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goughy

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

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I actually feel like a sook for having a whinge now! Thanks CG, and that's a genuine thanks, not a sarcastic one. And sorry to read how things have been for you.

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Whinge away!! It's good for the soul :) My dog has been on the receiving end of my whinging for some time and has even developed an expression that seems to be a cross between "I love you mum" and "you're nuts".

 

One other recommendation I can make - try something different. After being told I shouldn't run, I instead concentrated on TT, paddling, and swimming. I'm plucking up the courage to try swimming (when the weather warms up i.e. 40 degrees!!), but I ride and paddle. Initially I kept my garmin in my pocket and then only compared my times with those I'd done post injury. That was good and not demoralising. I found it easier to push a bigger gear initially too and also couldn't stand up hills which was weird as I have no climbing ability (speedhumps scare me) and only made it up hills with brute force.

 

Then there is my paddling. I'm getting my distances up and my times down, but go backwards every time my program changes. I'm ok with that. I find there is something pretty relaxing about a slow paddle up the river when I hurt. I still do my minimum distance, but take it easy, watch the birds, and sometimes enjoy a visit from a dolphin or two, or I pack a picnic. It's not all about going far or fast.

 

So I suggest giving something a bit different a try. Something like paddling that uses different muscle groups but doesn't let you compare to anything you used to do. You can't feel like you have failed if you haven't done it before :)

 

Oh...and take time for yourself. On my last visit to the physio, she asked how my gym program was going. I said I'd not been there in the last fortnight as I was bored and needed a break. I then explained that I'd been riding a bit more and going for a paddle for 30 minutes before work most days. She's never going to tell me off for exercising and understands that any rehab is a long process and sometimes you just need to do what feels best rather than what everyone tells you to do.

 

So take some time out if you need to and don't beat yourself up if you do. And try something new.

 

I'm just saying what I've found works for me. But I still whinge to the dog ;)

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Great post GC, I reckon water is good for the soul & doesnt matter if youre on it, in it, looking at it or even drinking it! Paddling a kakyak or SUP can be magic, a piece of your own National Geographic sometimes. Something to try Goughy?

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So yesterday I finally got out with my old riding group and did the regular Tuesday ride. I've been so busy with work and family the last month I just haven't been doing enough of anything. Finally I've been able to stand on the pedals, which helped with the 500mtrs climbing. Can't remember being this bonked at the end of a ride before. Just nothing. Have lost a tonne of strength and struggled in getting my hr over mid 150's, when it would usually be in the mid 160's to mid 170's. Did get up there once, but I nearly had to get off and push.

 

Stupidly when a mate rang about an arvo walk I went for it. Still pretty swollen and sore this morning. I also got in my first game of golf in the last 6 months, as I wanted to see if it was worth me keeping up my membership. For the first time in 14 years I didn't carry my bag but borrowed a pull buggy from the club. Got through the first 9 ok (very hilly) but it was getting sore and tired by the 11th hole, and was buggered by the 18th. My swing doesn't bother it at all at least. But I doubt I could walk out 2nd 9 second, as it's very hilly and I think I would struggle to finish it.

 

I think I was expecting maybe some big changes? It's a bit frustrating that what's causing me problems wasn't bothering me or what I went in to surgery for, But that's the rub of it I guess. The mate I rode with yesterday who got me into the surgeon said yesterday that my knee is pretty much ****ed so I guess that's where it is. I'm not too happy about it, but there's no one to blame, it's just the luck of the draw. Though I'd like someone to hate. I'm really really missing being able to run. I really enjoy having the new dog and being able to take her for walks, but I really wanted to take her for runs. Was part of the reason I insisted on another border collie, instead of some fluff ball little thing that my wife wanted. Plus running is such a great de-stressor, nothing works like it.

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You stood on the pedals ... but done hardly any training? Isnt that a win??

You went for a walk AND played golf? Maybe, possibly, could be too much in one day ?

