Monday, December 08, 2008

Getting Back on Track: Part One


It is almost three weeks since the arthroscopic surgery on my knee and my rehabilitation is well underway. I seldom share personal health stories here, but as a physiotherapist, this first person journey into a significant joint problem is worth reflecting on. I can safely say that in the thirty plus years I have worked, I have treated thousands of patients. Knee, hip and back treatment routines are as familiar as the back of my hand and I can give ready advice on all types of joint and muscle problems.

My surgeon reported that I have stage 3 to 4 osteoarthritis in all compartments of my knee. He tidied the mess the best he could and trimmed the torn meniscus that was blocking my joint movement. He hoped he had deferred a knee replacement for 5 to 10 years. While this news is nothing compared to a diagnosis of cancer or other debilitating illnesses, I was in shock. I walk a lot and my knee had never caused significant pain or stiffness until the month before surgery. I know I do not want a knee replacement. So this is the time to explore ways to extend the life of this joint (and others) and to see first hand if my advice works.


It was alarming to note how quickly I lost strength and endurance in the three weeks before surgery. My knee was in a splint and I was on crutches. Following surgery, swelling and pain continued to limit my activities. Within a month I felt physically and mentally depleted and realized the climb back to normalcy would be harder than the fall into dysfunction. Winter arrived at the same time with snow and ice making outdoor ventures risky on crutches.


A new arena and sports complex just opened up a short distance from our home and I decided to check it out. It features an indoor track above the ice surface and is open to the public free of charge. Six laps of the track equals one kilometer and nine laps equals a mile. I purchased a pair of Urban Poles to provide the joint support I still need. Nordic walking poles are gaining popularity as a general fitness tool as they provide a good upper extremity workout when walking. Poles are readily available at a number of local stores and a good pair costs about $100. I bought a pair that has various tips for use in snow, sand, mud and stone and is suitable for rough terrain and hiking. The store fitted me and gave me a lesson on their use and I also received an instructional DVD with the purchase.


I have been going to the track daily and have worked up to a distance of 1.5 km before I have to rest. As well as allowing me to walk without a limp and with a good stride length, the poles provide me with an increased aerobic workout and work the upper arm and back muscles safely. One half of the track has windows that look out on a wooded area. I am not ready for trails yet but the view gives me hope that I will be back soon.

I plan to post information on joint care and rehabilitation related to my condition about once a week and will discuss specific knee exercises and the importance of proper footwear. Here is a link about walking poles as well as an excellent site about the knee joint.

Urban Poling Inc.
- This is a commercial site and I am not endorsing this product over others. However the site has good links relating to research, technique and fitting of poles.

KNEEguru
- A British site with plenty of relevant information on knees. Click on the Information Hub when navigating from the main page.

Getting back on Track: Part Two

19 comments:

  1. Nice sequence of your recovery. My husband had a hip replacement in the dead of winter in Wisconsin. We went to Home Depot and Lowe's to do our walking. The wide aisles were perfect. Wish we had had a sports arena.

    I used poles long before they were common. Folks would look give me strange looks or ask if I lost my skis.

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  2. I will be following your updates. I have a feeling that I will be having problems with both of my knees in the near future. They have suffered from abuse by my years of running and lifting weights without proper equipment.

    Keep that gorgeous view of the woods in your mind as you are walking. I bet using the polls on trails would be a lot of fun.

    Great outlook and keep going strong!

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  3. I can attest to the importance for good shoes (thank you for those by the way!) I am looking forward to reading about your recovery (and I pray for it to be a speedy every morning.) I was wondering recently if the joint care information would be equally applicable for someone my age?

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  4. Kudos to the store that sold you the poles ... that they gave you a lesson and a DVD ... I see so many people using the poles incorrectly. I'm glad that you are finding them so helpful in your rehab.

    That would be a shocker about the knee. Ahh ... footwear!!! Unfortunately, when young, one doesn't see the necessity of good footwear.

    All the best in your recovery ... I sure wouldn't want a knee replacement either.

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  5. Hello,

    I jumped to your blog from Beth's page, and was glad to read the information on knee rehab...and receiving inspiration to tackle my own arthritic knees. Look forward to checking back more often...

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  6. Ruth......I can understand why you do not want a knee replacement.....the sports arena sounds like a wonderful idea.....

    As you know I am a keen gardener, and have a one acre site.....so of course a lot of kneeling takes place.....I have always used a kneeling pad and I really do try to take care of my precious limbs.

    You have such a positive attitude.......

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  7. Good post...and here wishing to a full recovery. I use poles when Hiking because one or both of my knees act up at times. I love them! So good luck to you.
    Oh I have a question about your blog..The little Technorati search box and link thingy...i signed up for Technorati but cant find that gadget you are using. Can you lead me in the right direction? thanks.

