Katsmeow
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
- Joined
- Jul 11, 2009
- Messages
- 5,308
I was just advised by an orthopedic surgeon to stop walking for fitness and to either swim, cycle or use an elliptical. Since I really like walking I'm not that happy about this. One thing that complicates this for me is that while the doctor said said that I have bone on bone arthritis in the knee, my actual pain is not that great. Of course, that might make you wonder why I went to the orthopedic surgeon in the first place.
The situation is somewhat complicated (so I apologize for the somewhat long explanation).
17 years ago I had a tibial transfer to correct my knee alignment of my left knee. I also had arthroscopic surgery of the knee and learned that I didn't have much cartilage in the knee. The restrictions put on me were to not run and not to use leg extension machines. Anything else that didn't hurt was fine.
Flash forward until last year. I've been walking during this time in my hilly neighborhood and have a treadmill. Doing this I've lost 35 pounds but need to lose about 20 more to be normal weight.
About 3 months ago, I was increasing my walking including setting up a treadmill desk and doing some slow walking to increase steps. I also started doing some lower body strength training. When I did some lunges, my knees protested the next day. So I stopped doing them.
About 10 days later, the back of my thigh where it joins the knee starting hurting. If I pressed on the area it was excruciating. If I didn't press on it, I could feel it but it wasn't awful. So I took about 3 weeks off from doing walking or anything. The place didn't get better. The soreness in the knee did get better.
Long story skipped I had an MRI to see what was going on with the very sore place on the back of my thigh.
When I went in for the MRI results I was told that the area on the back of the thigh was likely a trabecular bone injury/microfracture (essentially a fracture of the inside part of the bone) which (since I couldn't recall any trauma to the area) might be a stress fracture from the greater walking I was doing.
I was also found to have Grade 4 chondromalacia patella, moderate proximal patellar tendinosis, mild insertional quadriceps and tendinosis. Chondral loss and thinning at various places. Osseous edema that was said to be compatible with trabecular bone injury/microfractures. No meniscus tear was seen but it was thought possible there might be a small tear. Also a small enchondroma along the distal femur.
The translation given to me by the orthopedic surgeon was the trabecular bone injury for which he told me to use a walker or crutches for 4 weeks, only using the affected leg for balance. He said during this time I could continue to use the Concept2 rower if it doesn't hurt my knees.
As for the rest of the knee he basically said it was bone on bone arthritis and that I should replace walking with swimming or cycling or using an elliptical. I guess I will -- if I have to -- replace my treadmill with an elliptical. But, I really hate the idea of having to give up walking in my (hilly) neighborhood.
Here is the part that confuses me. I did some reading on all this and saw that walking is often a recommended activity for mild or moderate knee arthritis. The exception seems to be severe arthritis which seems to be (at least on the internet) equated with bone on bone arthritis. But, when I read about severe arthritis that is bone on bone everything I read about is how much it hurts and the person is hobbling around and the knee locks up, etc.
The thing is that while I may not have much cartilage (and in some places apparently have none), my actual knee (apart from the trabecular bone injury) is not that painful. When I was walking a lot it would occasionally mildly hurt under the kneecap. And certain strength training exercises would hurt (the orthopedic surgeon told me not to do deep lunges, squats or anything else that bends my knee beyond 90 degrees). At this point, the pain under my kneecap which I sometimes (not always get) with heavy activity is not even severe enough for me take over the counter medication. I can feel it, but it is not a big deal.
So I was really startled to be told not to walk. I guess the point is that if I continue to walk on it -- even if it doesn't hurt that much now -- I will continue to damage my knee.
But, if my knee is so bad that it is bone on bone why doesn't it hurt more? I guess I have a hard time seeing it as being that severe when it really isn't that painful. Yet, I have the MRI report right in front of me.
Has anyone experienced anything like this? That is, not having pain that is all that severe but avoiding a particular activity in order to avoid or limit future damage?
