The health and fitness thread about random things

[DuncanM]

There are ways of stimulating the growth of cartilage, but they are never pleasant:
https://en.wikipedia.org/wiki/Microfracture_surgery

[simonp]

And you get hyaline cartilage rather than articulatar iirc, so it’s not anything like as good as the original surface and can only be used to repair small defects.

[DuncanM]

And it needs a big period of time off, and it's not enormously reliable. Maybe worth it if it can prolong your multi-million dollar career, but unless the rewards are huge I suspect the replacement type options are actually more palatable. Obviously the usual "not a doctor" caveats apply.

[chrisbainbridge]

microfracture surgery is really great if you are a sports doctor attached to a majorleague franchise or even a significant private practise.  I have read nothing which makes me think that it has the ability to really heal cartilage.  it will produce some blood clot and a scar, possibly cheap, useless hyaline cartilage in the laboratory animal.  Fundamentally it is placebo surgery for the patient and non placebo surgery for the surgeons wallet.

If I really thought it would help I would be doing it on all the arthritis patients I see every week.

[hellymedic]

I am surprised that hellymedic has not weighed in on this one. my understanding is that cartilage except in very young children does not regrow.  If cartilage could regrow we would not do joint replacement.

I have been minimally indisposed following a somewhat complex dental extraction and a visit to my aged parents yesterday.
Abnormal service will be resumed when I can be *rsed.

[chrisbainbridge]

I have been minimally indisposed following a somewhat complex dental extraction and a visit to my aged parents yesterday.

Sorry to hear that.  Hope you are better soon. 

[hellymedic]

I'm fine! Thanks!¹
I have just spent somewhat less time on this computer because of Real Life.

1) Don't seem to need analgesics, not bleeding, minimally fatigued.

[Charlie Polecat]

microfracture surgery is really great if you are a sports doctor attached to a majorleague franchise or even a significant private practise.  I have read nothing which makes me think that it has the ability to really heal cartilage.  it will produce some blood clot and a scar, possibly cheap, useless hyaline cartilage in the laboratory animal.  Fundamentally it is placebo surgery for the patient and non placebo surgery for the surgeons wallet.

If I really thought it would help I would be doing it on all the arthritis patients I see every week.

I thought so too, but my ortho docs assure me cartilage regrowth is a thing of myth perpetrated by quack on-line sites. Once cartilage (meniscus) goes, there is no turning back the clock. I wish it were otherwise. I have a titanium knee and it is likely the other knee will need the same in time to come.

[DuncanM]

Articular cartilage != meniscus.
The first one lines the ends of the bones to provide a low friction surface (hence the theory around microfracture producing a clot on the end of the bones).
The latter appears in 2 C shaped plates near (hanging off?) the collateral ligaments and stabilise and cushion the knee bones.

I've torn my medial meniscus twice and have (recurring) kneecap tracking issues that inflame the articular cartilage on the back of the kneecap (plus MCL and ACL tears). Hence an amateur interest in knee injuries and their treatment...

[Kim]

Don't seem to need analgesics, not bleeding, minimally fatigued.

Mental note:  Hellymedic's used up all the dental karma.  Avoid eating hard foods for a while.

[hellymedic]

Don't seem to need analgesics, not bleeding, minimally fatigued.

Mental note:  Hellymedic's used up all the dental karma.  Avoid eating hard foods for a while.

Rejected salads at lunch time. Was fine with Ruff Nut and Kit Kat.

Will be dining with Brent Cyclists later. Reckon most Indian veggie foods will be OK and there's always Lassi & Kulfi!

Might take a couple of Vit I before I leave the house; might not bother.

I have NO discomfort if I don't bring my teeth together.

I have every intention of taking things a bit easy and half-following the dentist's advice. (He suggested 48 hours analgesics and they've been tapered. Leaflet stated 'no rinsing 24 hours' but advised keeping other teeth meticulously clean. I brushed & flossed elsewhere, then swilled GENTLY.) Some advice is somewhat contradictory!

Extraction was a lower tooth but it seems upper teeth complain most on chewing; Suspect cantileverage!

[Kim]

I can go home with a surprising amount of pain simply from having my jaw held open for prolonged prodding-about.  I had TMJ problems as a teenager, which cleared up when I reached adulthood (I assume due to reduction in stress), but it's never been entirely happy about that sort of thing.

This, combined with the pain of evaporative cooling when they use suction means the hygienist doing their polishing thing can be at least as traumatic as actual dental surgery, sometimes more so.

[BrianI]

And it needs a big period of time off, and it's not enormously reliable. Maybe worth it if it can prolong your multi-million dollar career, but unless the rewards are huge I suspect the replacement type options are actually more palatable. Obviously the usual "not a doctor" caveats apply.

