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| February 1, 2011 | | New blog: Consistency and starting to put together some good weeks | | It has now been 39 weeks since Dr. Glashow and his assistant Chris Prezzano transplanted a De Novo NT Allograft into my left knee. It has been 15 weeks since my last arthroscopy. And it has been a year and five 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.
Generally, I feel really great now. I am getting around so much better. As far as normal life is concerned, I have very few complaints! The graft has integrated very well and I feel no pain whatsoever at the graft site. Below is a shot of the knee. I think it looks great! Thank you Denovo, Dr. Glashow and Chris Prezzano!
Unfortunately, when it comes to training or any exercise involving my legs, I still experience medial knee pain associated with patella femoral syndrome. This pain is intermittent but extremely sharp! The fact that it is transient combined with the fact that it reacts to stress inconsistently makes it very difficult to overcome.
The great folks at Endurance Rehab have been all over it. However, Patella Femoral Syndrome is a very complex condition, often with several different contributing factors. Boiled down to the basics, it centers around the patella, and the way that it tracks within the femoral groove.
The patella is a small bone that sits on the end of the femur. The femur has a shallow groove in which the patella moves up and down during knee flexion and extension (bending and straightening). The quadriceps muscles are the large muscles on the front of your upper leg, and all four connect to the patella, and then the patellar tendon connects them to the lower leg. Everytime the quadriceps contract, the patella moves along the femoral groove. It is within this groove, and as a result of Patella Femoral Syndrome, that i tore a .5 X.5 CM hole in the Articular Cartilage surrounding the Femoral Notch doing rehab for my Denovo NT.
As a result of swelling and VMO atrophy I have a rather serious case of Patella Femoral issues. With patella femoral compression syndrome, the patella is not quite centered within the groove. As the quads contract, the patella moves along the groove, but if it is not aligned correctly, there are areas of greater pressure, and areas of lesser pressure. Repetitive activities often cause irritation of the patella and surrounding structures, because of this mal-alignment and abnormal pressures.
As irritation increases, you begin to have pain around the kneecap, and eventually have a continual ache throughout the knee with all activities. The good news is that by increasing flexibility and strength of certain muscle groups, your alignment issues can be overcome. Weak muscles can contribute to patella femoral compression syndrome as well. This is true for the quadriceps, as they are the primary muscles that move the patella along the groove.
In the past week, my VMO has actually started to fire again. Literally, for the first time in over a year I am pain free again in one area of my knee! My VMO had not fired in over one year! It is not firing great but it is firing again which is way cool. So long as the Microfracture works and my VMO starts to fire consistently and with vigor then the issues associated with the patella femoral syndrome should be overcome.
I owe this change to Electro Acupuncture which I introduced last week,. 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. Below is a shot of my VMO as I underwent Electro Acupuncture. 
There is no end in sight to my winter swimfest as it continues and continues and continues! This week, I swam 32,000 more yards. The highlight of the past week was another set of 100 X 100's. This was another great experience. Sun Devil Masters offered it so Jeff Basset, Kevin Taddonio, George Gage, Elizabeth Rich and I all did it! It was also great to see Simon and Jonny! They are both Pac-10 legends and all around great guys!
My riding has continued to improve and I have been able to get out a little more. I was able to get out four times last week. In total, I rode just over one hundred sixty miles on the week - and again I had a great time. Per Wolf's instructions I held right around 150 watts average. I did go over at times but in general I sat at 150 the whole time. In addition to getting outside again, the good news is that I experienced no pain during the ride but I did have some transient pain after riding. I am so excited.
The highlight of the week was a little fifty miler, my longest ride since Kona '09, with Steve Rink and Elite Runner and Rock and Roll Marathon Champion Sally Meyerhoff! A close runner up was a loop of the IMAZ course with Basset and Taddonio following our 100 X 100 smashfest - Great times!!!!
I am really excited about all the changes that I am experiencing now. The folks at Endurance Rehab have made so much of this possible. And for all of these gifts I am so grateful.
Never give up folks. You can and will destroy your limitations!
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