Experience with knee cartilage damage and patellar dysplasia?

Kettlebelephant

Level 6 Valued Member
Good evening ladies and gents!

First of all I just want to ask for some experiences and not concrete medical advise, because that's what medical professionals are for. We are all different and what works for one person, might end up hurting another. Still, I see this as a kind of "support group setting" where I can get a bit of help by exchanging experiences.

I'd like to know if anyone here has experience with knee cartilage damage and/or patellar dysplasia, either him-/herself or as a medical practitioner (PT, physician).

After a couple of weeks with knee pain I had an MRI last week and finally got my results today:
Patellar dysplasia with grade 3 cartilage damage and baker's cyst in both knees...

I have to wear a bandage for the next 6-8 weeks and do some easy exercises to strengthen the muscles around the knee (things like banded leg extensions) and after that we decide what to do further.
According to my physician I should avoid heavy loads/stress to the knees in the future. Now my question is "what are heavy loads?"
I know I should probably avoid heavy barbell squats going forward, but what about deadlifts or swings or calisthenics like pistols?
His answer was "if it hurts you should avoid it".
Not a bad answer, but squats didn't hurt for years until they finally did.
Right now deadlifts don't hurt, but that doesn't mean that they won't hurt in the future and do a lot of irreversible damage until they start hurting.
Maybe they do further damage, maybe they don't. Maybe they will hurt in the future, maybe they don't. I don't know that, but at only 32 years old and already having grade 3 cartilage damage I can't afford doing something that may end up doing further damage even if it feels ok right now.
Deadlifting is just an example, you could insert swings, pistols, hip thrusts, running or any other lower body dominant movement here.

That's why I'm asking about experiences with this.
What could/can you still do?
What can't you do anymore?
Any exercises/movements that particularly worsened the situation or made it better?
 

ShawnM

Level 8 Valued Member
Good evening ladies and gents!

First of all I just want to ask for some experiences and not concrete medical advise, because that's what medical professionals are for. We are all different and what works for one person, might end up hurting another. Still, I see this as a kind of "support group setting" where I can get a bit of help by exchanging experiences.

I'd like to know if anyone here has experience with knee cartilage damage and/or patellar dysplasia, either him-/herself or as a medical practitioner (PT, physician).

After a couple of weeks with knee pain I had an MRI last week and finally got my results today:
Patellar dysplasia with grade 3 cartilage damage and baker's cyst in both knees...

I have to wear a bandage for the next 6-8 weeks and do some easy exercises to strengthen the muscles around the knee (things like banded leg extensions) and after that we decide what to do further.
According to my physician I should avoid heavy loads/stress to the knees in the future. Now my question is "what are heavy loads?"
I know I should probably avoid heavy barbell squats going forward, but what about deadlifts or swings or calisthenics like pistols?
His answer was "if it hurts you should avoid it".
Not a bad answer, but squats didn't hurt for years until they finally did.
Right now deadlifts don't hurt, but that doesn't mean that they won't hurt in the future and do a lot of irreversible damage until they start hurting.
Maybe they do further damage, maybe they don't. Maybe they will hurt in the future, maybe they don't. I don't know that, but at only 32 years old and already having grade 3 cartilage damage I can't afford doing something that may end up doing further damage even if it feels ok right now.
Deadlifting is just an example, you could insert swings, pistols, hip thrusts, running or any other lower body dominant movement here.

That's why I'm asking about experiences with this.
What could/can you still do?
What can't you do anymore?
Any exercises/movements that particularly worsened the situation or made it better?
So I've damage the cartilage in both knees to the point where I don't really have much, if any , at all. As far as heavy loads go the one thing I can no longer do is run on any surface or walk with an added load of more than a few pounds. I'm able to do heavy squats if I want and my knees feel fine for the most part. Most of my mobility work I do before every training session, to include walking, is a physical therapy program based of of a lot of single leg work such as step ups to the front and the side, rear lunges, single leg deadlifts to various heights loaded or unloaded. Banded side shuffles and banded frankenstein walking is done as well for twenty step. A lot of what has helped me is focusing on quad strength and glute strength. We can swing and snatch our brains out but we may still have week glutes, no matter how big they are.

Hope this helps. Things aren't over athletically for you, just takes some time to learn what works and what doesn't. Dropping weight and ditching alcohol has also helped me. Alcohol can inflame the body, after a week of cutting it completely this summer my joints felt so much better.
 

Steve W.

Level 6 Valued Member
@Kettlebelephant
I have grade 4 osteoarthritis in my knees and ankles, and had arthroscopic surgery to repair an acute tear in the meniscus in one knee.

My knees actually don't bother me all that much. Even the surgical one only bothers me if I try do a full bodyweight squat to the very end range of full flexion. I can do KB front squats no problem.

My ankles are another story. I can't really walk or run normally or without pain and can barely jump. Both lower legs have very noticeable chronic edema. There is also a torn tendon in one foot that doesn't hurt but prevents me from exerting force in calf raise type plantarflexion above parallel with the ground. On good days, I walk the dog all the way around the block instead of just up around the corner and back.

I am under orders from the orthopedist not to do anything involving running, jumping or cutting (quick changes of direction). Against those orders, I still play basketball (at least before Covid) because I just love it so much and it's such a big part of my identity. It's very painful and I am very athletically limited, but can still not embarrass myself against young adult players at a decent level (high school varsity/low level college). I'm just nowhere near the player I used to be.

When it comes to training, I am not limited much at all. I can do any kind of hinge drills, lunges, crawling, etc, but do have to work around limited ankle flexion when it comes to squats. I can do full KB front squats or goblet squats, but have to use a stance a little wider than probably ideal and with a little more turnout. I used to be really good at pistols, but can no longer do them at all. Jerks and overhead squats are also a little problematic. And of course I can do pretty much any upper body work I want.

