Saturday, October 8, 2011

Reasons Why You Should (or Shouldn't) Keep a Knee Journal

In Saving My Knees, I described my experience keeping a knee journal, and how it helped me. Since then, I've been flattered to learn that at least a few readers of the book have chosen to do the same.

Perhaps one day knee journaling will even be widespread. While excited by this possibility (an idea goes viral in the knee pain community!), I also feel a little trepidation. That's because I can imagine some people taking up the activity with a half-hearted shrug -- "Ah okay, I'll give it a try, what the heck" -- then losing interest some weeks later, muttering, "Well, that was a waste of time."

So I thought I'd write about what makes a useful knee journal, in my opinion. Note at the outset, I'm saying "in my opinion." You may feel otherwise. If you want to include the dates of lunar cycles and observations about local flora and fauna, well, hey: It's your knee journal.

Still, I think the best use of such a journal is to pretend you're a scientist, you've just been given these things called "knees" that don't work all that well (and which unfortunately have been implanted in your body), and you're undertaking a study to try to determine what makes them feel bad, what makes them feel good, and how you can transition from the first (undesired) state to the second.

With that objective, a knee journal becomes a place not to kvetch aimlessly about your aching joints ("Ah, another miserable day in the wretched land of knee pain, as I regard the wind-swept fields from my balcony!"), but an aid to healing. Your knee journal should be working for you, not lying there passively to record random thoughts about your pain. How?

(1) If you use a knee journal smartly, it should give you a fairly detailed picture of where you are in your recovery and what your knees can and can't do.

If you're trying to heal your knees on your own, you face at least two big challenges: (a) figuring out a "baseline" level of activity your knees can handle, without getting worse (b) figuring out how much and you quickly you can push beyond this baseline, in an attempt to strengthen the soft tissues in the joints.

A good knee journal can help because you should be wearing a pedometer (mine was practically bolted to my hip) and scoring, or otherwise quantifying, how your knees feel day to day (and throwing in notes about your daily activities and the nature of the pain sensations from your knees).

(2) As you experiment, trying to find the right exercises to do, in the right amount, a knee journal provides invaluable feedback. (Note: a big benefit of working with a good physical therapist is that you shouldn't have to experiment nearly as much.)

I often tweaked my regimen, such as by introducing a new type of exercise that I thought might help. Later, I could look back in my journal and get a sense of what effect that exercise had, good or bad.

(3) Inspiration!

So there is a soft, fuzzy reason to keep a knee journal after all. :) There were times (after the first three or four months of my recovery program) when I was discouraged and felt I hadn't made much progress at all. My knee journal lifted my spirits by showing me that yes -- even though progress was slow -- I was getting better. I could look at entries and summaries from my first few weeks, and see my limitations then, and be grateful I had gotten beyond some of those problems at least!

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