General Discussion Triathlon Talk » To those of you with post-operative knees Rss Feed  
Moderators: k9car363, alicefoeller Reply
2009-11-13 7:12 PM

User image

Member
15

Lafayette
Subject: To those of you with post-operative knees
Tell me about your training, how you manage your pain (if you have any,) and how you preserve your knees, in general.

I've had 4 knee surgeries, and I'm thinking hard about making Ironman a goal but I'm not sure

A) If it can be done
B) If it can be done within a fairly minimum amount of pain
C) If it can be done with a fairly low chance that I am going to continue to decrease the lifespan of my knee.

(Brief history: The big issue is my right knee. Multiple tears in my lateral meniscus, 2 scopes, 1 huge meniscus repair. Last surgery was in Feb '09. I got a cortisone shot in October and am still taking PRN mobic for continued pain/inflammation.)

Not looking for medical advice here (obviously) but just other people who have succeeded despite fairly complex knee histories.


2009-11-13 9:58 PM
in reply to: #2513369

User image

Master
2474
20001001001001002525
Oceanside, California
Subject: RE: To those of you with post-operative knees
I was all about the wrap that holds the ice pack.

2009-11-14 9:20 AM
in reply to: #2513516

User image

Member
15

Lafayette
Subject: RE: To those of you with post-operative knees
I love mine, too. I have more ice packs in my freezer than frozen food.

Also, I am planning a visit to my surgeon (sports medicine) to discuss all this. Wondering if it's possible to do an Ironman, really focus on the swim and bike, and walk the marathon?
2009-11-14 2:25 PM
in reply to: #2513369

User image

Master
2474
20001001001001002525
Oceanside, California
Subject: RE: To those of you with post-operative knees
As far as your questions, I don't know if my experience applies.

I only had one problem with my knee, the injury was more based on the stress, I had an otherwise healthy knee.

I tore my ACL and Medial Meniscus in a super-heavyweight submission wrestling match.
2009-11-14 6:54 PM
in reply to: #2513715

User image

Champion
7704
50002000500100100
Williamston, Michigan
Subject: RE: To those of you with post-operative knees

Sweet Caroline - 2009-11-14 10:20 AM I love mine, too. I have more ice packs in my freezer than frozen food.

Also, I am planning a visit to my surgeon (sports medicine) to discuss all this. Wondering if it's possible to do an Ironman, really focus on the swim and bike, and walk the marathon?

All you have to do is swim and bike fast enough to e able to walk the whole marathon.  You could look into speed walking as well.  See what your surgeon says and good luck

2009-11-15 4:59 PM
in reply to: #2513369

Extreme Veteran
562
5002525
Subject: RE: To those of you with post-operative knees

Multiple repairs to right knee, apparently they were successful because my knee no longer bothers me. After second, the doctor told me to train differently or I would be back under the knive, so I train differently since second surgery. Are you listening to your doctor? Why constaint injuries/pain?



2009-11-15 5:53 PM
in reply to: #2514983

User image

Member
15

Lafayette
Subject: RE: To those of you with post-operative knees
I am a nurse, so I take my doctor with a grain of salt. Ha. Just kidding...we have a good understanding for the most part. Several months ago, he told me I could do whatever I wanted. However, it ended up being a more complex repair than either of us were expecting. That's why I'll be having a chat with him about all these new fangled ideas I have. I expect to need another cortisone shot in the next few months (and that's part of the problem...) There's just a part of me that is scared to screw it up again. If my repair fails, I end up with a total meniscectomy which will eventually lead to its own set of problems, of course. I'm only 27 so I'm trying to be really, really, really careful and conservative, particularly with the running.
2009-11-15 7:50 PM
in reply to: #2513369

User image

Master
2474
20001001001001002525
Oceanside, California
Subject: RE: To those of you with post-operative knees
More than medical advice, I am wondering if you should spring some money for a coach/trainer who can see if running gait or something else about how you train if putting undue stress on things.

