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Medical and Physical Therapy questions A place to talk about current and or past injuries and possibly how to deal with those injuries. Any advice should not be considered as medical advice, but rather from one person to another as you might ask a friend.




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  #1  
Old 04-03-2017, 05:14 PM
garyforsan garyforsan Is Off Line
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Self Knee Injections

To begin with I’m a pretty experienced knee suffer. I have had 6 knee surgeries, 5 for torn meniscus and the last was a microfacture a technique used to generate a cartilage like structure for where there is no cartilage. With bone on bone and calcium building in the remaining cartilage (Osteoporosis) I was in pretty bad shape. A total knee replacement TKR was scheduled for months in advance, because if you know anything about TKR it is a terrible surgery and recovery (which you never fully recover from) and you have to plan your life around it. By an apparent act of God my surgeon disappeared days before my scheduled surgery. I mean really disappeared. He told the orthopedic clinic he was quitting, backed his stuff, and was gone. That’s all the clinic staff could tell me. After this I found about the microfacture procedure and had this done, which saved me for another 6 years.

One thing everyone who has knee cartilage/meniscus problems is you should be stationary bicycling almost every day. By the time I had the microfacture surgery the internet was pretty good and I learned a startling fact, which my orthopedic neglected to tell me. That is the procedure is only half the program. Stationary bicycling is the other, because it creates the synovial knee fluid which turns the scab into a cartilage like substance. Without bicycling all you have is a scab which will fall apart pretty quick.

I got along fairly good for the next few years, that is with the only cardio exercise being bicycling, no squats or anything resembling them. Usually had pain standing up after seating for a while, and now and then I would feel my tibia slide on the femur off the meniscus and have shooting pain which would take a few days to go away. Then my daughter decided, against my will, she was going to play basketball. Now I was pretty good in my day at B-ball, but to even shoot around a little hurt my knees. I starting doing all the physical therapy I had been taught over the years after surgeries, which helped for a while, but soon the dads of the other kids wanted me to play with them and their kids.

In my 30 plus years of knee problems I have had a lot of knee injections including two series of Synvisc. So I knew it was possible to inject things into the knee joint which would help relieve pain and made the knee surfaces slide better thus increasing mobility. Fooling around in body building several years ago I knew enough about syringes and needles to not be scared of them. First I tried BPC-157 under the skin (subcutaneous) on the sides of knees. BPC-157 is pretty amazing stuff and I felt an immediate relief (probably from swelling), but it also made me realize how much I had ignored the pain I was in. I wanted more. So I tried an injoint injection ((intra-articular). I read and watched youtube videos on it, while trying to remember the injections the doctors gave me years earlier. The first time I successfully injected the BPC-157 into the joint, it was like heaven opened! Within 20 minutes my knee pain was gone. I think it was probably the anti inflammatory affect BPC-157 has, but who really knows. I could only find one study on rats where it helped heal meniscus.

In addition to BPC-157, who nobody really knows what it does for cartilage, there are several other medicines which have shown real promise, some are approved in other countries for OA, and some are even approved here for other things then joints. The reason they and BPC-157 are not used in the USA for all the millions of people who could use them is $! Think about all the millions, probably billions of dollars the orthopedic industry makes from joint issues and their priority isn’t our joints, it is maintaining their livelihood.

Just look at one real popular horse joint medicine called Pentosan Platinum. It contains sodium pentosan polysulfate – a drug made from beechwood trees and approved in Australia for Osteoarthritis, glucosamine – same stuff you can take orally, and hyaluronic acid – what Synvisc is as well as about four other prescription brands. You can google all of these with “human studies” and find great results with no or little side effects.

After a lot of studying and trial and error the intra-articular knee injection procedure I use now is the McNabb. His injection is a little lower down the leg (Distal) closure to the knee, but he gives a great visual of where you are trying to get the injection. The McNabb injection aim is actually beneath the quadricep tendon above (superior) the patella (knee cap), which is above the knee joint, not in it.

In my opinion, which is by no way a professional medical opinion, the ultrasound guided knee injection is a money making scam. Yes cartilage can be damaged when injecting directly into the knee joint, but there is no reason to inject there when you can use the McNabb approach and inject it above the knee joint and let the solution run down under the patella into the joint.

The equipment and drugs I use are: 28 ˝” gauge insulin needle for 1% lidocaine numbing (I might be brave, but it doesn’t mean I’m immune to pain), 23 gauge 1 ˝” needle with a 3ml syringe, rubbing alcohol, antibiotic cream with pain relief, and the a closed ball point pen (as Dr. McNabb describes in his video) to mark the injection spot.

First I load the 3ml syringe with 600mcg of BPC-157 then 1 1/2ml of Pentosan Platinum. (Does the ingredients in Pentosan Platinum damage the BPC-157, because it is a sensitive peptide? I don’t know, but my knees seem to think it works). I push with my finger in the general area to find a little area in between the tendons. I use the close ball point pen to mark the spot and after a good washing with rubbing alcohol I rub some antibiotic cream with pain relief on it. It provides infection protection as well as numbing the skin for the 28 gauge insulin needle. I use 2/10 of a ml of 1% lidocaine and inject a little as soon as it pierces the skin and the rest as it goes into until it is the full ˝” deep. I don’t use the lidocaine with a longer needle, because I have found by not numbing the deeper tissue you have good feeling on when your guiding the 1 ˝” 23 gauge needle into the pocket between the tendon and the bone, and also there is a strong belief in the medical field that lidocaine, like cortisone, is bad for cartilage.

