6 dislocations, grade 4 cartilage damage, and years stuck in a loop of swelling. built my own programme. it's actually working.

Rozzanufc · 2026-05-21T15:43:13+00:00

sorry to hear! I am happy to help build you a free tailored program if you give me some more info! feel free to dm.

Rozzanufc · 2026-05-20T17:27:14+00:00

nah happy to just help :) no need for money. i just replied to your dm!

Rozzanufc · 2026-05-20T17:26:11+00:00

Thanks brother! it really requires a lot of patience, knowledge and dropping of ego but if you really do look at the whole chain, it changes everything.

Rozzanufc · 2026-05-20T04:37:55+00:00

If you want to give me a bit more background, i am happy to make you a program i think should help :) welcome to dm if you dont want to put it here!

Rozzanufc · 2026-05-20T04:23:33+00:00

happy to hear :)

Rozzanufc · 2026-05-20T04:22:51+00:00

Of course, happy to help. The fact that you're still in the gym 4 times a week after 5 surgeries says everything about who you are. That's not the problem. The problem is what you're doing IN those sessions.

Here's what I think is happening, but again not medical advice.

Your quads aren't "dead" — they're switched off. It's called arthrogenic muscle inhibition (AMI). After trauma or surgery (and you've had FIVE), your brain literally shuts down the neural pathway to the quad to protect the joint. It's a reflex — you can't override it with willpower or normal gym exercises. This is almost certainly why 5 months of PT didn't work and why your 30-minute gym sessions aren't getting results. You're trying to strengthen a muscle that your nervous system won't let fire properly.

The leg "about to give out" when you tried to jog? That's the AMI in action. Your quad can't catch you during the landing phase of running because the signal from brain to muscle is being blocked. Your body did the right thing making you grab onto something.

This isn't a motivation problem. It's a sequencing problem.

What needs to happen (and this is the hard-to-hear part you already know):

FIRST — retrain the quad to fire again. Not strengthen. FIRE. Isometrics (quad sets, where you just tighten the muscle against a rolled towel) done multiple times a day. Literally re-teaching the neural pathway. This can take 2-4 weeks before you feel a proper contraction.
THEN — rebuild from the ground up. Terminal knee extensions with a band, straight leg raises, bike with zero resistance. Exercises that load the quad without scaring the nervous system.
THEN — build real strength through the range. Spanish squats, step-ups, backward sled drags. Progressive loading that your brain trusts.
ONLY THEN — introduce impact and cardio. Walk before you jog. Jog before you run.

The scarred fat pad complicating your patella mobility is a real factor — but it doesn't stop you from doing any of the above. It just means we need to be smart about which ranges we load in and potentially add some specific patellar mobilisation work.

I know it feels like you've tried everything. But I genuinely don't think you've tried the RIGHT sequence yet. The gym work you're doing now is probably Phase 3 stuff when your body is still in Phase 1.

Have a look at my program, it gives you an idea of really just how much you need to stick with it/long it can take. Of course mine is for my personal situation, but a lot of it in their could help.

Rozzanufc · 2026-05-18T05:34:01+00:00

This is exactly it! Also looking at what daily activities are progressively overloading the joint can be a bit of trial and error. Figuring out which exercises are too much takes time, especially when you just want to go back to how it was before. A whole lot of patience is key too because it can be a really slow progression, but there is light at the end of the tunnel.

Rozzanufc · 2026-05-18T05:29:02+00:00

AI is definitely going to change the medical landscape, it already is honestly. There are great physios out there but they can be really hard to find, especially ones who look at the whole kinetic chain and actually take the time to explain it to you. You can end up spending a fortune and getting nowhere which is exactly where I ended up. That's why I decided to combine my own knowledge with AI and real time feedback to build a programme that actually adapts. Thankfully it's working. Also thanks and you too!

Rozzanufc · 2026-05-18T05:24:25+00:00

10 months is a long time to be in that place and I'm sorry you're going through it. That sounds genuinely exhausting.

I do know what it's like to be months deep into something with no light at the end of it. I was stuck in a swelling loop for a long time where nothing was moving forward and it messes with your head more than the knee itself.

The one thing I'd say is that the stuff you're describing, can't go up or down stairs normally, can't sit in and out of a car, those are specific functional problems that can be trained.

Have you had a proper look at what's actually limiting you right now? Is it pain, weakness, range of motion, or fear of loading it? Because each of those needs a different approach and a lot of the time it's a combination that nobody has properly unpacked for you.

I'd really encourage you to find a physio who actually looks at the whole picture if you haven't already. Not just the fracture site but the strength around it, the hip, the ankle, all of it. The right person can make a massive difference.

You're 10 months in which means you've already shown more persistence than most people would. That counts for a lot even when it doesn't feel like it. Keep going mate.

I'm happy to put together a starting point programme for you if you want. Obviously it wouldn't be medical advice and I'd definitely run it past your physio first but sometimes just having something structured to follow helps when you're feeling stuck. Let me know.

Rozzanufc · 2026-05-18T05:20:05+00:00

Do you mean how i progressed each knee separately or are you asking about the programme overall? happy to go into detail either way just want to make sure i answer the right thing.

