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SereneProdigy
Posted: Tuesday, September 10, 2013 1:24:20 AM

Rank: Cryptic Vigilante
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Hello everyone,

Since a few months, I've been suffering from pain in both of my knees. Nothing major really, but enough to cause discomfort and get me worried. I must say that I lift weights regularly, and train my legs once per week.

The pain is located on the front, below the kneecap. I can also hear/feel my knees cracking at times when I flex my legs. I did some research and I believe it might be arthritis (deterioration of the joint). I'm seeing my doctor in 2 weeks ; hopefully she'll offer a diagnosis or a x-ray exam. I also asked for advices here and there, and so far I've been recommended to :

- Take glucosamine supplements (I already did that)
- Perform stretch routines to increase flexibility
- Use knee sleeves to improve support during exercises

One thing I'm confused about is concerning inflammation. Some say it should be eliminated, while others say it is a natural healing process and shouldn't be hindered (the latter has received more attention recently). Almost opposite regimens can be followed in each case, RICE or MEAT.

http://www.caringmedical.com/meat-vs-rice-treatment/

RICE = Rest, Ice, Compression, Elevation, used to reduce inflammation

MEAT = Movement, Exercise, Analgesics, Treatments, used to stimulate joints and accelerate the healing process

Does any of you know about these regimens, or have any other advice to share?

Thanks a lot!
Dancing_Doll
Posted: Tuesday, September 10, 2013 7:30:24 AM

Rank: Alpha Blonde
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Joined: 2/17/2010
Posts: 7,185
Location: Your dirty fantasy
Look this up and see if your symptoms match: Chondromalacia Patella (Patellofemoral Syndrome)

It's quite common, sometimes known as runner's knee and young athletes often develop this, either do to misalignment or it can be exacerbated by chronic injuries. If you have crackling/crunching when you squat/flex, it's possible this is the scenario. There is a very quick and painless arthroscopic surgery called a chondroplasty they can do to basically 'file down' the bone spurs and clean up surface defects causing the grinding and cartilage deterioration. It's day surgery and down-time is very minimal. From there, supplements, physio and strengthening exercises/adjustments (see below) and knowing limitations is best for a long-term strategy.



Chondromalacia patellae refers to the progressive erosion of the articular cartilage of the knee joint, that is the cartilage underlying the kneecap (patella) that articulates with the knee joint.

Description

Chondromalacia patellae (CMP), also known as patello-femoral pain syndrome or patello-femoral stress syndrome, is a syndrome that causes pain/discomfort at the front of the knee. It is associated with irritation or wear on the underside of the kneecap, or patella. In a normal knee, the articular cartilage is smooth and elastic and glides smoothly over the surface of the thighbone, or femur, when the knee is bent. Erosion of the cartilage roughens the surface and prevents this smooth action.
CMP is most common in adolescent females, although older people may also develop it. An average of two out of 10,000 people develop this condition, many of them runners or other athletes.

Causes and symptoms
CMP is the result of the normal aging process, overuse, injury, or uneven pressures exerted on the knee joint. In teens, CMP may be caused by uneven growth or uneven strength in the thigh muscles. Growth spurts, common in teens, may result in a mildly abnormal alignment of the patella, which increases the angle formed by the thigh and the patellar tendon (Q-angle). This condition adds to the damage. Symptoms include pain, normally around the kneecap, and a grinding sensation felt when extending the leg. The pain may radiate to the back of the knee, or it may be intermittent and brought on by squatting, kneeling, going up or down stairs, especially down, or by repeated bending of the joint.

Diagnosis
Diagnosis is established during a physical examination performed by a general practitioner or an orthopedist, and is based on frequency of symptoms and confirmed by x rays of the knee. The CMP erosion can also be seen on an MRI, although this type of scan is not routinely performed for this purpose. The patient should inform the doctor about any previous injuries to the joint.

