Knee Problems historical posts May 1998

Re: Chrondomalacia

Posted by Bobbie Lawson on May 09, 1998 at 19:52:38:

I'm 41 and have suffered from this problem for most of my life. Basically, I was told that this condition comes about as predisposition to it, genetically. There are knee braces other than the neoprene sleeves that work better. Also, lots of exercises to strengthen the muscles in the thighs will help somewhat. I've had a total of 5 'scopes so far with a 6th coming in the next few months. I feel badly for your daughter, to have so much pain and problems at such a young age is a shame. I wish I knew of a magical cure, both for her and myself and others that suffer with this condition.



Re: Chondromalacia

Posted by Walt Stoll on May 11, 1998 at 10:33:35:

In Reply to: Re: Chrondomalacia posted by Bobbie Lawson on May 09, 1998 at 19:52:38:

Dear Bobbie,

Whoever told you that what you are experiencing has a genetic susceptibility is exactly right. However, what that means is that you will have to work harder than those without this susceptibility to keep your cartilege functional.

I hope you will become a student of all this so you can change the things you CAN change and see how much better you will be.

I know that unsolicited advice will likely be ignored. SO, rather than waste my time giving it, I will wait for you to ask.

You would be a good one to give glucosamine sulfate a try while you are learning what you can do to reverse this. It cannot hurt you & just might help rebuild cartilege at this stage. Since it is not an analgesic, ANY improvement in symptoms means that the surfaces are improving.

I do not know that we can make you prefectly normal but I would bet my reputation that you could be a lot better than you are.

Walt



Re: Chrondomalacia

Posted by Julie on May 15, 1998 at 01:47:23:

I've also had this problem since about 12, and I'm now 38, just had 5th knee surgery and looking at a knee replacement since I've worn the top of my tibia completely thru the bone. I have found a support group on the Net you might be interested in. We were just a loosely connected group of people, but www.protonics.com is going to be sponsoring a newsgroup for those with patella-femoral problems. Not sure if it's up yet, To subscribe all you need to do is send an email to majordomo@kdsi.net and put one of the following lines in the body of the message.

subscribe pfd-chond yourname@youraddress

OR

subscribe pfd-chond-digest yourname@youraddress

There will be some back and forth stuff, but you can join the newsgroup. We'd love to have you


Re: Chondromalacia

Posted by Walt Stoll on May 17, 1998 at 09:52:29:

In Reply to: Re: Chrondomalacia posted by Julie on May 15, 1998 at 01:47:23:

Dear Julie,

Sorry we made contact at this late date. When this problem is this far gone, knee replacement is probably your only option left. The only saving grace is that you have said KNEE rather than KNEES. The same mechanisms that ruined your knee are still operating--one of the reasons that your condition has continued to develop to this sorry state.

At least you could learn WHY this happened to you & change those susceptibility factors before this becomes KNEES instead of KNEE.

If we had made contact 26 years ago, I would not have known any more than your current docs about how to stop this. NOW, however, there is no longer any excuse for your docs not knowing. It is too late for this knee.

With your wealth of experience, you could help many others avoid your sorry history.

Walt



Chrondomalacia

Posted by Hugh Williams on May 18, 1998 at 15:07:09:

I am 26 years old and five months ago after some longer-than-usual runs I started experiencing pain in my right knee when it is bent. There is no pain when walking or even running, only when sitting and the knee is bent for longer than 30 seconds. I have seen two orthopedists, both of whom diagnosed it as chrondomalacia and gave me some quad-strengthening exercises to do and also suggested anti-inflammatories (ibuprofin), stretching and ice. I was also given a pair of orthotics. My legs are now like tree-trunks from the exercises and I wear the orthotics all the time but the problem persists. I received a shot of cortizone which had zero effect. I have not run or been physically active other than walking in four months. The pain is annoying at best and very discomforting at worst. I cannot sleep with my knee bent because I will wake up with throbbing pain in the knee. I can't sleep on my stomach because the knee pressing into the mattress causes pain. I get a lot of clicking in my knee when bending it and I also feel it "catching" at about the 20 degree angle when I try to do hamstring curls on the weight machine. My orthopedist has no answers for me other than a surgical procedure to slice my cartilage and remove pressure from the outer knee which he claims has about a 50% success rate. Other than that he says "some people just have to live with it". I refuse to accept this.

