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Author Topic: Knee in severe pain, no explanation  (Read 21049 times)

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Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #60 on: January 27, 2011, 12:03:52 AM »
I've been continuing to read Dr Ronald Grelsamer's kneeguru page on PF pain (linked a few posts back) and this caught my eye:

"Part 5 was only a brief overview of the history and examination. What I am hoping you have noticed is that it is not possible to assess the knee without a proper history. Nor is a cursory look at the knee the sign of a competent doctor.

If nothing else, I hope at least you take away with you an overview of what you should be expecting from your doctor!"

I think the doctor looked at my knee for all of 20 seconds! How do I always get so lucky? I go to the chief of surgery at the 3rd ranked orthopedic hospital in the US, and I get this kind of garbage treatment? If that's the case, how does anyone get competent care? I think this fellow is just against any and all surgery for PF problems, so he doesn't think he needs to bother with a comprehensive evaluation. Is he in any way warranted in that belief? Dr. Grelsamer is obviously in disagreement. Who is correct?

Offline SqshPlr8

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Re: Knee in severe pain, no explanation
« Reply #61 on: January 27, 2011, 10:25:24 PM »
Hey KAH,

So sorry about the uneventful visit with the doc!  Keep looking for a PF specialist and keep trying new things with your own rehab. 

You might also want to look into clinical studies.  Your treatment is paid-for -- including an examination, pre-screen MRI and other images, perhaps--which may get you going in the right direction, regardless of whether you continue with the study. For example, there was an ad on the kneeguru site which is testing a new cartilage grafting system:

http://www.kneepainstudy.com/

I think they have a site in Peabody, MA.

I have no idea if this study (or any other study for that matter) is worth anything, but you would at least get another (and hopefully more careful!) set of eyes to look at your knees -- not to mention the free care/images.

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #62 on: January 28, 2011, 12:09:37 AM »
Thank you for posting that Sqsh! Interestingly, I was just reading about the newer generation of cartilage replacement therapies, as there are some in Europe that are already approved and used regularly, but unfortunately have not be approved by the FDA in this country. One of the things I found interesting about this newer generation is that in some cases the surgeries are entirely arthroscopic. It appears that that is the case with the CAIS procedure as well. I'll definitely check that out, as if cartilage replacement does make sense for me, it would be greatly preferable for it to be arthroscopic than an open arthrotomy!

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #63 on: January 28, 2011, 12:19:51 AM »
That was a simple process! They should be contacting me at some point in the next few days. As you said, whether or not I choose to go through with it, at least I can get an evaluation and perhaps some answers. I'll let you know when they contact me.

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Re: Knee in severe pain, no explanation
« Reply #64 on: January 28, 2011, 04:14:49 AM »
If you're in Boston area (which if I read correctly you are) and think you may be a candidate for cartilage restoration procedures and/or potential realignment procedures, why don't you go see Dr. Minas or Dr. Gomoll?  They're leaders in the country for those procedures?

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #65 on: January 28, 2011, 07:58:31 PM »
Certainly, I would consider it. Honestly, the idea of open knee surgery with a 6 inch incision just freaks me out a bit. But if it's necessary to get my life back, I'll do it.

My GP called this afternoon, and inquired as to how I was doing. I told him about the incident with the new doctor, and he said that is unfortunate. I told him about the trial that I signed up for, and he said that might be something that makes sense and to get back to him if I need anything. A real swell guy, he is.

I also started doing the Egoscue E-cises again that I've mentioned in the past. Amazingly, they seem to be helping quite a bit. I actually walked cumulatively for about an hour this morning. That's quite amazing since a very minimal amount of walking was pure agony for me not too long ago. No it wasn't completely pain free, and my knees are quite sore right now. But the fact that I could do it is remarkable. One of the central ideas of the Egoscue approach is that joints can be brought back to health with motion under the right circumstances. He also believes that even cartilage can be rehabilitated. So in some respects, it is similar to rbcyclist's approach. I really believe that my severe inflammation over the summer caused extensive cartilage damage, and it's probably so-called "kissing lesions". As far as I understand it, that is the worst case scenario for cartilage replacement techniques (kissing lesions under the patella). If any physical therapy approach is going to work for me, I think that it is contingent upon cartilage actually being able to regenerate. So I'm hoping that those theories are correct. Since at least preliminarily, it seems to be helping, I'll stick with it. One of the things about the Egoscue approach is that it really requires you to do the routines every day. It will be interesting to see if I keep making progress, or if my current state today is about as good as it's going to get.

