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Author Topic: Suitable Exercise for Damaged Articular Cartilage - HELP!!  (Read 8970 times)

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Offline Elkie

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Suitable Exercise for Damaged Articular Cartilage - HELP!!
« on: July 08, 2005, 11:09:00 AM »
Hello!

I've just had an arthroscopy after over 10 years of knee problems to discover that I have softening and damage to the articular cartilage behind my kneecap. I've always been really active...netball, running, climbing, kickboxing...anything and everything basically and have a month before I go to see the specialist again, during which time he's asked me to think about what exercise I want to be doing and what I think I can do. I'm not someone who likes swimming or yoga or anything like that but realise that a compromise has to be made somewhere in order that I get as much use and as little pain from my knees as possible.

Can anyone suggest any sports that are energetic but not so harsh on the knees or warn me off any particular types of activities?

Thanks....any help would be most appreciated!!!

Offline Nettan

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Re: Suitable Exercise for Damaged Articular Cartilage - HELP!!
« Reply #1 on: July 08, 2005, 01:31:18 PM »
I'm thinking of watertherapy or aerobics in water or run in water. Water are good for the joints, not hard on them and there's a lot you can do in water. I excercise in water, my phys made a programme for me, no swimming as I can't cause of my legs. Its good for whole body, you can build muscles and also get a good cardio workout.
Just a thought. Good luck to you in finding a good way to excercise.

Hugs nettan  8)
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline blackbeltgirl

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Re: Suitable Exercise for Damaged Articular Cartilage - HELP!!
« Reply #2 on: July 08, 2005, 01:51:08 PM »
Elkie -

First of all - what was done in terms of treatment during the arthoscopy?

Second - with damage on the back of the patella, you probably want to avoid activities with lots of repetative bending.  Every time you bend the knee you run the kneecap through it's groove, wearing on the damaged site.  So something like biking is probably not your best bet.  (I have damage to the trochelar groove, the groove the kneecap runs through.  That's how I've learned this.)  Kickboxing is probably also bad.  I gave up tae kwon do.

Good ideas, besides the pool: the elliptical trainer or arc trainer at the gym.  Probably not the stair machine, but ask your OS.  Sports that require a lot of lateral movement should be checked with your doctor - stopping quickly in a lareral position may put stress on the damaged part of your joint.  But it depends exactly where the damage is.  Climbing is probably ok.  Walking.  Hiking.  Downhill may hurt a lot more than uphill.

I'm out of ideas.  Hope this helps.
Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline Sesna

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Re: Suitable Exercise for Damaged Articular Cartilage - HELP!!
« Reply #3 on: July 08, 2005, 03:57:11 PM »
Elkie,

Don't know if you enjoy dancing, but you could try bellydancing. It's low impact, but gives you a hell of a workout, plus strengthens all your core muscles. Plus you get to wear fabulous costumes and once you learn how to roll your belly, you can impress all your friends at parties!

--Sesna
Canadian gal living in Tokyo, slipped and dislocated patella in May, joint capsule damage.

Offline Janet

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Re: Suitable Exercise for Damaged Articular Cartilage - HELP!!
« Reply #4 on: July 11, 2005, 02:42:16 AM »
Everyone automatically thinks that water exercise is good when you have cartilege problems in your knees. But the patella is different. I, too, have a chondral defect in the articular cartilege behind the patella. I found that taking a water exercise class was one of the worst things I had tried in a long time. It didn't hurt in the water, but I was more sore for three days afterward than I had been in months. I mean, really sore. I think that all the bicycling movements and jogging movements under water were absolutely the worse things I could be doing, even though it was in the deep end with a float belt and there was no impact at all. If you do water exercise, I would suggest doing only straight-leg exercises.

I have not found anything that I can do and still be pain-free. Probably the least-painful is the recumbent bike. I used to do the regular bike with no resistance, but that now hurts after 12 minutes or so. I had to give up the elliptical completely. Jess is right that repetitive bending is really hard on the patella, as is anything that puts a full load on the knee such as squatting, getting up and down off a chair, etc. And never, ever, ever do a leg extension machine!

You don't say what degree of damage you are at, or what you do that causes the most pain. It also depends on where the damage is on the patella. You will probably have to do some experimenting. Add one new exercise (at a gentle pace) at a time and see how your knee reacts. If you have pain during exercise or the day after, you can try something else.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline blackbeltgirl

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Re: Suitable Exercise for Damaged Articular Cartilage - HELP!!
« Reply #5 on: July 11, 2005, 02:09:59 PM »
Janet -

I usually respond the same way when I see people recommending the bike or stationary bike.  You're right - there's nothing that's good for ALL of us.

If it helps - I've been taking water classes for a while now.  Not deep water, though.  And I do modify MANY of the exercises.  I will not do anything that requires too much bending of the knee.  If the class is doing an exercise that requirse bending I either modify it to accomodate my needs, or do something else altogether.  My gym also offers personal training in the pool, and has a rehab center with physical therapists who do pool work.  That may be an option to work with someone familiar with the disorder, who can teach you proper form for exercises that will help, not hurt you.

Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline Elkie

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Re: Suitable Exercise for Damaged Articular Cartilage - HELP!!
« Reply #6 on: July 11, 2005, 03:25:34 PM »
Thanks all for your helpful responses.....I think I'm struggliing for ideas because I'm not exactly sure what exercise is bad exercise as far as my knees are concerned.

The only other thing that was done at the time of the arthroscopy was a meniscopy. My OS was going to do a Lateral Release but decided having had a look that it wouldn't necessarily be of any benefit to me.

