Gla:d program for knee arthritis

earlnabby wrote: »

33gail33 wrote: »

I am 56 and active up until the last 2 months due to my knee being *kitten* (arthritis). I am now limited to riding spin bike daily for 10-30 minutes (with lowest tension) and some seated upper body dumbbell work - walking, swimming, mountain bike, kayak, yoga, heavy lifting are all a no go due to severe pain/locking/popping/loss of mobility. I can't extend or bend my knee (range of motion is 15 - 90 ish degrees) and I can't kneel or get up off the ground, and I now walk with a noticeable limp.

I've had a physio assessment which indicated significant loss of strength on the quads, glutes and hamstring on that side and booked for an 8 week Gla:d arthritis program beginning next week. Wondering if anyone has done that particular program and what to expect with regard to being able to rebuild some strength? Is there anything else I should be doing within my limitations that I haven't thought of?

I am booked for an MRI next month and still hoping there is some meniscus or cartilage problem that didn't show up on Xray/ultrasound that can be repaired, but preparing that it might just be a progression of arthritis, and this is how it is going to be until I can get a joint replacement. It sucks to have such a sudden and extreme loss of mobility at my "relatively young" age - suggestions on how to get through/live with this are welcome.

What is this program? I am in line for an eventual knee replacement and just received my first cortisone shot last week (HUGE improvement!!). I need to improve my BMI before they will consider surgery which will also give me time to strengthen the muscles in order to increase the chance of successful surgery.

MikePfirrman wrote: »

I was told 15 years ago that I desperately needed a total knee replacement. I had like maybe 25 degrees range of motion and shredded the meniscus off the bone. Was told I'd have severe arthritis for life in that knee.

I still have the same knee. No pain, full range of motion. I'm not sure when, or if, I'll get it replaced. I've had one guy, that specializes in rich platelet therapy tell me, if he were me, he'd go that route instead since I have full ROM now.

I just did what I could for two years after my knee dislocation. Sometimes it was just a few revolutions on a bike. I now row on a machine an hour at a time, I can ride an Assault Bike for an hour, no problem. I can walk for miles with no pain. I can't jog or run anymore, so what (though I did love it).

I do struggle with barbell work -- feels like the knee will basically destruct under heavy pressure -- but I do what I can with machines and heavy kettlebells (I use a 70 lb KB for swings, I worked up to that very gradually).

Like Chief said, our bodies, even damaged, love to move more than they like to stay inactive. You'll have immensely more pain doing nothing or limiting yourself. Sometimes you have to play around to see what hurts and what doesn't. Things that used to be off limits for me are no longer off limits. Just one example, Bulgarian Split Squats I can do now -- not hardly any weight, but still, that's a huge win for me.

I'm around your age (57 next month). Even if you have to get a joint replacement, movement now will help immensely with that recovery. I'll be honest, the only folks that I know that haven't had any issues with joint replacement were folks that were VERY active to start. 40% of joint replacements don't go well. I have two siblings that have had terrible times after joint replacements. One with a hip and she still can't walk and the other with a knee that hurts more now than it did before. Joint replacements are not a guarantee of being pain free, contrary to what docs tell you.

Chieflrg wrote: »

33gail33 wrote: »

Chieflrg wrote: »

I have a autoimmune disease that attacks my joints, tendons, and organs with chronic pain 24/7. I walk with a cane at times and also professional train others of all types of issues that are challenging. I can't comment on the program you are about to use, but if you haven't trained in months I expect any program to deliver some strength gains.

Any training now and in the future would be enhanced for long tern utilizing both proper load management and auto regulation. Sometimes we may be limited in range of motion or the ability to perform certain exercises, the trick is to find what we can do within a well written program.

Here is a pic of me exactly one week after I literally couldn't walk because my left knee was too swollen and painful. Training is better than not, as long as it is useful stress we are dosing.

Interesting - I know for me there is a factor of "fear" as well. I mean the pain is bad enough, but when it hits there is also that fear that my knee is about to "blow". I have chronic pain and swelling which I can live with, but what scares me is the sharp popping/locking pain - when that hits it's like a knife behind the knee cap and if I had full weight on that knee I would probably fall. But that thankfully is down from a few weeks ago when it was happening 50 ish times a day, to just occasionally now. I was doing heavy (ish) for me weight training in the spring but I feel like I have lost any gains now - I think probably best if I start back with this program and then when I graduate continue on to something more intense. It is so frustrating to have to keep starting over.

