Anyone Want to Talk About Using a Walking Desk?

I got this comment recently. Lately I have been trying not to sound like a broken record (it feels like I've written about so many topics already on this blog), so I've been sifting through the comment section for ideas for new posts.

Richard - Thank you for publishing your experience and being a resource for us. I've been dealing with pfp for 2 years and it's when I'm sitting at my desk that it's worst. Recently I fashioned a DIY cycling desk at my apartment, which has been effective but nothing helps as much as walking. Curious if you, or others, have invested in a walking desk?

Anyone want to share their experience with a "walking desk"?

I was curious about walking desks -- no, I've never used one -- so I did a quick Google search. They look like a treadmill married to a small, simple table at the proper height. See here for an example.

Hmm. Looks interesting. Prolonged sitting is poison after all, right? I really do believe that.

So here are a couple of quick thoughts from me about "walking desks," and I warn you again: this is coming from someone who has never tried one:

* They look like an interesting idea for people who are already fit. I noticed that in the images that Google brought up, most everyone pictured looked like they could go out and run about 5 miles, no problem.

* For people with bad knees, I'm not so sure, but I guess it depends on how bad your knees are. They remind me too much of my early failed experiment with walking constantly, after I realized that the key to rehabbing bad knees was motion. But I overdid the walking. In a big way.

* So with a walking desk, what happens when you need to take a break? After a while you will get tired. Your muscles will be tired. Your feet will be tired. Maybe your knees will be tired too. Do you shift over to your non-walking desk nearby? Or are you supposed to be walking for an entire eight-hour day? Not sure I'd be keen about that.

Who out there has tried a walking desk, or a similar setup? Want to share what you learned?

When Your Doctor/MRI Speaks a Foreign Language

I got this comment recently:

Hi Richard, not sure if you have any suggestions or experience on exercises or treatments regarding diagnoses of focal chondrosis, narrowing of the patellofemoral joint, subluxed patellas or joint effusion?

Well, that's a mouthful certainly. What's all this clinical jargon mean? (And why do medical technicians and professionals always speak in some baffling foreign language?)

Anyway, here's my take. If I'm wrong, someone feel free to correct me, but I think I'm in the ballpark:

"Focal chondrosis" appears to be simply a loss of articular cartilage. "Focal" suggests a particular location (or locations).

"Narrowing of the patellofemoral" joint is what it sounds like, and was perhaps seen on an X-ray. If there's loss of your protective cartilage, an X-ray will simply detect that the joint space has narrowed. That's because the cushioning cartilage has thinned, showing the bones closer together. Remember: an X-ray can't actually see the tissues, so basically someone infers what's going on based on how far apart the bones are.

"Subluxed patella" seems to be a patella that's mistracking or becoming partially dislocated. On this point, I'd be curious. Is this something that's just been "clinically observed"? Or what exactly is the evidence of this?

There are plenty of reasons to be skeptical when it comes to the role of patella mistracking when it comes to knee pain. See here, here and here, for instance.

And finally we have "joint effusion." "Effusion" is just swelling. So you've got swelling in your joint. D'oh! No big revelation there, I'm guessing.

At this point, what exercises might be suitable?

Well, "effusion" suggests that the joint is being stressed beyond what it can handle. That means that, whatever exercise regimen you choose, it should probably be fairly easy, at least in the beginning.

As for the cartilage loss, this bears repeating: cartilage loss, by itself, doesn't have to be a sentence of knee pain and misery. It does often correlate with knee pain and misery, true. But someone can have knees that feel healthy while having pockmarked cartilage.

What exercises are good for these conditions? You might want to consider activities that slowly build the strength of the remaining cartilage. They could be low-load, high-repetition. And, of course, you want them to be easy (see "joint effusion" above).

Finally, what about the "subluxed patella"? Hmm. A couple of quick thoughts:

(1) It's not really medically significant, even though some misguided doctor/physical therapist thinks it is. In that case, you might want to just try the light-load, high-repetition, and see how it goes ...

(2) It is medically significant. In that case, honestly, you might not get any satisfactory results apart from surgery. "Muscle strengthening" programs probably won't do the trick.

So those are a few thoughts. Others are welcome to comment below. And, of course, remember: none of us has seen your knees. We're just throwing out things to consider. Your best advice, in the end, is really to see another doctor and get that second opinion.