I was hoping today I could announce the second edition of Saving My Knees was out. But alas, while I was downloading it to Amazon's Kindle publishing center, with the new cover and five additional short chapters, Kindle burped up an unfriendly message.
Namely it had found 11 spelling errors.
Now, nine weren’t really spelling errors, but two were legitimate typos, which made me cringe. So I am going to see if my ebook formatter will correct these two, then we’ll be off to the races – for real this time.
Meanwhile, I thought it would be fun, especially for relatively new visitors, to show you the five most popular blog posts I have done. You see, I have access to the dashboard behind this blog, which shows all sorts of nifty details, such as where visitors are coming from and how many views each post has gotten.
The winner, by a long shot, is “If You’re Overweight and Have Knee Pain, You Need to Read This” – 37,363 views so far. Nice!
The others rounding out the top five:
2. Here Are My "Radical" Beliefs About Healing Bad Knees (17,422)
3. "What Should I Do If I Have 'Weak' Knees?" (14,155)
4. Comment Corner: Sleeping Position, Signals From Bad Knees (10,417)
5. Why I think Cycling May Be the Best Activity for Rehabbing Bad Knees (9,220)
One thing I noticed while doing this little roundup: all these posts are from 2011. So maybe, gulp, I’m running out of things to say?
After the second edition comes out, I’ll probably write fewer posts, and just invite people to chat among themselves. It’s always interesting to hear from people out there who are struggling with knee pain, and listen as others try to help them. Thankfully I’m no longer struggling (which is perhaps why I’ve become a bit boring ... ah well).
Now for something completely different:)
ReplyDeleteJust want to share what came to my mind for those who consider surgery. For some of them it may be useful.
While measuring my improvement by trying to enter into half lotus (I couldn't sit on a chair without discomfort even for 10 minutes for 8-9 months!), I just had the following insight. The doctors who recommend surgeries without asking the simple question - Have you noticed any improvement in the last couple of months? - are very unprofessional to use a mild wording.
The last guy who recommended surgery to me was 3-4 months ago and since then I made a massive improvement (knock on wood). I may still need surgery for the soft tissue damage I have, but to my mind to have surgery before the natural cycle of healing is still going and uncomplete is just appalling.
All the best to everyone struggling with their joints!
Agree entirely Sveto. Most OS's seem to be one-trick ponies!
ReplyDeleteThankfully, mine was not, and advised against surgery for PFPS, though he did not really have an alternative solution - unlike Dr Scott Dye who knew the process which should be followed.
BTW have those bands of Eds made it to Bulgaria yet?
Glad you got my meaning despite the lousy English, TriAgain:) Just read what I wrote again LOL
DeleteStill waiting for the bands.
Meanwhile, once I got the upper hand in the fight with inflammation, the total trainer started working miracles for me at once. I got more improvement for two weeks than the last 2-3 months combined. In all fairness, perhaps this was just a tipping point that is based on other right things I've done previously.
Let's see how far this can go. I will report back soon. Let's say in a year from now:) But so far I find TT quite precise in measuring the loading and controlling the movements.I can work with emphasis on certain problematic positions, which is something walks cannot do for me.
For the folks who want to give TT a shot, I have to say that old, basic models are very cheap. Got mine for 50 Euro. The thing just needed to be tweaked a bit so the feet could have a solid footing.
TriAgain, today when I got into half lotus for some minutes with my "better" leg on top and there was complete silence in terms of pain&symptoms, I almost got moist when I thought how much help&encouragment I got from the correspondence with you, the two Amys, Racer as well as this blog, Dr. Dye and now Doug Kelsey's idea about this device.
It took about 14-15 months to be able to sit cross legged again without pain in my left leg. Crossing fingers, the more problematic right leg just needs some more years of healing to be able to get in this advanced postures again without pain. Not sure if that is possible but for the first time in a long while, I dare to dream again!
Sounds encouraging Sveto - though that phrase 'almost got moist' is not encouraged downunder in Oz...or at least not said unless everyone has had way too many beers (lol!). I'm about to head out for an hour on the mtb. I've gone over to the dark side, and though I still ride the roadbike, I enjoy far more flirting with disaster on the mtb single-track. Hope those bands arrive soon - will be a good test of the mail speed from Oz to Bulgaria.
DeleteSveto, I am thrilled to hear you are experiencing continued improvement. That's really fantastic!
ReplyDeleteThis is my story of PFPS and chondromalacia patella, based on a year long (seemingly never ending?) experience.
ReplyDeleteI wanted to share my story because I hope that people who have a similar problem might find a solution.
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1.Beginnings
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2 years ago at the end of the summer I started doing long (+50min) runs, which caused a stress fracture in the
first metatarsal of my right foot. I went to an orthopedist and he confirmed this diagnosis with an MRI.
