Knee Problems historical posts July 1998

Re: repair of cracked or broken Patella

Posted by Teresa on July 12, 1998 at 23:04:52:

Dr Stoll

I recently (3/15/98) fractured my left patella. No surgery was required. I wore an immobilizer then a brace and attended 6 weeks of physical therapy. My Dr says the fracture has healed nicely.

Prior to the injury I was diagnosed with bilateral patella femural syndrome.

Currently I am having bilateral knee pain- especially with stair climbing, squatting and sitting.

Question: what is the prognosis and treatment for this type of syndrome?

I am a 33 y/o female, not overweight and very active with 2 small children. I would appreciate your opinion.

Thank you

Teresa, RN


Re: repair of cracked or broken Patella

Posted by Walt Stoll on July 13, 1998 at 08:23:48:

In Reply to: Re: repair of cracked or broken Patella posted by Teresa on July 12, 1998 at 23:04:52:

Dear Theresa,

If you do not hear from Doc Dave about this, within a few days, I would retype your note & title it something with Doc Dave in the title to attract his attention. I know he will have some ideas.

In my own experience, you are going to have to deal with the causes of this or you are heading for knee replacement in 10-20 years.

If I had your knees, I would be doing an effective skilled relaxation technique at least 20 minutes twice a day (not including any done within 2 hours before retiring). I would be testing for my intracellular magnisium level and seeing a Rolfer in consultation. I also would be avoiding those movements that caused knee symptoms. ANY symptoms mean damage is being done.

THEN, while I was working on the above, I would be taking glucosamine sulfate (750 milligrams twice a day) and omega 3 essential oils (2 grams 3 times a day). Let me know how you are doing in about a month.

This is a resolvable problem AND it needs to be resolved.

Walt



Attn: Doc Dave.... Re: repair of cracked or broken Patella

Posted by Teresa on July 18, 1998 at 22:19:09:

In Reply to: Re: repair of cracked or broken Patella posted by Walt Stoll on July 13, 1998 at 08:23:48:

Attn: Doc Dave

Could you please give your opinion on the treatment and
prognosis for patella femural syndrome (pfs)?

Thank You
Teresa


chrondomalacia

Posted by chris nelson on July 13, 1998 at 16:32:41:

Dr. Stoll,
I have had two knee scopes (January 98 & July 98). The first scope was after a severe fall while running a relay race with a 230lb man on my shoulders. My knee gave way and was forced into the ground. The first surgery resulted in the removal of both plicae. I still had locking,clicking, grinding, and my knee gave way daily after two months of rehab. I can not walk in the mornings without taking my knee through a series of motions before I get out of bed. I was given a large brace to keep me from falling when my knee gave out. An MRI in May showed a large medial meniscal tear so I had surgery again last week. The surgeon (I got a new one this time) who did the scope said I did not have a meniscal tear but I had Chrondomalacia and showed my pictures after the scope where my cartilage (what was left) was soft and it was shredding off my bone. I have over fifteen years in the US Army now and he has advised me to consider a medical discharge before I talk to him again on 24 July. What is your opinion on this. Will my knee survive the pounding it takes in the army for another five years so I can reach a 20 year retirement.


Re: chrondomalacia

Posted by David Ferguson, D.C. on July 13, 1998 at 21:53:58:

In Reply to: chrondomalacia posted by chris nelson on July 13, 1998 at 16:32:41:

As the patella tracks between the condyles of the distal femur(the end of the thigh bone) it must be tracking down the middle and not to one side or the other. If it is tracking to one side or the other it will grind and destroy the cartilage. The only pratitioners that I know of that are even remotely educated to asses this are chiropractors who have graduated within the last 10 years or so. If you can correct this tracking then you can stop the grinding and halt the degeneration that is occuring. I can try and help you find someone in your area(at least give you some names to call) if you would like.


Re: chrondomalacia

Posted by Walt Stoll on July 14, 1998 at 11:49:06:

In Reply to: chrondomalacia posted by chris nelson on July 13, 1998 at 16:32:41:

Dear Chris,

Listen to Doc Dave!

Also, I would recommend you learn how to reliably produce alpha/theta brain rhythms and practice imagry during each session. See your knee as healthy as it was before your injury. If you are not aware of imagery as a specific way of focusing healing of any bodypart, go to your library & ask the librarian for books on healing imagry. All professional athletes are now using it because their livelyhood is dependent upon keeping going (as is yours, apparently). Imagry only works at its potential if it is used during the practice of the alpha/theta skill.

