Do you think I will be able to play football again? It gave me purpose and a social circle. I am desperate to play again. I understand it is a long recovery process, and I am willing to be completely disciplined and dedicated to that. Whilst in recovery, would you recommend wearing knee braces? My last question: out of the three books recommended in 'Saving My Knees,' which are: Scott Dye's Envelope of function, The Doug Kelsey book and 'There Is A Cure For Arthritis', is it important I buy all of them? And which book should I read first?Okay, the easy stuff first:
Wear knee braces or not?
I’m somewhat skeptical. The ones that probably do make a difference in terms of knee support are expensive and make you look like a cyborg. The ones you can buy at Walmart (or even some high-end stores) aren’t doing anything to reduce the load on your knees.
However ... as always, your mileage may vary. You may get a placebo effect. Or, as I mention in this post, there could be a different beneficial effect. Neoprene sleeves are thought to help by aiding proprioception. That big word describes your body’s sense of how it’s positioned in space. Better proprioception might mean better balance, which could improve knee stability.
Which books to buy?
Scott Dye has no book on envelope of function that I know of. However, you can probably find some of his papers online. Still, I wouldn’t even bother chasing down one of those. You’ll get an adequate sense of envelope of function by searching this blog or from Doug Kelsey’s “90 Day Knee Arthritis Remedy” at Doug’s website.
Will I be able to play football again?
This is the question I wanted to address.
The answer is a definite maybe. That’s the best anyone can tell you. Anyone who says otherwise is probably a charlatan or a fool.
I wanted to pull out this question because many active people ask it. They want to know, “Will I ever be able to dance/bicycle/rock climb/whatever again?” For me, it was ride my bicycle, of course.
I tried hard to get back on that bike as soon as I could. I got back on the bike before my knees were ready. I tried biking, failed, tried biking, failed.
To get better, I think you have to move beyond that question of “Will I ever be able to participate in my favorite sport/activity again?” You have to accept that the answer might be “no.” You have to look for new physical activities that won’t stress your knees that you can do in the interim.
I gave up on biking for a while, after even easy cycling disturbed my knee joints. So I decided not to even think about it. Pushed it out of my mind. I told myself I could be happy just being able to go for long walks. Once I made my peace with that, I no longer was focused on, “When will I be able to get back on my bike?”
Before then, I had been rather obsessive about cycling. But sometimes you have be prepared to move on. I did, and then when I got better, many months later, I rolled the bike out of the driveway, took a deep breath, climbed on the saddle, and slowly off I went.
So maybe you can play football again (which I assume is what we Americans would call soccer). But for now, you might want to think about pushing that thought far out of your mind. That tends to make things easier during what can be a long recovery.
Well, I've to disagree that it is not worth chasing the online papers of Dr. Dye. In fact, I think it is worth finding everything available. While Saving My Knees and Doug Kelsey's work outline some of the main principles relating to EoF, Scott Dye has some crucial points that are missing or understated here.
ReplyDeleteThe value of rest for example. Also, what Racer calls aiming for short recovery. This is not only to establish a proper loading but also implementing 24-48 hours of rest afterwards so the blast of inflammation can settle down and give a chance of the tissues to adapt. These principles have been crucial for me.
I keep on restoring my muscles and improving.
Good luck everyone!
A great post and also interesting view from Sveto. I will look down all avenues. I went to the physio and she seems to think I have Patella Tendinitis, so i'm all very confused now. She is also recommending I do squats, which I just cant see being a good idea, as well as telling me to wear patella tendon straps. Any advice/opinions? I don't know weather to discharge from her therapy and just follow the kelsey book etc or carry on with her and risk further damage. My knees feel fragile
ReplyDeleteI hope you have read the book of Richard because if you have read it you would probably say no to do squats. I have read many success stories and I only know one person (a guy who has a wordpress blog named as "The Inscape") that healed through using knees with high loads such as running. All the other knee patients healed through staying in their envelope of function. And many of them failed through standard physical therapy programs which include squat, leg press etc.
DeleteAccording to my knowledge, patella straps works temporarily because straps somehow stop the impingement of soft tissues which create pain. This is just a theory since it is impossible to know for sure. I personally did not use any strap since I have no tracking issue at my patella.
