Knee Injury

[[old] brianric]

I just got the results of my MTI. I have meniscus tear and bruising of the bone (contusion) of my left knee. I see my doctor Tuesday night for a consultation as to course of treatment. The doctor wants me to minimize walking (I'm an advid walker) but he ok the use of the rowing machine. Is this wise advice?

[[old] drkcgoh]

The ergo is an excellent rehab machine. If your lower limbs hurt, you can still exercise your upper body, thus maintaining fitness and speeding up recovery. You can either row with a straight knee, or even with the feet on the ground. That way there is no strain on the knee at all. In fact, after knee surgery there is a machine called the continuous passive motion (CPM) machine that promotes mobiity of the knee joint to help in the healing. That is similar in action to the sliding seat of the ergo. <br>You can proressively increase the load on the legs as you recover, and using reduced damper setting with the CBreeze gives you less load than when using conventional weights or isometric exercises with elastic bands. <br>Presently I have a 71 year old with a torn lateral meniscus who has just restarted on his ergo after sustaining the acute injury a few weeks agi.<br>KC63

[[old] brianric]

My knee doesn't bother me when I row, ever since I lowered my foot position on the Model D where my ankle is between the top and bottom rail, right smack in the middle. When I had my angle parallel to the top rail, it did give me some pain, and in fact may have caused the damage. About seven weeks ago I would see stars in my eyes when I got up from my desk, and would have to wait about 30 seconds before I started walking. Now, the pain is light to no pain at all, and really only bothers me when I sleep at night.

[[old] kamdo]

brianric,<br> In the acute phase of your injury, I'd be weary of overflexing the knee as is done in the catch phase of the rowing motion. Meniscal tears can cause a "pinching" sensation and limitation of motion as the meniscus is trapped between the femur and tibia. You'll probably need a partial meniscectomy and some point. <br> I had a medial meniscal tear about two years ago which kept me from straightening my left leg...I lost about 5-10 degrees of full extension for a few days. Any time I tried to flex the knee past 90 degrees, it was painful and felt "pinched". I was still able to do a stationary bike during the worst phase of the injury because the knee range of motion is more limited in cycling. The day after my surgery, I rode 30 minutes on the bike without pain. Within a week, I was able to do the erg again with full range of motion. I tried to erg sooner, but had some pain. Two months later, I had the same problem ith my right knee, followed the same approach, and did very well. <br> Don't get into the trap of thinking that only one form of exercise is always the solution to your fitness needs. Cross-train with the bike for awhile, limit your knee flex on the erg, and mix it up a bit. That being said, if you have no pain while you erg, even with the meniscal tear, then you must be doing something right. If you overflex however, you could extend the tear and make rehab more difficult and have more potential for long-term complications...namely arthritis.<br><br>Kevin A. Mikesell, DO (kamdo)<br>Emergency Medicine Physician

[[old] brianric]

Not possible to use a bike, unless I join a health club. One question, I read a lot about taking Glucosamine. Is this hype or does it really work.

[[old] kamdo]

Glucosamine works reasonably well for the type of cartilage that lines the actual joint surface (hyaline cartilage). Unfortunately, it does nothing for the meniscus which is fibrocartilage. You need the injured piece trimmed up in surgery, or you could elect not to have surgery, but the tear could extend as I mentioned in the last post.<br><br>kamdo

[[old] tow rope]

Glucosamine is never going to repair a tear. I have taken it daily for nearly a year trying to forstall what for me is inevitable knee replacement. <br><br>Speaking from experience (5 knee surgerys with 2 replacements now looming) your concern should be about the chain of events that might start with the scope. Read the Doctors report on the MRI. Pay particular attention to the dr's assesment of the current condition of your articular cartilage. They can trim the meniscus but the real danger lies in the condition of the cartilage that covers the bone. <br><br>Good luck<br><br>Tow Rope<br><br><br>

[[old] brianric]

