I am getting to a better place and acceptance to be able to talk and share about my visit with the rheumotologist .
A little back history:
I have had knee pain in my right knee for sometime now. Actually ever since my ACL surgery over 10 years ago, my knee has really never been the same and has cause me problem since then.
I have had multiple surgeries on my knee in addition to my ACL including exploratory and meniscus repair.
With that, I have always been told that arthritis in the knee was inevitable-I just thought and hoped that it would happen later in life.
Well it didn’t and the reality is that I have severe arthritis in my right knee and the Dr. has strongly recommended that I no longer run long distance races.
I can’t tell you the devastation I felt when the Dr. uttered those words. I literally broke down crying in his office (I totally freaked him out-he didn’t know what to do-blesss his heart!). Even as I type this, I am getting teary eyed.
After training and running my 1st half in May 2014, I have falling in love with the half marathon distance. I like that it is a distance that is just long enough that it push me through my comfort zone and requires some degree of structure and discipline to train for it. It saddens totally breaks my heart that after only a little over a year, I will have to stop running the race distance that I have falling in love with.
I have had some serious decisions to make as I have a fall running schedule that includes 2 half marathons and DC Ragnar (which will equal just over a half).
I have decided to run my scheduled races with modification in training and finish expectations and that my half in Dec, will be the last half marathon that I run.
Additionally, I will have 2 cortizone shots; one on October and one in December. The cortizone will significantly help with inflammation and pain and will allow me to run with significantly less pain.
So what does my future hold?
I will continue to run and race but at shorter distances mostly 5ks and 10ks. I am not going to rule out a 10 miler; specifically the Cherry Blossom but we will see. I have also decided that I will make the transition to biking and swimming which will lead to me participating in duathlons and sprint triathlons- both which will have running components but ones that will be manageable.
Here is a some information about arthritis in the knee that I found very helpful and informative. I found this information on: Orthoinfo
Arthritis of the Knee:
Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in the knee.
The knee is the largest and strongest joint in your body. It is made up of the lower end of the femur (thighbone), the upper end of the tibia (shinbone), and the patella (kneecap). The ends of the three bones where they touch are covered with articular cartilage, a smooth, slippery substance that protects and cushions the bones as you bend and straighten your knee.
Two wedge-shaped pieces of cartilage called meniscus act as “shock absorbers” between your thighbone and shinbone. They are tough and rubbery to help cushion the joint and keep it stable.
The knee joint is surrounded by a thin lining called the synovial membrane. This membrane releases a fluid that lubricates the cartilage and reduces friction.
The major types of arthritis that affect the knee are osteoarthritis, rheumatoid arthritis, and posttraumatic arthritis.
Osteoarthritis is the most common form of arthritis in the knee. It is a degenerative,”wear-and-tear” type of arthritis that occurs most often in people 50 years of age and older, but may occur in younger people, too.
In osteoarthritis, the cartilage in the knee joint gradually wears away. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can result in bone rubbing on bone, and produce painful bone spurs.
Osteoarthritis develops slowly and the pain it causes worsens over time.
There is no cure for arthritis but there are a number of treatments that may help relieve the pain and disability it can cause.
As with other arthritic conditions, initial treatment of arthritis of the knee is nonsurgical. Your doctor may recommend a range of treatment options.
Lifestyle modifications. Some changes in your daily life can protect your knee joint and slow the progress of arthritis.
Minimize activities that aggravate the condition, such as climbing stairs.
Switching from high impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) will put less stress on your knee.
Losing weight can reduce stress on the knee joint, resulting in less pain and increased function.
Physical therapy. Specific exercises can help increase range of motion and flexibility, as well as help strengthen the muscles in your leg. Your doctor or a physical therapist can help develop an individualized exercise program that meets your needs and lifestyle.
Assistive devices. Using devices such as a cane, wearing shock-absorbing shoes or inserts, or wearing a brace or knee sleeve can be helpful. A brace assists with stability and function, and may be especially helpful if the arthritis is centered on one side of the knee. There are two types of braces that are often used for knee arthritis: An “unloader” brace shifts weight away from the affected portion of the knee, while a “support” brace helps support the entire knee load.
Other remedies. Applying heat or ice, using pain-relieving ointments or creams, or wearing elastic bandages to provide support to the knee may provide some relief from pain.
Medications. Several types of drugs are useful in treating arthritis of the knee. Because people respond differently to medications, your doctor will work closely with you to determine the medications and dosages that are safe and effective for you.
Over-the-counter, non-narcotic pain relievers and anti-inflammatory medications are usually the first choice of therapy for arthritis of the knee. Acetaminophen is a simple, over-the-counter pain reliever that can be effective in reducing arthritis pain.
Like all medications, over-the-counter pain relievers can cause side effects and interact with other medications you are taking. Be sure to discuss potential side effects with your doctor.
Another type of pain reliever is a nonsteroidal anti-inflammatory drug, or NSAID (pronounced “en-said”). NSAIDs, such as ibuprofen and naproxen, are available both over-the-counter and by prescription.
A COX-2 inhibitor is a special type of NSAID that may cause fewer gastrointestinal side effects. Common brand names of COX-2 inhibitors include Celebrex (celecoxib) and Mobic (meloxicam, which is a partial COX-2 inhibitor). A COX-2 inhibitor reduces pain and inflammation so that you can function better. If you are taking a COX-2 inhibitor, you should not use a traditional NSAID (prescription or over-the-counter). Be sure to tell your doctor if you have had a heart attack, stroke, angina, blood clot, hypertension, or if you are sensitive to aspirin, sulfa drugs or other NSAIDs.
Corticosteroids (also known as cortisone) are powerful anti-inflammatory agents that can be injected into the joint These injections provide pain relief and reduce inflammation; however, the effects do not last indefinitely. Your doctor may recommend limiting the number of injections to three or four per year, per joint, due to possible side effects.
In some cases, pain and swelling may “flare” immediately after the injection, and the potential exists for long-term joint damage or infection. With frequent repeated injections, or injections over an extended period of time, joint damage can actually increase rather than decrease.
Disease-modifying anti-rheumatic drugs (DMARDs) are used to slow the progression of rheumatoid arthritis. Drugs like methotrexate, sulfasalazine, and hydroxychloroquine are commonly prescribed.
In addition, biologic DMARDs like etanercept (Embril) and adalimumab (Humira) may reduce the body’s overactive immune response. Because there are many different drugs today for rheumatoid arthritis, a rheumatology specialist is often required to effectively manage medications.
Viscosupplementation involves injecting substances into the joint to improve the quality of the joint fluid. For more information: Viscosupplementation Treatment for Arthritis
Glucosamine and chondroitin sulfate, substances found naturally in joint cartilage, can be taken as dietary supplements. Although patient reports indicate that these supplements may relieve pain, there is no evidence to support the use of glucosamine and chondroitin sulfate to decrease or reverse the progression of arthritis.
Have you experiences an injury that has changed your fitness/race plans and training? How did you handle it?
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