Jump to content
goughy

Stuffed knee again.... should I get a look inside?

Recommended Posts

So I've stuffed my right knee again playing indoor netball. It's the 4th time in about 8 years it's had some sort of injury, usually I just go to physio to work on it. My physio this time (first time he's seen me for this knee) asked if I've ever had it scanned, and while he's working on it I get the feeling from him that he's only working on it cause I want him to. Last few appointments he's either given me a partial refund, or last time he applied a pensioner discount to my fee; cause he's felt it wasn't fair to charge me the normal fee for the work he did. Last time he even asked if I wanted some more work on my back to make up a full appointment.

 

The guys I ride with (mostly doctors of various sorts) said I need to get it looked at and done and said they will make it all happen if i want. Both knees have had issues since at least my mid 20's, but I've injured them both (left once, right 4 times) since taking up running and tri 8 years ago.

 

I know the physio hasn't nutted down what's happened. In the past I've had a tracking issue, and something like 3 strains (cartilege strains I think....). It's been 4 weeks now and while the pain has gone, it's still 'uncomfortable' I guess you'd say, and I can tell it's not right with some uncomfortable loud cracking (as opposed to it's usual soft squeaky cracking) and light soreness in everyday life. It was very swollen for the first 2 weeks I guess, though that's gone down.

 

OK, I guess I'm just trying to talk myself into going to the extra trouble of a specialist.

Share this post


Link to post
Share on other sites

 

 

OK, I guess I'm just trying to talk myself into going to the extra trouble of a specialist.

 

Head to the GP.

Tell them about your netball incident and the fact it isn't really improving.

Get them to refer you for an MRI.

My fiancee was informed if she could have pointed out a single incident that hurt her knee, she could have claimed more on medicare for her MRI.

Share this post


Link to post
Share on other sites

You need a diagnosis, which you haven't had. A thorough history taking and examination should give that to you. I would see someone who can provide this.

 

If the diagnosis is elusive, MRI may be an option, but bear in mind the interpretation of the MRI is important (e.g it may show 4 things, only one of which is contributing to your symptoms).

  • Like 2

Share this post


Link to post
Share on other sites

Not sure Indoor Netball is the best sport to be playing if you've got an ongoing dodgy knee issue... :-)

  • Like 2

Share this post


Link to post
Share on other sites

Probably more so was not playing the second week after it was swollen from the first!

Share this post


Link to post
Share on other sites

you can get the MRI bulk billed if your doc suspects an acute meniscal tear.....

Edited by Cat Lady

Share this post


Link to post
Share on other sites

What's worse, is it was on my daughters mixed team, made up of her other 13 and 14 year old friends, who are playing in an adults league. So it looked even worse! But, full team fee has to be paid regardless if everyone is there or not, and since I end up paying the short fall figured I might as well play. Was such a good idea....

 

Saw doc today, scans booked, specialist booked, and my mate had gone to see him first thing this morning so they were waiting for me to call them.

 

Funny system the govt requires to get it bulk billed. She has a check sheet there she runs through. But, they have to do an xray first, and if the xray shows nothing then they can request the MRI. She said the xray never ever shows anything, but they have to request it first. What a waste of money! But that's govt systems for you. The xray and the mri are getting done at the same time - the place said that's normal for this sort of thing. So the xray won't even get looked at before the mri is done.

Share this post


Link to post
Share on other sites

When my physio suspected meniscal tear, both my doc and then the referred specialist said mri's are useless. About 50/50 false positives and false negatives.

 

I had an mri last year which diagnosed lateral colateral ligament tear. Specialist and physio and outcome called bullshit.

 

Mensical tear (undiagnosed with mri) yes.

Share this post


Link to post
Share on other sites

Massive problem in musculoskeletal care these days with over-reliance on MRI findings. It's only getting worse too with practitioners losing their clinical assessment skills.

 

Operations for meniscus recently been show to be associated with early onset osteo-arthitis.

