fitness · injury

A non-four-letter word I really dislike, but have to deal with: fragility

Exactly two weeks ago, as I was walking down the stairs from my apartment, my right ankle rolled out and just crumpled underneath me.  I went down, luckily on my rear end instead of my head.  It hurt like nobody’s business– the kind of pain that makes you scream and curse (even if that’s not your thing) and get nauseated and maybe faint.

My very nice neighbor Melih came right away and took me to the ER, whereupon I was x-rayed and determined to have a bad sprained ankle.  They gave me ibuprofen (which helped a lot with the pain), an ice pack (ditto), a pair of crutches and sent me home.

Injuries suck. They’re unexpected, often super-painful, and they snarl up our lives and schedules.  And they take a long time to go away, often requiring surgery, physical therapy, and sometimes devices to wear to support us or prevent re-injury.

Injuries upset me because they highlight my vulnerabilities– places in my body where I am fragile. For me, it’s my ankles.  I’ve always been prone to sprains, and I fractured my left ankle 4 years ago (minor avulsion fracture, but still). Yes, yes,– I’ve gotten very good physical therapy, and I did those exercises religiously. But once I was functional again, I turned away from focusing on my more frail parts. I didn’t give them the care that they so clearly needed.

So here I am again. This time, at age 56, living alone, and on crutches.  Crutches suck, too, by the way. I had a terrible time crutching around on one foot– my upper body didn’t feel strong enough to manage it. I know, there are techniques for making this easier, and I paid attention to folks at the hospital teaching me, and also looked online (because that’s what we do these days…)

Let me say now that I’m lucky and grateful to have good friends and neighbors and colleagues and health insurance and enough money for car rides and takeout and a job where I can do some teaching online and all sorts of other things that make my life so nice.  It could be a lot worse.

This feeling of fragility though– throwing money at the problem doesn’t help.

(Taking a few breaths here)

Two things:

First: My bad ankle sprain is a wake-up call for me as an aging person. I want to be stronger, and I can do things to make myself stronger: continue PT exercises; get a personal trainer or join gym classes; create a regimen that includes more strengthening; pay more attention to my core and upper body (I do yoga, but need to focus more on specific areas of strength and flexibility).  I don’t want to have to go to rehab because I live alone and cannot care for myself.  Yes, that happens, and no, it’s not the worst thing.  But it scares me. A lot.

Second: Turning toward and taking in my physical fragility and vulnerability is emotionally painful. It makes me scream and curse and feel nauseated and maybe faint. Why?  Because maybe some of that vulnerability is beyond my control.  I have the body I have.  I have the ankles I have. I can balance on bosu balls all the livelong day, and those ankles will still be my most tender parts. This is what my life feels like.

(breathing again)

I know, my world is not ending.  I have a bad sprained ankle and months of physical therapy ahead. My world, however, is a bit different now. I’ll be paying attention to fragility and vulnerability more, even though it took some tumbling and kicking and screaming to get here.

Readers, how do you deal with fragility? Does it scare you? Is it okay?  If you feel like it, I’d love to hear from you.

 

 

athletes · blogging · fitness · injury · monthly check in · motivation · sailing · weight loss

Sam’s monthly check-in: What’s up, what’s down, the July version (CW: long, some sad bits, some discussion of weight loss)

Down, is of course, my knee

Saw the surgeon and his team on Monday. I’ve been crying on and off since.

The easy bits are that I got another shot of synvisc under my kneecap. What is it and what’s it for? “SYNVISC is a viscosupplement injection that supplements the fluid in your knee to help lubricate and cushion the joint. SYNVISC is for people with knee osteoarthritis who have not received enough pain relief from diet, exercise and over-the-counter pain medication.”

Read more here.

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Knee injection

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I’m also still wearing the knee brace and it’s helping on days when I’m on my feet a lot. I spent the weekend in New York and even though I took the subway more than usual and hopped in a few taxis for good measure, I still got 13,000 steps in on Sunday including a walk through Central Park. Thanks knee brace. I did some shopping for more leggings for under the brace and for short skirts and dresses to wear over the leggings. The brace presents some fashion challenges and I’m warmer than usual with black leggings on no matter what.

Image description: A photo of Sam just outside Central Park. I’m wearing black leggings, sandals, a sleeveless black jumper and a purse over my shoulder. Also, a knee brace. I’m smiling and the sun is shining.

I’m still going to physio and doing lots of knee-supporting exercises.