I think I need to get more mobility back before I trust lifting heavier - my knee right now I am unable to straighten and being constantly bent it just doesn't feel secure to me. Does that happen to you? Maybe this program will give me more mobility.

Yes the "fear" is even there for people that aren't experiencing this. That is why it's ideal to keep you performing a ROM with a intensity you can handle confidently for a exercise you can perform the task at hand. With goal of improving over time hopefully...right?

Yes the pain you describe was very similar to one of my knee caps probably from the swelling(doesn't really matter why but more than likely)....boy it is sharp like a knife....lol. The other knee is just "loose" from the deformity from the disease but I can usually reign technique to keep that in check and use spotters with the understanding if I have a problem where it will happen.

Yes you have lost the intensity of where you were in Spring, but hopefully things take a turn for the better you can get that back in appropriate time.

With any well written program that uses auto regulation and proper load management we expect to increase ROM and strength.

Working towards more ROM before increasing intensity is usually the way I dose training in these cases though it is based on the individual & how they are responding and recovering.

I don't know enough info on you to advise you other that what I have bolded. You need the correct weight, dosage of volume, at the best ROM you can perform confidently with the goal to improve over time. A careful eye by your medical team/trainer should be able to accomplish this and obviously follow your team .

I will also say "heavy" is subjective to the individual and his/her adaptations. Somebody's "heavy" might be 20kg or 300kg. I wouldn't concentrate on the number as much as what the actual stimulus is with the short and long term goals.

AnnPT77 wrote: »

kshama2001 wrote: »

AnnPT77 wrote: »

I'm late to this party, but: I have at least one torn meniscus (diagnosed via MRI), and I think I've torn the other one, too (feelz) . . . and suspect both were at least made more acute, if not fully caused, by running (not very much running, even). I do have some OA, not super bad I think, and some debris in the joint (presumably from the meniscus or OA). I was offered surgery (clean-up, first; with likelihood of needing knee replacement later whether I had the clean-up or not).

Things that have helped reduce discomfort, improve function:

* Cortisone shot: Just had one, which helped me feel enough better that I could do . . .

* PT, focused on helping me learn to walk and especially climb stairs in ways that would reduce knee stress. (PT assessment found my muscular strength was OK, or we would've worked on that, too. I was not new to exercise at that time.)

* Weight loss - huge improvement. Maybe the single biggest persistent improvement, for me. One of several reasons I prefer to be on the lower-ish side of normal BMI range (around 21 +/1), a thing that's OK for my skeletal configuration.

* Experimenting to figure out what types of exercises made things worse in a persisting way, and avoiding those (I still do some that don't feel great while doing them, but that don't seem to make things head downhill further over time). I think this will vary by person, but I find I can do things that involve strong, straight-line pushing (rowing, cycling), but need to avoid high impact (running, high-impact dance-y things); most things with fast-break moves (say, running games like tennis or basketball); or things that involve turning on a weighted leg (some of the game type stuff, some martial arts).

* Good shoes, not too worn out, for longer walking especially.

* Experimenting with sleeping positions, pillow props, etc., to minimize nighttime discomfort, maybe improve sleep quality.

* I say this next with trepidation: Acupuncture, which I did briefly, but with good effect. I'm not usually suggestible, but the science to support this is poor to limited, so 🤷‍♀️.

* The stronger I get (without causing more injury), the better.

* To a limited extent, paying attention to balance, both balanced muscular strength, and unbalanced tightness (stretching or massaging/foam rolling things that get too tight), in the knee-related muscle groups.

Totally subjective experience, no proof, just my opinions, blah blah blah.

Oh, this caught my eye when it was mentioned it on the stairs thread. I see my PT Monday and will have to remember to ask her about it. She has 5 stairs in the PT room and I've added a reminder in my phone.

Hope you learn something useful. You may be doing it right. I wasn't. I assume there could be multiple ways to do it wrong, too. 🙄 I needed to push from the bottom leg more, pull from the top leg less.

earlnabby wrote: »

33gail33 wrote: »

AnnPT77 wrote: »

kshama2001 wrote: »

AnnPT77 wrote: »

I'm late to this party, but: I have at least one torn meniscus (diagnosed via MRI), and I think I've torn the other one, too (feelz) . . . and suspect both were at least made more acute, if not fully caused, by running (not very much running, even). I do have some OA, not super bad I think, and some debris in the joint (presumably from the meniscus or OA). I was offered surgery (clean-up, first; with likelihood of needing knee replacement later whether I had the clean-up or not).