I know that minimal changes in my gait (without a coach, just friends and research) has made an immense change in my knees and back.
2009-11-15 8:16 PM
in reply to: #2513369

User image

Expert
1087
1000252525
Portland
Subject: RE: To those of you with post-operative knees
The only thing that ever helped with my knees is... STRENGTH.  Strengthen your quads and hams, this will keep the strain off the maniscus.  Biking more also helps.  Space your run workouts out best you can so you have at least 48 hours rest in between, and you should remain healthy.
2009-11-16 9:48 AM
in reply to: #2513369

User image

Pro
5011
5000
Twin Cities
Subject: RE: To those of you with post-operative knees
You do not want a total meniscetomy. I will tell you that. (And chances are, your doctor doesn't want that either..they will do a lot of partials before they take it all.) I've had 4 surgeries (incl. debridment/chondroplasties, partial--and then total--menisectomies, and microfracture), and my next one will be a osteotomy, most likely. As I've gotten older, they've gotten harder and harder to recover from.

If you had a repair, and have been given the go ahead to resume training, and your articular cartiliage is in good shape, though, I'd say formulate a good training plan, stay off concrete as much as possible, do a ton of core strengthening (VERY VERY IMPORTANT...back, abs, GLUTES AND HAMS). Get a good PT who specializes in runners to set you up with a core routine.

Take glucosamine/chondroitin if you want--I do, and find it helpful, but then again, my OA is fairly severe, and studies show it doesn't tend to work on mild OA, so if your cartilaige is okay, it may or may not help.

Find an orthopedic surgeon, and stay in touch. Get yearly MRIs, if you feel you need to (more important for cartiliage than for meniscal, though).


2009-11-16 6:55 PM
in reply to: #2515767

User image

Member
15

Lafayette
Subject: RE: To those of you with post-operative knees
Yes, the articular cartilage on that knee is "pristine" according to the operative reports. The meniscus itself was detached from the capsule and also had mutiple tears of various types. I had 2 previous partial meniscectomies. This time he did an open repair and ended up with about 10 sutures in the meniscus, itself.

All these suggestions are excellent. I've been doing a lot of strengthening but it sounds like I'll need to continue at the pace I was. I may even hold off running this winter in favor of even more strength training, instead. I'm on my feet for 12 hours a day at work; that ought to count for some kind of base-building, right? Like I said, I plan on talking to my doc about all this...just wanted to get a vibe from anyone else who had some experience with an angry knee.


2009-11-17 8:35 AM
in reply to: #2516714

User image

Pro
5011
5000
Twin Cities
Subject: RE: To those of you with post-operative knees
If your repair went well...excellent! If you find yourself looking at another menisectomy--look into meniscal transplants. I wish I could have done one, and the folks I've talked with who have had them seem pretty happy.
2009-11-17 4:48 PM
in reply to: #2513369

User image

Expert
1149
100010025
CenTex
Subject: RE: To those of you with post-operative knees
Sweet Caroline - 2009-11-13 7:12 PM Tell me about your training, how you manage your pain (if you have any,) and how you preserve your knees, in general.

I've had 4 knee surgeries, and I'm thinking hard about making Ironman a goal but I'm not sure

A) If it can be done
B) If it can be done within a fairly minimum amount of pain
C) If it can be done with a fairly low chance that I am going to continue to decrease the lifespan of my knee.

(Brief history: The big issue is my right knee. Multiple tears in my lateral meniscus, 2 scopes, 1 huge meniscus repair. Last surgery was in Feb '09. I got a cortisone shot in October and am still taking PRN mobic for continued pain/inflammation.)

Not looking for medical advice here (obviously) but just other people who have succeeded despite fairly complex knee histories.


I just signed up for IM LOU as my first full.  I have done 4 HIM with varying degrees of success. 

My background:  2 scopes, torn ACL, MCL and meniscus(2x).  According to my ortho (I feel to young to have an orthopedic surgeon!), I have little to no meniscus in my left knee. 

