Dina has knee osteoarthritis

August 16, 2016

I have knee osteoarthritis especially in my right knee. As a teenager I dislocated both kneecaps a couple of times when I was a volleyball player. At 19 I did a knee surgery that was supposed to prevent the dislocation to happen. After my surgery my knee never went pain free again.  After meeting several doctors and specialists I finally, at age 25, found out what was wrong: knee osteoarthritis.

I’ve been active and love exercise so even with my bad knee I continued with exercises avoiding too much jumping (so no more volleyball), running occasionally, boxing and cycling. I always had a hope that one day it will be a cure that will make my knee better.

Today, at age 36, I’ve been told I’m on stage 4, meaning that I nearly have no cartilage left at all. Been seeing several specialists and they say there’s noting they can do. I’m to young for total knee replacement and my knee is too bad for trying the alternative treatments. I’m still active and cycle, do pilates and some boxing. But I really struggle to walk downstairs and I’m limping which makes my lower back stiff.

I truly believe there might be something I can do. to make it better that doesn’t involve surgeries.  Have read about knee braces and so on, but not sure if it will work for me.

Any ideas are welcome.

August 16, 2016

Hi Dina

OA is a funny old term – it’s a bit like saying “wrinkles” or “grey hair” – it’s describing an ageing process which may, or may not be associated with pain.

It sounds really scary “grade 4” as is not a good as 3 or 2 but I’ve seen plenty of people with grade 4 changes and are totally pain free.

I’ve also seen people with huge amounts of pain and yet have no OA changes at all.

The MRI describes a process, a place in time, a static image. It doesn’t and can’t tell you about pain, what it was like yesterday or what it’ll be like tomorrow or how the joint moves. MRI tells you about structure. It doesn’t tell you about how that structure functions in things like going downstairs or running.

So for me the diagnosis is secondary to the cause of your pain. The OA cannot be changed. The process can be slowed down and maybe stopped as you’re young (anatomically and I don’t think you’ve got many grey hairs!) because of what you’re making your knee do – you can make your knee function better.

Exercise and movement are King, but it needs to be the “right type” of movement – you need to load your knee appropriately (not too much, not too little but just right). You need to control the amount of bend and straightening and the speed of how you do it.

Think of it as you’ve got a really nasty bruise at the back of your knee cap. To allow the bruise to get better, you don’t poke the bruise. When you move poorly or without control (downstairs, down deep stairs, slowly etc) you’re poking the bruise and it can’t get better.

You need to rewind a little.

You need to get better motion through your thoracic spine. You do this to allow your gluts to work “better” with more control and greater activation. You don’t need to get stronger, yet. You absolutely should have your kneecap taped like this, watch our video, and if you’ve already had it taped and it “didn’t work” then go and see someone who can tape well – it’s really easy to blame the tape and not the taper! Shoes and footwear may also have a big part to play too. The McConnell approach to PFJ pain is a really decent pathway.

And finally time – bruises take a while to get better and feel normal, the same with your knee. Have a really sensible think/chat about what you think is reasonable amount of time to get to somewhere you’d like to be in terms of long term progress.

There are a few decent braces out there – it depends what you want the brace to do. What it won’t do it is give you better control of the muscles that support and control how your knee functions – from your hip down to your foot.

Hang in there.

The Guru

Guru Responded

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