 

The more we know about many orthopaedic operations (esp. knee and lower back surgery) the more it's being shown that it's often better not to do it.

Share this post


Link to post
Share on other sites

Oh feeling much better now!! ;)

Share this post


Link to post
Share on other sites

 

Operations for meniscus recently been show to be associated with early onset osteo-arthitis.

 

The more we know about many orthopaedic operations (esp. knee and lower back surgery) the more it's being shown that it's often better not to do it.

What's the alternative though?

A tear isn't going to heal itself is it?

Share this post


Link to post
Share on other sites

What's the alternative though?

A tear isn't going to heal itself is it?

A small tear can, especially in the outer meniscus.

Share this post


Link to post
Share on other sites

Stay clear of all things that will hamper your goal to get to Port. Yes....this may be boring, but just remember the goal ahead - Ironman!

 

You know you want it!!!

  • Like 3

Share this post


Link to post
Share on other sites

What's the alternative though?

A tear isn't going to heal itself is it?

 

 

That's the type of thinking that is very natural and understandable when you view an MRI and what drives this reliance on them from both sides.

 

Over 50% of 50 year olds will show meniscus tears and disc bulges on MRIs.

 

I reckon musculoskeletal car was better before the invention of MRIs. Not nearly as profitable but patients had better lives/outcomes.

Share this post


Link to post
Share on other sites

Stay clear of all things that will hamper your goal to get to Port. Yes....this may be boring, but just remember the goal ahead - Ironman!

 

You know you want it!!!

That's exactly what my thinking is with getting this sorted! 4 times I've had this knee treated for problems, but it's had them more than that. A couple of times I've just let it rest and sort itself out. I'm barely running and walking atm, and it's affecting my cycling too. Swimming, meh, who would know. It's not really painful atm, but I know it's not stable and worse than other times.

Share this post


Link to post
Share on other sites

 

I reckon musculoskeletal car was better before the invention of MRIs. Not nearly as profitable but patients had better lives/outcomes.

 

It's interesting to me at the moment because Future Mrs Tyno had a scope for a meniscus tear recently.

She couldn't run without pain.

It was a triangle type tear.

At the moment, she's still in recovery, but has mentioned she notices knee pain in the chilly weather.

Share this post


Link to post
Share on other sites

Â

It's interesting to me at the moment because Future Mrs Tyno had a scope for a meniscus tear recently.

She couldn't run without pain.

It was a triangle type tear.

At the moment, she's still in recovery, but has mentioned she notices knee pain in the chilly weather.

I've had 3 scopes for tears the first at age 15 for a tiny tear that probably should have been left alone. Surgeons love to cut and they're never going to suggest a different option. .

 

Did my second tear age 16 but left it alone for 20 years with only minor issues until the swelling etc became too regular. . Id avoid surgery as long as possible and enjoy being able to predict the coming rain. .

  • Like 1

Share this post


Link to post
Share on other sites

My knees have been useless for predicting rain. But about every bone in my wife's body has that covered.

Edited by goughy

Share this post


Link to post
Share on other sites

I swear you'd have to be a doctor to be able to work out anything on these images!

Share this post


Link to post
Share on other sites

That's what I just said to my sister (a radiographer).

Share this post


Link to post
Share on other sites

What's worse, is it was on my daughters mixed team, made up of her other 13 and 14 year old friends, who are playing in an adults league. Â So it looked even worse! Â But, full team fee has to be paid regardless if everyone is there or not, and since I end up paying the short fall figured I might as well play. Â Was such a good idea.....

So the man-bun was to fit in?

  • Like 1

Share this post


Link to post
Share on other sites

Massive problem in musculoskeletal care these days with over-reliance on MRI findings. It's only getting worse too with practitioners losing their clinical assessment skills.Â

Â

Operations for meniscus recently been show to be associated with early onset osteo-arthitis.Â

Â

The more we know about many orthopaedic operations (esp. knee and lower back surgery) the more it's being shown that it's often better not to do it.

