Run.
Running is good for your knees.
Running is protective for osteoarthritis.
Running does not cause arthritis.
It doesn't matter is you don't have any cartilage (ie, "bone on bone").
Run from doctors who tells you not to run.
(I am a doctor).

 

mileswimr - your response caused me much joy!

But your info seems to fly in the face of conventional medical wisdom.

Can you provide any more info?

Thank you for the uplifting thoughts!

When 58 had good bit of medial posterior horn removedin one knee. Running did not go well. Not painful, just something off with knee, which seemed to transfer more responsibility/load to other knee. Running just not fun and when i hit 65 thought i tore something in good knee. Turned out no surgery as just potholes from OA. Could not bend knee without pain. Tried stemcells/prp in 2013 and gave it time to take. Cleaned up diet and used Mobilitywod website to get my mechanics/physics squared away plus stronger core. Started racing and running again in 2014 and still going. I don't do IM type training any more. Can swim and bike seemingly no restriction. But i do run less now 10-14 mi per wk peek traing. Focus on sprints. Since knee is hinge joint you have to make sure hips and ankles are working well. One other thing, despite damage to menisci in both knees when xrayed i had pretty good space between bones which meant i still had some cushion, except that major tear in posterior horn.

I'm a PT and absolutely concur. If you were truly "bone on bone" you would have repeatable excruciating pain the same way every time you run. If pain actually does get worse then find a PT and not an ortho surgeon. There is nothing you've said that predicts future knee replacement. As was stated, running does not equal osteoarthritis. In fact, there are many couch potatoes who never ran or worked out who have the same knees on X-ray or MRI as you. Keep running.

Hello smallard and All,

I am not a doctor and this info is off the Internet .... it is a topic I am interested in as I have one knee that occasionally hurts after running on hard surfaces ... even with Hokas.

https://www.ncbi.nlm.nih.gov/...articles/PMC2556152/

Excerpt:

"CONCLUSION

Provided trauma is avoided, moderate exercise does not lead to acceleration of knee osteoarthritis, whether or not there is evidence of pre-existing disease. In either case there appears to be improved physical functioning and reduction of pain and disability in those who exercise. It is likely that exercise interventions are underused in the management of established knee osteoarthritis symptoms."

http://abc7news.com/...ernative-way/545184/


http://sanfrancisco.cbslocal.com/...t-stanford-hospital/


http://www.npr.org/...wont-kill-your-knees

I noticed that much of the above information is qualified by 'individuals condition' of prior damage and BMI.


When you look at the literature some of the treatments are exercise (running/walking), corticosteroids, platelet rich plasma, hyaluronic acid, and stem cells .... and some of the forgoing in combinations ..... before knee replacement ...


I have a friend that is bone on bone and has good results with the hyaluronic acid injections.


Looks like your 'mileage may vary' no pun intended .... or said another way ...... 'you pays your money and takes your chances' .....

What interventions have you found that look promising?

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Cheers, Neal

+1 mph Faster

 
Thanks all for the thoughts. Very encouraging.

I certainly do not experience excruciating pain when I run...so maybe I'm really not bone-on-bone (although that's what my ortho is telling me).

Things I have tried - one is dumping my Hokas and switching to zero drop Altras. This has helped me switch from heel striking to midfoot striking and that has definitely helped with discomfort (as well as made me faster).

I also have RunScribe sensors on each shoe and have confirmed that midfoot striking has reduced shock impact to the knees.

(Next I will experiment with barefoot running - there's some research that suggests this will reduce impact still further)

I did try hyaluronic acid injections (Orthovisc) and these helped for a couple of years but then seemed to stop working for me. Plus my mean-spirited health insurance company stopped paying for them.

In October last year, I shelled out $5000 on stem cell therapy - no appreciable benefit to report yet but I am still hopeful.

Hello smallard and All,

You are way ahead of me ........ How old are you?