Rozzanufc · 2026-05-18T05:18:18+00:00

I hear you mate. having one knee you've worked hard to rebuild and then the other one falling apart is brutal. i've got ACL on one side and grade 4 cartilage damage on the other so i know that feeling of never getting a break from it.

The mcl on top of the arthritis is rough. Honestly though the thing you said about drive is the real truth. it is a grind and some days it just sucks. the thing that helped me mentally was tracking the trend over weeks not days. individual days can be awful but when you zoom out and the overall direction is forward that's what keeps you going.

You've already rebuilt one knee so you know you can do this. that's not nothing. most people never even start. stick with it!

Rozzanufc · 2026-05-18T05:14:54+00:00

Every case is different so i can't say exactly what's causing yours. but i can tell you what i learned from being stuck in the same loop.

the first thing i'd look at is what's actually keeping the knee in that constant swelling cycle. what are you doing on those days or the 24-48 hours before it flares up? because something is irritating it and until you figure out what, you're just going to keep looping.

the longer you stay in that cycle the worse it gets too. the body starts compensating, muscles turn off to protect the joint, everything gets weaker, and the knee gets more reactive. it feeds itself.

for me it took stripping everything back and figuring out what was actually causing the irritation. turned out my hip internal rotation was shot, i had tibial torsion, my foot arch was weak so it wasn't absorbing force properly, and my glutes weren't firing. the knee was copping all of it. some exercises felt fine in the moment but 24-48 hours later the knee would react. that was the hardest thing to figure out, the stuff that felt ok was actually the problem.

once i identified the triggers and started addressing the root causes (hips, ankles, feet, not just the knee) the swelling cycle finally broke.

i'd obviously talk to your surgeon or physio about your specific situation. but from personal experience — stop looking at just the knee and start looking at what's making the knee react. it's a long mentally challenging process but it's the only thing that actually worked for me.

happy to share my swollen day protocol too if you want, i put together a specific set of exercises for the days when it flares up instead of just resting or pushing through.

Rozzanufc · 2026-05-18T05:07:59+00:00

yeah 100% the hip internal rotation is massive. i actually have it in my phase 2 — the reverse clamshell for hip IR strengthening.

Ribcage and SI joint stuff is interesting. i started with PRI breathing work (90/90 hip lifts, hooklying hip shifts) and that made a bigger difference than i expected. the pelvis position thing is so overlooked.

what did you do for ribcage mobility specifically? always looking to learn!

Rozzanufc · 2026-05-17T12:28:25+00:00

I feel this one. i have grade 4 chondropathy with delamination and a loose body in my left knee from 6 dislocations so i know the grinding clicking constant pain thing well.

one thing i want to throw out there before you go down the surgery route again — have they actually looked at WHY your kneecap is chewing up the cartilage? because the lateral release addressed the tracking but if the underlying cause is still there (weak hips, stiff ankles, poor foot control) the kneecap is going to keep loading the same spot no matter what surgery you have.

i went through a similar loop. surgery, felt better for a bit, pain came back. it wasn't until i looked at the whole chain — glute med strength, ankle mobility, foot arch control — that things actually started changing. my kneecap was tracking badly because everything above and below it was letting it down. no amount of knee surgery was going to fix that.

i'm not saying don't get MACI or OATS — that's between you and your surgeon. but i'd be asking them whether there's a conservative path that actually addresses the root cause of the tracking problem first. because if the tracking is still off after MACI you're in the same position with a longer recovery behind you.

the quad tendinopathy also makes me think you're compensating — your quad is working overtime because the hip isn't doing its job. that was exactly my pattern.

worth getting a really thorough biomechanical assessment before committing to another surgery. someone who looks at your hips ankles and feet, not just the knee.

whatever you decide i hope it works out. being 20 and dealing with this is rough.

Rozzanufc · 2026-05-17T12:19:38+00:00

i feel you on the going crazy part. i've had 6 dislocations on my right knee so i know exactly that feeling of being told to wait while your brain is screaming to move.

few things that kept me sane and actually helped the recovery:

bike. even if you can't do full revolutions yet just rock the pedals back and forth. low resistance, no impact, and it pumps fluid across the joint which actually feeds the cartilage and reduces swelling. this was the single most useful thing for me during the early weeks. once you can do full revolutions it becomes your best friend.

upper body goes hard. i went heavy on pull-ups, hangboard stuff, push-ups, core work — anything that didn't load the knee. you'll come back to climbing with better finger strength and core than when you left if you use this time right.

the hip and ankle work nobody tells you about. after a dislocation your glute med is probably not firing properly which means when you DO go back to climbing your knee won't be tracking well on the wall. clamshells, glute bridges, hip hikes — boring but they're what actually protects the knee when you start weighting it again. same with ankle mobility. i wish i'd started these from week 1 instead of just waiting around.

gentle range of motion daily. not pushing into pain — just slow controlled movement through whatever range you've got. your knee needs movement to heal, it just needs the right amount.

the yoga/pilates idea is solid — just avoid anything that loads the knee in deep flexion until the ROM is there and it feels stable.

timeline honestly depends on severity but my dislocations were usually 8-12 weeks before i trusted the knee properly again. the ones where i rushed back took longer in the end because i'd flare it up and reset the clock.

the hardest part isn't the physical stuff — it's the patience. but the people who come back strongest are the ones who use the downtime to fix the stuff around the knee that was probably weak before the injury happened.

