'popping' lateral miniscus? Can I prevent it?

[schnozzles]

Hi everyone

I have a problem with my right knee - it feels like the lateral cartilage pops out every now and then, but then after a while (could be hours, could be days) it pops back into place and once the swelling has gone down, it's fine again. Presumably this is causing more damage each time it happens? The problem is, because when I manage to get to see a doctor or consultant, it's usually back in place, they don't seem to want to do anything - it didn't even show up on an MRI scan because it had settled down by the time I got one.

I'm quite happy to not have surgery until it's necessary, but I want to take up running again - is there anything I can do to prevent the cartilage from 'popping' while I'm running? Would a support that inhibits lateral movement of the joint help?

PS initial damage to knee probably caused by excessive sports as a teenager: running, soccer, rugby, ice-skating, athletics, tennis,cycling!! I am now 36 and desperately want to get fit again but at the moment I only really dare walk, and even that seems to 'upset' my knee.

THanks in advance

[krunchie]

This is long answer but you should read it..ref prolotherapy...


Do not give too much credibility to people who do not recognise that their own knowledge is limited.....especially when they are giving you advice about your health !!!


I am staggered by the attitude and arrogance of some doctors and physiotherapists (and even professional national sports team medical advisors - for example look at the reaction by the US Ski Team medics when Bode Miller, Eric Schlopy, Bryon Friedman all had prolotherapy and rave about it's success !) who dismiss certain treatments and ideas simply because they do not know anything about them. The one's I am thinking about use their own lack of knowledge as an argument as to why something cannot possibly exist or work. They know who they are, don' they ??

I find their arrogance mind boggling - their arrogance is only exceeded by their ignorance - beware !

I am particularly referring to conversations I have had about the treatment called Prolotherapy or Sclerosant therapy.

I have spent 3 years researching the treatment and during that time have been treated with astounding and rapid success - and I speak from experience of talking with many medically qualified people and patients ......but I know I can only be sure of what I have experienced..not what I have been told, read...or not read for that matter !

In my experience the most arrogant and dismissive "qualified" people with whom I have had conversations have been General Practitioners and Physiotherapists - these are people who hold a position of respect in society and to whom people look to for advice about their health. Ironically, they are the "medical" staff who require and go through a much shorter training than the doctors that I know who administer prolotherapy. They have considerably less (if any at all) experience in diagnosing and treating musculo-skeletal issues. Many GP's spend most of their time dealing with headaches, earaches, flu, period pains, depression, pregnant 15 year olds etc etc etc...they probably get to see an MRI scan once a year...if at all...and may not have a clue what they are even looking at - some admit this of course but many do not !

So when a physio (with their 2-4 yrs training under their belt) or a GP (with their 5-6 year training) , tells you that something is impossible just because they have not been taught about it (or because no drug company has sponsored it !!!)..question why some orthopaedic surgeons - who have taken possibly 14 years to get to the point where they can start to practice independently - who have had the same training as the GPs and physios at the beginning of their career, then studied much further for much longer, then specialised and focused in particular injuries and conditions FULL TIME...who then also often go on to study and qualify as Osteopaths....a further 4-5 years ( so now we have approximately 20 years of study and hands on experience in specific medicine and LIFE)...just ask yourself who is likely to have the greater knowledge...and strangely, the people to which I am now referring are open minded and curious.

Maybe the above-mentioned arrogant sceptics do not know that (and I quote..) "the American Association of Orthopedic Medicine
AAOM) promotes Orthopaedic Medicine by teaching doctors integrative diagnosis techniques and comprehensive/ integrative nonsurgical treatment methods including proliferant injections (prolotherapy), steroid injections, fluoroscopic spinal interventions, osteopathic manual medicine, therapeutic exercise and interventions with various pharmaceuticals/nutriceuticals/ herbal/ homeopathic based treatments."......well maybe these sceptical GPs and physios should be questioning why they have not read about it..why they have not informed themselves of what treatments are successful at treating their potential patients...why they have NOT
kept up with their own profession...mmm ??? Think about it !


