Knees and workouts

LynnFinn

Cathlete
Cathe:
Just to begin on a positive note, I own almost all your tapes, and just got three DVDs to add to my 'collection'. Yours are, by far, the BEST workouts on the market for variety, choreography and sheer fun. I recommend you to EVERYONE! (And even my 20 year old daughter in Oklahoma City is moving away from Reebok and others to do your tapes).
Now for my question/concern:
I couldn't help noticing, some time ago, while doing one of your 'older' videos (It was Power Step or Step Max...one of those), where the camera zoomed in on your knees. I couldn't help but notice a horizontal scar across your (left?) knee.
Since I suffer from chondromalacia patella (and have been fighting the pain and disability for nearly three years now), I was curious as to what kind of knee injury you sustained and what you did to get your knee back to normal.
My knee will never be normal, at least not without extensive surgery or a total knee, which, because I'm only 46 years old, I'm too young for.(I was diagnosed with chondromalacia via MRI after a serious fall onto concrete where all my weight slammed down on both kneecaps...ugh!) No ortho doc in his right mind would even contemplate a total knee on me until I was closer to 60. So, I have a lot of years to wait. There is an experimental surgery right now that is being done at Johns Hopkins and here at Rush St Lukes in Chicago. It is the harvesting of a patient's own cartilage, which is then 'grown' and placed back into the knee beneath the patella. Unfortunately, insurance doesn't pay for this (yet) and just the intitial cost outlay for harvesting and growing the cartilage is approximately $14,000.00!!!! YOWZA!
Anyhoo, I'm at a point where I'm restarting your workouts, combined with Firm workouts (and trips to the gym with my hubby) after a two-plus year layoff (and a 50 pound weight gain...boy does THAT really get to me). Im working on strengthening the quads, esp. on the right with leg extensions and seated leg presses in the gym.
If you can give me assistance in what video sequence I might find as a decent starter rotation to help improve function of the musculature surrounding the knee, plus anything you might have done yourself post-injury, I'd appreciate it.
I am taking a strong NSAID (Mobic) daily and have used Ultram sparingly when the pain gets too bad. Plus, hubby puts ice on the knee after each workout, and then wraps it in an ace. The "chopat" strap (often suggested and used for chondromalacia) has had little, if no effect in preventing the pain.
I'd also welcome any comments, suggestions, etc. from anyone out there who might suffer from chondromalacia (or a post-knee-injury problem) and what you have done to cope with this problem while continuing your workouts. I figure, since the ortho docs have all said there's really nothing more they can do at this point, I refuse to sit and let the disability make even more problems for me...like the weight gain and all the associated health risks therein. I'd rather deal with pain than die of a heart attack before I'm 50!
Thanks in advance. And Cathe...keep up the good work. You are an inspiration to me. My oldest daughter was watching "Rhythmic Step" as I was previewing it today, and she remarked, "Gosh, THAT'S Cathe? She's so cute! I want to try this workout on Wednesday, OK mom?" (She's 22 years old and still asks permission...ain't that sweet? LOL Maybe another Cathe convert in the making....)
Hugs,
Lynn Finn
 
Hi, Lynn, I damaged my knees in a skating accident when I was young and I get some knee pain during leg work. As long as my form is impeccable, it's ok. I have been taking glucosamine with condroitin for a while and it seems to ease the pain. I take it very faithfully. It is actually supposed to restore some of the knee lubrication which is lost after injury or disease.


http://www.plaudersmilies.de/natur/twinkle.gif Bobbi http://www.plaudersmilies.de/natur/twinkle.gif
 
Yes!

Joining Bobbi in the taking of glucosamine & condroitin! I was experiencing some aches and pains in my knees also from my workouts about a year or so ago. I also had what I think was arthritis in one of my little fingers (for a couple of years) to the point I could barely touch it without it hurting. After taking this combination, and my normal vitamins, within a couple of months, it dawned on me one day that my little finger didn't hurt at all!! I also never have ANY knee pain at all now. I am not one to take supplements at all except my vitamins but after hearing medical professionals talk the G & C up on different occassions, I decided to give it a try and I am so GLAD I did! It is expensive so I go to a wholesale club to buy it where it is a bit cheaper. Good Luck, Lynn. I hope you can find some relief. BTW-your daughter is in for a real treat with Cathe's tapes!! Have fun!

Your-Friend-In-Fitness, DebbieH http://www.plaudersmilies.de/wavey.gif If You Get The Choice To Sit It Out Or Dance...I Hope You DANCE!!!
 
