Just What I Kneeded

What happens after a life-altering knee injury?


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Thirty seconds

Spring lasted all of thirty seconds around here. Seriously, it was blowing snow on April 2, and it was 85 degrees today. I’m not going to complain… but I want to complain. Because it’s hot. I spent the weekend shearing llamas, and it was sweaty, dirty business. I only got 16 done, which means there are 48 still waiting on me. Oy.

I’m getting ready to do something this weekend that I haven’t done in four years. I’m going to compete at a llama show. Yes! Legit. I actually signed up, and I’m going. I’m totally unprepared and haven’t practiced AT ALL, but I wanted to do it, so I’m doing it. I had to sign up before I chickened out.

This show is actually the same one after which I stopped competing four years ago. At the end of that day, I drove home in tears. I was in agony. That was also the day I decided to get serious about the big surgery.

For the last two years, I’ve gone to shows and helped friends with their animals. I even went in the ring once or twice. But I never exhibited my own animal, and I certainly didn’t do the performance classes.

I’m pretty excited about this. I’m taking an animal that I trained years ago (but that I haven’t practiced with in about four years), and I enjoy him oh so much. His name is Zin. He’s big and fluffy and patient, and we’re going to go make fools of ourselves.

This is kind of a prove-to-myself-that-this-was-all-worth-it moment. We’ll see how it goes. Fingers crossed!

 

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Motivation is hard to find sometimes

I am no closer to not resembling a couch potato than I was when I last posted after a 5k in March. I did do the 5k I’d signed up for on April 2. Despite the BLOWING SNOW through the whole race, I actually made my best time yet, but it was also my first road race (read there were no real hills). Regardless, my current strategy of running exactly once a month–at a race–is clearly working.

Not really.

But sort of.

Seriously, who does this? Not smart people, that’s for sure. A friend of mine was incredulous after I told her about the last race, “How do you even do that? Just go out and run  5k?” I think it may simply be my stubborn streak.

I decided after the last race (yes, if you’ve been reading, it’s like the fifth time I decided) that I need a plan. For a variety of reasons, I’ve stopped doing pretty much anything active for the last four months (aforementioned one race a month doesn’t count), and I know I need to get back to it. I feel the need to get back to my PT exercises now more than ever because the knee is aching on days when I do nothing. I think the down time was good for the knee for a while, but even it has had its fill.

I made it my goal this year to do one race per month–12 total. I’ve managed to do the first four by the skin of my teeth. Now, I’m going to plan a bit better. I have the next two races planned–a 5k in May and a quarter marathon trail run in June. I’ve done both distances already this year, so I’m not worried about finishing. I am, however, worried about finishing with an intact knee. I can’t blow it now after all the blood, sweat and tears that I’ve expended rehabbing it over the course of five years.

So… I spent time this past weekend putting together a plan to get back to doing my PT exercises. I also ordered a Bosu ball and helped a friend make me a slant board so that I can do some of my most important exercises at home. Not completely sure why, but actually getting to the gym feels like such a burden right now. But it doesn’t (read shouldn’t) matter because I can do nearly everything from home. I also found a good online yoga practice, so I can start doing yoga at home, too. I’ve done it twice already, and, um… I’ll be easing back in to that. I’ve lost an awful lot of strength while sitting on my butt.

I also ordered a new pair of running shoes. I tried them on in the local running store, and they felt like I was seriously walking on clouds. I couldn’t stop smiling while I was wearing them around the store. But the price was a bit steep for me, especially for a pair of shoes that might not get all that much mileage. I had to leave them in the store. But then I found them online for nearly $50 less. I ordered them immediately, but I have yet to receive them, so we’ll see if that deal was too good to be true…

I hope I’m headed in the right direction. I certainly feel more motivated than I have in a long time. Maybe it’s because spring feels like it might actually arrive this week, and that has me feeling pretty happy.


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So much

“The question isn’t who is going to let me; it’s who is going to stop me.” – Ayn Rand

In my last post, I was lamenting the fact that I hadn’t posted in a while. That was in March, and I haven’t posted since. Boo. I’ve just had SO MUCH going on, it’s been nearly impossible to sit down and write. The good news is that the knee–the reason I started this blog–is in pretty good shape for the shape it’s in. In short, it’s gotten me on a plane to the beach, through the spring shearing season and on my first jog of the spring. All good things.

I’m feeling really positive about the knee, and it’s more than the short bursts of positivity I’ve had all along. I’ve been on an upward trajectory since December/January when I finally directly addressed the patellar tendon issues. Lots of give and take, but no more taking one step forward and two steps back.