Treatment
Initial treatment may consist of resting the knee using crutches, along with aspirin, Tylenol, or a nonsteroidal anti-inflammatory drug (NSAID) such as Motrin for seven to 10 days. The person should limit sports activity until the joint is healed and may use ice followed by heat to decrease inflammation. When the doctor allows the patient to resume sports, a knee brace may be prescribed in the form of a stabilizer with a hole at the kneecap.
Treatment also includes low impact exercises to strengthen the quadriceps muscles which help stabilize the knee joint. Physical therapy may be suggested at the start of this program so as to help the patient learn the correct method of performing the exercises.
Approximately 85% of people do well with conservative CMP treatment. The remainder still have severe pain and may require arthroscopic surgery to repair the tissues inside the knee joint. In more severe cases, open surgery may be required to realign the kneecap and perhaps other corrections.

Alternative treatments
Physical therapy offers treatments that may help CMP patients. Aqua therapy has the benefit of exercising the knee without putting stress on it and it also strengthens the thigh muscles. Biofeedback can be used to learn tensing and relaxing specific muscles to relieve pain. These techniques have the benefit of no side effects. Massage therapy might be beneficial as well. Calcium, minerals, and vitamins as part of a balanced diet will aid healing and help prevent further problems.

Prognosis
In most teens with CMP, the prognosis is excellent since the damage is reversible when treatment starts before the cartilage begins to break down. With proper treatment and preventive techniques, teenagers will complete their growth without permanent damage to the joint. Only about 15% of patients require surgical intervention. Older people may go on to develop osteoarthritis in the knee.

Prevention
Proper exercises are the best preventive measure. Since tightness of thigh muscles is a risk factor, warming up before athletic activities is recommended, as well as participating in a variety of sports rather than just one. Stretching exercises increase flexibility of the quadriceps, hip flexors, and hamstrings. Strengthening exercises such as short arc leg extensions, straight leg raises, quadriceps isometric exercises, and stationary bicycling are also recommended.


elitfromnorth
Posted: Tuesday, September 10, 2013 8:36:27 AM

Rank: Brawling Berserker

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Posts: 1,637
Location: Burrowed, Norway
Ask your doctor if there's anywhere they can take a mould or scan of the underside of your foot. It's a very common problem that the weight isn't distributed evenly like it should when you walk or run. This can cause problems all the way up to your lower back. Treatment is a pair og custom made soles you put in your shoes.

If you have knee problems in general then get good shoes and don't run on pavement or treadmill. Find a softer surface to run on.

"It's at that point you realise Lady Luck is actually a hooker, and you're fresh out of cash."
elitfromnorth
Posted: Tuesday, September 10, 2013 8:37:59 AM

Rank: Brawling Berserker

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Posts: 1,637
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Ask your doctor if there's anywhere they can take a mould or scan of the underside of your foot. It's a very common problem that the weight isn't distributed evenly like it should when you walk or run. This can cause problems all the way up to your lower back. Treatment is a pair og custom made soles you put in your shoes.

If you have knee problems in general then get good shoes and don't run on pavement or treadmill. Find a softer surface to run on.

"It's at that point you realise Lady Luck is actually a hooker, and you're fresh out of cash."
MadMartigan
Posted: Tuesday, September 10, 2013 11:59:12 AM

Rank: Raised on Blackroot

Joined: 6/17/2013
Posts: 2,206
Location: United States
elitfromnorth wrote:
Ask your doctor if there's anywhere they can take a mould or scan of the underside of your foot. It's a very common problem that the weight isn't distributed evenly like it should when you walk or run. This can cause problems all the way up to your lower back. Treatment is a pair og custom made soles you put in your shoes.

If you have knee problems in general then get good shoes and don't run on pavement or treadmill. Find a softer surface to run on.


This. I have terrible knees in general, however, I got diagnosed with a mild case of plantar fasciitis a couples years ago. The inner parts of my feet were 'falling inwards' because I am pretty much flat footed.