Lynn: I was wondering the same thing (it was the bodymax tape). Cathe's scar looks like an ACL reconstruction? I had that done summer of 1999 and continue to do Cathe's tapes w/o any problem (so far!!). I'm 37, though, and expect that I will need a new knee in the future, only b/c I beat up on them with so much step, and having the reconstruction, I heard, weakens your knees later on.
I don't know about your condition, but my dr. and therapists told me to continue strengthening the hamstrings and quads, to make the muscles around the knee stronger.

Good luck in your return!
Lynne
 
Lynn--let me add an endorsement for glucosamine, which I started taking about a year ago (1500 mg. per day is the recommended dosage of glucosamine sulfate). It's really made a difference. I don't have chondromalacia, but I do have a chronic problem with one of my knees going out on me--grinding out of joint inward. It's very painful, and last year, I ended up with a fractured ankle as a "bonus". It didn't happen during exercise, but I decided when I started to work out again to wear a McDavid hinged brace. This, too, has helped to stabilize my movements, and I am now able to do lunges with confidence, and virtually no pain. I had almost given up lower body weight work, and now I am up to 45 lbs on the SH tape,and what I still cannot believe, I find MIS and PS legs a piece of cake at 35 and 40 lbs on my barbell. I think I have seen braces specifically designed for chondromalacia at www.kneesupport.com. You might try them out. I really hope you find something that works for you. Avoid impact, too, until (with luck) the glucosamine treatments kick in.
 
Lynda...

Hmmmmm...what is a McDavid Hinged Brace? Never heard of such an animal...Tell me more. You say you can workout with it on?
BTW...Thanks to all of you with the advice re: Chondroitin/Glucosamine mix.
I started taking it but the durn pill was soooo big it made me gag half the time, so I sortof "forgot" about it. Just recently, I came across a powdered form, which isn't very palatable, no matter what you mix it in (kinda has a consistency of creatine...ugh!). I've just started taking it, though I'm still working on taking it consistently on a daily basis. Somehow I've always had a tough time remembering to take vitamins, thyroid, etc. regularly every day. (And I'm a nurse...terrible patient, me<G>)
How long before you really noticed a difference? And was it sudden, or did it sneak up on you...like one day, you just happened to notice the pain was diminished or gone?
Today I didn't "work-out" (technically), but got another kind of workout...a "houseworking workout"<VBG> I completely re-designed the furniture placement in our den, moved the big screen, swept every nook and cranny, trying to make more room so that my son and I can do workouts together. I broke a good sweat, but nothing like a Cathe workout ;-D. At any rate, the knee was singing "Ave Maria" by the time I settled down. It's so durn unpredictable. So, today I HAD to give in and take two Ultram...which I try to avoid unless I'm really ready to knaw off my own leg.
God Bless you all for being so helpful and such an inspiration to me. Plus, it's great to see some (ahem) mature women continuing to workout HARD even as we enter the so-called twilight years...is that what it is? LOL....Guess I'm not gonna give up without one heck of a fight!
Thanks again,
Hugs,
Lynn
 
I don't know if this will help you but I'm 26 and was diagnosed with rheumatoid arthritis when I was 12. The pain used to be terrible in my knees and I am very prone to knee injuries. Believe it or not, becoming vegetarian got rid of about 90% of my pain. My father, who has lupus and has had multiple knee surgeries, went vegetarian as well and was able to stop taking his pain killers.

Let me know if you are interested in any resources. :D

Becky
 
McDavid is the name of the manufacturer. It's hinged so that you can bend your knee, but it has two iron slats (covered) on either side and two straps, one above and one below the kneecap. Also a round shaped hole over the patella. It's like a sheath over the knee with knobs on either side. My husband is the one who found it for me. It cost about 80 dollars. You can definitely find it at the website above. They also have a telephone number where I think you can get more information. On the glucosamine, my capsules aren't so big, but I take three of them a day, not the whole 1500 mg. all at once. Good luck. Oh--you can see pictures of all the braces at the website too--in case my powers of description are not so splendid!
 
I also have chondromalacia in 1 knee. I am (on my own) taking glucosamine, chondroitin and MSM - hoping to see some improvement. I have been on it only 2 months but I starting to notice some reduced grinding. As far as braces, I use a Breg brace that has a J-channel that forces the patella to 'track' in the joint properly to reduce the wearing of the cartilage. I also have some exercises from a physical therapist, which include: inner thigh lifts, knee squeezes (sit with legs straight out in front of you, squeeze the knee to press the back of the knee into the floor), a theraband exercise similar to knee squeezes only you do it standing with the band wrapped around the back of the thigh and you sqeeze back against it (it's hooked into a door), step ups onto a step (6-8" tall) and a couple other deceptively simple exercises focused on the vastus medialus (the 4th part of the quadracep that is often overlooked). The vastus medialus keeps the knee cap traveling in the groove as well.