Good luck
I also wanted to make some comments to contribute the post. I will be careful about making statements even if I mention as “I think" since what I believe or think can be risky for my/our knees. An example from near past is that I strongly believed that healing with working is possible but I tested it for the second time but I somewhat failed both physically and emotionally. I think we should get used to "maybe"s as Richard mentioned above. And yes, living through uncertainty is very hard.
ReplyDeleteKnee braces;
I used Genumedi E+motion knee brace for the first 4 months of my injury while I continued to do sports without knowing that my injury will develop into anterior knee pain in time. I really like this knee brace since it has really good, knitted pieces at sides which act as a muscle. I feel pretty relieved when I wear this product and this relief can come from feeling confident psychologically via strong support. It is a German product and it has silicone quartz pad which encloses the patella. I do not wear it everyday but I wear it if I have more pain at that specific day.
Link for the product: https://www.mediuk.co.uk/shop/genumedi-e-motion-knee-support.html
Books to buy;
I still did not read the book of Doug Kelsey. I cannot buy it from my country via Amazon. (I would be grateful if someone help me about this issue) So I do not have an opinion. But Doug Kelsey mentioned to to me that this book may not be the book for synovitis patients. (My diagnosis is synovitis)
I think that other book is for patients of arthritis. According to my story, I possibly do not have (rheumatoid) arthritis. I scored negative for all of the tests of Rheumatology doctor/department. I also have a negative bone scan (bone scintigraphy). So, I read papers about arthritis only if I want to get opinion from a similar health problem.
I have read all of the papers of Dr. Scott Dye since I really like the theory of envelope of function which also resembles with the story of Richard. And I also know that he has no book about the subject. I can recommend following papers if someone want to dig in to the subject;
* The Knee as a Biologic Transmisson With an Envelope of Function (1996)
* Conscious Neurosensory Mapping of the Internal Structures of the Human Knee Without Intraarticular Anesthesia (1998)
* The Mosaic of Pathophysiology Causing Patellofemoral Pain: Therapeutic Implications (1999)
* The Pathophysiology of Patellofemoral Pain: A Tissue Homeostasis Perspective (2005)
* How to Deal With Anterior Knee Pain in the Active Young Patient (2016)
Returning to sports;
I still cannot run, cycle, jump, do snowboarding, do weight training. (List goes on like climb, do capoeira, do tai chi quan and do lotus position for meditation) I know I can do them for 10 minutes or maybe even for an hour. But tomorrow can be a disaster for pain, so I do not try them. (It has been 16 months from the first injury and 12 months from the start of my anterior knee pain) What I can do now is trying/waiting to be well and empathizing for other knee patients. I think we should try to accept and adapt the current situation to heal and get better as Richard also mentioned in his book at the last part of 8. The Experiment in his book. Other success stories also have this acceptance part.
Why do you say that your knee pain will develop into anterior pain in time?
DeleteHi, this comment isn't directly related to the article but I'm not sure where else to put it.
ReplyDeleteI have very slight knee pain from taking an intense spin bike course, and running a few times. The pain is very slight, but I am only 21. I want to start exercising my lower body more but I am worried about injurying my knee worse and falling into the dark pit of physical therapy. I was already diagnosed with Patello-Femeral Pain Syndrome and given exercises that caused more slight pain. Not sure if that's good.
Basically I'm wondering is strengthening the quads ever a good idea? Is it something you should focus on when exercising? Thanks
And if not what are good exercises to add to an exercise routine for the lower body?
DeleteIn my opinion, for my own situation, the physical therapy exercises were still intense for my knee joint. For example, they wanted me to do quad strengthening exercises, but even those were just too much for my knee joint.
DeleteInstead, what seemed to work better for me was to first do low (or no) weight exercises with high reps of gently bending the knee. Meaning, don’t put weight on the knee joint, but get it moving. Such as sitting on a bike and slowly peddling. This can be an upright bike in a gym or s recumbent bike in a gym.
Or in my case, I found that doing the “bike pedaling motion” while floating vertically in deep water was very helpful and I mysteriously just enjoyed that more. (And I also started off with a neoprene knee brave and then built up to take it off).
