So I found out that my brother, he of the torn meniscus, decided against surgery for now. He learned that his health insurance would leave him exposed on thousands of dollars of the cost and decided to take a pass. But his doctor told him he should expect to have a knee replacement in ten years.
How’s that for a future? Ugh.
Now, if I were him, I would not accept that. I can imagine a doctor saying the same thing to me about ten years ago, and today my knees are fine. But I also know that a lot of bad knees never heal. For us active types, there’s a very good reason for that.
Quite simply, it’s because we can’t give up what we love doing most. For me, it was cycling. For him, I think it’s hiking and weightlifting.
With knee pain, I think there has to be a sort of “come to Jesus” moment. Your knees have to get so bad, your misery so complete, that you resign yourself to the fact that everything must change.
Everything. And that means that sport that you love has to go.
I know I clung to cycling for as long as I could. I convinced myself I’d pedal differently, or stop going up mountains, and gradually the pain would go away. It did not. But I labored under this delusion for as long as possible, unwilling to face the truth.
Unwilling to have that “come to Jesus” moment.
I believe one key turning point in my recovery was fully, and unconditionally, accepting this statement:
I will stop riding my bicycle, and I may never ride it again, and I’m okay with that.
That was both a depressing and liberating realization. The sweaty physical activity I took part in, those wonderful, heart-pumping, intense workouts, involved cycling. Losing that seemed terrible.
But it was necessary.
I switched over to easy, high-repetition motion. For some people, that can be cycling. For me, it wasn’t. I found my body liked slow walking the best. I structured a program around that.
And, over the course of many months (as I detail in my book), I healed.
I’m not sure if my brother is at that point yet, where he can say, “I may never go hiking again, and I don’t care.” I don’t think so. But I think that’s the beaten-down point you have to reach, and in some odd way, embrace, before you can begin the journey up and out of a pit of despair.
What about those of you out there who are active? How have you dealt with this problem of resisting facing the reality of your limitations?
Hey Richard,
ReplyDeleteI totally know what your brother is going through now because I went through the same depression and sad realization that I will never be able to play high performance sports ever again... But that's ok, at least I can still play with my daughter and spend time with my wife and child when I come home from work.
Is your brother in constant pain? Or whenever he walks?
I know doctors will always say "you'll need to go for a knee replacement soon" blah blah blah.. It's like they want to see you fail..
Whenever I goto the gym and exercise the knee, it feels much better.. Whenever I slack or don't have time busy of busy life schedule, I would feel discomfort.. So exercising definitely helps...
What's the science behind that, Richard? I know you do high reps and low resistance... But why does that help you think?
I'm also curious as to why the doctor mentions he has 10 years before he requires a total knee replacement. Where is he getting that assumption from? It sounds like most doctor pressures their patients into going under the knife as if they receive some kind of referral commission...
ReplyDeleteI encourage your brother to have a read at these interesting articles...
https://www.regenexx.com/blog/research/should-i-get-meniscus-surgery-stop-and-read-this/
https://www.regenexx.com/blog/research/surgery-to-remove-cartilage-in-the-knee-not-effective/
Thanks for the messages and links, Stan. I don't know how constant my brother's pain is now. Most of what I'm hearing about his condition is being relayed through my mother these days. I don't know why the doctor says "in 10 years" he'll need a knee replacement. Does sound rather like he yanked that timeframe out of his posterior, doesn't it? :)
DeleteI think high reps and low resistance are just what joints like best. Cartilage appears to adapt best with high reps and low resistance. You'll see more on this in my book and if you search around this website.
Hi Richard -
ReplyDeleteI just bought your book on Amazon -and stayed up nearly all night reading it as I was in pain with my left knee. Your book is on the mark and has a lot of good stuff in it - I am interested in buying the Pedometer you have. What is it and where did you buy it. I have a pedometer that was a free one given to me because I order Prevention Magazine. It has Cals and Miles on it - not STEPS and I think I would like steps as it is easier to calculate. I have never used the pedometer I have - but I think if I have the one you have I would use it to see how the distance of my walks are affecting my knees. I would really appreciate a reply - larisadup@gmail.com
Thanks
Lara
Hi Lara, I bought the pedometer in Hong Kong and doubt I could even find it again (it's probably out of date by now). However, a cursory inspection of pedometers on Amazon shows that most indicate steps, such as this one here:
Deletehttps://www.amazon.com/3DFitBud-Counter-Walking-Pedometer-Lanyard/dp/B07DWFC62X/ref=sr_1_4?ie=UTF8&qid=1544306984&sr=8-4&keywords=pedometer+step+counter
Looks like yours is the rare one that has only calories and miles. I too think steps is the way to go. Good luck!