<!--QuoteBegin-tow rope+Oct 11 2004, 06:26 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td class='genmed'><span class='genmed'><b>QUOTE</b></span> (tow rope @ Oct 11 2004, 06:26 AM)</td></tr><tr><td class='quote'><!--QuoteEBegin--> Glucosamine is never going to repair a tear. I have taken it daily for nearly a year trying to forstall what for me is inevitable knee replacement. <br><br>Speaking from experience (5 knee surgerys with 2 replacements now looming) your concern should be about the chain of events that might start with the scope. Read the Doctors report on the MRI. Pay particular attention to the dr's assesment of the current condition of your articular cartilage. They can trim the meniscus but the real danger lies in the condition of the cartilage that covers the bone. <br><br>Good luck<br><br>Tow Rope <!--QuoteEnd--> </td></tr></table><br> I'll find out more tomorrow night when I see my doctor. I have full movement of my knee. Pain happens when I sit for a while, then stand up. When I start walking I'm OK. My doctor is concerned about the bruising of the bone (contusion) of my left knee, as he said it could lead to stress fracture. I did piss him off by doing a 26.2 mile walk for a Boston based children's cancer hospital on Sept 19. I told the doctor that I didn't notice the pain in my knee after the nine mile point. What I didn't tell him was I was blistering the daylights out of my feet, which was a lot more painful. In fact, by the 22-mile point my socks were soaked in blood. BTW, I finished the walk, and was ok two days later.

[[old] brianric]

Saw my doctor last night. The meniscus tear is just normal wear and tear due to age. He mentioned something about ALS, but that won't have to be looked into until many years down the road. There is no popping or crackling of the knee. He is concerned about a very nasty bone bruise just below the knee. He plans on talking to a bone specialist, and may order a bone scan. May have to be put in a cast or brace. Told to lose weight.

[[old] brianric]

I just been informed by my doctor that I have a stress fracture just below the left knee. Told to minimize my walking for the next 8 weeks. If it does not heal then I'll be fitted with a custom made brace to relieve weight off the knee. Got ok to use rowing machine and an exercise bicycle, as they are non weight bearing.

[[old] drkcgoh]

<!--QuoteBegin-brianric+Oct 11 2004, 12:09 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td class='genmed'><span class='genmed'><b>QUOTE</b></span> (brianric @ Oct 11 2004, 12:09 PM)</td></tr><tr><td class='quote'><!--QuoteEBegin--><!--QuoteBegin-tow rope+Oct 11 2004, 06:26 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td class='genmed'><span class='genmed'><b>QUOTE</b></span> (tow rope @ Oct 11 2004, 06:26 AM)</td></tr><tr><td class='quote'><!--QuoteEBegin--> Glucosamine is never going to repair a tear. I have taken it daily for nearly a year trying to forstall what for me is inevitable knee replacement. <br><br>Speaking from experience (5 knee surgerys with 2 replacements now looming) your concern should be about the chain of events that might start with the scope. Read the Doctors report on the MRI. Pay particular attention to the dr's assesment of the current condition of your articular cartilage. They can trim the meniscus but the real danger lies in the condition of the cartilage that covers the bone. <br><br>Good luck<br><br>Tow Rope <!--QuoteEnd--> </td></tr></table><br>I'll find out more tomorrow night when I see my doctor. I have full movement of my knee. Pain happens when I sit for a while, then stand up. When I start walking I'm OK. My doctor is concerned about the bruising of the bone (contusion) of my left knee, as he said it could lead to stress fracture. I did piss him off by doing a 26.2 mile walk for a Boston based children's cancer hospital on Sept 19. I told the doctor that I didn't notice the pain in my knee after the nine mile point. What I didn't tell him was I was blistering the daylights out of my feet, which was a lot more painful. In fact, by the 22-mile point my socks were soaked in blood. BTW, I finished the walk, and was ok two days later.<!--QuoteEnd--> </td></tr></table><br>[QUOTE]I did piss him off by doing a 26.2 mile walk for a Boston based children's cancer hospital on Sept 19. I told the doctor that I didn't notice the pain in my knee after the nine mile point. What I didn't tell him was I was blistering the daylights out of my feet, which was a lot more painful. In fact, by the 22-mile point my socks were soaked in blood. BTW, I finished the walk, and was ok two days later.<br><br>Proper race walking technique with a straight knee on landing does not hurt the knee. I've done a continuous 65Km walk wihout any knee pain or blistering; only a 76Km run hurt the ilio tibial band. I have also rehabilitated many patients with osteoarthritis of the knees and damaged menisci through erging. Some have managed to avoid total knee replacement, and some have taken the surgery and rehabilitation better after strengthening their knees thru erging. Erging remains an unknown rehabilitation tool to most doctors and PTs, and many prohibit it thru fear of the unknown. There is also the fact that many ergers are highly competitive, and may push themselves too hard to improve their PBs rather than patiently focus on rehabilitating themselves. <br>KC63