The problem in finding a prolotherapist is that there are very very few of them. This is because the skill set and legal qualification required is much greater than just becoming a "doctor" or just an "osteopath" and certainly much greater than just a "physiotherapist"....after all...on paper...a physiotherapist when compared to the doctors that I know who perform prolotherapy..is like comparing the mechanic at your local
Ford garage with Ernst Fuhrmann, the man who designed the incredible, world beating Porsche type 547, 4 cam roller bearing engine for the Porsche 550 Spyder in 1954 - you get my point ??? One knows what goes on..the other needs to be told what to change and how !!

Okay - I know you are not all like that...and apologise to those who are not but choose to be offended......but I bet you know many who are !!

To be a good prolotherapist you need to specialise in musculo skeletal issues (so you are probably an osteopath - incidentally prolotherapy was part of the osteopaths training until the 1960's when the law changed so you then had to be a qualified medical doctor to treat people with the long needles used in prolo - so it was dropped from osteo training because they would never be allowed to do it unless they went on to become a doctor..another 5-6 years training...""oh oh..long time before earning any money..I will stick with just being an osteopath thanks")...so in the UK at least, you really have to be a medical doctor legally and in order to have sufficient knowledge in musculo skeletal issues...an osteopath too....this is before you really get any real life hands on experience...at the minimum.

Then to be any good.....you still have to have a great deal of experience even to accurately diagnose the problems...most ligament and tendon issues are not visible even on MRI (in fact especially on an MRI !!!)

You also need to be very sensitive with your hands and have natural skill and a steady hand....very steady hand...and be very confident...have you seen the needles and where they go ?????? Wow ! I have, I felt them, in my case they didn't hurt because I was treated by someone who had been doing this non stop for 35 years, a qualified doctor who then qualified as an osteopath having been treated by one and amazed by the result, then was treated by prolotherapist and further amazed by the result (and remains totally cured of the problem 35 years after the treatment !) - and so studied that technique too.This man has been the president of the British Osteopathic association and an examiner at London College of Osteopathic medicine.

Now..there are at least 2 orthopaedic surgeons that I have spoken with...remember they require much longer training than even my doctor !!...who treat with prolotherapy in place of surgery in many cases, they still research prolotherapy and they TEACH IT !! These surgeons practice at the ROYAL ORTHOPAEDIC HOSPITAL in the UK.....and still I hear some GP s or physio therapists say..."Prolotherapy cannot work because I haven't read about it, I haven't been taught about it so it must be rubbish...." Ie...they know NOTHING about it...but they insist that their own lack of knowledge proves that something doesn't exist !!

Well....what would you think of me if you asked me what I thought about your favourite book and I said - I haven't read it, I don't know anything about it - it's rubbish - would you consider me very credible ?


If anyone is interested I will be happy to tell them my case - and all the very expensive "specialists" I went to see - none of whom could fix me..or in many cases couldn't even see anything wrong despite MRI etc and them being orthopaedic trauma specialists in their own right..but had no knowledge whatsoever of prolotherapy - the treatment that has fully repaired my problem ( these qualified traumatologists and orthopaedic surgeons were very interested to read the information I had discovered and asked me to return to their clinic in Spain after my treatment in the UK to tell them about it - of course I did and they are now looking into it in detail).

I would love to share that story with any of you !

Do your own research - do not believe the first thing you read - do not believe the 100th thing you read - do your own research - talk to as many people as you can - find people with experience not uninformed opinions - find people who have had it and done it - then decide what to do.

Remember when you read an article and it says "experts say this , experts say that "...look up the definition of an expert - my friends from Argentina define an expert as somebody from the next town !!!!!

There is no doubt whatsoever that....

if you have an accurate diagnosis

if the injury is appropriate for prolotherapy - many are !!

if administered by a skilled and experienced therapist who uses the correct solution and gives enoguh treatments spread over the optimum timescale

if the patient follows the therapists advice regarding eg:
non use of antiinflammatories, diet...reduce sugar for example increase vitamin C, correct exercise

if the above situation applies...there is no doubt that prolotherapy is a natural, harmless complete and permament cure that in many cases leave the patient even stronger and mechanically more stable than before their injury.