He suggested that I wear a boot or use orthopedics to relieve the stress on the fracture so it could heal without a boot.
I went with the orthopedics and although they helped to relieve stress and pain, it took a long time to get used to them and to get the stress fracture to heal.
1 year later me and my girlfriend decide to buy some land and start construction of our house.
My father, being an almost retired construction worker, suggests we do most of the work ourselves to save money.
Construction starts and every saturday is spent from 7AM to 6PM at the construction site. About a month ahead,
I start noticing my knees being sore on sunday and even a few days further. I also notice I limp when I have to walk alot;
there appears to be a period I can walk normally, followed by an annoying feeling in my knee (like there's something in there where it shouldn't be)
which only stops after there's a sudden but silent pop in my left knee.
Having almost no experience with injuries and recovery time, I thought I needed to strengthen my lower body.
Unfortunately, I began with squatting and deadlifting with too much weight. A few training sessions later, I decided to go to my local doctor
because my knees were really sore and the limp became worse. He said that with some IBUPROFEN, suspended training and limited action on saturday I would be fine.
Unfortunately, this didn't work and a few weeks after I convinced him to see a specialist in the hospital, to discuss an MRI of my left knee.
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Delete2.Patella Femoral Nightmare Syndrome
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The specialist diagnosed me with chondromalacia patella grade 2 on the lateral sides of my left knee and said that it would be
best that I should avoid squatting entirely. He said I could last with the current amount of cartilage
if I'm careful, but ensures me that cartilage doesn't heal. Thinking this diagnosis to be final, I fixated on resting to speed up whatever healing was left.
While I'm 'healing' I continue to go to the construction site, under pressure of my family, because they think it's impossible that a 25 year
old has knee problems after being healthy all his life. After all, what is 1 day of hard labour a week, I had the rest of my week to rest, since
I don't have to do much walking at work. Sadly, my father thinks I'm being rediculous because he has arthiritis in several places
and he thinks I should just suck it up and pick up the pace. At one point I was so scared of doing more permanent damage to my knees, so I asked for a 2nd MRI.
To everybody's surprise, this came back completely OK; my knees were supposedly 100% healthy. This left me very confused and made me wonder
if my family wasn't right, maybe I was exaggerating?
At this stage my life became a nightmare; every saturday I would go to the construction site, only to spent the next few days with
numbed knees and if I was unlucky, my knees would 'wake up' and have a burning sensation from the slightest increase in activity.
Every distance I had to walk was calculated, because I had to rest and I was afraid to trigger the burning sensation in my knees.
You might think I'm exagerating but those who have ever experienced PFPS and/or chondromalacia can probably confirm that the quality of life
is affected in a huge way. I can't stress enough how depressing it was to see all my hard earned rest from an entire week be blown away by a single day of (limping) work.
Somewhere in this nightmare there was a calm period where I had 1 month of rest. I thought that would be the end of it, because I always
said to myself that if I just had a few consecutive weeks to heal, I would be rid of this condition for good. All hope was immediately lost
when I tried to go back to the construction site and my knee pain returned. After that I thought I would remain crippled
for the rest of my life so I hoped for the best and underwent the torment of everyday knee problems. Depressing thoughts
were always close by, which affected my personal life and my work. I really wasn't a pleasant person back then, but it's hard to be
happy when you are constantly reminded of your shortcomings. After all, you have to walk all the time so you have plenty of reminders.
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Delete3.Second wind
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That would've been the end of it if I hadn't decided to go to a different podiatrist to adjust my orthotics. Instead she suggested a biomechanical analyis,
to identify the true cause of my knee pain. Up until that point it had nevery occured to my that maybe the problem wasn't directly located in my knees,
but that they were only the victim of another dysfunction. I found her way of thinking interesting, and agreed to have a scanografy of my lower body,
to look for a leg length discrepancy. The first scanografy showed my right hip being slightly 'pushed up', though the length of my legs was almost the same size. (<0.5mm difference)
After that consult, I started to self diagnose more often because I was tired of all the waiting and didn't have that much faith in their way of working.
I thought it was depressing to see that the problem I was experiencing could be fixed if somebody took the time to properly go through my kinetic chain
and look for a dysfunction. Sadly, no doctor seemed to be able to do that, let alone take more than half an hour per consult.
They just said that I needed to rest and learn to live with any permanent damage that had occured.
With the information of the first scanografy I deducted that I had a functional leg length discrepancy (my right was functionally shorter),
so the logical explanation was that my left leg was trying to make itself shorter by overpronating. This caused my limp and aggravated knee.
So I went to a chiropractor and together we worked to release my right QL to even my hips. For a short while, I thought I had found my 'cure' because things were going better.
Unfortunately this happened in a period where I had another few weeks of consecutive rest so looking back I think that my feeling of getting better was false,
and it was mainly the resting that helped me.