I still meet the conditions for knee replacement surgery (in both knees actually though only the left hurts) but neither of the surgeons I saw recommend it. I’m too young and I’m too active. The surgeons made me laugh, which is something, given the general message they had to deliver.

They said they like to make people happy. The person they make the most happy through knee replacement is somebody who arrives in their office, sad and older. Someone who just wants to walk to the grocery store without pain, the kind of person who says they want to lead a normal life, get a decent night’s sleep, and not suffer all the time. Knee replacement apparently makes that person very happy but they said for someone like me it wouldn’t make me happy.

Why not? Because I want to regain function and their line on knee replacement is that you shouldn’t do it to regain function, you should do it to lose pain. Also, knee replacements don’t last very long maybe 20 years and I’m young. I want to do things like ride my bike and some patients after knee replacement have difficulty bike riding because they don’t have the full range of motion back necessary for riding a bike.

So, no.

Instead they discussed a different surgery called high tibial osteotomy. That surgery involves breaking bones and resetting them so I have a bigger gap in my knee cap on the side that’s in a lot of pain. It’s a good sign that the brace helps because this does surgically what the brace does mechanically. But it’s not a permanent fix. There’s a chance the other side of my knee will become painful as arthritis advances. So it’s good for 2-10 years maybe. Also, it’s big deal surgery. Like knee replacement it’s months and months of recovery. I’d trade off 10 years of active living without pain for six months painful time consuming recovery but I’m not sure about 2 years. There are no magic globes I can peer in to see the future.

I’m trying to decide. See them again in three months.

In the meantime my fit feminist friend Sarah is having that same surgery. Wishing her well.

But the other depressing piece of news from the surgeons was the strong recommendation of weight loss, both as a way of avoiding surgery and as essential to recovering from it. Either way I should lose a lot of weight. It will definitely, they say, help with pain relief. The pain is all about weight bearing. That’s why downstairs is harder than up. It’s all about force on the kneecap. And as far as motivation goes this is pretty horrible pain. Like pain that makes hard to think about other things.

Now as I’ve said before I wish that it were the case that medical reasons for weight loss changed the facts. But that’s not so. Your body doesn’t care how good, how “pure” your motivation is. It’s still tough. It’s tough losing weight and tough keeping it off.

I don’t have any choice but to try. The worse case scenario is that I lose it, gain it back, and more and need knee replacement surgery. But that’s the same worst case scenario I face now. I’ve lost significant amounts of weight in my life, 70 lbs in grad school, 60 when I turned 40. The trick, the hard part, is keeping it off. This time, if I actually lose weight, I’ll be unicorn training, learning the habits of people who actually keep weight off.

Don’t worry. This won’t become a weight loss blog. Likely I’ll save any angst, any updates, to my monthly check in posts. I’ll also add content warnings.

I thought about leaving blogging but making this pain manageable and movement possible is a big part of my life right now. And I’m very much still a fit, feminist just one who is coping with injury and aging and hoping to keep in moving.

Wish me luck.

Up, still Snipe racing

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Our Snipe!

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It can be tricky moving around in a small boat in ways that don’t hurt my knee but I’m learning how to do it. I haven’t raced a small sailboat ever. All of my sailboat racing experience is on relatively big boats so this is new to me. With all the knee misery, see above, it’s good to have something new to focus on. It’s fun and exciting and lots to learn.

family · fitness · injury

How was your weekend?

Selfie of Sam with white bike helmet and her Sweet Ride Cycling bike jersey.

I’m not training for anything these days. I’ve got the one day version of the bike rally that I’m still hoping I can do. Please, please sponsor me here! But really my main goal is staying active while managing my knee issues, avoiding pain and surgery.

This means that my workouts look like a little haphazard. They’re more like active lifestyle than anything you’d call exercising or working out. It’s definitely not training. I’m still having fun.

Catherine’s post on Sunday really resonated with me.

This weekend I logged two workouts over the weekend in the 218 in 2018 group I’m part of.

97. Short hike through fields and meadows, lots of moving things around, mini archery lesson.

My son Gavin got a new bow and we took it to Sarah’s family farm so he could practise shooting into balloons, hay bales, and dirt piles.

98. Bike 30 km to cheer Tracy in her Guelph 10 km running race. Great to have her in my new town. A group of us got together for brunch after.

How about you? What did you get up to this weekend?