Basically, my rule is that if some form of training hurts I avoid it, but when it comes to my favorite sport I'm willing to suffer. And daily discomfort is just the new normal.

It sucks getting old, but mostly beats the alternative.
 

Kettlebelephant

Level 6 Valued Member
@ShawnM @Steve W.
Thanks for your replies. Really encouraging, that you can still do all those things.

I'm on my way to my first session of my new program "one exercise a day", which means for the next couple of weeks I just do warm-up, my rehab exercises and then one other exercise for 10-15min to see if it hurts during the movement or afterwards. That way I can pinpoint exercises that are a no-go.
 

Bauer

Level 6 Valued Member
I'd like to know if anyone here has experience with knee cartilage damage and/or patellar dysplasia, either him-/herself or as a medical practitioner (PT, physician).
I think @Geoff Neupert has had complete knee cartilage replacement/damage on one of his knees and struggled with it for years.

He prescribes, among other things, high rep dead bugs (tailbone off the floor) with abdominal breathing.
 

Pete S

Level 6 Valued Member
Back in 1963 while running full speed I collided with another athlete and wound up with a knee injury that would periodically swell up and lock up my knee. During a recurrence of these symptoms in 1967, I was limping and subsequently captured by an Army surgeon who dragged me to an army hospital for surgery. Back in those days there was none of this sissy stuff of MRI, CAT scan, or arthroscopic surgery. "To cut is to cure" was their motto, and they gleefully removed the right meniscus cartilage from the knee. I received a one page list of do-it-yourself physical therapy and was admonished to "Move out and draw fire!"

To answer your question of what I could or could not do afterward: Subsequently, I attended Airborne (parachute) training, Special Forces training, ran countless miles, humped ridiculous sized rucksacks, slogged through mangrove swamps, wet rice paddies, jungle terrain, and up mountains. I also spent countless hours doing TKD, judo, and other sports. When I was examined by an orthopedist 29 years later during my mustering out of the Army physical exam, he commented that I should have had a joint replacement after 7 years and perpetual replacements about every 7 years thereafter. All I wanted to know was whether it was OK to continue prepping for a marathon as I had been. He just said to "Drive on!" Later I spent considerable time learning power lifting to include squats. Yes, I was a bit cautious about the knee over the years but I did not let it slow me down. In retrospect had I known about all the tools that are available from Pavel and this forum, I would have done more leg work.

To be totally honest, I have slowed a bit of late. I do have arthritis in both knees and both big toes plus a plethora of other niggling aches and pains that seem to accumulate with age (78). Consequently, I choose to not run but to rely on walks and rucks 3-5 times a weeks. I just transitioned from 9 months of S&S 5-6 days a week to Q&D 3 days a week plus bodyweight exercises on alternate days.

The point is to keep doing what you are able to tolerate. Just don't stop. As you are a level 2 OS instructor do not fail to incorporate resets into your recovery. I have been doing OS for many years and it helped me overcome ruptured disks and sciatica. Patience and Perseverance has been a motto of mine; I hope it will serve you, too.
 
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ali

Level 6 Valued Member
No knees here too.
Sitting in seiza ...use pillows/cushions to be pain free and reduce overtime. Feldenkrais method.
Was told I would need knee surgery 10 years ago or so.
Feldenkrais gave me back full knee flexion.
It's the dog's bollocks of movement training and body awareness.
 

Steve Freides

Staff
Senior Certified Instructor
Elite Certified Instructor
@Kettlebelephant, I will add my voice to the chorus.

For me, keeping everything tracking correctly is key. I'm rather bow-legged, and stretching groin and hip areas really seems to help keep my knees working mostly pain-free. My diagnosis was "chrondromalacia patella" in both knees, close to 40 years ago now, and although I can't do certain things, somehow I'm getting by.

@Pete S, nice to know I'm not the oldest one here. :) Sounds like you're doing very well.

-S-
 

Geoff Neupert

Level 6 Valued Member
Beast Tamer
I think @Geoff Neupert has had complete knee cartilage replacement/damage on one of his knees and struggled with it for years.

He prescribes, among other things, high rep dead bugs (tailbone off the floor) with abdominal breathing.
@Bauer, and @Kettlebelephant -

I actually have congenitally laterally shallow trochlear grooves - meaning the "track" in which my patellae ride, are shallow on the outside of the track, and both patellae pull laterally causing [in the past] chronically tight IT bands and commensurate pain. Plus, I punched a hole under my right patella in the cartilage as a result of a dislocation while wrestling. The Ortho said looks like a pothole/manhole with a lip that sticks up. That lip caught every time I bent my knee and caused massive amounts of pain. I had that mess for over 20 years. Good now.

And yes, dead bugs w/ the tailbone off the floor, plus diaphragmatic breathing are 2 of several things that seem to help most with knee pain.

@Kettlebelephant - PM me if you want to know about our knee pain product and what I used to finally get my lunges back.
 

Malcat

Level 6 Valued Member
To give my experience with medial knee degeneration. I find activating the muscles around the knee, in particular vastus medialis the answer. Walking, while good, won’t necessarily correct faulty gait pattern but maintains and supports what you’ve worked on. I found step ups to a low platform not as effective as walking up and down stairs. If you hold a stick in the opposite hand to the affected knee and walk deliberately slowly up and down working on posture, pelvic stability and feeling and sensing the vastus medialis contracting, you can build up quantity then load stressing the knee stabilisers in a controlled manner and strengthening the muscles and tissues in a natural unilateral gait pattern
 
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