I would also start taking glucosamine sulfate (750 milligrams twice a day) as a non-toxic way of regenerating your joint surfaces. If you need more information about that, talk to your veterinarian. Vets have been using this stuff, successfully, for 20+ years.

Finally, you only have one set of knees. They are going to have to last you the rest of your life. Unless you are willing to consider total knee replacement in about 20 years, I would seriously consider taking the medical discharge. You are not going to be able to keep up anyhow.

The very last thing you need for the next few years is the kind of pounding I assume you will get in the army.

Let us know how you do. If you have more questions, write again.

Walt



Knee pain

Posted by Frank M on July 14, 1998 at 08:06:06:

Dr Stoll, I have terrible pain on the inside surface of my left knee. I did some physical work a week ago, bending and twisting and am now suffering the consequences. I tried ibuprophen 600mg and it takes the edge off but wonder if I did some damage to the cartilage. I can rub the area and it is very sore. I hesitate going to an orthopedic doctor right away because I know the drill. My wife said to go when I have the pain so it can be diagnosed. Do you have any suggestions?


Re: Knee pain

Posted by David Ferguson, D.C. on July 14, 1998 at 13:32:59:

In Reply to: Knee pain posted by Frank M on July 14, 1998 at 08:06:06:

The symptoms you describe are traditional with what is called an "externally rotated" tibia. Essentially, a toes pointed out on that side problem. Try to keep your toes pointed straight or even in especially while sitting(car more than anywhere), while reclining, and lying down. Give it a little time and if this doesn't get things turned around you may need to find a qualified chiropractor to correct the problem. There is obviously no way for me to give any type of diagnosis on this over the computer but maybe these suggestions will improve things. If not, then you will obviously need to consult someone.


Re: Knee pain

Posted by Walt Stoll on July 15, 1998 at 09:54:48:

In Reply to: Knee pain posted by Frank M on July 14, 1998 at 08:06:06:

Dear Frank,

Listen to Doc Dave. This sounds like a self-limited condition to me & Dave's suggestions just might keep it self-limited.

If I had what you seem to have, I would also consider pulsed diathermy and ultra sound. If you have a physical therapist friend or family member..............

I would also avoid doing things that produced symptoms.

Walt



Chrondomalacia: Paging Dr. Ferguson

Posted by Hugh Williams on July 17, 1998 at 02:12:05:

Dr. Ferguson,

I have read a few of your posts on this board in reference to Chrondomalacia and would love to have a longer discussion with you than is allowed here. Regardless, here is a brief synopsis of my condition and I hope that you can give me some advice and point me to a chiropractor that can help me (as the last one did not).

About six months ago I was diagnosed with Chronodomalacia after excessive running (trying to increase my distance way too fast). At the time, I only experienced pain when my knee was bent (it would start hurting within seconds) but not when straight. Two orthopedists diagnosed it and I had an MRI done which showed "irregularity over the lateral femoral condyle articular cartilage". They gave me some excercises to do, which didn't help. Then they gave me a shot of cortizone, which didn't help. Then they told me "some people just have to live with it", at which point I went to a chiropractor.

The chiro found some chronic tendonitis in the knee which he helped me clear up. He also had me doing what he reffered to as "clockwork" with my knee cap to clear up the "tracking problem". This involved sitting with my leg straight and moving my knee cap around in different directions to work out any "spots of resistance". He also had me stretching and doing leg strengthening excercises. To make a long story short, this didn't help and I fear the excessive knee cap movement may have even hurt as I now seem to be in even worse shape. I have dull pain now even when my leg is straight, which sometimes prevents me from getting to sleep. I have been taking Glucosamine Sulfate w/Chondroitin but that doesn't seem to be helping either.

I live in Minneapolis now but I will be moving to New York City in two weeks. Can you point me to someone that might help? Do you have any other advice for me? The thought of living the rest of my life (I'm only 27 now) in this type of condition makes me sick to my stomach. Thank you in advance for sharing your knowledge!


Re: Chrondomalacia: Paging Dr. Ferguson

Posted by David Ferguson, D.C. on July 17, 1998 at 09:16:37:

In Reply to: Chrondomalacia: Paging Dr. Ferguson posted by Hugh Williams on July 17, 1998 at 02:12:05:

I will try and locate someone for you in NYC. It souldn't be too difficult but I will need to make a couple phone calls to get what I am looking for so it may be a few days before I can get back to you.