It is such a shame that there are so few practitioners because 90% of people suffering today with arthritis and arthrosis pain, damaged discs and cartilage, damaged or just old, worn and loose ligaments could have their pain eliminated permanently - and save the NHS enormous amounts of money - the treatment requires skill and training but the material to do it costs nothing...a syringe, needle and simple solution of sugar, water and antisceptic..it takes half an hour and you just wlak straight out...no hospital time !!

[krunchie]

I suggest you look at how prolotherapy has fixed Bode Miller, JJ Johnson, Eric Schlopy and Bryon Friedman of ligamentous knee and back injuries. Big news in feb 2006 because they went to a well respected doctor who has in fact lost his US licence but that is another story - they went against advice from their team trainers - because they don't know anything about the treatment - went to Mexico and bingo - fixed..I have done a ton of reasearch on prolotherapy (and the doctor these guys went to ..he is in fact one of the pioneer and has written many papers that are still used today by ORTHOPEDIC SURGEONS in the USA and UK...and taught many practitioners BUT that fact has been conveniently omitted from the press reports !!!!!) because I had a chronic back problem with stretched ligamnents...I am fixed...if you have time here is my story...BUT BEWARE....Prolotherapy is only as good as the doctor who diagnoses and treats you..it requires very accurate diagnosis and incredible skill, experience and a STEADY HAND...you have got to get a very long needle into the ligament..especially at the point it connects with the bone..I was very lucky that I picked the only doctor in the UK who had been doing it non stop for 35 years and had had the treatment himself 40 years ago...which was why he studied it !!