This is why I subscribe to the theory that orthopods should only be allowed to operate on bones they can't fit in their mouths

  • Like 1

Share this post


Link to post
Share on other sites

As a recipient of ACL grafts in both my knees (together with associated meniscus trims and repairs), I think it's worth adding that orthopods are good at dealing with gross trauma (if not less obvious injuries).

Share this post


Link to post
Share on other sites

Well I couldn't wait to see the specialist next week, so rang my doctors and they told me what she had written down. Most of it was over my head, but the basics was a horizontal meniscus tear blah blah blah. Will see what the doc says next week.

 

Pains fine down a lot, but I can still tell it's not completely stable. Luckily been so busy at work I haven't been training out anything (ok, there is that sore knee thing). But should I not be running and riding on it till I see the specialist?

Share this post


Link to post
Share on other sites

Well I couldn't wait to see the specialist next week, so rang my doctors and they told me what she had written down. Most of it was over my head, but the basics was a horizontal meniscus tear blah blah blah. Will see what the doc says next week.

 

Pains fine down a lot, but I can still tell it's not completely stable. Luckily been so busy at work I haven't been training out anything (ok, there is that sore knee thing). But should I not be running and riding on it till I see the specialist?

 

Medial or lateral meniscus tear Goughy?

 

When I tore my medial meniscus (quite badly) there was no way in Hell I could even contemplate running on it. And pushing off the end of the pool was a problem. But I could easily cycle on it (which I did for a month before the loose bit was trimmed out) which I thought was OK, but in hindsight was probably not because the loose bit rubbed on the end of my femur and caused damage to the cartilage there. My pain did improve a lot over the first 2-3 weeks, but the piece kept popping out and locking the joint (and damn that hurt).

 

I tried to PM you with my long-winded experience, but the system would not let me.

 

If I had my time over again, I'd have waited maybe another 3-6mths before opting for surgery, and done only swimming - and not pushing off the ends with my legs. The wisdom of hindsight eh!

 

I think all knee surgery is a much bigger gamble than the othopods let on - though mine did warn me trimming cartilage = likely earlier onset of osteo-arthritis.

 

If you have immense patience read the novel about my journey (still on it) - http://forums.transitions.org.au/index.php?showtopic=68825&hl=%2Bstay+%2Bthat+%2Bknife

Edited by ComfortablyNumb

Share this post


Link to post
Share on other sites

Thanks CN. I'll have a read. Can't remember which it was, or if the receptionist said which. I just remember horizontal meniscus tear and tonnes of words I didn't know. Mostly just wanted to see if it found anything or not. I've only run twice I think since I did it, and it was a little sore. But even when I've gone for walks it felt like that. The only two times I've cycled, I don't know if it was me trying not to use it or not, but there was a distinct lack of strength. I haven't had out lock up as such, but certain movements do aggravate it.

Share this post


Link to post
Share on other sites

Knees and knee surgery are my soap box topic after my bad experiences (just in case no one noticed yet :lol: ). I've spent the past 3-4yrs researching mostly anterior knee pain and meniscus problems. The best info I got came from fellow knee pain suffers, not the medical world, in particular a masters cyclist in California who went from crippled to recently riding hard again over 4yrs. He delved deep into systemic inflammatory issues and knee pain, and worked out his own rehab/recovery regime.

 

Re meniscus tears, apparently lateral is worse them medial in terms of future athletic prospects.

 

Your knee not locking is a good sign - it means the torn piece is more stable than mine was. If it was me knowing what I know now, and not being obsessed with doing my first IM, I'd be treating it conservatively and trying to avoid surgery.

 

Read this - http://dougkelsey.com/meniscus-tear/ - he had PRP injections (which I also had, but after surgery). My own GP (a runner) healed his own meniscus tear over 3-6mths by being conservative. He warned me about surgery but I was stupidly too impatient, wanting to get back to my IM quest.

