In case you’re curious, here’s what I typically do when I’m not going into the clinic for physiotherapy.
On most days I divide this into a morning set and an afternoon set with another round just of flexion and extension in the evening. When I’m going into the clinic, I let that count as my afternoon set.
After a round of physio exercises, there’s then elevation and icing but that’s getting less urgent now which is good since I’m returning to work next week. Luckily there’s a freezer at my workplace for ice and a ton of room for physio in my office.
In preparation for returning to work, I’m moving all of my physio appointments to the evening. I’m very excited about biking there. It’s about 5 km from my office and then another 7 km home, so a perfectly reasonable summer evening bike ride.
I do other stuff too–TRX squats and some kettlebell swings. At the clinic, I also do some weighted sled pushes and pulls, I use the leg press machine, and then there’s my least favorite, monster walks. My favorite is riding my bike on the trainer which also helps a lot. But the eleven above are the everyday, mainstay of my daily rehab workout.
More than a few friends have watched me go through knee replacement surgery and recovery with the thought that they want to avoid this in their life.
I get that.
If you’re at the stage I was at that I couldn’t walk around a grocery store, and you’ve tried years and years of shots and physio and braces, then knee surgery is necessary. Once you’re at that point, I don’t think avoiding knee surgery is possible.
I also don’t think it’s worth putting off until 70 when at 70 you’ll be doing it with years and years of inactivity behind you.
But how to avoid getting there in the first place?
Now, to be clear, I’m a PhD but I’m not a medical doctor. Everything you’re reading here is just based on my own reading and experience. YMMV and it’s always good to do your own research.
The causes of knee osteoarthritis are many. And they’re mostly things you can’t control. The list includes age, sex (more common in women than men), weight, prior injury, and genetics.
I sometimes wonder if there was a sport I shouldn’t have done because of knee injuries. Mostly I worry about soccer. But it’s unclear that I could have avoided this.
The single biggest thing you can do to help is strengthening the muscles that support the knee. I’ve been advising friends with minor knee aches and pains to take those pains seriously. You can read through by post blog posts to see that’s how things began with me. See a physiotherapist now and start a preventative routine. Physiotherapists are wonderful people and I think they’d love seeing patients interested in preventing future damage to their joints.
I shared it with the blog team to see if anyone had anything more profound to add. Someone suggested that you might also choose to wear yoga pants on your way to divorce court after leaving this guy and any other guys who hold this opinion.
Probably the best internet response came from Twitter user @shesbonky. She honed in on the double standard angle of it all.
My right knee is healing well. I can do a lot with it now.
For example, I can walk upstairs now the normal way. I don’t need to lead with the good knee. Both knees are good enough for that task.
Also, and this is more exciting, five weeks past total knee replacement, I can pedal forwards on the bike. Yay! I’m doing about five minutes of forward pedaling at a time. I haven’t turned Zwift on yet as I’m not keen to see my speed, power, or cadence but being able to pedal forwards is exciting enough.
I’m also impressed that my knees match. Check out those surgical scars. A friend reminded me to use sunscreen on them.
I spent some time looking at tattoos for knees but then decided I don’t want to cover these up. Also, if I need revision surgery in there future I’d hate to mess them up.
My much more functional knees make me smile. And I’m not bothered by the scars. I’ve been wearing shorts and not feeling at all self conscious about them. I do notice now that lots of other people have them and I don’t think I noticed at all before.
Do you have visible surgical scars? How do you feel about them?
So normally here on the blog the vibe is all about discovering your own fitness groove. Find something you enjoy and do that, we say, because if fitness finds its way into your life as one more thing you have to do, another tedious, unpleasant, time consuming task, it’s very hard to stick with it.
Add pleasure to your life by finding a form of movement you enjoy.
Along with “start small” it’s probably the most common piece of fitness we give.
Now in this case, the reader did ask so we were on solid ground I think offering up our advice.
But there’s another theme lurking just below the surface at the blog. Lately I’ve been wanting to stand up and yell from a soapbox about women and the need for strength training. It might not be the thing that brings you joy but it might be necessary for functional fitness and independent living as you age.
“Aging causes muscles to lose mass, bone density to thin and joints to stiffen — affecting our balance, coordination and strength. At the same time, hormonal shifts and persistent low-level inflammation can set the stage for chronic diseases such as cancer, cardiovascular disease and diabetes.
And the changes start earlier than you might think. Muscles begin to shrink in our 30s and continue their downward spiral in midlife, with up to 25 percent of their peak mass gone by the time we’re 60.
But there’s hope: Exercise can stall muscle loss, cognitive decline and fatigue. “It’s never too late to start exercising, and it’s never too early,” Chhanda Dutta, a gerontologist at the National Institute on Aging, said.”
Women have been sold a bill of goods about fitness. There’s the focus on thinness, on appearance, and the over emphasis on cardio fitness over strength training. These things are also planks in my soapbox.
I was in hospital recently, after my knee replacement surgery, I was struck by how many of my elderly hospital roommates lacked the upper body strength to perform basic functional movements. Yes, they’d just had joint surgery but some of them struggled to be able to move themselves around in bed.
I think I said after the last surgery that using the toilet after knee surgery all of a sudden one legged pistol squats made a lot more sense. After this visit, core and tricep strength seemed pretty essential to a hospital stay where you’ve got some control over how you position yourself in bed. It felt like a lesson about muscle loss, strength training, and aging.
Now it maybe that we are over valuing independence. Maybe we should care less about it. I think this is a genuinely hard question. But to the extent that we do care about it, we should be in the gym lifting weights.