[[old] brianric]

<!--QuoteBegin-drkcgoh+Oct 22 2004, 10:13 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td class='genmed'><span class='genmed'><b>QUOTE</b></span> (drkcgoh @ Oct 22 2004, 10:13 AM)</td></tr><tr><td class='quote'><!--QuoteEBegin--> Proper race walking technique with a straight knee on landing does not hurt the knee. I've done a continuous 65Km walk wihout any knee pain or blistering; only a 76Km run hurt the ilio tibial band. I have also rehabilitated many patients with osteoarthritis of the knees and damaged menisci through erging. Some have managed to avoid total knee replacement, and some have taken the surgery and rehabilitation better after strengthening their knees thru erging. Erging remains an unknown rehabilitation tool to most doctors and PTs, and many prohibit it thru fear of the unknown. There is also the fact that many ergers are highly competitive, and may push themselves too hard to improve their PBs rather than patiently focus on rehabilitating themselves. <br>KC63 <!--QuoteEnd--> </td></tr></table><br> I’m not an athlete by any means. I’m a loser in life, being a recovering alcoholic. I’m 54 and overweight. But for 10 years I did an annual two day 192 mile bicycle ride, and for the past 7 years a 26.2 mile walk in memory of my parents who died of cancer. I usually get clobbered on these events, but the pain in my heart to having 17 members of my family coming down with cancer, with 12 dying from it, far exceeds any discomfort I go through on a walk. I got tired of losing a toenail the past two years doing the walk, so I switched to a different shoe and thinner sock, and paid dearly for it. You can go to <a href='http://www.brianric.com' target='_blank'>my site</a> if you want to read the letters of my adventure over the past 17 years.

[[old] brianric]

Just got cortisone injections in left knee. I have Osteoarthritis (OA). Will be undergoing over a 5 week period 5 injections of HYALGAN. Told to lose weight. May have to repeat this every 60 to 90 days. Told to resume my walking program.

[[old] drkcgoh]

More enlightened Drs & therapists would recommend a non-weight bearing exercise like erging. Even stationary cycling or the Nustep places a greater strain on each knee. Walking definitely strains the knees more than erging. <br>The alternative to Hyalgan is Synvisc, with only 3 injections of a more viscous fluid, but Hyalgan has been there longer. Stay with light erging with a really low drag factor, and progressively increase the load with great restraint and self discipline. You may yet avoid a total knee replacement. <br>KC63

[[old] brianric]

<!--QuoteBegin-drkcgoh+Nov 6 2004, 06:08 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td class='genmed'><span class='genmed'><b>QUOTE</b></span> (drkcgoh @ Nov 6 2004, 06:08 AM)</td></tr><tr><td class='quote'><!--QuoteEBegin--> More enlightened Drs & therapists would recommend a non-weight bearing exercise like erging. Even stationary cycling or the Nustep places a greater strain on each knee. Walking definitely strains the knees more than erging. <br>The alternative to Hyalgan is Synvisc, with only 3 injections of a more viscous fluid, but Hyalgan has been there longer. Stay with light erging with a really low drag factor, and progressively increase the load with great restraint and self discipline. You may yet avoid a total knee replacement. <br>KC63 <!--QuoteEnd--> </td></tr></table><br> I wouldn't call the physician who is also the sports doctor at the University of Delaware as non enlightened. He put my knee through the full range of motion while I was lying on a table with no pain. The MRI shows normal wear and tear of a knee that went through as an adult ten years of doing over 10,000 mile on a bicycle, the last seven years of walking between 2,000 to 3,000 miles (exercise), and now rowing 15,000 meters a day. I plan on cutting my walking to 25 miles a week once I'm able to do it. <br><br>I row with a drag factor of 0.95. As far as total knee replacement is concerned, not likely for quite some time. The doctor ruled out knee operation, but did order another set of x-rays, because my PCP blew it on the first set of x-rays.