Got custom orthotics to treat it. It has helped greatly.

And yea, running on pavement KILLS your legs/feet. Doesn't matter who you are, they will. Our bodies, at least as they've evolved now, aren't built for running miles upon miles a week.
SereneProdigy
Posted: Tuesday, September 10, 2013 1:56:57 PM

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Thanks a lot guys. My doctor will surely tell me more about my issues, but it might take a while before I receive an official diagnosis/treatment (x-rays, etc). What bothers me a bit is that I've been taking it easy for a month, but still feel pain. I think exercising helps the overall health of the joints ; it seems the less I'm active the more the pain takes over. But I don't want to cause further damage either. I might engage in light exercises only before I meet my doctor.
elitfromnorth
Posted: Tuesday, September 10, 2013 7:00:14 PM

Rank: Brawling Berserker

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I would suggest riding a bike, it be stationary or actually going outside the gym, and run it on lighter gears. Then you keep movement but you don't really put pressure on it. Movement is good unless you're healing from a fracture or a torn tendon or something, but not putting weight on it.

"It's at that point you realise Lady Luck is actually a hooker, and you're fresh out of cash."
jeremiahbull
Posted: Tuesday, September 10, 2013 11:28:11 PM

Rank: Forum Guru

Joined: 10/30/2011
Posts: 2,091
Location: United States
You need a professional diagnosis but you got some pretty good advice here. As far as the RICE vs MEAT question you raised...it comes into play if the diagnosis is muscle or tendon damage. Cartilage has essentially no blood flow and cannot be rebuilt (there is some debate about this however now). Joint re-alignment and surgery as others suggested will be required for cartilage issues. So if you are dealing with muscle or tendon damage the answer is MEAT. RICE may make sense in the first 24 hours to reduce swelling but after that you need to rebuild tissue. You MUST have blood flow to rebuild tissue. You need exercise to increase blood flow. You need proper nutrition (including quality protein) to rebuild tissue. You also need proper rest. So don't try to lose weight when healing from a serious injury - better to err on the side of too much fuel than not enough for healing.

I successfully recovered from a serious tricep tendon tear without surgery by following this advice from an orthopedic surgeon. Surgery could have eliminated the pain but I would have lost strength. High rep lifting to promote blood flow did not eliminate the pain for quite some time but eventually the pain left and my strength returned.

Just recently an acupuncturist said the same thing and was impressed and surprised that an orthopedic surgeon had recommended the same.
LYFBUZ
Posted: Friday, September 13, 2013 10:32:26 PM

Rank: Forum Guru

Joined: 12/27/2012
Posts: 4,461
Location: 1st star to the left, Canada
Lots of good advice here...I had knee pain from years of distance running...I switched to biking and my knees are better than ever..
Serene: you said you worked your legs only once a week? Maybe you are overdoing it? I'd suggest 3 times per week, maybe with less weight but you could try a combo of weights and biking...
sprite
Posted: Friday, September 13, 2013 10:53:38 PM

Rank: Her Royal Spriteness
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don't pay attention to anyone else. you're dying. that's the truth everyone is afraid to tell you. sorry, but sometimes, you just got to be honest. it starts with the knees and then, pretty soon, it's your brain and then it's lights out. it's been nice knowing you. Big Hugs



Love not hate.
Adagio
Posted: Saturday, September 14, 2013 12:30:15 AM

Rank: Forum Guru

Joined: 1/24/2013
Posts: 2,192
I broke my knee cap once and I thought it was the worst pain ever
c50t
Posted: Sunday, September 15, 2013 10:33:57 PM

