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Knee deep in nagging pain


KNOWLEDGE IS POWER When pain from an old injury continues, find out what’s really wrong rather than worrying about it.


Andrew O'Brien

‘Practice what you preach’ is a turn of phrase that most of us know well. More often than not it’s used as a form of criticism, a way of pointing out hypocrisies in another person’s life. However when you are daft enough to put your views in print on a regular basis, it’s worth following as a bit of a mantra, lest others point out your own inconsistencies.
It’s a conundrum faced by all health professionals, and one that can be hard to live with. How many health workers smoke? How many are overweight? How many of us drink more than we should? Do we all get as much exercise as we should? It’s a reality that many healthcare workers aren’t as health conscious as they could or should be and, while there are a multitude of factors at play in everyone’s personal circumstances, I believe we should all aspire to set a good example to the people we aim to help.
And so it was, over the last little while, that I decided to improve upon the example that I set for others and bought myself a height-adjustable desk. For about €200 in Ikea, since you ask, and easily assembled in half an hour. No problem then, I’ve set my example, I can now sanctimoniously preach about the dangers of sitting at a desk without feeling guilty. And it was on that same day, while basking in my own smugness, that I learnt how difficult it can be to truly practice what I preach.
A couple of years ago, I hurt my knee playing tag rugby. Nothing serious, just a nagging ache at the inside of my knee. Then, after a while, a strange lump seemed to appear as well. I could still run, and I didn’t miss a game in our march to winning the competition, but my knee would get sore when driving, and even more so when I borrowed a friend’s car and their extra-long key chain rubbed against the inside of my knee.
It made no sense to me, so I asked a physiotherapist colleague for an opinion. He politely suggested that, considering my age and history, it might be worth getting an MRI. Of course by the time I had the scan the knee didn’t hurt anymore, so I never bothered to chase up the results.
Then last week, with my post-Ikea glow lighting up the office, I happened to ring my own GP’s surgery looking for an MRI report of a mutual patient. At the end of the phone call I said, “While you’re at it, you might as well send me my own report if you don’t mind.”
So there I was, doing something I’ve advised hundreds of people not to do. Worrying about a radiologist’s report.
There was mention of chondral defects, bone marrow oedema and sub-chondral cysts. Degenerative changes, wear and tear, arthritis, call it what you will. I could hear my physio self, saying, “Don’t worry Mr O’Brien, those sort of findings are incredibly common in men your age. MRI studies have shown that some of these things are as common in people who have never had knee pain as those who do.” I could also hear my knee saying, “Do you know what? Maybe I do hurt a bit today.”
Wow, what a learning experience! Try as I might to forget about the MRI report, for the next few days my knee grumbled at me. I played tennis on it, and all was fine for a couple of hours – until I got home and back it came again. Which reinforces several other research findings; namely that weight-bearing exercise can be pain relieving, has an anti-inflammatory effect and is beneficial for people with, cough, arthritis.
You’ll be glad to know that right now, as I stand here at my desk, self-righteously practising what I preach, my knee is fine. There are numerous ways to put what the last week has reinforced to me personally: movement is medicine, motion is lotion, and undue worrying will get you nowhere.

Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at