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This is very exciting. This type of work can even benefit people who aren't paralyzed — damaged cartilage can also be repaired this way.

When I ran track in college, I somehow developed focal cartilage defects in both knees. This brought my running career to a halt and made walking extremely painful for about a year. In an attempt to fix this, I had a type of surgery known as the OATS procedure performed. This is where the surgeon takes a plug of undamaged articular cartilage from a low load bearing region of the knee and swaps it with the damaged cartilage. Walking is mostly pain-free for me now, but it still hurts too much if I attempt to run.

As though one cartilage injury weren't enough, I somewhat stupidly decided to take up weight lifting after I couldn't run anymore and attempted to set down a barbell that was way too heavy for me. In doing so, I triggered a mild lower lumbar disc herniation. So now I have two permanent injuries. Luckily, neither injury is very severe, so some days I don't even notice the pain while other days it approaches mildly annoying "background noise".

These types of cartilage injuries are common, and arthritis is even more common. But the issue with cartilage is that once it's damaged, it doesn't heal on its own because cartilage has no vascular system. You can break all the bones you want and eventually they will heal, but damaged hyaline cartilage will not. The best that your body can do is to produce "low-quality" fibrocartilage in place of the damaged hyaline cartilage.

Fortunately, there's been a lot of research over the last decade on using mesenchymal stem cells (taken from your own bone marrow) to regrow true hyaline cartilage as opposed to fibrocartilage. The stem cells have actually been shown to differentiate into hyaline cartilage. For me, this has the potential to permanently alleviate both knee and back pain. Moving this research away from clinical trials seems to be taking forever for some reason though...




It's interesting. I was just consulting with a new doctor yesterday about my back pain. We went off on a tangent and he was telling me he knee was so bad with cartilage damage that it would hurt for over a month, leaving him limping, after attempting to run or play sports. He did some stem cell injections in his knee and it's all better now. Not sure how long ago he did that.

It's really cool technology. I can't wait to see where it goes in the next few years!


As I recall some of these techniques were used on race horses long before trying them on humans. Stem cell injections in particular I think. Thank the gamblers for that :)


I also know that in horses they routinely inject hyaluronic acid, which appears to be significantly beneficial. E.g. The horse limps in, and one day later the arthritis is gone. My mom always jokes that she should just do it for herself but it is not apparently approved for humans. She's been injecting many of he horses for 10+ years with it.


It is approved for humans actually. I had a hyaluronic acid injection my for knee injury. I didn't really notice that it did anything though. But I think it's generally supposed to help lessen the pain for cartilage damage that isn't a focal defect. Note that it doesn't do anything to improve the cartilage — it just helps the pain.


An interesting example of serendipity. Did the research done on horses help directly in developing solutions for humans?


This is rather odd. Knee cartilage damage is extremely common among athletes, so one would think that the treatment would be as well. But I've never heard of it used for professional athletes.

Speaking anecdotally, I've had 4 wrist surgeries over the past 5 years (coming up on my fifth next week). I've never once heard of the stem-cell injection treatment, despite having 3 surgeons and 9+ other consulting doctors. Did your doctor give you any papers to describe the procedures that made his knee "all better now"?


> But I've never heard of it used for professional athletes.

That's because stem cell therapy is not generally approved for use yet. It is still in the research stage. There was one company that did it for a while in Colorado, but nobody could really figure out whether they were legit or a scam, and the FDA ended up putting a halt on their stem cell injections.


It looks like it may be possible to grow new cartilage. I'm not sure if it's the low quality type you are referring to though.

https://www.samumed.com/pipeline/default.aspx


I'm really hoping for a breakthrough within next few decades. I shredded the TFCC in my wrist to the point where I couldn't type because of the pain. Since that region is pretty much avascular, it couldn't be repaired. So they snipped what was hanging, and then shorten my ulna in order to reduce pressure while pronated when typing. I can type again, and do most activities, but I'll have issues in a few decades for sure.


You might want to look into AMIC for your knee.

http://www.geistlich-pharma.com/en/orthopaedic/therapeutic-a...


I can posit one reason for it not getting through trials easily.

The technology isn't "hard" per say, nor is it patented. You can find doctors willing to do "prolotherapy" procedures for you today.

The problem arises with trying to study it. I assume that they do phase 1 trials for therapies like this, which means that they have to find healthy individuals willing to get bone marrow removed, and then get that injected into joint spaces. Not many people want to sign up for that study, unfortunately.


Interesting! Do you think this could be used to augment our capabilities beyond normal strength/fitness levels?


I started getting into weightlifting this past year, and doing deadlifts has always scared me.

I still do them, and try to do them with proper form, but it's always in the back of my mind that I might hurt my back due to the load.

Could you give me more detail on how you hurt your back? How heavy of a load was it? Was it during a deadlift?


It actually had nothing to do with deadlifts or bad form. I was working on my bench press and couldn't get the fifth rep up. I set the bar down on my chest and instead of calling out for help (to any of the fifty people standing nearby), I thought it would be less embarrassing to just roll it down to my knees and then stand up and set the weight down. Stupid decision. Once I got the weight to my knees, I severely underestimated my back-to-chest strength ratio and the weight plummeted to the ground, pulling my (arched) back down with it. I think it was about 215 lbs (97 kg).

The key to deadlifts is good form and not letting your back arch at all. I would recommend getting an expert trainer or an advanced lifter to help you practice your form if you are worried about it. It's worth the time to prevent an injury.


You should really use safeties when bench pressing. I just read about a guy who died doing a bench press when he lost control of the bar and it landed on his neck!

https://stronglifts.com/bench-press/safety/


Man... I feel your pain.. been in the same situation a few times, but why not just shame-roll (drop the bar to one side and just sort of wriggle out from under it on the opposing side)? It sucks but keeps you safe.


not the person you're responding to but a lot of times people have clips on the weights at gyms


I was taught not to use a clamp on the bar when doing bench, so you can lean to one side and let the weights drop off if you get stuck.


Seems like questionable advice - sounds like a great way to accidentally drop a bunch of weights to the floor if you're at all uneven with your bar path (not at all unusual when fatigued).


Not only that, but even a little shift in the weights can cause problems with your lifts. Warmups (135 or so) I'll leave them off, but anything over 200 I'll put them on.


Then you really have to look out for the recoil as the suddenly-unbalanced bar whips around.

Bench press at any significant weight just flat-out isn't safe without a spotter.


My friend was a powerlifter. According to him, back injuries are far more common on the squat than the dead. It's somewhat counter intuitive, but the dead is generally quite safe.

You should always use good form and always have respect for the weights (don't get cocky), but maybe have a bit more respect for the squat :P


I recommend reading Anatomy Without a Scalpel.

DLs are complicated, but you'll see a lot more uniformity when you take your advice from people who are strong themselves.




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