As I’ve said, I love success stories. Mine, of course, is one. But someone who can't relate to mine may be able to relate to someone else’s, so the more success stories I can share the better.
In the early days of this blog (that takes me back!), a frequent visitor was a woman who went by the simple moniker “Knee Pain.” She was one of the people I was rooting especially hard for, as I could feel her complete determination to beat this curse of knee pain in virtually everything she wrote.
Well, she checked in late last year and told her story in the comment section. And she had made some very good progress, I was pleased to learn. Because I love success stories, I kept meaning to pull out all the bits and give them a proper home inside one of these posts.
Finally I’m getting around to that.
Here’s her story, with my editing as usual. If you want to see her full comments, go here.
Also, Knee Pain, if you're out there reading this, you're welcome to update us on your progress and field questions in the comment section below. I know it's been four months since you posted the story below.
"I was diagnosed with chondromalacia patella in 1993. In later years, it's also been diagnosed as PFPS (patellofemoral pain syndrome). Doctors say that the kneecap is not tracking properly and the cartilage has worn down too much. There's no signs of knee arthritis.
My pain is in my right knee. My bad knee doesn't swell or turn red or other colors. It seems to look exactly like my good knee -- even when it's at its most painful.
I don't have the "burning and aching.” Instead, when my knee is irritated/flared up, I get stabbing pain when I bend my knee. The severity of the pain can range from a just a dull stab to a gut-wrenching pain. (It feels like a flying elf is hovering over my knee with a long knife and gleefully plunges it into my knee.) I only get these stabs when I move my knee. Not at rest.
I didn't quit my job. As long as I am sitting perfectly still, it doesn't hurt while I'm sitting. My type of work uses a computer, so I can still type with my fingers without moving my knee. I went on 2 business trips with the help of a wheelchair when the pain was just too bad and I couldn't walk very far. I've also used a cane.
I've trained myself to never run or jump. Ever. That would cause a flare up. I don't even move quickly. Stairs are a constant nemesis (especially walking down stairs), but I can conquer them one at a time, making my good knee take on all the burden. As for household chores, kneeling or squatting are not a possibility. I sit on the floor or in a chair.
I've had soooo many ups and downs since 1993.
For the most part my doctors recommended physical therapy in the form of strengthening the quads and the vastus medialis. I really don't think that worked for me. Even before reading Richard’s book, I had the gut-feeling sense that trying to strengthen the quads flares up the knee joint itself, sooooo.... instead of helping me, it kind of sets me back. It was only after reading Richard's book (in 2012) that I felt like my gut-feeling was validated!
In 2010, I had the synvisc injection. That made it worse. My knee got a brand-new symptom which was that it would catch and lock up, which was horribly painful.
In 2010, I had arthroscopic surgery to smooth out the cartilage in the knee. The result was that it definitely helped with the knee locking problem! But I kept having irritation and flare-ups.
I asked my doctor if she thought I should next try the total knee replacement? She felt very confident that I should be able to get well with just physical therapy. So I kept trying to use natural methods to get better. But .... not very successfully ....until I tried water therapy starting in March 2012. More on that later. :)
My knees are doing very well right now and I'm grateful every day.
Currently I can swim, bike (up to 10 miles with small slopes), and play a court sport (running around after a ball on a court -- including jumping!!) I can walk up and down stairs without pain.
I'm still scared I could have a setback, but I keep trying to move cautiously forward.
This is the THIRD TIME I've gotten to this "happy golden knee health level" with my knee. I think that the thing that seems consistent with how I've achieved the "happy golden knee health level" is the low-load/high rep that Richard talks about in his book.
The first "happy golden era of knee health" was approximately 2000-Sept. 2006. This started by me taping my kneecap into the "correct spot" (what I learned from a physical therapist) and then gently biking. I started off with just very short and easy. Flat. I would walk my bike up any slopes. Over time, I built up and was able to bike further and with tiny slopes. Then, over the course of months and years, I built up more and more and I could bike really tough routes. I danced. I learned the Lindyhop. I hiked. I learned to windsurf!
But in 2006 I had a catastrophic relapse. Why? I'm not totally sure, but I SUSPECT it's because i had a lifestyle change in which I wasn't as physically active. I stopped biking as much. More sitting. Less moving. And then, after a night of very intense waltzing ... boom. That was it. Back to all the pain. It was devastating.
In March 2012-October 2012 I had my second happy golden era of knee health.
I got the idea of doing water therapy! I got a book called "the complete waterpower workout book" because it has suggestions for people with bad knees (and all sorts of other injuries). I wore my neoprene knee brace to start.
Some exercises involved standing in chest high water and doing movement like moving my leg in a circle. Some involved wearing a floatation waist belt in deep water and moving my legs in different ways.
I also learned I have to listen to my knee because it didn't like all the leg exercises -- even the ones to help with "bad knees." For example .... swinging my leg forward with a straight leg -- as I recall -- was too intense for my knee initially.
After about a month I took off my knee brace. I did have a little trouble. But I was able to work through that by just going slower and more carefully.
In July 2012, I got Richard's Saving My Knees book and read it in one sitting.
I learned about high-rep/low load.