PLEASE tell me what to do! I led a very active lifestyle up till now and I am going insane not being able to play sports or be active. What, exactly is my problem? Why do I experience discomfort when my knee is bent but not any of the other popular chrodomalacia symptoms like "pain when walking up or down stairs, pain when running", ect.? What are my options? Is this surgery recommended? Is there anything else I can do outside of surgery?

Thank you in advance from a chrondomalacia sufferer who is getting desperate!




Re: Chrondomalacia

Posted by Charles Kemper on May 18, 1998 at 17:16:27:

In Reply to: Chrondomalacia posted by Hugh Williams on May 18, 1998 at 15:07:09:


This condition is actually a roughening of the inside surface of the patella and is the bane of cyclists. As unfortunate as this is, it should have very little to do with pain while sleeping unless you have chronic inflamation.
This could be from the abrasion of the patella but is more likely from the LGS syndrome so widely discussed on this board. Research this and in the mean time, get some borrage or evening primrose oil and max the dosage. Try eating fish rather than land animal protein sources.


Re: Chrondomalacia

Posted by Fran on May 18, 1998 at 20:31:48:

Out of sheer desperation I am seeking answers on the internet, but it sounds like I should have started here. I am 49.5 and have never been very athletic. Last year I started walking 3 mornings a week & when it started to be too cold, I decided to purchase a treadmill. I absolutely was having the time of my life on this treadmill for about 2 weeks. I am Realtor and as I was showing houses one day, I felt excruiating pain in both knees and couldn't get up the stairs. I went to my Internist immediately, who sent me to my first othropedic. He told me to do leg lifts & take Aleve and come back in 4 weeks. The leg lifts were too painful so I did not do them. Went back in 4 weeks and was told he could do nothing for me. I asked for physical therapy, he agreed. Therapy was OK but no great improvement and after 12 visits with no improvement I asked my PT for a referral. Orthopedic doctor #2 put me in an immobilizer which was so painful I only lasted two days & went back to PT for 6 more visits. I returned to Orthopedic #2 and he recommended arthoscopy of both knees. A colleague recommended I see a chiropractor before I consented to surgery. I saw a chiropractor 6 times and felt some relief but only if I had several days between appointments. The chiropractor than referred me to Orthopedic #3 who diagnosed me with quadracep tendinitis, put me on Voltarin. I have been taking Glucosamine Chrondrotin since Dec'97. My pain is tremendous and to complicate matters I am scheduled to go on a 3.5 week visit to Asia July 12. I have been looking for an acupuncturist. My business has really become a problem not being able to walk steps and my frustration level is so high.
The chiropractor said there was a knee alignment problem and orthopedic #3 said my alignment is just fine. So many mixed messages.
I have told every person that I also get a lot of burning in my knees and no one seems to have address this at all.
I understand your explanation above, because it have been explained to me several times now. The explanation I haven't received is what is my future with this problem.



torn miniscus

Posted by erinaldi on May 19, 1998 at 16:07:38:

Dr. Dave - Dr. Stoll: I've been diagnosed with a "slight tear" to my miniscus (right inside knee); too much kneeling and running. I had a similar diagnosis several years ago on the left knee which, after weeks of exercise and stretching was wonderfully resolved with orthoscopic surgery. My MD today tells me to give my knee a rest, cycle (spin with little resistence 90-100 rev/ minute) and stretch. Similar approach as last time (different MD). Will anything like this ever clear up? I understand that there is no blood supply there and that tears do not heal. I'm ready for the knife - let's get on with it. Any thoughts or referrals to information on this subject would be greatly appreciated.


Re: Chrondomalacia

Posted by Walt Stoll on May 20, 1998 at 12:20:10:

In Reply to: Chrondomalacia posted by Hugh Williams on May 18, 1998 at 15:07:09:

Dear Hugh,

Listen to Charles. He is right.

I would add that one of the things that causes this is also the same bracing that causes the LGS. An effective skilled relaxation technique would do you a lot of good--and is probably the only thing that will resolve it in the long run & prevent recurrences. This has been discussed MANY times here on this BB and is on the home page as an article.