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Hey Goughy how's the knee going. I am off to get my knee done Toowoomba Thursday after a couple of frustrating months. Ended with a MRI showing a horizontal tear in the meniscus.

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Hey matto1, it sucks. But the problem I actually was going in to get fixed is great!

 

Who are you seeing/where are you going?

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Seriously! Whacky Pun! Ok, sorry, don't know them at all but every time I see that name at St Andrews that's what I think.

 

Hope it goes well. I know my mate who got me in to my doc ride his bike the next day, but my doc told me not to be stupid like him.

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I got in to Eddie Barui, but I had an inside man ;) Pretty much straight in and then done straight away. He's been great. Did a lot of extra unplanned work.

 

Not the time of the year to see a specialist, that's for sure. They're all skiing of something.

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Hey Goughy how's the knee going. I am off to get my knee done Toowoomba Thursday after a couple of frustrating months. Ended with a MRI showing a horizontal tear in the meniscus.

 

 

...... and want it fixed asap

 

Go and read my 'Stay that knife Surgeon' thread first Matto (if you have the patience to wade through it all :shy: ). A year or two off may be better than being out for life!

 

Unless your knee is locking, think long and hard about having the meniscus trimmed. If they can repair your meniscus (longer recovery, but worth it), that is a much better option. You need to preserve as much of that meniscus as you can.

 

. Did a lot of extra unplanned work.

 

And here's what my mate from California who like me got knocked out for years after what was supposed to be a 'simple knee surgery' says about this Goughy:

 

"If I ever have knee surgery again I will bring a medically trained lawyer and a bodyguard."

 

Even the best surgeons will monkey about in your knee and play God like they know exactly what they are doing, but believe me unless it is an acute injury like torn ligaments or broken bones, everything else (meniscus, and especially the ubiquitous 'clean up') is a lottery.

 

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I'm knocked out of running for life, basically, not years.

 

Don't get me wrong CN, cause I read through all your stuff at the time too! Believe me when I say I didn't take what you said lightly! Could my tear have settled over time, I don't know. It was folded back on itself so who knows? But the problem with my knee cap, no cartledge, and it gouging into bone, what else could be done? Am I happy about it all, no way. Do I like that my knee is sore still most of the time. No. Am I pissed I can't run again, as all hell I am. Do I trust what my doc told me. Yes, absolutely. He even explained at my last checkup that he is loath to do lateral releases, and never does them but my situation was so extreme he had no choice. And that now it's all about holding off a knee replacement for as long as we can!

 

I maybe should say too, that I was just going in for a little meniscus repair. He clearly did a heap more work than planned. He actually apologised for not taking an initial photo when he got in there, he said he was so shocked by what he saw he completely forgot. I checked up about this guy before I went to see him. I already knew of him by reputation, but I asked people I knew who'd been to him. They were all glowing. One in particular is a multiple Kona competitor who is also the guy I've gone to for bike fits and advice (paid) regarding training etc. He's a very 'earthy' guy, all about the bare foot running, stuff like that. Was also still competitive in his 50's at the trex series'. He waited over a year to have a knee fixed so he could get this doc to sort him out through the public health system, and couldn't speak higher of the results.

I don't know if this makes any difference either, but he hasn't charged me a cent either. My mate got me on 'his list' and it's cost me nothing other than what he charged to my health fund. The anesthetist also hasn't charged me either. So I am very grateful for that, and I doubt if I was going in for a little thing, that they'd have gone that far without charging a lot extra or going back in later to fix the rest.

 

I'm sorry if it feels like I have to justify what happened, or defend my doc. But it kinda does feel that way. I totally understand how bad things have gone for you, and others. Including others I know locally who I've also spoken to, who are now trying radical things to get back to running again. And I've certainly seen within other medical industries where things can be a bit gungho, way above the necessary and of little benefit to those other than those getting paid.

 

I am absolutely gutted with where I am now, it is doing my head in, and even my wife who knows physical activity is fantastic for my head, can't grasp how walking and riding or swimming, doesn't do it the way running does. There is just something about it. She even reckons I should try crossfit out now - I mean, Crossfit!