I passed the five-year mark from initial injury in March… and I didn’t even realize it at the time. I no longer have the knee on the top of my mind. Unless, of course, I’m about to do something physical that I’m uncertain whether the knee can handle. But it’s been responding really well in the last few months. I still have pain/inflammation if I do something like jog 2-3 miles; it hurts when I stop running and will continue to ache for the next 24-48 hours. But since I’ve been assured that I am not damaging the knee with activity and it doesn’t hurt enough in the moment to stop me, I keep doing more and more.

I started doing hack squats with my gym buddy a couple months ago. Amazing. I can do squats. Not half-assed squats through only a portion of the ROM, but real ones through the entire ROM. He also had me try lunges. Those are more difficult. There is enough pain that I don’t always activate the right muscles to do the movement, so I have to do them slowly and deliberately. But I can do them.

I think, perhaps, the best part is that I haven’t seen any health professionals in any capacity since January. No OS. No PT. No chiropractor. No pain doc. It’s been absolutely freeing. I respect and am thankful for all of their work because I wouldn’t be here without each one of them, but I am happy to be completely on my own.

Right now, I feel that there is no one and nothing that will stop me from doing anything that I want to do. That’s why a triathlon is marked on my calendar for October. It’s happening.


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Shake it off

I was going to title this “Haters gonna hate,” but I was informed no one over the age of 15 uses that phrase, except Taylor Swift. Pfft.

I’ve been at this knee thing for five years now. Almost. It will be five years at the end of March. In the beginning, people in my life were all really positive and spent lots of time cheering me on. I had all the help I needed in the first weeks after the big surgery, and people would go out of their way to be encouraging. I had people asking after me, and I wondered how they even knew about my knee. I was always thankful to have such support, and it was difficult to be anything but positive when so many people surrounded me with optimism.

Then came the last year. Some people in my life, though very well meaning, became downers. I was struggling quite a bit last year, and some people thought the best approach was to begin telling me that maybe I just needed to accept the knee was as good as it was going to get. I understand they were trying to be helpful, and they didn’t want to see me hurt. Except I wasn’t ready to throw in the towel, and I didn’t take it so well. It pissed me off.

It also motivated me. I wanted to prove them wrong. I wasn’t ready to believe that I wouldn’t be able to do simple things (like sweep my floor or go up/down stairs) without eliciting pain. I also still didn’t want to believe that I wouldn’t compete again, but that was no longer as worrisome as not being able to live everyday without pain.

One of the naysayers was my primary OS. He told me in June that he didn’t think there was anything else to do for the knee and that I needed to consider that this was maybe as good as the knee was going to get. I appreciate that he’d run out of ideas and was being honest with me about that, but I took it as a challenge. And I proved him wrong over the course of the next six months. Even if I get no better from here on out, I’m definitely better than I was last June.

I’m not writing this to be all “in your face!” (I like my primary OS, and I certainly wouldn’t be here without all the good work he’s done.) I’m writing this for the folks who might be reading and who have their own naysayers. Don’t listen to your critics. Well, you can listen to them, but prove them wrong. Whatever is going on right now, it’s your journey. You can let people help guide you along the way, but it’s ultimately your decision how you move through life. Make your life about you and not about what other people think, especially when they’re loudly whispering in your ear that you can’t do something.


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Goals are generally good

I frequently overestimate my ability to do anything that requires two healthy knees. It’s like, if my surgeon or PT gives me a glimmer of hope or a confirmation of a small progression, I’ll take that small thing and turn it into a giant RAINBOW OF OPTIMISM. I don’t necessarily know that it’s a bad thing. Sure, I’ve overdone it before with PT exercises or physical activity because I don’t always pay attention to my own limits, but on the other hand, this optimism is largely what’s kept me going.

Now that I’ve had three weeks of positive progress, I can’t help but begin to think about all the possibilities. I’m trying to temper that with what’s realistic, but it’s so hard. Because rock climbing and snow skiing. And biking and competition.

I’m setting goals to have something meaningful to work toward. Below are some of the ideas rolling around in my head. I’ve no clue whether any of these are possible because I have a hard time visualizing my progress past the week in front of me. Meaning that I don’t exactly know what it’s going to take to reach any of these goals. I also haven’t breathed a word of these to anyone on my healthcare team because I suspect most of them are unrealistic. Nevertheless, I’m spending my time making grand plans.

Physical Therapy/Rehab Goals

Not completely sure what I can accomplish here, but I’ve been told from the get go that strength is the key to successfully rehabbing my knee. It follows, then, that the rehab goals are largely strength related.

