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Author Topic: Sore knees, no diagnosis  (Read 23272 times)

Offline SuspectDevice

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Re: Sore knees, no diagnosis
« Reply #75 on: March 18, 2013, 05:18:48 AM »
Guys, how did things end up for you?

I'd love to know also.

Their stories are very similar to mine (though their pain sounds worse)- i.e. no real reason why their knees suddenly became so sore & sensitive.

I can't PM anyone, but if anyone else can get in touch with the two main posters in this thread (knee always hurts and highroller) & get them to respond, it would be be fantastic.
L Medial menisectomy May 2012
PFPS in both knees ever since
Pre-CRPS diagnosed 2014
Also looking into Dr Scott Dye's Tissue Homeostasis & Envelope of Function work
2017 - 80+% cured thanks to Dr Dye's research
2017 - first small triathlon in 5yrs
2017 - back to 30% of training volume - that'll do!

Offline SuspectDevice

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Re: Sore knees, no diagnosis
« Reply #76 on: March 18, 2013, 07:01:37 AM »
I'd like to re-activate this thread, as the experiences are so similar to mine.

Briefly, I was a keen triathlete.

Tore left medial meniscus April 2012, had 1/3rd removed May 2012 (age 48).  Rest of knee looked really good when he went in.  MRIs in the past for right knee pain have shown some 'high grade' chondromalacia, but it never caused me too much trouble.

Was back on my bike within 6 days of surgery (but did not attempt to run for 8 weeks), but over the next few weeks, both knees developed PFS within a month. Aching, burning, stiffness, pain anterior & medially both knees. 

Really weird that it should start after a massive decrease in my training load????

Have seen physio, GP, OS & 2 Sports Drs.  Lateral release was mentioned, platelette injections.  Latest advice from Sports Dr seems to be a cessation of aggravating activities, hip & glute strengthening exercises and conservative activity. 

Reading the posts of High Roller and Knee Always Hurt, I realise I'm pretty lucky - despite constant pain of varying levels, I can walk without the stabbing pain they had & am not house-bound, can still do most daily activities, though have to take them easy (e.g. lawn mowing in 20-30min bursts, not the 2hrs I used to do).  And I can't imagine how bad it must be to go thru this at just age 26 like one of the posters - just terrible, at my age you can understand it, especially given the work my knees have done, but at 26 !!!

I tried 15mins easy riding on my bike today after taking it pretty easy for 6 weeks, but forget it, I can tell it's going to send me backwards.

Had dinner with my OS last week - he very sensibly said forget more surgery, it is unlikely to help.  He also said they know sweet FA about PFS, and agreed that the conservative approach recommended in the Richard Bedard & Paul Ingraham Ebooks was a good way to go.

But damn it is frustrating to go from such a high level of athletic ability to this.  Gotta hang onto the positives though.  I can still swim (but can't kick too much so use a pull-buoy), can do upper body weights and walk 30-40mins.  I can also use the hamstring, adductor and abductor machines in the gym without aggravating (I think) but anything that works the quads (leg extensions, squats, lunges) is out.

I'll use this thread to inform others of how I go and hopefully it might help them.
« Last Edit: March 18, 2013, 07:04:35 AM by SuspectDevice »
L Medial menisectomy May 2012
PFPS in both knees ever since
Pre-CRPS diagnosed 2014
Also looking into Dr Scott Dye's Tissue Homeostasis & Envelope of Function work
2017 - 80+% cured thanks to Dr Dye's research
2017 - first small triathlon in 5yrs
2017 - back to 30% of training volume - that'll do!

