Saving My Knees: How I Proved My Doctors Wrong and Beat Chronic Knee Pain

~~~~~~~~~~~~~~~~~~~~~~~~

SAVING MY KNEES
How I Proved My Doctors Wrong and Beat Chronic Knee Pain
By Richard Bedard

FRESH VISIONS PRESS :
NEW YORK

The greatest obstacle to discovery is not ignorance; it is the illusion of knowledge.

—Daniel J. Boorstin

Copyright 2011 by Richard Bedard. All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means including information storage and retrieval systems without permission from the publisher, except by a reviewer, who may quote brief passages in a review.

Foreword
 

Sometimes it’s good to know the story behind the story. That’s certainly true for this book.

I wrote the first draft of
Saving My Knees
in a white heat of passion, my mind brimming with ideas. Afterwards I spent too many hours to count in researching, revising, fixing style. Every single line was scrupulously fact-checked; that took the better part of a month and left me exhausted. I hired four readers, from Arizona to New Hampshire, to go over each page with a critical eye, then made changes based on their suggestions.

As a veteran journalist, I was convinced the story of how I saved my aching knees was fresh and different and could help millions of others. There are lots of “heal your bad knees” books, but they follow the same tired formula. They feature the same information, the same dull, pedantic writing style, the same types of illustrated exercises, the same detached clinical viewpoint.

Feeling confident, I began to approach literary agents with my polished manuscript. And I quickly slammed into a brick wall. It soon became clear no agent would ever agree to represent
Saving My Knees
, nor would any major publisher ever offer to buy it.

Why not, considering I had a compelling first-person story not only of beating the odds to recover, but also of making surprising discoveries along the way? After all, I learned why standard physical therapy so often fails patients and how damaged knee cartilage has been shown to heal and grow back. These weren’t opinions either; my findings were backed by extensive research.

All fine, an agent told me, except for one problem: I’m not a doctor.

That created a maddening Catch-22. A book that isn’t prescriptive at all would be easier to sell to publishers since I lack the authority conferred by a medical degree. At the same time, it would be harder to sell to the public, since knee pain sufferers want tips on how to get relief and heal.

I was on the horns of a dilemma. To get through a publisher’s door, I needed a book that contained no advice, which the publisher would then reject, realizing it contained no advice. Crazy, huh?

After spotting this intrinsic absurdity, I had a soul-searching moment while mulling what to do next. What did I want
Saving My Knees
to be? Of course I liked the thought of creating a tangible book that a talk show host could thrust in front of a TV camera, or that a Barnes & Noble clerk could stack near the store entrance in tall, imposing piles.

But failing that, I just felt a strong compulsion to share what I had learned. I wanted this story to spread far and wide. I wanted this book to be accessible to anyone from Birmingham, Alabama, to Bangalore, India. Because, in my heart and mind, I believe the message on these pages represents the cutting edge of what will be a revolution in rethinking how to treat chronic knee pain.

So I decided to bypass the corporate publishing conglomerates and make
Saving My Knees
widely available, though only in electronic form. The year 2011 seemed like the perfect moment for such a move. Amazon.com has begun selling millions of Kindles a year; much of the world now has personal computers and Internet connections.

Now that you know the story behind the story, you may be curious about what kind of book this is. I guarantee it’s unlike any other you’ll read about beating knee pain.

I don’t include twenty pages of illustrated exercises, with precise details on how far your heels should be away from the wall or where your hands should be placed while doing single leg wall slides. This isn’t a “Be Like Mike” book either: I don’t claim that doing exactly what I did to get better is what you should do.

My preference would be to call
Saving My Knees
broadly prescriptive. I lay out what I tried, how I succeeded, and what I learned. My goal is to show how knee pain sufferers have to start thinking about their knees and what’s important for those ailing joints to heal.

There is no manual to
your
knees
. Sure, there are textbook chapters on knees in general, and it’s good to know how cartilage inside a joint works (chapter 7), but if you want to heal
your particular
knees, you have to become much better acquainted with them. You also have to stop throwing up your hands and writing off pain as “just another bad knee day.” Take charge of your plan to get better!

When you finish, and find your mind, too, spilling over with ideas, come visit my blog and join the conversation.

savingmyknees.blogspot.com

(Also, my home page is
www.savingmyknees.com
.)

IMPORTANT NOTE
: If you have knee pain, start by seeing a trained medical professional. Reading a book (this one or any other) is no substitute for a comprehensive in-person examination and tests that may illuminate what’s going on. Also, obviously, I’m not a doctor or physical therapist—though I did achieve something that they said I couldn’t.

Richard Bedard ([email protected])

Introduction
 

In 2006, the National Center for Health Statistics released a wide-ranging study on pain. Among the findings: almost one in five adult Americans complained of knee pain.

A year later, I joined that unhappy cohort.

Until then, what I knew about knees wouldn’t have filled the front of a Post-it note. Mine had always worked great. I was like the owner of a smoothly running car. Why bother to look under the hood when it always started right up?

In early 2007, that all changed. I had just begun doing some serious training on my bicycle. On weekends, my workouts included repeatedly pedaling up a steep 1.9-mile section of road.

That August, I planned to ride the Mount Washington Hill Climb. The gentle-sounding name is a misnomer; the “hill climb” consists of a brutal ascent to New Hampshire’s highest point at 6,288 feet above sea level. Hundreds of riders mash up the mountain’s slopes and try to reach the top first.

The event attracts top cyclists of all ages. One winner went on to glory in the Tour de France, the most famous endurance cycling contest in the world. In my mid-forties, I knew that I lacked the youth and talent to even place in the top ten. Still, I was fiercely competitive and vowed to train hard and do my best.

