Knee cartilage - what's my outlook?

Discussion in 'Health Tips for the Martial Artist' started by Orion Nebula, Nov 15, 2019.

  1. Orion Nebula

    Orion Nebula Green Belt

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    Calling all folks with knee knowledge!

    I've been training for almost 10 months, and I've had knee issues on and off for the past 6 months. I finally went to the sports doc and started physical therapy in September, which helped immensely. However, I seem to have developed a whole new knee problem. At our last seminar, I had a sharp pain under my knee cap when I did a round kick on someone, and since then my knee hasn't been the same. I spent a week in Canada at a conference shortly after the karate seminar, and walking up stairs was pretty painful, even occasionally just walking hurt. One day I forgot to take my anti-inflammatory and I spent the whole day wiggling around because my knee would hurt if I left it in any one position for too long.

    I resumed therapy when I returned and it's helping, but I also followed up with the doc who suspects I have some softening of the articular cartilage that lines the groove which the patella sits in, which is causing irritation and pain. We have to do a little hoop jumping to get my insurance to pay for an MRI, so we don't know for sure what's going on in there right now. He suggested I try a supplement called CH alpha which is supposed to help restore softened cartilage and continue with physical therapy for a month, then we'll start bugging the insurance company for an MRI if there's no improvement.

    So my questions for all of you knee people - has anyone used CH alpha and did it do what it claims? Let's say it does help... what's the likelihood of developing more cartilage issues down the road, especially if I stop taking it? The stuff is $55 for a 30 day supply... that's more than my monthly karate dues! Thinking about my physical therapy, we're mainly focusing on fixing muscle tightness and imbalance and strengthening muscles around the knee. It seems to be pretty standard therapy for a few different knee problems. How have other people made out that have done this kind of therapy?

    Mostly, I'd just like to know if there's a good outlook for this. I'm feeling pretty down because I've been out of class a lot lately because of the pain, and when I'm in class, my performance is pretty terrible. My stances are shallow, my turns on the affected leg are slow, kicks are pretty lame, I have little power, and really everything just feels off because of my lower body being off.
     
  2. dvcochran

    dvcochran Senior Master

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    ***Standard disclaimer. Get advise from a health professional.
    I did a little surfing and do see that CH alpha has a patented compound. That May make it more effective But I doubt it. There are tons of supplements out there that claim to improve joint health for less $$$. Most of what they do can be accomplished with eating the right foods.
    From what I have studied and been told by Orthopedic doctors is once cartilage is damage it is damaged. New cartilage can be regrown by the bodies bone structure but it requires surgery to make small cuts in the bone surface to cause bleeding. Once cartilage matures is has no blood flow to help it regenerate, hence the "bone cutting". This is all certainly over my head. I have been told this surgery is only suggested for fit athletes.

    I am no doctor but I have to do a lot of diagnostics in my work. That said, since you really don't know if there is a definite issue going on inside the knee it is well worth "going to battle" with the insurance company to get an MRI. I agree that it is wrong that we have to fight so hard for good health care but so be it. It is hard to know what to do until you really know what is going on.
    For several years I had a tear behind the Patella that would "flap" open occasionally and hurt like hxxx. A simple outpatient surgery fixed the issue. Like you, I went for a long time thinking it was just inflammation and irritation.

    Are joint supplements good or bad? I don't know. I take Glucosamine/Chondroitin twice a day and I do believe it helps my joint pain. Plus I have had multiple doctors recommend it. I have one knee that is shot with no cartilage left so no amount of supplements will help. The other knee, while out of place and messed up in it's own way, still has cartilage so I take the supplements.
    Time. Time is the greatest healer in my opinion. Research the foods that aid in joint health. I fully believe in them. Physical therapy is a very good thing; talk to your therapist about progressive therapy.
    Listen to your body but don't floorboard the gas pedal when you are feeling good. Establish a workout/exercise schedule and stick to it and you will get back to where you were and more.

    You did not mention your age but the "itis" brothers are real bastards.
     
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  3. Buka

    Buka Grandmaster

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    Oh, them “itis brothers”. Bastards have been with me since I was a kid. I swear to God the only reason I’ve lived this long relatively healthy is because of Martial Arts training.
     
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  4. JowGaWolf

    JowGaWolf Grandmaster

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    I can only give you my experience. Long story short. I used to think I had bad knees. It would get so bad that I couldn't go up and down the steps. Of my classmates was a doctor and he was able to fix both of my knees. He's an Alternative medicine doctor. He said that the reason my knees were hurting was because the tendon was wrapped around in a bad, (something like that). any way. He fixed it. right their on the spot took him may 10 minutes. The point I'm getting at is that sometimes Modern doctors don't have all of the answers. When I here statements like. "Doctor suspects softening of the articular cartilage ..." To me that's an uncertain answer in which maybe an alternative medicine doctor may have some idea. When I say alternative medicine doctor, I don't mean one of those crazy guys who don't believe in modern medicine. I'm talking about the ones who do both modern medicine and alternative medicine. Those doctors may know something that the modern doctors may not understand yet.

