There are many ways to heal the knees that your Orthopaedic specialist won’t tell you about–because their drug-company education never taught them!
Contents
Tendons and Ligaments
One time it makes sense to see your Orthopaedic specialist is when you have a serious tear in one of the tendons or ligaments surrounding the knee — a tear in the medial collateral ligament, for example (on the inside of the knee), or the anterior cruciate ligament (on the outside).
A good physical therapy program can rehabilitate a minor tear, and any good physician will offer that as the first thing to try, unless the situation is serious. (Even then, you should investigate Prolotherapy — discussed later in this article — before you commit to surgery.)
For any kind of serious rupture, the surgeon can staple things back together and get you back on the playing field. That’s the good news.
The rest of the news is not so good, unfortunately. Because in other common situations, the Orthopaedic approach can do more harm than good.
Painful Pressure
If you had a minor ligament tear, it could easily heal in a week or two. But if you remained active while there was tear, especially if there was a lot of side-to-side movement, you could easily create a tear in the meniscus (the spongy pad that separates the upper and lower leg).
That tear, too, could heal in time. In fact, you may not even know you have it, if you rest a lot and let your knee recover.
But if you were as inebriated as I was when I had my mild ligament tear, you can shift the torn bit around it until it becomes a flap. And since the ligament tear allows the two parts of the leg to move farther apart than they should, that flap can overlap the remainder of the meniscus, creating a painful pressure sensation when you try to walk or run.
That, in fact, is the most common way that meniscus problems occur in athletes. (Something I read back in 2007, when I was researching the original version of this article.)
I went to the doctor, because my normal physical activities had suddenly become very painful! I didn’t know what was going on, so I went to the “experts” for assistance.
That was my big mistake. You see, I had come to trust Orthopaedic specialists. On more than one occasion they had fixed the broken bones, strains, and sprains that curtailed my activity. They got me back out on the playing field, and I was grateful.
Little did I know that when it comes to treating the meniscus, they were all but entirely uneducated.
Healing A Flap
For a meniscus flap, there is a chiropractic maneuver that has a good chance of success. None of the three doctors I spoke to even knew of the procedure, much less recommended it.
In that procedure, you start by lying on your back. The chiropractor grabs your ankle, and gives your leg a sharp tug, directly away from your hip. As they do, they jiggle the leg slightly.
That tug creates a millimeter of separation between the upper and lower leg. The jiggling gives the flap a chance to move back into position. If it succeeds, the pressure problem goes away. You should still give it a lot of rest and light exercises to heal the tear as described in the next section, but surgery is avoided, and healing a tear is relatively easy compared to the difficult task of restoring the meniscus after doctors have finished “improving” it.
Now then, if you don’t have a chiropractor handy, or a friend who is willing to stand in for one, there is a do-it-yourself (DIY) option to try:
- Get a 4×4 block of wood, 6 or 8 inches long.
- Attach a strap to it, with a loop at one end of the strap.
- Put your ankle through the strap.
Or, better, put a Gravity Boot on your ankle, and put the loop over the hook. - Stand on the block with your other foot. (It should be partially bent.)
- Push yourself rapidly upright with that leg, jiggling your other leg as you do so.
That technique isn’t guaranteed to work, any more than a visit to a chiropractor is. But give it a try for a few weeks (or two months, if you can). In the best case, the pain disappears and you have avoided surgery. In the worst case, you’ve lost some time and back to the doctor’s office you go.
Surgical Destruction of Meniscus
Now we get to the real problem — the one that Orthopaedic surgeons create. Because when there is a problem inside the knee, they go with arthroscopy.
If you look it up, it sounds pretty good. It just means “scope” (take a look) at the inside of the knee! And if that’s all they did, it wouldn’t be too bad. That’s how they saw the flap in my knee.
But what do they do, while they’re in there? The only thing they can do, it seems, is to put a little “nibbler” vacuum-tool in there that chews up the flap into small pieces and sucks them out.