However, this will take 6-12 months to dischare your inappropriate muscle tension. For immediate relief, in the meantime, I would see a Certified Rolfer in consultation. Call (800) 447-0150 for information.

You might also consider 750 milligrams of glucosamine sulfate, twice a day, since this is the perfect condition for that to be effective (especially in the presence of the essential oils mentioned by Charles).

The main thing will be, as your symptoms get better, that you do not stop dealing with the causes (by doing the skilled relaxation & learning about LGS) just because you are no longer hurting. Those benefits will be temporary (a year or so). In the meantime, ANYTHING that causes pain you should try to avoid. Even though the classical stairs, etc., doesn't bother you you would be wise to avoid the wear & tear of them because they finally will till you get this under control. The absence of these sympotoms does not mean that the diagnosis is incorrect since it undoubtedly IS. This only means that your inflammatory damage is not exactly in those spots yet.

For the bedtime soreness, hot compresses (hot as you can stand for 5 minutes at a time) right over the painful spot, at least several times a day will make short work of at least that. Charles is right: This is a secondary effect of the actual chondritis & can be eliminated from the surface.

Let us know how you do.

Walt



Re: Chrondomalacia

Posted by Walt Stoll on May 20, 1998 at 12:35:39:

In Reply to: Re: Chrondomalacia posted by Fran on May 18, 1998 at 20:31:48:

Dear Fran,

Although is sounds like you have had enough knee examinations, I wish I could do one too. I am not sure you have had a complete diagnosis yet but your multiple diagnoses all fit into the same basic causation so I am going to go ahead with the following:

1. ANYTHING that causes pain should be avoided. I know that that will be impossible for you without becoming an invalid but just keep it in mind so you do as little of that as possible.

2. You MAY have to give up your trip. If you can find an effective skilled relaxation technique IMMEDIATELY and practice is at least 3 times a day for 20 minutes (not counting any you might do within 2 hours of retiring) you MIGHT have enough relief by then to be able to go. You are going to have to keep this up for 6-12 months for permanent relief and THEN, if you ever stop doing it less than twice a day, you are asking for it to return.

You would need to digest a copy of my book to learn of the other options that would ALL contribute to this being a one time experience (link on this page).

Walt



Re: torn miniscus

Posted by Walt Stoll on May 21, 1998 at 10:56:22:

In Reply to: torn miniscus posted by erinaldi on May 19, 1998 at 16:07:38:

Dear Erinaldi,

Surgery is probably your best bet again. HOWEVER, the real question is why do YOU keep getting this when others with similar exercise patterns do not?

THAT is where you need to be putting you efforts since, without doing something about this susceptibility, you will surely keep getting this till it can no longer be resolved by surgery.

Walt



Re: torn miniscus

Posted by Antonio Alvarez on May 22, 1998 at 23:59:41:

In Reply to: torn miniscus posted by erinaldi on May 19, 1998 at 16:07:38:

Dear Erinaldi:

I have the same condition as you do. A slight tear to the "posterior horn of the medial meniscus" in my left leg. That is what the MRI says anyway. My main symptom is pain in the knee when going upstairs. I did not do anything about it for a couple of years but started fighting it this year in March. My right knee which was never injured but I was overusing started complaining. So I am know treating both knees. What I have done in the last 3 months may be of help to you.

Before I start I WOULD LIKE TO ASK YOU about the length of time (10 minutes, 30 minutes? and how many times per day) your doctor recommended the cycling exercises. My doctors have mentioned the cycling without resistance but none was specific like yours about the 90 to 100 revs/min. I would like to know how long he recommended you to do the cycling exercise.

Listen to Dr. Stoll's reply. You need to get to the bottom of your problem. I used to walk 2-3 miles a day and did quite a bit of other exercises like squatting & touching my toes. One GP & 2 orthopedic surgeons did not tell me to get off my feet. Dr. Stoll was the first and only one that did so. The orthopedic surgeons recommended surgery (a good business recommendation... for their business).