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #66 on: January 29, 2011, 12:48:25 AM »
Well, this is unexpected.

I probably walked more today than at any point in the last 6 months. No, actually probably more than all the days in the last 6 months combined. I was expecting some benefit, but this is really amazing. My muscles are so sore right now, it is ridiculous. But my knee doesn't really hurt when I walk. I'm actually starting to walk pretty fast. And it seems the more I walk, the less it hurts. My knee is only mildly sore right now. Let me say it again, this is amazing. My foot and ankle are actually really starting to hurt because I am walking so much and my calf in my left leg is still so weak. But my knee doesn't hurt when I walk. I don't know if this is going to "cure" me in the long run, but I'm a happy fellow right now!  ;D

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #67 on: January 29, 2011, 01:00:42 AM »
I don't want to exaggerate, because I'm still getting some pains when I walk, but mostly 1-3 out of 10 on a pain scale. Nothing that is stopping me. Now my glutes and hip flexors are really sore, which is a good thing. Those muscles should be driving locomotion, and now they are. I hope I'm not walking too much, as I still have lots of muscular imbalances and what must still be a very injured knee. But I just can't stop, it has been so long...  :'(

Offline SqshPlr8

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Re: Knee in severe pain, no explanation
« Reply #68 on: January 29, 2011, 04:17:27 AM »
Fantastic!  But, yes, take it easy.  I had a similar experience about a month ago.  Walked a lot more, which made me feel better, which made me walk more and so on.  Giddy with unbridled joy.  After watching 127 Hours (a movie I highly recommend to anyone going through his/her own set of seemingly endless troubles; extraordinarily uplifting), I was on Cloud 9.99999...

At the end of the week, however, the bases of my IT bands were ridiculously sore, perhaps impinged, and so I had to cool off.  Besides that, though, more moving -- particularly long walking, something I had thought was bad and had experienced as painful -- seems to help.  Of course, I have to keep it within reason and experience.  Check that.  Just experience. Pure Reason? Pure Logic? Hahaha! 

Given the wide range and severity of pain and my relatively young age, I wonder if all of this crap is the result of semi-impinged or -compressed soft tissue, causing a vicious cycle of hyper-innervation and -sensitization, which can be partly alleviated by, well, moving.  At the very least, my left knee twisting/kneecap subluxation started this whole thing.  As you alluded to in your posts, I can only hope the inflammation of the soft tissue didn't itself do any serious damage to the more inert and stubborn, though healable, cartilage.

Well, then.  There I go theorizing immediately after I openly chide and mock Reason and Logic! Sometimes I just have to heed the words of the dervish:  Shut my mouth/reflexive theorizing, and cultivate my garden/knees!

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #69 on: January 29, 2011, 05:43:31 AM »
Oh my goodness, my feet hurt like all heck! And I just know my glutes are going to kill like no tomorrow tomorrow!

I think I walked for 5 hours today. So yes I overdid it. My knees are fine, but I'm going to kill tomorrow. 4 hours would have been good. But I did 5. My knees actually continued to hurt less with time. But I could've done less.

I think the thing-in-itself is ultimately unknowable to us. I like theory as much as the next guy, but no theory encompasses all conceivable variables. And even if it does, it is merely a model by which we attempt to comprehend the otherwise ineffable. But you know, I don't need any theory right now to know that I feel better than I have in a long, long time! Reason is the internal logic of the mind. But of knees, it knows nothing. So let us mock reason and logic together!

Offline SqshPlr8

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Re: Knee in severe pain, no explanation
« Reply #70 on: January 29, 2011, 02:12:11 PM »
Amen!

