knee pain

[audrey]

After reading your stories, I have to consider myself lucky. I tore my posterior meniscus and hobbled around for a week before I could see the orthopedist (Sports Medicine, New England Baptist). There was a painful Baker's cyst too and what with the usual delays I didn't have surgery for 6 more weeks. Walking was not fun, let alone trying to do any kind of exercise. Post-surgery, recovery was uneventful with lots of PT and gym time, and though it seemed long, I was on the ski hill within 8 weeks. The Bakers cyst didn't go away for a few months after that, but I'm as good as new.

Pat also had meniscus surgery (different location) around the same time and recovered at about the same speed. He still feels some pain,but he does have arthritis. The harder he hikes, the better he feels, it appears.

Yes everyone's different, and I have always trusted our orthopedists.

 

[erugs]

Audrey's right. Everyone is different. My former knee pain transitioned to foot pain and has now settled in my left arm, leaving it weak and in pain. For me, as most of you know, these were related to Lyme disease. Aleve is my friend, Maddy.

 

[loanshark]

Thanks everyone for all the input. It is frankly a bit overwelming. I think what I have taken from all this is to slow the process down a bit and do some more research. Not working in the medical profession makes it a bit tough to pick the right direction. Who knows, if surgery is the way to go if you have chosen the right doctor. It all seems to be a bit of a crap shoot.

 

[DougPaul]

Great thread. I've had moderate knee pain (both knees) since a weekend of hiking three weeks ago, and I've been wavering between going and not going to the doctor over it. I think I'll give it a bit more time. I'm pretty sure I was just too aggressive coming down hill, and pounded my aging knees more than I should have. I've been using a treadmill with Ace knee braces, and that seems to make a big difference. The first test will be this Monday, when I head up Monadnock.

Lack of muscle strength and/or endurance particularly in the quads can also cause knee pain. Most exercises focus on concentric contractions (muscles shortening under tension, producing energy, lifting weights, hiking uphill)--eccentric contractions (muscles lengthening under tension, absorbing energy, lowering weights, hiking downhill) are also important.

I have posted on this a number of times--the following search will bring up the threads: http://www.google.com/search?q="ecc...rg&hl=en&num=10&lr=&ft=i&cr=&safe=images&tbs=

Doug

 

[marti124]

I have the same brace Marty has and it worked well on my John Muir Trail hike and in daily use. I wear it every day. Holds up well.

http://www.amazon.com/gp/product/B000V1RLG4

Price is right too. $38

I bought two, so days I wash one, the other is ready to use. I only carried/used one on the hike though.

 

[Little Rickie]

Where is Neil on this? I'm sure he is knowledgeable about this stuff?

 

[marti124]

Another thing to consider is whether or not over the mid-term if your recovery will enable you to do as much hiking as you did prior to the injury. A good analyses (findings are not encouraging for traditional orthopedic treatment) is given here:

http://www.eorthopod.com/content/getting-real-about-meniscus-surgery

The way I looked at myself is the following.

I can choose conventional surgery where the risk of not recovering to where I was prior to the injury is a significant 2 digit figure, yet the surgery is deemed "successful". (and the negative risk is also a significant 2 digit figure too).

Or I can choose the stem cell bone marrow prolotherapy where the risk of recovering to where I was prior to the injury is a very high significant 2 digit figure if the surgery is deemed "successful" and the negative risk if it is not is near zero.

I do not deny that conventional orthopedic surgery also has a 2 digit significant success rate too for full recovery. To those who've had the surgery and fully recovered, my hat is off to them. My own luck is so rotten I prefer to hedge my bet. My first attempt may be a waste of money but it won't make things worse. I have very, very good odds it will enable me to get back to where I was July 1st, 2011.

Man, oh man, what a difference 5 minutes in a life makes. Blast that Cornell Crack.

 

[marty]

I have the same brace Marty has and it worked well on my John Muir Trail hike and in daily use. I wear it every day. Holds up well.

http://www.amazon.com/gp/product/B000V1RLG4

Price is right too. $38

I bought two, so days I wash one, the other is ready to use. I only carried/used one on the hike though.

Your Mueller brace and mine have one difference: yours was hinged and mine is not. Glad your hinged version worked well for you.

Marty

 

[Maddy]

I ordered the hinged brace because I thought it might give me more support for showshoeing, some easy skiing, (I hope), and of course some winter hiking with Molly.