Offline highroller

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Re: Sore knees, no diagnosis
« Reply #77 on: March 28, 2013, 11:39:19 AM »
Just checked my old thread on a whim and note the recent posts - welcome to the new arrivals! I'm a bit pressed for time right now but will provide an update in the next week or so and fill you all in on my trials and tribulations over the 2.5 years since I last posted. I'm still struggling and can't offer any silver bullet insights but hopefully my experiences will be of some use. Later folks...
10/09: knees sore from gym, MRI ok, fluid in fat pad
01/10: knees worse, OS recommends PT
03/10: barely able to walk
04/10: arthroscopy left knee, no problems found, fat pad trimmed
08/10: begin PT, rheumatoid arthritis ruled out
09/10: neuropathic pain diagnosed, prescribed Amitriptyline

Offline SuspectDevice

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Re: Sore knees, no diagnosis
« Reply #78 on: April 08, 2013, 09:03:18 AM »
Just checked my old thread on a whim and note the recent posts - welcome to the new arrivals! I'm a bit pressed for time right now but will provide an update in the next week or so and fill you all in on my trials and tribulations over the 2.5 years since I last posted. I'm still struggling and can't offer any silver bullet insights but hopefully my experiences will be of some use. Later folks...

Looking forward to your response, let us know anything you can.

cheers
L Medial menisectomy May 2012
PFPS in both knees ever since
Pre-CRPS diagnosed 2014
Also looking into Dr Scott Dye's Tissue Homeostasis & Envelope of Function work
2017 - 80+% cured thanks to Dr Dye's research
2017 - first small triathlon in 5yrs
2017 - back to 30% of training volume - that'll do!

Offline SuspectDevice

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Re: Sore knees, no diagnosis
« Reply #79 on: April 21, 2013, 05:30:51 AM »
An update - my knees seem to be heading in the right direction, less regular pain/burning/stiffness.  But not out of the wood yet. Was able to cycle for 30mins y'day without any major setback in pain levels.  But can't get too excited, still need to be very careful not to overdo it.

But my back is killing me!  Tweaked it with a slight twist after a long 1hr swim last weekend & can't get it to settle.

Aging is crap!
L Medial menisectomy May 2012
PFPS in both knees ever since
Pre-CRPS diagnosed 2014
Also looking into Dr Scott Dye's Tissue Homeostasis & Envelope of Function work
2017 - 80+% cured thanks to Dr Dye's research
2017 - first small triathlon in 5yrs
2017 - back to 30% of training volume - that'll do!

Offline BTSF

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Re: Sore knees, no diagnosis
« Reply #80 on: April 27, 2013, 05:12:55 PM »
Hey everyone,

Echoing the sentiment of other recent posts, I'd love to hear from the two original posters.  I just came across this thread, and have been reaching my own low point of sorts of late. 

Without getting into details, I am seeing a very very reputable doctor in this field (let's just say he gets this injury), and a PT recommended by him for the last 6 weeks.  I've also been using crutches to get around, and trying to stay well within my envelope of function.  Under my PTs guidance, I've been doing extremely light muscle strengthening (quad sets, heel slides, leg raises).  However, my knee still swells with inflammation at the end of each day.  Ice, rest, and elevation does seem to help, but each day is a recurring pattern.

I'd love to know if either of the two original posters found success along the way.  Like the original poster, I'm 25 going on 26 years old, and have been dealing with my own PFPS journey for over a year now.  I'm finally with medical professionals who know what they're doing, but it would help to hear about the story from the patient side of things to help brighten my outlook.

Offline knee always hurts

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Re: Sore knees, no diagnosis
« Reply #81 on: May 08, 2013, 05:55:10 AM »
I've noticed that several people have requested an update on my condition over the last few months. I haven't logged into my account for probably a year or so, but I'll use this opportunity to break the good news. My knees have made something like a full recovery. They seem to be a lot creakier now, for some reason, but no more pain!

Truthfully, I'm not fully sure how or why the recovery happened. But I'm convinced that there was never anything structurally wrong in the knee, hence surgery would have been pure folly! I am grateful that the doctors I went to always told me the truth, even though I didn't want to hear it at the time. I'll never know for sure why it even happened, but I suspect a muscular imbalance developed, probably because of some of the exercises I was doing. Maybe the quadriceps were overpowering the hamstrings, or something along those lines. And so the joint wasn't tracking properly, and then inflammation developed. At that point the problem became one primarily of inflammation. So fixing any muscular imbalances didn't matter much once the inflammatory process was activated, which is why PT failed for me.

