Knee Strain and Prednisolone

[Tonch]

Hi, I’m currently on around 5mg for PMR and are doing OK - from 15mg June. Unfortunately I have a slight case of ‘runners knee’ since a week ago. I’m a little concerned that taking Pred may slow healing and my return to serious running, so was thinking of reducing down quicker for a week or 2 even if it causes a temporary worsening of PMR? Thinking is that as I can’t run because of the knee anyhow, then stiffness will not be so much of a problem. Does this sound like a plan? Have a GP appointment to ask, but 2 weeks away!

[PMRpro Ambassador]

Have you been able to reduce below the current dose before? If not - is there anything that makes you think this week will be different given that injury actually often means you need more corticosteroid in the body to recover?

Simply reducing the pred suddenly won't lead to faster healing - the muscles and soft tissue require time to recover after longterm pred and now injury. Pred, even at above 10mg has never made any recovery of mine any longer, the doctors commented on how quickly I regained stability in a totally torn colateral knee ligament a few years ago.

[Tonch in reply to PMRpro]

Thanks - reassuring that levels of Pred I’m at are not likely to affect healing. Think I will leave it at 5mg for now and see how rest helps. Annoying because I have an important race on in 2 weeks time, but fingers crossed!

[Blearyeyed in reply to Tonch]

I'm going to sound very like a Mummy but sometimes you just have to accept that you need to put your overall long term health over short term goals.

The Pred will actually help you cope with the pain and inflammation from the injury anyway , and , as you have been on steroids for a relatively short time in comparison to other sufferers , and have maintained intensive training during your recovery , it would not have the same effect on recovery time as it would for other long term sufferers .

Trying to Push it to take part in a race before the tissue damage has had appropriate time to heal is more likely to lengthen your full recovery time and return to full " Match Fitness" and running times than your medication would.

Give yourself time to heal

[Yellowbluebell]

Sorry but my thoughts are why would you risk making both your knee and pmr worse just so you can run sooner. Ridiculous!

[Tonch in reply to Yellowbluebell]

I don’t post on here to be trolled Yellowbell. If you can’t comment without abusing me then don’t comment! I don’t ridicule your posts. I simply wanted to know if reducing Pred would help promote recovery st the cost of extra stiffness - a perfectly reasonable enquiry.

[Hidden in reply to Tonch]

You do realise that over exercise is most likely the cause as your muscle and tendons are effected by pmr and pred. That is why we advise lowering the intensity and length of exercise. For healthy people the period of not running or doing weight bearing through the knee is often 4 to 6 weeks. When I had bursitis 2 years ago I had to RICE for at least a week. I tried being active then and 2 days later ended up with a knee that took 6 weeks to even start feeling OK when walking. The idea that you would risk a flare to keep running on an already damaged knee is ridiculous I am afraid. The quads will most likely have lost strength because of pmr so building then up when the blood supply is potentially reduced from vasculitis means taking more care, rather than running faster times artificially enhanced by pred. The reason we may seem a bit fed up is we have spent hours giving you advice and much of it was ridiculed or dismissed. In the end directness was the only way you seemed to take any account of our experience as a forum. Given the mouthful and attitude you had to me it's rich you calling someone a troll. Ask a silly question....

[Yellowbluebell in reply to Hidden]

His behaviour to you was unacceptable. Strange he seems to have forgotten this!!

[PMRpro Ambassador in reply to Tonch]

I really don't think that could be classified as trolling - having been subjected to some very interesting sorts myself.

However - I think you do need to look at the other replies you have had and really think about your relationship with PMR, pred and what you want to do. You are by no means the only person on this forum who has been faced with giving up something they love doing because of ill health or injury. If you go about things properly you are more likely to be able to follow Skinnyjonny's example and get back to running, But forcing the issue when you have soft-tissue injury could result in having to give up running altogether.

[Blearyeyed in reply to PMRpro]

Absolutely spot on , and the same advice that my Physiotherapist gives to his clients , many of whom he has managed to help return to Professional Sport in both Football and Triathlon.

You don't push it , or work through it , you allow the body to heal at its own pace and build up your exercise accordingly as the body can cope with the activity to the level the body can sustain.

Muscle Stress from over exertion causing gradual weaknesses is often the root cause of Sporting injuries.

Quicker recovery times and less repeat injuries come from balance.

[Yellowbluebell in reply to Tonch]

I am doing anything but trolling you and i take offence to your comments. If you think this is a suitable route to take thats fine but i wouldnt want the other users of this forum to think this is something we would reccomend they do.

You know that pred and pmr affects your muscles and as a runner i am sure you know the dangers of pushing on through pain and stiffness. Not a good idea without pmr but dangerous with it. Your body needs rest not more strain. You have made it more than clear over the months that you are quite rightly reading anything and everything about your condition so i was aghast at your thoughts that just dropping pred was a reasonable action to take.

[Darcy2000 in reply to Tonch]

Saying “ridiculous “is not being trolled... a bit abrupt granted but some folks are just that way

[Tonch in reply to Darcy2000]

I would NEVER say that another’s post was ridiculous whatever my private thoughts. it is rude, and disrespectful.

