Saturday, August 10, 2019

Are You Mentally Ready to Beat Knee Pain?

I was pondering this question recently, because it occurred to me that beating knee pain depends first of all on being in the right mental state. Specifically, there are four traits you need.

(1) You need to be receptive to the right message.

I’m not even saying, arrogantly, that it’s necessarily my message. I’d like to think that my message makes a lot of sense. But maybe you disagree. Or maybe you like parts of what I have to say about understanding and healing from knee pain and dislike others.

Nevertheless, you can’t shut yourself off from being receptive that the right message will come along. If regular physical therapy doesn’t work for you (as it didn’t for me), giving up shouldn’t be the default option. The default option should be to study other types of treatments and thoughtfully evaluate them, and keep pushing forward.

(2) You can’t be consumed with negativity.

This seems obvious, but it’s easier said than done. Most people who have tried a lot of things to overcome knee pain, failing many times along the way, become deeply discouraged. That’s not surprising. When something new is suggested, they might think, “Might as well try it, because everything else has failed.”

That heavy negativity weighs you down and prevents you from giving a new treatment a fair chance. Negative people tend to flit from one cure to the next, in manic depressive style, and never stick long enough with something to learn anything useful from it. How many successes do “I can’t do it” people have versus those who embark on new programs with hopefulness, even when things seem bleak?

(3) You have to be prepared to think “outside the box.”

Thinking “inside the box” has failed a lot of knee pain patients over the last few decades. The conventional prescription of muscle strengthening around the joint doesn’t work well for those with really weak knees. It just trashes your joints. And you figure that out quickly, unfortunately.

So what do you replace it with? You should be ready to look at creative, sensible alternatives that maybe aren’t part of a typical physical therapist’s playbook. Discoveries aren’t made by people entranced by the status quo; they’re made by those who dare to think differently.

(4) You need to possess a certain stubbornness, patience and will to persevere.

Healing from knee pain can take a long, long, long time. That’s what I learned. Luckily for me, when I set my sights on a goal, I pursue it with a steady, single-minded determination. And there are other people whose stories appear on this blog, who have shown an even greater singularity of purpose along with complete devotion to doing whatever it takes to get better. And they make the time it took for my recovery, over more than a year, seem downright fast.

Sure, even if you have these four traits, there's a lot of other things you need to do. But I think being in the right frame of mind is where you have to start.

19 comments:

  1. Thanks for this, Richard. It's really important to take the long view and not get discouraged. I know first hand that never giving up on a mysterious chronic pain condition can pay off. For a decade I had daily urinary pain that was very distressing and disruptive to my life. I went from doctor to doctor, all of whom examined my bladder and told me everything looked normal and sent me on my way. To make a long story short, after 10 years of this I figured out on my own that the problem was my posture: for years I had terrible sitting posture that--unbeknownst to me--was compressing a spinal nerve in my lower back that was connected to my bladder. It took me a long time to make the connection because I didn't have any back pain. The pain was referred. I corrected my posture and my debilitating bladder pain disappeared. That was several years ago and I've been fine since. I figured out the lower back-pelvic floor problem after lots and lots of reading and closely monitoring my habits and how they were affecting my symptoms. The moral of the story is that while conventional medicine is a good ally, doctors don't always have the answers or the patience to work with you over the long term, so you have to be your own advocate. I've been to multiple specialists on two continents about my knee pain and they all give me the same advice, which hasn't helped (physical therapy focused on muscle strengthening). None of them has been able to tell me what's causing the pain in the first place. But I have faith that there's as solution to this problem and that some day I'm going to figure it out. My previous experience gives me hope.

    Cheers,
    Pax

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  2. Hi there, some great posts lately, may i ask a question: is it possible to actually get a clear diagnosis? Everyone seems to know what they have but i'm just being tossed around from pillar to post with no clear diagnosis. i have seen the doctor, had a blood test, xray and seen 2 physios - and still no diagnosis.

