Sunday, August 1, 2021

'I'm Not Dead Yet,' as Monty Python Once Said

Reading all the comments come in after I announced an easing away from the blog was almost like having a ringside seat at my own funeral. Part of me wanted to shout, "Hold on, hold on! I'm still here!"

Yes, my posting from now on will be more sporadic. The blog might go dark for months at a time, or maybe for good at some point. But we're not at that point yet.

If you want to keep the blog alive in some form, go ahead and post questions you have, and I'll answer them (and invite others to help me do so).

Finally, I did want to post this comment from Knee Pain. I realize to many of you reading this, "Knee Pain" is just another online moniker. But she's been with me almost as long as this blog's been around.

She is one of the original hard-luck cases. Look up her success story and you'll be amazed. Her comeback is much more inspiring than mine.

She left a very kind comment, and a great update on how she's doing.   

Hurrah for 10 year anniversary!! I'm very grateful that I found your book.

I remember I practically read it in one sitting. It was very encouraging and great to find someone who could RELATE to this tricky problem of finding just the right amount of movement BUT not too much that would cause a flare up

I remember stories that you shared that I could relate to like the one where you carried something kinda heavy around Hong Kong (maybe it was a fan?) and that caused a flare up. I carried a computer monitor down several flights of stairs and that caused a flare up and I also remember pulling a suitcase on a leash and somehow even that caused a flare up (I think because the act of pulling something heavy with just arm changed my weight distribution on my legs?) Argh.

I was just reflecting recently that my bad knee now seems totally reliable. I'm doing lots of walking and hiking and biking and even backpacking and.... I've stopped worrying that it is going to have a flare up. It doesn't even send me little grumpy warning signals anymore.

That said, I feel it's important to stay vigilant and keep moving and exercising and not get complacent. I don't want a relapse.

Excellent! That's the kind of comment that brightens my Sunday!

Have a good knee day, everyone. 

9 comments:

  1. Yes Richard, your blog has been a Godsend to many, myself included.
    I think one of the biggest lessons was to ignore the pessimism of the 'experts' and to keep the faith that there was a way out of my constant dual-knee burning/aching/stiffness.

    Also, somewhere in the back of my mind was the notion that it just didn't make sense that BOTH my knees could go from fine to terrible in just the space of a few months. The cartilage in BOTH knees could not just magically disappear that quickly, which led me to online research, your book, and the key to the puzzle - Dr Dyes loss of tissue homeostasis theory - which proved to be precisely my problem.

    My knees continue to improve. As do aches and pains in other joints (thumbs, toes, wrists). One supplement I have recently found which I think helped with all these things is collagen powder, which I now take every morning. I think it has also helped lift my knees to another level.

    I train for 30-90 minutes 6 days a week now (triathlon training, mountain biking & the gym) and it is going well.

    cheers

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  2. I intend to keep posting on your blog as I have been reading it avidly and getting tips of many who have commented. It's a relief to find that other people have navigated this nightmare.
    I am still finding what my 'envelope of function is'; for me, it seems to be finding what level of activity does not make things worse and going from there. I think the walking is the most practical way to go and as you say, we all need to walk. I'm trying mainly rest and frequent walk-arounds at the moment. My only activity is open water swimming with a pull buoy which is a hard upper body workout. I wonder if any readers had an issue with tumble-turns in the pool as it's essentially a mini squat. As I progress, I hope to be able to do these.
    It is also interesting how many people seem to suffer from other joint aches with this; is it because we use our upper body more?/generalised inflammatory response. It seems weird that knee synovitis could result in inflammation elsewhere but then many have bilateral knee pain.
    Thanks again for this blog and the book. I'll update on a bi-monthly basis as to how I get on with my plan.

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    1. I probably would have had issues with tumble turning....if I could do it! (tried to learn in the past, but could not do it without using too much energy). Besides, triathletes don't need to know how to tumble turn (lucky for me).
      Most big triathlons have an open water swim, though our local ones have a pool swim (25m pool at that). Tumble turning was banned a few decades ago when a girl tumble turned powering off the wall straight into an om-coming bloke busting his nose.

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  3. Thanks to TriAgain for your frequent posts. Extremely helpful as I felt there was no hope. I have read Dr Dyes papers. Common sense is not that common and as eluded to, many profit from bad knees in the medical industry.

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  4. Hi,
    I came across Richard's book a couple of weeks ago and I also started to read through the blog and I just have to say it has been so inspirational and motivational reading all of these stories. Having knee pain can for sure feel very lonely and hopeless at times.

    I have had knee pain for more than 6 years (it started when I was 25 years old), and like many others here I have had numerous sessions spent with physios, naprapaths and other health professionals, but they have not been able to help me with the conventional approach of strengthening muscles and stretching (as for many others; it made my knees worse). My xrays and MRI have all come back clean and there's no reason for me to have knee pain, but still the pain is there. Luckily I have now found a physio that has a different approach for me to heal my knees and i feel hopeful about it most of the time. We take it slow, with small incremental progression, but it is for sure a slow process.