I think that the main decision of going or not going for the knife is up to you. It depends on how much pain and how much patience and desire to avoid a surgery you have. Your prior good experience with a surgery may entice you to go for it. I don't like surgeries so I decided to fight it out. I think I am doing OK. If my rate of improvement continues I may be almost OK in a few months. Because of the lack of blood supply to the cartilage these injuries are very slow to heal, probably several months. I am almost 59 years old. If you are younger you will probably heal faster.

After I got the diagnosis of my torn meniscus, I ran (by luck) into an article about glucosamine sulfate and its cartilage rebuilding (so far officially unproven) properties. Then I ran into Dr. Stoll's BB while looking for info on glucosamine sulfate via a search engine. In the last 4 weeks, since going to Chiropractor # 3, I have improved about 40%. I took the "shotgun" approach. I don't know what has helped the most but here is what I did and what I am doing.

1. I started on glucosamine sulfate at 1500 mg/day (1-capsule of 500mg 3X/day) on March 5. Most articles indicate that this is the only active ingredient of the book about the arthritis cure.

2. Late March after seeing no appreciable improvement I started on chondroitin sulfate at 500 mg/day (1-250 mg capsule, 2X/day). Most readings indicate that this is a questionable ingredient. I took it with the thinking (I saw in 1 or 2 publications) that it will not hurt but it may help some.

3. A very good chiropractor in this BB (Dr. David Ferguson) responded to my posting and suggested I see a chiropractor in my area. He also suggested that the "toes pointing outward" position from sleeping on your back, driving or reclining in a couch will aggravate my symptoms. If you have any questions about chiropractors post them in this BB and address them to Dr. Ferguson.

4. I started going to my first Chiropractor (Chiro # 1) in mid March. He was honest man but I was not improving fast enough. I kept finding things, like exercises, that I should have been doing but was not doing and then he would agree that I should do them. Finally he thought I was "so much better" that I could decrease the treatments. I disagreed. His "back adjustments" were also giving me a slight pain in my lower back.

5. Chiro # 2 was a crook. He was affiliated with a regular MD to rip off the Insurance Companies. I went to him only one time.

6. I am now in Chiro # 3 since early May and I think he is helping very much (40% improvement in 4 weeks). He is a graduate from Palmer Chiropractic University.
a. He has given me a full set of exercises to STRETCH (in addition to strengthen) the


Re: torn miniscus

Posted by Walt Stoll on May 24, 1998 at 11:10:37:

In Reply to: Re: torn miniscus posted by Antonio Alvarez on May 22, 1998 at 23:59:41:

Dear Antonio,

Thanks for the wonderful note!

I hope you have included a regular practice of skilled relaxation somewhere in there.

Walt



Re: torn miniscus

Posted by Antonio Alvarez on May 24, 1998 at 15:25:17:

In Reply to: Re: torn miniscus posted by Walt Stoll on May 24, 1998 at 11:10:37:

Dear Dr. Stoll:

Thank you for your note. No, I am not doing any Skilled Relaxation yet (I was only up to page 137 of your book and did not realize all of the potential benefits of Skilled Relaxation). Next time I go to my library I will ask them to order the two books you recommend: The Relaxation Response and the Relaxation and Stress Reduction Workbook.

On a side note, your son and Pamela have done a tremendous job with your site. It looks real nice and professional. They are both to be commended. (A small comment is that the link to Glucosamine is not working. Maybe it is not complete yet).

Also thanks to YOU for the time and effort you put in answering and guiding people with their health. The other day (the day I wrote to eribaldi) I just learned something new in your site about the detrimental effects of sun screens and the use of Vitamins C & E for blocking out the harmful sun rays. You are providing a tremendous service for the education of the general public. BE CAREFUL, the AMA may try to kill you one of these days (...half joke & half serious).

If I can be of any help just let me know. Best regards and peace.

Antonio



Re: torn miniscus

Posted by Walt Stoll on May 26, 1998 at 09:39:52:

In Reply to: Re: torn miniscus posted by Antonio Alvarez on May 24, 1998 at 15:25:17:

Thanks, Antonio.

I have had enough experience with the AMA to know that your warning it not frivolous. I am hoping that there have been enough people on this 'site to at least put the fear of God in the AMA if they do.

Walt



1998: May

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