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    1. Craig, you're actually in good company. A lot of us have been diagnosed with "patello-femoral pain syndrome" aka "chondromalacia patella", which is no diagnosis at all. It's just another way of saying "you have chronic pain at the front of your knee with no clear cause". The cause of the pain is probably different in different people. That means the best treatment probably also varies from person to person, which explains why some people respond well to something that doesn't help others at all. That's what's so frustrating about knee pain; it's just this big diagnostic black hole. All I know for sure about my nagging left knee pain is that it was triggered by a lot of hill running four years ago. That's it. I don't know what happened to me or what will get rid of the daily pain I have experienced ever since. I have seen multiple specialists who performed many tests including imaging studies and arthroscopy and are still unable to satisfactorily explain why my knee hurts. It's always some version of "it's a biomechanical problem and you should do physical therapy", but they're really vague about what the problem actually is and the physical therapy they prescribe just exacerbates the pain.

      Pax

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    2. Richard, thank you so much for starting and maintaining this blog. I'm a firm believer that we are our own advocates when it comes to our health, and having found a website like this that allowed me to cure a decade-long bout with asthma, I hoped I'd find a site like this to help me with my knee issue.

      I'm being told I have no cartilage at all in one of my knees. My doc says I shouldn't even be able to walk on it. My first question is, do you think there is hope for someone who has been told there's no cartilage left? I walk pretty well, nobody knows I have pain. Usually it's only getting up and taking the initial steps that cause pain. I cannot fully extend my leg, nor can I kneel, because I can't bend at the knee. That's annoying because so many things require squatting down.

      I also have a soft bump on the outside of the kneecap that is tender when I press on it. Tender in the same way trigger points are tender when you press on them. Any idea what that could be?

      I've noticed that the pain in my knee is better if I work on massaging the muscles behind the knee. I guess they're tightening up to compensate.

      Thanks again for all you do, Richard!

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  3. Hello! This is "Knee Pain" checking-in with an update and with a question for our community!

    (For those of you who don't know me yet, I've been struggling with knee pain for many many many many years, BUT.... finally after a few ups and many catastrophic and debilitating lows, my knees are doing really well and seem quite healthy!)

    My update is that my knees are doing SO WELL that I have finally gotten back to my beloved Lindy Hop (a type of swing dance) and also Rotary Waltz. These had been two activities in my life that I missed the most when my knees were so bad. (Well, in addition to biking, hiking, and ....hello..... even just plain walking!!!) I started off very cautiously in May and.....so far it's going well! Now i"m going dancing twice per week! I'm SO grateful and so happy. I'm not even wearing a knee brace or anything!

    So, here's my question!!

    Is there any link between suffering from debilitating knee pain and.....Plantar Fasciitis (inflammation of the tendon on the bottom of the foot)?

    Here is why I'm asking!

    My history of knee pain is that I've always only had the knee pain in my right knee. And, I've been favoring my right leg for YEARS -- meaning, my left leg has been working overtime and the right leg has hardly been used. I used my left leg to bear my weight going up and down all stairs and also curbs on the sidewalk. Even when i stand I put most of the weight on my left leg.

    Anyway, finally around 2014 I started developing Plantar Fasciitis BUT ONLY ON THE RIGHT FOOT.

    So..... I'm highly suspicious. Is there a link between my under-use of my right leg due to the right knee pain and developing Plantar Fasciitis ONLY on the right foot??

    (Initially, i didn't make any connection, but, it's been going on SO LONG and finally i thought....hey.... i wonder if there is a connection?)

    And.... here's another thing...even though I was finally able to get my knees in pretty good health....the Plantar Fasciitis in my right foot just won't go away. And... I'm a little suspicious that maybe over the last many years I developed a "way of walking" to put less strain on my right knee....but, now it's causing or aggravating the Plantar Fasciitis.

    So, I've had this now since about 2014/2015. and, in some ways it wasn't a "huge deal" back then because I wasn't walking or using my legs much anyway because of the knee pain. BUT!! Now I'm able to be active! I'm able to walk, hike, bike, and DANCE!!!! But...I'm in Pain when I do all these activities. For example, after about 2 hours of dancing i just can't tolerate my foot anymore and I have to limp away home slowly -- my foot is killing me. (But, I dance anyway because I'm just SO HAPPY to be able to dance again with my healthy knees. But, i'm going to have to stop or slow down because I think it's making my foot worse.)

    So! I wanted to see if Richard or anyone out there also thinks it is highly suspicious to have ONLY Right Knee Pain and then... ONLY Right Foot Pain.