 

The way I look at it, sometimes you're just ****ed. There's a heap out there who have things a lot worse than me, that's for sure.

 

I'm sorry for this big response. But honestly, with the mood I'm in this morning you weren't gonna get a haiku. And don't get me wrong, I'm not pissed at you. Just feeling frustrated, that's all.

Edited by goughy

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I feel ya pain too goughy. I dont blame my doc so much as the timing.

 

I had mine in feb, but picked up riss river virus while still healing.

 

The arthralgia i developed is mostly in my knees, but worst in the one that was healing from surgery.

 

Looks like i might be sliding out of running too. I have one sprint and 2 ODs lined up in the next 10 weeks. The 10ks will be tough

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My thoughts Goughy:

 

I'm knocked out of running for life, basically, not years.

 

Maybe, maybe not.

 

Don't get me wrong CN, cause I read through all your stuff at the time too! Believe me when I say I didn't take what you said lightly! I know.

 

Could my tear have settled over time, I don't know. It was folded back on itself so who knows? Probably not if folded back.

 

But the problem with my knee cap, no cartledge, and it gouging into bone, what else could be done? Am I happy about it all, no way. Do I like that my knee is sore still most of the time. No. Am I pissed I can't run again, as all hell I am. Do I trust what my doc told me. Yes, absolutely. Did he also 'shave the kneecap cartilage'? This is what f*cks a lot of people (including my internet mate Ed in California). He went in for one thing, and the surgeon did other undiscussed stuff. He was extremely pissed BUT the good news is he is now back riding hard again. Kneecap cartilage is the best to have damage to as it appears to have some capacity to heal BUT IT IS VERY SLOW TO HEAL AND NEEDS VERY CAREFUL ATTENTION. And figuring out how to heal it is like solving the da Vinci code - except there are 7 billion codes because everyones knees are different.

 

If your knee is still swelling, I'd be going nowhere near bike or run, and doing what I did for a year or more. Swim with pull & band (minimal kicking), easy walking every morning for 20-30 mins, upper body gym work, perhaps some lateral thera band crab walks to keep hips/glutes working. Nothing that loads the kneecap esp in the mid-range of motion (eg. squats, seated knee extensions, though after the swelling settles you may be able to start shallow sissy squats (supported with arms on frame) and light deadlifts/kettlebell swings. But keep knee flexion less than about 60 deg.

 

Your knee knee some serious healing - years probably. So also watch what you do at work (crouching/kneeling probably out).

 

He even explained at my last checkup that he is loath to do lateral releases, and never does them but my situation was so extreme he had no choice. And that now it's all about holding off a knee replacement for as long as we can!

 

My view is that unless your kneecap is seriously mal-tracking, lateral release should be avoided BUT it will require going very gentle on your knee for a long time to allow the holes in the kneecap cartilage and on your femur bone to heal. It requires the patience of a Saint to heal this stuff, but I've seen examples of those who have done it, and I followed their route (though not as patiently hence I'm still not fully mended).

 

I maybe should say too, that I was just going in for a little meniscus repair. He clearly did a heap more work than planned. He actually apologised for not taking an initial photo when he got in there, he said he was so shocked by what he saw he completely forgot. I checked up about this guy before I went to see him. I already knew of him by reputation, but I asked people I knew who'd been to him. They were all glowing. One in particular is a multiple Kona competitor who is also the guy I've gone to for bike fits and advice (paid) regarding training etc. He's a very 'earthy' guy, all about the bare foot running, stuff like that. Was also still competitive in his 50's at the trex series'. He waited over a year to have a knee fixed so he could get this doc to sort him out through the public health system, and couldn't speak higher of the results.

I don't know if this makes any difference either, but he hasn't charged me a cent either. My mate got me on 'his list' and it's cost me nothing other than what he charged to my health fund. The anesthetist also hasn't charged me either. So I am very grateful for that, and I doubt if I was going in for a little thing, that they'd have gone that far without charging a lot extra or going back in later to fix the rest.