In my case I had microfracture of the retropatella with  12 weeks off work on crutches recovery(surgery november 2015). So far it has been successful, considering I'm employed as a postie walking upwards of 10 miles a day.  A shame it seems my left knee is now going the same way...

[chrisbainbridge]

No pain at all?

That is the great thing about a good placebo.  It carries minimal risks and the patient gets better.

[hellymedic]

Put the Vit I in the wheelchair's back pocket, where it remained untroubled until my return home, when I put it away. I have no sensation of even minimal mouth discomfort so see no point in any kind of medication. The Vit I that I took yesterday expired over 5 years ago. I take these things at the drop of a hat, really I do but isn't very often!
The lassi was so thick that the straw stood up by itself and I ate so much other stuff there was never room for kulfi!
I am FULL, pain-free and happy - which can't be bad...

[hellymedic]

I seem to have meralgia paraesthetica on both sides, left worse than right.
I initially thought this was an MS thing.
I do not possess jeans of any sort, never mind skinny jeans.
I am not obese.
I have not lost weight recently.
I only wear my bumbag when I go out and don't stand at all then.
Excess exercise is not a factor.

It is possible my trousers might be a bit tight over the kips and thighs when I sit.

Think I'll go back to BIG trousers...

[DuncanM]

Bah. I was shovelling snow earlier, and I kicked at an annoying bit with my left foot.  It didn't move, but my knee twinged. I continued shovelling as if I didn't then I couldn't get out of my close, and it didn't hurt. Now it's sore, and feels just like when I've tweaked my MCL before. My left knee is supposed to be the good one.

I had managed to do 9 weeks of uninterrupted Trainer Road training. Since then I've had a week off because no energy, then a cold, now a bad knee (and if it's MCL then it'll be sore for 4-6 weeks). Back to square 1.

[T42]

Sympathies.  I had a jolly time shovelling snow yesterday, then an hour later sciatica said "wotcher!" in cheery tones.  Didn't stay long but it's hanging around outside, just waiting.

Then it rained like buggery and the snow's gone, apart from the odd heap.

[simonp]

Frustrating, isn't it?

I came down with a cold, and injured my wrist, within a day of each other. On 2nd October, my CTL was 65. By 10th November I'd managed to train twice and my CTL dropped as low as 26 as I started ramping back up on the 17th. My CTL will only recover to 39 by this Friday, after 4 weeks, so it will likely be February before I'm back where I was 4 months previously.

=> I hope that you recover from your cold faster than I did and that your knee isn't as badly hurt as you fear.

[hellymedic]

I'm not too good with abbreviations, sorry!

What is CTL?

[simonp]

I'm not too good with abbreviations, sorry!

What is CTL?

Chronic training load. It’s a measure of accumulated training stress (ie fitness). Its corollary is ATL (acute training load) or fatigue. When you do a workout both CTL and ATL metrics increase. But when you rest, ATL drops faster (as in tapering or during a recovery week).

This can be plotted over time. https://flic.kr/p/213wq26

The blue is CTL, purple is ATL and yellow is the difference between today’s CTL and yesterday’s ATL which is form. The big spikes in ATL are long Audax rides.

The far right of the graph is in the future so includes some planned training I’ve entered. I’ve entered up to the end of the recovery week at the end of my current training block.

[DuncanM]

Frustrating, isn't it?

I came down with a cold, and injured my wrist, within a day of each other. On 2nd October, my CTL was 65. By 10th November I'd managed to train twice and my CTL dropped as low as 26 as I started ramping back up on the 17th. My CTL will only recover to 39 by this Friday, after 4 weeks, so it will likely be February before I'm back where I was 4 months previously.

=> I hope that you recover from your cold faster than I did and that your knee isn't as badly hurt as you fear.

That sucks. I don't know how to calculate CTL - TR shows that my weekly TSS has been between 170 and 260 (with the exception of the rest week and the cold week).
My cold has abated without really getting going, and my knee is sometimes sore but not excessively painful.  My hamstrings and glutes are still super tight and sore. I'll give it all a test tomorrow (though I don't think Kaiser is the ride to do it with - might just skip to Lamark and dial it down a bit!). I think that will then illustrate whether I can ride with this knee or whether I'll have to wait until after Christmas...

[simonp]

CTL is, I think expressed as TSS/day so eventually a weekly TSS of 280 would stabilise with a CTL of around 40, I think. It's a longer term rolling average than weekly, though.

[matthew]

What's Total Suspended Solids got to do with training. Health I can understand as you end up with poorly treated water (be it potable or effluent). 

[mrcharly-YHT]

MrsC has been on 3 months of injections to prep her for a major op.

Just been for her pre-op and the injections have sent her bp sky-high (she normally has low BP).

187/91

Op might get postphoned now.
Since this is a known side effect might it have been a good idea to have checked her BP over the last 3 months?