Visited the doc

I met with John Boyle out of the North Shore Center for Orthopedic Surgery and we reviewed my MRI and discussed what is probably the cause of the pain/issues that have been plaguing me.

What is definitive is that I have patellofemoral arthritis on the medial side of the knee cap. It's bone on bone for a couple centimeters. There is also some broken, floating pieces of cartilage in there causing an impingement. Apparently, a vast majority of people with this kind of arthritis are worn badly on the lateral side (outside) of the patella but my cartilage there looks fresh as a daisy. He told me very clearly that "going in and cleaning it up" would "almost certainly make (my) knee feel better".

But, given that most of the pain I experience is on the lateral side of the knee and actually behind my knee, he is suspicious that I have inflammation in the joint where the fibula meets the femur. He advised that I begin by trying a cortisone shot in that area. If the shot cleared me of the pain that prevents me from running, then the arthritis, though not good, is probably not the thing hanging me up.

So... step 1, if I want to pursue it, is a cortisone shot. I think I'm going to do it. But I don't know what to hope for. It would be cool if the cortisone shot took the pain away, but the implications of that would mean I have a complicated and difficult to treat inflammation of the joint there. But if the shot doesn't have an effect, surgery might be the only thing that could get me up and running consistently again. I'm wary of the possibility for other crap to result from surgery and in general I consider surgery a very last resort.

I guess the silver lining is I can still bike as aggressively as I want without any pain whatsoever. With or without surgery, maybe it's time to make multi-sport stuff more of a focus. When I consider the long-term, I get nervous that another 15 years of road running will trash my knee for the rest of my life. I've always understood that seriously training would yield some degree of arthritis eventually but I'm shocked at the degree of the breakdown in this one area of my knee. Ironically, the remainder of the knee looks super good. The primary joint in the knee looks "like an 18-year-old's". Completely healthy. My left knee is in super good shape, too.

So maybe I'll schedule a cortisone shot for next week. The doctor asked me to run for a few days to "make it hurt" and be sure the pain I'm experiencing really is on the lateral side of the knee before I go ahead with the shot. Meanwhile, OF COURSE  I'm sure that's where it hurts; I've been dealing on and off with this problem since I started this blog back in 2010.

That's all for now.