I learned about delayed onset pain.
I started posting on this blog about how I was improving.
Then after my knees were starting to feel better I started gently biking again. And I could go up and down stairs without hurting. Amazing!! And then I started biking more and I started biking more.
I thought I was CURED!!
But no!!!
I "overdid it" on one of my bike rides and BOOM that was it. Another catastrophic relapse.
My big takeaways from Happy Golden Era #2 in combo with what I learned from Richard's book were:
1) I'm a believer in low-load/high-rep, thicken the synovial fluid. I saw it work two times for myself -- even though I didn't know it was called that or that the biking and the water therapy were essentially doing the same thing.
2) I definitely agree with the idea of not even attempting to strengthen the quad muscles until after I've got the knee joint itself feeling calm and stable.
3) I was so glad to learn that Delayed Pain Onset is a real thing. Not my imagination. It helped give me the courage to believe in my own hypothesis that maybe when I'm doing something, only days later I will feel the negative result. So I need to be patient and "let the dust settle" after doing knee activities and make sure I'm OK.
4) Patience. Patience patience patience patience. I promised myself 100 times that if I ever got the chance to get to another "happy golden era" again, then I would be a lot more patient.
Starting 2016, I used all this knowledge to try to make another big (but slow and gentle) push for a third "happy golden knee era."
It worked!! (So far!)
-- I can go up and down stairs without pain.
-- I've walked without knee pain for up to 5 miles
-- I can bike up to about 10 miles with small slopes
-- I can swim for up to 90 minutes
-- I'm playing a court sport (running around a court after a ball -- including occasional jumping)
How I got to this point was once again using the water activity.
However, this time I did my water activities in cold water. (BTW: I was learning on another post that maybe being in cold water helped reduce inflammation and that might've helped with my success this time.)
I did once again start with essentially wearing a thick knee brace. Once again, not "swimming" but more like gentle leg motions. (When I did opt for "swimming" then I just dragged my legs.)
By July 2017 I built up to swimming a mile! But still, I wasn't supplementing this with land activities.
Then in 2018 I really realized wow my knees are feeling pretty great.
So then I started experimenting with land activities such as walking up to 5 miles.
And I was doing really well so I invested in buying a road bike in April 2018. I started super cautiously riding short easy distance on flat. 4-5 miles. Then wait at least 72 hours. See how my knees feel. Bike another 4-5 miles on flat. Then wait at least 72 hours. See how my knees feel.
Then I decided to try a court sport running around after a ball. The court sport did stress my knees some. I did get a few SMALL sharp stabbing pains within the 72 hour waiting period. So that was kind of scary. I decided to try again and just be cautious. After a couple sessions, the small stabbing pains went away. Now it's been two months of trying the court sport and I'm not having any stabbing pains anymore.
Anyway!
This is where I am now.
But.
I know I have to remain cautious.
I need to remain patient.
And it's really hard to be careful and patient because I'm feeling very excited that I can once again do all these different kinds of activities!! I feel like my life possibilities are opening up again!"
I read 2 times the story of "Knee Pain" from the comments section. Therefore it was important to highlight this success story. It would also be great to hear the latest situation.
ReplyDeleteIt will be too long but I also want to share my journey in this comment section.
***MY JOURNEY***
I am one of the people who keep following this blog and digging internet continuously. I was in the faded background but I think it is time to say “hello”.
On December 23, 2017, I was snowboarding at night which was a bad move since I was an amateur on snowboarding. My speed was a little bit high and I lost control. After a few tumble, left side of my board was stuck to ground at the last tumble and my right knee wanted to keep going but it was impossible. I felt a great, focused pain in the center of my knee and I felt it will be broken if this move will continue. I immediately pull myself to my right knee to stop this hurtful move. I have managed to stop it but the pain stayed.
I did my second mistake with trying to continue to snowboarding the day after. I was brave, energetic and I always liked to push myself whatever the situation is. But I knew that the injury was not something that I can forget about. Therefore, I went my first orthopedist 2-days after the injury.
He did hand examination on my knees and said “You are fine”. I said “But my knee is hurting. There is a focused random pain at the center of my right knee”. And I convinced him to do a MRI scan. There were 3 results on the report which somewhat tell the results of the crash.
I was doing three kinds of sports when the crash happened. I was cycling, running, doing weight lifting 5-times in a week. You could understand my hesitation to lose them because of an injury. They were the key elements of what I was those days because they are the main and only cause to produce serotonin for my brain which results countless positive events in my life.
The doctor said again “You are fine but sports are forbidden for a week. Then you can start them again”. I was very happy when I left the hospital but we were missing that I have A-type personality, which I learned from this blog. I was doing my sports like a machine, pushing my limits everyday and every week. I was doing weight lifting with 50-pounds dumbbells.
Between January 3, 2018 and March 2, 2018, I did less cycling and running to keep my knee comfortable. But the pain was always there and I continued to do sports which was a serious mistake.
On March 2, 2018, my right knee was locked while I was walking. I could not move it like 5 seconds. I was horrified and went to the second orthopedist.
