I’m hoping to get a second edition of Saving My Knees out by the end of the summer, or early fall. The major reason for a new edition is to update a few things, such as how my knees have been since I wrote it (they generally feel great) and what I’ve learned since then (such as the envelope of function framework for understanding knee pain).
But not to worry: I’m not backing away from what’s contained in the heart of the book. I still think the program I followed made the most sense. I may have focused a bit too much on this idea of restoring my cartilage, but I will say: my cartilage was very crunchy before, and it isn’t any longer. So something apparently improved.
Now, on to the subject of what have become increasingly sophisticated spam comments:
I expect that the people who really need to read this won’t, because they don’t really read this blog. Rather, they’re like those people you see briefly in a neighborhood, stapling advertising fliers to a telephone pole, then moving on.
I realize there are ways of escalating against spam comments, such as (most severe) putting comments in a pen until a moderator (that would be me) can approve them. Then nothing that’s spammy gets in the comment section.
But honestly, I don’t think that’s good for people who want live back-and-forth discussions here, plus it’s not great for me either, having to constantly moderate. I’d rather jump in on my usual occasional basis and clean up the comments. So far it seems to be working.
What is a spam comment? This is a good question. As some of you may know, when my book first came out, I was accused of promoting it on the KneeGuru website and thrown out of their online community. In that case though, I was actively participating in the boards. I went on there and told my story and answered questions. Honestly, I strongly believed that I had a message that needed to be spread that I wasn't seeing anywhere else.
So back to the question: What constitutes a spam comment? What gets a comment deleted? Here are a few things I look for:
* Someone I’ve never seen on the site before, who posts once with a link, and that’s it. That's often a red flag.
* A comment that’s blandly approving (“This is a great post”) or that speaks in generalities but doesn’t really address the post above. Believe me, after a while, it gets easy to spot the spam comments where a person probably making $2.15 an hour in some Third World country is trying to engage superficially with the blog, all the time thinking, “Gotta get this link in.”
* A short comment that has a link, either embedded or at the end, to something like “orthopedic supplies.”
Basically, I apply the smell test to a lot of stuff. I hope I haven’t inadvertently deleted any legit comments. But I strongly suspect that if I have, the ratio is something like one good deleted for every 300 bad.
Anyway, that’s the end of the housekeeping stuff. A Happy Fourth to all!
Richard, on this issue:
ReplyDelete"I may have focused a bit too much on this idea of restoring my cartilage, but I will say: my cartilage was very crunchy before, and it isn’t any longer. So something apparently improved."
The more I think about this and talk to other people with similar symptoms to us, the more I think the cause less about cartilage and more about inflammation - probably mostly synovial.
I wonder if the crunchy sound is one of two things:
1. Inflammation mean the tolerances (spaces) in the knee are reduced = more cartilage 'rubbing' on other structures = noise (and ultimately probably more cartilage wear).
2. Inflammation does actually promote cartilage breakdown = noise and wear.
Either way, getting rid of the inflammation allows the cartilage to settle and 'repair', even though it was not the primary cause of the problem.
The frightening thing is how quickly extremely robust knees with accompanying well-trained leg muscles which are used to very high loads can be tipped into meltdown, and how incredibly difficult it is to get it all back to homeostasis.
TriAgain, you stated beautifully what is so wrong with the 'weak muscles' theory of causation. So many of us were strong, active, healthy people before we developed knee pain. I don't believe there was anything wrong with my quad strength at the time my knee pain set in.
DeleteYes, TriAgain, agree that the descent into hell is like a bobsled ride, while climbing out is lots and lots of slow steps. I'm not exactly sure of the acoustical reasons behind the crunchy sounds in my knees. I do think the cartilage has improved now -- at the very least it has gotten stronger, the way it was before my knees went downhill. Also, I'm guessing I may have had some surface fibrillation, and I think that's gone now. But all of this is just speculation. I do feel that cartilage is in a dynamic two-way state (at least from studies I've read that show defects get better and worse at about an equal rate). And that's good news.
DeleteRichard, I am looking forward to the release of your second edition. That's a great idea. I've often wondered how your knees have fared in the intervening years and would like to read about that.
ReplyDeleteThanks, Amy. The short answer is my knees are pretty good. Today I just got off the bike after riding 51 (hard) miles. I've had a few burning-knees episodes over the years, but I've been able to get on top of them without too much trouble.
DeleteRichard, that's fantastic to hear. I am really happy you made such a good recovery.
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