What’s wrong with that, you ask? After all, the painful pressure goes away. Yay! Right?
Wrong! Because what they don’t tell you is that the meniscus, in general, does not grow back.
In short, they remove tissue that typically grows only when we are very young. (My suspicion is that it has to do with the fact that, at that time, our bodies are flooded with growth hormone. More on that subject later.)
Now, I just naturally expected that like the skin, or bone, anything they removed would come back on its own, it time. But I could not have been more wrong. Nor did the “doctors” feel obligated to share that little bit of information.
Instead, they used euphemisms like “cleaning” the knee to describe the process. Or they used an accurate term like “debriding”, but again without explaining that was taken out was in effect lost for good!
Note:
When I heard that Tiger Woods was scheduled for a second procedure to “clean” his knee, I knew that he had been subjected to the same arthroscopic treatment I endured. It damn near ended his career! I know it ended mine (such as it was).
One doctor in particular was really good at avoiding making promises that could be used as the basis for a lawsuit later: “We know it’s bad now. And we know if we nothing, it won’t improve. So what do you think?”
In other words, he left the decision to me — without giving me sufficient information to decide intelligently! (But I’m not bitter… Much.) But here, in this article, I am trying to give you the information you need to make intelligent decisions.
Because the fact of the matter (according to other articles I found during my original research) is that no one resumes their former level of activity after meniscus surgery. In fact, only a small percentage regain even normal function.
That’s true in America, at least. Its seems there are regrowth programs that are permitted in Europe, that are not allowed here. I suspect that is how Tiger Woods recovered from the knee surgeries that came close to ending his career.
Surgically-Induced Bone Spur
Now, when bone meets bone, the bone responds by growing. That’s how bone fractures heal. The problem, once part of the meniscus has been removed, is that with sufficient pressure, the bones in the knee joint come together.
Now, that pressure is extremely painful. So you tend to curtail your activities to the point of doing virtually nothing! (At one point, I took up bird watching. But I had to give it up — it was too strenuous! As a former volleyball player, volleyball coach, soccer player, and runner, it was painful to admit that short walks to watch birds were too painful to endure!)
But let’s say you are bound and determined to restore some level of activity. I was. And it took decades. But I got there — sort of.
The problem was that every time that bone-on-bone contact occurred, the bone was encouraged to grow a small spur — a tiny pimple of a growth that had the effect of reducing the space between the knees.
That reduced space not only made bone-on-bone contact more frequent, but it meant that the pressure was concentrated in an ever smaller area as the peak formed, which meant that the more it grew, the faster it grew.
(Are you getting the idea that meniscus removal is a bad idea? I should hope so!)
Restoring the Meniscus
Fast forward to 2018. The first surgery was in the late 1980’s. The next (glutton that I am, before I became distrustful) was in the early 1990’s. Finally, I have found a few things that do make a difference. (A couple I reported on earlier. Several are new.)
The fact is that if we don’t do something, the knee will not improve. But the “something” we need is not more “cleaning”. It is not more surgery. What we need are several “somethings”, a couple of which I have found thanks to YouTube and the chiropractors who post there.
The Mechanism of Action
Most of the procedures described here act by alternately decompressing the knee, and mildly compressing it again.
That’s important, because there are no arteries in the knee to provide nutrients to the meniscus, or to remove toxins caused by metabolic activity (like growth processes!). Instead, the meniscus and other joints are “fed” when fluid is pumped through the joint, as a result of movement.
In short, if you don’t move the joint, you don’t heal! The trick is to move it in ways that promote healing without causing further damage.
Swing Your Legs
Dr. John Berman’s excellent video, How to Regenerate Joints describes this simple exercise:
- Sit on a table that is high enough for your lower legs to swing freely.
- Swing them back and forth, so one leg is going forward while the other is going back.
- Don’t swing very far forward. There should be no sense of lifting the lower leg. It should be just swinging back and forth.