1. Single leg press 180 lbs. Why? Because that’s the number I tested at when I did the machine test, but there’s no way that I can do that without pain right now. I’m working on just the eccentric single leg press, and I’m only at 105 lbs.

2. Single leg extension with 70 lbs. Again, that’s the test number, but I can’t get there without pain. My goal on these first two is to be able to do the full movement (full ROM) with no pain at the level I tested at in early September.

3. Use the elliptical for 30 consecutive minutes. Right now, I’ll use the elliptical for about 10 minutes to warm up, but no more. If I fully engage my quad, I’ll get a nasty spike of pain right through the middle of my knee, so I’m still compensating with my left leg. I want to be able to increase my time on the elliptical and be able to use it without pain.

4. Do 3 sets of 10 full squats. I could do these now, if I simply used my left leg. The goal is to be able to do them with my body weight equally settled through both legs. Squats are an important exercise, and one that I’ve struggled with for a long time.

5. Do a Bulgarian split squat. Just because.

6. Find some more rehab goals. These don’t seem like all that much…

Cycling Goals

I’ve admittedly not been on the bike in months. While I’m still willfully ignoring that my absence from the bike might play into improving on the rehab, I’ve made some goals for this next year.

Tour de Lou (Louisville, KY; in conjunction with Kentucky Derby) on April 26; choice of 20- or 35-mile routes
April might be a little ambitious for much more than simply getting out on my bike. But… one can hope.

Tour de Cure (Indianapolis, IN) on June 20; choice of 50k, 75k or a century
While 50k translates into only 31.0686 miles, it falls well within what I used to be able to do without even thinking about it. But I’m no longer at that level, so we’ll see. The end of June seems more realistic than the end of April. Plus, I have friends who have done this ride, and that makes me more inclined to join them.

Tour de Upland (Nashville, IN) on August 14-16; choice of 50- or 100-mile relays
This has the best description. “30 hours of cycling (road and mountain bike routes), beer, camping, and music in Nashville, IN. Plus the toughest Century in Indiana.” This one is a relay, so I could crap out and still have fun because beer.

Little Miami Triathlon (Cincinnati, OH) on October 4; 6 mi of kayaking, 5.5 mi of running and 18 mi of cycling
The running here might be the issue. Plus, the biking is mostly hills, and I don’t know how well I’ll be able to handle those. But the kayaking? I can do that! I’ve done this “triathlon” before, so I think I can do it again.

Hilly Hundred (Ellettsville, IN) on October 9-11; two days of riding approximately 50 miles each day
The description makes me nervous: “The challenging terrain is a wonderful mix of gently rolling country roads and breathtaking hills (literally).” Again, it’s the hills that might mean I can’t do this, but I should certainly be able to pedal 100 miles in a weekend by October.

Life Goals

Indoor rock climbing
Apparently, indoor rock climbing is a thing. I knew that there were places where you could go and climb walls, but I don’t think I ever realized that there are places dedicated to indoor rock climbing. A friend of mine told me about Climb Time Indy where you can get private lessons and day passes. My real goal is to go climbing “out west,” but I think this is the best first step.

Hiking at Red River Gorge
I love this place. I must go back.

Finisher’s medal
Basically, I just want to do something to earn a finisher’s medal. I’m all about the competition, but for now, I just want to finish something. I’m going to try to do this as part of a relay for the Muncie Ironman 70.3. I found two willing teammates (a swimmer and a runner) last year, but we’re kind of waiting to register until I figure out if I can actually ride. I guess this could go under the cycling goals, too.

I don’t want to set any goals that pertain to riding because I’ll be brutally disappointed if I don’t make those. I think I need to be happy with whatever I’m able to do with the horses.

That’s about it. I’ll need to work on those PT/rehab goals in order to make the others happen, but I’m very much looking forward to 2015. This year is nothing but possibility right now.


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Holy shit

I sent my PT a progress report last week, and I told her that I really wanted to put “holy shit” in the subject line of the email. I didn’t because I thought it might get flagged as inappropriate, and the email was important. But this is my blog, so I get to title this post whatever I want to title it.

But why the title? Why the email? I’ll tell you why! Because I’ve never made such significant progress in such a short amount of time… ever. I don’t even know that I should be sharing this progress out loud in case it’s a blip or something, but I’m too damn happy to keep it to myself any longer.