Share this post


Link to post
Share on other sites

Yeah, been reading through your stuff. You know, you really really wrote a LOT ;)

 

While I'm never keen for surgery, I'll see what he says. It doesn't lock, but jeeze it's noisy. Sometimes the cracking sound when I straighten it is so loud my wife cringes. The physio, when he was putting pressure on the knee when straight, managed to get a massive crack out of it while still straight. He was a bit apologetic. But this is about the 5th time it's stopped me, with me seeking physio 3 times and twice I just rested it. I've looked at the scans myself but they mean squat to me. I'll see what he says and can show me with them next week. I do know I'm seeing 'the guy' in town, and know a number of people who have come back successfully from knee work by him. Just trust me when I say I'm not going into it lightly. I work on my feet all day, and often am doing heavy lifting and moving stuff around, and this is hampering things to some degree. It's possible that that is also hampering it's recovery.

Share this post


Link to post
Share on other sites

Yeah, been reading through your stuff. You know, you really really wrote a LOT ;)

 

I write better than I talk.

 

Big cracking noises are not necessarily a problem - unless they hurt. My knees made some horrible noises before my problems started, but it never stopped me.

 

MRI scans for cartilage damage are a bit like satellite photos of Iraq in the 80s - there might be WoMD in there, but there might not be. And most knee surgeons are like GW Bush. If the MRI hints at damage, go in with all guns blazing.

 

I agree, your type of work might hamper healing.

Share this post


Link to post
Share on other sites

My knees have always cracked, particularly when squatting. Bit the right one is noticeably louder now, and while I won't say it comes with some resistance, there is like a little point where you can feel it stiffen (I guess, or want to stop), before cracking and straightening out.

 

And yeah, I know what you mean about writing. 'An economy of words' is not a phrase used to describe my writing.

Share this post


Link to post
Share on other sites

The best info I got came from fellow knee pain suffers, not the medical world, in particular a masters cyclist in California who went from crippled to recently riding hard again over 4yrs. He delved deep into systemic inflammatory issues and knee pain, and worked out his own rehab/recovery regime.

 

Any details on this CN? Cheers.

Share this post


Link to post
Share on other sites

 

 

Incoming!!!!!

 

Inconvenient truth:

 

"comfortablynumb - great post, thanks for going to the trouble.

 

i too am going through my own PFPS challenge (potentially compounded by pain sensitisation) after going way too hard on the infamous leg extension machine 9 or so months ago. i am a ripe 28 years old. really troubling to have such a innocuous and mild injury continually degenerate - all whilst following 'best practice' medical orthodoxy. FWIW, i tend to think my own anxiety has really fed into the issue also. damn this type-A personality..

 

i found and read paul ingraham's ebook relatively early - but largely dismissed the advice, sensing the whole rest thing was too extreme given the mildness of my condition. that and all the 'experts' i was seeing / had seen subscribed to a different school of thought.

 

would you recommend i get stuck into Richard Bedard's and/or Doug Kelsey's books or are they much the same as Paul's?

 

i know you posted quite recently - but how's the recovery going? still on the right track? seems to be a long and slow road. glad to hear you're coming out of the mist.."

Share this post


Link to post
Share on other sites

Where do you live, the guys at BaiMed in Wollongong will fix it - for sure.

Share this post


Link to post
Share on other sites

Where do you live, the guys at BaiMed in Wollongong will fix it - for sure.

 

Unfortunately I've tried the best of the best in the physio world and it's not working for me.

 

 

Niseko/ComfortablyNumb - what / who should I be searching for? This systemic inflammation stuff sounds interesting.

Share this post


Link to post
Share on other sites

 

Unfortunately I've tried the best of the best in the physio world and it's not working for me.

 

 

Niseko/ComfortablyNumb - what / who should I be searching for? This systemic inflammation stuff sounds interesting.

