Cartilage Damage and Rehabilitation After Weight Training Injuries

Weight training can lead to cartilage wear?

Hello Dr.
Lee,
I would like to ask a question.
In July of this year, I sustained a knee injury while doing strength training, which has caused discomfort in my knee.
It feels weak when walking, and I experience discomfort after walking for a while.
I went to the hospital for an examination, and the doctor suspected cartilage damage.
After an X-ray, it showed that the cartilage size was normal, but the doctor concluded that there was cartilage wear.
When palpating the knee, there is a cracking sound, but no cartilage has been lost.
I have been undergoing physical therapy and hydrotherapy since then.

I would like to ask about what the doctor mentioned during the consultation regarding cartilage rehabilitation not having a true recovery.
He suggested that hydrotherapy should be done, and that strengthening the muscles in the affected leg is necessary to allow space for cartilage repair.
I don't quite understand this concept.
Why is there no true recovery in cartilage rehabilitation? Will my current hydrotherapy and strength training to strengthen my leg muscles ultimately not allow me to return to my pre-injury condition? I find this part a bit confusing, so I would appreciate your clarification.
Thank you!

Jason, 30~39 year old female. Ask Date: 2017/10/07

Dr. Li Yongheng reply Orthopedics

Hello, cartilage can be classified into meniscus or general articular cartilage.
Based on your description, it seems more like patellar tilt causing wear on the cartilage of the patellofemoral joint.
Therefore, the physician has arranged for hydrotherapy and quadriceps strengthening exercises to enhance the strength of the leg muscles, which may improve the lateral tilt of the patella.
As long as the cartilage damage is not too severe, it should be able to heal gradually.
Wishing you a speedy recovery.

Reply Date: 2017/10/07

More Info

Understanding cartilage damage and rehabilitation after weight training injuries can be quite complex, especially when it involves the knee joint. Cartilage is a resilient yet vulnerable tissue that covers the ends of bones in joints, providing a smooth surface for movement and acting as a cushion to absorb shock. When you experience knee discomfort following weight training, it can often be attributed to cartilage damage, which may not always be visible on X-rays.
In your case, it seems that the doctor suspects cartilage wear or damage, even though the X-ray results did not show any significant issues with the cartilage size. This is a common scenario because X-rays primarily reveal bone structures and may not adequately depict soft tissues like cartilage. The "crackling" sound you hear when you move your knee (known as crepitus) can indicate that the cartilage is roughened or damaged, leading to friction between the joint surfaces.

The rehabilitation process for cartilage damage is indeed different from that of other injuries. Unlike muscles or ligaments, cartilage has a limited ability to heal itself due to its avascular nature (lack of blood supply). This means that while you can strengthen the muscles around the knee through physical therapy and water therapy, the cartilage itself may not fully recover to its original state. The goal of rehabilitation in this context is not necessarily to restore the cartilage to its pre-injury condition but to improve the overall function of the knee joint and reduce pain.

Your doctor’s advice to focus on strengthening the muscles around the knee is crucial. Stronger muscles can help stabilize the joint, reduce the load on the cartilage, and improve your overall mobility. This approach can alleviate some discomfort and enhance your ability to perform daily activities. Water therapy is particularly beneficial as it allows for low-impact movement, reducing stress on the knee while still promoting muscle strength and flexibility.

It’s important to understand that while rehabilitation can lead to significant improvements in function and pain management, it may not completely return you to the pre-injury state. Many individuals with cartilage damage learn to manage their symptoms effectively and continue to engage in physical activities, albeit sometimes with modifications to their routines.

In summary, while cartilage rehabilitation may not lead to a complete recovery of the cartilage itself, focusing on muscle strengthening and joint stability can significantly enhance your quality of life. It’s essential to maintain open communication with your healthcare provider throughout this process, as they can provide tailored advice based on your specific condition and progress. Regular follow-ups and adjustments to your rehabilitation program may be necessary to ensure optimal recovery and prevent further injury.

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