Fitness is relative. You can be fit in one thing, unfit in another, this conundrum is what is giving me (or rather my knee) a bit of a headache (or more particularly knee ache!)
I struggle to stand for any length of time, if I sit too long I struggle to get up. I can’t walk that far without a stick, yet on 17-8 March I managed to get out for a road bike and a mountain bike ride in the same weekend, a sum total of 48km all in all.
This doesn’t happen often, or regularly, however my knee allowed me to cycle the local short loop, cycle to Oreti beach AND cycle the surf to city. When you think about it, 12km on a bike for some people is quite far. The client I cycled it with wasn’t sure she would make it. 12km running is certainly quite far. For your average joe.
So does that mean the knee is better? Does it heck. It means my super strong new drugs are working.. AT LAST!!! I’m pleased to say they don’t make me sick (the first that haven’t) and they do actually help alleviate the pain (also the first that have done this). Good news, even if I do now have to worry about an opiates based drug addiction! I’m now on a class B controlled drug equivalent to morphine.
I am also back at the pool, I try to get there at least once a week, depending how work is going (because am is waaaay better than PM for a pool visit!) however for now I’m adopting the idea that the cycling will work the legs and the swimming will work the arms so I’m sticking to freestyle, fitting in a steady set of however many I can for the time I have on the day that I visit.
It is rather a roller coaster though. I had 2 full days of massage this week (something I am trying to avoid but I had to respond to demand) and I was in so much pain by lunchtime Saturday that I was back on the opiates. This is the day that I found they actually don’t sedate me half as much as morphine has. Which means I can take them during the day also.
Is it not better for me to rest?
I have been asked this question frequently this last week or so. Well, the fact is that working the knee doesn’t make it worse, just like resting it doesn’t make it better. It is what it is. It will progress and eventually I will be totally crippled. There is nothing at all I can do about it.
But, resting it in fact could give me more problems than the pain I have to deal with, which is ironic.
The problems with rest
Muscle atrophy: muscle wastage due to not using them. It takes a lot of physio to get this back.
Loss of function: don’t use muscle for long enough, you eventually lose the ability to move the limb as the neuro-transmitters will switch off.
Incorrect loading on stress on other joints/ tendons/ ligaments: I already have this problem, as I avoid loading the knee so incorrectly load the hip, giving me pain in other places and more recently actually making lifting that leg at all really painful. To combat this I regularly have a deep tissue massage and am very mindful of where new aches appear, then have to work out what biomechanics have gone wrong and fix those too.
So, the question was, should I really still be doing all this?
The short answer is yes, because the more disabled I allow myself to become, the worse the long term prognosis will be.
It’s all a nasty viscous circle of events that I have to trundle around while STILL waiting for my third opinion.
Things I can no longer do:
- Walk any distance at all without a cane
- Get up out of a chair without assistance
- Stand for any length of time
- Demonstrate lunges
Things I struggle to do:
- Demonstrate squats
- Cycle (at times)
- Walk up / down hills and up / down steps
- Get in and out of a car
Why does massage give me so much trouble?
Because to maintain correct body mechanics, not load the back or cause any other unnecessary injury, a massage therapist is required to hold a squat or lunge position to keep the load off the back and arms, using something called joint stacking to create pressure when applying stokes.
As I have said above, I cannot lunge and I struggle to squat therefore my back tends to take a lot of the load when I am massaging, which, if I do too many in a row, causes me back pain. This in itself is not good at all.
That is why I am offloading as much of my massage as I can at the moment to other staff, to protect myself and prevent further injury. Rarely will I now take an hour massage appointment (30 mins is my current preferred appt length) and rarely will I have more than 4 massages in a day.
There will come a time when I have to stop completely, the thought makes me deeply sad because it is something I enjoy. But for now I will exercise common sense and you might not get an appointment with me as fast as you would like. You will always be able to get one with one of my other massage staff though, who are all equally as capable.
I have had to take a totally different approach to this. As long as I am tootling along at a steady pace on the flat, no sudden bursts, sprints or hills (thankfully Southland is flat), then I can manage the load and cycling is relatively pain free. This means I have to avoid going out in unpredictable weather or when the roads are particularly busy.
I just do freestyle, I stopped swimming breast stroke a year or more ago. I predominantly use arms, however do sometimes do kick drills to try and maintain quad strength, but these must be done butterfly kick and on my back for them to be manageable. Even so, some days are more painful than others so this really is a take it as it comes type thing.
Signs that I am probably in more pain than usual
- Sitting down more than usual
- Perhaps slightly less smiley than usual
- Not demonstrating exercises as much
- Asking you to have appointments with other staff members instead of me
- Limping when I walk
I’m not asking for sympathy, or any special treatment. I ask that you continue on the same as always, but with a slight understanding of what I might be having to deal with on a day to day basis. Plus, the reason I write this monthly update is for all of you who want to ask how it is but don’t feel like you can / should.
Trucking onwards with a smile (because, what is the point in doing anything less?)