I do plan to talk more to the orthopedic surgeon about this when I go back in 4 weeks. I always kind of thought I would have a knee replacement in my future and I guess this is mostly about making that be farther away. And, I sort of agree with that, but I don't like having to not walk just to try to postpone the inevitable for a few years.
The situation is somewhat complicated (so I apologize for the somewhat long explanation).
17 years ago I had a tibial transfer to correct my knee alignment of my left knee. I also had arthroscopic surgery of the knee and learned that I didn't have much cartilage in the knee. The restrictions put on me were to not run and not to use leg extension machines. Anything else that didn't hurt was fine.
Flash forward until last year. I've been walking during this time in my hilly neighborhood and have a treadmill. Doing this I've lost 35 pounds but need to lose about 20 more to be normal weight.
About 3 months ago, I was increasing my walking including setting up a treadmill desk and doing some slow walking to increase steps. I also started doing some lower body strength training. When I did some lunges, my knees protested the next day. So I stopped doing them.
About 10 days later, the back of my thigh where it joins the knee starting hurting. If I pressed on the area it was excruciating. If I didn't press on it, I could feel it but it wasn't awful. So I took about 3 weeks off from doing walking or anything. The place didn't get better. The soreness in the knee did get better.
Long story skipped I had an MRI to see what was going on with the very sore place on the back of my thigh.
When I went in for the MRI results I was told that the area on the back of the thigh was likely a trabecular bone injury/microfracture (essentially a fracture of the inside part of the bone) which (since I couldn't recall any trauma to the area) might be a stress fracture from the greater walking I was doing.
I was also found to have Grade 4 chondromalacia patella, moderate proximal patellar tendinosis, mild insertional quadriceps and tendinosis. Chondral loss and thinning at various places. Osseous edema that was said to be compatible with trabecular bone injury/microfractures. No meniscus tear was seen but it was thought possible there might be a small tear. Also a small enchondroma along the distal femur.
The translation given to me by the orthopedic surgeon was the trabecular bone injury for which he told me to use a walker or crutches for 4 weeks, only using the affected leg for balance. He said during this time I could continue to use the Concept2 rower if it doesn't hurt my knees.
As for the rest of the knee he basically said it was bone on bone arthritis and that I should replace walking with swimming or cycling or using an elliptical. I guess I will -- if I have to -- replace my treadmill with an elliptical. But, I really hate the idea of having to give up walking in my (hilly) neighborhood.
Here is the part that confuses me. I did some reading on all this and saw that walking is often a recommended activity for mild or moderate knee arthritis. The exception seems to be severe arthritis which seems to be (at least on the internet) equated with bone on bone arthritis. But, when I read about severe arthritis that is bone on bone everything I read about is how much it hurts and the person is hobbling around and the knee locks up, etc.
The thing is that while I may not have much cartilage (and in some places apparently have none), my actual knee (apart from the trabecular bone injury) is not that painful. When I was walking a lot it would occasionally mildly hurt under the kneecap. And certain strength training exercises would hurt (the orthopedic surgeon told me not to do deep lunges, squats or anything else that bends my knee beyond 90 degrees). At this point, the pain under my kneecap which I sometimes (not always get) with heavy activity is not even severe enough for me take over the counter medication. I can feel it, but it is not a big deal.
So I was really startled to be told not to walk. I guess the point is that if I continue to walk on it -- even if it doesn't hurt that much now -- I will continue to damage my knee.
But, if my knee is so bad that it is bone on bone why doesn't it hurt more? I guess I have a hard time seeing it as being that severe when it really isn't that painful. Yet, I have the MRI report right in front of me.
Has anyone experienced anything like this? That is, not having pain that is all that severe but avoiding a particular activity in order to avoid or limit future damage?
I do plan to talk more to the orthopedic surgeon about this when I go back in 4 weeks. I always kind of thought I would have a knee replacement in my future and I guess this is mostly about making that be farther away. And, I sort of agree with that, but I don't like having to not walk just to try to postpone the inevitable for a few years.
