It has now been 38 weeks since Dr. Glashow and his assistant Chris Prezzano transplanted a De Novo NT Allograft into my left knee. It has been 14 weeks since my last arthroscopy. And it has been a year and four weeks since I tore a pothole (1.5 cm X 2.1 cm) in the articular cartilage of the femoral condyle of my left knee.
I am very close to discontinuing this chronological approach to blogging. I feel great and it is almost time to move on. I am, however, still suffering medial knee pain associated with patella femoral syndrome. Thus, it is somewhat helpful to still provide a chronologic timeline.
Trauma to the knee in the form of impact, twist, or surgery can leave the VMO defenseless. 20 cc's of swelling in the knee basically shuts down the VMO. It takes 80 cc's to shut down the vastus lateralis. Because of this difference, the vastus lateralis muscle pulls the kneecap to the outside, dragging the kneecap along the lateral femoral ridge. Unless VMO weakness is addressed, this will continue to happen until pain and degeneration of the kneecap makes it too painful to walk.
This is exactly what has now happened to me. Thus, rehabilitation from this injury continues to focus on rebuilding and reeducating my VMO. Because I am limited in the exercises that I an do this little project requires some more thinking outside of the box. Next on my list of outside the box thinking is "dry needling."
Dry needling is the use of a solid needle for therapy of muscle pain, sometimes also known as intramuscular stimulation. Dry needling contrasts with the use of a hollow hypodermic needle to inject substances such as saline solution, botox or corticosteroids to the same point. Such use of a solid needle has been found to be as effective as injection of substances in such cases as relief of pain in muscles and connective tissue. Analgesia produced by needling a pain spot has been called the needle effect. Acupuncture and dry needling techniques may be similar, but their rationale and use in treatment are quite different.
In addition to the dry needling, I have begun a series of sports medicine acupuncture. Sports Medicine Acupuncture is a series of needling techniques specifically geared towards the treatment of orthopedic disorders and painful musculoskeletal conditions. The scientific approach behind this style of acupuncture is fairly modern, however the points utilized remain largely traditional and historical in nature.
This style of acupuncture follows the theory that most painful orthopedic conditions are due to an imbalance of the muscle systems of a particular area. By treating these conditions through a re-alignment and balancing of the pathological muscles involved, range of motion is restored, pain is reduced, and the speed of recovery time is increased – often with exceptionally fast results.
This is achieved is through the use of Motor Points. Motor points are areas on each muscle that possess the least resistance to electrical conductivity. Extensive research and practice has found that, by stimulating stainless steel needles in these particular points, a nerve response occurs which essentially ‘re-sets’ the communication between that particular muscle and the central nervous system. This ‘re-setting’ of the muscle helps to release spasms in chronically tight muscles, and conversely, helps to ‘turn-on’ muscles that have become weak through over-stretching, atrophy, or fatigue.
This style of acupuncture is exceptionally popular with athletes who are actively training for events or needing a quick recovery from an injury. It also serves as an excellent therapy for those individuals struggling with injuries due to chronic overuse and repetitive stress.
In addition to the Sports Medicine Acupuncture therapy I have also introduced Electro-Acupuncture. Electro Acupuncture is most often used in conjunction with Sports Medicine style acupuncture, though it can be used with nearly any type of acupuncture. With Electro-Acupuncture, small electrical leads are connected to already-inserted acupuncture needles and an electrical current is sent through the needles and into the acupuncture point. This process has exceptional health benefits.
Below is a video of Electro Acupuncture on a healthy VMO - clearly not mine!!!
Below is a shot of my VMO as I underwent Electro Acupuncture. When compared with the above video it is clear that my VMO is not functioning correctly yet. However, I have no doubt that it will get there.
A couple of months ago I suggested that a time would come when I needed to start focusing again on my weight. Well that time has come. Below is a shot of me when I made that statement. A little puffy and heavy me thinks!
Since then I have continued to work on core and related strengthening with Andi Felton at Endurance Rehab. We have focused on a program where I do a series of core exercises while keeping my heart rate elevated. After two months of this program, I am beginning to feel rather good again. Below is a shot just before I rode yesterday. In addition to Andi's program I am writing down absolutely everything that goes into my mouth and this seems to keep me on task. One good site that I have found that facilitates this nicely is www.livestrong.com.
Well, I did not get dressed for a picture. Nope I got dressed to ride. I was able to get out twice last week. I rode just over seventy miles on the week - and I had a great time. First, it was awesome to get out and ride again. But more importantly, I had absolutely no pain while riding or the morning after I rode. I have not had that experience since my crash in Germany in July '09. To say that I was stoked would be a huge understatement.
My winter swimfest continues and continues and continues! This week, I swam 33,000 more yards. I also spoke with Ironman legend Hillary Biscay, www.hillarybiscay.com and she wrote me a couple of quality smashfest workouts. I promptly hopped on these and definitely smashed myself! I certainly miss Hillary and her smashfest approach to Ironman Training!
This weekend several of my mates and I are going to try to expedite the getting into swim shape process by knocking out another set 100 X 100 long course meters. Why? I don't know other than Sun Devil Masters is offering it! After that I have my first brick - a 37 mile ride out to the Ironman Ariona turn around with Jeff Basset. He has promised not to drop me as he will be riding his single speed. I am holding him to this.
This week's things that I like is a double edged sword. I guess I like weather. Living in Arizona we have weather - hot and hotter. Thus, we don't have four seasons. Below is a shot of my friend Allie Lind as she prepared for her long run this week. I gotta say that this looks like a good time!
Thanks for stopping by folks. I have no doubt that I am going to overcome this darn knee injury. Just know that you can and will destroy your limitations.
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