MR: Knee Rehab

Mike,

I know you’ve had some knee problems lately, so I wonder if you have any thoughts on supplementation/good rehab for the knee. I recently underwent arthroscopic surgery for a torn meniscus (ultimately had about 1/8 of it removed) and Grade I-II damage to the articular cartilage. I was a fairly serious runner, and I would like to return to it to the extent that’s possible.

I’m presently on month one of a three month course of glucosamine/chondroitin and am proceeding through the rehab program my PT recommended: straight leg lifts, bodyweight squats, lying hamstring curls, and single leg calf raises.

As an aside–and this predates the tear and knee problems–my calf on the injured leg is much, much smaller than my other calf. No idea if this has any connection to the knee issues but it does seem odd.

Anyway, was wondering if you had any suggestions for the short/long term?

Glad to hear you are up to speed on what they did; this always makes rehab Rx a lot easier.

Now, you’ll be happy to know that it’s good news that they took out so little of the meniscal tissue. The typicaly cut-off is about 20%, with taking any more than that increasing the risk for osteoarthritis down the line. Hopefully with the supps/program I’ll recommend, the irritation to the articular cartilage will simmer down.

First off, I’m a huge believer in glucosmaine and chondroitin, and I don’t think 3 months is enough. Hell, in most that’s just about the time you’ll start seeing benefits! I’m a lifer on this one, with or without any injury history. Another big one is EPA/DHA; I know Biotest will be coming out with theirs soon, but there’s a boatload of research discussing the many benefits of fish oils, just one of which is its role as a natural anti-inflammatory. I would start your supplement program from there, then possibly think about some antioxidants as well.

As far as the rehab, really focus on getting the swelling/inflammation down, while getting the range of motion (ROM) and proprioception back around the joint. Again, I stretch daily and will continue to do so; if you want stretches, check out my “Hardcore Stretching” articles. As far as proprioception goes, any kind of single leg balance stuff progressing even to unstable surfaces would be great.

That should be a good start. I was actually thinking about writing up an article on this stuff, so maybe I should eh? :wink:

Stay strong and good luck
MR

[quote]thompssf wrote:
Mike,

I know you’ve had some knee problems lately, so I wonder if you have any thoughts on supplementation/good rehab for the knee. I recently underwent arthroscopic surgery for a torn meniscus (ultimately had about 1/8 of it removed) and Grade I-II damage to the articular cartilage. I was a fairly serious runner, and I would like to return to it to the extent that’s possible.

I’m presently on month one of a three month course of glucosamine/chondroitin and am proceeding through the rehab program my PT recommended: straight leg lifts, bodyweight squats, lying hamstring curls, and single leg calf raises.

As an aside–and this predates the tear and knee problems–my calf on the injured leg is much, much smaller than my other calf. No idea if this has any connection to the knee issues but it does seem odd.

Anyway, was wondering if you had any suggestions for the short/long term? [/quote]

Thanks Mike, I appreciate the advice. I’ll defiantly check out the EPA/DHA and focus more on the stretching. That article would, I?m sure, help a lot of people. Hey, I don’t want to put you in a position to recommend a particular company for glucosmaine and chondroitin, but is there anyone that you?ve had good luck with, considering there is no biotest product in the area? I?ve read here about the studies that suggest that some OTC brands provide little no active ingredient?.

[quote]Mike Robertson wrote:
Glad to hear you are up to speed on what they did; this always makes rehab Rx a lot easier.

Now, you’ll be happy to know that it’s good news that they took out so little of the meniscal tissue. The typicaly cut-off is about 20%, with taking any more than that increasing the risk for osteoarthritis down the line. Hopefully with the supps/program I’ll recommend, the irritation to the articular cartilage will simmer down.

First off, I’m a huge believer in glucosmaine and chondroitin, and I don’t think 3 months is enough. Hell, in most that’s just about the time you’ll start seeing benefits! I’m a lifer on this one, with or without any injury history. Another big one is EPA/DHA; I know Biotest will be coming out with theirs soon, but there’s a boatload of research discussing the many benefits of fish oils, just one of which is its role as a natural anti-inflammatory. I would start your supplement program from there, then possibly think about some antioxidants as well.

As far as the rehab, really focus on getting the swelling/inflammation down, while getting the range of motion (ROM) and proprioception back around the joint. Again, I stretch daily and will continue to do so; if you want stretches, check out my “Hardcore Stretching” articles. As far as proprioception goes, any kind of single leg balance stuff progressing even to unstable surfaces would be great.

That should be a good start. I was actually thinking about writing up an article on this stuff, so maybe I should eh? :wink:

Stay strong and good luck
MR

thompssf wrote:
Mike,

I know you’ve had some knee problems lately, so I wonder if you have any thoughts on supplementation/good rehab for the knee. I recently underwent arthroscopic surgery for a torn meniscus (ultimately had about 1/8 of it removed) and Grade I-II damage to the articular cartilage. I was a fairly serious runner, and I would like to return to it to the extent that’s possible.

I’m presently on month one of a three month course of glucosamine/chondroitin and am proceeding through the rehab program my PT recommended: straight leg lifts, bodyweight squats, lying hamstring curls, and single leg calf raises.

As an aside–and this predates the tear and knee problems–my calf on the injured leg is much, much smaller than my other calf. No idea if this has any connection to the knee issues but it does seem odd.

Anyway, was wondering if you had any suggestions for the short/long term?

[/quote]

For the long-term, I can tell you to make sure and train your legs. I ran at a high level and have had my share of injuries. Long before I shifted my focus to weight training, legs needed to be a priority. They would always act up when I was slacking on or skipping my leg workouts. I have also found that direct hamstring work is important. People tend to have stronger quads than hamstring and this imbalance can cause problems, particularly in those who have been injured. Whether I’m doing a program of my own devising or an excellent T-Nation program I add some sets of hamstring curls in addition to the deadlifts, front squats, and back squats that are staples. This helps my knees from flaring up. For the short term, listen to your physical therapist and work hard on your rehab! You might need to incorporate your rehab-specifc exercises into whatever future training you do to some degree, as well. Good luck!

I also take glucosamine chondrotion and fish oil regularly. Green tea extract and grapeseed extract also when I have a flareup.

I’ve tried them all…but nothing compares to…
Cetyl Myristoleate, Celadrin,and to a slightly lesser extent… hylauronic acid and coral calcium