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Soft Tissue Healing Problems - General / Testing this board - admin
« Last post by JustTesting on August 09, 2022, 04:01:31 PM »
Just testing this board with a testing account
KNEEguru
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I had no swelling at all that I could detect.

Do you get any burning/tingling type pain?
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Yes, that's all I can do is swim with a pull buoy. My knees don't even like the tumble turns but it's a mini-squat. Paddleboard-ing sat down is also OK. It's not enough though. I'm totally miserable.
I've read Paul Ingraham's work and he seems to be correct. He dis-regards injections and also has an article discussing the placebo effect of joint replacement. Most replacements are successful however; they can definitely make people worse but there are many reports of re-instation of activity.
I'm not sure about whether I have loss of homeostasis. My bone scan was fine. It had increased uptake in the tibial tuberosity which represents the extreme of the PFJ (according to Dye). Loss of homeostasis is an eloquent way of saying tissue overload which is basically any structure (fat pad/cartilage/tendon)....I definitely agree I have that so I will persist with trying not to irritate things....which I am finding virtually impossible.
I've researched this condition so much! I agree it is not understood by many physios or even surgeons.
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Heh, that reminds me of my pre-plastic days - the only thing I could really do was swim freestyle with a pullbuoy. It is a good workout, though, but not enough.

It sounds like you've got less of a condition that requires replacement of cartilage, rather, loss of homestasis causing chronic irritation and pain. I think SuspectDevice is probably the most knowledgeable on this subject, particularly relatable to you since you both have athletic aspirations.

I will drop one link, as I think there's a lot of good info for you that contradicts a lot of terrible information that usually comes from physiotherapy clinics (and I believe the author is from BC) - there's a lot on the site that doesn't require a subscription.

https://www.painscience.com/tutorials/patellofemoral-pain-syndrome.php
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Hi WD-  yeah the biopoly stuff looks neat in theory, basically an artificial oats implantation with less recovery time, I assume. There was another lady that got something similar on here a few years back.

I'd have a few questions about how the surrounding cartilage integrates with the plugs though. One of the biggest issues with the oats procedure was maintaining a smooth surface on the transitions, and patellar catching/pulling was an issue. But maybe that's addressed somehow. It seems a lot of these options are better applied to tibial-femoral lesions as opposed to patella/trochlear- where shearing is such a huge impact.

Anyway, it's good to see new ideas and options come to market. Surely as the science improves, each generation yields better and better results.
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Did either of you get swelling with activity? I get some suprapatellar effusion. I would expect this though as my knees can't really take my body weight.
I don't think I can do low rep/high load but something to consider.
The high rep stuff does seem to aggravate things as you say....I think this was all caused by the repetitive motion of cycling.
Thank you for your support. I don't enjoy my life in this predicament and am struggling a lot mentally. I feel like my life has shut down.
I think I'm going to just stop all physiotherapy other than on core and hips and just try and not aggravate the joint. I'm swimming upper body only which is something.
I really do appreciate the advice and encouragement
Such a lonely journey.
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I always had pain on both knees and did 18months of trying to stay in my envelope of function- used to be an avid cyclist and stopped completely. The right I could feel a flap and the surgeon said he could help (I genuinely believe he thought this) and that's when I did the arthroscopy. That weakened the right knee considerably. I think it's slowly improving but imperceptibly really. I still have a slight limp. The pains in both are around the knee cap, not underneath. It's aching and the more I use the joints, the worse it gets. Both are weak and that's why I think I struggle with standing and walking as essentially they don't support my body weight. The right I'm not putting much weight through now. I try to walk on the flat heal-toe etc but any incline and I use my left. I'm hoping with time, it will get stronger but I try not to push it.
I don't have problems sitting with bent knees like many of you do, although I've been told to avoid this. The surgeon said there was no synovitis and the knee was in the groove (although I don't buy all this theory of maltracking unless it actually subluxes). He said the rest of the knee was pristine. The right showed a chondral flap (small apparently) and a fissure, so grade 3 chondral damage and I expect the left is the mirror image.
I'm doing lots of high rep/low load movements. I've avoided all injections as I believe there is no evidence having read all the studies.