The eccentric exercises and the Graston-like (but done with the handle of a reflex hammer and by myself) work that I’ve been doing for the last two-ish months seems to be helping. Like a lot. Over the past two weeks, I’ve been able to do the eccentric phase of the single leg press with 105 lbs with minimal pain. And the eccentric single leg extension with 35 lbs through the ENTIRE ROM with minimal pain. Can we just take a minute to appreciate that last sentence? Not the part about the weight–that’s kind of lame yet–but the part where I’m suddenly able to do a single leg extension through the entire ROM. I have not been able to do that since the initial injury nearly five years ago (five years in March). In fact, I would elicit pain just straightening my leg when in a seated position. It’s not entirely pain free, but it’s a huge improvement.

I do the exercises after I’ve been in the pool, so I completely warmed up. I’m still having lots of trouble on the stairs, but I think it might be because I do those cold. I’m hoping that the improvements in the gym carry over to real life.

So, yeah, 2015 is just full of possibility at this point.


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Suck it up, Buttercup (part deux)

I explained in the last post that a new MRI clearly showed patellar tendinopathy (degenerative process in the patellar tendon). This post will explain what we plan to do about it (I mean “we” as in “my healthcare team and I,” not in a royal sense).

I have a lot of pain right straight through the front of my knee during a specific ROM (have since about four months after the big surgery), and I thought perhaps that was the scarred fat pad because it feels like there is something physically in there that my knee has to work around (I’ve described it like someone jammed their finger into my knee right below the patella and now the knee has to bend around it; it’s weird). Doc said he doesn’t think it’s the fat pad; he thinks that the tendon is so thickened, it’s catching/rubbing during ROM.

I was inadvertently making the problem worse over the last couple of months. I knew the pain had increased, but I didn’t yet know for sure that the pain was coming from the patellar tendon. I was doing leg extensions with increasing weight/pain, and some nights, it was all I could do to get through the leg extensions. I had to turn my headphones all the way up to help take my mind off the actual exercise, and I’d occasionally sit in the gym literally talking myself into doing the sets. I might go deaf because of a knee issue, but, by gum, I’m going to do the exercises I’m told to do. I’m sure I looked and sounded like a crazy person talking to myself and singing along to my tunes.

I knew I had a problem when the knee started hurting in the pool, but I didn’t stop because the PT had told me that I should push through the pain. I’d worked the knee into such a tizzy that, by the time I had the MRI, I was having all kinds of trouble going up/down stairs again. The pain was so bad, I would throw my leg out from the hip to get it bend enough to go down the stairs. Not good.

I was not a fan of the new PT for a number of reasons. I think a lot of the issues stemmed from his inexperience. He had a specific protocol for a specific diagnosis, and he couldn’t tailor it to a specific patient’s needs. I had to make a quick decision when the doc said to continue with PT for the patellar tendon issue, so I decided to go back to my previous PT (the awesome one who has helped immensely over the past year). It’s a bit odd since she’s in a different clinic, but I trust her and value her guidance.

I met with my previous PT last week, and she showed me a few things to do to see if the tendon will respond favorably. She also did ultrasound while in the office (we’re not sure it will work, but it shouldn’t hurt). I’m supposed to do some at-home work to see if I can reconfigure the scar tissue in my knee and to see if I can stretch the quad to allow my kneecap to drop down into a more normal position (we know from the exam and a previous MRI that I have patella alta). In addition to these things, I will do eccentric exercises to load the tendon in a protected manner. We didn’t specifically talk about squats on a decline board, but quite a bit of the research I’ve read in the last couple of weeks shows decline squats are something that works for patellar tendon issues. Like with everything else, there are also detractors who don’t think decline squats are the way to go (so confusing!), so I’m unsure whether or not I will do those. I will, however, go back to the leg extension machine and use it in a slightly different way. I’m only using 30 lbs (so lower weight), and I use two legs to push it up and then lower it with just one very slowly. I still freaking hate this machine.

We’ll see if all of this helps a tendon that first showed signs of a problem on the MRI in May 2013. That’s 19 months that have gone by without directly addressing this issue, though we did work around it because I’ve always been sore there. In some ways, like the single-leg extensions I’ve been doing, we’ve probably made the issue worse. Seems like it’s going to be a lot of slow work, but I am glad there is something specific to address.

The good news is that, through all of this, the lateral portion of my knee that had caused such pain in the past has not been affected. At some point during the summer/fall, that particular pain largely dissipated (I’m willfully ignoring that there might be a connection to the fact that I was swimming so much, I stopped biking very much at all), and it hasn’t returned. Let me be clear. There is “pain” there, but it’s minimal and totally manageable. That really just leaves the big pain through the front of my knee. I feel like there’s nothing I won’t be able to do, if we can improve that pain. Well, nothing other than running and other high-impact activities. But the doc indicated he sees no reason I can’t ride, as long as I can manage the pain. Exciting!