IMO, every day that I continue to run I decrease the lifespan of my knee.  My philosophy is that I am irreparably down the path of knee replacement, so I might as well enjoy it as much as possible.  That said, I do as much as I can to run w/out pain.  I have found that ART helps me achieve this.  I also use the Trigger Point rollers to keep the scar tissue to a minimum, which seems to help.  I am also planning on starting yoga this winter to help with flexibility, which I believe will help.

I have found a training plan that is slightly more bike- than run-focused.  (Fink, beironfit.)  I think that this will help as well.  I use arnica montana to help decrease swelling and will take advil on before/after long runs to help ease pain.

Lastly, I have a great chiropracter that has been a great help with adjustments, acupuncture and massage therapy. 

Good Luck!  It can be done and it can be done mostly pain free!  I am a living example!
2009-11-17 8:54 PM
in reply to: #2518635

User image

Extreme Veteran
360
1001001002525
Lafayette, CO
Subject: RE: To those of you with post-operative knees
It's Caroline...just a different moniker. I found my old login information and decided to go back to it since this is where I've logged my 1st tri! I remember what fun it was...

Anyway...it gives me great hope that this kind of activity CAN be knee friendly if you take the necessary precautions. Yes, my repair went well, it was just unexpectedly large. I was non-weightbearing for 8 weeks, then another 4 months of significant activity restrictions. I did everything in my power not to screw it up. I have been religious about physical therapy and strengthening. I ice it after almost all of my workouts. I back way off at the first sign of weirdness. I think I am probably a little "too" sensitive...just scared, maybe. I do have some slight catching, and still struggle with pain and inflammation at times. It's just that I'm way too young for a knee like this, and although I don't want to end up with a TKA, I don't want to hang up my shoes, either.

Please keep your experiences coming! Really interested to hear how your training continues to treat you. I will do the same. So far, so good, though! (Yeah...1 bike, 1 swim, and 1 strength training into it...doing great!)
2009-11-20 3:00 PM
in reply to: #2513369

User image

Elite
2796
2000500100100252525
Texas
Subject: RE: To those of you with post-operative knees
I've had 7 right knee operations, on both the lateral and medial meniscus. ACL is 50% torn, big holes in the articular cartilage. Last scope was in 2005. Pics from my last scope are in my album.

I'm running with less pain now than I have at any point in the past 15 years.

What I do that I KNOW was helpful:

1) I got light. I went from 220+ lbs and over 20% body fat to under 180 lbs and 8% body fat. It seemed to me that with every pound I lost I had a coresponding percent reduction in pain at a ratio of about 2:1 (feel 10% better with every 5 lbs lost). But that's subjective and only based on my personal experience so your mileage may vary significantly.

2) I learned that some pain means "hold your pace and run through it" and some pain means "stop".

What I do now that I THINK is helpful:

1) I run more or a treadmill than outdoors. I hate it, but I do it. The surface is more forgiving and it's even/flat. I ran on a trail and paved roads for years and the surfaces were always canted a few degrees. I believe that exacerbated my biomechanical issues.

2) I do Triggerpoint Massage, foam roller, and "the stick" before most and after every run workout, and after every bike session. I'd do it a disservice trying to describe it here. But the manufacturer of the kit I use describes it on the website:
http://www.tptherapy.com

3) I stopped taking Mobic, Celebrex, ibuprofen, naproxen, etc... I now take an OTC compound called Zyflamend, an extract called bromelain, and fish oil (all from the local natural foods store). I have fewer episodes of pain than I did on NSAIDs, but I cannot say 100% this is from the OTC stuff being any better as it may be attributed to other factors like weightloss. The Zyflamend and bromelain were "prescribed" to me by my medical doctor who is a board-certified internist, former olympic swim team alternate and current triathlete. I say that so it's clear I didn't just go to a healthfood store and asked the salepeople what to get. I trust my doc, he knows where I'm coming from, and he uses the stuff himself for a similar problem.