Now comes the big needle, actually most doctors use 21 gauge, so it’s not as quite as bad. 25 gauge will work fine for straight pentosan polysulfate, but not the Platinum brand with hyaluronic acid. I don’t know how thick straight glucosamine is. BPC-157 does fine with as small of insulin needle as you want, but I prefer the thicker 28 gauge then the 29 and 30, because the later ones bend so easily and with the pain relief antibiotic ointment I can’t feel it anyway. I push the big needle in slowly and if I feel an ouch I back it up and try a different angle. Seems like I usually go a little to the front side of the body (Anterior) and sometimes a little toward the knee (superior). When I get the needle in the right place it moves easily and I could easily sink the whole 1 ˝” needle in with no pain, but I try to keep about 1/4” out, because that is the way the medical professionals always do it. Then for one last measure, I found that a little BPC-157 injected subcutaneous around the injection site does wonders for keeping the swelling down and speeding the healing from the shot.

I walk immediately after injecting both knees and within an hour I can walk without anyone noticing anything. By the next day I feel like playing basketball, but I don’t until more days have gone by. My knees feel better than they have in 25 years! When I feel pain it is the exception rather than rule. I go days with absolutely no pain. I don’t have to keep a little bend in my knees anymore at night or on the recliner, and I play basketball once a week with men half my age. I am even thinking about running a little. It is scary and mind blowing to think about doing things I ruled out of my life years ago.

Last edited by A1food4u; 04-03-2017 at 05:28 PM. Reason: no linking please
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Old 04-03-2017, 05:29 PM
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Hello Gary,

we do not allow links to outside pages in initial posts. Please understand, as you build trust on the site, the linking will be allowed. Please contact me with questions...

As a guy who suffers from bad knees and has gone the cortisone injection route I found the article a good read.
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Old 04-03-2017, 05:58 PM
garyforsan garyforsan Is Off Line
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No problem

No problem. Looks better without the long links anyway. All anyone needs is the name McNabb if they want to research his procedure for giving knee injections. He even has book on it.
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Old 04-03-2017, 06:11 PM
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Originally Posted by garyforsan View Post
No problem. Looks better without the long links anyway. All anyone needs is the name McNabb if they want to research his procedure for giving knee injections. He even has book on it.
Thank you for understanding, and yes, that's why I left the names intact. Hope you continue to post!
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Old 04-03-2017, 06:45 PM
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Self injecting in the knee some concoctino is a good way to lose a leg. Ever get an abscess from an injection GaryforchuckiChan? Thye chop a piece of your muscle out. In the knee they chop off the leg.
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Old 04-04-2017, 10:10 AM
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Take my advice: do not self inject in your knee. I know people who injected Adequan or other stuff and they all had issues.
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Old 06-10-2017, 01:57 PM
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Originally Posted by millenium girl View Post
Take my advice: do not self inject in your knee. I know people who injected Adequan or other stuff and they all had issues.

I have to totally disagree with this. Don't do it unless you know what you are doing but I have been very successful with injections like this.

Maybe 7 years ago I blew out all three vasti and the patella. My doctor used Platelet-rich plasma (PRP) therapy after surgery which was still in the experimental stages. He told me to expect to rehab for 6 months. I was released 4 weeks after surgery (2-4 weeks early) and he said he has never seen anyone heal so quickly. What did I do? I did daily IGF-1 Lr3 and PEG MGF injections in the area surgically repaired. Of course my doctor did not want to hear about it but said he realized there were things athletes do that can really speed up recovery. But he said I was theposter child for this one.

Now, I also have some damage to the medial meniscus probably from the same incident that was not bothering me at the time. Seven years later I have been having pain for the past year. Especially after training. So I got a few bottles of the Pentosan Gold. Injected 1ml into close to the area of pain (subq) and after 4 weeks of injections the pain is almost completely gone. The first time in a year that I have been able to even walk or stand pain free.

The only issue I had either time was fast healing and no more pain. This is the same treatment done to race horses that are very expensive and is commonly done in some sport medicine centers. There is no risk to it if yo know what you are doing. The Pentosan Gold does burn like shit but front loading it with Lidocaine kills the pain. Most will not be able to do this type of treatment only the hard core can stomach it. Of course I have also done cortisone injections to myself too. A quick note, with the Pentosan products you do not have to do articular injections and can do IM instead. It goes systemic either way but I prefer the faster results getting close to the center of pain.

Last edited by bigtex; 06-10-2017 at 01:59 PM.
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Old 11-15-2017, 11:41 AM
garyforsan garyforsan Is Off Line
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Just a quick update from my original thread starting post. Although I never read this anywhere, I believe I stumbled on to the reason Doctors only do a three week series of Synvisc or other hyaluronic acid type injections, once a week. The puncturing of the knee capsule in itself is somewhat irritating and traumatic to the knee. If I go past 5 weeks, my knee swells with fluid and takes several weeks to normalize again. Removing fluid didn’t appear to help, the fluid would just come back.
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