I paid a big more because at the time I did not realize that Amazon had it. The advisor at the Brace Place was very good explaining the three different braces so I feel like I did get my money's worth. I am hoping it works well. Some of the reviews I read indicated that it was not too bulky which I wanted to stay away from.

Thanks for all you your help and good sound advice..

 

[marti124]

Maddy, your brace looks very nice. Is that steel bars inside the vertical slide sleeves of your brace. Do the bars have a hinge to allow knee flexing without you're noticing it? My brace weighs 10.05 oz (size large, I did cut off the bottom 2nd-(outer) wrap, as the base was already firmly tight (not too tight, not loose at all), so there was no need to keep the second (outer) wrap.

I agree, it's worth extra money to get good brace advice. Oddly my Orthopedist had no recommendations on any braces, he just said to find and get a brace, whatever. I was disappointed in that. I depended upon amazon reviews to find and get the brace I got.

 

[--M.]

Thanks everyone for all the input. It is frankly a bit overwelming. I think what I have taken from all this is to slow the process down a bit and do some more research. Not working in the medical profession makes it a bit tough to pick the right direction. Who knows, if surgery is the way to go if you have chosen the right doctor. It all seems to be a bit of a crap shoot.

I felt overwhelmed, too (still do, sometimes), and I have family in the business!

Yes, beware bulletin-board medical advice. The same goes true for non-bulletin-board medical advice; sift everything. I was fascinated when there was disagreement between the various pros (rheumatologist, pcp, pt-guy, surgeon, nurses, MD family members, etc.). In the end, you have to own it; don't get talked into anything until you get it and agree.

Finding the right doctor is a function of personal referral: find someone who had it done and loved his/her surgeon. If you're anywhere close to medical Mecca (Boston), you probably have access to an excellent professional who can be trusted, even out in the rural areas. It shouldn't be a crap-shoot; it's not a brandy-new procedure that they're still figuring out (like LASIK in the '80s).

I agree with slowing down if you're rushed; but I eventually decided it was time for action, so I avoided analysis-paralysis and came to a conclusion. Good luck with that!

--Mike.

 

[marti124]

M is right on stating " In the end, you have to own it; don't get talked into anything until you get it and agree.

Finding the right doctor is a function of personal referral: find someone who had it done and loved his/her surgeon."

But there are other tools for finding and evaluating physicians too. I work for an insurance company that has nearly a 70 person team that evaluates which physicians they've contracted with excel and are either "High Quality" or "High Quality and Cost Efficient".

For example, www.myuhc.com has one of the best recognition programs in the business. (UnitedHealthCare). Even if you don't have their insurance, pretend you do such as "United HealthCare Choice Plus" (you have to indicate which insurance you have when you do a search for physicians), then give your zipcode and what specialty you're interested in and how many miles from that zipcode. You're not asked for your name or anything. If UHC has rankings for those physicians (based upon scientific analyses of two years of medical claims filed), you'll find the premium designated doctors.

Orthopedic surgery is one of the specialties covered.

Other companies do such rankings but I know that not all do Surgical Procedure specialties as they're hard to evaluate.

But in the end, it's your knee, and you have to live with your decision. Research your options. The times, they are a changing, and your choices are no longer only a couple of options from only one type of provider. Look at what the pros are doing who make their money with their knees. But share your experiences, other hikers as they get older often suffer such problems (like me).

 

[Maddy]

Maddy, your brace looks very nice. Is that steel bars inside the vertical slide sleeves of your brace. Do the bars have a hinge to allow knee flexing without you're noticing it? My brace weighs 10.05 oz (size large, I did cut off the bottom 2nd-(outer) wrap, as the base was already firmly tight (not too tight, not loose at all), so there was no need to keep the second (outer) wrap.
I agree, it's worth extra money to get good brace advice. Oddly my Orthopedist had no recommendations on any braces, he just said to find and get a brace, whatever. I was disappointed in that. I depended upon amazon reviews to find and get the brace I got.

This is the one I got.
http://www.braceshop.com/productcart/pc/Mueller-Hg80-Hinged-Knee-Brace-202p284.htm

You can click on the pics and see the details. It is hinged and will give me decent support for hiking and winter activities. I believe it's the same one you have. The other brace was not hinged and would not have provided quite as much support.

 

[marti124]

Marty's brace? About the Bauerfeind-Genutrain brace (questions).

Maddy, I think I misread your earlier posting. Rereading it, it must have been Marty's brace and my questions should have been directed to him. Yes, Maddy, you, and I have the same exact brace. It's a great one.

