How do I get my knees into better shape

  • Posted by a hidden member.
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    Jul 26, 2007 2:38 AM GMT
    I had a towen maniscus a few years back and it is still feel like it is ready to give out. How do I get my knees back into shape?
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    Jul 26, 2007 10:41 PM GMT
    Did you have your torn meniscus repaired (or shaved off, which is the more accurate term)?

    Was it the medial or lateral meniscus? If medial, was there MCL and ACL damage?

    Was it anterior or posterior portions of the meniscus, and did you have a complete mensectomy or partial...?

    Knees giving out because of weakness, pain, or feeling on instability...? Happens mostly when wlaing and twisting or ascending or descending stairs..?

    I can give you more answers if you are more specific...
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    Jul 27, 2007 4:51 AM GMT
    Hey NYC - how about a ruptured ACL and a partial tear to the medial meniscus (from a dislocated kneecap due to a fall).

    The doc elected not to do any surgery - and at my last exam with him after PT said "of course, if you'd been an athlete, we would have operated". Fucker.

    They used a lot of cortisone, and my right quad has always been somewhat stunted since the injury and drugs.

    Comment?
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    Jul 27, 2007 5:03 AM GMT
    Hmm... I'm avidly watching this topic, but it looks like there's going to be no easy answers. I had juvenile rheumatoid arthritis, and basically, my knees always hurt. And make crunchy noises when I walk up stairs. Descending mountains with a heavy pack is the worst. (Sometimes I have to do that for work... pack full of rocks. I often do it backwards.)

    Basically, I just stick to relatively light weights for exercises that tweak the knees.
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    Jul 27, 2007 7:00 AM GMT
    Big Joey,

    You are lucky you did not have the "Unhappy Triad" where the MCL is also damaged... Are you sure your MCL is not strained? How old is this injury...?

    Let me try to explore this topic this way:

    1. Meniscual tears... Why do surgeons sometimes hesitate to operate..? It is because menisucs is cartilage, about only about 1/3 of the outter ring of the meniscus is somewhat vascular but the rest is like most cartilage, that it is not vascularized and does NOT regenerate, it is nurished by intra-articular synovial fluid.. As a matter of fact, these inner portions of meniscus cartilage, once there is bleeding of blood into it, it often calcifies, turns into a bit like pseudo gout! And you have bone on bone!

    If the surgeons "fix" it, they only have 2 choices: Shave off the offending torn pieces, or implants.

    Shaving off cartilage can be problematic as if too much is shaven off, your medial knee compartment will be loose as the space previously occupied by the cartilage is no longer filled physically by the cartilage and your MCL stays the same length.. This will cause cluncking of the medial compartment, therefore WILL lead to early onset of truamatic oesteo arthriitis/DJD...

    We have no cure for DJD but only compensatory treatments such as cortisone shots, repeated hyaluronic acid injections, bracing, and total knee replacement surgery. Cortisone shots cannot be performed more than twice a year as it has a ton of catabolic and blood sugar and immuno supresant side effects. Hyaluronic acid injections only works for mild and early onset of DJD, and it is not permanent and requires schedule repeat injections. Total knee replacements only lasts about 10 to 15 years, and revisions after it expires may end up with a leg that is an inch shorter.. That is why most surgeons would like to do it when yoaure 60 or 70, hoping the knee will outlast your life...

    Now, meniscus implants are not the most common as the failiure rate is very high. We currently do not have any adequate artifical material that mimic natural cartilage because the combination property of slippery yet hard and pliable AND durable is not really achievable... Cadever meniscus has to be cleaned by freez-dry, and this alters the moisture and water content of cartilage, therefore can make the tissue unviable, so failiure rates are high.

    And a meniscus can be "torn" in many ways. If it is just a crack, there is no sense in fixing it but just to avoid deep knee flexion or heavy weights (due to the reasons mentioned above.) The surgeon will only shave it off, whole or partial, if the shape and orientation of the tear is in danger of jamming into other structures, or get caught and be torn off to become a floating loose body within the joint (bad, bad, bad)...

