What’s the Relationship Between Knee Pain and Cartilage Damage?

Ah, what an interesting question. Early on, I tended to think that, where there was chronic knee pain, you’d find damaged cartilage in the joint.

Of course, not in all cases. But in very many.

However, after I learned more (and heard more personal stories from all of you), I modified that belief. People who have knee cartilage that appears perfectly fine get terrible knee pain sometimes. And people with potholed cartilage can have pain-free knees.

But – here’s the but – I definitely think there’s a high correlation between knee pain and bad cartilage. One does not necessarily imply the other. But there is a good likelihood that if you have persistent knee pain of difficult-to-determine origin, you have issues with the cartilage in the joint, or vice versa.

In fact a recent study, looking at 565 people who had a knee arthroscopy, supports this:

Published results showed a strong association between patient-reported knee symptoms and the burden and severity of underlying cartilage damage rather than with specific meniscal pathology ... researchers intraoperatively confirmed and classified the diagnosis of meniscal pathology and concomitant cartilage damage.

The researchers found that “the mean average symptom score increased with the severity of cartilage damage.” Also, there was a relationship between the number of compartments where damage was found and the intensity of symptoms reported.

When there was damage in three knee compartments, there was more frequent catching and locking of the joint, as well as grinding and clicking symptoms. Women and heavier people (a BMI of more than 25) were more likely to have more widespread cartilage damage.

The good news is that cartilage doesn’t have to be restored to a pristine state to get rid of bad knee pain, I believe. So, in the end, “damaged cartilage” shouldn’t mean you’re stuck with those bad knees forever!

I Love Success Stories! Here Are Some You Should Read.

It's easy to get discouraged when trying to heal your knees from chronic pain. One step forward, one step back ... when will it ever end?

It's comforting and uplifting to hear occasionally from people who have beaten stubborn cases of knee pain.

In my last post, I wrote about a triathlete who posts here as TriAgain, and his success story. I thought that today, for ease of reference, I'd do a short post that provides an overview to the success stories that have been published on this site.

* The most useful post of TriAgain's success story was probably this one, on lessons learned. It's worth a close read.

* Here's a success story I found on Yahoo's chondromalacia forum. This person had left knee cap pain that was getting worse, and exercise aggravated his knee.

* I was delighted to find out that my book had found its way into the hands of a couple apparently from South America. The husband, Luis, wrote about his wife, a professional runner, and how she beat knee pain. It was a success story in two parts: here and here.

* This one is from "Ron," and one of my first success stories. I was so excited that I went in and shared it with my wife and daughter, who was two at the time (and is now 11!).

* You're never too old to heal! "Pat" told me the story of how she did, and she was 66!

* One of my favorite commenters over the years was "Knee Pain." She seemed to be the epitome of a "can do, never say die" attitude. She got discouraged, I could tell, but vowed not to give up. So I was particularly pleased to be able to offer her success story.

* This was a "train through the pain" success story. I shared it, but with a caveat that the approach taken wasn't one I would endorse. But still: it's good to be open-minded about ways to heal.

* "Karen" shared a success story that involved my favorite sport: cycling. But she had a clever way of dealing with the sometimes too-heavy joint strain of pedaling.

I hope you enjoy these and are able to learn something from them!

Another Success Story to Celebrate!

I love success stories. They lift the spirits of people struggling to stick to what can be a years-long process to rehabilitate their bad knees.

I was pleasantly surprised last month to learn that TriAgain, an Australian triathlete who was one of the first people to post comments on this blog, has announced that he has completely healed.

"I'm declaring my knees 100% fixed now," he wrote in a comment. And how long did it take?

Only ... eight years and six months! How's that for dedication to a cause? It makes my own experience seem like a walk in the park.

Congratulations to TriAgain! There's more on his story here; I wrote about his battle back in September 2015. And his latest comments are here.

One thing I have come to realize is that we all don't heal in quite the same way, or hold quite the same beliefs. For instance, I'm quite skeptical of the value of stretching. Meanwhile, there are some who have healed from knee pain who swear stretching really helped.

But I think we agree on the important stuff. To me that's:

That bad, cranky knees can get better. If you choose to give up on your knees, that's your choice, but it's not as if they must inevitably stay the same or get worse.

That the road to recovery is often not easy, and there aren't any gimmicks or magic pills. I suspect that a number of people bought my book looking for some "secret" on page 159 or some such. I truly learned a lot from having knee pain and healing, but there's no magic juice or exercise that does the trick for all.

That healing requires a certain fortitude, optimism (but very much grounded in the possible), tenacity, determination, and stubbornness not to give up the fight, even when you seem to be losing (and there will be plenty of those times).

That, in a world where facts sometimes don't seem to matter, facts and science really do matter if you are serious about healing, because a knee pain sufferer is running an experiment of sorts, trying to unlock the combination that leads to steady, slow improvement (per Scott Dye).   

That patience is a key virtue, because it can take months (or even eight years) to get better.