I'm throwing things wide, wide open because, for one, there isn't much for me to post about that relates to my own knees.
They continue to be great (knock on wood), especially considering I hit the dreaded milestone that begins with the number "6" this year (believe me, when you get there, you'll stare at yourself in the mirror for a while, saying, "Nah, can't be, really? Seriously? Am I?")
By the way, this winter, after I had a bad Zwift ride on my bike, I decided to do something a bit different for me: training. My idea of "training" has typically been: ride as hard as you can one day, then the next day, take it "easy" by riding not quite as hard but still pretty hard.
This led to the predictable results. I rode hard a lot, in an unstructured fashion, and sometimes was close to that overtrained, burned-out feeling.
I finally got mad at myself after a particularly miserable Zwift group ride that I should've done well on. And I said to myself: "Hey, you were disciplined enough to beat knee pain. You can be disciplined enough to keep to a training schedule that lets your muscles recover, then grow stronger."
My goal was to finish a flat-stage century with the "B" level riders on Zwift. This is no easy thing. They crank out from 2.8-3.2 w/kg for almost four hours. I kind of wondered if my chance to reach this goal had passed, considering I wasn't getting any younger, you know.
But training made a difference: I finished not one, not two, not three, but seven centuries with the Zwift B riders this winter. I'm not dumb enough to think I'm as good as them (sometimes I'd sneak a peek around the pack and most of them had lower heartrates than mine by 10, 15 beats per minute).
You can attain your goals, no matter your age! That includes vanquishing knee pain from your life.
So: How is everyone doing out there? What's the problem you have right now that you need help solving? This is a wonderful little community of problem solvers, I will say, and I've enjoyed browsing through the comment section recently.
Please drop a comment below; I would love to hear from everyone, cheers.
Richard,
ReplyDeleteI just wanted to say you inspire me to heal my own knees. And hopefully I inspire others in a similar position.
I'm 25 years old and I injured my knees in December 2021. All imaging came clean (X-ray, MRI ) and doctors are not able to help me. Chondromalacia Patella is the official diagnosis, although imaging does not indicate that.
The best knee surgeon in my country told me - western medicine does not have an answer to this problem. There are surgeries we can try but I discourage that. Try everything else first. If you can't walk, we'll operate on you. Devastating news.
At my worst, I was afraid to go to the grocery store as that was hurting quite a bit. I stayed at home all day, every day.
My girlfriend of 3 years left me as I was too depressed and too "boring". I felt like I lost everything.
I started looking for alternatives in April 2022. I came accross your book read it on one go and got inspired to take charge of my knees health. I slowly started building my tolerance by walking more. In the beginning I was walking 3-5k steps per day.
As of today, I'm able to do 10k+ steps per day with only minor discomfort. Stairs hurt much less ( if any ). I still can not squat and do other basic movements properly but it feels like I am in the right track and I'm healing.
Step by step, every day. There are setbacks ( they're brutal ) if I overdo it. But once I get some rest, I feel better.
For anyone else reading this - It truly takes patience and hard work. There are ups and downs. But you can make progress.
I decided to avoid any invasive procedures for now ( PRP and Hyalorone Acid injections, surgery, etc ). If i'm not happy with my progress, I may consider them.
On the other hand - accupuncture, hot showers and floss bands seem to aid the journey.
I'm excited where this journey will take me and I am grateful that I found your book and blog. My next goal is going back to the gym and start regaining the lost strength.
Keep pushing.
I'm sorry you discovered what many of us do in this situation: people show you who they are. The good thing about that is we stop wasting time on people who found us boring while we were injured....its our trauma really not theirs but there are fine people who won't leave
DeleteGlad you are starting to get better.
I would appreciate any advice.
ReplyDeleteI have had identical symptoms for over 2 years.
I ended up getting an arthroscopy and minor chondroplasty (chondral flap) 5 weeks ago. I have found this surgery recovery very difficult. I am just beginning to be able to walk short distances. I saw a surgeon today who said my quads were very wasted and that I needed to aggressively do physiotherapy. To date, this has always made my symptoms worse.
If I do too much- I hurt a lot. If I do too little, I become wasted.
The medical community are all saying build strength. I feel this is impossible as the patellofemoral joints are so weak. They seem to not believe me- almost like it's in my head- although wasting and muscle weakness are physical manifestations of my problem. The surgeon said today it should take 2-3 days to recover from chondroplasty and here I am at 5 weeks. I am improving but I see it taking several more weeks to get back to where I was. Two surgeons have both said my knees are in good shape and I should return to sports. I can't even imagine it and I was sport-obsessed. I feel like they are speaking a different language.
It's a lonely world this chondromalacia patellae. I'm utterly miserable and it zaps the joy out of life. This community is the only one where people have the exact same symptoms.
There is one school of thought which is envelope of function and progressive load tolerance and the medical community saying build up and push things.
I can't seem to get anywhere at present and am doing a slight push of steps so that the next day I am no worse. It requires unbelievable discipline.
After many physios I found one that prescribed the following and I was amazed I could tolerate them: leg curls, romainian deadlifts, isometric leg extensions and double legged spainish squats (after a couple of ILE to preactivate quads).
