TriAgain, an Australian triathlete who has spent long years rehabbing his knees, left a link behind to a post that I found amusing.
Amusing, I guess, because it does sound a lot like what I’ve been preaching for the last 15 or so years (and what Doug Kelsey was preaching before me) about the ability of knee cartilage to strengthen and heal. It’s by a fitness coach called Julien Raby.
Right near the top, he says:
Cartilage is a living tissue with active cells that respond to movement — and certain types of movement can actively help it rebuild.
Yes, yes, exactly. He then goes on to helpfully explain:
Cartilage consists of living cells called chondrocytes, which produce collagen and matrix—two components responsible for the tissue’s ability to absorb shock and allow for smooth joint movement.
These chondrocytes respond to specific types of physical load by increasing anabolic (building) activity. In other words, move right, and the tissue gets stronger. Move wrong, and degradation accelerates.
That’s pretty much the formula, in a nutshell. Of course finding that sweet spot of exactly the right amount of movement, that builds up the tissue instead of tearing it down further, generally involves a lot of exasperating trial and error. Or at least it did for me.
But the underlying optimism is correct, I’m convinced (cartilage can heal). And so is the broad prescription (movement, of the right kind, and in the right dose).
I’m not sure I agree with all he has to say. He thinks leg presses are a suitable high-repetition activity for knee pain. I’d be rather doubtful, but maybe if the weight is very light and the motion is smooth and easy? Also, he mentions glucosamine as a “promising” nutritional supplement — I tend to doubt that, for reasons explained elsewhere (on this blog, in my book), but your mileage may vary.
Still, it’s great to see someone out there proclaiming cartilage can heal, so confidently and so openly. When I published “Saving My Knees,” fifteen years ago, I hoped and thought that the day would come that the thinking about knee pain would evolve. The old model, that knees simply wore out like a pair of old tires on a car, never made sense. It amazed me that so many people bought into that line of dismal thinking, and not because I’m a pie-eyed optimist (if anything, I’m a pie-eyed pessimist).
And here we are, a decade and a half later, and there are more voices emerging, saying, “Hey, cartilage can get better. Your knee pain today doesn’t have to be your knee pain forever.”
That’s a great message to have at your side if you’re trying to recover from knee pain.
