Test Results & Going Forward

Friday, Sep 21, 2012 at 17:21

TriathlonOz - Michelle

So here I sit in late September, finally with a clear picture of what has been ailing me since January. Those that know me have some idea of how rough it's been not being able to rehabilitate this problem despite many repeat visits to physio (3 physios in fact), podiatrist, done the yoga, had lots of remedial massage, used the foam roller, ice after runs, full dose nurofen in 3 days lead up to events, done daily glute & quad strength exercises, wore my orthotics during the day as well as running, had my running & walking form video assessed, tried rocktape, tried McConnell taping, modifed training loads, take Magnesium + Zinc supplements, & included anti-inflamatory natural foods to my diet, plus Fish Oil, and basically researched and read everything I could on the subject of knees with no improvement. A few times I thought I was close to cured - only to suffer another setback.

Finally, a few weeks ago I opted to get an MRI to get some definitive idea what was going on inside these blasted knees. I found a sports doctor who specialises in athletes knee problems (Dr Gerard Taylor, from SportsMed Subiaco). When I saw him I really only concentrated on the long-term pain specific to my left knee. But during the few weeks of waiting for the MRI I started to develop pain in both knees that felt different. I even rang to ask if I could get both knees done by the MRI but it could not be done at the time.

So anyway, when the results came back, I was told my knees aren't that bad structurally - no Bakers Cyst or fluid, normal femoral trochlear articular cartilage, normal quads & patellar tendons, normal medial & lateral compartment articular cartilage.

But 3 things were found:
1. small knee joint effusion
2. mild oedematous soft tissue thickening deep to the ITB & superficial to the lateral femoral epicondyle
3. shallow surface chondral ulceration from medial facet of patella.

I discussed these results with Dr Taylor and he listened to my description of the pains/problems and targetted the ITB issue. We went through his list of treatments - but it was everything I'd already been doing all year, except for having a cortisone injection so he gave me a shot.

I was told to come back in 2 weeks for a second injection. In the meantime, no swimming for at least 2 days (I swam on the 5th day), no cycling for 5 days (I rode on the 6th, 8th, and 11th days), and no running at all. I briefly mentioned I also did karate (but I'm just a yellow belt so its not too intense), and I do weights at the gym regularly to target my hips/glutes/quads in my lower session, and back/biceps/triceps/obliques/core in my upper session. He didn't suggest I needed to change any of that but just take it easier for the first week. So I did.

Any walking, swimming or karate was noticeably causing aches in the back of my knees and hamstrings so thought I'd discuss this with him when I went back for my next shot, which was Wednesday this week.

When we discussed these new pains, he turned back to my MRI results and pointed to the patellar chondral pathology statement and said this was why. He says for me, this is not curable and is a degenerative athritic problem so I need to stop doing certain things so it doesn't get any worse. I demonstrated some of the karate moves that I felt were causing it and he agreed they were all no good. He called them "the worst thing I could be doing". Ohhh.... :(

Then he said cycling hills and cranking big gears would also flare up the knee pain. I've now realised why I sometimes get aches in lower-hamstrings after riding, and that this is quite different to the running pain, because that is the left ITB. !!

He says we'll continue the ITB fix - so I got the 2nd shot which means by next fortnight I'll have had 4 full weeks of no running. I then start a 6 week rehabilitation program for running, which is very basic. By the last week I will get my longest run of 40 minutes! He feels confident that this will "cure" my running!

In the meantime, he wants me to stop karate and see if taking this out of the equation is enough to stop the aching back of knees and hamstrings. If so then also avoid all other knee load activities. No lunges, squats, or leg preses and avoid loading up the knees on hilly rides or using big gears. He wrote my physio (David Host at Whitfords Physiotherapy) who he was pleased I was seeing, a note to explain his recommended treatment for the patella issue. He wants me to try some specific approach that he said David would write up for me.

So there I have it. Two knee problems that affect quite a lot of things I love to do. So I'll take the good doctors rehab plan and see how I go.
There'll be no events entered and no plans, goals or dreams set other than to get pain free. I am thankful for getting to 44 years old without injury but its time now to approach my sports with a new focus so I can keep going for another 20 years.

I've also had a full series of blood tests done and all is good except my cholestrol is a little high but I'm used to that, it's genetic but my doctor has put me onto a specialist in King Edward hospital as one of his research patients so that will be something new.

Sorry for the long story, but I felt it best to write it all for my own memory and to explain to others that have been interested.

I'll write another blog update in 8 weeks time, which is when I will have got through my 6 week run rehab program and done my first 40min run session. Fingers crossed I'll feel ready to tackle a reduced training plan for the Albany Half.
Some wish for it, others work for it!
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