My understanding is that The theory is that this will thicken the synovial fluid in the knee joint. And having a thicker synovial fluid helps cushion the knee joint and helps everything slide better in there. Then. Over time.... can start exercising with a low percent of body weight. Then over time build up to slightly more. Slightly more.
In my case, the tendency is to want to hurry the process along. But then that just caused set-back after set-back. So so frustrating.
Best of luck.
I get DD Kelsey's newsletters in my mail box. A while back, he had a post in which he recommended a VIP (vertical incline plane) machine as his best exercise purchase ever.
DeleteIt allows you to do squats without the full weight of your body.
So we purchased a Total Gym 1400 about a month ago. I've been riding my recumbent regularly to ease my knee joints. When it does, I will immediately replace it. It has been the best medicine for my recovery from a hyper-extension that nothing else would touch, and the subsequent discovery that I have no cartilage in either knee, per my MRI.
I can now do squats! I am hoping that this will help build muscle. Kelsey's article came right on time, as I was beginning to look around for something to help me on that front.
For reference, my injuries happened in late Oct 2017. I came across this blog shortly afterward and ate it up. PT was no help and no doctors seemed to have a clue about my anterior knee pain and lack of full extension. After reading all I could, I told myself that it was probably going to take at least a year, maybe two. I'm 1.5 in and work at it just about every day. I'm so grateful for this site, and my progress.
Keep at it! Low impact, tolerable repetitions in your envelope of range with adequate rest.
All the best!
Does anybody know if there is a way to find out EXACTLY what is wrong with your knees? As i hear X rays and MRIs are useless
ReplyDeleteI think that it is impossible to know for sure what is happening in the knee of a specific person that creates pain (with the current imaging techniques) unless the knee is opened in arthroscopy/surgery.
DeleteThere are possible ways to interpret what is happening through MRI and bone scintigpraphy but these imaging techniques cannot show inflammation of soft tissues. Therefore, answer to your question is no.
For example, my MRI result shows that there are grade 1 chondromalacia patella, grade 1 degeneration at posterior horn of meniscus and liquid increase in suprapatellar bursa for both of my knees. Therefore, a person without any knowledge in knees can interpret that something bad is happened to my knees. But many orthopedists in my country did not able to explain my pain with these MRI results since they follow standard literature which only searches for a structural failure like ligament tear or bone fracture.
I hope I could give you an idea for the current situation.
Hello. I’m not sure why my “knee pain” profile image is no appearing. But. I wanted to share more good news!!
ReplyDeleteI am so excited to say that after so so so so many years of knee pain, I’ve FINALLY been able to get back to two of my most beloved hobbies which are the waltz and Lindyhop styles of dancing. I took a two-hour waltz lesson last weekend in order to refresh myself with the main moves. Two Hours!! And I have also partaken in two Lindyhop dance outings with a lower quantity of time.
These styles of dance both put a lot of torque on the knee joint because of all the spinning & pivoting. And. My knee did absolutely fine. I didn’t even think about my knee. Which is miraculous.
For the two days after the waltzing, my knees did speak up a teeny tiny bit saying “hey, what’s going on?” However, I was never really worried. I was pretty confident that it was not going to be a full-on flare up. And I was right!!
How I responded was to keep my knees gently moving by walking normally through my day, but not do anything too crazy.
It’s taken me 12.5 years to get back to waltzing. Which is really kinda heartbreaking that it’s taken so so so long. But. At least now I finally have waltzing and Lindyhop back in my life. I’m so grateful!!
This is wonderful news! I know the missed years of dancing bother you, but I am so happy that you can resume a treasured sport once again.
DeleteThank you! I wrote my comment back in May. Now it is Mid-August and I've built up to dancing TWICE PER WEEK! I'm so thrilled!
DeleteI like Doug Kelsey's explanation of the "envelope of function" the best. His includes a "functional zone", "adaptive zone" where you can build back "joint strength", and "failure zone" where damage occurs.
ReplyDeleteIt helps understand that you can stay too low in the functional zone and stay the same, but never improve. The trick is finding that adaptive zone.
The linked article talks about back pain, but the diagram in it is the same regardless of the joint:
https://dougkelsey.com/running-hurts-lower-back/