Here’s another example of the kind of rants I’m drawn to,
Last Sunday, I ran my first Half Marathon in thirty-nine months. I was very, very nervous: it had been a long time since I tried to hold any kind of race pace for more than 10 km. I decided I would put my trust in the Pace Rabbits holding the 1:50 sign. Usually I’m not a fan—I don’t like the crowd around the Rabbits and want my watch to set the pace, not theirs. But this time out, I wanted to avoid looking at my watch, to run by feel and just hold steady.
Immediately, I liked my Rabbits. They made the pace feel effortless and the woman’s strong legs had an easy cadence. They were great on the hills—“We’re going to run this together”—and good at negotiating water stations. They didn’t talk too much. I kept my eye on the dark pony tail in front of me and remembered to breath. I thought about how the race might feel for the Rabbits. Presumably, the pace was not demanding for them, but they had to hold those signs and check the times written on their arms and compare their watches while making encouraging noises to the small pack behind them. They had given up a race day of their own to make someone else’s day better.
After the race, I thanked them. And then I suddenly realized that I knew the woman from Before Times. Before Covid cancelled Boston, before an injury robbed me of hope, for a while, and eighteen months of running, there had been a woman at races in Kelowna who ran ahead of me. I had tried to catch her but never could. She was training as a massage therapist and spent two years in my valley before returning to her home town. We had talked. And now, here she was: Jamie Komadina.
To say that it felt miraculous to have the past meet the present on the streets of Vancouver is to understate how comforted I was to see Jamie’s face again. She told me about her recent Boston marathon odyssey l (travel horrors, a sudden flu, and the miracle of making it to the start line) and how she hoped to run it again. “Boston 2025!” And there it was: the future. With strong legs and an easy cadence.
We all should have a Pace Rabbit in our lives. Someone who makes the hard things easier, who gives up time in the limelight so that others can have theirs. Someone who opens the door to the future and says, “Look!”
We all should have a Pace Rabbit in our lives, so that we can learn to be one in turn.
Tuesday marks one month since my second knee replacement surgery.
While recovery from knee replacement surgery is a long slog, here are some of the things I’m looking forward to this week.
♥️ I put my gym membership on hold for a month and that ends Tuesday. Tuesday I’m back to the gym for some upper body weight training and some time on the recumbent bike.
♥️ I pedaled backwards six times today on my bike that’s on the trainer at my house. Pretty soon, I’m guessing this week, I’ll be able to manage a full pedal rotation forwards. You can read here about how I discovered that backwards is easier than forwards.
♥️ End of the week Sarah and I are going to go visit Jeff on the boat. You can read about his summer boating plans here.
♥️ Cheddar and I are looking forward to some longer dog walks together. We might go visit the Arboretum with my mother and Charlie and Chase. I can’t drive yet so that would be a team effort.
♥️ Speaking of team efforts, my mother and I have some garden centre visiting to do before I get back to work.
♥️ And speaking of work, my plan is to gradually start looking at my email and tackle some small tasks as I start to get my energy back. I’m booking some meetings and looking forward to my return to campus.
Anyway, wish me luck. It’s a long haul and a lot of work but I’m excited about the summer ahead.
“The WNBA is heading to Toronto for the first-ever WNBA Canada Game, featuring a preseason matchup between the Minnesota Lynx and the Chicago Sky on May 13th at Scotiabank Arena at 4 p.m. ET. Hoop, there it is, baby!”
“Join the 2022 the womens field as they take on the highland trail 550, a 550 mile, self supported bikepacking race in the scottish highlands. The route is rugged and technical, with lots of river crossing and steep climbing. The scenery is stunning though and makes the journey so worthwhile. The scottish weather is always fickle and it didnt give the riders an easy time. I wanted this film to show a different side of ultra racing, reflecting the variety or riders and not just focussing on those chasing podiums or records. Every rider who starts has a valid story regardless of result or finishing time, and there are many different ways to complete an ultra. Success might be getting to the startline, having juggled kids and a full time time job to get there. The film was made with permission and guidance from Alan Goldsmith, the route creator and race director.”
I’m struggling with sleep because of knee surgery. For the first week after knee surgery you can only sleep on your back (ugh!). After that, it’s a struggle to arrange pillows to make side sleeping possible. I awake with knee pain frequently. It was pretty much on the hour right after surgery and then 3-4 hours sleep at a stretch after that.
For the first while, I was staying awake until I was absolutely completely exhausted and falling hard and fast asleep at about 6 am.
To be clear, it’s not excruciating pain. There are very strong drugs for that. But it’s enough pain to make sleeping through the night a thing that just isn’t happening. It’s enough pain to wake me up and enough pain to make getting back to sleep challenging.
I’m napping most days, sometimes twice a day, and then I fret about napping because maybe it’s making it more challenging to sleep at night.
There are various life stages in which this has been an issue for me. Normally sleep is my super power. The two most obvious are new knees and new babies.
And in both cases, I think self-compassion is important. You’re not ruining your sleep habits for life. It’s not a disaster to have a patch of time when you’re not sleeping 8 hours in a row.
I’ve blogged before about placebo sleep and the idea that what we think about the sleep we’ve gotten matters more than the amount of sleep itself.
So I’m focusing less on sleep and more on relaxing about sleep. I’m not back at work until the third week of May. If it’s still an issue I’ll worry about it then.
Catherine wrote about the Dalai Lama sticking his tongue out. She was writing about mediation but I guess people searching key terms related to the recent controversy found her post. This was our most read post in April.