 

The concept that systemic inflammation can cause arthritis or arthritic type symptoms does not seem to have hit the mainstream medical/physio world yet, And that is fair enough because it is a fairly new theory and a bit out there (see http://www.ncbi.nlm.nih.gov/pubmed/23641259

 

So most medicos/physios work on the idea that knee problems like mine (and perhaps yours) start with physical damage of the cartilage, which leads to inflammation. The article in the link suggests the exact opposite - that something triggers inflammation which causes cartilage deterioration.

 

You won't find much to help you in this area because it is a fairly new and mostly unproven theory. But if you have found your knee pain was accompanied by other issues (e.g. I also got pain in thumb, toe, elbow, shoulder and back joints - but nowhere near as bad as the knees), IBS? depression? anxiety? then it is worth considering.

 

BTW Niseko is a physio in Japan, so my rants on this topic probably peeve him and the other physios on here, but I think he and I are on the same page about some of this, esp the dangers of knee surgery/orthopedics in treating anterior knee/kneecap pain which often leaves patients worse off.

 

And there are physios who think beyond the simple 'strengthen your VMO' recipe for anterior/kneecap knee pain.

 

Pete Jacobs is now exploring the systemic inflammation issue for his fatigue/injury problems. Eyes are now rolling all over Trannies, but he appears to have had every test possible without getting answers, so why would he not pursue some more left-field ideas?

 

What aggravates your knee (apart from the leg extension machine, which in my experience/observation aggravates all knees with anterior pain)? Running? Riding? Swimming?

Edited by ComfortablyNumb

Share this post


Link to post
Share on other sites

I've got my appoint with the orthopod this arvo, where I'll get the actual results, hopefully in a manner I can understand!

 

While the worst of the pain and soreness (and cracking) has gone down, it's still tender, in particular on the inside side of the side. Have done next to nothing for 4 weeks now I guess. It's been pleasant not to be thinking about having to get out, but I'm missing the camaraderie, about the only people I've seen in that time have been my own family - and that's never good ;)

Share this post


Link to post
Share on other sites

 

you can get the MRI bulk billed if your doc suspects an acute meniscal tear.....

 

Not in my experience and certainly not in Victoria.

Share this post


Link to post
Share on other sites

My brother got his bulk billed. He was told that if the doctor puts in the referral that there is instability, then it can be bulk billed.

Share this post


Link to post
Share on other sites

GP MRI rebates are available on medicare

For patient 16 years or older with:

• Inability to extend the knee suggesting possibility of acute meniscal tear

• Clinical findings suggesting acute anterior cruciate ligament tear

 

Would be good if they extended that to Physiotherapists. Would save time and money for the patient and save us asking the GP to do it. While I'm at it, giving us direct referral rights to specialists would be handy too. With the AMA basically dictating Medicare funding in this country I won't hold my breath.

  • Like 1

Share this post


Link to post
Share on other sites

When I first saw my physio for this, he asked, kinda with a nudge nudge wink wink, if I'd ever had a scan of it.

Share this post


Link to post
Share on other sites

 

The concept that systemic inflammation can cause arthritis or arthritic type symptoms does not seem to have hit the mainstream medical/physio world yet, And that is fair enough because it is a fairly new theory and a bit out there (see http://www.ncbi.nlm.nih.gov/pubmed/23641259

 

So most medicos/physios work on the idea that knee problems like mine (and perhaps yours) start with physical damage of the cartilage, which leads to inflammation. The article in the link suggests the exact opposite - that something triggers inflammation which causes cartilage deterioration.

 

You won't find much to help you in this area because it is a fairly new and mostly unproven theory. But if you have found your knee pain was accompanied by other issues (e.g. I also got pain in thumb, toe, elbow, shoulder and back joints - but nowhere near as bad as the knees), IBS? depression? anxiety? then it is worth considering.