That is very interesting.

I had a knee expert also tell my I did not have synovitis (just based upon him poking around my skin with a finger) but I think I did.  Yours really does sound like the Dr Dye 'loss of tissue homeostasis' but who knows?

I fully agree with you about the mal-tracking BS.  I think it is far far rarer than surgeons & especially physios say.

My pain was also around the kneecap & also underneath.

Strangely for me, once I got on Celebrex, what worked was more higher load/low reps (e.g. sissy squats, squats against a wall with a fitball behind my back, deadlifts up to 50kg, kettle bell swings with 16-20kg in each hand).  Too many reps seems to be more of an issue for me (e.g. too much cycling).  I'd built back up to fairly solid 2hr rides, but that might be too much now.

The fact that the rest of your knees are 'pristine' bodes very well IMO (mine are certainly not).

Hang in there.  Try and be patient (unlike me!).  There is hope. 

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Iím glad Suspect Device has joined this conversation. He talks a lot of sense and his experience is very like mine. Yes, it took a long time to start making Improvements to PFP and as Suspect says sometimes it is one step back. I also have some cartilage issues in the PFJ which mean it can go out of the envelope more easily at the moment but itís gradually improving. Allowing things to calm down in the joint first can take months to years. Very tedious and aggravating but the key is not to cause irritation though keep moving gently. It was a matter of listening to my knee, avoiding irritating it, consistently doing all the right things and being patient while remaining positive.

After over two years itís greatly improved and my exercise / fitness are too. Die et al are a clever bunch. Give it time and bear in mind that even if that didnít work for you (which I hope and believe it will eventually), you could opt for a plastic and metal joint in (the hopefully distant) future (PFJR/TKR). Dave33 and RGB have posted lots of really helpful stuff about their experiences of PFJR. The longer the better as the technology only gets better too.
All the best.:)
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I always had pain on both knees and did 18months of trying to stay in my envelope of function- used to be an avid cyclist and stopped completely. The right I could feel a flap and the surgeon said he could help (I genuinely believe he thought this) and that's when I did the arthroscopy. That weakened the right knee considerably. I think it's slowly improving but imperceptibly really. I still have a slight limp. The pains in both are around the knee cap, not underneath. It's aching and the more I use the joints, the worse it gets. Both are weak and that's why I think I struggle with standing and walking as essentially they don't support my body weight. The right I'm not putting much weight through now. I try to walk on the flat heal-toe etc but any incline and I use my left. I'm hoping with time, it will get stronger but I try not to push it.
I don't have problems sitting with bent knees like many of you do, although I've been told to avoid this. The surgeon said there was no synovitis and the knee was in the groove (although I don't buy all this theory of maltracking unless it actually subluxes). He said the rest of the knee was pristine. The right showed a chondral flap (small apparently) and a fissure, so grade 3 chondral damage and I expect the left is the mirror image.
I'm doing lots of high rep/low load movements. I've avoided all injections as I believe there is no evidence having read all the studies.
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Am I correct in thinking you had surgery one one knee, then ended up with pain in both knees? What sort of pain is it?

That also happened to me.  5 years of Hell and mostly useless (even damaging) expert medical & PT advice followed after a meniscus trim on my Left knee.  In fact my Right knee was worse, but I think my bilateral problem was coming on anyway and surgery was the final straw.

Then I found the material you seem to have already read - Dr Dye, Bedard, Ingraham etc.  Following Dr Dyes protocol starting with 5-6mths on the anti-inflammatory Celebrex was the key to getting out of the nightmare.  I basically had chronic synovial inflammation.  There was underlying patella and femur end cartilage damage, but that was not the main problem.  And those issues have healed a lot now.

I've posted lots of stuff on here about my journey.

I still have to be careful though.  Recently I ramped up my cycling and that combined with some kneeling stretches for another injury (pelvis) saw my symptoms starting to come back.  But I know how to get on top of the issue now, to back off fast and let things settle and what to avoid.
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