The Devil is in the Details

Well, today is another day.  I think it helped a little to get all of that out yesterday and I really appreciate the support I’ve gotten.  Of course I couldn’t totally let it go (and I probably won’t be able to for a while) so I did some more research yesterday to get a little more clear on the terms being used in osteoarthritis/chondromalacia.  Of course, I’m no doctor…this is just my understanding based on a lot of reading.

Chondromalacia in itself is not really a diagnosis.  It really is just a descriptive term for the condition of cartilage.  Chondro=cartilage. Malacia=softened.  If you have a mostly normal joint and get some chondromalacia under the kneecap that causes pain, 6 months of rest from the irritating activity might alleviate it and all the cartilage to heal somewhat (cartilage is notoriously hard to heal due to lack of blood supply).  If the joint stays inflamed, it can set up a cycle of damage that permanently affects the cartilage and bone which is what people commonly mean when they say they have arthritis.  The source of inflammation varies (eg. rheumatoid is auto immune, osteoarthritis is mechanical), but the end result is chondromalacia or softening of the cartilage and damage to the joint.  Some people can have a lot of joint damage and no pain, some can have lots of pain and little damage.  Currently I have lots of pain and moderate damage.  The the best way to prevent more joint damage is to use the joint in a way that protects the remaining cartilage, which most doctors think is non weight bearing exercise.  However, if you have healthy joints to start with don’t think that running causes osteoarthritis!  There have been multiple studies that show this just isn’t the case and that it may even be protective.  In fact, after reading these studies again it gives me hope that I may be  able to return to running at some point (especially if they get this whole stem cell thing down…there has already been some success with knee cartilage regeneration).

My short term plan is evolving as I am beginning to accept the reality of the situation.  I’m in pain.  That has to stop and since running makes it worse that has to stop too.  I’m getting older and I can can’t afford to be cavalier with my health.  I’m going to have to commit to  doing the physical therapy exercises to make the tendons and ligaments surrounding my knee as strong as possible.  I’m going to have to work on my weak hip abductors and imbalance in strength between my hamstrings and quads, all of which are classically related to knee pain and instability.  If I can successfully do all of that maybe I can return to at least some running without doing further damage to my joints.

In the meantime I’m thankful that I have supportive friends and family, have health care insurance and I can walk.  Being in that wheelchair last weekend gave me a taste of what life could be like and I need to be focused on how much I have and how lucky I am, not whining about my exercise routine.  Wishing you and yours a Happy Thanksgiving!  I hope you have lots to be thankful for too.