 

BTW Niseko is a physio in Japan, so my rants on this topic probably peeve him and the other physios on here, but I think he and I are on the same page about some of this, esp the dangers of knee surgery/orthopedics in treating anterior knee/kneecap pain which often leaves patients worse off.

 

And there are physios who think beyond the simple 'strengthen your VMO' recipe for anterior/kneecap knee pain.

 

Pete Jacobs is now exploring the systemic inflammation issue for his fatigue/injury problems. Eyes are now rolling all over Trannies, but he appears to have had every test possible without getting answers, so why would he not pursue some more left-field ideas?

 

What aggravates your knee (apart from the leg extension machine, which in my experience/observation aggravates all knees with anterior pain)? Running? Riding? Swimming?

 

 

They don't rile me. I find them interesting actually and don't subscribe to the 'I'm better educated so therefore everything I say is more valid than someone less educated'. That is what is perpetuating the mistakes of the past in diet where people with PhDs are dispensing terrible, damaging advice and this happens in many other areas too. Am not so arrogant to say physio couldn't be one of them. A lot of the time new advancements/discoveries come from outside the profession.

 

Don't thin it's accurate to say physios just do VMO as most good ones will do much more than that. Personally hardly talk about VMO for patella-femoral these days at all.

 

Understand how frustrated you are CN keep up the research I hope you get better.

 

However I can imagine if you were my patient and I saw your name pop up in my diary my eyes would roll and I curse under my breath and think 'not that farkin guy again' :smile1:.

Edited by Niseko
  • Like 2

Share this post


Link to post
Share on other sites

So just back from the doc. Scope being done next week for a clean up. Big tear in one meniscus. A big chunk out of one too. He wasn't too impressed with the arthritic signs either. Few cysts, and a lot of fluid too (I thought it had gone by the mri).

 

But maybe more so, biomechanically I am a nightmare, the kind that scares kids. If my left side is Sully from Monsters Inc, then my right side is Pennywise the clown. And he thinks that is where the problem lies, maybe right up to my right side lower back issues.

 

He said the right could have gotten much worse after my stress fracture a few years ago. And certainly since then my right knee has been an issue. Flat out he said he would expect me to need orthotics for everyday use, though he couldn't say if I'd need them for running. He wouldn't be surprised if I even needed shims for cycling. Booked appointment with pod, and he's also sending notes to my physio and he said all three will work together to get this sorted, cause he can't believe I try and do any of this stuff with things working so poorly. Reckons if I give it the time I won't believe how much better things can get.

Share this post


Link to post
Share on other sites

Re the systemic inflammation thing: again your assumption re Physio is not quite correct.

 

Physios in musculoskeletal/sports are educated to look for non structural causes for joint pain. Systemic inflammation implies a disease process affecting widespread parts of the body. These broadly come under the rheumatologists area of speciality. Rheumatoid arthritis lies at one end of this spectrum of diseases, there are a multitude of others including psoriatic arthritis, ankylosing spondylitis, ulcerative colitis etc etc that can manifest with joint pain. Typically there will be muscle and joint problems in numerous pairs of joints, and the "inflammatory" presentation includes things like morning stiffness or pain, difficulty after being immobile (get up and go problems). Someone presenting with one joint with a very mechanical sounding story would not raise any flags, even though there are weird single joint inflammatory problems (gout being one). These are systemic inflammation. There are blood tests for some of them, some are diagnosed based on a careful history and response to treatment. Being told by a naturopath you are allergic to everything except kale and quinoa doesn't count.

 

Your suggestion re depression/anxiety is an important distinction and one where advances are constantly happening. I would make a distinction about the systemic inflammatory diseases that the majority of symptoms happen from the neck down (except iritis which can happen with one inflammatory disease). From the neck up things like depression, anxiety, fear/avoidance behaviour and beliefs may coexist with/drive chronic pain states and the role of the brain and nervous system is advancing very quickly in this area. In a nutshell, if you have a series of joints that are stiff and sore in the morning, recurring tendon attachment pain (plantar fascia, back of heel etc, you have skin, gut or eye issues and you feel better on anti-inflammatories, you may have an inflammatory disease and should see a Dr with knowledge of this area.

