FUBAR of the Knee

May 22, 2007
3,595
1,422
143
Kawasaki
halffastcycling.com
#1
By the end of the second day of my Golden Week trip around Noto Peninsula my right knee was painful and badly swollen. Figured overuse and too much luggage (both on the bike and around my waist). Taking it easy for a while should sort it out.

And it did - for a while. I was feeling much better by the beginning of last week. Then two days of riding left me in pain again. I got a referral from my GP to Teishin Hospital and went there this morning.

A series of X-rays revealed the problem all-too-clearly. Osteoarthritis in both knees. the cartilage in my knee joints has worn away to just a sliver of its former, healthy self.

This is due to a combination of factors: most significantly being obese and pushing my body too hard. I'm on the low end of the age scale for this condition, no history of it in the family.

So there will be a string of joint strengthening and stabilizing exercises, and some significant weight loss, in my near future. I'll have to find a way to keep exercising while not stressing my knee too much - probably swimming. I don't mind swimming, except that it doesn't get me anywhere except the other end of the pool.

Interested to hear any other experiences of this condition, especially its treatment as pertains to continued cycling. I definitely want to continue cycling!
 

microcord

Maximum Pace
Aug 28, 2012
914
294
83
Tokyo
#2
I'm sorry to hear of it.

If you haven't swum recently, you'll discover the hard way that it uses muscles you'd never know even existed. Be very unambitious at the start; build up slowly.

On my first day of swimming after more than a decade, I could hardly lift myself up the ladder out of the pool. And what I found hugely annoying was that the wizened, the obese, everybody was hugely faster than me, and (it seemed) effortlessly so. (And yes, the only novelty in the scenery was: Which 80-year-old is overtaking me now?)
 

GSAstuto

Maximum Pace
Oct 11, 2009
945
242
103
tokyo
www.roadfixie.com
#3
Sorry to hear that , Mike! The body IS capable of recovery, though, so don't be depressed about hearing such seemingly final diagnostics. Along with cycling, which actually helped my knee more than anything, the associated weight loss was perhaps the most significant factor. Dropping a few kg goes a long way to reducing the constant stress on the knees. Push lighter gears and actually riding a bike is better for you getting around than walking - which only smashes the cartilage more! I had severe cartilage, tissue and bone damage and the treatment was pretty much as you mentioned:

1) Strengthening and Stretching (Range of motion torture machine)
2) Cortisone injections (000 needle of mayonnaise stuff directly into my knee periodically)
3) Brace while walking (robocop sorta thing that distributed the weight above and below the joint)
4) NSAID therapy
5) Electro stim therapy (amazing for the pain - ask Machin about the Compex)
6) Then, finally, 2yrs on the fixed gear at a 42/18..
 
Likes: Forsbrook

bloaker

Maximum Pace
Nov 14, 2011
1,538
1,209
433
Miura, Japan
#4
Mike that sucks! I was having some knee discomfort this weekend on climbs... I did nothing noteworthy, but anytime I had to crank uphill, I ended up coming out of the saddle to mash just to save my knee.
I spoke to Megan about it when I got home and one of the first things I said - I need to lose weight to save my poor knees. I sometimes feel I am working twice as hard as the next guy on climbs.

Good Luck on the knees getting better.
I am of no use on offering solutions for you as I am trying to find them myself.
 

kiwisimon

Maximum Pace
Dec 14, 2006
2,661
477
103
Japan
#5
Change the title to FU knee, I disagree with the BAR. Sorry to hear the diagnosis but better you hear the news now while you are young enough and energetic enough to change the prognosis.There are plenty who have found relief by dropping wheat from their diets and yes Mike beer is a wheat product, fortunately tequila isn't wheat based. Advice that is free is worth just that but start here. http://www.marksdailyapple.com/arthritis-diet/#axzz2Tnb9Rt5Y and then pick and choose what you feel you can do. Shut out the naysayers cause saying aye won't change a damn thing. Keep riding on light gears and maybe stay out of the hills for a while. I'm sure Tim can convert your Titan beast into an awesome looking SS commuter, oh yeah he can.
That gearing is 34X17 and it gets me everywhere I need to go, not the fastest but you don't have to go fast to look good.

All the best wishes for a rapid change in your knees, and other places.
KS
 

theBlob

Bokeh master
Sep 28, 2011
2,864
1,450
129
...
#6
That really sucks. No insight, but I really hope you can find relief quickly and a long term solution so you can keep doing the stuff you love.
 