[Darcy2000 in reply to Tonch]

I beg to differ ..sometimes statements are ridiculous maybe not in this case but that is not a trolled word but

An honest thought on what was being stated

[Hidden in reply to Tonch]

Please don't accuse others of such things. You have said much worse to people (me) when I made a serious point about how your post lacked consideration and empathy to other members and the problems they were having with mobility. You said me asking you to be more compassionate was quote "making you feel suicidal". Despite you 'shouting' at me, I did post you numbers and addresses of the samaritan and asked you to seek counseling.

I asked if you could consider discussing running issues with another group and you said.. " I don't care at all what you say 'an along the line that I could stop talking as I said was f***ing worth nothing. Despite the, shouting at me, , I did post you numbers and addresses of the samaritan and asked you to seek counseling.

After the comments about suicide you deleted your comments and wrote a message saying you always got too aggressive and found it hard to climb down. You then deleted your ToncCh account.

When you returned as paulBut we thought you should be given a chance because of pmr. It felt like a backward step as the injury is exactly one of the kind we feared, if you keep running (especially if running faster times.).

Obviously illess can affect peoples sense of humour or they may loose sense of other people suffering. Ridiculous is a nothing way of tell you you need to be more sensible if you want to be fully mobile the rest of your life.

[Blearyeyed in reply to Tonch]

I think it's probably worth trying to consider trying to remain calm and keep perspective when reading replies and receiving the advice or opinions you ask for.

If a comment makes you angry , allow yourself time before you answer it then read it again.

Our initial reactions to some straight talking can be very different to how we feel about what is said a few hours after and we have had time to digest what is being said as a whole in a number of replies.

Otherwise , you can fall foul of losing the point of why you posted in the first place , to get vital advice by losing its importance in our reaction to hearing that others disagree with our behaviour .

Straight Talk can feel like a sting , it's not nice to hear that our efforts are being judged as inappropriate, sometimes getting angry with people's comments is a way we mask feeling angry with ourselves for making mistakes along the way , we lash out at others for making us feel annoyed with ourselves.

But , a bit like getting repetitive injuries or Pain , it's usually better not to rush to anger or negativity and accept what is being said when we get repeated words of advice too.

Everybody here has always given you advice be it straight or sugar coated from a place of caring .

Part of Pacing with Chronic Illness also involves learning Emotional Health strategies not just Physical Health techniques. To Count to Ten then think again is one of the best tips I have .

Is a thing really worth getting angry about ?

Are you really angry with the person or more sensitive because of the Pain?

If it still annoys you after the event that's the time to react but you will be able to do so with balanced perspective and calm words saying what you really need to , often, the anger usually hurts you more than anyone else .

Learning Serenity and not Sweating the Small stuff reduces our Stress more than getting angry and that is 100% better for our symptoms too.

[SnazzyD]

Not quite sure of the logic there. If you have a flare of PMR you won’t be running anyway, plus you might be dealing with an adrenal crisis on top. Plus the “temporary” worsening may develop into a protracted worsening that you find harder to get under control; it isn’t something that turns on and off like a tap.

My experience is that the reduction in the Pred effect on tissues lags behind dose reduction by quite a bit, so if you dropped to 1mg tomorrow say, you won’t be getting a 1mg equivalent of tissue effects on day 1.

[scats]

I have never had any problem healing while on pred.

I do wonder if you have read the advice given to others on this site, because reducing pred as fast as you are is the best way to start a flare, which would be very counter productive.

[HeronNS]

My heart sank when I saw your idea, and I'm glad that others have stepped up with reasons why you shouldn't. Many athletes have missed important events because they had to take time to heal. A young man who is arguably one of the best ice hockey players who has ever lived is currently recovering from surgery to repair something torn and when he was early in his career he missed an entire season recovering from a concussion. A lot of us say that one of the key things we learned from our PMR/pred adventure was patience. A difficult lesson for me! But in the long run your body will thank you if you take time to heal, and you will be a better athlete for it. There should be no shaming by your peers. Anyone could be in your situation. If you'd broken a leg or had torn muscles it would be more visible and easier to deal with because others would recognise the issue. But PMR is an invisible illness so it makes it harder. But in your heart you know what is the right thing to do, the best thing for you and your future. This is the support you need. Give yourself permission to take time to heal.

Best wishes.

[Blearyeyed in reply to HeronNS]

Well said , been there , done that , in my youth as an athlete , it was better to miss a meet or two or even a season than put pay to your ability to take part at all.

[HeronNS in reply to Blearyeyed]

The headmaster of a school near where I lived (I dated his son, actually) walked with a cane and was in constant pain throughout his adult life because in his youth he'd broken his leg during a rugby game and continued to play out that game.

[Hidden in reply to Blearyeyed]

Yep... Too true. And not being able to do what you want is frustrating at any level. The psychological aspects of illness are there for everyone and is as hard for those who can only get to the front gate (at first) , can't go to the shops alone, be a parent or grandparentand as not training is for those who run or cycle. We all adjust and adapt across time.