here you are.....
In response to anyone asking about experience with prolotherapy.
yes I have ! I am a ski instructor. I am now 44 but had the first treatment almost 2 years ago
The treatments were not painful - just a sensation of the needle going in - this depends entirely on the therapist and even then..there is a risk of hitting a nerve but that is ot too much to worry about - a qucik stab then you feel ok..the local anaesthetic and gas works a treat.
The treatment has been utterly successful and I would like to share my story - because there are some CAVEATs....read on.
I had a chronic lower back problem(which was basically slack SI ligaments and lumbar ligaments on lower right side...very common indeed) which I had been having treatment from 2 osteopaths for which would not heal - osteopaths who had cured me of all other aches and pains very quickly over the preceding 5 years - I was very confident in these guys so when they couldn't fix me I looked further.
I had xrays and MRIS done so I could see if there were any other reasons for my pain other than lax ligaments - the xrays and mris looked perfect - the traumatologists, osteopaths etc all looked at them and said the same - you look perfect...PERFECT...it's just a bit of hypermobility..it will go away...well after 28 months of NOT going away I was not going to just accept their answers...not just because they had letters after their names and nice white coats...oh no...not me....
I found prolotherapy on the internet and spent 1 year reseearching it every day - I asekd many osteopaths, orthopaedic surgeons - ones who were personal friends AND by going to see specialists at clinics in the UK and Spain and France....nobody that I spoke to had even heard of it !
Well...I can tell you that I wish I had not spent 1 year researching it because I wasted a year of my life by having to tolerate the pain - the prolotherapy was effective very quickly - I wish I had just gone to the doctor I found the first day I read about it !!! BUT...I was lucky....the doctor I saw does nothing but prolotherapy and had had the treatment himself 40 years earlier and as a result studied it and has been a leading practicioner for 35 years - I was lucky to find someone with this experience first time.
I have since learned - through more research and discussions with my doctor - that it is very clear that the success of prolotherapy depends on 3 IMPORTANT THINGS..
1) The skill and experience of the therapist - the therapist needs to be VERY skilled, sensitive and accurate
2) The actual solution the therapist uses - they are NOT all the same - each therapist has his preference - therfore one with more experience can judge what wrosk better.....for example...the solutions used in the US are often NOT as effective as the solution my doctor uses because many doctors are unwilling to use enough of the one of the irritant substances - which also happens to be an antisceptic - because it has in a very small numbers of cases caused temporary but painful side effects - this is apparently very very rare and often due to the inaccuracy of the therapist - as I am informed. The effectiveness of the treatment is clearly
governevd by how much irritant solution is used in each treatment - the more used the quicker and more pronounced the healing BUT there is a limit to how much the body will tolerate - do not forget the healing process is an immune response - prolotherapy provokes an immune response..or it should do if given correctly !
3) ACCURATE diagnosis....I knew what my problem was because I had felt it grow over the years and remember the final injury that provoked this particular injury - I had had lots of treatment with osteos, physios, etc during 15 years of sport - I could feel what the problem was - after a few little injuries you can recognise what type of problem you have.
BUT...to confirm I had the luxury of private health and so i just kept going to see different people - inclusing the main professional winter sports clinic in Barcelona - until I was satisfied I had the info. I went to see the prolotherapist in London with all my mris etc...he just laugheed and said.."I have seen your problem every day of the week for the last 35 years - almost everyone has this problem - I dont need these mris but thanks I will look at them for you...oh yes..as i suspected...you cannot see any problem...well you won't ! The SI ligaments will not show any damage on an MRI..the slightest stretching or damage to these can be very painful but you can't see it. Do you want me to treat you now or do want to mess around for another year ?"
He examined me and clearly demonstrated to me that one side of my pelvis was far more mobile than the other...my previous osteopaths had both diagnosed the same thing - and explained which ligamenst would be treated.... I started there and then...I had far fewer treatments than recommended - I was in the gym within 48 hours...skiing within 2 weeks...I am a ski instructor....I have to travel from Spain to the UK for treatment.
I had 3 treatments between nov 2005 and feb 2006....the problem was 95% resolved by the 3rd treatment...but i should have had a treatment every 3 weeks for about 6 months I reckon..it would have solved it totally and much quicker..i have since had 5 more sessions between may and oct 2006...the function of the joint was stabilised within 4 weeks of first session..my osteopath in Spain was astonished at the change and increase in stability of the right side....bearing in mind he had treated me for 5 years before and regularly had to realign my pelvis...since prolo he has never had to do that. The mobility/movement in the joints is now almost equal on both sides. That has been confirmed by the 2 osteopaths who are not connected to my prolotherapist - both of whom had seen me with the problem.
The pain had gone almost completely by the 3rd treatment..it had reduced to about 20% of original pain after the first treatment.
If I had to sum it up...I would say I am now 100% functional and pain free for 90% of the time..before I was in pain 90% of the time.
the other 10% I feel a slight sensation of stiffness - not PAIN - and this continues to reduce and occur less often..even without treatment...however..i stress...I would prefer to have had more treatments close together to be sure of eliminating the problem and strengthening the ligaments as much as possible..I will have another 3 or 4 treatments very close together when i can afford it just so I don;'t have to think about it for another 30 years !!
Is that enough of a postitve vote for prolotherapy when administered correctly and appropriately ????
Good luck...back pain is horrible..and in most cases TOTALLY curable...DO NOT accept back pain advice from doctors who have NOT suffered it themselves !!!! And do not accept it as part of growing old and something you have to live with. Ask your proltherapist lots of questions..how long have they been doing it, what solution they use etc....they are not all the same - but when you find the right one - you will be very happy !

[schnozzles]

Um. Thanks, Krunchie, I guess - but I think your agenda was more to do with publicising a particular therapy than actually helping with my knee. I do not have ligamentous injuries, nor do I suffer from either acute or chronic pain.

I should perhaps have mentioned that I live with a Shiatsu practitioner so my physical therapy needs are well catered for, it was more a medical reply I was after or advice on using a particular knee support.

[krunchie]

Hello schnozzles..no actually ...you are mistaken..i have no agenda..I am a patient..or was...I simply want to share my experience in case it helps others..if you have no problem then you don't need help I guess - but if you do have a problem with our kee - I know lots who do seeing as i am a ski instructor - I have seen people resolve their problems but naturally it depends on what the problem is..if you have stretched ligamnets a Shiatsu practicioner is probably not a lot of use but there we go.

[hopalong]

krunchie, who is this uk prolotherapy guru? i need his help..

[RayKon]

I'd like to know how to locate that "specialist". So much is linked to the specialist, how does one evaluate all those that claim to be that specialist.
My problem is living in the US. I can't make those trips to the UK.
I do appreciate your information. And, I agree on evaluation of who is treating you.
Ray