Saturday, May 16, 2020

Could I Have Healed My Knees Without Quitting My Job?

This question occasionally comes up. It was in the comments section recently, and since I’ve decided to try to flip as many comments into posts as possible, I thought, “Why not?”

So, could I have gotten better without quitting my job?

The honest answer, really, is I just don’t know. I’m doubtful. But maybe I could have. It would have been much harder certainly.

But let’s unpack this one for a moment. Because, partly what I was doing by leaving my job to try to heal my knees, was establishing “proof of concept.”

Remember: the only doctor I had faith in, while living in Hong Kong, had told me flat out that my knees would never get better. “Never” is a big, final-sounding, devastating word. I’m sure he saw himself as a truth teller, trying to dissuade a naive patient of notions he could still heal.

But I took this as a challenge, because I’m that kind of guy. Could my knees heal under the most optimal conditions – if I quit my job, devoted my life to what I was convinced it would take to get better? If I succeeded, it would show that at least some of those dire verdicts that doctors deliver to patients are unwarranted.

In the end, it was a great feeling of vindication when I realized I was right, and I was going to heal all the way. I felt as if I had won my life back.

But what about you? That’s really what you want to know, even though you’re asking about my knees. Can you heal without quitting your job?

And, my wishy-washy answer is, it probably depends. On how bad your knees are. On what you do at work to try to alleviate the stress of sitting. On your own inner fortitude and will to beat this thing.

I’m not advocating that everyone quit their job to fix their knees. It may work, but it may not. First, I’d try everything possible to heal my knees while staying employed (ahem, especially right now). Then, if you have to confront that hard decision, give it a lot of thought.

I also got this question:
Light flat gradual building up walking is the way to go. My question to Richard is how do you know what’s too much? As long as there is no pain during and after is that ok?
Well, no pain during and immediately after is, I would say, the minimum. But you also have to monitor for delayed onset symptoms, which can pop up a couple of days later. So this can be a very, very frustrating exercise, determining “how much is too much?”

So I would think of starting at a low base. What’s the easiest walking that doesn’t bother your knees at all? Then maybe cut that in half. One of the hardest lessons I learned early on was that my knees were much weaker than I thought, and I had to go more slowly than I expected.

Okay, that’s it for now. Take care everyone, and be careful. I know the warm weather is tempting all of us into going outside, but the world is not a completely safe place yet.

10 comments:

  1. I think this is a very interesting topic. I have seen others comment on this idea during the quarantine time. For myself, I have been lucky enough to work from home during COVID, and my knees have been doing very well. Now is it because I am working from home or is it coincidence because I have also been progressively walking and doing Doug/Laurie's knee exercises religiously for almost 2 years. Scientifically there is no way to tell. My personal opinion is that you can heal in any environment, but being at home or working at home can dramatically help. And I think the reasons are very simple. When at home, or really anywhere outside the office, you subconsciously get up more, stand more, move more, cross your legs less, and it is much easier to get outside for that 5-10min walk more frequently. Those are all things you can do in an office place, however we are creatures of habit and I always tend to stay seated more and accidentally cross my legs more at the office. So my hope when this is all over is two fold, increase my work from home time, and carry over my habits from home to the office.

    On another note about delayed onset pain. After working at this for 2 years I think this is the #1 symptom people with bad knees need to pay attention to, and it is the top symptom doctors ignore. And to expand on this I think you will always get delayed onset pain, especially in the early stages, BUT it is important that this symptom decreases over time (kind of like the concept of diminishing returns, or as Richard calls it "phase shift"). Using myself as an example when I started my quad exercises on a VIP (vertical incline plane per Doug&Laurie) even at a very low level I would almost always have sore knees the next day, but by the next day it would be less or gone, so I kept at it. Over time either the delayed onset pain the next day would decrease...or I could increase the load very slightly but keeping the magnitude of the symptoms the same. Now I have never been perfect and have made many many many mistakes and still have a ways to go, but my confidence in the over all outcome has increased significantly. Hope everyone stays healthy!

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  2. thanks for the reply richard very helpful. Does anybody have an opinion on footwear? at the moment i walk bear foot around my balcony but am now wandering wether slippers would cushion the blow. Thanks

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    1. I would recommend HOKA. I recently ordered a pair of their sneakers and its been noticeably better than other sneakers. I got a pair rated plush under cushion details.

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  3. Any experience with Spinal Cord Stimulation?

    I have a very bad case of bad knees and this is the only forum where I found a match to my symptoms. My case deteriorated so much that I have been unable to walk without crutches for the last year and half and mostly walk for 10-20 steps at the time before the pain flares up. It has been a roller coaster of getting a bit better then getting worse for a while now and I am in a dark place emotionally. I am contemplating using this device called Spinal Cord stimulation. If you have any advice on that or anything else please reach out. I would appreciate it.

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    1. Hello Zak, I've not heard of this before. I myself have been on and off crutches for a year now and have pain in my hip, groin and feet now which I guess is a sort of spread of neuropathic changes. Just had an arthroscopy to remove an impinging plica but feels same as before still (2.5 weeks post-op). Let me know if you manage to find any relief or progress. I'd be interested to know do you struggle to sit as well? For me I spend all my day lying near horizontal on the sofa with bits of walking in between as if I sit normally it only takes 1 minute to have pain in my feet and knee quite badly.

      I have had a transforiminal epidural and two lumbar synovectomies but these did nothing at all so just to let you know that's something I have had experience with that targets the nerves. Also considering going down the radio frequency ablation route which I believe targets the group of nerves above the knee joint to cut out the pain for up to 18 months...

      Have you tried anything like these?

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  4. Knees can get better.After 7 years ( I am 49 now). I still feel pain with squating or doing stairs but constant pain (the bad one) is gone.

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  5. 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?

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  6. As a note to the community.... I was able to recover without quitting my job. And, I have an office job where I sit in front of the computer all day. Not great for knees.

    (This is from someone who went on two business trips in a wheel chair because my knee hurt so much I could not walk, but I still wanted to go on the trip! I had periods where I could not straighten my leg without pain. I had periods where I had to use a cane. I had periods where I was not in daily pain but only because i just didn't do anything.)

    Now I can bike 30 miles, and hike up and down 1200 feet elevation, swim a mile, and swing dancing for up to 2 hours. (Well, that swing dancing was pre-covid! No swing dancing now during this pandemic!)

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    1. Hi Knee Pain,

      Same here. Also office warrior with a busy career and life (2 dogs, wife, friends) full of constant pain. I thought about quitting my job many times, but actually found that i can do my job if i also prioritize resting (true resting) and the right exercising regime (not too much, not too soon!).

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    2. I will just add that it took me a long long long long long long time to get my knees into this good of shape. :-(

      And.... I do wonder sometimes if I could have gotten better SOONER if I had quit my job.

      I guess there is no one right answer except "Keep Trying" and "Do Not Give Up."

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