He examined my knee, examined my second MRI results and said “I cannot explain your situation and pain. It can be tendinitis. We can inject Monovisc to your knee.” I was frustrated and I somewhat felt that Monovisc is not a good option. But I accepted it. I think he crashed to my cartilage by mistake and mentioned that it was because of my strained position. I pushed a doctor to decrease my sport level for the second time and we agreed that I should stop cycling and running completely. Only the weight-lifting was left for me but I was still happy for not losing all of them.
Between March 2, 2018 and April 25, 2018, I continued to do weight-lifting but the pain was a little bit worse. So, I remember that I was holding my right knee on air while I was sitting on the bench to prevent pressure on my right knee. I think I was falling down day by day when I look this period metaphorically.
On April 25, 2018, the same pain started on my left knee which I left horrified for the second time. Then I went to third orthopedist. He also could not diagnosed what is happening but he gave an exercise list which includes basic and mid-level exercises (there was no full-squat, wall squat or leg press). He also gave a painkiller which is dangerous when it is used unconsciously. I felt fine for the week that I used medication and did exercises. But the pain came back (normally) after medication and I did not get results with exercises. I called the doctor and he only said “there is no alternative method, you can continue exercises”. I had countless number of questions which go around furiously in my mind. What was happening to my knees? How and when will I get better? Will I get a chance to cycle or run anymore?
DeleteThen, I went to fourth and fifth orthopedists. Fourth one examined my third MRI and said “you could have no pain under these circumstances.” I was terrified for the third time and this was a kind of a shock. Because what he mentioned was a psychological problem or being a liar. He also said “you will live a calm life from now on.”
The fifth doctor also could not diagnosed what was happening and gave me a list of exercises which includes 25 harder moves when it is compared to the list, the third doctor gave me. I tried to do them for a week but they were not helping. I decided that I should dig internet much more. Then I found book of Richard Beddard.
I read it immediately. I was happy while I was reading it because finally there is a man or some event whom/which I can relate my problem. I still don’t know or I cannot know whether I have the same specific problem in science since we cannot open and examine our knees but the symptoms he wrote were the same. He was also telling about its emotional effects which comforted me a lot because I was suspicious about myself because of the doctors’ comments. The other thing which boosted and helped me a lot was knowing that a person was healed from a very similar problem.
I also went to rheumatologist (sixth doctor) to be sure whether I have rheumatoid arthritis or not. He did full examination and results were negative. He mentioned that the pain can be persistent because of stress.
After April 25, 2018, I stopped weight lifting, my last sport activity. I started to live my life with the mindset of what I learned from the book. What I should tell is that was really hard. I also stopped social activities like going clubs, meeting with people which needs long hours of sittings or walking. I did not left social activities intentionally. My knees were hurting too much and I could not ensure a positive mindset with the pain.
I tried to keep a journal but I stopped it after 1 month but the mindset remained. I somewhat managed to go on a trip to Rhodes on July 15, 2018 after two and a half months when I stopped all kinds of sports. I walked for seven days with an average of 12000 steps. But I was not completely healed because I could not go to a concert where I would stand for 5-hours or so.
I also went to a 1-night camp where I carried numerous supplies to the camp site. I still don’t know whether it was a logical move or not. I felt fine but my knees were weak and I still had some pain on summer period. Maybe I could act calmer. 7-days walking or 2 days camping could be done after 3 months or 9 months with a complete heal.
I somewhat forget all of the papers, books, step tracker, blog, short period journals etc. till the mid-October 2018.
There is a small forest behind the building where I work as a developer/consultant. We loved to walk around in that very tiny forest to calm our minds. I preferred not to go to the forest in my injury period since it is risky. I went there a few times but small hills were risky. One day my colleague asked to go into forest. I hesitated first but accepted since I want to move freely for the last 5-6 months.
I slipped very badly from one hill on my right knee because my right knee was still weak and I stepped on a pine cone. Normally, the pressure which I applied to the ground/pine cone would be high and my footwear would have gripped the pine cone securely. But it was not possible with my weak right knee.
DeleteSo, I returned back to start which I read numerous times in this blog or in Richard Beddard’s book.
I went to seventh, eighth, ninth and tenth doctors. Number 7 who was an orthopedist said “you have a full tear on ACL on your left knee and partial tear on ACL in your right knee. He proposed two surgeries. Number 8 who was a physical therapist said “you have no tears on your ACLs in your both knees”. Number 9 who was a physical therapist recommended exercises and Number 10 who was an orthopedist said “you have a partial tear on your ACL in your right knee” and he also proposed a surgery. Some of them were wrong since I cannot have these contradictory situations which are having a tear and not having a tear at the same time.
It was harder to continue healing. My colleagues were also suspicious about the issue since there are hundreds and thousands white-collar people who try to escape from work with faking a sickness or injury and I had no single report that I have an injury since doctors cannot diagnose what is happening. The work became a hurtful event where I had discomfort in my knees. Then I contacted Dr. Scott Dye for help.
He prefers a program which includes painkiller and cold application. I somewhat do not like them but I feel like I am on a cracked ice sheet where I cannot move without help. There was a post in this blog where the writer described how it is hard to live with this pain while people do not pain attention to your pain. She or he also mentioned that when s/he started to use crutch, people changed immediately on caring about him or her. ‘Since I can walk’, I have the same problem that even my older brother asks “you had a pain on your muscles, right?”... I always propose him to read Beddard’s book to understand my situation but of course he will not.