The only thing that worked was rest. I realize now that I always made the mistake of not resting enough, for months on end. In retrospect, I think my knee may have been fine sooner than I realized. But I become anxious at the most marginal pain, always suspecting it was a harbinger for the full return of the by then intractable problem. I slowly built up my strength, and then worked up the courage to being walking more and more. I did feel some slight pains in my leg at the time, but I convinced myself that it was something else, maybe trigger points. Within a few months I found that I didn't have any limitations at all.

I have a few pieces of advice. One is to always do less than you think will be necessary for recovery. That sounds strange, because our natural inclination is to think we have to do something to recover. But at least for me, rest was key. If you have a problem with exercise, cut out all exercise. If you have a problem walking at all, you probably need 3 months or so of complete rest. Generally that's a bad thing, but if you've tried less than that and it didn't work, then that's your only alternative. I'm assuming that there isn't some other structural problem, which only a doctor can identify. I had advanced MRI imaging done which found no structural issues whatsoever. If there is no identifiable pathology within the knee, then I think inflammation is the likely issue, in most cases. Remember that the compressive forces within the knee are extremely intense. Only rest will allow the irritation to subside once it has begun. Strengthening alone won't allow irritated tissue to recover.

I'll conclude for now by saying that at its worst, it couldn't have been any worse. But I had never had any problem like that before, so it didn't make any sense that I couldn't achieve a full recovery.  Even a really severe case can recover. If anyone has any questions, I'd be happy to try and answer.

Offline SuspectDevice

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Re: Sore knees, no diagnosis
« Reply #82 on: May 08, 2013, 06:31:14 AM »
I've noticed that several people have requested an update on my condition over the last few months. I haven't logged into my account for probably a year or so, but I'll use this opportunity to break the good news. My knees have made something like a full recovery. They seem to be a lot creakier now, for some reason, but no more pain!

Truthfully, I'm not fully sure how or why the recovery happened. But I'm convinced that there was never anything structurally wrong in the knee, hence surgery would have been pure folly! I am grateful that the doctors I went to always told me the truth, even though I didn't want to hear it at the time. I'll never know for sure why it even happened, but I suspect a muscular imbalance developed, probably because of some of the exercises I was doing. Maybe the quadriceps were overpowering the hamstrings, or something along those lines. And so the joint wasn't tracking properly, and then inflammation developed. At that point the problem became one primarily of inflammation. So fixing any muscular imbalances didn't matter much once the inflammatory process was activated, which is why PT failed for me.

The only thing that worked was rest. I realize now that I always made the mistake of not resting enough, for months on end. In retrospect, I think my knee may have been fine sooner than I realized. But I become anxious at the most marginal pain, always suspecting it was a harbinger for the full return of the by then intractable problem. I slowly built up my strength, and then worked up the courage to being walking more and more. I did feel some slight pains in my leg at the time, but I convinced myself that it was something else, maybe trigger points. Within a few months I found that I didn't have any limitations at all.

I have a few pieces of advice. One is to always do less than you think will be necessary for recovery. That sounds strange, because our natural inclination is to think we have to do something to recover. But at least for me, rest was key. If you have a problem with exercise, cut out all exercise. If you have a problem walking at all, you probably need 3 months or so of complete rest. Generally that's a bad thing, but if you've tried less than that and it didn't work, then that's your only alternative. I'm assuming that there isn't some other structural problem, which only a doctor can identify. I had advanced MRI imaging done which found no structural issues whatsoever. If there is no identifiable pathology within the knee, then I think inflammation is the likely issue, in most cases. Remember that the compressive forces within the knee are extremely intense. Only rest will allow the irritation to subside once it has begun. Strengthening alone won't allow irritated tissue to recover.

I'll conclude for now by saying that at its worst, it couldn't have been any worse. But I had never had any problem like that before, so it didn't make any sense that I couldn't achieve a full recovery.  Even a really severe case can recover. If anyone has any questions, I'd be happy to try and answer.

Thanks so much for replying, and your story gives me a lot more hope.

Your story also matches exactly what the 2 Ebooks I've read on this problem say - the key is rest.

One question - apart from limiting your exercise, did you have to limit any normal day to day activities?
L Medial menisectomy May 2012
PFPS in both knees ever since
Pre-CRPS diagnosed 2014
Also looking into Dr Scott Dye's Tissue Homeostasis & Envelope of Function work
2017 - 80+% cured thanks to Dr Dye's research
2017 - first small triathlon in 5yrs
2017 - back to 30% of training volume - that'll do!