I will try ditching my Hokas and see if I can get more of a mid foot strike .... although I have tried that before without much success as I run so slowly now.

If I can crank out 2 more years of regular running on Orthovisc that would be great ... also I will look into RunScribe .....

For the Orthovisc did you get one big injection with 6 month intervals or smaller ones at 6 week intervals? What method is best? And did you use high density hyaluronic acid?

My friend did 6 week intervals for injections with good success.

I am really curious as to how your stem cell therapy will turn out ...From what I read stem cell and platelet rich plasma were not so successful with those subjects over 60 years of age.

Please PM me with your progress as I am following in your footsteps I think ....

Good luck in the future ......

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Cheers, Neal

+1 mph Faster

When i got my stem cells (from hip) and follow up prp. The doc said wait a while before running. I could tell within days the oa was better and was able to bend knee fully with no pain. Gave it 9 months no running, just walking. Also went lower carb which seemed to help too. If you had desk job like me then work on hip flexors and hip tilt. The oa in my back improved greatly too.

Nealhe - I'm 56.

Re: OrthoVisc - I was getting them every 6 months. Three injections spread a week apart. My experience was that they would take about a month to kick in but then I'd get about 4-5 months of pain-free running by which time I was ready for the next round. However, health insurance company (BlueCross) then stopped paying for them - they said research showed they were not effective after 2 years. I did pay for one more round out of my own pocket ($450) but I did not see much effect. So maybe there is some truth in what the health insurance company claims.

Re: stem cell therapy - probably too early to tell if this has been successful for me (it's been just a little over 3 months at this time). I started gentle running after 8 weeks (per doc's instructions) and certainly not pain-free at this time. However, I remain hopeful.

By the way, I had it done at Emory University's sports medicine clinic in Atlanta.

Good luck, PM me if you like.

Got my stem cells too at emory (mautner and x did surgery in 2006). When x did my surgery i started running 8 weeks afterward but probably should have worked on mechanics and core a lot more in prep. Since i was about 65 when got stem/prp i figured last chance or the glue factory. Go slow and maybe someone could look at your mobility and mechanics before you embark on running.

tyrod1, Dr Mautner was the guy who did my stem cell procedure too. Like you, they harvested from my hip.

I also did PRP about 6 weeks later, per their recommendation.

Their guidance to me was that I could re-commence running after ~8 weeks.

I do like your suggestion that I should get my form reviewed, I will research that.

Thanks!

if you are in atlanta, several good pts (athletes potential) also dr. josh glass a chiropractor and experienced runner has a group that shares or used to share his location that did video etc

dr glass website http://www.georgiasportschiropractic.com/?page_id=806


since i took 9 months to return to running the mobilitywod website opened my eyes to good mechanics (especially the deterioration from sitting and aero positioning)

GOOD LUCK

Hello smallard and All,

Thanks for the scoop ...

I took a minute and reviewed WADA USADA TUE requirements for following procdedures ..... none required ....so cortisone injection - OK .... stem cell harvest and injection - OK .... rich platelet plasma injection - OK ..... and hyaluronic acid injection - OK

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Cheers, Neal

+1 mph Faster

I am 68 years old and have been running endurance-wise since high school. First injured my ACL at age 21 but waited until about age 50 for my first knee op. Had a second clean out about 8 years later and continued to struggle with the knee doing IM and HIM races. The lead up to the 70,3 world champs last year was proving difficult and although I performed creditably in the race, a few training runs afterwards told me I had reached the limit of enjoyable running.

I had hoped to continue running and doing triathlons into my dotage but common sense tells me that if I want to keep walking comfortably into the future I had better take a more conservative approach and stop running completely. After 33 years of triathlon racing I have achieved every goal I would have wanted in the sport. I continue to swim and bike so I remain committed to a lifestyle of fitness and I admit I do not miss the feeling of pervasive fatigue that comes with long distance run training. I will now look to aquabike to satisfy my competitive streak.

