at various angles. I can't say how happy and encouraged I am!

      Still feel a pinch once in a while if I'm going up sitars, but it's just a small pinch. I'd say a 0.5 out of 10 for pain.

      I followed my previous plan of action and it seems to be working.

      Aquafit is proving to be not just helpful to keep my leg muscles strong, but fun also.

      I've also been doing 30-60 minutes on a stationary bike with no resistance a couple times a week.

      I've been icing my knees at least once a day, usually when I get home from work or before I go to bed.

      Been thinking about trying to use the elliptical trainer this week. Going to try 10 minutes first and see how I feel after a couple of days. If I feel good, I'll stick with 10 minutes a few times a week then progress to 20 and so on. If I feel any pain or discomfort I'll stop, take a rest then scale back.

      Definitely feel like I'm on track to get back on the ice early in the new year.

      Until next time....keep healing!

      TSM

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    9. I forgot to mention that I'm taking the approach of treating a bone bruise/contusion, which is the only logical cause of pain I can deduce from my imaging, which showed areas of localized bone marrow edema in the places I was feeling pain in the same spot in both knees.

      Google the term for more information. For some reason I can't include URL links in my posts.

      My own personal research has shed quite a bit of light on my issue, and how to go about fixing it. So far so good.

      TSM

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    10. Posting another update!

      Several weeks ago I started to use an elliptical machine for short 10-20 minute. Things felt great for a couple of weeks but then I started feeling a degree of pain return.

      I immediately stopped using the elliptical and stationary bike for a couple of weeks and now I'd say the pain is about 1 out of 10. A minor setback but I'm feeling better each day.

      I have added comfrey to my recovery plan. There's a lot of controversy about whether taking it internally is a health hazzard or not. After doing the research myself I have decided to brew the commercially sold dried leaves as a tea, AND use the ground root for a topical treatment directly over the injury site.

      I'm also adding Boron supplements to the roster after doing research on it's ability to support calcium health in the body.

      Still focusing on my overall bone health as the main goal. I'm beginning to believe more and more everyday that the cartilage has very little to do with my pain.

      Keep healing, friends!

      TSM

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  6. Hi,

    In my experience with bilateral chondromalacia patella, I am comfortable wearing any shoes that act as a shock absorber, all the time.It reduces the pressure thats transmitted to the knees to a good extent.

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  7. hello everyone,
    has anyone taken the supplement Cissus?
    been searching and reading online and it seems a lot of people are getting positive results from it for knee pain; or is this just another placebo like glucosamine?

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  8. Hi, I have a question…

    Now that you are walking on bike, do you still keep pushing harder and harder? Going more time and stronger on your bike exercise? Do you still keep trying to climb the ladder?
    Do you now feel any pain?

    When one is exercising often one don't feel pain until it's to late. One is slowly eroding cartilage but receiving no feedback. When pain appears usually cartilage is already badly degraded. How one knows if one is in the functional zone or not. If one is in the safe zone or not.


    Also do you think you can't reach your previous point of bike exercise before injury and keep your cartilage at the same level?

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    1. If this is addressed to me: I push as hard as I physically can when I ride my bike on the weekends. Really, I push myself to the limit. However, I ride that intensely only on Saturday, then do an easier ride on Sunday. Cycling doesn't bother my knees anymore, and I'm riding as hard as I ever was.

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