I also left my job for 3-months unpaid leave in the meantime which is started on December 1, 2018. It is sad but I should focus on my knees without accidents.
No one diagnosed me with chondromalacia patella or patellofemoral pain syndrome. But the results of my last MRI indicates “grade 1 chondromalacia patella” for both of my knees. (There is also grade 1 degeneration on medial meniscus posterior horn and minimal increase in the articular fluid of suprapatellar bursa in both of my knees) I have preferred that one of my doctors could have diagnosed me with a sickness or injury where I can freely tell people around me that I do not make up my pains or exaggerate my pain level.
I also could not imagine a world where the book of Richard Beddard does not exist. I would probably have stuck in the level where one of my doctors tacitly mentioned those are made up pains. I believe it would be very hard to move on while I have been suspicious about myself whether these pains are real or not.
DeleteSo many thanks to Richard Beddard for what he had achieved and telling people his experience in full detail.
***Useful Tips***
1) I am using Xiaomi Mi Band 2 which is a smart wristband where it tracks your movement all the time. It can also warn you with vibration to walk when there is 1-hour inactivity. There is no application in IOS to adjust inactivity duration but I found an application, called Mi Band Tools, in Android. So I adjusted it to 15-min inactivity duration and it keeps warning me to walk. (You can also adjust a barrier to break inactivity level like walking 50 steps. When you walk 50 steps or more after the warning, you are marked as active)
2) An injury timeline is very beneficial for the doctors. I created a full timeline with dates where events are mentioned. If you go to a doctor with the printed version or soft copy of this timeline, they will be happy to interpret what is happening.
***Hard Truth***
1) Inflammation enzymes become active after 6-24 hours of the activity. (You can read it in one of the papers of Dr. Scott Dye with references) It is a real challenge as Beddard mentioned in his book and many other patients mentioned in this blog.
2) 12.5 months passed since my first injury. I want to heal as soon as possible since it become chronic. But I should not forget it will be a long road since I can fail and turn back to the start with an excess load to my knees.
***Wishes/Plans for 2019***
1) I still could not find magical formula since my last injury in October 2018. What I try to mention with “magical formula” is a stabilized program where I do not go backwards but have a chance to develop the capacity of my knees. Otherwise, it will be a random trial-and-error method where the healing will be occurred by chance. I still struggle to find the magical formula.
2) I once tried to cycle for 10 minutes in September 2018. The results were bad. I wish I can cycle for even 5-minutes without post-pain.
***A Question***
I prefer not to attend meetings with friends or go to cinema since they are risky for my knees. But this is a fragile environment where your psychological well-being also affected negatively. It also creates a vicious cycle where your knees hurt > your well-being worsens > your knees hurt > your well-being worsens ...
Question: Do you apply your program without exception or do you go out once in a month or so? (I would be grateful if Richard Beddard can also answer since we cannot know what is happening in this context after he mentioned in the first chapters that he also withdrew from social life)
Last words;
I hope I did not waste your time with my ultra-long comment. I hope all of you feel better and move as in your pre-injury period in 2019.
A 29-year old guy from Istanbul
Deathgrip (almost sounds like a video game character!), you have my sympathy. Cycling doesn't sound like a good option for you right now. You could try the electric bike (that's a great idea that TriAgain suggested), or even cycling backwards at no resistance. But if it still isn't working, probably best not to push it.
DeleteI was very religious in following my program and limiting what I put my knees through, but still, it's not healthy to isolate yourself socially. I'd look for ways to meet and mingle with friends. Spending six hours at a club, dancing and standing, may not be a good idea. But maybe there are other activities you can all do? In fact, you might take the initiative yourself: Figure out some activity that is "knee friendly," and invite them to come join you. A depressed/negative attitude is definitely a contributor to pain, so best to be around friends who lift your spirits.
Good luck, and check back and let us know how things are going.
Hi Richard,
DeleteYou are somewhat right! Deathgrip is the name of a card in a game called, Magic: The Gathering.
Thanks for the bike advice. I think I can try it in the near future. I have tried RotWild R.C1 Hybrid 26 Pro before my knee injury period. These engines can help a a lot to decrease the pressure at my knees. By the way, I missed my Focus Arriba so much!
You are right about finding an activity to keep my positive attitude. Dr. Dye is also on the same page that stress can magnify the pain level. I think I can try these ways like meeting inside where I can sit comfortably.
I will be around and I hope I can give a positive update in future.
And sorry for the misspelling of your surname in the story.
So if we continue to walk for 2-3 miles a day and bicycling 20-30 minute every day, are we going to heal in 2-3 years?
ReplyDeleteI mean we do not need anything else with the exception beign so cautious. I just want to learn if i need to do something else. Thank you
If I understood your comment right;
DeleteI think there is no single magical formula in this journey. The damage in the knee and the pain level of that specific knee can change from person to person. I also do not believe to heal with strengthening knee muscles like quadriceps but they can help you a lot in this journey if you have a strong muscles because of your genes or active sports life. So, every person is different and their activity level to heal will be different. You can also remember what Richard mentioned in his book: You can walk and cycle outside but what is your activity in your home? Do you walk 1000 steps or 4000 steps? For instance, I am a very active person and I walk minimum of 2000-3000 steps in house during this injury period.