I know I'm very lucky to be able to run. My surgeon told me to quit 5 years ago. He also said if I were 20 years older he would do a total knee replacement now. To that I asked "how would I know if it was time to do that once I am at an age where that type of surgery would be appropriate?" He said pain is generally the guide. When I get to where it hurts too much to do my daily activities, it's time. Not only do I not always have pain, I'm on pace to have my fastest run splits ever next season if I stay healthy, and I just set a new PR at the 5k distance last month (avg 6:44/mile), so I don't think it's time to get a new knee yet.

To your questions:
A) If it can be done.
Sure. It can be. Whether you feel like it can be done by you in particular will be a matter of how you feel each day, and you will have periods where you feel great and periods where you feel there's no chance. Remember that year over year consistency is more important than week to week in the big picture. Sure, you need to complete a well-designed week to week training plan to finish an IM. If it's this coming year, great. If not, don't sweat it. Two or three years ago I never would have imagined my knee would feel the way it does now. It still bothers me some days of course, but it's actually better when I'm training the run more somehow. I can't explain it, but that's been my experience.

B) If it can be done within a fairly minimum amount of pain. If you can learn to tell the difference between pain that will go away in a moment and pain that means stop, that helps keep painful running to a minimum. I don't really know how to describe it. I can just tell at this point. If you have to cut a run short, don't beat yourself up about it. It's going to happen sometimes.

C) If it can be done with a fairly low chance that I am going to continue to decrease the lifespan of my knee.
Everyone is different. I read an article recently that said running may actually be good for the overall (and long term)  health of knees, but I'd venture to guess this applies to people who don't have significant cartilage trauma and who are not biomechanically predisposed to running in a way that could be bad... (whatever that means). I like to think it applies to ME. It was written about ME so I would read it and I would know I'm doing the right thing. Did I mention that it helps to be crazy and have the ability to harness the power of positive thinking through hallucination? It all factors in. Your results on the other end shake out as the product of a lot of variables. Just remember to get that year over year consistency you have to take it one day at a time... enjoy the good days and shake off the bad ones.

Good luck.






2009-11-23 6:15 PM
in reply to: #2524231

User image

Extreme Veteran
360
1001001002525
Lafayette, CO
Subject: RE: To those of you with post-operative knees
Bill, you've given me a boat load of good info, and even a little bit of hope. I do hate the treadmill, but maybe I could learn to love it. Wondering about the elliptical, think it's any easier on the ol' joints?

Started foam rolling again, also on your suggestion. Talk about "hurts so good." They have them at the gym and I have one at home, so I can foam roll to my heart's content.

Thanks for the great info, Bill. And everyone. Let me know if you guys think of anything else!!

Bill - 2009-11-20 2:00 PM

I've had 7 right knee operations, on both the lateral and medial meniscus. ACL is 50% torn, big holes in the articular cartilage. Last scope was in 2005. Pics from my last scope are in my album.

I'm running with less pain now than I have at any point in the past 15 years.

What I do that I KNOW was helpful:

1) I got light. I went from 220+ lbs and over 20% body fat to under 180 lbs and 8% body fat. It seemed to me that with every pound I lost I had a coresponding percent reduction in pain at a ratio of about 2:1 (feel 10% better with every 5 lbs lost). But that's subjective and only based on my personal experience so your mileage may vary significantly.

2) I learned that some pain means "hold your pace and run through it" and some pain means "stop".

What I do now that I THINK is helpful:

1) I run more or a treadmill than outdoors. I hate it, but I do it. The surface is more forgiving and it's even/flat. I ran on a trail and paved roads for years and the surfaces were always canted a few degrees. I believe that exacerbated my biomechanical issues.

2) I do Triggerpoint Massage, foam roller, and "the stick" before most and after every run workout, and after every bike session. I'd do it a disservice trying to describe it here. But the manufacturer of the kit I use describes it on the website:
http://www.tptherapy.com

3) I stopped taking Mobic, Celebrex, ibuprofen, naproxen, etc... I now take an OTC compound called Zyflamend, an extract called bromelain, and fish oil (all from the local natural foods store). I have fewer episodes of pain than I did on NSAIDs, but I cannot say 100% this is from the OTC stuff being any better as it may be attributed to other factors like weightloss. The Zyflamend and bromelain were "prescribed" to me by my medical doctor who is a board-certified internist, former olympic swim team alternate and current triathlete. I say that so it's clear I didn't just go to a healthfood store and asked the salepeople what to get. I trust my doc, he knows where I'm coming from, and he uses the stuff himself for a similar problem.