 

He sounds like a good bloke, but I still think conservative treatment & patience should be tried first for kneecap cartilage damage. I agree your meniscus (like mine) probably could not avoid surgery. But surgeons do not seem to be up on some of the research about patella cartilage recovery (though it takes a LONG time). My OS thankfully avoids patella shaving.

 

I'm sorry if it feels like I have to justify what happened, or defend my doc. But it kinda does feel that way. I totally understand how bad things have gone for you, and others. Including others I know locally who I've also spoken to, who are now trying radical things to get back to running again. The most radical thing they can do is educate themselves and come to terms with the fact that it can take years (another bloke I know took 6yrs, but he got there).

 

And I've certainly seen within other medical industries where things can be a bit gungho, way above the necessary and of little benefit to those other than those getting paid.

 

I am absolutely gutted with where I am now, it is doing my head in, and even my wife who knows physical activity is fantastic for my head, can't grasp how walking and riding or swimming, doesn't do it the way running does. There is just something about it. She even reckons I should try crossfit out now - I mean, Crossfit!

 

I know how it feels, and I'm not out of the woods yet, but it can be done by finding your 'sweet spot' - just the right amount of knee exercise to promote healing, without making things worse.

 

The way I look at it, sometimes you're just ****ed. There's a heap out there who have things a lot worse than me, that's for sure. You may not be f*cked. My knees felt that bad it was terrible. It felt like ALL the cartilage had disappeared within a matter of months. but it had not. While some was no doubt damaged, it was the loss of tissue homestasis that caused the most pain/inflammation. You need to get that under control which means avoiding 90% of what you used to do, making peace with that for a while, but finding enough exercise to keep your sanity (it is tough I know).

 

I'm sorry for this big response. But honestly, with the mood I'm in this morning you weren't gonna get a haiku. And don't get me wrong, I'm not pissed at you. Just feeling frustrated, that's all. It's all good mate. I became a complete prick when the pain was at its worst. Chronic pain is farkin tough.

Edited by ComfortablyNumb

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The 'knocked out for life', is partially a choice of mine. He said if I continued to run I could be looking at a knee replacement within the next 5ish years. His advice was that we want that to happen (and it will happen he said) as far down the track as I can make it. Taking everything into consideration; my family, my work, etc etc it was a decision I have to make. I have just too many other responsibilities to place above being able to run.

 

I don't believe he touched what was left on my kneecap. He said there wasn't much, and it was very soft. He repaired the damage my kneecap had done to the bone in my femoral groove, but there was no cartilage left there at all.

 

My exercise physiologist has me doing some banded crab walks, plus a handful of other things, mostly with bands. I have some squat like things to do, but all supported with bands in every bloody direction. I swear you'd think I'm into S&M there's so much rubber strapped around me!

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I had both knees done in 2002/03 - torn meniscus. Still have me grief to the point where I said to myself in 2006 that I would train for the Canberra marathon and either break myself for good, or tick off a bucket list item. I manage to finish that marathon (in a very slow 4:26) but I've gone on to finish 6 more plus 4 IMs plus 3 x 100km trail races plus a bunch of other races. My knees have only gotten stronger and stronger and there is no way I would have done any of those races without the operations. Some people get poor outcomes, but plenty get great outcomes.

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This rehab stuff sucks! How come, every time I start to get good at an exercise, the ex physio goes and makes them bloody harder again!

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Well, things are progressing swimmingly!  Ex Physio last week and he's happy with how I'm progressing, he said considering when he first saw me and tested me he had no idea what he was going to be able to do......

Unswimmingly, a few weeks ago I hurt my back doing the stiff leg deadlifts and haven't ridden or swum since (as they both can aggravate my back), though I think it's nearly back to normal.  Then, naturally, after thrashing me at the ex physio last thursday, as I left and walked down the stairs I knew I was gonna be in trouble.  Since then my good knee has been pretty painful, in particular very stiff and sore after sitting or lying for a while.  It's sore around the cap, and also in the crook of my knee.  Has me limping a fair bit and has left me doing lazy walks with the dog at best.  Clearly I'm just not made for this crap as I keep breaking myself.  Don't know what to do about this one as it hasn't really improved much at all in the last week.  Maybe it's just a strain....

