Microfracture Surgery

So I had some long standing cartilage damage to my left knee. I went to the surgeon at the BMI Runneymede and had Xrays and MRI's taken which showed that I had medial cartilage damage from poor liftng technique, a small cyst and a lateral femoral tear that seemed to go down to the bone. The surgeon informed me that he could tidy up the torn cartilage and remove the cyst without any problems, but if the lateral tear did indeed go to the bone that he would like to do some microfracture surgery to repair.

I hadn't heard of microfracture before so I started reading around and although it has been around since the late 80's it is still a work in progress. It was actually developed by Richard Steadman, founder of the Steadman Clinic. The basic idea is that if you can make bone bleed the blood is rich in mesenchymal stem cells that can become a number of tissues. So special tools are inserted into the bone to create a rough, broken surface, deep enough to cause bone bleeding. A super clot or blastema then forms over the damaged bone, the bone heals and also new cartilage grows to cover the operated area.

Although new tissue will be formed in 6 weeks there is a long process of tissue remodelling that is required to cause the tissue to become what is required. Articular cartilage that covers the ends of bone is strong and elastic so it can last and absorb the impact forces it is subjected to. Unfortunately the new cartilage that formed during the early years of this technique was fibrocartilage, a much stiffer and less robust cartilage. It seems the great progress in the last 20 years has not been in surgical technique but in rehabilitation. Actually doing the right things to tell the tissue what it needs to become is the main focus of rehabilitation. Unfortunately the physio dept. at the Nuffield Woking seemed only to want me to be walking again and that was the limit of their care.

So post surgery I was non-weight bearing on the left leg for 6 weeks. Not a pleasant experience but it certainly grew my respect for those who use crutches on a daily basis. I was told by my consultant only to do mobilisation exercises for the 6 weeks. This didn't seem consistent with what I was reading so I decided to take control of my own rehab. For 2 weeks I only did mobilisation to get the full range of motion. After that I bought a cycle exerciser from ebay (an exercise bike is fine but place no resistance through the wheel) and started doing 5 mins of cycling twice per day as well as my mobilisation exercises. I very slowly and carefully and watched how my body responded to gauge what was too much. Any swelling or discomfort I took as my limit, when I could complete that without any symptoms I increased the duration. Eventually I built up to 40 mins of unloaded cycling per day.

Another technique I used was Revitive: Circulation Booster. This is a device I have worked on and I had one so I thought I know it improves circulation so it should speed my recovery. I used this 2x per day for 20 mins each time. Again building up the intensity as I got used to it. I would perform my mobilisation exercises after using Revitive: Circulation Booster as I found that I could get much larger ranges of motion after my leg was warmed up. Within a month I had full range of motion back in my leg. I did suffer from swelling in the leg and Revitive: Circulation Booster quickly removed this.

I also kept using my aerosure: youbreathe training device to keep my lung performance up to speed and this helped a lot especially whilst on crutches.

So 6 weeks came and went and when I went back to the surgeon he was very happy with the condition of my knee, full ROM and no pain or swelling. So he took my crutches away and sent me back to physio. I decided to move physio to a team I had used before, Balance Physiotherapy in Clapham North. I saw a knee specialist Paula Coates and she started me on a programme of knee strengthening and flexibility. I cannot jog till next year but I am back swinging my kettlebells which was the main aim for me. I am getting stronger and fitter by the day and knee feels great, very smooth and little discomfort. One important thing Paula added to my rehab is stretching as the quad had shortened from lack of use, getting the muscle back to normal length has been hugely helpful.

The links to some interesting research are here:

Pulsed ultrasound

Pulsed ultrasound observational study

LIPUS in rats

Microfracture rehab 1

Microfracture rehab 2

In my next entry I will describe my nutritional and supplement strategy.

Tune in!

Hi, I have been very busy for the last 2 years and have been doing many exciting things. Now again I have created the time and space for myself to start blogging about what I have been up to. I have being doing a lot of work in altitude simulation with the England Football Team, London Broncos academy team and we have more work coming up with Wasps academy. I have also been working at King's College Hospital with COPD patients and that has gone very well. I will be updating about all of these projects over the next few weeks. I am glad to be back, thanks for reading.

Marathon man benefits from aerosure!