I know I'm very lucky to be able to run. My surgeon told me to quit 5 years ago. He also said if I were 20 years older he would do a total knee replacement now. To that I asked "how would I know if it was time to do that once I am at an age where that type of surgery would be appropriate?" He said pain is generally the guide. When I get to where it hurts too much to do my daily activities, it's time. Not only do I not always have pain, I'm on pace to have my fastest run splits ever next season if I stay healthy, and I just set a new PR at the 5k distance last month (avg 6:44/mile), so I don't think it's time to get a new knee yet.

To your questions:
A) If it can be done.
Sure. It can be. Whether you feel like it can be done by you in particular will be a matter of how you feel each day, and you will have periods where you feel great and periods where you feel there's no chance. Remember that year over year consistency is more important than week to week in the big picture. Sure, you need to complete a well-designed week to week training plan to finish an IM. If it's this coming year, great. If not, don't sweat it. Two or three years ago I never would have imagined my knee would feel the way it does now. It still bothers me some days of course, but it's actually better when I'm training the run more somehow. I can't explain it, but that's been my experience.

B) If it can be done within a fairly minimum amount of pain. If you can learn to tell the difference between pain that will go away in a moment and pain that means stop, that helps keep painful running to a minimum. I don't really know how to describe it. I can just tell at this point. If you have to cut a run short, don't beat yourself up about it. It's going to happen sometimes.

C) If it can be done with a fairly low chance that I am going to continue to decrease the lifespan of my knee.
Everyone is different. I read an article recently that said running may actually be good for the overall (and long term)  health of knees, but I'd venture to guess this applies to people who don't have significant cartilage trauma and who are not biomechanically predisposed to running in a way that could be bad... (whatever that means). I like to think it applies to ME. It was written about ME so I would read it and I would know I'm doing the right thing. Did I mention that it helps to be crazy and have the ability to harness the power of positive thinking through hallucination? It all factors in. Your results on the other end shake out as the product of a lot of variables. Just remember to get that year over year consistency you have to take it one day at a time... enjoy the good days and shake off the bad ones.

Good luck.








2009-11-25 7:03 PM
in reply to: #2513369

User image

Elite
2796
2000500100100252525
Texas
Subject: RE: To those of you with post-operative knees
No problem. GOOD LUCK.
2009-12-01 1:16 PM
in reply to: #2524231

User image

Expert
1149
100010025
CenTex
Subject: RE: To those of you with post-operative knees
Bill - 2009-11-20 3:00 PM 3) I stopped taking Mobic, Celebrex, ibuprofen, naproxen, etc... I now take an OTC compound called Zyflamend, an extract called bromelain, and fish oil (all from the local natural foods store). I have fewer episodes of pain than I did on NSAIDs, but I cannot say 100% this is from the OTC stuff being any better as it may be attributed to other factors like weightloss. The Zyflamend and bromelain were "prescribed" to me by my medical doctor who is a board-certified internist, former olympic swim team alternate and current triathlete. I say that so it's clear I didn't just go to a healthfood store and asked the salepeople what to get. I trust my doc, he knows where I'm coming from, and he uses the stuff himself for a similar problem.


Bill, What are the benefits of Zyflamend?  I have heard of bromelain but am not familiar with Zyflamend.