I do agree it can be hard to face up to one's new limitations as a result of a banged up knee or both of them. I used to be a very active person before I started having serious symptoms with both of my knees. I had no choice but to stop doing all that I liked doing altogether. It is simply no longer an option. I had to even stop walking almost completely--something that I really enjoyed before that. Nowadays, even a half-an-hour walk can aggravate my knee pain somewhat. The same goes for riding a bicycle or running. But all of that is not a very big deal for me. I only wish I were able to somehow stop the further deterioration of my knees. I am still able to train without loading my knees and that's okay. I do feel sorry for myself quite often, but a person gets used to everything. I don't understand people who keep pushing themselves while their knees hang in the balance. No sports or activity is worth doing if that means that one is going to end up needing an artificial knee or painkillers sooner than later.
ReplyDeleteI don't think you should give up hope. Maybe find a level of walking or cycling that you can tolerate and slowly try to increase it. Definitely don't run. Running puts a lot of force through our knees. Don't push, but nudge. I think that's the only way to improve.
DeleteI thought about this all day, so I figured I'd add a little more. I don't have some great success story to give you, but I got to the point I could barely walk at all, and I'm way better off now, although nowhere near out of the woods yet.
DeleteNot to put words in anyone's mouth but, I think the point is accept where you are now and what you have to give up now. Also believe you can improve, maybe not to 100%, but definitely to a better place than where you are now.
Richard's exact words:
"I will stop riding my bicycle, and I may never ride it again, and I’m okay with that."
"may never ride again" not "will never ride again". Having hope and a goal is very important I believe. If he had decided he would never ride again, he probably wouldn't have.
Don't lose hope and never give up.
Thanks Jk. I am trying to be realistic here, but I do, like all of us, have the optimism bias, secretly, or not so, hoping and believing it's gonna be okay or somewhat okay. But I do have nagging thoughts that it won't. After all, sometimes things don't turn out the way we want. But my main point was that for me personally, giving up things that I loved doing turned out to be relatively easy. I do regret I can't do some things, and I even wish I was able to do some other things I have long ago stopped doing (like jiu-jitsu, for instance), perhaps for the sheer reason I am not quite able to do them now.
DeleteI hear you bro. I'm in the same boat and have the same thoughts myself.
ReplyDeleteMaybe you won't do jiu-jitsu again and maybe I'll never run again. I'm going to get as close as I can though.
I can't claim victory over knee pain at this point, but throughout life I've found that if you aim high, when you fall short, your performance is acceptable, whereas if you aimed for acceptable, that's he best you could hope for and falling short would be failure.
I think we need to take that focus and discipline we applied o jiu-jitsu or whatever physical training we did before to getting better.
And thank you for the support as well. Just talking to other people in the same position helps.
An update relevant to this. After making good gains (finally, after 5yrs, following a Dr Scott Dye type protocol which involved 6mths on the anti-inflammatory Celebrex), I got a lot of improvement in my dual-knee synovitis and was able to start a little cycling/running again & even did a short triathlon back in October. But as I continued to become more regular with my training, things went backwards, though the pain was different - more the patella chondromalacia sharp catching pain, and less the chronic burn/ache of knee synovitis.
ReplyDeleteSo I've stopped biking & running again (which is a shame as I got a nice new mountain bike early in 2018 & found I enjoyed MTB far more than triathlon).
But it's time for another re-set. Back to swimming with minimal kicking and a short intense gym circuit which involves minimal knee pressure. I've also read about a hiker who cured his chondromalacia by strengthening his glutes so will give that a try.
Sigh.......
Hi Richard,
ReplyDeleteI'm glad your brother held off on getting the surgery. I am hopeful that he could explore other pathways (physical therapy, etc.) that might help him without it. I have found that I have gotten much stronger with weight training and physical therapy, specifically, strengthening my hips and learning how to apply less load to my knee.
I do think there is a point where you have that "come to Jesus" moment where you realize that life will never be the same and you don't know what, if anything, you will be able to do with your knee from that moment. I do feel that I hit that moment. At the same time, my rolfing practitioner encourages me to keep an open mind and to live my life as much as I can. That you really just don't know what is possible and to stop doing the things you love can be worse than the actual injury. Not that he encourages me to hurt myself, but to nudge the knee and experiment with what I can do with it. My doctor said the same thing -- to keep doing the things I love, but to adjust and modify according to the strength and abilities of my knee at that moment.
Today I went to a dance class, and I wasn't sure what to expect. My knee hurt, as it does everyday, but I was going to dance, darn it! And I did and felt really good, even as my knee tweaked from time to time. I tried to work with my lessons from PT and utilize my hips and be careful about the load on my knee in certain positions.
