How I fixed my knee pain

[Pseudonym]

Thought I'd post this here in case it helps anyone else.

I was having real problems with my left knee - a sharp pain at the top of the kneecap as I was squatting, followed by a strong ache for days afterwards - particularly if I couldn't straighten my leg for a while. Movie theatres and long car journeys were agony.

I tried resting it, but every time I went back to training it would flare up again. This went on for about 6 months or more.

Finally I limped off to the physio (Justin Lopes, on the excellent recommendation of Trainlikeafreak). He diagnosed patella tendonopathy - an inflammation of the tendon that connects to the patella. CT scans later confirmed this.

First of all, Justin put me on the usual course of treatment - stretches and light weight exercises to strengthen stabiliser muscles. I followed this religiously, but it didn't help.

So he sent me off to Dr Mark Fulcher at the Unisports Clinic. Mark gave me an autologous blood injection. This is where they draw some blood from you, mix it with anaesthetic, and squirt it back into the problem area - in this case, my knee. The theory is that the artificial bruise it creates kick-starts the body's own repair processes, and it's a lot safer than cortisol shots. It certainly seemed to help me.

The two of them also put me on a different rehab programme - one designed specifically for those of us who are used to resistance training. Interestingly, it's very similar to my normal legs workout, with a few crucial exceptions...

Heavy slow resistance training (HSR)

• 4 sets of squats

• 4 sets of seated leg press

• 4 sets of hack squats

Start out on 15 reps per set for the first week, then every couple of weeks after that, drop it down to 12, 10, 8, then finally 6 reps. Obviously, you increase the weight as you go, so each set is almost to failure.

So far, so ordinary. But here's the critical difference... Go slow. Real slow - count 3 seconds, then 3 seconds back up. (Trust me, that's a killer on squats!) Range of motion isn't important here - don't bend your knees more than 90 degrees. Do this workout 3 times a week.

More info here: http://www.sportsmed.net.nz/patient-inf ... n-program/

This technique seems to be quite new, and no-one is totally sure how this works yet, but the heavy slow reps seem to recondition the tendon. Obviously that makes it great not only for knees, but also elbow tendon problems as well.

And it really does work. The pain is 90-95% gone for me now. Better still, despite a crappy diet that saw me lose size everywhere else, I swear my quads got bigger, particularly on the outer sweep.

No pain.

Now able to train.

Size gained.

Yep, that's a win. \:D/

[Phedder]

This technique seems to be quite new, and no-one is totally sure how this works yet, but the heavy slow reps seem to recondition the tendon.

I'm thinking the heavy loading and large total Time Under Tension would encourage more collagen to be laid down in the correct alignment, but without using the full ROM there'd be less tensile stress to further aggravate it. Heavy squats do cure everything :grin:

Good info there Pseud, could definitely come in handy for many here.

a sharp pain at the top of the kneecap as I was squatting, followed by a strong ache for days afterwards - particularly if I couldn't straighten my leg for a while. Movie theatres and long car journeys were agony.

I've had small bouts of the same issue 1-2 weeks at a time then go away for a month. Never really bothered me during squats, but sometimes the next day prolonged sitting with a bent knee, and then straightening it would be agony. Since I started wearing knee sleeves for squatting I haven't had it happen again. Good to know a few things to try if it ever comes back :nod:

[AZIDE]

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[crazyfacials]

hmm wonder if something similar can be done for my shoulder grrr

[Pseudonym]

":38unoyav]cheers for the info. with your knee, did it pop/grind/crack/click (feeling and sound) if you were sitting down and extended the leg from 90 degrees to straightish with one hand on the kneecap?

Yeah, there was a bit of creaking occasionally, but the physio didn't seem too worried about this. It always felt more like muscle/tendon rather than bone/joint pain though.

[steak]

Ive heard of the autologous blood injection being a god way to get the healing happening...something a physio or Dr Google wouldnt do for you.

I have used these 2 techniques in the past and still do for a couple of clients

This first one is pretty good but a little painful but works fast at getting blood flow through to the tendons via "the flooding" at the end.

the second technique is to use 2 medium strength bands looped around an upright and place you knee through the loop - one band just above the knee and one just below. Walk the band out from the upright so you some comfortable tension on it. Not so much that you cant flex the knee but not a loose band either. Flex the knee out by raising you heel and pump away for for about 40 reps. Turn the leg around in the loop of the band and doing the same thing flex then straighten the leg against the bands tension. Again 40 reps . Repeat X 3 every day and you should see/feel some change within 1 week. :nod:

Hope you heal up well. Knee pain is not pleasant and a little disabling

[severe]

Mine hurt when I get up from sitting. My left is painful. Physio at the moment, but will try this. I don't want to go 6-8 weeks wthout squats, as it has taken a long time to get to where I am and don't want t to fall backwards. No assthetics skinny legs for me! ffs

Thanks for sharing.

[Grover]

Thanks have similar probs so will try this out as due to change program, will measure thighs and see what difference it makes

[Chemo]

Had the exact same thing. 2 blood shots later made a world off difference.

Compared to physio, electrotherapy and acupuncture it's by far the best.

The injections fkn hurt tho !

[Pseudonym]

Chemo, I went back for my second shot, and they wouldn't give it to me! The doc said I was already recovering much faster than they'd expected, and another shot wouldn't speed it up any more. He said the autologous blood injections help kickstart recovery, but it's the resistance training that actually does most of the repair.

The moral of the story, boys and girls, is this: follow the rehab programme!

[musclenz]

Really good information tks Pseudo. Those slow reps sound a killer. Do you think there would be benefit in incorporating them into your leg workout without the blood injection, to help knee issues?

[Pseudonym]

Absolutely. That's exactly what I was getting at. From what the doc said, it sounded like the blood injection was just the icing on the cake - most of the recovery was caused by the weights programme. :nod:

[Chemo]

Chemo, I went back for my second shot, and they wouldn't give it to me! The doc said I was already recovering much faster than they'd expected, and another shot wouldn't speed it up any more. He said the autologous blood injections help kickstart recovery, but it's the resistance training that actually does most of the repair.

The moral of the story, boys and girls, is this: follow the rehab programme!

Ha thats awesome! Super human man.

I agree the blood shot makes the rehab a ton faster!

I kinda thought the main contributing factor to the repair, was that the blood shot increases the amount of growth factors available to the tendon, where it usually doesn't have that much blood to work with.

That's what I picked up from my doc.

Tendon issues are the worst :x

[Bluto]

I just had my 2nd blood injection in my right patella couple of weeks ago. Given 2 injections 6 weeks apart.

Rehabing now with lots and lots of light squats 2-3 times per week.

So far zero knee pain for the first time in years, hopefully stays that way as I start to add more weight.

Sports doc also gave me Nitoglycerin Patchs to try on another injury. Anybody else tried these?

[terman8trs]

Now im thinking its really worth the drive up to glenfeild from newlynn to see justin.