May 22, 2007
3,595
1,422
143
Kawasaki
halffastcycling.com
#7
Thank you all for the support, ideas and encouragement.

I have another appointment in a month, by which time I'm supposed to have done 3 sets daily of 20 reps of 3 exercises the rehab nurse taught me. Suddenly I'm noticing things like my posture, and a tendency to lock my knees when standing. What have I been doing to myself!?
 
Jan 14, 2007
2,514
213
83
Noda
japanichiban.com
#8
Thank you all for the support, ideas and encouragement.

I have another appointment in a month, by which time I'm supposed to have done 3 sets daily of 20 reps of 3 exercises the rehab nurse taught me. Suddenly I'm noticing things like my posture, and a tendency to lock my knees when standing. What have I been doing to myself!?
Take your time. The physio says my knee will take a year to heal properly...
Spin light gears. Lose weight as you said....and remember the weight is on your bum when you bike and knees when you walk...so no need to cut back on the cycling unless you're pushing a heavy gear.

I had my skeletal alignment checked last month and have been doing gym work to strengthen my legs and straighten up my posture. Having that re-assessed tomorrow.

With the weight loss, I'm finding it very difficult to lose weight and also build up the loss of muscle in my right leg that atrophied a bit after the operation.
It's a tricky catch 22 situation... trying to lose weight too quickly and you lose muscle as well.
Was rudely told yesterday by an ugly woman 'You're fat!' ... I know I can lose the weight but I didn't point out her shortcomings...She was right though!

My right knee though is finely showing some good strength... Left knee has been a little dodgy doing all the work since October...

Take it slow I guess is the best approach.
 
Sep 2, 2009
5
0
0
#9
Bummer about the knees.

Pointless echoing everyone else, but yeah, reducing the 'down-force' sitting on top of the knees is bound to massively improve things.

I am in no way an expert on dieting and all that, but I have now lost 16kg since January, and would be more than happy to go on and on and on about how I did it, if you feel like it might be a good addition to the rest of the advice that people are no doubt firing at you. Cool if not, of course.
 

bloaker

Maximum Pace
Nov 14, 2011
1,538
1,209
433
Miura, Japan
#10
Bummer about the knees.

Pointless echoing everyone else, but yeah, reducing the 'down-force' sitting on top of the knees is bound to massively improve things.

I am in no way an expert on dieting and all that, but I have now lost 16kg since January, and would be more than happy to go on and on and on about how I did it, if you feel like it might be a good addition to the rest of the advice that people are no doubt firing at you. Cool if not, of course.

He's gonna tell you to stop drinking!!!
Your knees are not worth it!
 
Likes: eimaiosatanas

FarEast

Maximum Pace
May 25, 2009
5,528
538
193
Yokohama
#12
I would also suggest weekly collagen and Hyaluronic acid injections

Cortisone injections will only reduce the inflamation and pain and do nothing for the actual problem that he has been diagnosed with.
I would also not go anywhere near a fixed gear bike with knee problems.
 
May 22, 2007
3,595
1,422
143
Kawasaki
halffastcycling.com
#13
I am in no way an expert on dieting and all that, but I have now lost 16kg since January, and would be more than happy to go on and on and on about how I did it, if you feel like it might be a good addition to the rest of the advice that people are no doubt firing at you. Cool if not, of course.
Please do. I'm open to all suggestions. Up to you whether to put it in the thread, on PM, email or carrier pigeon.
 
Sep 2, 2009
5
0
0
#15
Please do. I'm open to all suggestions. Up to you whether to put it in the thread, on PM, email or carrier pigeon.
Alright then, here goes!

I quit drinking alcohol (etc.) on November 18th, 2012. I was 83kg then.

I didn't do any training or anything throughout the rest of November and December, but due to the lack of beer etc., I naturally dropped a couple of kgs. I fluctuated between 79kg and 81kg throughout December and into the start of January.

January 7th, got blood work done, mainly to check out what I had, or hadn't done to my liver and pancreas. The results uncovered the fact that I needed to cut down on the sugar, and salt (high BP and blood sugar). From that day on I cut out the following;

-Bread
-Sugary drinks of any kind
-Pasta
-Rice of any kind
-Potatoes

This felt dreadful at first, which combined with being in the middle of withdrawing from junk, pretty much crippled me. I stuck it out, however.