Offline knee always hurts

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Re: Sore knees, no diagnosis
« Reply #83 on: May 09, 2013, 02:21:12 AM »
Quote
One question - apart from limiting your exercise, did you have to limit any normal day to day activities?

Well, on account of the stabbing pain, I wasn't able to do much. Crutches were the order of the day. And crutches = no hands. If you mean during the recovery phase, well then my limitations were more of a precaution. Though I suspect at that point that the problem was gone. But it was better being safe than sorry.

As I've looked at your story, at first I thought it might have had something to do with the surgery you had last year. But it was only on one knee, correct? And the pain is bilateral. It may be that the recovery from the surgery caused some muscle and tissue degeneration, which then led to vulnerability when you resumed exercise. I don't think the chondromalacia, which you've likely had for years anyway, is the cause. And if I recall the evidence that I examined at the time, chondromalacia is not typically associated with any pain at all.

Based on what I can glean of your case from what you've posted, I think it would be best to abstain from all unnecessary activity for a while, perhaps a month or two. I don't think that you have to stop normal activities such as grocery shopping and the like, but if possible you should delegate lawn mowing to someone else or hire someone to do it if necessary. I'd definitely suggest that you stop going to the gym. You're probably aggravating the tissues in your knee even if you don't realize it.

After the period of rest, I'd recommend slowly building your strength back and then slowing reintroducing physical activity. I'm not sure if you're currently in PT, but if it isn't working for you, don't hesitate to stop it. Don't sacrifice your future for the sake of medical orthodoxy. It might be worth a try if nothing else works, but it isn't the only option. Perhaps it would be more sensible to enroll in PT after you've given your knees a good, honest rest.

Is any of this guaranteed to work? No, but unless you have a better answer, it's probably worth a shot. Keep me updated on your results!

Offline SuspectDevice

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Re: Sore knees, no diagnosis
« Reply #84 on: May 10, 2013, 10:21:18 AM »
Quote
One question - apart from limiting your exercise, did you have to limit any normal day to day activities?

Well, on account of the stabbing pain, I wasn't able to do much. Crutches were the order of the day. And crutches = no hands. If you mean during the recovery phase, well then my limitations were more of a precaution. Though I suspect at that point that the problem was gone. But it was better being safe than sorry.

As I've looked at your story, at first I thought it might have had something to do with the surgery you had last year. But it was only on one knee, correct? And the pain is bilateral. It may be that the recovery from the surgery caused some muscle and tissue degeneration, which then led to vulnerability when you resumed exercise. I don't think the chondromalacia, which you've likely had for years anyway, is the cause. And if I recall the evidence that I examined at the time, chondromalacia is not typically associated with any pain at all.

Based on what I can glean of your case from what you've posted, I think it would be best to abstain from all unnecessary activity for a while, perhaps a month or two. I don't think that you have to stop normal activities such as grocery shopping and the like, but if possible you should delegate lawn mowing to someone else or hire someone to do it if necessary. I'd definitely suggest that you stop going to the gym. You're probably aggravating the tissues in your knee even if you don't realize it.

After the period of rest, I'd recommend slowly building your strength back and then slowing reintroducing physical activity. I'm not sure if you're currently in PT, but if it isn't working for you, don't hesitate to stop it. Don't sacrifice your future for the sake of medical orthodoxy. It might be worth a try if nothing else works, but it isn't the only option. Perhaps it would be more sensible to enroll in PT after you've given your knees a good, honest rest.

Is any of this guaranteed to work? No, but unless you have a better answer, it's probably worth a shot. Keep me updated on your results!

Yes, your suggestions are in line with where my thinking has got to.

Unfortunately, I'm rather exercise addicted, so am experimenting with ways to keep some form of fitness (e.g. swimming without kicking using a pull buoy, and gym work which does not stress my knees, easy walking).  But I don't think I've cracked it yet & so complete abstinence from exercise may well be needed  :'(

We are currently moving house which means packing = extra stress on knees, but in a few weeks, I'll have more opportunity to really rest up more.

