Running with minimal knee cartilage (Read 3900 times)

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    I have full thickness loss of the patellar cartilage in my righ knee. I don't have pain but it will sometimes swell tremendously. I've found that if I pay attention and back off as needed, I can avoid that most of the time. I see a sports injury doc who specializes in runners. He basically said that there is no research about running's effect wig this sort of injury - running didn't cause it per se, but it's not clear if running will hasten deterioration. There are animal studies to show that it might but I'm not a pig. I did get the viscosupplementation which didn't seem to help me. He said if I have more pain at some point I could look into surgery but since it's not interfering wig daily function there didn't seem to be a reason to look at it now. I asked a while back for stories of propel with similiar issues who run with problems and got a lot - you might want to search. Anecdotes aren't data but they sure made me feel better!



      I notice that this link is two years old-but I happened to be searching online for info. related to running with no cartilage-and this is the first link that came up. You story is like looking in the mirror for me. I have been running for most of my life-it is passion and I am having a hard time replacing it with another sport-

      I am 30 and as my doctor says-I have the knee of a 60 year old-osteoarthritis-probably genetic. I can no longer run without days of pain afterward-hence I have stopped completely to spare me being able to at least walk longer. I have been told by one of the best surgeons in Chicago that at this point knee replacement is my only option-but they will not perform this on  someone until they are at least 45 or older-he also said that I would not be able to run with a knee replacement. So-if anyone still reads this link-I wonder if anyone has advice for a fellow runner with no knee cartilage?


      Hi Clarke30-

      Sorry to hear about your struggles. I know first hand how frustrating it is not to be able to run. I've been though quite a bit with my knee since I posted this 2+ years ago, but since I started out in the same place (even a half mile run would make me be in serious pain for the next 3 days), I'll share my path with you.


      I ended up having surgery on my knee in May 2008, to clean up the cartilage that was left and make sure I didn't have any tears (the doc suspected meniscus even though it didn't show up on the x-ray). The surgery did nothing to help me, and I had a tough, slow recovery, probably because I had lost so much quad strength due to lack of exercise in the months before the surgery. BUT, the good news was that during the surgery, the doctor said the cartilage I do have left is in really good shape, and maybe was only a level 2 in terms of cartilage loss. So that was encouraging.


      I started going to PT to build back my strength after the surgery and work on my knee alignment. The PT told me the same thing, that I was going to have to give up running. But I was still in serious pain with day-to-day activity, so the doctor tried the Supartz shots. It's a series of 5 shots and I felt *slighty* better after the first 3, was even running a little bit. Then the last two shots did something (no clue what), but the pain was worse than ever and I couldn't even walk for several weeks without awful pain.


      I decided I had had enough with that doctor, and went to a knee specialist (the best in Miami). They were a bit puzzled by me, said that with the pics taken during the surgery, they couldn't see why I was in so much pain even without running. They sent me to their PT, who I really liked. We (again) worked on quad/knee strengthening, and day-to-day life got better, but the few attempts I made at running a mile would set me right back again.


      So now we are one year post surgery, and I would still be in pain after walking around a mall for 2 hours. Forget about running. As a last resort before doing a 2nd exploratory surgery to consider a knee replacement, the knee doc sent me to a 3rd PT, this one who specialized in running. And this is when things started looking up for me. This new PT realized that quad strengthening obviously wasn't the answer (since I had quads of steel at this point!). He spent a long time examining me and found a whole bunch of other weaknesses in my legs, some of them connected to weaknesses in my foot (which I had problems with about 1.5 years before my marathon). He started from scratch, working on my foot, then my legs, and had me add on fitness walking slowly, working up to an hour (4 miles) 5 days a week over the next month. A lot of the moves he had me do were running-specific strengthening, we changed a lot of my running form, and he did tons of hurts-so-good manual therapy. Once I was walking so much and tolerating it OK, we added in 1 minute of running every mile, then 2, and so on. I started working with him last June and it wasn't until November that I ran 3 miles non-stop. And it wasn't pain-free but more of an achy sensation that I learned how to tolerate. I kept adding on the mileage and we kept checking in and tweaking what exercises I was doing depending on where most of the pain was. By December I was running 6 miles and felt pretty good! This year I have had some IT Band issues flaring up, and we are working on that now, but most of my original sharp under-the-kneecap pain is just a dull ache now. I know I can't run more than 2 days in a row, and if the pain starts intensifying I back off. It's been a long long LONG road, but if you look at my running log you will see that I've been around 20 mpw for about 8 months (ignore the past week as I have been really sick). I always warm up well, and alternate running days, and supplement with cross-training. I still get frustrated because I want to be running more, and would love to do at least half marathons again, but at this point I just keep reminding myself that I am lucky to be running at all and I need to be happy with that.



      So, long story short, I believe that there is hope. Make sure that your doctor is a runner. Keep trying new things. If you truly have no cartilage left in your knee, then replacement may be the only option, but I would definitely make sure you explore all of your options, work with a running PT, get another doctor opinion, etc. It took me a long time to get to this place, and I am not pain-free, but it's not awful pain either.


      For me, even though I only have about half the cartilage left in my knee, just working on my knee tracking while running has lessened the wear and tear and at least given me back a small part of something I love. Maybe I won't be able to run forever as the genetic deterioration continues, but for now running doesn't seem to cause any harm and I'm enjoying it while I can.


      Good luck!

        Shauna, Great story of perseverence and hard work. Good for you!

        Those who try, fail! Those who do what it takes to succeed, succeed!!


          Shauna  - sorry to hear about your knee problems.


          This will cheer you up, I have ZERO cartilage in my right knee and I had 5 operations on my knees, ACL replacement in both and cartilage cleanup.   My consultant who did the OP told me that the cartilage was so badly damaged that they had to remove it.    He also asked me not to play basketball anymore (this is how I picked up all of these injuries over time), this wasn't what I wanted to hear.


          Anyway, I had the OPs in 2008/2009, rehab was long and tough. I had to work on my legs to build up strength, a lot of simple exercises, physiotherapy, gym etc.   I came back to play basketball in 2010/11, have been gradually increasing the amount of activity.    Last week I completed my first half marathon and I have been running quite a bit.  I do monitor my knee and if I play basketball I need to work on my legs to get ready.  The knee without the cartilage swells up if I do too much e.g. now it's swollen after the half marathon, but the swelling should come down slowly.


          I'm 31 and I hope that I will be able to run and play basketball for good few years, I understand the risks but the physical activity is too much to sacrifice even if I will need a knee replacement at the age of 60, it's still worth it.


          Also read about Brandon Roy of the Portland Trail Blazers, professional basketball player, he played a couple years with no cartilage and it's an interesting case of someone who even tried to come back to NBA.  He is retired now.