I'm ****ed.

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And now pics are going to be done of my left knee. Doc doesn't think it'll find anything he'll need to work on, but since it was pretty sore and is still a bit off, may as well take a look.

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So doc visit today, and he told me before I walked into his office that I'm gonna hate him.

We didn't talk much about my kneecap, where the report says I have grade 3 chrondalmasia. Mostly he said at least it's not as bad as your right ;)

But I also now have a horizontal tear in my left cartilage on the inside. So where to from here. We chatted for a bit, but right now his recommendation is to not scope it. He is leaving that decision up to me, but since it has felt better (though I aggravated playing with the dog on the weekend) and it hasn't been bothering me cycling, he doesn't think we should go in. He said to give him a buzz if it starts bothering me at work or something and then he'll sort out straight away. But that management would be a better way forward for now.

I feel a little older today..... have to start borrowing my wife's walking stick (if only it wasn't purple with polkadots).

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Bummer, still it sounds like cycling may be your "out". 

See how you go over the coming weeks. 

FM

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Sucks Goughy. I had the meniscus in both of mine done and both would be good if I could only lose some of the weight my shoulder injury made me gain!! I remember my surgeon telling me that he would have seen me 10 years previously if I didn't ride a bike and that I'd most likely done them both just over 20 years ago (I remember a really bad tackle playing hockey). The muscle was keeping everything stable. So ride a bit more (trainer so you don't go overboard) and start doing the strengthening exercises you were given for the other knee. It might just help :)

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Quite a big position statement from British Medical Journal in the last week, with a recommendation to NOT have arthroscopic surgery in patients with degenerative knee conditions e.g. meniscus tears, osteoarthritis. 

http://www.bmj.com/content/357/bmj.j1982

Such a change in stance from 15 years ago

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5 hours ago, Aidan said:

Quite a big position statement from British Medical Journal in the last week, with a recommendation to NOT have arthroscopic surgery in patients with degenerative knee conditions e.g. meniscus tears, osteoarthritis. 

http://www.bmj.com/content/357/bmj.j1982

Such a change in stance from 15 years ago

and all too late for so many, where the old medical ethics stance of primum non nocere has been breached.

My knees are 90%+% fixed though it took almost 5yrs  Even found myself kneeling and squatting out fishing the other day.

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Well, I had to run today, full out (for me) for about 1k. Was out walking my dog and she got out of her collar and bolted, so off I went after her. And as exhausted as that 1k felt, it felt friggin awesome! My legs felt great and absolutely zero discomfort in my knees. I really wish I didn't have to do that..... It's like giving someone who hasn't had chocolate for a couple of years a Freddo frog, then after telling them they'll never have chocolate ever again......

.......mmmmm chocolate!

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On 5/18/2017 at 6:40 AM, ComfortablyNumb said:

and all too late for so many, where the old medical ethics stance of primum non nocere has been breached.

My knees are 90%+% fixed though it took almost 5yrs  Even found myself kneeling and squatting out fishing the other day.

Best practice is vastly different in many areas of medicine than it was 15 years ago. Knowledge, techniques etc all advance. Long term results of new procedures take, um, a long term to be studied properly and transformed into clinical practice. I read on the inter web that it takes 24 years from discovery for something to become mainstream medical practice.