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  8. It's hard to fathom that you had no symptoms and then you were suddenly hit so hard. My knees first pained me on the 30th birthday or close to it, but so far, I endure. I wonder what stage they're at?

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  9. Glad your feeling better!

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  10. I am proud to be your Mom. You have always been a fighter and were always very compasionate in my many leg problems. I am really interested in the walking sticks for my walks here around the ecological parks. They would also help on the hills on the property here,
    In Vallarta for a week. Is walking in the sand too much or should I take advantage of it? here in Flamingos we have 2 K. of uninterupted beach in either direction
    Love and prayer

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  11. Thanks Ruth for sharing your story. There are a lot of aging knees out here with attached persons reading your story. The thought of OA and eventual knee replacement freaks me out; I hope mine hold out until the surgery is perfected with marvelous appliances. I've had patients fitted with the wrong size and more than one with post-op DVTs.

    Researchers keep putting healthy young men to bed for weeks and testing the loss of muscle mass and bone mass. Scary what a little inactivity can do and even worse for 'women of age' such as ourselves.

    Physiotherapist, heal thyself! And thanks again for taking us along on the track to recovery! (I must admit that I'm at ease with clunky sensible shoes and getting the paper in the morning in my robe, but I'm not sure I could set out down the avenue with poles just yet!)

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  12. How's that for turning a negative experience into a positive one. Thank you for sharing your experiences with us here in bloggerville. I am also looking forward to your blogs on joint health.

    Good thing you have that arena and view of the woods to help with your rehab. You go girl!

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  13. I started hiking with poles a couple of years ago in hopes of warding off knee problems and, like you, enjoy the added upper body workout. Good luck with your rehabilitation and thanks for keeping us posted.

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  14. Boy, it's so different when the shoe is on the other foot, so to speak, isn't it? So glad to hear that your rehab is going well Ruth. It's amazing the difference in perspective we gain when we go through these things ourselves. Be gentle with yourself. :c)

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  15. I enjoyed this informative post Ruth and am sorry you are dealing with this, but it's good that you know what you need to do...The poles look interesting...

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  16. NCMW- I hope your husband's hip replacement healed well. Good thing you don't care what people say about your poles. I have only had one stupid comment.

    Kim- I don't think I will be on the trails for a while. It just will not stop snowing here. Glad you are no longer abusing your knees.

    Jaspenelle- Keep checking. I will talk about some family knee issues.

    CS- Working in a rehab centre I see many knee replacements that went wrong, badly!! Even if they go well, they do not last forever.

    Sharon- Thanks for visiting and commenting. I hope you find ways to work on your knees.

    Cheryl- I realize now that I had gradually stopped doing things like kneeling and squatting because they hurt. I will be looking at more long handled tools for the garden.

    Dawn- I signed up with Technorati over 2 years ago and cannot even remember how to sign in. People can add blog feeds to their Blogger sidebars now and that has really messed up the Technorati results. I don't even check the site anymore...sorry.

    AC- I also wonder how many bad knees are out there. My Xrays never indicated the degree of damage seen on arthroscope. I wonder about my other knee too...

    Birdman- Thanks...hope we can get out again soon.

    Mom- You always face life with a smile and I do so most of the time. If you get a chance, try some poles before you buy them. They do work your shoulder muscles. I think they would be good for you though.

    FMDoc- Our city has walking clubs for able-bodied polers. I am too slow for them just now. I feel the same way you do about TKJR. I have had more than one patient die from a PE or MI after surgery. And the the number of joint infections...!

    Wendy- I hope things turn out even more positive in a few weeks. And I am thankful for all the great facilities available in our community.

    Beth- I really feel the upper body workout and know my posture is better with poles. You are being pro-active...I wish I had been.

    Jayne- We always tease the old nurses we get as patients at the hospital. Most are good natured, but others think nursing care isn't what it used to be... no back rubs at bedtime anymore.

    RW- I was thinking of you when I said I really cannot complain. Hope you are feeling stronger and stay well this winter.

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  17. Ruth, you have a positive attitude. And you know that positive attitudes help you heal sooner. God speed, my friend. For those of us who don't have knee problems, we should be grateful and thank the good Lord for providing us with healthy limbs.

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  18. Thanks for your well wishes Mary.

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  19. I would hate to be faced with a debilitating injury.It sounds like you have the determination and strength to will yourself back into shape.-It's interesting that you are now the patient in a field that you are usually on the other end of.-Here's to hoping that all the good Karma from the patients you have helped will come back to you.

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