Olympian Dan Robinson has been using his aerosure vibrated breathing training device and this is what he has found:

Since using aerosure, the improvements in my lung function have been significant and I have found it a really useful and important training aid. As an endurance athlete, I am continually looking for ways to improve my racing and training performance and the aerosure has enabled me to get the maximum benefit from my training sessions. Regular use of aerosure has meant that when I get to the start line I am confident that I have covered all bases in training and will race well. I thoroughly recommend aerosure. All the best, Dan.

We have no doubt that Dan is the first of many elite performers who will benefit from regular aerosure training.

90 degree press-up

I would like to recommend a website of Dr Barry Drust, a senior Sports Scientist at Liverpool John Moores University who is preparing and training to do a 90-degree push-up. As well as giving great training information he is keeping a personal diary of his training:

http://90degreepressup.wordpress.com/

I think this website is very interesting for those interested in devising their own training programmes.

Thanks

Low-cost Portable Altitude Simulator Nearly Here!

Coming soon, from London South Bank University, a low cost portable altitude simulator called Hybreathe. A small device that can be used at rest or during exercise, Hybreathe will bring al the benefits of altitude training to anyone who wants it, and not only the elite and wealthy.

Currently a market research survey is under way and prizes can be won by lucky respondents. Please visit www.hybreathe.com for a chance to win one of several youbreathes (a vibration respiratory training device), one of several Flexi-bar vibration training devices or Code13 t-shirts and hoodies.

To participate click here:

www.hybreathe.com

youbreathe/aerosure for colds and flu

This is a short post to continue my discussion from last time. I was talking about trials getting underway to test the efficacy of youbreathe/aerosure in clearing mucus in clinical patient populations. Well various feedback from users has indicated that once the initial fever during a cold or flu is over, that youbreathe/aerosure can be very helpful in clearing chest congestion.

Try to get a little olbas inhaler or some eucalyptus oil and hold it in front of youbreathe/aerosure as you inhale and you will feel the effects of youbreathe/aerosure pulsing the vapor right down through your full respiratory system. This has the effect of moistening the mucus membranes and reducing respiratory tract inflammation.

I hope youbreathe/aerosure can be useful in so many conditions as breathing is so fundamental to everything we do.

This is a link to the BBC website for cold and flu:

BBC colds and flu

Here is a link to the BUPA cold and flu website:

http://hcd2.bupa.co.uk/fact_sheets/html/colds.html

The following are a couple of links for relief from colds and flu:

http://www.webmd.com/cold-and-flu/9-tips-to-treat-colds-and-flu-the-natural-way

http://www.vpul.upenn.edu/ohe/library/cold/relief.htm

Please keep an eye on the download page of the youbreathe website for new user manuals : http://www.youbreathe.com/products.php

Stay healthy

improve respiratory health with youbreathe

In our lab at London South Bank University we are progressing the youbreathe research and the results are getting more and more interesting and exciting. We are currently costing up a study in cystic fibrosis patients. Cystic fibrosis and other respiratory diseases such as COPD, neurological diseases such as motor neuron disease and multiple sclerosis and some forms of cancer can lead to increased mucus production which patients often have trouble clearing. If not cleared this mucus can move into the smaller airways of the respiratory tree and even to the alveoli where it can impair the functional units of respiration, block the airways and lead to secondary problems.

Because of the oscillatory nature of youbreathe and the frequency range it operates we believe it can be of enormous benefit in promoting the clearance of mucus through altering the viscosity of the mucus, breaking the bond between the mucus and the airways and promoting the cilia to do their job and move the mucus up and out of the respiratory system.

There are other devices out there which can perform this function such as Flutter, Acapella and other laboratory equipment. The advantage of Flutter over some of the other devices is that it can be used in the home which allows greater freedom to the patient and reduced cost to the primary care trust. The feedback we have received about the Flutter is that it works but the user adherence is low.

The following is a link to a chest respiratory physiotherapy site which describes all the basic forms of sputum clearance :

Chest Physio

This is where we believe youbreathe has a significant advantage. youbreathe can not only promote mucociliary clearance but can improve respiratory system performance, which can assist those with respiratory problems get active and live as normal a life as possible. This should increase patient adherence lading to long term benefit.

The trials will hopefully be underway soon and I will report on the findings as soon as possible.

Best wishes, stay healthy.