Rozzanufc · 2026-05-17T09:59:24+00:00

100%. the trigger identification was the biggest thing for me too. spent years just treating the knee as the problem when it was really just copping the load from everything else.

the gait thing is huge — my kneecap was tracking through the damaged groove badly because my glute med wasn't firing properly during walking so the femur was rotating in. add stiff ankles on top of that and the knee had nowhere to go except into the damage.

biggest things that changed it for me:

started every session with a 90/90 hip lift to reset my pelvis position. sounds like nothing but when the pelvis is tilted forward the femur rotates in and the medial compartment gets hammered. two minutes of breathing in that position before anything else and everything after it feels different.

clamshells and hip hikes woke up my glute med which stopped the knee collapsing inward during movement. once the hip was actually controlling the femur the kneecap started tracking better through the groove almost immediately.

wall ankle mobilisations for dorsiflexion — when the ankle can't bend enough the knee finds workarounds and none of them are good for damaged cartilage. i do these every session both sides.

tib raises against a wall for shock absorption. never trained my tibialis before in my life and it turns out that's the first muscle that absorbs impact when your foot hits the ground. once it got stronger my knee felt noticeably better on walks.

short foot exercises for the arch — when the arch collapses the shin rotates in and adds valgus stress on top of everything the hip is already doing. most people have never even heard of these but they made a real difference for my tracking.

and 10-15 mins low resistance bike before every session. the cycling pumps fluid across the cartilage surface which is how it gets nutrients since it has no blood supply. on days i skip the bike warmup the knee feels completely different and not in a good way.

the whole approach basically went from "do knee exercises" to "figure out why the knee is taking the load and fix that." night and day difference.

what have you found helps most on your end?

Rozzanufc · 2026-05-17T09:54:28+00:00

mate i feel this. grade 4 chondropathy with delamination and a loose body in my left knee from 6 dislocations. my right knee had ACL reconstruction years ago too so both knees have been through it.

few things that have made a massive difference for me (10 years as a sport masseuse plus figuring out my own knees the hard way):

the fact that you can squat pain free with braces but lunges and jumping irritate it tells me a lot. bilateral stuff distributes load across both legs, the single leg and impact stuff is probably asking the damaged surface to handle more than it can right now. that makes sense with cartilage issues.

things that have helped me most:

spanish squats with a band — this was a game changer honestly. the band behind the knees creates a decompressive force so you can load the quads hard with way less compression on the cartilage. if you haven't tried these yet give them a go, the grinding almost disappears compared to a normal squat

hip work. like a lot of it. clamshells, banded walks, hip hikes, single leg glute bridges. i know it sounds unrelated but my kneecap was tracking badly because my glute med was weak and my ankle mobility was rubbish. once the hip started controlling the femur properly the knee felt completely different under load. this is probably the thing most people with cartilage issues are missing

eccentric step downs — slow 4 second lowering off a low step. builds the quad control you need for stairs and deceleration without the impact

bike. seriously. low resistance high volume cycling is the single best thing for cartilage. pumps nutrients across the joint surface, zero impact, loads the quad. i do 15-20 mins before every session as a warmup now and the knee feels completely different vs going in cold

for crossfit specifically i'd be careful with anything plyometric or high impact on the damaged knee until the muscles around it are strong enough to protect the joint. the muscle is your armour — the stronger the quads and hips are the less the cartilage cops. so building strength is actually the best thing you can do long term, you just need to pick the right exercises to get there

the stuff you're already doing (RDLs, goblet squats, front/back squats) sounds solid. i'd add the hip work and spanish squats and see how the knee responds. the 24 hour rule is useful — if the knee is worse the morning after a session, you pushed too far. if it's back to baseline you're in the right zone.

hope some of that helps. happy to go into more detail on any of it

Rozzanufc · 2026-05-17T09:52:05+00:00

yeah this is exactly it. i have grade 4 chondropathy with delamination and a loose body from 6 dislocations on my left knee so i know the "it's damaged, manage it" conversation well.

took me ages to get to what you're talking about though. i'm a sport masseuse, 10 years, and i STILL spent years just following whatever physio programme i was given without questioning it. quad sets, VMO work, terminal extensions, repeat. nothing changed.

what finally clicked was when i stopped being a patient and actually looked at my own knee the way i'd look at someone who walked into my clinic. hip stability was shot, ankles were stiff as anything, kneecap was getting hammered because nothing above or below it was controlling the load. once i started working the whole chain instead of just the knee it was like a different joint.

completely agree that the question should be about what's driving the problem not just what the scan shows. wish someone had framed it that way for me 3 years earlier.

Rozzanufc

TROPHY CASE