[Blearyeyed in reply to Hidden]

As someone whom can't go out alone at the moment and feels like I'm being mothered by my daughter rather than the other way around I know exactly what you are saying.

I miss being able to do simple things like Sports but it pales into comparison , and is something I would happily reduce in priority , to make sure I didn't make my overall symptoms worse and stir up more trouble in the future if I was Paul.

[Hidden in reply to Blearyeyed]

Yes I came to live near the peak district as I walked in the hills and mountains (since reclassified) there. I had 15 good years of doing that and cycling in the peaks amongst other daily activities. I used to spend Friday mornings in the cinema using the pass I had. I can't even sit through a film nevermind walk in the hills. But I enjoy sitting/walking in the valleys looking at the hills and driving through the hills looking at the valleys.

Hopefully you will feel better eventually. As long as you don't do a Trinity impression in bullet time chasing the bin you should feel better. It's the lighter blue bin that is most often naughty. 😉

[Yellowbluebell in reply to Hidden]

No bin belonging to bee is wrll behaved. She just attracts madness!!

[squashie]

I'm considerably older,and very active, playing competitive squash 3 - 4 times a week as well as a daily gym session and regular 15 - 20k walks. I recently had a spate of leg injuries (quad and hamstring) and learnt that the best management was carefully targeted rehab exercises and patience. I still don't know whether the causes were pred related muscle issues or doing more than I was fit enough to do. I've just managed to (successfully) get down to 4mg after just over a year, and I think that is fast. With each injury I maintained my current dose until I was confident I'd recovered.

I guess you have to listen to your own body, and manage it in whatever works best for you. That said, I'd have thought that any strategy based on letting inflammation build up wasn't a sound one. I don't know about you, but my full blown PMR symptoms caused a significant loss of mobility and flexibility - not something I'd be prepared to deliberately let recur.

[Yellowbluebell in reply to squashie]

To be fair i dont think there are many of us that would opt for any more pain, stiffness and lack of mobility deliberately. My aim is to live life without pain and pred allows that and doesnt cause a decrease in my ability to heal

[Yellowbluebell]

Hi tonCh/paulb

Have you got an IT problem with your avatar? Just worried as you seem to have changed names over night and wondered if this was down to IT problems on the forum?

[Sofarbrnun]

Try not to let it get you down, if you can help it. It's a rough road. I don't run and, at times, could barely walk around the block. My pain was mostly in my shoulders, glutes, and groin. Once that was somewhat resolved, pain went to my knees. Couldn't even kick my shoes off. I was getting a lot of pressure from rheumatologist to reduce the pred. I just couldn't go any lower and still function. (4mg after 2.5 yrs of PMR) The knee pain was a real game changer. I couldn't hack limping and the inability to do simple things. It just wouldn't go away. Several months went by. I found a new doc. Got some treatment. Sought inspiration. Getting better. Tried the physical therapy. It only made things worse. After having put up the good fight, I found acceptance was the beginning of healing for me.

[Highlandtiger]

I'm late to this thread as I’ve been locked out the forum for a couple of days for some reason and just catching up now but I’m genuinely puzzled about something so please forgive me replying albeit late.

I remember you posting at the outset as TonCh and indeed remember replying to you along with many others trying to support you then and asking you not to despair when the pred effects didn’t kick in as quickly as you’d hoped. I also remember you leaving the forum when you were unhappy with some answers.

I also remember the PaulB posts but confess I didn’t realise it was the same person.

I remember from your previous posts that you have done extensive research yourself and come from a scientific background.

So, what puzzles me, is why you’ve asked the question you have, as I think you knew what the answer from the experts would be. I certainly did when I read it and I’m no expert.

Our many experts, (I won’t name them as you and they know who they are), spend hours giving the best advice they can, advice which I’ve found invaluable, as have many others.

They are all different in their approach which I quite like as you feel you know a bit about what their personalities are like even when you’ve never met. Some are very gentle, others are more forthright, or strictly scientific, and some (one or two in particular) always manage somehow to inject some humour into their responses even when they are clearly suffering badly themselves. But without exception they give their time and expertise generously.

I honestly can’t believe that you didn’t know what the answer would be and it is with genuine puzzlement that I read your response to our experts' replies.

Just because you don’t like the answer doesn’t mean you’ll get a different one if you keep asking it. You’ve been advised lots of times not to push yourself too hard on the running front but you’ve chosen to go your own way which is fine; you’re an adult and can make your own decisions.

Lots of us on the forum were also extremely active before getting hit with PMR so please don’t think you’ve been particularly hard done by compared to the rest of us. We’ve all had to give up activities and modify others. I certainly have and it’s had a massive impact on my life. But I’ve taken the advice on here and have accepted that I have to change my lifestyle and accept that PMR will take its own time to go. I would suggest that you should do the same but, obviously, each to their own. Good luck anyway whatever you decide to do.

[scats in reply to Highlandtiger]

You have brilliantly summed up what I think a lot of us are thinking.