- To make it more effective, put on ankle weights (3 to 8 lbs is sufficient, depending on your size and strength).
Note:
For a DIY option, I tapered a piece of plywood and C-clamped it to a stool. Then I put a pad on the plywood. To cover the edge of the plywood, I cut a section out of one of those foam “pool noodles”, then sliced down one side to create a gap I could press onto the plywood. It works pretty well!
In the video, he recommends 10 minutes a day. That’s a fair amount of time, but it’s worth noting that I’ve experienced a difference (going by the feeling when I walk) in as little as 108 repetitions a day. That takes somewhere between a minute and a minute-and-a-half.
Note:
Okay, call it 100 reps. I do 108 because that is the magic number they use in India when chanting. (That’s how many beads there are on the circular string they call a mala. You move beads so you don’t have to count.)
I did 10 minutes a day for a while, but it was taking enough time that after a while I just stopped. A minute a day is a lot easier. Only so much growth can happen in a day, in any case, so I suspect that a lot of extra time produces only marginal extra benefit.
The magic number is probably somewhere between 1 minute and 10 minutes. Or maybe 10 minutes really is best. (Experiment. Let me know what you discover. :__)
“Anywhere Swings”
It can be hard to find a table at the right height to swing your legs. An alternative is to swing them one at a time while holding your upper leg with your hands.
To do it, sit on a bench or on the edge of a chair, so you can lean back. Lift your leg and hold your upper leg behind the knee. Then pull the knee towards your chest.
Your foot is now dangling, so you can swing it towards you and away, a little bit in each direction.
The important point is that your hands are now acting like the edge of the table—as your foot swings in, it “opens” the knee joint of fraction. It closes again as the foot comes back, producing the beneficial pumping action.
Rocking Chair Push
Sitting in a rocking chair one day, I noticed that my quadriceps (top of thigh) muscles were active as I pushed back. (They were actually exercized quite a bit!) As they tensed and relaxed, I noticed a slight pulsing around my knees.
In fact, the knee was moving slightly back as I tensed, and slightly forward as I relaxed, creating the same kind of internal pumping action as leg swings.
Later, I found that I could duplicate that action on any chair. Since you’re not rocking, you don’t push very far. But that’s okay. You don’t need to push very far for this purpose.
Just put your feet flat on the ground under your knees and use your leg muscles to rock your hips back a quarter of an inch or so. As your quadriceps muscles alternately tense and release, you not only create that internal pumping action, you also build strength in the muscle that needs to be strong to protect your knee.
(Strong quadriceps are needed to hold your upper leg above the lower leg, so you don’t experience bone-on-bone contact pain. But of course, it’s only really possible if you’ve had only some of your cartilage removed, rather than all of it.)
Moist Heat
Bergman’s video also recommends moist heat, following the exercise. Here’s how I do it:
- Soak a small towel in water. Ring out the excess.
- Put it in the microwave for one minute, on a microwave-safe plate.
- Put the hot towel on the knee, and cover it with a wet/dry heating pad to keep it hot for longer.
Doing that increases “inflammation”, but in this case inflammation is a good thing, because it leads to healing.
After the exercise and the moist heat, you will notice a sense of pressure in the knee — not a painful pressure, but a definitely increased pressure sensation. That’s the extra fluid that has been drawn to the knee by the exercise and the heat.
That fluid brings with it nutrients, and as it is squeezed out, it carries away the metabolic byproducts created by tissue growth.
Bergman says he spent 4-years regrowing his cartilage after 4 surgeries, and I believe him. But as someone who has been negatively impacted by surgical “repair” of the meniscus for the past 30 years, I can tell you that I am quite willing to devote a few years to this procedure!
Cycling and Rowing
Light activities that don’t create more problems include cycling and rowing, both of which cause the knee to move, creating a pumping action that moves fluid. These suggestions among others are in another video, 3 Tips For Knee Cartilage Problems.