So after the rest period my knee quickly worsened when I worked a few hours on the construction site, even though the chiropractor said that in my current state
it shouldn't have been a problem. I had 2 other scanograms and to my surprise 1 contradicted the first, while the 3rd agreed with the first. This put me close to a depression,
but I was still determined to find the solution to my problem. There had to be a dysfunction that was causing this, I just hadn't found it yet.
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Delete4. Laying the groundwork
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What followed was an almost religious training schedule I followed that would excercise my lower body every other day. I looked for signs where
I was weak and found that my glutes (espescially my left glute) had almost no activation at all when walking or cycling. In contrast, my adductors were very tight.
So I focused on strengthening my glutes by doing clams and monster walks, supplemented with excercises for calves, quadriceps and hamstrings. I even
started to cycle to work, becayse it was just far enough to avoid the burning knee sensation en give me some much needed cardio.
Stretches included hip openers (pidgeon stance) and seated adductor stretches. Doing these stretches were also a major game changer!
While getting my lower body back on track, I sometimes experienced some slight discomfort in my first metatarsal.
I did some research and found that stress fractures typically don't take that long to heal and orthotics usually don't have to be worn forever.
I figured almost 1 year and a half was long enough, stopped wearing my orthotics and tried to strengthen my feet by walking without shoes as much as possible.
This wasn't advised by my podiatrist; she wanted my to keep wearing orthotics, but new ones that she would make to provide extra support for my metatarsals.
At first, the tendons and muscles in my feet complained and my first metatarsal of my right foot was a bit sore after a full day but this gradually improved.
Upon later examination, the podiatrist said that the reason my first metatarsal was getting better is that while the orthitics let my stress fracture heal, the bone itself
might have been weak by insufficient exposure to stress. By walking without the orthotics and slowly regaining my 'old' way of walking, I was
healing my stress fracture once and for all.
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5. Last piece of the puzzle.
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All in all my legs were getting stronger, but the slight 'pop' sensation of my left knee was still there if I walked too much. Too much hours on the
construction site still lead to a few days of minor discomfort, so I was certain that there was a piece of the puzzle missing. If it wasn't my glutes,
adductors or feet, which was causing that annoying limp?
The final piece of the puzzle turned out to be my job. I work in IT and that means I sit 80% of my time.
I read somewhere that sitting a lot of might cause the biggest hip flexors to tighten and that in turn might cause issues at the knee. To explain further:
a tight psoas might cause your femur to externally rotate too much, while your lower tibia wants to do the opposite b/c of he pronation of your foot.
I did the 'Thomas test' and concluded that my left psoas was very tight, so I started including psoas stretches into my routine. The first day I started
was an immediate relief in walking and pain. During the day I felt a tingling sensation in my left psoas, which was probably the reduced tension of the muscle.
Thus by combining all of the excercise (training schedule, hourly 5 min walks, cycling to work & stretches) I can finally walk normal again.
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Delete6. Reflection.
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If I look back at all the professionals I consulted, not one of them really came close to solving my problem. Hell, if it were up to them,
I would have avoided (much needed) excercise and would still have my orthotics to 'ensure' my first metatarsal wouldn't have a stress fracture again.
It seems really likely that somebody who isn't used to scanning the internet for possible (correct) information would comply with their terms and be limited all their lives.
And who knows, maybe in some cases their patient will get 'better' because he isn't really that active anyway. It just frightens me that,
for example my podiatrist, would've given me orthotics based on the way I walked, without looking at the full kinetic chain. One can also argue that
this many doctors/consults should have given me a definite answer, without all of my own research.
-Professionals/consults:
5 house doctor consults
4 knee specialist consults at the hospital (2 MRI's)
1 physiotherapist
5 chiropractor consults with 2 separate chiropractors
2 podiatrists
I personally think PFPS 'scares' doctors because it is an umbrella term and many don't want to spend the necessary amount of time to find and solve dysfunction(s).
To be fair, solving PFPS is a time consuming, trial and error process but one that is very rewarding, seeing that the quality of life improves greatly
when finding the solution. I would've gladly given more money to a doctor to have him examine me properly, instead of having x short consults getting nowhere.
7. Advice
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So anyway, I hope I have made some sense and I apologize for any typo's in this story. Some general advice:
Don't give up!
Don't be afraid to second guess your doctors
When/if self diagnosing, don't jump head first into every possible diagnosis; there is a lot of (contradicting) information.
Be determined to figure out what is wrong; otherwise you might set yourself up for major discomfort!
When cycling, set your saddle a bit higher then normal to ensure glute activation and avoid extra stress on knee.
Be patient, knees take time to heal and muscles take time to grow.
Consider all options before you take surgery or injections!
Be religious in your physical therapy schedule