One of the most common questions I’m asked is whether or not it’s “too late” to use my knee pain exercises, once a person has undergone knee surgery. It’s actually a pretty reasonable question. The answer, however, is good news.
They’re just as effective and even more important after you’ve had necessary knee surgery, whether that’s arthroscopic, or a full open surgery, like partial or total joint replacement. In fact, these very exercises were derived from those I prescribed for my own pre and postop patients, while I was in active private practice. And, of course, I used them myself after my own knee surgery.
If you’re new here at Dr. Bill’s Clinic, you may not know it, but I had arthroscopic surgery of my left knee on Tax Day, 2005 (thought it best to get all the unpleasantness out of the way on the same day).
My knees were injured in the same fall in which I broke my back, in 2001. Or so I assumed. In all probability, I had some degenerative changes prior to that, especially since I had prior pain behind my kneecap, where I had known chondromalacia patellae (a degenerative softening of the retropatellar articular cartilage) for years, based on my symptoms.
In fact, I had written previously about my inner “teenager” being responsible for a momentary lapse in judgment that resulted in me injuring myself on the leg press machine. But though I had some pain on deep squatting, or steep stair climbing, due to that condition, what we in the trade call “evocative activities,” I did NOT have spontaneous pain, just on walking.
That emerged only after the fall and suggested that I had done some inner damage with that injury, not present before. And I had tried my best to exercise the knee, specifically to avoid surgery. Last thing I wanted was a knee surgery. After all, I KNOW, as few do, after a couple of decades doing just that, exactly what is done. And no one wants that done, unless it’s really necessary. So I did my best to avoid it.
Which is what I have always recommended to others, with the same problem, then and now.
But sometimes, your best just isn’t good enough. Sometimes, you have an injury that can’t be healed, without help.
That was the case with my own knee: persistent pain was beginning to limit my walking, which in turn made it harder and harder to stay in shape and keep my weight down. I finally decided that I’d better find out what’s going on in there, before I do irreparable harm by neglect.
That’s when I got an MRI scan-of BOTH knees. Might as well get all the bad news at once. And it’s always a good idea to have the other side for comparison. Helps to make an accurate diagnosis.
I reviewed my scan images with the radiologist, who’s an old friend of mine (one of the very best on Long Island-Dr. Steve Kuchta, of Suffolk MRI in Smithtown). We both agreed that I had a probable tear of the posterior horn of the medial (inner side) meniscus. The other knee was suspicious, but not definitive. That side could be just degeneration of the substance of the meniscus.
Bad news is that once you have any physical disruption of cartilage, like a tear, it simply won’t heal. Doesn’t have a blood supply (except for the outer 25% periphery, which is less than 10% of tears and almost never degenerative tears) and without blood in the tissues, nothing can heal.
So, my choices were, live with the pain and accept the consequences (ie., progressive degeneration, meaning arthritis), or have arthroscopic surgery and get it fixed. Which is what I opted to do.
I had a good friend do the surgery (almost as good as me, as I loved to tell him-HA!). And as expected, he did a great job: partial removal of the meniscus, removing the tear and sculpting the remainder, so it approximated the ring-like shape of the normal structure, débridement (shaving of the shredded, arthritic surfaces, to make them smoother) and synovectomy (shaving away redundant and inflamed lining membrane of the joint).
But I turned out to have some areas of arthritis, much worse and much deeper than I would have thought. One area of the tibial surface was right down to bare bone, beneath the remaining meniscus rim in the back. That’s not good. Fortunately, however, the area was relatively small, less than a centimeter (smaller than a half inch). And it was covered by the meniscus rim.
Well, postop, I started right away on my quad exercises and gentle active range of motion stretches. I actually did my own physical therapy. After all, I had been prescribing this regimen for years. I knew what to do. It was just a matter of DOING it. Which I did.
I got my functional motion back under a week, though it took a few months to achieve those last few degrees of flexion. I needed crutches and pain pills for the first few days, as my surgeon did a lot of work in there. But after that, it was daily progress with the exercises.
So when I tell you how good these exercises are and how well they work, I’m telling you based not only on my clinical experience with my own patients, but I’m telling you what I personally experienced, with my own knee.
In addition, I used the same exercises on my right knee, too. As a result, as my muscles strengthened, any residual pain gradually disappeared and I have not needed to have surgery on that knee, to date.
So, if you, or someone you know, has a similar story, or similar knee pain, you now know what will work: my popular and effective PAIN-FREE PROGRAM & DVD. No reason to suffer needlessly, any more. Take charge and get started on these great knee pain exercises and stretches NOW-Just click the link:
http://www.drbillsclinic.com/exercise_eliminate.html
Whether you’ve already had knee surgery, or you hope to avoid it, these specially modified exercises are the long term solution to knee pain. And the answer to the original question is that, before or after surgery, it’s never too late to start.
Til next time, my friend, be well.
Yours for a pain-free tomorrow and your optimal health,
Dr. Bill
“The Wellness Warrior” TM