For either one, you want easy repetitions, with no weight and no pressure on the knee.
I mention them because they are good ideas, and because his video contains some other good suggestions, starting with the leg-swinging exercise mentioned earlier.
Cycling Walk
This exercise was inspired by videos on running technique, which showed the foot coming up after landing, then swinging forward with ankle relaxed so the toes rise above the heel as the foot comes forward, but then the ankle straightens as the foot comes down, so the ball of the foot strikes the ground first.
Then came the day I was needed to take a train home, with the station several miles from my home. I thought about taking a cab, but didn’t see one. And it was a nice day, so I decided to walk.
Now, walking any distance gets painful after a while. I’ve found that sitting here and there gives the muscles time to recover, making it decidedly less painful. So that helps. But then it occurred to me that I could use the walk as an opportunity to create the pumping action.
As I walked then, I consciously swung my foot upward after I pushed off. That upward swing created a slightly-more-than-normal bend in my knee. Then, as I swung the foot forward, the leg straightened.
That movement seemed to produce a small pumping action that was similar to cycling. At the very least, it reduced the sensation of pain!
Mini Squats
An action similar to cycling and leg-swings that strengthens the quadriceps muscle is a very small squat where you go from standing to a slightly-bent leg and back again. It produces the same kind of pumping action, with very little strain on the muscles, without adding much pressure on the knee.
This something you can standing in line, waiting for the microwave, or any other time it’s convenient.
Special Procedure / Special Knee Brace
Dr. Stephen Stokes has another excellent video, Regenerate Your Knees that mentions his version of the decompression technique that pumps fluid through the knee, coupled with a Class 4 Laser, which he finds to be especially effective.
His procedure may well be worth a try, at some point. In the meantime, I decided to try his special knee brace.
The DDS KneeTrac Light ($140) is a special decompression brace that has a patented hinge. It claims that when you put pressure on it, the legs are lifted apart. As they come together again, the knee is treated to an alternating decompression and compression that aids the healing process.
But perhaps the most noticeable benefit is that separating the leg removes pressure! The idea is that you can resume normal activities (like walking!) without pain. That helps the recovery process, and helps to reduce the weight you inevitably gain when you have lost your former level of activity.
Mine got here yesterday. It works beautifully. Here’s what I wrote in my Amazon review:
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p style=”padding-left: 30px;”>Walking normally again!
Wow. This thing really works. I’ve tried other knee braces in the past, but nothing like this. I don’t know what’s going in that patented hinge, but it is a goodness, for sure.
Over the years, I had developed a noticeable limp as walking got more painful. Put this brace on, snugged it tight, and voila! I’m walking normally, pain free. Too cool.
The upper part of the brace consists of 3 “struts”, connected by the pad. Two are at the sides, one is at the top. As the previous reviewer noted, the top strut, held in place by thin strap, can work itself free of that strap, from time to time. A small piece of duct tape solves that problem nicely. (My thanks to that reviewer!)
Prolotherapy
I spent close to $10,000 on Prolotherapy, in hopes that it would help me repair the meniscus. Unfortunately, it doesn’t work that far inside the knee!
I think it holds great promise for repair of tendons and ligaments, where the injections can reach the parts that need healing. (Everything surrounding my knee was greatly improved, in fact. It just didn’t solve the fundamental problem!)
The injections stimulate inflammation, which triggers the healing process. So for a ligament or tendon, they are ideal. (A muscle has plenty of blood flow, so it tends to repair on its own. But ligaments and tendons do not — they need the extra assist!)
So for meniscus repair, I unfortunately cannot recommend it. I wish that the doctor I spent so much on had been able to tell me that! But I did learn one thing: An Oesteopathic doctor (not an Orthopaedist) is someone who is committed to the idea that the body heals itself.
In their eyes, their mission is to set up conditions that allow the body to do its job. They are not so arrogant as to think it is they who are doing the healing, and they do things that do not have undesirable side effects.