Things that have helped reduce discomfort, improve function:

* Cortisone shot: Just had one, which helped me feel enough better that I could do . . .

* PT, focused on helping me learn to walk and especially climb stairs in ways that would reduce knee stress. (PT assessment found my muscular strength was OK, or we would've worked on that, too. I was not new to exercise at that time.)

* Weight loss - huge improvement. Maybe the single biggest persistent improvement, for me. One of several reasons I prefer to be on the lower-ish side of normal BMI range (around 21 +/1), a thing that's OK for my skeletal configuration.

* Experimenting to figure out what types of exercises made things worse in a persisting way, and avoiding those (I still do some that don't feel great while doing them, but that don't seem to make things head downhill further over time). I think this will vary by person, but I find I can do things that involve strong, straight-line pushing (rowing, cycling), but need to avoid high impact (running, high-impact dance-y things); most things with fast-break moves (say, running games like tennis or basketball); or things that involve turning on a weighted leg (some of the game type stuff, some martial arts).

* Good shoes, not too worn out, for longer walking especially.

* Experimenting with sleeping positions, pillow props, etc., to minimize nighttime discomfort, maybe improve sleep quality.

* I say this next with trepidation: Acupuncture, which I did briefly, but with good effect. I'm not usually suggestible, but the science to support this is poor to limited, so 🤷‍♀️.

* The stronger I get (without causing more injury), the better.

* To a limited extent, paying attention to balance, both balanced muscular strength, and unbalanced tightness (stretching or massaging/foam rolling things that get too tight), in the knee-related muscle groups.

Totally subjective experience, no proof, just my opinions, blah blah blah.

Oh, this caught my eye when it was mentioned it on the stairs thread. I see my PT Monday and will have to remember to ask her about it. She has 5 stairs in the PT room and I've added a reminder in my phone.

Hope you learn something useful. You may be doing it right. I wasn't. I assume there could be multiple ways to do it wrong, too. 🙄 I needed to push from the bottom leg more, pull from the top leg less.

I "twist" my foot when stepping up stairs, or getting up from a chair, etc. I learned that on my last physio go round, like she was watching me and I will be sitting there with my feet aligned and as soon as I go to stand up I automatically move/twist it. It's weird the unconscious adaptations we make to compensate for pain, that we have to pay attention to undo.

Thanks for sharing your experience - I think you are about 10 years older than me and I hope to stay active for at least the next 10 years and beyond.

In 2001 I was trekking in Nepal and fell. I landed where a rock hit me right in the lower left back which slightly tipped my iliac. Long story short, I was walking with a twist which caused problems in my knee. When I started PT, the doctor had to order separate "prescriptions" for the hip and the knee but the therapist treated the entire left leg. It is all interconnected.

snowflake954 wrote: »

33gail33 wrote: »

Saturday I over did it and my knee locked up completely, severe pain, then around 5AM I rolled over in bed felt a pop and it unlocked and went back to "baseline" ROM. Weird.
Last night I tripped over my dog and fell hard on my bad knee (and face ), so it is battered and bruised but didn't seem to do any real damage.
Had my first session this morning - mostly bands and body weight type stuff - got through it OK. Left glutes are super weak so have to concentrate on making sure to engage them in the exercises. Also enrolled as part of a study where they will track my progress and follow to see when/if participants in this program end up getting knee replacements and if it helps to prevent or delay that - so that's interesting.

Can you do any of this stuff at home? Like alternating days? Once I learn how to do exercises I incorporate them in my home routine, if they are useful.

AnnPT77 wrote: »

33gail33 wrote: »

Saturday I over did it and my knee locked up completely, severe pain, then around 5AM I rolled over in bed felt a pop and it unlocked and went back to "baseline" ROM. Weird.
Last night I tripped over my dog and fell hard on my bad knee (and face ), so it is battered and bruised but didn't seem to do any real damage.
Had my first session this morning - mostly bands and body weight type stuff - got through it OK. Left glutes are super weak so have to concentrate on making sure to engage them in the exercises. Also enrolled as part of a study where they will track my progress and follow to see when/if participants in this program end up getting knee replacements and if it helps to prevent or delay that - so that's interesting.

I hope you'll be willing to update us occasionally on how it's going. I, for one, am really interested in non-surgical interventions that can help put off surgery, improving functioning, etc.

Glad to hear you had a positive pop, and the fall didn't cause any major damage. Bodies are weird!