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So, during yesterdays little race I decided to run instead of walk.  I'm not surprised by this, after my mate egged me on for a while saying it's only a little bit of running.  Plus, it really was hard not to around everyone else who was!  I might have a different attitude on a longer race (like an IM), but for 6k..........  Anyway, that was pretty much the first time I've run a step since, well pretty much since this thread started (or longer).  I actually had less, or really no, discomfort from my knees than I was prior to all this.  But what really affected me was after 4.5k I just couldn't run (let's call it jog from now eh) anymore and had to walk.  My muscles had just given out!  My pace had dropped to just over 6min/k but my hr, which had been up around 170+ since the start of the ride and the first 4k of the run, was back down to 141.  So I started walking and was going at about 7:50/k and in short order my hr was back up to around 170 again but I was feeling fine.  So after a bit of walking I started running again but fairly quickly I was just stuffed again and had to walk.

This is similar to what happened when I did the GC Half mara on pretty much no long training prior to getting into tri.  Then I hit 16k and just couldn't hold my pace and it dropped right off.  Nothing I could do to go faster but by the finish line my hr had dropped.  I put it down to my muscles giving out because I simply didn't train to run even near that distance, and I'm thinking the same thing happened here.  I haven't run in ages so my muscles/body wasn't used to it?  Am I on the right track with this?

If so, is there anything I can do without running to get them into shape for events?  I absolutely am not going to do any run training at all!  But I kind of thought during the event, that the doc said if I run I'll be looking at a knee replacement in about 5 years.  I figure it I run only at events, which I don't go to often, I'll only end up running in a year what I used to in a week.  So surely that can't hurt too much could it?  I thought I'd be able to handle walking at events (I'm not typically someone who cares what people think of me, or can be egged on to do something they don't want to) but around everyone and in the atmosphere of the race it was really really hard when I had to drop to walk, especially in only a 6k race.  I realise there probably isn't something that will replicate the impact and stress of running except actually running.  I might look next time at something like a 2min/1min run walk where I go hard during the run but get plenty of walking breaks.

Afterwards, while cooling down, my knees (felt like knee caps) were getting sore, but a quick quad stretch and that pretty much instantly went away.

I know if I did something much longer I could suck it up - it's a different sort of thing.  But these sprint to OD distance races...... just don't know if I can.  Maybe if I could walk the distance at 6min/k, that would be different.  But the reality is atm I could only sustain I think about 8 to 8.30/k (maybe lower since courses seem flatter) but certainly not 6.30 to 7min/k.  I can hit those paces during interval sets of 200mtrs, but not over sustained distances.  Maybe in time.........

And my wife wasn't too happy with me either - I couldn't lie to her about having run (my daughter promised to not tell her).  But in the big scheme of things, I mean running 30 or 40k a year total, could it cause me much long term trouble?

Edited by goughy

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I was wondering if pool running was the best answer...... hoping it wouldn't be.  Just a pain to get to the pool (yeah, excuses excuses).  But I have used it in the past and am fine doing it without the flotation belt. 

Edited by goughy

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can you not do any run training? 20km on hard tarmac in racing flats vs 4km on grass in nice spongy hokas? What about adjusting your run technique so there is very little impact when you land. My mate has a crook back and runs sort of between a runner and powerwalker and there's very little impact.

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Only going on ortho's advice and my wife's insistence: suppose to be zero running at all. I just figured, zero isn't really zero; I mean you have to run sometimes. I ran a K a few weeks ago chasing my dog. So just thought if I only run at races, in a year I'll really do very very little running still.

I expected it was gonna hurt and I would struggle, so I either just have to put up with that, or find a way around it.

I will say, I had less pain in my knees than I've had in years, if not actually ever. And by less, I had no pain or discomfort in them at all until that soreness while cooling down, which went away after a stretch.

Edited by goughy

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4 hours ago, goughy said:

  But what really affected me was after 4.5k I just couldn't run (let's call it jog from now eh) anymore and had to walk.  My muscles had just given out!  My pace had dropped to just over 6min/k but my hr, which had been up around 170+ since the start of the ride and the first 4k of the run, was back down to 141.  So I started walking and was going at about 7:50/k and in short order my hr was back up to around 170 again

I did an all out 30min run on the weekend.  After good warmup.  Felt not too bad. 

Av pace 6:07.  Max hr 176

F##k it all

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