I agree with you - somehow the surgery triggered problems in both knees unrelated to the actual surgery spot in the left knee.  Could be muscle changes, could be I changed the way i use my legs as a response to surgery pain, could be some sort of chemical imbalance.  Don't know, but it is bizzare that my knees would get bad with less exercise post surgery - pre-surgery, I was running/cycling/swimming around 6-13hrs/week, smashing my legs to pieces.

I don't do PT - my experience has been our local ones (I live in rural Australia, so not much choice of PTs) are clueless on this stuff.  And I'm certainly wary of medical orthodoxy.

Anyway, thanks for your thoughts & ideas.  It is really good to get some input from someone who has been thru this sh*t.

BTW, I've come across several other triathletes who have had this problem.  One is about to get bilateral lateral releases (which I'm betting won't be a solution).  The other basically rested for 5 years (no running, cycling), then got back into it gradually including barefoot running & minimalist shoes & is good now.
« Last Edit: May 10, 2013, 10:27:30 AM by SuspectDevice »
L Medial menisectomy May 2012
PFPS in both knees ever since
Pre-CRPS diagnosed 2014
Also looking into Dr Scott Dye's Tissue Homeostasis & Envelope of Function work
2017 - 80+% cured thanks to Dr Dye's research
2017 - first small triathlon in 5yrs
2017 - back to 30% of training volume - that'll do!

Offline BTSF

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Re: Sore knees, no diagnosis
« Reply #85 on: May 26, 2013, 07:27:51 PM »
'knees always hurt' - thank you for your encouraging story. I've been on crutches coming up on three months now, and I've found the hardest part to be the mental aspect. So hearing from someone who's successfully come out the other side definitely helps.

Here's my question - how long did it take you to transition from crutches to walking again, and when did you feel "ready" to take that step? 

I recently saw my doctor and PT again (reminder - this doc knows his stuff, and is a research pioneer when it comes to this injury), and they both advised me to begin walking a little bit, standing on two feet, and using one crutch in the mornings. The theory is - "you've healed tremendously, now we need you to re-build your muscle memory and make sure you don't atrophy further." While they both admit that I need to listen to my body and be careful, they essentially want me to start testing my boundaries.

After following their advice for a day or two, my knees still became symptomatic - swollen and inflamed at the end each day, which leads to throbbing then sharper pains if I put weight on it. So I've since decided it's too early to do what they're saying, and I still probably need a few weeks more of rest. I'll still keep water walking in the pool (which I picked up a few weeks ago), but other than that it will be rest, ice, and very very basic PT (light quad sets, drakes, and the like).

Any advice from someone who's made the transition?

Offline Chicagodude

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Re: Sore knees, no diagnosis
« Reply #86 on: May 31, 2013, 05:30:37 AM »
knee always hurts, I'm glad your knee is doing better and you're able to do stuff without pain.

A few questions for you:

1) You said you think inflammation was the main cause of what you were experiencing.  Do you think ice would've helped reduce the inflammation faster?  I also want to ask specifically about ice massage, which in my experience is much more effective than standard icing with an ice pack.

2) As you believe inflammation was the problem, do you think a pro-inflammatory treatment such as prolotherapy with PRP would've helped?
« Last Edit: May 31, 2013, 05:32:46 AM by Chicagodude »

Offline BTSF

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Re: Sore knees, no diagnosis
« Reply #87 on: November 12, 2013, 07:05:16 PM »
Hi all,

This thread was one of the first I saw when I was desperate to recover from my patellofemoral knee pain. I often refreshed the page hoping others would post details of their stories, but that rarely happened.

In any event, I've been crutch-free for two weeks now, and am on an upward trajectory. I've distilled my story into two blog posts I want to share with you:

Part 1: Injury and Recovery - http://themindfulcaveman.com/my-knee-story-part-1-injury-and-recovery/

Part 2: Reflections - http://themindfulcaveman.com/my-knee-story-part-2-reflections/

I hope you find something insightful and useful from the experience I went through. Please reach out via the comments section of either post if you'd like to chat with me about anything in further detail.

Bryan
« Last Edit: November 12, 2013, 07:11:15 PM by BTSF »