I was told to avoid knee extensions but that I could do squats and also limited range leg presses. Overall I always exercise with my Breg brace on (about $120... if your insurance covers it from your knee dr. it's virtually nothing... or you can go to www.breg.com and order it), try to keep my physical therapy up and am now trying the meds on my own.

I wish you the best on your knees. I use the squats (esp. the plie squats) in Cathe's videos to build up my legs. It's done wonders for me. I limit the number of lunges and usually only do a few to avoid the grinding and pain.
 
Hi Lynn Finn!

I literally feel your pain! I had my first knee surgery at the age of 17, then 20, and most recently at age 40 - this one a major patellar realignment procedure - he also found no viable cartilage left on the posterior patella and about half in the knee joint itself. :'( After having my leg immobilized for six weeks, I had to undergo a very long and painful rehab - and I still don't have full mobility in the joint even yet! But I'm working on it!

A few things for you to consider:

1. If you're having that much pain, you might want to really focus on lower impact activities than Cathe's step tapes, which are really pretty high impact. The other option is to modify them and take out a lot of the power moves, sometimes this is hard. I think the best one to start with would be the Wedding tape, since there's not a huge amount of twisting/twirling moves in this one. It also has weight work. The problem is, her tapes are so fun, sometimes I have to make myself tone it down! But I think that's your best bet to start with. I would also suggest walking with interval work and hill work to build stamina and keep the impact low and to enjoy the outdoors!

2. Please pay attention to your flooring. Anything over concrete is bad news, especially for high impact - check out old threads regarding this, or look at Cathe's excellent section regarding flooring. This is what really did me in I think - working out on what seemed to be squishy carpet over concrete. Now that I've got some good flooring, I notice a huge difference in pain after I do a high impact cardio workout.

3. If you want to go with Cathe, which is an excellent choice, you might want to start with her slower weight tapes, to build your strength up - I would suggest Pure Strength or Slow and Heavy. I find that when I'm moving slowly, I can pay better attention to how my knee is tracking throughout the movement, rather than the faster tapes. Be sure to keep your knees behind the toes in any bending exercise, so you don't over stress them any more than you have to.

4. Another medical option would be the injections or Hyalgan or Synvisc. I call this motor oil for the knee joint - you get three or five injections of this stuff weekly and it lasts for six months or a year, and works to lubricate the joint. I had the Hyalgan myself -

5. Consider yoga or pilates to work on propper tracking of the knee, improve flexibility and strength. I have found these to be extremely helpful - didn't realize how tight I was in the hips and shoulders, and how all this alignment can affect your knees! Plus I feel great after these workouts.

Okay, I'll quit - probably more than you ever wanted to know, but i can relate to the frustration of being limited - however, wanted to encourage you that you can make a comeback! Keep us posted!

Cheers!
Colia
 
RE: Hi Lynn Finn!

Thanks to Colia, Gibbee and all of you wonderful and helpful exercise enthusiasts-with-knee-problems out there in "Cathe-Land"!
Whew! LOL...
I have re-started on the Glucosamine/Chondroitin mix I purchased several months ago (in powdered form...easier to take than those huge horse pills I had before). I will check out the "Breg" brace suggested by Gibbee. If you are having luck with it and actually have been diagnosed with chondromalacia, it may be the best bet yet.
I neglected to mention that I've already gone the Synvisc route, to no avail. It was worth the try. The worst part of it was, my doc couldn't get the needle in on the lateral (outer) side of my kneecap, so he had to inject from the medial (inner) side. Did it that way for the whole series of injections(ouch). Not pleasant! :p
I am finding that using the elliptical trainer at the gym has been beneficial. I have also been doing no-weight squats on the Smith machine, and limited range of motion leg extensions without too much trouble...meaning, no sharp pain, and little residual pain, the latter of the two being the worst, because it lasts a LONG time.
Plus, an added bonus; I've started wearing Nike Air walkers, which seem to cut down on extended walking impact and has resulted in less pain over the long haul. I'm more of a "loafer" gal; Maybe it's the "preppie" in me or whatever<VBG>. Give me bluejeans and penny loafers any day. But, if the Nikes help reduce pain (despite how they look) then I am willing to wear them all the time (except under evening gowns, of course!)
Hubby and I went to the Chicago Auto Show today. LOTS of walking and maneuvering between crowds. I maintained for about 4 1/2 hours before the pain set in, which is a record for me. After that, it was 100mgs of Ultram and the shuttle bus back to the parking lot.
This degenerative condition will never leave me, I know, but I will NOT let it beat me!
And soon....SOON!!! I will be doing Power Max with the best of 'em!
Hugs to all my Knee-dy workout friends,
Lynn
 