Thanks. 
2009-12-17 10:59 AM
in reply to: #2537914

User image

Elite
2796
2000500100100252525
Texas
Subject: RE: To those of you with post-operative knees
cornchexs - 2009-12-01 1:16 PM
Bill - 2009-11-20 3:00 PM 3) I stopped taking Mobic, Celebrex, ibuprofen, naproxen, etc... I now take an OTC compound called Zyflamend, an extract called bromelain, and fish oil (all from the local natural foods store). I have fewer episodes of pain than I did on NSAIDs, but I cannot say 100% this is from the OTC stuff being any better as it may be attributed to other factors like weightloss. The Zyflamend and bromelain were "prescribed" to me by my medical doctor who is a board-certified internist, former olympic swim team alternate and current triathlete. I say that so it's clear I didn't just go to a healthfood store and asked the salepeople what to get. I trust my doc, he knows where I'm coming from, and he uses the stuff himself for a similar problem.


Bill, What are the benefits of Zyflamend?  I have heard of bromelain but am not familiar with Zyflamend.

Thanks. 


Zyflamend is an herbal compound that is used as an antiinflammatory. 
http://www.prohealth.com/zyflamend.htmNew

Chapter's Zyflamend represents a scientific breakthrough in herbal, COX-2 support to promote a healthy inflammation response.

Recent scientific studies suggest that an enzyme known as cyclooxygenase-2 (COX-2) may affect the inflammation responses and may serve an important function in promoting normal cell growth in the colon, pancreas, breast tissue, and other organ systems. Zyflamend's ingredients promote a healthy inflammation response and normal joint function.

Endorsed by Dr. Andrew Weil
In an article published on Prevention.com, Andrew Weil, M.D., a leading proponent of complementary therapies, recommends Zyflamend as a way to support a healthy inflammation response:

"The hottest topic in medicine these days is inflammation...The most studied...herbs are ginger and turmeric...You could use ginger and turmeric in cooking, but it would mean consuming a lot of both herbs on a daily basis. That's not practical for most of us. So I usually recommend using them as supplements. A good supplement to try is Zyflamend from New Chapter...It combines ginger and turmeric with other...herbs and gives good results. "

Examined at Columbia University
In research conduced by Dr. A.E. Katz of Columbia University college of Physicians and Surgeons, Zyflamend demonstrated potent activity.

According to an article published in Holistic Primary Care magazine, Dr. Katz, "said he was particularly interested in New Chapter's Zyflamend, because the company grows most of its own constituent herbs organically, and obtains its extracts using a supercritical CO2 process, meaning there are no toxic solvent residues such as acetone or hexane, as is the case with other extraction techniques."

 

How it works
New Chapter, the maker of Zyflamend™, has extensively researched the herbal pharmacopoeia and international medical databases and discovered that the following time-tested herbs, properly extracted and blended in the correct proportions, contain at least eight phytonutrients that may safely and significantly support a healthy inflammation response:

New Chapter's Zyflamend represents a scientific breakthrough in herbal, COX-2 support to promote a healthy inflammation response.

Recent scientific studies suggest that an enzyme known as cyclooxygenase-2 (COX-2) may affect the inflammation responses and may serve an important function in promoting normal cell growth in the colon, pancreas, breast tissue, and other organ systems. Zyflamend's ingredients promote a healthy inflammation response and normal joint function.

Endorsed by Dr. Andrew Weil
In an article published on Prevention.com, Andrew Weil, M.D., a leading proponent of complementary therapies, recommends Zyflamend as a way to support a healthy inflammation response:

"The hottest topic in medicine these days is inflammation...The most studied...herbs are ginger and turmeric...You could use ginger and turmeric in cooking, but it would mean consuming a lot of both herbs on a daily basis. That's not practical for most of us. So I usually recommend using them as supplements. A good supplement to try is Zyflamend from New Chapter...It combines ginger and turmeric with other...herbs and gives good results. "

Examined at Columbia University
In research conduced by Dr. A.E. Katz of Columbia University college of Physicians and Surgeons, Zyflamend demonstrated potent activity.

According to an article published in Holistic Primary Care magazine, Dr. Katz, "said he was particularly interested in New Chapter's Zyflamend, because the company grows most of its own constituent herbs organically, and obtains its extracts using a supercritical CO2 process, meaning there are no toxic solvent residues such as acetone or hexane, as is the case with other extraction techniques."

 

 

New Thread
General Discussion Triathlon Talk » To those of you with post-operative knees Rss Feed