    3. ACL tears: A lot of people actually walk around with complete tears of ACL... It prevents the tibia (shin) from gliding too much forwad, too much forwad movement of the tibia will result in instability and the knee to hyper extend. A patient with detacehd ACL will feel it most with stairs, cutting, and single leg activities... It is often fixed with cadever tissue or harvet from your own hamstrings. The sucess rate of this procedure is very high and quite common, so I am not sure why your orthoo did not perform this for you.

    4. Quad and VMO strength: There has been recent research studies where healthy, strong professional NFL football players were injected with saline solution into the knee joint. With as little as 3cc of fluid injected intra-articulary, these player could not even squat and their knees buckle... It turns out that inflammation of the knee joint will neurologicaly shut off the quad muscle activities. As soon as these athelets were aspirated, their strength came came without any rehab. This is als the reason why we see alot of post surgical knee patients with no way to build their quads for sometime.. So we resort to Russian Electrical stimulation while having them perform active contractions in sync with the electrical current...

    So, there maybe reasone why your ortho did not "fix" your menicual tears, BUT I am not so certain why your ACL was not fixed... AND I am not sure why you need cortisone injections, as that indicates you had intra-articular (within the joint capsule) inflamation and pain, AND your ortho should identify what is causing this inflamation and why is this not fixed and that cortisone is abetter treatment than other surgical procedures.

    A good ortho rehab team should alwasy take the patietns functional level into consideration when discussing expectations and goals... At least educate the patient the options of various treatments available out there today, and explain the pros and cons of each option. Cortisone shots, as mentiond above, can only be given so often.. Did your orth mention hyaluronic acid injections...? Does your ortho specialize in knees and treat alot of athletes, or treat general g
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    Jul 27, 2007 7:05 AM GMT
    Opps got cut off..

    Or does your ortho treat mostly geriatric population...? There are good and bad orthos out there, and some a specialized in only a certain joints and treat professional athletes. Be an educated consumer and shop around!
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    Jul 27, 2007 7:08 AM GMT
    Lose weight.

    Do leg extensions.
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    Jul 27, 2007 7:10 AM GMT
    I forgot to mention the patellar joint..

    That is another can of worms, as it can be orgnaized into 4 categories just for the kne cap alone..

    Most people feeling popping and crackling is actually most likely your knee cap joint, as severe crepitus of the actual condyle joint (the actual knee of tigh and shin boens) would indicate severely painful end stage knee DJD, which can only be fixed with a total kne replacement.

    If youre interested in knee cap pathologies, I have posted this already in the Cycling Forum:

    http://www.realjock.com/topic/3423/

    Take a look if you have any questions...
  • Posted by a hidden member.
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    Jul 27, 2007 7:23 AM GMT
    Leg extensions and any open chained quad exercises would be VERY bad if you have a knee cap problem... You need to know what is wrong..? Condyle joint problems or knee cap problems? Etc, etc..
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    Sep 13, 2007 11:34 PM GMT
    Do not do the leg extentions...swim.
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    Aug 21, 2010 9:05 PM GMT
    Howdy - just joined site not sure how to msg. Would like to meet for coffee & conversation aztravjack@comcast.net
    subject line - howdy
  • ja89

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    Aug 21, 2010 9:14 PM GMT
    Whoooff saidI had a towen maniscus a few years back and it is still feel like it is ready to give out. How do I get my knees back into shape?


    that's crazy man. My training partner tore his meniscus recently while we were practicing. he just got surgery on it and now has been getting into lifting slowly by using resistance bands and other machines that i hope to have to never use. I can't really give you much advice other than don't rush it and be patient.
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    Aug 21, 2010 10:51 PM GMT
    Wow...a three year old thread. Someone had to dig DEEP for this one. icon_lol.gif