I'm not suffering greatly in terms of pain at the moment which is another reason why I'm finding the whole concept of this so difficult. Running is about the only thing which is really causing me issues and I do get some pain from cycling but I'm stubborn by nature and in the past have just been inclined to plough on regardless.

I have come across the concept of Nordic Walking though which I understand is better for cardio than normal walking and also takes more pressure off your knees because of the use of poles.....www.nordicwalking.co.uk.....has anyone tried it and can recommend it?

The other thing I thought might be OK would be boxing which is also quite full on but doesn't require a great deal of jumping about and impacting on the joing??

Thanks again....any further comments would be welcomed!

Offline blackbeltgirl

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Re: Suitable Exercise for Damaged Articular Cartilage - HELP!!
« Reply #7 on: July 11, 2005, 03:42:46 PM »
Again - asking us is not the same as asking your doctor.  The safest, smartest way to keep fit and manage the joint, is to ask your OS.  Make a list of sports/activities you enjoy, putting those you are most likely to do at the top of the list, then new activities you're thinking about trying (and want to try), and those that you arely do, or think you might try but not do regularly at the bottom of the list.  Then you can mail, e-mail, or call your OS and go through the list together.

I don't know much about boxing, vs. martial arts.  But staying on the balls of your feet, and all the bouncing movements and lateral movements (whether you lift your feet or just shift your weight) may put pressure on the damaged part of the joint.  I've learned the hard way that there is rarely anything positive to pushing through this pain.  Aches - yes.  But if you'r working through bone or joint pain, you're only increasing the amount of damage, and leading to mroe pain in the future.

Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline Aya

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Re: Suitable Exercise for Damaged Articular Cartilage - HELP!!
« Reply #8 on: July 11, 2005, 05:10:50 PM »
So glad to see someone suggested belly dancing, since this is my chosen method of exercise before knee problems. Just don't try to do floor work, which is pretty easy to avoid, since it's rather specialized within belly dancing anyway (very few dancers in my area do it at all). I've heard a lot of stories about professional belly dancers who have chronic knee problems (not from belly dancing), but can still dance because it can be very gentle on the knees.

Offline Heather M.

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Re: Suitable Exercise for Damaged Articular Cartilage - HELP!!
« Reply #9 on: July 11, 2005, 08:16:26 PM »
I have to agree 100% with Janet--water therapy is enough to cripple me.  I did the shoulder-depth stuff and really gentle exercises, didn't do anything that hurt...and couldn't walk for about four days after.  This has happened every time I get in the pool.  If I just get in to fool around and don't use my bad leg, I still get some swelling but it's not as bad.  Lasts a day or so.  It just slays me when everyone recommends it....as for the bike, I've never really had a problem with it, though it can irritate my scarred patellar tendon.  Recumbent is best for me, and I sit with the seat fairly far back to always keep the bend less than 70 degrees (my loading point seems to be 90 or so).  And ALWAYS keep the resistance low, adding one notch of resistance every few weeks in 30 second time increments.  So you start at level 1 or 0 (lowest one) and ride for 5 minutes for a few days.  If this irritates your knee, go down to 30 seconds.  Every few days, add another 30 seconds.  When you get up to 15 minutes at level 1, then go to level 2--but cut the time way back to 5 minutes.  Go back to 30 seconds if necessary. 

The thing with having cartilage damage is that any stress or exercise seems to be cumulative.  So while you may be able to walk for 2 miles on level ground on Monday, if you try to do it again on Tuesday you may find the knee sore.  Again on Wednesday, and it's throbbing by bedtime.  This goes for many types of weight-bearing exercises, so you are really encouraged to start slow with very low duration workouts and SLOWLY work up.  And keep at least two rest days between any workouts that use the leg or knee in the same way--so you might want to walk one day and bike the next, swim two days later, etc.  Some lucky folks can exercise every day if they change things up.  Others will work the leg one day and do upper body work the next--or they will sit on a bike or rower, for example, but set the bad leg on a chair or a slide (most PT places have these) so that they are not using the bad leg at all during the cardio workout.  Many athletes do this after surgery to a leg--they'll work the rest of their body and the other leg like crazy, but prop up the surgical limb and not use it at all.  Evidence shows that this actually improves healing time on the bad leg!  No one knows why, but when you work the good leg, there are spillover benefits for the bad one.

Another possibility, perhaps already mentioned, is an arm bike.  These workouts, even when done seated in a chair, will kick your behind!!  I can barely do 10 minutes of low to moderate resistance, because I'm so out of shape.  Also, I have a blown shoulder, so I have to be very careful of it--don't want another orthopedic surgery!!

A final possibility to consider is hiring a professional to help design a workout for you.  I'm talking about someone with a physical therapy background--try to find a performance enhancement clinic that also does physical therapy.  My last place like that was a "Center for Spine and Sports," and had physical therapists who had dual degrees as Certified Athletic Trainer.  So they had the initials PT or MPT (meaning they had a Master's degree in Physcal Therapy) AND ATC after their names--check their business cards or on the web site of the clinic, if possible.  A person with this type of educational background will be able to evaluate you and your knee, and devise a workout program for you that covers every day of the week if you want.  Sometimes this process is only through trial and errorto find stuff that doesn't hurt you, so be patient.  You can pay for a few sessions, then get a workout series that you can do on your own.  Go back every month or so for new stuff to do so you can step things up.

I will admit that it's very hard to exercise when you have severe damage to articular cartilage or osteoarthritis, especially on your kneecap.  I have had extreme difficulties finding anything that doesn't irritate my knee joint and increase my pain dramatically.  I've gained a ton of weight over the last few years of knee troubles, and in the past the only way I've been able to lose weight has been to exercise.  It's a Catch 22.  So I sympathize completely.

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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