I am so relieved that Richard and Dr. Dye are on the same page on this finding your formula to heal. Nobody but you can find this recipe for you.
I hope your question was not rhetorical or ironic. I hope you will get better in near future.
Good story Deathgrip & good luck.
ReplyDeleteOne issue re cycling - because some knee experts say it is good for thickening synovial fluid & nourishing damaged cartilage. That might be true, but only at low intensity.
I recall doing a 3 day, 50kms/day cycling tour in NZ a few years ago. I was very worried about my knees, so used an electronic bike, but ended up not using the motor that much. But because it was flat & we were only riding at an easy pace, my knees just got better & better each day.
But on my return, I tried to return to my more intense cycling levels, and backwards things went.
So my current plan is to try much easier cycling again as part of my knee management regime. The past 6-12mths I did get back to more competitive intensity cycling, but that has started to have negative effects again.
Hi Triagain,
DeleteThanks for your comment and sharing your story in the previous posts. I learned subversions or setbacks by mistakes and experiences which were instructive. I will try to be cautious if I would return cycling or running in future.
Can I ask how were those negative effects which you mentioned at the last sentence? I mean did you went back to start or just had some pain for a few times during a day?
No, not back to the start, but pain for a few days/a week.
DeleteNow getting good progress using the TENS machine once per day for 45mins.
I'm considering getting a TENS machine. Could you tell me about yours and how you use it? Thank you!
DeleteCheck out the YouTube link below for one Dr. Ken Berry..
ReplyDeletehttps://m.youtube.com/watch?v=ePg3V4iOBI4
High rep low load is the rule, Walking and cycling.
ReplyDeleteWhat about running if we can?
I found a research that shows running decreases cartilage thickening.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660554/
Hi,
DeleteThanks for sharing this paper. I have read it and I think it was nice to see "biological/metabolical damage" in the cartilage in another paper.
It summarizes that even fully healthy people can have temporary biological damage on their cartilage after running or any other high-impact activities which has repetitive or static joint loading like jumping, kneeling, knee bending or standing without moving for 1 hour.
Therefore I think running is not an option for knee patients who have irregular and continuous pain (or I should have said "pain syndrome"). Maybe those special treadmills (with a decreased gravity environment) which Richard posted in this blog can be an option.
Hi Richard,
ReplyDeleteI have some questions for you after reading your book in the past week. First, I’m grateful for coming across it and want to provide a summary of my backstory.
I had fallen rather hard skiing last February (2018), but no popping noises, my right ski popped off and seemed to land funny. However, I continued to ski the rest of the day. During this winter, I had also began running more than usual including occasional crossfit-esque workouts. By the end of the ski fall week, after going for a short run (maybe 2 miles) it was apparent my knee was injured. I made an appointment with the ortho who diagnosed an MCL sprain, avoid lateral sports for a couple weeks and resume with a knee brace after words. Fast forward a few months into June, and the knee pain changed from hurting running (mostly hard surfaces) to a chronic pain while sitting especially at work. I had an MRI done in July that confirmed no ligament damage (although the MCL could have healed by that point) but slight chondromalacia. The same ortho then prescribed PT 4-6 weeks and the pain should subside. If not, call in a couple months and maybe have a cortisone shot (although he was hesitant in the suggestion). During the next couple months (July-August), I went to a PT about once a week while doing the take home exercises at the gym. The emphasis was constantly on strengthening the quads and hips and some balancing work. Like you and others have shared, the knee would feel ok, sometimes good, during these sessions and the onset of pain was not for a day or so after. However, it became apparent that the PT was not resolving the issue completely. This is when I began to heavily do research on my own. In the following months (Sept-Jan), I tried a self-PT program with 4 levels of exercise – focusing on stretching, strengthening and balancing, a different PT – who suggested “stretch the quad and push the patella” it will be fixed in no time, and doing some yoga. There were times over these months where I had good knee days, and unfortunately, on some of these days I decided to go for runs, hikes or play a sport. With hindsight, obviously this caused setbacks. However, all the research I did still prescribed the traditional strengthening of the quads and hip muscles. I did stumble across the “envelope of function” theory before your book but the detail never mentioned the science of the cartilage needing to heal first. In the beginning of this month (Jan 2019), I went back to the ortho and decided to have the cortisone shot – figured why not? Knowing it has mixed results but maybe it would reduce some of my inflammation and allow a better rehab. A week after the shot I went on a family vacation and, as you may be able to guess, my knee felt good over the week. I falsely contributed this to the cortisone shot, instead of all the reasons you bring up in the book. Yet being back in my office the week after quickly brought back that familiar nagging pain. It was at this point that I was down on the situation, it is coming up on a year from the injury, why was nothing working? After going back to searching the internet once again, I came across a forum who suggested reading your book and looking up Doug Kelsey. The sample of the book had me hooked and then ended up reading the whole thing pretty much in one sitting. As you can see from my story, I feel like I now finally have a plan to recovery.