    Either that or a test that can show what's really going on and if there is some physical damage. Either way getting professional medical advice is the best way to go even if you have to shop around.

    It might do well to get a second opinion and second perspective before
     
  5. JowGaWolf

    JowGaWolf Grandmaster

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    I read this and thought about my pinky. The problem is that my pinky is hollow. It grows cartilage instead of bone. It breaks really easy because there's nothing but a thin layer of bone with a cartilage filling.
     
  6. Tony Dismukes

    Tony Dismukes MT Moderator Staff Member

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    That's unusual. Does the condition have a name?

    Next time I come through Georgia we can compare weird pinkies. I'm missing a metacarpal and my left pinky is just loosely connected to the side of my hand with no knuckle.
     
  7. Buka

    Buka Grandmaster

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    For some reason I picture an x-ray of you two doing a pinkie swear. Yikes!
     
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  8. JowGaWolf

    JowGaWolf Grandmaster

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    I call it a Jacked up finger. I had an injury to it when I was teen but I didn't think it did any real damage. I had a chain link dog chain wrapped around my hand. My dog took off running and the chain tightened around my hand . I tried to unravel it but was too slow and eventually it pulled around my pinky. I'm assuming that's why it's like that.

    The doctor didn't say that it had a name, just that cartilage grew where bone should grow, and the only way to fix it is to scrape out the cartilage and put bone there. Being that the only time I've broken it is during sparring. I figured that I'll just live with it. I was originally going to get it fix so I could do some competitive fights, but now that I'm too hold with some additional health issues., It looks like that ship has sailed for me.

    When I do finger push ups I have to move it out of the way and not put pressure on it.
     
  9. JowGaWolf

    JowGaWolf Grandmaster

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    ha ha ha. I wonder if I have access to my xray.
     
  10. Orion Nebula

    Orion Nebula Green Belt

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    The CH in CH Alpha stands for Collagen Hydrolysate, which I've done a little research on. It does seem to be effective for regenerating softened cartilage (which isn't really damaged, per se, more like the precursor to damage), as well as help with pain. But I'm always a bit skeptical of low sample sizes (which some of these studies have, particularly the ones on regeneration) and the general wisdom I've received on supplements is that they give you expensive urine (with some exceptions). I find it weird that this particular supplement doesn't have much attention on it if it works as well as the guy at the sports medicine store says. Or maybe that's a sign that it does work, since there must be about 50 supplements plastered all over the Internet as the magic bullet for weight loss ;)

    Anyway, since supplements don't hurt and some do work, I did try a Glucosamine/Chondroitin supplement over the summer, but it didn't seem to have an effect. I think the PT will be the key to the tendonitis I have for sure, since it seems to be an issue of muscle imbalance and tight quads. I'm just not sure about this new issue, although the recommended PT is basically the same. The sports doctor mentioned that greater hamstring flexibility will help as well, but my hams are pretty flexible as it is. Of course I'll work on it, though.

    I'll definitely look into foods. I wonder if a nutritionist would be helpful with that. I can see one for free at school. Might be worth a visit!

    PS - I'm 34. I feel like I'm too young for this nonsense, but I guess not,


    Thanks for your perspectives! I'll definitely try to get that MRI if nothing is resolved in a month, but it's really annoying that I have to go through several months of therapy and try supplements before my insurance company will consider letting me do an MRI. Man, I hate insurance companies sometimes. Quite a while ago when I had different insurance, they refused to cover a standard test for a condition the doctors suspected I had. They claimed it was excessive and unnecessary, which I'm not sure how they came to that conclusion, because it's literally the only way to test for it. At least it was only a $200 test!

    Anyway, I think your experiences are quite similar to my tendonitis experience. My physical therapist helped it a lot through massage of my IT band and quads and some pretty simple exercises to equalize the strength between different muscles. My knee caps apparently pull slightly to one side because of it, which is causing the irritation to the tendon. My sports doctor didn't even notice anything was off with my kneecaps, even after an X-ray, but the therapist could feel it right away. When I get a flare up of pain, rolling the IT band and quads with either a foam roller or rolling pin really soothes it. We do have some alternative medicine on campus, too, although I'll stick to my current treatment plan until I get that MRI.
     
  11. JowGaWolf

    JowGaWolf Grandmaster

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    I'm with you on that.

    That's why it's always good to get that second look, maybe someone else can identify what's going on.The insurance company should just pony up the money.
     
  12. jobo

    jobo Grandmaster

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    hows the weight loss going ??

    that would seem a good way of getting load of the knees. as to the supliment, it rather depends how much 60$ is to you, that's less than my monthly coffee budget, if you have some spare cash in your budget it may be worth a try, obviously if you cantt eat for the month then it's a different matter
     
  13. Orion Nebula

    Orion Nebula Green Belt

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    It's coming along. I'm another 10 pounds down, so 50 pounds lost total. I still have a way to go, though. But you're right, when I get to a more normal weight, my knees (and many other parts of my body) will be thanking me.

