I’m currently experiencing some knee inflammation I believe attributable to overuse (i.e., squatting). In addition to stim and ice, has anybody found supplemention of any kind to be effective for inflamed joints? I consistently take high-quality fish oil (Omegabrite, six grams/day) and Evening Primrose Oil (270 mg. GLA/day). What about MSM, Glucosamine Sulfate, medicinal mushrooms? Any success with any form of supplementation? Thanks in advance.
Bob Tomlinson
I had a little tendonitis and inflammation in my knees before. One thing is if at all possible give it a little time to rest. You can still do exercises such as various forms of deadlifts but I would recommend that you take a brief break from squating. Also if you are already not doing so, you might want to do all your tempo/conditioning work on grass or a similar soft surface as this will cut down on the pounding that your knees take.
Glucosamine/msm/chondroiton seemed to work. Nothing miraculous but it definately helped. I would also imagine that like you said the fish oil should work to help with the inflammation. By the way just out of curiosity, what are medicinal mushrooms?
The product (mushrooms) I am referring to is made by New Chapter (Mycomend) and includes different species of mushrooms that supposedly help reduce joint inflammation.
The pain is accompanied by some swelling on the lateral side of the knee. I’m curious, how long before the glucosamine/chondroitin/MSM cocktail take to work? Thanks in advance.
Bob Tomlinson
I presume quite fast - but as far as ‘feeling’ anything I recall it talking about 3 weeks for MSM.
The others you don’t generally feel anything.
edit: Just checked notes - in human studies with Gluc., symptoms can start to ease after even 7d.
3-6 weeks.
yeah I would say this is about when I started to notice it too.
O.K.-
Last night things got noticeably worse. Some background, I am 47 yrs. old and have had 12 knee surgeries. ALL surgeries were performed during a period when I was doing alot of middle distance running and NO squatting. In addition, I have’nt had any problems in over 20 yrs.
The knee is now very swollen and the pain is acute at the top, inside medial area of the patella. The pain is excruciating when I lower into a squat position with bodyweight. I am not aware of serious knee problems that can arise through the performance of a well executed squat. My technique is deep and very good. Does this sound like tendonitis or could it be something more severe? Thanks in advance for your help.
Bob Tomlinson
well first let me say that I am not a doctor or a physical therapist so take my suggestions with a grain of salt. I had something somewhat similar to what you are mentioning back in high school(apparently 240 lb guys are not built to run 3+ miles a day on hard surfaces, thanks alot coach :mad: )
The biggest suggestion I could give you is switch from doing squats to doing deadlifts or one of its derivatives(eg. romanian deadlifts, good mornings, etc.) for a while. This way you still get the general strength needed in the posterior chain but without as much possible stress on the patella tendon. At least for me this seemed to work. If it is needed, most of the hypertrophy and strength in the quadriceps can be at least maintained by ems. You probably will want to ice the irritated area after workouts as well to keep any swelling down to a minimum.
Keep with the Glucosamine/chondroiton/msm and fish oil for a month or two and if your knee is feeling better then try squatting again. If that still doesn’t work you might possibly need a knee scope(arthrescopic(sp) surgery) to get rid of any torn cartilage that could be irritating the patella, although again, I am not a physical therapist or a doctor so it would probably be better to consult with one of them before making any decisions such as surgery.
I would consider this a last case scenario though cause I don’t know about you but the last thing I want to do is go under the knife if it can in any way be avoided. Try all other means first, but if nothing else is working look into it. I know some guys who had previous knee problems such as torn ligaments and they felt that they needed the scope and felt better afterwards.
Any of the sulphates should assist in pain relief and movement in general,
but they are not dramatic pain relivers as they must gradually accumulate in the system.
So the variation in experienced effect is dependent on the levels in the body.
I would expect you are talking fish oil, so I would expect you to have the benefits of its inflamatory response already.
With Tendon injuries pain relief is best achieved with rest and minimal movement.
But treatment to the muscle is also needed to relieve muscle tension and tendon stress.
From your description it could be a number of things such as full (or a version of chrondomalacia patella (sp)), misalignment or crepitus under the knee cap.
It could be a simply a tendonus injury of the patella tendon too.
I have other suspicisions also - but I can’t really assess this on-line.
My (internet) advice is rest improve flexibility and muscle tone and see a therapist.
I would avoid strengthening for the time being and reduce volume.
I would not reccomend EMS considering the number of surgeries espcailly if you have metallic pins etc inserted.
To be honest that apart as you can appreciate - I won’t give anymore advice because without seeing you it’s just like picking a number out of a hundred.
(If you want to drop me a pm feel free)
Try the exercises for knee pain here:
http://www.egoscue.com/htdocs/global/where_pain.asp
If you can’t do 'em then at least you have a clue why your knee has been getting worse despite all the surgeries and PT.
I want to thank you guys for taking the time to post responses to my questions. First off, I lease three ARP’s (EMS) and began aggressively stimming the knee (two fifteen minute sessions/day; 7.5 minutes normal polarity, 7.5 minutes reverse polarity) taking as much voltage as I could tolerate. During my second session I was able to get the machine turned up “all the way” which is almost unbearable. With the ARP waveform it is possible to put the joint in motion during treatment which I accomplished by performing four bench squats, resting and turning up the machine, and continueing until I could not tolerate the discomfort.