Thanks to anyone reading my story, some questions I still have:
ReplyDelete• Do you believe you could have still recovered in the office setting?
o With a diligent walking schedule (catered to the individual) along with quad-sets or crab walks/stretches?
• Based on your story, leading up to the one-year mark you made significant improvements to your function – longer hikes, etc. However, the story somewhat ends abruptly, in the 2nd year of recovery did you slowly increase your activities on the same rigid scientific approach or did you begin to reintroduce prior activities such as long bike rides or running? At some point did it feel like you came out of the rehab stage?
• Does research suggest a cortisone shot prevents cartilage from healing?
• How did you explain your injury to outsiders? I find it difficult or too consuming to go into details unless it is someone I’m close with.
• Does research suggest age playing a factor on speed of cartilage recovery? Not to discourage the older populace suffering but looking for more optimism. For the record, I’m in my late 20’s.
• I’ve seen your comments on diet that you think it did not play a significant part in your recovery but losing weight is one of your 4 keys to rehab. Have you done any research on the claims that low carb/keto type diets can help arthritis patients? I think I might try it not expecting it to play a significant role, but it could help with losing a few pounds anyway. Also, for the record I’m low body fat but think losing 5 or so lbs would only be beneficial.
• Do you think weightlifting – upper body type workouts are safe to resume? Any other exercising activities you came across that don’t overload the knee joints? I think my knee is responding ok to low watt biking.
Hello. I don't know where I fit in exactly in these discussions except to say that I also have knee pain. I am a 63 year old man in otherwise good health. I take no medications and have no medical conditions other than this "life sapping" knee pain! Several years ago I went through a two year period recovering from right knee pain which has been attributed to OA. I recovered from that and thought that I was out of the woods. Flash forward to September of 2018 where I re-injured that same knee by pulling out grocery carts out of a river near my house. So much for doing my share of community service. Since that time I had struggled with right knee pain again until about two weeks ago when...........struggling to get out of my bath tub after a hot epsom salt bath I strained/hurt my "left" knee! At the moment my right knee feels much better but my left knee hurts to walk. It hurts right across the middle section of the knee as well as a slight burning sensation. I don't bother going to doctors anymore because with my prior history of OA the only things they offer me is total knee replacement or drugs. I am beyond stressed and depressed. I take numerous supplements, consume bone broth almost daily, take gelatin daily etc. etc. I am at my wits end and truthfully I dread seeing the sun come up in the mornings. Thankfully I am already retired and no longer have to go to work. I feel as if my life is on hold and this knee pain has become all-consuming. I empathize with anyone and everyone who like me is dealing with on-going pain. PS. I did read the book as well. Thank you for that. And thank you for letting me vent,
ReplyDeleteI was so surprised (and delighted) to see that MY STORY was the success story for January! Wow! And it’s also very touching that folks would like to hear how I’m doing now.
ReplyDeleteI have good news!!
My knees are still doing well! So so well. So well that in November 2018 I felt ready for the next step: leg strength training.
What my plan has been is to get the knee joint feeling healthy (High Rep / Low Load) and THEN do strength training to get the whole leg feeling strong. Legs. Feet. Abs. Glutes. Back. Get these muscles strong to help support my knee during land-based activities.
Why? Because .... although I’m using my legs to swim (AND I can go up & down stairs now) but, I don’t have strong, solid quads, hams, calves for weight-bearing activities on land. I’m scared that my enthusiasm combined with weak leg muscles will lead me to a knee relapse.
So!!
In November 2018 I hired a personal trainer to help me to get on track. This personal trainer is experienced with working with clients who have physical limitations and who have had chronic pain. And. She has the temperament for working with clients who have the emotional pain and fears that come along with working through these long term debilitating conditions.
So far it’s been great!!! :) I am making slow & careful progress in strengthening my leg muscles. Although. I could definitely NOT have done these exercises if my knee joint was not in its current healthy state that I’ve been building up since 2016. (How I think about this “current healthy state” is that think I’ve thickened the synovial fluid in the knee joint and also improved the knee’s ability to cope with some weight-bearing without flaring up. But of course I don’t really know what’s going on in there. It’s just what I imagine.)
I’ll just add that I’ve had EXTREME FEAR in trying some of the exercises. My body has taught me over and over to never do certain types of movements or else I’ll face severe consequences. A big one is “never put weight on my right knee when it is bent.” But. Now I’m trying to DO that exact crazy thing and I get terrified I’ll have a knee relapse. But. I’m trying hard to not let fear win. My approach is to try it just a smidgen and then observe if my fear is warranted or not. (As compared to letting fear completely stop me from even trying.)
For example, I’ll just start off by doing a supported version of the SCARY ACTIVITY in a small range of motion and just do three reps. Then stop. Do 2 sets like that. Then wait 72 hours to see how my knee reacts. And. Then I can see for myself that my knee is doing fine. I have zero pain the next day or within the 72-hour window. So this is building confidence that my knee joint CAN handle these activities.
