'This doesn't make sense..'

LIFETIME HIP & KNEE

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Read time: 1.5 minute

#133: 'This doesn't make sense..'

'Um, yeah, it absolutely does..'
'..and please can you spread the word..!'

Referral => 58yr old male, LEFT knee pain

X-ray film => Looks a lot like the knee from last week (it is different!)..

A lot of my job can seem quite repetitive..

BUT everyone is different. And this is another good story..

So, I'm thinking the same thing as last week..

Good joint space
(gap between the bones)
Plan MRI knee if he gets catching pain
± Knee Arthroscopy if there's a target on MRI
(a meniscal or cartilage tear)

Alf's story goes back a bit further,

Around 2 years ago he ran his usual parkrun on a Saturday morning. I'm a big fan of parkrun 😀

In his dance class later that day his left knee didn't feel quite right.

Then the knee niggled on and off for a couple of weeks. And then..

On a routine walk it got a lot worse.

An MRI scan at the time showed a medial meniscal tear. That's a tear in the shock-absorbing cartilage on the inside of the knee.

And the knee continued to ache for the next 18 months. Alf was keen to avoid surgery. Always sensible..

And he remained active.. golf, skiing, weight training. I also applaud that..

AND cycling really helped.

More applause..!

AND then the knee got better.

Great..

'This doesn't make sense..'

THEN the same thing happened again

6 weeks ago..

Except this time, Alf REALLY carried on as normal.

And that, for him, included a bike trip to Majorca.

A full on bike trip 👏 👏

Cycling ~100km most days.

..and the pain..?

Completely gone.

Why this DOES make sense..

There's a big difference between a cartilage tear age 27yrs..

And a cartilage tear age 57yrs.

Early adulthood it's injury. An acute / clean tear.

In middle age any 'tear' is degeneration.. the cartilage is abnormal to begin with.

Alf had always been slightly bow-legged

Just like the root cause of Dai's knee osteoarthritis

That's led to him loading through the inside of his knee his whole life. And as he got older..

The collagen and other bits of his joint cartilage also got older

That's led to degeneration, osteoarthrtis or OA

Throughout the inside (medial) compartment of his knee..

The cartilage tear is just part of that process.

The Solution

Cartilage- old or young- likes / NEEDS to be loaded..

BUT not too much.

And that's what Alf did here.

He takes care of the 'not too much'

=> His bodyweight is bang in the right place. Zero extra.

AND this time he REALLY carried on as normal.

=> That Majorcan bike trip. His full on active self.

Alf's unconscious strategy meant he bounced through this flare up.

AND I just reassured that he knows what to do IF there's a next time..

I love hearing these stories! ❤️👏 👏

Coming up..

Another great case. And not a marathon runner, or sportif cyclist in sight. This next story comes with an important lesson for me 😀

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Duchy Hospital
Truro
TR1 3UP
United Kingdom