Then, while sitting at work one day, I noticed an uncomfortable burning around both of my kneecaps. I tried to ignore the sensation, thinking it would go away. Instead, over the following weeks, it got steadily worse.

What I didn’t know was that my knee joints were in deep trouble. Hard uphill cycling had damaged the shock-absorbing cartilage that pads the bone endings (for months before my training officially began, I was riding vigorously in the low mountains). I later learned that bad cartilage is a common culprit in knee pain. Many sufferers head down a one-way street to osteoarthritis.

So I dropped out of the Hill Climb and called in the cavalry. Over the course of a year, I visited four doctors and sought help from two physical therapists. I was determined to beat this problem (it went by a grab bag of names: patellofemoral pain syndrome, chondromalacia patella, runner’s knee). No one could help me. My confidence began to crumble.

My knees kept getting worse. Eventually it wasn’t only sitting that hurt. Sometimes it also hurt to walk. I couldn’t stand comfortably in one place for more than a few seconds, so riding in elevators became an agony. My knees burned constantly while at my desk, forcing me to contort my body into strange positions to get through the workday. I began to struggle with bouts of depression.

The doctors were pessimistic. My physical therapist, who initially advised against surgery, finally threw in the towel as well. He suggested that for me, maybe going under the knife wasn’t a bad option after all.

When everyone gave up on me, I got mad enough to do something radical. I quit my job and decided to live off my savings for one year. Those twelve months would be devoted to my own scientific experiment of sorts. Could the health of my knees improve at all? If so, how? Was the answer a certain dietary supplement or kind of exercise or what?

Every day I jotted down detailed notes about my knees, from how they felt to how many steps I walked. I researched with a passion to understand how knee cartilage functions, right down to the cellular factories called chondrocytes that churn out this incredible tissue. I read scientific studies about how cartilage defects change over time.

My most serendipitous online discovery was the Web site of a physical therapy clinic in Austin, Texas, by the name of Sports Center. In lucid, compelling prose, Chief Therapist Doug Kelsey broke with some of the most cherished orthodoxies of his profession. He helped me understand why the standard physical therapy regimen had been hurting, not healing me.

Those orthodoxies can be deeply ingrained. I casually mentioned my knee problems once to a physical therapist treating me for something else. She replied without hesitation, like the smart kid at the head of the class, “Stretch the IT (iliotibial) band, strengthen the quads.”

Inside I cringed. My former therapist believed that too; he prescribed exercises to build up my quadriceps muscles that left me hobbling for weeks. Must the village be destroyed in order to save it?

At some point during my recovery, during long sessions of deep thinking, the seed of the idea that became this book took root in my mind, and began to grow. Early on, I remember hunting high and low for a thoughtful, inspiring first-person account of overcoming chronic knee pain. My doctors had robbed me of the most precious commodity any patient has: hope. I needed someone to restore that, but sensibly.

There are many pessimists when it comes to aching, burning, grumbling knees. Cartilage deteriorates and that’s a fact of life, they say, shaking their heads. Trying to arrest this process is as futile as King Canute commanding the incoming tide to bend to his will and recede. Bad knees don’t improve. They may feel better if you strengthen the nearby muscles, but a damaged joint can’t repair itself.

I now know that’s dead wrong.

You can nurse bad knees back to good health. Broadly, my successful effort required three things:

1.
A plan
.

At first that sounds trite, or even misplaced. Recovering from a bruised shin or sprained ligament doesn’t require a plan. Injured knees, however, present a much trickier proposition. They heal on a much slower timeline. It’s often easy to lose track of where you are on that timeline. And it’s all too easy to reset that timeline—in a bad way—when you carelessly walk too far, or carry a few heavy bags of groceries (or a backpack full of books) before you’re strong enough.

When the journey is long, yet the goal is clear, a plan is indispensable. If you embarked on a two-week European vacation, hoping to see Buckingham Palace in London, the Eiffel Tower in Paris, and a half dozen other landmarks, you would sketch out a plan first. Saving my knees required a much better plan. For this journey, I was traveling between two amorphous states: feeling not very good and feeling good. Going from New York to Berlin is a cinch compared to this trip.

At times the plan may change. Flexibility is a virtue.

Just never lose sight of where you’re going.

2.
A commitment to motion
.

I once read a comic book that featured a tale about an Eastern emperor upon whom was laid a deadly curse. He can escape it only by building monuments and palaces, one after another, never ceasing. No sooner is one completed than he commissions the next. Then, while inspecting a work site, he slips and falls. Days later he awakes in bed, his head bandaged, horrified to discover that all the building has stopped because of his injury. The long shadow of the curse he tried to outrun at last catches and kills him. 

This idea of perpetual motion to ward off evil resonated with me. Too much inactivity can be deadly for knees. Understanding how motion helps the joints adapt and heal turned out to be a major breakthrough for me. Of course that was only a start. What kind of motion? How often? And the classic dilemma: how do you exercise knees that hurt almost all the time?

3.
A readiness to learn the language of “hurt knee.”

Bad knees send out a flurry of signals, all the time. Many may not reach the pain threshhold, but they’re still significant. Decoding this language obsessed me. Mastering it was essential to getting better; I was saved repeatedly from stupid behaviors because I knew how my hurt knees communicated and what the different sensations meant.

Many people think they listen to their aching knees because they follow the well-worn advice, “If it hurts, don’t do it.” That, I learned, was sort of like saying you speak German because you know how to say “Where is the train station?” and “Can I have a glass of water?” If I had remained stuck on that very simple level—allowing “if it hurts, don’t do it” to guide my activity—I never would have healed.    

I finally did recover. It took the better part of two years.

How did I save a pair of bad knees that my doctors said would never get better?

Well, that’s a long story.

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