Rank: Forum Guru

Joined: 4/9/2011
Posts: 382
Location: United States
Overall I have to side with Sprite. You are dying. No one gets out of this world alive.
However, in the short term, I will offer my 2 cents. In today's monetery exchange it's worth ... well, let's say I owe you ...
I've had some knee pain like you describe. In one knee, but not both. Tried glucosimine. Nothing. Went to my chiropractor, and casually mentioned it as something that I was sure he could do nothing about. It turned out that the reason he became a chiropractor in the first place is because after three knee surgeries as a professional athelete he only found releif from a chiropractor.
He fixed me up. Now, when symptoms resurface, I go straight to him and he clears it up with one adjustment.
justforfun9
Posted: Monday, September 30, 2013 9:46:16 PM

Rank: Forum Guru

Joined: 2/9/2012
Posts: 140
Location: United States
I have had three knee surgery's two ACL AND one MCL. could be meniscus needs cleaning up and gluecose would help but i am leaning toward Dancing Doll with tendinitis in that case fish oil helps as well and ice when you are done working out. for your legs if you are doing squats us the sled instead less strain on the knees.
SereneProdigy
Posted: Monday, September 30, 2013 9:54:51 PM

Rank: Cryptic Vigilante
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Joined: 7/16/2013
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Update : I was officially diagnosed with Chondromalacia Patella. My doctor recommended that I seek advice from a physiotherapist to correct my knees alignment. I'll keep you informed.

Thanks for all the advices. I really appreciate it!
Guest
Posted: Saturday, October 5, 2013 12:30:16 PM

Rank: Lurker

Joined: 12/1/2006
Posts: 781,128
SereneProdigy wrote:
Update : I was officially diagnosed with Chondromalacia Patella. My doctor recommended that I seek advice from a physiotherapist to correct my knees alignment. I'll keep you informed.

Thanks for all the advices. I really appreciate it!
Did your Doc refer you to an Orthopedic Doc? Or just make the diagnosis on examination? Second opions aren't a bad idea in this day and age. Take it easy on your knees for awhile. Try swimming for leg exercise. Also make sure to focus on using your muscles correctly when working out.
Guest
Posted: Monday, October 7, 2013 12:19:18 PM

Rank: Lurker

Joined: 12/1/2006
Posts: 781,128
I was going to say stretching your hips. When running sometimes my knees ache and that's what the physical therapist suggested. Since you've seen your doctor follow their advice.
Guest
Posted: Thursday, October 10, 2013 1:19:49 PM

Rank: Lurker

Joined: 12/1/2006
Posts: 781,128
have you tried the natural methods? like ayurvdic and siddha medicine?
else, do meditation .... you'll analyze it and locate the pain .... and you can find what's the source !!
Tellerman
Posted: Saturday, January 18, 2014 4:09:26 PM

Rank: Active Ink Slinger

Joined: 12/18/2013
Posts: 31
Location: Australia
SereneProdigy wrote:
Hello everyone,

Since a few months, I've been suffering from pain in both of my knees. Nothing major really, but enough to cause discomfort and get me worried. I must say that I lift weights regularly, and train my legs once per week.

The pain is located on the front, below the kneecap. I can also hear/feel my knees cracking at times when I flex my legs. I did some research and I believe it might be arthritis (deterioration of the joint). I'm seeing my doctor in 2 weeks ; hopefully she'll offer a diagnosis or a x-ray exam. I also asked for advices here and there, and so far I've been recommended to :

- Take glucosamine supplements (I already did that)
- Perform stretch routines to increase flexibility
- Use knee sleeves to improve support during exercises

One thing I'm confused about is concerning inflammation. Some say it should be eliminated, while others say it is a natural healing process and shouldn't be hindered (the latter has received more attention recently). Almost opposite regimens can be followed in each case, RICE or MEAT.



RICE = Rest, Ice, Compression, Elevation, used to reduce inflammation

MEAT = Movement, Exercise, Analgesics, Treatments, used to stimulate joints and accelerate the healing process

Does any of you know about these regimens, or have any other advice to share?

Thanks a lot!

You don't say how old you are but it sounds like Meniscus tear or arthritis. My ortho surgeon reckons nothing works except losing weight.
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