Monday, January 15, 2024

A Success Story: Gradual Strengthening and a 'Reconditioned Brain'!

It's a new year, so what better way to start than with a success story? This one I got in the comment section. I edited it lightly:

I'm a long time reader. I first had knee pain in 2018 and lived with it through lockdown. It was agony. For much of it, I was ready to just chop my leg off.

Through walking, and cycling, and following your advice I healed about 70% in 2022. However, my wife and I learnt that we would have a second child in 2023 and I was desperate to fix it even more.

I visited my 5th physio. The others hadn't helped at all, but this physio had been highly recommended and seemed, well, enlightened.

So we began a very, very gradual strengthening program, always playing it safe and being careful. The physio was convinced I'd been badly advised by a doctor (who said I had very cracked cartilage and was basically a lost cause). This time, my physio reassured me that they were wrong, and that nearly everyone my age (45) has wear and tear, but that lots don't feel pain.

The physio based her treatment around the concept that the pain I felt was a memory - something stuck in my nervous system.

By slowly strengthening, I both made my leg stronger, but also reconditioned my brain, telling myself that the knee was good now and the pain had gone.

After 6 months of this, I was able to return to light jogging in summer 2023. Jogging now is helping - my knee feels strong, pain free and functions so much better.

My physio now feels that it wasn't cracked cartilage that caused my agony, but patella tendonitis .. My tendon certainly feels stronger now, and doesn't complain when I kneel on hard floors.

I would never have believed I could get back to running and cycling. One physio told me that I'd been stuck with it for four years so it was 'chronic'. I hope my story gives hope to others, as yours did for me.

Great to hear! I don't know as I really have much to add. Very, very gradual strengthening? Great idea. Pain as a memory, stuck in someone's nervous system? Hmm ...

That part reminds me of a post I wrote last year, Rethinking Osteoarthritis Pain (a Recent Presentation Now on Video). The speaker in the video talked about how bad knees are about more than the knee, and more specifically, as I wrote then:

Chronic inflammation kicks off a process where pain signals being sent to the brain are intensified, and at the same time the ability of the brain to repress such signals is damped.

Interesting, and if that does happen, it wouldn't surprise me at all. I think the longer that someone lives with chronic inflammation, the more mischief it stirs up in the body.

And not in a good way.