Hi everyone,
I’m a 52 year old from London. I’m primarily a runner (1:27 HM time) but also do tris, and completed my first 70.3 in Cascais in 2019. Hoping to return to the distance in Estonia this year.
I posted a few months ago about Hylauronic acid injections for a chronic knee issue that’s now been bothering me for ten months or so – thanks to all who replied. In the end, I didn’t receive them as the ortho worried they may cause a joint flare.
Since then I’ve seen a sports medicine Dr who’s highly regarded and was recommended personally by a physio friend with with no ulterior motives. He’s suggested trying a leucocyte-poor PRP injection, with the caveat that it may not work. If it does, he’d suggest a second. So I thought I’d now see if any STers with knee issues have experience – positive or negative with PRP.
Has it helped you? And what is the recovery time? Obviously, I say this with usual caveat that no one can diagnose me virtually – everyone’s experience is unique.
Quick background. Living in NYC in 2006, I overtrained for the Philadelphia Marathon and developed some mild but persistent knee pain. MRIs were clear. However, I was talked into ‘exploratory’ knee surgery because ‘MRIs don’t show everything’. Under the knife, I was given a plica removal and small partial meniscectomy. The surgeon assured me I’d be on my feet for an intensive job three weeks later, that I didn’t need physio, that I’d be doing a tri three months later, and that - whatever happened - I wouldn’t be in greater pain after the procedure.
He left me unable to walk, with severe pain and swelling, and washed his hands of me once he’d collected my insurance money. I required a second operation six months later to remove scar tissue that locked my knee, and it took 8 months of intensive physio to return to even gentle running.
That was a massive success. I’ve never run a marathon since, but I’ve returned to all other distances, needing only maintenance physio to keep my leg strong, and I as I say, did a 70.3 in 2019.
Last July I woke in the middle of the night with deep, throbbing medial joint line pain. Running was ok at first, but I soon found that I’d have sharp, stabbing medial pains an hour or so after training. These pains then started bothering me on the run itself, and I had to stop for a month. The down pedal stroke on the bike became painful.
My immediate thought was that I’d finally succumbed to the dreaded post op arthritis - but two MRIs and two opinions from excellent Drs have shown that while my knee cartilage is far from pristine and I have some small chondral defects, it’s in good shape for my age and activity level, and that there shouldn’t be any reason I can’t train or compete. My meniscectomy was apparently (thankfully) very small.
I’ve now done 10 months of physio. I’ve tried everything suggested – and while I can run, I have regular ongoing sharp medial pains during the run and after, have no confidence increasing my intensity, and night pains continue to disrupt my sleep.
As I mentioned, HA was discussed, but not given. That ortho sent me on my way saying I’d be fine long term. But I know this knee, and I’m far from fine – so I’ve ended up at the sports Dr who suggested PRP (with the caveat that it wasn’t a magic bullet.) He also said I may have chronic medial compartment overload and nerve sensitivity, and suggested amitriptyline to reduce this response.
If you read this far – thanks! ïŠ I’m basically wondering whether PRP has helped those with meniscal/chondral issues in their knee, or has made you worse/made no improvement? I know the scientific evidence is increasingly positive for PRP, but seemingly not yet conclusive.
And how long did you hold off activities afterwards? The sports Dr has said I should rest for between 4-6 days, but otherwise can live life as normal.
However, other recovery protocols I’ve read have said no running or heavy physio for as long as three months post injection. I’m adopting a dog 8 days after the proposed first injection date, so really need to be able to walk without issues!
Hope you’re all doing well – thanks for any insights.
Cheers, Will