That is a philosophy I can subscribe to, and believe in. (So I’m happy to give them a plug.)
Weight Training?
One area I have not seen discussed anywhere by in my previous article is the potential benefit of high-resistance, low-rep weight training.
There is no more powerful (yet natural!) way to release growth hormone. The kind of training I’m talking about is in the 3 t0 5 repetition range: If you can do six reps, increase the weight; If you can’t do three, reduce it.
That kind of weight training promotes serious muscle growth. Since muscle growth requires growth hormone, it is clear that it promotes a strong release of growth hormone.
The two exercises that have the biggest effect in that regard are the deadlift and the squat. And I can tell you that during a period of time when I was doing those exercises, my knees improved.
The problem, of course, is that you need to keep from further damaging the knee. The solution, to my mind, is to keep the knee within the same range of motion you use when cycling (a recommendation that applies to rowing, as well). In other words, you never lock it out all the way to a full extension, and you never bring your heels and your butt together, when weight is involved. (You can do it with body weight, if you’re not too heavy. But not with heavy weights used to promote growth hormone.)
DeadLift
For the deadlift, the constraint means that you keep your knees bent throughout the movement. They’re bent when you start the lift, and they’re bent when you end it. You never lock them out, and you never squat down.
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p style=”padding-left: 30px;”>Important!
Before doing that exercise, though, make sure you know how to do it. If you haven’t trained to it before, get someone to show you, and have them check out your form. Otherwise, it is easy to hurt your back.
Squat
For the squat, a machine is ideal. In general, I recommend (and prefer!) free weights over machines. But here we want to prevent the leg from extending too far, and from flexing too much. In other words, you don’t want to go too high, and you don’t want to go too low.
The lower limit is where the top of your thigh is parallel to the ground. The upper limit is at something like a 30-degree angle to vertical — approximately the same angle you get when cycling on a properly-fitted bike. Any sort of machine that lets you keep the motion within that range should work well.
For the kind of heavy weights I’m describing here, once a week is sufficient. In fact, once very 10 days is fine! As Dr. Michael Colgan writes in The New Power Program, it takes a few days for a muscle to fully recover from that kind of effort. After that, it spends several days overbuilding, in response to the challenge (7 days, in total). So clearly, there is a lot of growth hormone is circulating through your system during that time!
The muscle only begins to atrophy after 10 days of non-use, so anywhere in that 7 to 10 day window is a great time to hit it again. (If you hit before it has finished recovering, it’s like tearing down a building while you’re building it. If you hit before 6 days are up, you short-circuit your gains.)
To be clear, though, real atrophy only sets in as a result of total non-use. Just walking around and going to the bathroom is enough to prevent serious atrophy, so any gains you make are yours to keep, for a very long time!
In short:
- Once a week is ideal.
- Once every 10 days is fine.
- Whenever you can is better than nothing!
Stem Cells!
Stem cells, it turns out, can be created from virtually any cell in the body. Studies reported by Dr. Robert Becker in The Body Electric show that under the right conditions, cells can be persuaded to de-specialize, so they are free to re-specialize into any form they are needed.
In the Prolotherapy treatments I took, they carved a tiny bit of fat out of my abdomen (wish they could have taken more), and converted those cells to stem cells. It’s a procedure that holds a lot of promise!
The trick, when it comes to the meniscus, is to keep them from floating away in the synovial fluid that fills the knee joint (and other joints). So you need some kind of “matrix” to hold them in place, and that matrix needs to be slowly absorbed into the tissue that results.
The HealthLine article, Stem Cell Treatment to Repair Torn Meniscus ‘Very, Very Close’ , suggests that this kind of procedure may be coming along fairly soon. I hope so. (But I believe it may already be possible to get it done in Europe!)
Conclusion
There are many ways to promote healing of the knees, and your Orthopaedic surgeon is probably aware of only a few of them! So be sure to evaluate the alternatives before committing to drastic action.
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