Marty, what about this brace -- does it have hinged steel bars on the sides? Something is there (it might be plastic). It looks like a nice brace too.

http://www.braceshop.com/productcart/pc/Bauerfeind-Genutrain-Elastic-Knee-Brace-108p252.htm

This is the one I got.
http://www.braceshop.com/productcart/pc/Mueller-Hg80-Hinged-Knee-Brace-202p284.htm

You can click on the pics and see the details. It is hinged and will give me decent support for hiking and winter activities. I believe it's the same one you have. The other brace was not hinged and would not have provided quite as much support.

 

[marty]

Maddy, I think I misread your earlier posting. Rereading it, it must have been Marty's brace and my questions should have been directed to him. Yes, Maddy, you, and I have the same exact brace. It's a great one.

Marty, what about this brace -- does it have hinged steel bars on the sides? Something is there (it might be plastic). It looks like a nice brace too.

http://www.braceshop.com/productcart/pc/Bauerfeind-Genutrain-Elastic-Knee-Brace-108p252.htm

Hi,
the Genutrain has non-hinged plastic side bars, which are not quite as rigid/supportive as the steel ones on the Mueller HG 80. I compared the Genutrain to the Mueller HG 80 (non-hinged) earlier in the thread.

Regards,
Marty

 

[TCD]

Certainly DougPaul's input is generally accepted - the location and type of tear are major factors in the success rate of repair type surgery. Regarding patient age, there are really two effects: The older patient does not usually heal as fast; and the older patients injury is often degenerative, as a result of long term use, as opposed to a result of an acute injury. The degenerative type tears have a poorer success rate in repair.

To TEO's point, thinking is changing on the candidate's age. Many ortho web sites still take the position that the ideal candidate is less than 20:

http://www.stcroixortho.com/magazine/Vol2-Issue3/1.aspx

However, Barrett, 1998 appeared to show that success can be good in older patients as well:

http://www.sciencedirect.com/science/article/pii/S0749806398700180

Other researchers have questioned whether Barrett's follow up was long enough to assess the rate of long term re-injury.

Most of the community stil believes that age is a significant factor in candidate selction:

http://www.northernmichigansportsmed.com/physical-therapy/post-surgery-rehab/knee-arthroscopy

http://ukhealthcare.uky.edu/cartilage/quick_info/Meniscus_tears_treatment.pdf

As I said, YMMV, and get multiple opinions from Orthopedic Surgeons.

Good luck.

 

[forestgnome]

Skip, sorry to hear about this condition We're praying for you

 

[Maddy]

JUst received my brace this am.
http://www.braceshop.com/productcart/pc/Mueller-Hg80-Hinged-Knee-Brace-202p284.htm

It's much lighter than it looks and it gives my knee incredible support. Was hiking with Molly yesterday and needed to turn my right leg inward to get down an slick embankment near a river to get her leash untangled. I could not turn that leg so I sat an edged down. With this brace on, I am imitating this maneuver and appear to have complete stability. This is without a doubt the best brace I own. I have absolutely no pain in my knee. Might have to buy a spare one.

 

[marti124]

JUst received my brace this am.
http://www.braceshop.com/productcart/pc/Mueller-Hg80-Hinged-Knee-Brace-202p284.htm

"It's much lighter than it looks and it gives my knee incredible support."


I agree, Maddy, this is a super brace.

Yes, this Mueller Hg80 Hinged Knee Brace is the best I've tried and I own two myself. I found the outer-tightening wrap beneath the knee cap is not needed as the brace is totally tight enough (size large) for my leg, so I took a utility knife and cut that outer-tightening wrap off. The resulting brace with the steel hinges weighs 10 oz. Not a bad weight at all. I wore this daily on my 20 day John Muir Trail hike and wear it daily since then.

 

[una_dogger]

Audrey's right. Everyone is different. My former knee pain transitioned to foot pain and has now settled in my left arm, leaving it weak and in pain. For me, as most of you know, these were related to Lyme disease. Aleve is my friend, Maddy.

Everyone IS different. I suffered terrible knee pain in my mid twenties that was diagnosed as meniscus tears. I waffled on surgery because at the time the only people I knew who had undergone it had poor outcomes.

Sometime in my early thirties my knee pains went away.

I'm now in my mid forties, and haven't had knee pain in nearly twenty years despite being very active and never having the surgery.

Go figure.

Docs don't know everything. If its their bread and butter to operate on you, think about that. Trust your body and do what feels right.

And above all, accept no medical advice from people you don't know on the internet.