After two sessions the knee was noticeably better with the pain decreasing and actually shifting from the superior aspect of the patella to the patellar tendon area. After four treatments I was able to perform bodyweight squats almost pain free. Yesterday (Sunday) I ignorantly performed three sets of three back squats with 255 lbs. (1 rep max is roughly 420 lbs. slightly below parallel). The squatting was painful but possible. I know this effort was ill advised.
Today I went to see my orthopoaedic and he diagnosed Chondromalacia (sp) which is what Fergus anticipated. I still have about 6.7 mm of cartilage under the kneecap which is better than I expected. The physician felt fluid on the knee which he drained (roughly 50 ccs) and gave me a shot of cortisone. His recommendation is to lay off squatting, etc. for two-three weeks and then recommence slowly. The knee is relatively pain free at this point, now doubt due to the local pain killing agent that precedes the corisone shot. All in all I’m very grateful things arent more serious. My only regret is that I did’nt have him look at my right knee which is also providing me with some pain (identical in nature to the left) but not nearly the magnitude.
I know the ARP has been dicussed a little bit on this forum. Very expensive technology but incredibly effective. I have never used the Comdex or any other commercial units so I can’t compare but looking at the specs (nature of wave form aside) the ARP is substantially more powerful than the comdex (0-2.5 watts) and pulsates up to 500 pps. I’m not sure if the waveform provided by the Comdex allows the treated area to be put in motion or not (without undue lack of coordination, etc.) but the ARP allows joint movement very easily which increases the depth of the penetration achieved. In addition, this feature makes it possible to perform FES (functional electrostimulation),i.e., using the technology during resistance exercise. If any of you guys has any experience with EMS I would love to hear what technology you are using and how happy you are with it.
Thanks again for taking the time to respond to my situation.
Bob Tomlinson
What knee surgery was performed? do you have a pin in your knee? If so EMS can cause bone necrosis around the pin. Let us know.
Chondromalacia can be treated by underwater ultrasound. (The fluid medium allows the sound head to be aimed under the kneecap with good results.)
That is great to hear that it is nothing too serious. Speaking of the ARP, what exactly are the benefits as far as doing it while performing an exercise? I understand that it can reduce swelling/inflammation and allow the muscle to relax. I guess I just do not quite know what it specifically does.
I know that in regular EMS, there is a isometric contraction. From what previous threads on the forum have said, the ARP device puts the muscle into an eccentric contraction. What benefit does this have while performing exercises? Any input would be greatly appreciated as this is an area that I do not know alot about.
Bob - thanks for the feedback, and best wishes with the treatments.
Charlie, no pins; all surgeries involved removal of loose bodies floating in the knee. The ultrasound sounds appealing in that the treatment seems very precise in terms of location. With the stim I’ve been placing the electrodes on the VMO (positive) and vastus lateralis (negative). As mentioned, this has been pretty effective. The ARP wave tends to travel somewhat and is not strictly local.
OK good. Depending on what you want, the contraction tends to be strongest around the neg lead so you might want to reverse the pads on occasion to concentrate on the VMO (of course this will be more painful!) As well, you should be working the hamstrings with the ARP (neg lead higher up!)
The ARP does’nt actually “put the muscle into eccentric contraction” it simply allows eccentric contraction to take place. I don’t believe galvanic and/or interferential wave forms permit eccentric contraction although I’m certainly not the last word on that.
I’ll give you my take on the benefits of using the ARP during resistance exercise (although Jay Schroeder may very well have an entirely different position). The ARP is able to recruit significantly more motor units than the trainee can voluntarily recruit. As a matter of fact, using stim is the method Zatsiorsky indicates as the only reliable method of determining the strength deficit. As an example, we can hook up the hamstrings (bilaterally) and perform an RDL and recruit far more motor units than would be possible with the same weight w/o the stim. In addition to the maximum recruitment of MUs, stim preferentially recruits fast twitch fiber, i.e. recruits fast twitch fiber prior to slow twitch. Now imagine recruiting all available MUs with the fibers contracting 500 times/second. Thats’ quite a stimulus. I believe the Comdex units contract a muscle maximally at 50 times/second.
I think the question becomes how to establish the optimal training protocol employing the ARP? I know Schroeder has some specific ideas and I plan on spending some time with him next month. Candidly, at this juncture I have no idea how to optimally use the ARP during weight work. I experiment regularly but have not yet been able to quantify the benefits nor determine optimal protocols for developing a specific motor quality. If Charlie or anyone else is doing any of this, I would love to hear about it.
Bob Tomlinson
These points apply to all stims and the “pulse train” is determined by the hertz, with an effective max contraction occurring once tetany is achieved (approx 20 htz on up) I personally feel that a htz no of 80 to 120 is the most comfortable (thus ensuring compliance in achieving the max contraction). Most stims, other than Interferential, interfering at 2000htz per side, don’t go nearly that high because it would drain the batteries they use within minutes. (I assume that the ARP is plug-in?)
I’ve posted an article on EMS on the front of the site (somewhere!!)
I know the use of EMS will prevent strength loss and encourage nutrient healing etc - but should the focus not be more on reducing muscle tension and cartilage regen?
EMS can help with stability.