results of (L) knee MRI

Copy of an e-mail I sent to Chris Crampton:

Dear Crampton-sensei,

Here is an update on my knee following the MRI last Monday:

The good news is that the MCL and ACL are intact.

FOUR PROBLEMS with the left knee:
(1) arthritis: although this is not too bad per the MRI
(2) thinning cartilage: the cartilage in the knee joint is intact now
but thinning due to factors like bone spurs, inflammation, excessive
pressure in the joint
(3) bone bruise: on the top of the tibia (shin bone); the top of the
tibia is supposed to be protected by the meniscus, so Dr. Minami said
he expected to see a problem with the meniscus but can’t see anything
wrong with it on the MRI
(4) tendon damage: the quadriceps and patellar tendons are damaged in
three places–(a) where the quadriceps attaches to the top of the
patella (kneecap), (b) where the patellar tendon attaches to the
bottom of the patella, and (c) where the patellar tendon attaches to
the tibia.
(4b) inflammation from the tendon damage is also supposedly causing
inflammation in the fat pads underneath the tendon, which is where
most of the pain comes from
(5) there is a small amount of water in the knee, too, but the doctor
shrugged it off

I have attached an image that shows the bones and tendons I am talking about.

kneetendons

TREATMENTS:
(1) pill and cream anti-inflammatory medication: this is supposed to
reduce inflammation in the fat, the tendons, and from arthritis
(2) rest: this is supposed to let both the bruised bone and the tendons recover
(2a) avoid mechanical overload: bending the knee joint and then
loading it with weight (as in a squat, koho ukemi, or kihon dosa)
increases the pressure in the joint to many times that of the pressure
of standing.  Also, forcing the leg to straighten (ie, mild
hyperextension) causes pressure in the joint by pressing the patella
against it.  Dr. Minami said I shouldn’t do these things.
(3) hyaluronic acid injection: this is a controversial treatment that
is not done in the USA but is done in Japan; Dr. Minami seemed
unconvinced but suggested I try it; it is supposed to help the
cartilage recover and reduce some inflammation; ****THE COURSE OF
TREATMENT IS INJECTIONS INTO THE KNEE JOINT EVERY 2 WEEKS X 5 TIMES,
WITH A FOLLOW-UP MRI.**** I had the first injection on Monday August
11th and the next is on Monday August 25th.

If I understood Dr. Minami correctly, this means my follow-up MRI
would be Monday October 20th.

I would like to request mitori geiko and light training.

If it is okay with Payet-sensei, I would like to do mitori geiko until
the end of August, then light training in September.  Hopefully in
October I can find a way to assist with the embu preparation and then
resume a fuller schedule after the follow-up MRI.

Thank you.

Osu,

Chris

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