    I think this also links to a larger issue of.... what happens to the rest of our bodies while our knees are painful and we can't do too much physical activity. That leads to other problems, too, right!? Now that my knees are doing so well, I feel like i'm having to rehabilitate my whole body and get
    it to be stronger. Also try to work on my heart & lungs (i.e., cardiovascular health)

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    1. PS! One might think that since I was able to finally bring my knee back to health, I should be an "expert" at this "patient healing thing" and thus be able to solve my foot problem.

      Sadly, no!

      This foot problem has been dragging on for YEARS! Ugh.

      I should do a search to see if anyone has written a book called "Saving My Feet." :-)



      (Actually, I have watched several YouTube videos by people who say they have cured their foot by doing X or Y or Z, but, so far that has not helped me. I'll keep trying.)

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    2. PPS! Although having this plantar fasciits is pretty tough and limits me, but..... it's nothing compared to the pain and devastation and debilitation of the Chondromalacia Patella / PFPS.

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    3. Wow! Sounds like you have done great! So happy for you! I haven't heard of that foot injury so I cant help i'm afraid. Do you have any tips for how youve saved your knees?

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    4. Hello Craig h!

      Thank you! I hope I have finally arrived at Victory over my knees.

      BUT, I need to keep reminding myself to be vigilant and never stop trying to KEEP my knees healthy.

      You asked me for tips. Every time I try to write a short answer, I end up writing a novel.

      However! For the very first post of January 2019, Richard very kindly wrote a blog post summarizing my situation as a "success story." I was so astonished. So... please click back in time to Richard's post in January 2019 about a success story and ... that's me!! In it, I talk about what helped and what did not help.

      I've been plagued by this knee pain for DECADES.

      And... if EVEN I can overcome it and finally arrived at point where my knee joint is this healthy and where I am pain-free and I can do "regular" sorts of activity like dance and bike and walk .... well! I have high hopes for everyone else who is struggling with this as well.
      And, I hope it does not take you AS LONG as it took me!

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    5. Knee Pain,
      I have no cartilage in either knee, but my pain is in my Left knee due to a hyper-extension a few years back. I've greatly improved due to low resistance riding on my recumbent. It varies, but I am SO thankful. I, too, have developed pain in my Left foot. It might be plantar fasciitis. I'm not sure, but my pain is in the arch of my foot. I wear Crocs a good percentage of the time. They seem to be the most caring towards my foot troubles. Hoka for walking, but they don't bear up as well for standing while making dinner, etc.

      Keep dancing with joy!

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  4. Recently I have been diagnosed with Crohns disease. One of the symptoms of Crohns disease is joint pain. It is very possible that my knee symptoms were the beggining of Crohns disease. Any thoughts? Sorry for of topic post.

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    1. Interesting. I don't know much on the subject, so I'm probably not the best one to comment. Anyone here with Crohn's? I do suspect that inflammation, after a while, likes to wander around the body and cause mischief, so a link to Crohn's does sound plausible to me.

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  5. hey Richard why do you share so few articles people are eagerly waiting for your posts but you are writing less

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    1. Yeah, I was really hoping I'd get an answer to my question above, but I guess he's not replying like he once was. Will try to find another source of information but most of what I've come across is typical - you NEED surgery. OH well.

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    2. My Internet died a couple of weeks ago, right before the weekend! So that put a crimp in things. In general though, I'll probably try to post less because, really, I've mostly said what I want to say. I'm probably starting to repeat myself a lot at this point.

      MamaLM: Sorry, not sure what that bump is. As for the "do I have hope if I have no cartilage left in one knee"? Well, sounds like you are managing surprisingly well. So that's a good sign. Other than that, I might think about three things: (1) losing weight if you're overweight (2) considering doing some very easy low-load exercises for that bad knee (like Doug Kelsey's "sliders") and being careful about not putting too much force on that knee -- you have a tough hill to climb, so to speak, with that joint (3) getting to know "Shyla" (see a few posts above) as she apparently doesn't have cartilage in either knee and is making some great progress.

      Good luck!

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    3. Thank you for your reply, Richard, and so sorry to hear about your internet problems. I've read Shyla's posts and find them inspirational! Thank you, Shyla!! Will check out Doug Kelsey's sliders and other low-load exercises. Much appreciated!

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  6. Is there any use of pregebalin for mental and physical knee pain and seeing benefit

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  7. Do you think you have a blog about patella femoral syndrome? what are you doing

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