At one point the teacher gave us some moves that had us getting up and off the floor. While I was able to do it, I found it stressful and didn't want to aggravate my knee doing it over and over. She was more than happy to give me an alternative movement that didn't involve me getting up and down. I felt both proud for taking care of myself in the class, but also grateful to her for accommodating so generously.
At another point, I stepped outside to get some water, and found myself running to the fountain! I couldn't believe it! Now, I was running mostly on my toes (I was barefoot), but I haven't run in months and months because of my knee, and there I was doing it! Does that mean I should run a marathon? No! But it's a movement that I did without thinking and with no pain, that I couldn't do just a few months ago. Every time I do some movement with my knee that I don't think about, that I couldn't do just months ago, is a triumph for me.
It's that kind of thing that my doctor and rolfing practitioner encourage. To challenge the knee just enough, even when it hurts a bit, and then to watch and see how it recovers and the timeframe of that recovery. To build the resilience of the knee, slowly.
I don't think you should stop doing what you love. Perhaps you can just modify it? I will admit that I am not a hardcore exerciser, so perhaps what you wish to do simply isn't possible with your condition. But what if you could find a modified way to do what you love? I think that would be a good thing.
Finally, my doc said the same thing that he'd probably see me again about my knee in 5-10 years (arthritis), but that exercise would be the key factor in keeping me from needing any kind of surgery. So I do intend to continue with that.
I will keep dancing until I just can't. And I might never really run again, and that's ok. But today I ran on my toes!
Thanks for everyone comments. This knee pain/ after injury lifestyle has me re-confirguring my life around a lot. Yes, it's sad, I cry regularly every week for not being able to do what I was able to do(my flavor of activity was yoga, dance hiking, and some climbing) but I try to see the positive in that I'm able to walk(short distances only still, not going for "walks") and I can't give up going to outdoorsy movie festivals and getting pumped up at seeing others do crazy inspiring stunts on rock or snow...
ReplyDeleteMy chronic pain therapist told me of the story of this youngish guy-thirties- who had a bone-on-bone knee condition, doctors had told him he wouldn't be able to walk well again and after many years of work and trying he's able to live an active lifestyle, hike etc. So I do agree it's important to set a high bar so that if we fail at least we can fall on acceptable, as someone pointed out on this thread.
I had to stop doing my pool walking as my other knee started acting out, turns out I mild chondromalacia in the left one too, and I've been off of swimming and water stuff until it's better. Been doing pilates and flexibility work and It's month 3 and it feels like it's doing much better. Will resume pool activities soon!
Also I've been exploring with breath awareness and movement awareness a lot lately. I noticed that the days I do a lot of deep breathing, and meditation my pain is considerably low. I'm also gonna try an Alexander technique class and see if that helps further, and see what they say about unhelpful movement patterns.
@ Anonymous, does Rolfing help your knee pain? I want to try it but I'm a bit scared as I heard it's pretty deep work and I my knee still feels a bit reactive.
@ Richard: I wrote a similar statement to yours to help me surrender and accept where I'm at, but I wrote hiking instead of biking. Thanks for sharing your process!
@ TriAgain know that your posts have helped me in many ways and I'm sure with your perseverance you'll get back to your mountain bike soon.
Be well and happy new year to everyone! keep up the good work! Healing is possible if you believe it is.
Hi silvertongued,
DeleteI do recommend Rolfing, as I have found it really helpful. I think a good practitioner will talk with you about your condition and your pain, and then apply his/her methods accordingly. My practitioner could and did go deep sometimes, but he also worked very delicately depending upon my pain or sensitivity that day. He refers to his work as "structural integration". The work he performs involves changing the pain messages that our nerves are sending to our brain so that the muscles can relax and heal better. We talked a lot about working through the pain, not to a point of hurting yourself, but learning to be less afraid of pain so that you could live your life as fully as possible. I would say look for a practitioner who will consult with you, let them know how your knee is feeling and see if they can work with your issues and sensitivity. I too was not sure about rolfing, but I was willing to try it, and I am very glad I did! If you are interested in learning more, you can check out rolfing.nyc. Good luck!
Thank you so much for your response! Sounds like your rolfer works with the central nervous system which totally appeals to me, as I've read a bunch on pain messages being deceitful (especially with persistent pain). It may be a bit further into the future for me but definitely would give Rolfing a try.
DeleteI like your story about going dancing...and that you pushed yourself a bit! I'd like to do this too sometime soon. And also be less afraid of pain to be able to live life more fully! I miss my "care free body" days. Cheers and more healing your way!