6.27.2012

chondromalacia update

I posted a while back about my knee problems and my hopes/goals going forward with regards to what activities I would be able to do.  In short, I was diagnosed with chondromalacia after limping off the soccer field and being unable to walk without pain 3 summers ago.  It sometimes hurt on the bike and always hurt when running.   Slowing down, running downhill, cutting to my right or kicking a soccer ball were all pretty much not options.  I had been a long time athlete who had taken a break after college and was trying to get back in shape/enjoy the outdoors more again.  I felt like the care that I'd been given was poor and all options certainly weren't explored on a medical level, but didn't see a lot of options without incurring bills on top of other bills I couldn't pay so I just sort of did what I thought would be best.  I double checked the fit of my bikes and avoided running.  I did some specific exercises etc. etc..

It has now  been about 34 months since the initial issues came up.  What has been most interesting to me is that I've made steady progress thoughout that entire time period.  It was slow at the beginning and has been slow throughout the whole process but now I find myself able to do things that would have hurt previously and without thinking about it.  I'm still afraid to include running in any of my training-  and I do really miss trail running.  However, running to stay out of the rain, running a few blocks to get somewhere faster or the running necessary for cyclocross is no longer painful.  It took until this spring before I could rollerblade without any pain.  Rollerblading used to seem ok, but then the knee would hurt doing regular things the next day and sometimes on my bikes.  I learned to skate ski two winters ago and really braced the knee up, but still had to endure some pain (and the worry that I was making things worse).  This year it was a bit better, I could ski to exhaustion without any significant issues.

Downhill skiing is the biggest question mark for me.  I'm sure it was the actual root of the damage and it's also something I really don't want to give up forever.  Skiing has been a large part of my identity for most of my life. I've not gone to any 'real' ski areas since the first winter after the pain.  I'm sort of clinging to the hope that over time as my strength increases, time passes etc. that I'll be able to aggressively ski again.  I remember one trip to Welch three years ago where I was completely unable to ski whatsoever.

I've also lost 20-25 lbs since that summer (more on this in another post).  I believe that much of the gains I've seen this past winter/spring are directly related to the weight loss.  Weight loss and increased strength cannot hurt!  That said, I don't want a recurring problem that requires me to always work my ass off or have pain.  I felt like that was basically the direction my doctors wanted me to go with lots of physical therapy etc. and no other hope for the future.  I am hoping that by resting it and strengthening it I am buying time before an appropriate medical solution can be found and paid for.  I do have a new doctor who is much better with sports stuff now and I may bring it up again this year as well, although it was my provider's sports specialists previously who really left me with no hope.

Last year I posted that I had a long-term goal of being able to run the 6 miles or so each way to work and back.  I did try running a few times last fall and found that I didn't feel "ready", or maybe didn't have just the right brace, or maybe was just too worried about setting myself back.  I'm not sure when I'll get the motivation to get back at this.  At the very least it might be fun to be able to run a pain-free 5k or two with my friends.

Thoughts?

3 comments:

  1. I can relate to all of this. With out all the details a major knee injury in 72, 4 knee sugeries over the years, but with efforts of competition in cycling, running, and powerlifting. I understand your battles. You've done a great in managing your situation, ajusting, adapting, and learning. I found out like you one of the most important factors is weight. My battle of food and beer excess when lost means a sore knee. Keep on.

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  2. getting back into running is a very difficult task, its something ive been tring to do, but ive found that ive ridden so many miles this year (theo most ive ever done im at 3700) im having a hard time getting my body to accept the different use of muscles

    in summers past i had no issue going out and running 7 miles having only ridden 60ish miles total a week. now that im in the 200plus miles, the going is very slow, but it is also rewarding. so keep at it and eventually it will come back to ya.

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  3. GREAT ARTICLE!

    Losing the weight took 60 pounds of impact force off your pronation supination cuff muscles on the landings. If they cannot spring back the impacts your foot will roll either inside or outside and that means your leg will rotate misaligning the knee cap.

    In running as you know there is simplistically the "take off" and the "landing"

    When you run with braces (shoes) your body has an artificial support and an artificial landing gear that most think will keep the foot centered. You know that is the job of the muscles to do that.

    Most runners strengthen the take off muscles thinking the artificial support and think that their artificial landing gear (shoe cushion) will do the trick. We all know the majority of injuries occur in the landings.

    The key is to strengthen the muscles that resist the over rolling of the foot outside the "safe range between supination to pronation (rolling from the outside to the inside) during impacts. If the foot rolls to an unsafe position then the knee rolls to an unsafe position. Logical so far?

    I call these muscles the landing muscles, the spring suspension system muscles or the pronation supination cuff muscles

    Here are my last two articles you might find helpful:

    How Does The Body Spring Back Safely From Impacts Of Running and Walking?

    http://teamdoctorsblog.com/2012/06/13/video-tutorial-12-is-running-bad-for-knees-how-the-body-springs-back-safely-from-impacts-of-running/

    Self-Tests & Exercises To Reduce Over Pronation and Over Supination From Impacts During Walking and Running

    http://teamdoctorsblog.com/2012/06/18/video-tutorial-28-the-impact-absorbing-landing-muscles-of-the-human-spring-mechanism-testing-and-training-the-spring-suspension-muscles/

    Here is a more specific article on the knee pain under the knee cap that is cracking on deep squats or walking up stairs. I think you will get this but if not let me know


    Cracking Achy Knee Pain or Chondromalacia Patella – Treatment and Prevention Tips from The Barefoot Running Doctor
    http://teamdoctorsblog.com/2012/05/25/cracking-achy-knee-pain-or-chondromalacia-patella-treatment-and-prevention-tips-from-the-barefoot-running-doctor/

    Lets network on FB and the Twit thing too Thanks

    Doc Stoxen

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