That lateral femoral condyle articular cartilage obviously gets worn when the knee cap is tracking on the lateral margin. The tendon that connects to the top of the patella comes from the quadraceps muscle and then there is a ligament at the inferior portion of the patella that connects to the "bump" that is about 2" below your knee cap.

If the lower leg is rotated externally(toes out), and the upper leg is still straight, then the knee cap is going to rub along that lateral margin. Do everything you can to keep your lower leg turned in. Stick with the Glucosamine as it helps your body by giving it the building blocks it needs to repair this. The reason it doesn't seem to help is because you haven't been able to do anything about the cause yet.

As I said, I will try and find someone for you but it will probably not be until the middle of next week. I have your e-mail address.


Re: Chrondomalacia: Paging Dr. Ferguson

Posted by Karen Karagozian on July 30, 1998 at 01:38:28:

In Reply to: Re: Chrondomalacia: Paging Dr. Ferguson posted by David Ferguson, D.C. on July 17, 1998 at 09:16:37:

Dear Doctor,
I too suffer from chronic knee pain-diagnosed by an Orthopedic as Chrondomalacia- it was about 3 years ago. My age is 47. I have played tennis all my life, snow skied, water skied and did a lot of low impact aerobics during my 30-s. Now I can't do any of that. I love aqua aerobics and love to swim and walk. Going up stairs kills me and I have a two story house. Just went on a Sierra club hike and it did me in. Ice helps and i just started taking Glucosamine. I take either Ibupropin or Aspirin for pain. It helps a lot. Do you know of a Chiropractor in San Diego to help me???? Any advice would be appreciated. Should I quit swimming until the pain subsides? I love the jacuzzi. Is a combin. of ice and heat OK???
Thanks, Karen in San Diego
Ps The Dr. said there's nothing he could do for me. He didn't even do an MRI. I have Kaiser HMO. No help.


Re: Chrondomalacia: Paging Dr. Ferguson

Posted by Glenda Anderson on July 30, 1998 at 19:03:20:

In Reply to: Re: Chrondomalacia: Paging Dr. Ferguson posted by David Ferguson, D.C. on July 17, 1998 at 09:16:37:

My doctor informed me that I have chrondomalacia patella yesterday and prescribed Relafen. I will also start PT 2x wk. I am 43 years old. I have always had aching in my knees. It has gotton worse, especially to my right knee where I endured a severe blow when I was 18 in a car accident. Is there anything else I can do to help myself? Do you agree with the program set forth by my doctor? How can I become better educated? I am not finding much about chrondomalacia or relafen on the Internet. Any help would be appreciated.


Re: Chrondomalacia: Paging Dr. Ferguson

Posted by Walt Stoll on July 31, 1998 at 10:01:18:

In Reply to: Re: Chrondomalacia: Paging Dr. Ferguson posted by Karen Karagozian on July 30, 1998 at 01:38:28:

Dear Karen,

I am interested in what Doc Dave has to offer since I know it is substantial.

I would like to add MY 2 cents here that I am sure he will agree with:
1. Keep up your aqua areobics! It is ideal for what you have!!!! I would, however avoid any weight bearing exercises till this has been resolved for at least 6 months. Just daily activities are more than is good for you but I would not suggest you become a cripple yet.
2. Consider 750 milligrams of glucosamine sulfate twice a day along with at least 2 grams of esterified vitamin C twice a day. I also would consider taking a high quality hydroxyapatite with boron (about 2000 miligrams twice a day) and the essential oils described on the FAQ page of this 'site. Once you symptoms are clear for a month or so,you should be able to start cutting down the dose of the oils with a cut every 3-6 months till you reach a maintainance dose.

Thr regular practice of skilled relaxation (especially if you use the imagery all professional athletes use--with the relaxation) will help you more than you can know.

Let us know how you do.

Walt



Re: Chrondomalacia: Paging Dr. Ferguson

Posted by Walt Stoll on July 31, 1998 at 11:34:40:

In Reply to: Re: Chrondomalacia: Paging Dr. Ferguson posted by Glenda Anderson on July 30, 1998 at 19:03:20:

Deraa Glenda,

See the response I made to a similar thread today.

Walt



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