 

The article you link is interesting, I was taught 25 years ago that we shouldn't let people do sport with a swollen knee (an effusion) as the synovial fluid associated with this inflamed state of the joint weakens articular cartilage. (and also inhibits quadriceps activity).This is a major compliance problem with a lot of people, as they recover from knee scopes or ACL recos. They feel good to go but have a massive fat knee and holding them back is difficult.

Share this post


Link to post
Share on other sites

Re the systemic inflammation thing: again your assumption re Physio is not quite correct.

 

Physios in musculoskeletal/sports are educated to look for non structural causes for joint pain. Systemic inflammation implies a disease process affecting widespread parts of the body. These broadly come under the rheumatologists area of speciality. Rheumatoid arthritis lies at one end of this spectrum of diseases, there are a multitude of others including psoriatic arthritis, ankylosing spondylitis, ulcerative colitis etc etc that can manifest with joint pain. Typically there will be muscle and joint problems in numerous pairs of joints, and the "inflammatory" presentation includes things like morning stiffness or pain, difficulty after being immobile (get up and go problems). Someone presenting with one joint with a very mechanical sounding story would not raise any flags, even though there are weird single joint inflammatory problems (gout being one). These are systemic inflammation. There are blood tests for some of them, some are diagnosed based on a careful history and response to treatment. Being told by a naturopath you are allergic to everything except kale and quinoa doesn't count.

 

Your suggestion re depression/anxiety is an important distinction and one where advances are constantly happening. I would make a distinction about the systemic inflammatory diseases that the majority of symptoms happen from the neck down (except iritis which can happen with one inflammatory disease). From the neck up things like depression, anxiety, fear/avoidance behaviour and beliefs may coexist with/drive chronic pain states and the role of the brain and nervous system is advancing very quickly in this area. In a nutshell, if you have a series of joints that are stiff and sore in the morning, recurring tendon attachment pain (plantar fascia, back of heel etc, you have skin, gut or eye issues and you feel better on anti-inflammatories, you may have an inflammatory disease and should see a Dr with knowledge of this area.

 

The article you link is interesting, I was taught 25 years ago that we shouldn't let people do sport with a swollen knee (an effusion) as the synovial fluid associated with this inflamed state of the joint weakens articular cartilage. (and also inhibits quadriceps activity).This is a major compliance problem with a lot of people, as they recover from knee scopes or ACL recos. They feel good to go but have a massive fat knee and holding them back is difficult.

 

You wanna move up here to the country Parky? - damn we could use you! Sell up in Cronulla and you can buy 4 houses here. 5min drive to work, live the dream!

 

Best cross-disciplinary post on all this I've ever read, no other medico ever went down the systemic inflammatory route with me despite me suggesting RA, synovial lining inflammation etc. (and BTW stiff and sore in the morning def rings a bell, so I might be on the right track).

Share this post


Link to post
Share on other sites

 

Â

The concept that systemic inflammation can cause arthritis or arthritic type symptoms does not seem to have hit the mainstream medical/physio world yet, And that is fair enough because it is a fairly new theory and a bit out there (see http://www.ncbi.nlm.nih.gov/pubmed/23641259

Â

So most medicos/physios work on the idea that knee problems like mine (and perhaps yours) start with physical damage of the cartilage, which leads to inflammation. The article in the link suggests the exact opposite - that something triggers inflammation which causes cartilage deterioration.

Â

Its not really an out there theory the MJA very mainstream medical journal of Australia had an editorial about role of obesity in osteoarthritis. It has been long held that the excess wieght causes wear and tear on the joints but this fails to explain why people get OA in the hands. The idea is that the joint inflammation and damage is caused by lipokines, chemical mediators released by adipose tissue. Reasearch is underway to identify the lipokines and develope drugs.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×