    My physio told me to look up a guy named Lorimer Moseley, who's a pain reasearcher, for me to learn more about how the pain responses in the body work and as an explanation model to my knee pain. These last days I've been consuming Moseley's lectures online, and I have found it really helpful and now feel curious what this community thinks about this work.
    This lecture of his is very good:
    https://www.youtube.com/watch?v=lCF1_Fs00nM
    It is quite a long video, but he is funny and it is a very interesting take on pain, how pain works, and how you can treat chronic pain (he has worked with many patients that have suffered from CRPS). Having this understanding has helped me better deal with my own pain and in my world this fits quite well with DR Dye and the envelope of function, but with sort of different ways of looking at it.
    If any of you watch the lecture I would love to hear your reflections on it, if you can also see how Dr Dye's approach works with Mosley's approach on pain and how they complment each other and if you have some reflections in relation to your own knee pain story.
    Thanks :)

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    1. I watched Moseleys info. and a pain specialist diagnosed me with pre-CRPS.

      But in my case, I really don't think either were my root issue. Dr Dye's info was the key for me - I had chronic inflammation in both knees and had to find a way to get on top of that.

      Do your knees burn/get hot/go red....as well as ache and feel stiff? To me, that burning (inflammation) is the key signal that the problem is more in the Dr Dye arena, rather than the other possibilities.

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  5. TriAgain: when you started on your journey and had the burning/aching constant pain you attributed to synovitis and went on NSAIDS, what was your leg exercise plan? Did you rest for long periods of time/small walks and when did you introduce quad exercises? I ask because I am being told by a physio to do quad sets. There is minimal pressure on the PFJ but because I have the symptoms of synovitis that both you and Richard have, I feel that even light quad exercise is flaring things. I'm thinking of just doing the light quad contractions designed over months to increase synovial fluid quality and forgetting the ones designed to build muscle. At what point did you try and strengthen glutes/hamstrings/calves etc.
    I think I am asking since your symptoms seem to be identical to mine, what you think the best recipe is in the initial stages and whether I should hold off quad sets.
    Sofie- will have a look at that information.

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    1. My journey was long, stupid & impatient because I wanted to get back into triathlon ASAP. From memory:
      I tried to continue cycling, but that failed badly;
      After a year or more, I realised easy 20min walks and swimming freestyle but with no kicking (pull buoy and ankle band) was all I could do, and even that was suspect;
      Any sort of quad strengthening, even sitting contractions seemed bad, but my knees were in such constant pain/burning, it was really hard to tell what was bad and what was not;
      I only started to really get a handle on what flared my knees and what did not after a month or so on Celebrex (and I had probably at least 3-4yrs of pain before I got on the Celebrex).

      After maybe 3-4mths on Celebrex, and still just the walking & swimming, I decided to go back to the gym to do core and upper body work. Somewhere in there, I started doing crab-walks with bands, and then Sissy Squats with arms outstretched against a frame behind me for balance. Sissy squats are really quite extreme, but I found while they hurt, they did not lead to a long-term flare.

      I then re-introduced a little light running.
      Over the next 2-3 years (I'm off the Celebrex by then), I added more glute/hip/core/quad strengthening - deadlifts, kettlebell swings, sissy squats, wall squats with a fitball behind my back, planks, situps etc. And cycling. And swimming. But I dropped running. Sometimes my knees would go backwards for a day or so, but never back to the really bad old days.
      Then after about 7-8yrs I was able to get back into longer harder cycling, and a little more running (I can now run up to 5kms non-stop, but rarely do as it feels like I'm pushing my luck, so mostly do walk-run for my run training). and I've done a few short races again.

      So to answer your final question about quad sets - yes, if you think they are making you worse drop them. I did.

      Regarding long-rest periods. Yes and no. I rested from all my previous strenuous activity, but life still meant I had to do things I should not have (sit for long periods at a desk - which I did with my legs straight out on a box, move heavy stuff sometimes, go on holidays with the family dragging heavy suitcases). If I'd done what Richard did, I'd probably have recovered faster.

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  6. That is so helpful and I thank you so much for your reply. I feel like I am where you were and am going to go on naproxen for a few months and will do just swimming (upper body only) and small flat slow walks. My job is sitting but requires me to frequently walk and I don't get those symptoms that sitting worsens things. Otherwise, I seem to have the exact same symptoms as yourself.
    I think if someone was to arthroscope my knees, they would find peripatellar synovitis. I am also finding it difficult to get a handle on exactly where I am.
    It's good to know you have been able to get significantly better and I am grateful you can share your thoughts.
    I'll abandon the quad sets and focus on strengthening joints (I have bought a VIP which hopefully will take some guesswork out). Thank you again.

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