    The money for the supplement isn't impossible, although currently combined with the money I'm spending on PT ($15 per session after insurance), I'm pushing my discretionary budget towards its limit. Although thankfully we switched to one PT session per week and more home exercises.
     
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  14. JR 137

    JR 137 Senior Master

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    What you describe going on sounds like chondromalacia patella. MRI will rule out other things and if there’s an anatomical anomaly that needs surgical fixing. Insurance companies don’t want to pay for an MRI of this because it’s such a common problem and very, very few have something going on that an MRI will reveal. They want to make sure there’s a good reason to suspect it’s more than chondromalacia. Don’t hate me for saying that :)

    PT consists of basically what you said - correcting the muscular imbalance and soft tissue work like massage and release to treat the symptoms.

    The cartilage behind the kneecap can repair itself. It’s not like other types of cartilage. Yes, it’s hyaline cartilage as is most other articular cartilage that doesn’t repair itself, but the patellar cartilage does. Don’t feel like this is a forever thing or a knee replacement thing.

    Weight loss will definitely help, but it’s not the only thing and not is really the cause of it. It’s a patellar mistracking thing. I’ve had a few athletes get surgery for mistracking, and to be quite honest I think it was a waste of their time. That’s a very small sample size, like about 6 or so, so don’t base any decision on that.

    I have a cartilage tear in my shoulder and take Glucosamine with MSM religiously. When I don’t take it, my shoulder aches. The jury’s out on Glucosamine. Most studies, which are very few, focus on knees and hips. The problem with them is that those are weight bearing joints. Shoulders and kneecaps aren’t. MSM is known for its anti inflammatory properties, so there’s not much debate there. Whichever part is helping me is irrelevant; I just know my shoulder is better off :)

    What else can I say... oh yeah... try a patellar tendon/jumper’s knee strap. They’re a simple strap that goes right under your kneecap and holds it up a little bit, taking pressure off. Even more effective is using pre-wrap and making your own. Look up YouTube for jumper’s knee pre-wrap strap or similar. I’m sure there’s got to be some videos.
     
    Last edited: Nov 19, 2019
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  15. dvcochran

    dvcochran Senior Master

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    Thanks for the expert advise JR. I had never heard that any cartilage could repair itself. Like you, I just know my knees hurt less when I take Glucosamine. Probably the anti-inflammatory quality you mention.
     
  16. Orion Nebula

    Orion Nebula Green Belt

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    It's super good to hear that this is something that's likely to resolve with continued PT and maybe supplements. I actually did try a new taping method last night with kinesiology tape. I previously used a method that mimics those patellar straps, and it worked pretty good when I was just suffering from patellar tendonitis. However, it hasn't been as effective with my recent issues.

    So I tried one that is made for patellofemoral pain syndrome and helps pull the knee cap into alignment I guess. It worked ok and definitely decreased the darn crunchy sounds. But it came unstuck part way through class, so my knees were pretty sore at the end of class. I guess I need to cut my strips a little longer and rub the tape more!
     
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  17. JowGaWolf

    JowGaWolf Grandmaster

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    Is this class as in college or cooking class. If not, then. Heal First, Train Later.

    That knee is going to have a difficult time doing any type of healing if you are busy moving around training. if you have opportunity to give it some rest, then take it.
     
  18. JR 137

    JR 137 Senior Master

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    I’ve used the kinesio tape on athletes for patellar femoral syndrome too. Works very well. It’s a bit tricky to get it right, but even trickier to get it to stay on. You can try the spray skin glue (Tuff Skin by I think Cramer is what I used). Just a quick and a bit distant shot of it over the area. Definitely don’t saturate your knee like spray paint. It’s a pain in the a$$ if you’re not used to using it. If you use it, don’t rip the tape off like a band-aid; your skin will come off with it. I’ve seen it done by many a rookie. Roll the tape off, preferably in the shower.
    Just a thought.
     
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  19. Xue Sheng

    Xue Sheng All weight is underside

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    I'm not a doctor but speaking as one with knee issues and now arthritic knees, get the MRI. Pain like you describe is what I had recently in my left knee and it required surgery to fix the tear in the cartilage. I have torn it before, but they were small tears and I just had to take it easy and they kind of fixed themselves. However this last one was bigger and surgery was required. Recovery time for full recovery is 6 to 8 months, but not doing anything means you still go the 6 to 8 months, in pain and at the end you still can't train. With surgery, if it turns out to be necessary, after the 6 to 8 months you can get back to it.

    Get the MRI and see what the MD has to say.
     
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  20. Randy Pio

    Randy Pio White Belt

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    I often wonder why, in 2019 there aren't sythetic substitutes for these situations- nylon discs for spines, a gel type lubricant for hips/knees/rotator cuffs.123
     

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