DeleteHi Lindsey. When I read your comments I remember exactly where I was at after my arthroscopy and chondroplasty. I do not know why they give us those time tables because mine took several months to feel better and feel like it helped any at all. I've stopped listening to anybody's timetable and their predictions and luckily I have a doctor who has pretty much stopped providing them. I also experienced the same type of thing with physical therapy and for all the months I went it was a constant battle not to be pushed too much to where I was on the couch for days which really defeats the purpose you know. I finally stopped going and decided I could take care of it on my own just as well. I don't really do many of the exercises anymore at all. I just try to stay as active as I possibly can...piddle walking I call it - with a cane - without pushing them too much. It's a sobering condition to be in. However slow the progress is there is very very turtle like progress. You're welcome to email anytime if you want to talk more: I'm 2.5 years in from this trauma on June 12. My email is sillyteachergirl174@yahoo.com.
ReplyDeleteThank you for these comments.
ReplyDeleteIt's all a nightmare. People cannot understand what you are going through and why so miserable and I don't try and explain any more.
I've decided my joints are in charge, not me and try to 'listen' to what they are telling me. I've pretty much given up physio and more in favour of functional exercise. Even basic yoga moves are more effective than the straight leg raises and quad sets.
It tells me everything that all the health professionals have different advice- strengthen quads, stretch hamstrings, injections with zero evidence base, orthotics, etc etc. Basically no one really understands the patellofemoral joint, in a way that they do the tibiofemoral joint or even ligaments. A recovery from an ACL repair would be faster and more functional than any problem with the PFJ. People keep down-playing my symptoms and saying my knees are in good shape but walking is difficult and so they are not. End of story. I can't make up wasted weak quads with tired muscles with minimal use. That is arthrogenic muscle inhibition. It's frustrating when I feel I understand my condition better than the people advising me. It annoys me when people say strengthen VMO as well- if there is any significant pathology in the joint, it's virtually impossible and also the entire quad set is innervated by the same nerve- you can't isolate VMO. I never say these things, but I can rant here! The surgeon told me to push through pain in physio and reclaim my life. I found it difficult to hear, given that I have gone to huge lengths to understand this condition and I know pushing through pain is bad advice.
Simple physiology is the best answer: if it hurts, don't do it. Pretty difficult to actually do without becoming a couch potato and missing out on life. It certainly is traumatic in a way that people don't understand. Having dysfunctional knees is a massive health problem for the individual.
The only way is to stay positive and hope that with time things will improve; try not to have setbacks (difficult); move little and often and try to keep movements functional. That's all I have learnt so far.
I will email, thanks. I could use some support from someone who has also battled this awful condition.
Greetings all.
ReplyDeleteRe chondromalacia, I had that on and off since age 15 (I'm now 58). The past few years, I've basically eliminated it, through strengthening all my supporting muscles (hips/glutes/core) BUT not my quads (because I also had the same knee pain Richard had, and any quad -focused exercises - which all the 'experts' recommended - only made me worse). I also think taking collagen powder helped (the only natural supplement that has).
My problem now however is the dreaded osteitis pubis (I think - still need a firm diagnosis) which is a stress fracture/reaction in the front of the pelvis causing adductor and lower abdonimal pain. Been battling this for 10+ months after finally getting back into triathlon. Running is out for now, cycling is OK, swimming OK if I use a pull buoy & don't kick.
On top of that I had prostate surgery a month ago - nasty, but recovering well. I have a theory that the prostate medication I was on before surgery (Tamsulosin) which relaxes the bladder muscles also relaxes other core muscles = pelvic problems in someone who exercises a lot. The specialist seems to discount this, but most of his patients do not exercise intensely.
Anyhow, it is a moving feast, but I do what I can, and my knees are really good after 5-6 years of Hell.
Keep the faith. Recovery from chronic knee pain is possible.
Richard, thank you for this blog. Reading through the comments of the contributors here I could totally empathize with them all. I have had chrondromalacia patellae for almost three years in my left knee, which has affected my personality and left me quite miserable since I can't do daily activities like going down stairs or even walking without 24/7 discomfort. MRIs show possible Grade 2 damage with odema on the patellae. I have been fluctuating between knee alignment issues, VMO and glueus medius exercises with concomitant hip flexor stretches and there appears no light at the end of the tunnel. I had hyaluronic acid and PRP injected into the joint a couple of weeks ago which seems to be doing something; fingers crossed.
ReplyDeleteIt would be interesting to know if the injections helped. I hope so!
DeleteHow are you doing Jeremy? Did it help?
ReplyDeleteRichard, thank you so much for your book which I have just come across. Your symptoms and journey are very similar to mine and I have switched from treating my knee pain as a muscular-skeletal imbalance to treating it as a chronic cartlidge injury.
ReplyDeleteI work very long hours at a desk and I was wondering if you had any thoughts on the ideal sitting position that allows the knee cartlidge to heal. In your book, you mention that you spent a lot of time sitting on the floor. I am giving this a go - legs straight out in front with my knees slighty supported at the back with a pillow so that they aren't over-extended. But as you rightly point out, modern offices aren't set up this way! And there doesn't seem to be anything online about how to work long periods at a floor desk - there aren't even any floor desks.
Any thoughts or reflections from you would be incredibly useful. There is so much online about standing desks, but nothing on the floor level!