I’m grateful that my personal trainer is very patient with me. She’s understanding that I’m afraid, and so we find a way to modify the SCARY ACTIVITY so that I feel safe enough to try it. And then this builds my confidence. And then I’m a little less afraid the next time and I’m even EAGER to try it again and more reps. It’s thrilling that I’m slowly building strength.
Sometimes right after doing an exercise, I do have knee pain. It feels almost like the knee is seizing up. Hard to explain. I get scared!! Is this going to evolve into a relapse?? However, we have come to our method for how to handle this situation. What we do is 1) massage the muscles around the knee AND 2) I move/bend the knee joint to get the fluids moving in and out and also give the muscles something to do rather than seize up. So far this seems to be working! And. It does not evolve into a knee relapse.
This all may seems ridiculously slow. But. I have to do it this slow careful way because I’ve had such bad experiences with relapses. And. I just can’t face another relapse. I just can’t. I can’t.
So! I’m being slow & careful. :)
As a side note:
DeleteThe incident that prompted me to re-visit this blog now in March is that I came across my trusty cane as I was doing a Spring cleaning. My cane represents so much pain & crushing disappointments & struggles & trying over and over.
Back in mid-2012 when I had my “2nd Happy Golden Era”, I triumphantly donated my cane to the Good Will. I thought I was cured and didn’t want any reminders of all my suffering. But. Then in Oct 2012 when I had a devastating relapse, I had to go buy a brand new cane. Exactly the same style as the one I had donated. It was bitter. Deeply Bitter. And I had promised myself that if I could ever get back to another happy golden era, I’d be more patient. It took me from Oct 2012 to March 2016 to really get back onto a good path.
ANYWAY! My point is that I came across my cane during my spring cleaning, and this time I’m going to KEEP IT!! Yes. I’ll keep it because 1) I don’t want to jinx myself and 2) I feel that I’ve learned from my previous experiences that this knee pain might not ever be “cured.” I will ALWAYS need to stay on top of it. Always make “moving my knee joint” a priority. Develop hobbies that involve high rep & low load activities. Etc.
Hopefully I won’t need my cane again, but i can’t just sit back and hope. I need to do the work to give myself the best chance to not need my cane again.
Maybe I should frame my cane up on the wall for inspiration.
DeleteOh you are feeling lazy? You are feeling tired? Poor poor you. Yes, sit and rest. You’ve earned a rest. Reeeeest. The cane is right here waiting for you after you’ve rested and you are in pain again.
Knee Pain, this is great to get updates from you. I remember all your comments in the early days, and your enthusiasm and frustration and everything else. I think you're right to be cautious. But I also believe that with each day you make progress, you are building a bulwark against all that bad stuff in the past. Keep checking back in, please -- stories like yours help so much to reassure people who maybe believe that my story was a one in a million. You, and so many others, prove that it wasn't. Thanks!!!
DeleteHello! I have a HAPPY update!! I went cross country skiing yesterday (March 24). Now it’s been a full 24-hours and there are no signs of any knee flare up at all! No small stabbing pains. Nothing. My knee feels just as well as before I went cross country skiing.
DeleteAs a background: My knee hasn’t been healthy enough to cross country ski since.... sometime during what I call “Happy Golden Knee Era #1” which was around 2002-2006.
However, after doing water movement and then swimming, my knee got significantly better. Once my knee joint was feeling really well and healthy, I hired a personal trainer to help me do strength training to build up my leg muscles. My knee confidence has been very high ever since I built up to be able to do lunges without suffering any knee pain consequences!! So. I thought “my knee is finally ready for cross country skiing.”
I only skied about 1.25 hours. Very Slowly! I had SO MUCH FUN, but I didn’t want to “over do it” and cause a flare up. Plus, after 1.25 hours I was tired! Because of my history of knee pain, ALL my leg muscles have rarely been pushed, so this was a great workout for ALL the muscles in my legs.
Anyway! I wanted to report back to our knee community that my knees have healed up enough to cross country ski slowly for an hour. This was one of my knee health goals that I had posted about back in 2012. And now — seven years later — my knees are healthy enough to do it.
As a note, I’m continuing to swim! I believe that regular “high rep / low load” knee joint movement is important for my knee health maintenance.
Great news! I thought I will never ever snowboard again. You showed that it is possible to do competitive sports again with long-term incremental healing. Thanks for sharing your story and giving updates.
DeleteOMG thanks for this post Knee Pain. I have been through 1 short lived and 1 long lived "golden eras" myself. The last golden era was approximately 2016 and 2017. (The mostly dark era was 2009-2015). Then in Jan 2018 I caused myself to go RIGHT BACK TO THE START by a poor choice. Absolutely crushing. Now I am in a setback..but not to the start (I sincerely hope).. I had made it up to 30 min water walking and 7000 steps but have been going backwards since May, for less than obvious reasons but probably a mix of things that in total are too much, too soon, as I tried to transition out of the pool. Now I might be at 10 min water walking and I don't know how many steps (its hard to say as of yet). Anyway, if you are able, maybe you could list which water exercises WERE good for you? I suspect a lot of folks might be interested besides just me. I think I actually have that book...maybe you could just list exercise names. I get that we would all have to try carefully on our own, but it would help to hear from someone in who WAS in a similar condition. Congrats to you for the perseverence, because as we know all to well, its not "fall down 7 times, get up 8" as some proverb states, the fall downs number in the hundreds!!