"I took a minute and reviewed WADA USADA TUE requirements for following procdedures ..... none required ....so cortisone injection - OK .... stem cell harvest and injection - OK .... rich platelet plasma injection - OK ..... and hyaluronic acid injection - OK"

I understand your rationale of not wanting to "cheat", but lets be realistic here. What WADA says about how you treat your body should be one of the lowest priorities for your health. WADA rules are meant to control doping. They are not a blueprint for treating conditions or navigating the medical system. Do what you need to keep yourself healthy and moving. Worry about WADA later. Much later.

Hello Ralph20 and All,

I agree with your that overall health with emphasis on activity and longevity is primary .... after survival.

Sports are fun and provide a focus for health and longevity .... here in our tiny atmospheric film of life adhering to the surface of Spaceship Earth.

And I agree with you that when considering medical procedures and interventions that health comes first .... however thinking about a procedure in the future and taking a few minutes to cross the t's and dot the i's is not a burden .... more like due diligence .... and maybe learn something useful in differentiating/selecting between procedure and intervention options.

You can USADA/WADA check medical procedures and interventions here: http://globaldro.com/US/search and there is a page in WADA/USADA that lists steps to take when doing medical procedures .... and they emphasize in bold print number one on the list ..... first ... do what is best in the view of you and your doctor for your health ... and then WADA/USADA considerations for a TUE if needed .... and a phone number to call with questions.

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Cheers, Neal

+1 mph Faster

Hello smallard and All,

Motivation to continue running ..... these serious marathoners lived 19 years longer than average ...

http://www.runnersworld.com/general-interest/

http://www.runnersworld.com/...-longer-than-average

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Cheers, Neal

+1 mph Faster

Such a great post, as someone who has recently had knee surgery thank you!

I would concur with this. I have had osteochondritis since I was a juvenile and was told never to run. It wasn't until after college I realized that running actually seemed to improve my condition... with a few caveats.

1) It is hard to start running, take your time building up mileage and don't go for extended rest periods if you don't have to.
2) Limit your mileage - I can only run 20-25 miles per week, any more and it gets painful
3) Massage frequently - Your muscles may tense up more to protect the joint. I also get foot massages at the mall they are the best thing in the world

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Ride Scoozy Electric Bicycles
http://www.RideScoozy.com

Also,

Doctors say cycling is great because it is low impact but they forget to mention it is an unnatural motion and can wreak havoc on people with osteoarthritis. These pedals were designed to 'improve power and efficiency' which I don't really stand by, but they are amazing for reducing knee pain. You may want to check them out...

https://nikolainnovation.com/shop/chromoly-road-bike-pedal/

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Ride Scoozy Electric Bicycles
http://www.RideScoozy.com

The general rule that I've read is either the 1 hour or 2 hour pain rule. That is, if the activity increases your arthritic pain for more than an hour (or two) after doing it then you're doing too much.

You should probably be strengthening the leg muscles via weight training.

Pain is not equal to structural damage and especially not so in chronic conditions. Telling people that can make them fear avoidant and promote a "spare what spared can be"-mentality.

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Endurance coach | Physiotherapist (primary care) | Bikefitter | Swede

my wife just went through a bunch of MRIs etc for chronic back pain. It turns out to be arthritis in the spine. The spine specialist told her the best thing is to keep exercising and prescribed physical therapy to identify the best strengthening exercises.

So, keep running, and consider going to a PT to get some strengthening exercises to support the muscles that support the knee.

As the good doctor upthread said, running protects your knees. This is well established by multiple studies.
http://www.runnersworld.com/...e/run-for-your-knees
"increased risk of knee arthritis among former athletes is pretty much entirely explained by acute injuries."

Yes, midfoot striking will reduce the stress on your knees. The other effect is to increase the stress on the Achilles and calf muscles, so pay attention to any little pains there and treat them as soon as noticed.

also, Hokas. I don't know of any downside to these shoes - they have excellent cushioning and stability.