I completely agree.  No theory is perfect, but they can be very helpful, at times completely indispensable, even if they prove "wrong" in the end. I don't think automotive engineers take relativity into account. Mr. Newton does a fine enough job!

Either way, you can't argue with feeling good!  Keep up the good vibes!

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #71 on: January 29, 2011, 10:30:46 PM »
Update for today:

I no longer have any pain while walking. Both of my knees are still somewhat sore, though less so than before. I've even been walking faster than 4 miles per hour. Still no pain. I've already walked for over 4 hours today.

The lateral catching and popping that I experienced for almost 7 months now in my right knee is completely gone. Last week, when I tried to walk up a step with my right leg, the whole knee cap would pop. Now, I just hear a tiny click.

The popping in the superolateral corner of my left knee has significantly diminished, though it is still there. I tried to do a few single leg squats today, but there was still significant pain. Still, being unlimited in my ability to walk makes me feel able bodied again. I hope to eventually be able to squat, but for now this is far more than I ever could have imagined.

The thing that gets me is that I had that darn book on my bookshelf throughout all of this suffering. Why didn't I try it sooner? Sometimes we humans do foolish things, both through omission and commission. I've done both in the last few months, to my eternal regret. I can't get those months of my life back, but things are looking better every day.

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Re: Knee in severe pain, no explanation
« Reply #72 on: January 29, 2011, 11:37:23 PM »
If anyone is reading this post, you are probably intrigued, but may be skeptical. Well, the only way you can find out is if you try it yourself. You can buy the book here, which I really do recommend:

http://www.amazon.com/Pain-Free-Revolutionary-Stopping-Chronic/dp/0553379887/ref=sr_1_1?ie=UTF8&qid=1296343402&sr=8-1

But, I just came across a site which has the exercise menus in a pdf format:

http://egoscueportland.files.wordpress.com/2009/06/internal-knees.pdf
http://egoscueportland.files.wordpress.com/2009/06/external-knees.pdf

Now, as you'll notice, there is an internal knees and an external knees pdf. I suppose someone in an Egoscue clinic could probably tell you which one to do, but it never really made much sense to me. So I just do both. Now, it could take up to 4 hours a day to do both menus, but, given that it could permanently resolve at least some of the issues that people on this forum present with, I think it is worth it. There are some specific things that you should be aware of if you are going to pursue these exercises. If anyone is interested, I'll elaborate.

There are also pdfs for other joints as well:

http://egoscueportland.wordpress.com/where-is-your-pain/

Go to the drop down menu at the top and select the joint.

Offline soccer15

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Re: Knee in severe pain, no explanation
« Reply #73 on: January 30, 2011, 01:52:54 AM »
I'm soo sorry...But I have the SAME EXACT PROBLEM OMG I feel that everyone thought I was making it all up and they thought i was crazy and just exaggerating all the pain. But I finally found someone with the same problem. I've been resting for 3 months now and I have to start PT does it help at all? If it hurts what makes it hurt?
Dec 20 2011 Cortisone Injection R Knee
May 11 2011 Plica Excision/Scar Tissue Removal R knee
Oct 10 2010 Sprain the the ACL graft & Bad Bone bruise to femur and Tibia R knee
June 11 2010 Plica Excision/Scar Tissue Removal R Knee
Nov 11 2009 ACL Reconstruction (hamstring autograft)
R Knee

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #74 on: January 30, 2011, 05:06:35 AM »
soccer15,

Read my most recent post, I've made something of a "breakthrough" in the last few days. I can tell you, that at least for me, conventional PT really didn't help.

Just to give a little evening update as well, the soreness in my right knee is actually increasing quite a bit. I think that the five hour walks might have been a bit much, as nice as they were. I wasn't in any pain while walking, but I am feeling it now. It's interesting that the CM knee really feels fine, but the PFPS in my right knee is flaring up. But, if I've learned anything over the past few months, it does really require "relative rest". Hopefully, I'll still be able to walk a decent amount, but I suspect that I'll have to scale back my ambitions if I want to restore the homeostatic balance of my knee (a la Dr. Dye). Darn pinched synovium.  :-\