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DeleteHello Deathgrip and Heather. I am glad to know that my own battle and current victory is giving you both hope for your own struggles.
Now that my knees are doing so well... my main feeling right now is.... Gratitude! I'm so so so grateful to be able to do simple activities that other people take for granted. I'm still grateful that I can walk up and down stairs. I am grateful that I can dance -- and even if i'm not doing all the moves right, I'm just thrilled that I am even out there trying. I'm grateful that I can walk to my table in a restaurant without limping. I'm grateful I can cross a street without gasping from a sudden stab of pain.
I'm grateful that I can start or re-start hobbies that require knees. (Whereas... before I had to severely limit any hobbies to be those that don't require knees. Which is huge, right? It's a Different lifestyle. Even different friends in some cases.)
My goals are very humble! I am definitely not looking to do anything too drastic. I'm so grateful that I can walk. Dance. Swim. like to get back into road biking. I don't want to do anything that forces me to push myself too hard... and risk a relapse. It's just not worth it for me. My overall quality of life and activities is going so well.... nothing is worth risking that! For example...my relapse in 2012 was caused by putting myself in a situation where I had biked TOO FAR and I was at the bottom of long long long kinda steep hillside and I had to get back up that hillside to get home. Which I did. But... that resulted in how many YEARS of being in knee relapse mode. Three years? Four years. So. Now if I ever get into that situation again... I hope I will call a friend to come pick me up, or.... walk my bike home instead of trying to bike up that hill when my knee energy was depleted.
Heather I'm so sorry to hear of your setback. I know how devastating that is. I feel a twist of fear in my own stomach to think of setbacks. I'm glad to hear that you have at least experienced a "happy golden era" so that you know that it is at least possible.
Heather I'm reviewing the aquatic exercise book. I'm not sure what to say because of course all situations are different.
ReplyDeleteBut, here are some thoughts and things I did which I thought were helpful for me:
-- I looked up the suggested exercises the book lists for people with knee pain.
-- I tried them out SLOWLY. The slower you move, the less resistance in the water. So... that is safer.
-- I listened to my knee. I didn't do anything that seemed too scary.
-- I started off by wearing a neoprene knee brace in the water! Eventually, I gained confidence and stopped wearing it, which was really scary. And, initially when I stopped wearing it I could not do all the exercises I had been doing and certainly not at the same intensity. So... in a way.... I felt my progress went "backwards" because I could not do as much. But. Actually, it was a huge step forward.
-- I realized that my legs were overall just SO WEAK because I basically didn't use them for anything. So... pretty much ANY movement was good movement even if it wasn't directly involving my knee. It was a gentle way to use many different legs muscles. (In theory, I could have also done upper body workout, too, I didn't have enough time & patience. I just wanted to focus on my knee joint health.)
Section ONE: Initially... here are things that felt OK for me.
A: Exercises While Wearing a water floatation belt in the deep (so I'm hanging vertically in the water)
- Super slow high-knee march "bend my knee to lift it up towards my chest but not too high and then back down."
- Heel lifts (bend my knee such that the heels go to the butt.)
- Quick scissors (Legs are going sideways. no knee bending involved. this doesn't necessarily help my KNEES specifically, but i figured anything leg movement is good!)
- Bent knee twist
- Super slow "water running" motion (SLOW!!)
B: Exercises while holding onto the side:
- Body Swings
- 2-legged pendulum
C: Exercises while standing in chest high water:
- One Legged standing leg circles (SLOWLY!!!)
- heel lifts
SECTION 2: Initially... some water actions were TOO intense for my knee joint:
- Swinging my straight leg forward? Noooo.
- Holding on to the side and doing a bicycle motion with legs coming out of the water? Nooooo.
- Anything involving jumping? Nooooo. (i didn't even try those. I already knew that would be catastrophic.)
- The Slap Kick? Nooooo.
- Quad extension? Noooo.
But!! the good news is that slowly over time I would be able to do a few of those and then built up to including more and at greater intensity. Etc.
Now-a-days, it's still really satisfying to be able to do these really big strong bicycle kicks and make a ton of giant splashes because I remember back to when I could NOT do these at all. So. It just makes me still so grateful and happy that I can do them SO VIGOROUSLY now.
(I admit I never got up to the Jumping exercises. Basically... you start in chest high water get the legs used to that "springing action" while most of your body weight is supported. Then... over time you are supposed to build up to doing it in shallower and shallower water. Eventually, you should be able to jump on land. However, I never got that far. Maybe I should still try it.)
(For anyone else who is interested, the book i used is called "The complete waterpower workout book" by Lynda Huey and Robert Forster. I have no connection to the book other than I appreciate that it has rehabilitative exercises for people with soooo many injuries. Such a treasure! )
PS. Interestingly, NONE of the exercises i did in the water were "walking." Most were leg movements while floating in the deep end. A smaller percentage required hanging onto the side, or standing in chest or waist high water (usually while holding onto the side for balance, too).
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