Lynn,
Have you tried physical therapy? I find the best way to use it is to get a "menu" of exercises and techniques to use, then do them on your own (so you don't end up spending mucho bucks for things you COULD do on your own). After some good/bad experiences with PT for a bad knee (I was diagnosed not with CP, but "knee pain"--how's that for clear?), I finally came out with two things that really help me: a variety of exercises that I have available to strengthen the muscles around the knee and (what seems to help even more in my case) info on how to tape my knee while exercising so that it tracks better (at least until I get the muscle strength to keep everything on track, and I'm not sure how much that will be). I also have given up most step aerobics (I know you might not want to hear that) except the more controlled, slower tapes.
 
Kathryn

Yep...went the PT route three times, (no less...arghhhh). Also learned how to do the patellar taping you describe, so the kneecap tracks better. The taping works for a while, but winds up going with the path of least resistence after a couple hours and becomes ineffective.
These last three weeks I seem to be having much more success just working the quads, gradually building the weight amount. When I was going for PT, the therapist was having me do full range of motion leg extensions. When my Ortho doc found out about it he nearly flipped. We laid off the extensions for the next series of PT (at a different place), but the knee was still so easily irritated at that point, nothing we did except taping and ultrasound was benign.
Lo and behold, it's two years later, and through a series of non-impact cardio (elliptical machine) and more recently, short range of motion leg extensions (the leg is already in slight extension before you begin to actually lift the weight) I have (apparently) strengthened the distal quad (the part of the quadriceps closest to the knee). An ortho RN my hubby knows discussed several things we could be doing at home and in the gym, and short ROM extensions was one of her (very experienced) suggestions. I am having little or no pain, including post-workout, and I've almost been able to completely stop taking Ultram, the pain med of choice, which I WAS taking as often as three times a day for the last two years.
Soooo...either the exercise plan we are following this time is really working, or the knee was just healed enough to start to get stronger...I tried doing about twenty minutes of Cathe's "wedding" tape the other day, and despite calf and butt burning, the knee did OK. So, I am now excitedly looking forward to slowly incorporating more step and weight lifting tapes into my regimin.
A miracle? Maybe....but I think it has a lot to do with adequate healing time, aggressive approaches to rest vs exercise, using ice, knee braces and taping. It isn't any ONE thing...like most maladies, it's a combo of many little things that has gotten me to this point. I feel I could write a book about CPatella; I think most chondromalacia patients, however, have to find what's best for them, especially since no two people are ever the same.
Oh...and the best news yet? I'm starting back into my old job in the neonatal ICU at U of Chgo come March.
Hows THAT for progress?
Hugs,
Lynn
 
Hi Lynn! Thanks for the kind words. I see that you have already received very valuable advice so I simply wanted to wish you the best of luck with your workouts. As you already know, start all new exercises with no resistance and in a controlled manner to get the feeling for the execution of the exercise. Then add weight in 1/2 to one pound increments and evaluate your response. Take Care, be patient and cautious!

BTW, I had an ACL reconstruction due to a skiing injury. With aggressive assisted physical therapy and then a monitored continuation of it as I came back to work, I was back to just about full capacity in 8 to 9 months.
 
Full range of motion extentions

Lynn,
I had a similar problem with my second PT (who was the "boss" and had fired the first PT I liked, the one who had shown me the taping). He set me up on a machine to diagnose exactly where my muscle weakness was, and it had me doing full range extensions. The third try on my "bad" knee (the first two tries didn't register well enough) I heard and felt a crack, but he told me to keep on going (duh, am I stupid or what--an authority figure tells me to do it, and I comply). I ended up having worse knee pain than before therapy, and therapy (the little of it I continued with) was from then on electrodes and other rehab therapies to ease my pain (which THEY caused!). I quickly got out of that situation, and went to another PT for a while who showed me a whole array of different exercises. Now, I think I'm my own best PT!: after a couple of months, my knee wasn't as sore, and now its --knock wood!--better than ever. I just make sure to really listen to my body (like avoiding the "slow and heavy" version of lunges, which my knee immediately responded, negatively, to).
 

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