Then, despite already pushing it with what I had cut out of my diet / life, on January 18th, 2 months after getting clean I embarked on a proper training regime. Started with 1 hour on the trainer 2 times a week after work, situps, stretching, and swiss ball work (which is a wobbly LOL when you first start), and longer rides on the weekend. Again, this hurt at first, but part of it was a requirement to record my weight each day. I was excited to see that even after 2 weeks, I had dropped down to 78kg. I continued the training, which was designed by a coach, and as such ramped up slowly in intensity, and the weight continued to fall off me. After a month, I was down to 75kg, then 74, 73, 72, etc...

Then I got my blood done again at the end of February. All my levels were back within the normal zones, and my blood pressure was dropping down. I continued the training, and when the weather got better, went out on my first group ride since sorting myself out. This went well, and really spurred me on. I maintained the eating regime, despite it being very tempting at times to bosh a pizza, and finally saw my weight get to 70kg. This was a massive mental victory, and soon after that, I got sub-70kg. I am now at 65kg at my lightest and around 66/67kg when super-hydrated. This fluctuates throughout the day, of course, but has been stable for a week or so.

So, what do I eat?

Well, as I said, I cut out bread, sugary drinks, pasta, rice and potatoes. My average day of eating consists of something like; Breakfast; chicken breast sliced up and fried with bean sprouts, maybe an egg cracked on top. Black Coffee. Lunch; Couple of boxes of Tofu, eaten plain. Dinner; chicken or bacon, cooked in tomatos, with broccoli, and whatever other veg I feel like throwing in. OR loads of sashimi, and a few apples to fill up with.

I hammer a lot of fructose high fruit (sucrose high fruit I consider too risky for my blood sugar levels), like apples and strawberries.

When I am on a big ride, however, I do eat bread, pasta, etc., but never when I am at home.

Thinking about it, I would say this is basically the same as the diet you would get forced to go on if you were a Diabetic with Hypertension. So, if you start living your life as if you had those 2 chronic conditions, the weight is going to fall off you.

So there you go.

Last thing to mention; as I said, I have lost 16kg, and still think I could lose more. That is a large proportion of my previous body weight, and some people have been saying you will lose power by losing that much. I say to that; bollocks. You won't lose any power at all, and will be faster and more powerful. Anyone who rode with me last year, and who rides with me now, will tell you I am faster and more powerful having lost all that weight. I reckon all this talk of losing power when dropping weight is just people feeling fancy and applying ultra high level athlete training concerns to their own 'training' in a bid to sex it up a bit.

Hope that helps. Good luck with everything. I can't say it has been easy for me, but I suppose a large part of the pain I was feeling was not due to the weight loss and training, but rather the other stuff I was dealing with, which was of my own making.
 
May 22, 2007
3,595
1,422
143
Kawasaki
halffastcycling.com
#16
Alright then, here goes!
Thanks for that exposé. I really appreciate it.

This line, in particular, I think is very insightful.
this is basically the same as the diet you would get forced to go on if you were a Diabetic with Hypertension. So, if you start living your life as if you had those 2 chronic conditions, the weight is going to fall off you.
That actually gives me a really helpful starting point. I'm quite sure that your menu would drive me insane, and I would relapse/rebound and end up cooling to room temp. on a bariatric gurney. Now I can find some less extreme recipes to start with while I prepare myself psychologically for two boxes of plain tofu.
 
Sep 2, 2009
5
0
0
#17
Yeah, it helps if you are insane to begin with.

Seriously though, just Google a load of 'Diabetes diets' and 'Hypertension diets' and follow them religiously.
 
May 22, 2007
3,595
1,422
143
Kawasaki
halffastcycling.com
#18
...I embarked on a proper training regime. Started with 1 hour on the trainer 2 times a week after work, situps, stretching, and swiss ball work (which is a wobbly LOL when you first start), and longer rides on the weekend. Again, this hurt at first, but part of it was a requirement to record my weight each day. I was excited to see that even after 2 weeks, I had dropped down to 78kg. I continued the training, which was designed by a coach, and as such ramped up slowly in intensity, and the weight continued to fall off me.
Please may you say more about this? Was it an online thing, or in-person one-to-one, one-to-many? Costs?
 

theBlob

Bokeh master
Sep 28, 2011
2,864
1,450
129
...
#19
Whatever you do you need to believe in it. Or like you say you won't be able to stick to it. Once you believe, it's easy. I recommend joining a cult like Hare Krisnas.

No, seriously though. Don't beat yourself up or you will just create other problems.
 
Likes: Forsbrook