Exposed bone patches cause concern.I am 50 years old, and have been running for 30 years on paved streets. I run 40 miles a week, usually 6 or 7 miles at 7:00 pace. I compete in 5Ks and 10Ks at about 5:50 pace. I do speed work at this pace eight months out of the year, and usually try to work in a 10- or 12-mile run every few weeks. In 1997 I had arthroscopic knee surgery Arthroscopic knee surgery Surgery performed to examine or repair tissues inside the knee joint through a special scope (arthroscope). Mentioned in: Chondromalacia Patellae arthroscopic knee surgery for a torn meniscus meniscus /me·nis·cus/ (me-nis´kus) pl. menis´ci [L.] something of crescent shape, as the concave or convex surface of a column of liquid in a pipet or buret, or a crescent-shaped cartilage in the knee joint. in my left knee. After a few months I was back to normal pace and distance. My left knee is fine today, but this week I had the same surgery on my right knee. For the first time, I harbor doubts that I'll be able to continue indefinitely, and would like to know your thoughts on my future running and competing. Will I damage my knees further, and can I expect recurring injuries in a few years? Dale Watchel Gaithersburg, MD Don't let the history of two knee surgeries be a reason for despair. Speak to your orthopedic surgeon and find out the quality of the articular articular /ar·tic·u·lar/ (ahr-tik´u-ler) pertaining to a joint. ar·tic·u·lar adj. Of or relating to a joint or joints. articular pertaining to a joint. hyaline cartilage on your femoral femoral /fem·o·ral/ (fem´or-al) pertaining to the femur or to the thigh. fem·o·ral adj. Of or relating to the femur or thigh. , tibial tibial pertaining to the tibia. tibial crest a longitudinal prominence on the cranial border of the proximal tibia. Its proximal end (tibial tubercle) has a growth plate separate from the proximal tibia; hyperflexion injuries to , and patellar patellar of or pertaining to the patella. patellar cartilage a cartilaginous process borne on the medial side of the patella of horses and cattle. sides. That's the coating of the bones around the knee. If there are exposed bone patches, you might have to cut back on your running. If the coating is intact, then keep on trucking. Rob Meislin, MD NewYork, NY The critical issue isn't whether you've had the surgery, but what the findings were: do you have arthritis? What was the status of the articular cartilage? Based on the answers to these questions, your orthopedic surgeon can make activity recommendations. There is a multitude of low-impact aerobic activities you may try: bicycling, swimming, rowing and cross country skiing come to mind. But none of that may be necessary if all that arthroscopy Arthroscopy Definition Arthroscopy is the examination of a joint, specifically, the inside structures. The procedure is performed by inserting a specifically designed illuminated device into the joint through a small incision. revealed was grade one or two chondromalacia chondromalacia /chon·dro·ma·la·cia/ (kon?dro-mah-la´shah) abnormal softening of cartilage. chon·dro·ma·la·cia n. , which is a softening of the cartilage. Klaud Miller, MD Evanston, IL It seems like you may be neglecting to cross train, which is an important aspect of a running regimen that helps make injury less likely. If your surgeon advises that you have a lot of wear and tear on your knee, I urge you to incorporate cross training into your routine. I also would add that as a general principle, we don't wear out so much as rust out. If you don't have substantial knee disease, avoiding running will not be necessary, though after 50 slowing down a bit and easing up on the mileage may be a wise thing to do. Larry D. Hull, MD Centralia, WA |
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