A picture of Sam trying out her son’s new bow. She’s wearing wide leg blue pants. There’s a backhoe in the background.
climbing · Guest Post · injury

Climbing Injuries and on Finding a Better Balance (Guest Post)

By Catherine Wearing

I first started climbing (indoors) in 2009. I’d wanted to try rock climbing for ages but I didn’t know anyone who did it and (in the days before meetup and the proliferation of climbing gyms) it wasn’t obvious how to get into it otherwise. When I happened to meet someone who was climbing in the gym, I went along with them and fell in love with climbing. As someone who tends to get interested in something for a while, only to gradually lose enthusiasm and eventually turn to something else, I have been surprised by the ongoing passion that I feel for climbing. Almost a decade and still going strong. I fantasize about being a climbing ‘dirtbag’.

So that’s some relevant background. What I want to focus on is what could perhaps be called a ‘side effect’ of my passion for climbing, namely, injuries. Because I climb as often and as hard as I can, I tax my body – and especially my upper body – pretty severely. As a result, I’ve had a whole slew of minor soft tissue injuries over the past decade: both wrists, both shoulders, several fingers, and most recently, my right elbow. None of these injuries have required surgery and some have healed with rest alone. But most have required doctors’ visits, several months of physical therapy, and in some cases, X-rays or scans of various kinds to pin down what exactly is wrong.

In reflecting on this history, I’ve been led to wonder about two things in particular:

First, the threat of injury doesn’t act as much of a deterrent for me. I hate taking time off climbing to rest an injury, but I seem to end up doing it at least once every other year (and sometimes more often). Rationally, it is obvious that my body simply cannot climb as hard as I would like it to and so it should also be obvious to me that I should scale back my climbing ambitions to better suit what I can do. But I have incredible trouble doing this. When I am injured, that forces me to scale back (or stop), but when I am healthy, I only want to try to push myself a bit harder than before. For me, a significant draw of climbing lies in tackling problems that I’m not sure I’m capable of doing. I have learned to be better about building up my strength gradually and pacing myself (especially in the gym) to avoid overdoing it. But my ongoing string of injuries suggests that I haven’t mastered this self-control (if that’s what it is) yet.

The second thing I find myself thinking a lot about is that I consume a lot more medical resources than I did before I started climbing. On the whole, I have been fortunate not to need much medical care beyond routine preventative check-ups and tests. The various climbing injuries which send me to the doctor and the physiotherapist are essentially ‘self-inflicted’. That is, they’re not the results of accidents, but of overdoing it, of not exercising self-control in how hard I push myself. Given how overtaxed our medical resources are, I’m not sure this behaviour is justified. I suppose I could argue that climbing keeps me happy and healthy in ways that go beyond my ligaments and tendons, which might in turn help me avoid other kinds of medical care. But who knows whether that’s true? Perhaps I’d be almost as healthy if I stuck to the forms of exercise that I enjoy but am not as passionate about.

I’m trying to learn from experience, to push myself less hard and to draw as much enjoyment as I can from simply being outside on the rock, even when I’m climbing something easy. And I think my rate of injury is gradually slowing. But as I continue to age, I expect the physical demands of climbing, even at the easier grades, to increase. It fills me with delight to see climbing friends still going strong in their 60s and 70s. So I’m hopeful that if I can find a better balance, I’ll be able to keep climbing for a long time. But in the meantime, I wish I could do a better job finding the mid-point between the challenge which brings me such joy and a level of physical demand which my body can sustain.

Catherine Wearing is a philosopher, feminist, and rock climber. Also a runner, tea drinker, and mystery novel reader.

accessibility · aging · disability · injury · motivation

An apology: A thing Sam thinks she needs to stop saying…

My life has changed a lot since we started the blog and the fitness challenge. There are things I say when we’re promoting the book that now strike me as wrong or at least not as simple as that, or maybe even naive.

Things feel a lot more complicated since osteoarthritis and advanced cartilage degradation made me a candidate for knee replacement.

It’s hard to get a more nuanced message across when you’ve just got four minutes on television so I’ve been sticking with the simple story but the truth is I know it’s not so simple. I’m not staking out a position here or defending a claim other than than claim that things are messier than I thought. I do know the blog can handle more complexities than the media buzz around the book can take. So you blog readers get the messier story.

Maybe after the book promotion I have to stop saying “if you don’t love it, don’t do it.” There are a lot of things in life that I do but I don’t love. These days a lot of exercise feels to me to fall into that category. Knee physio can be tedious and sometimes painful. And I do it most days. There’s no way to love it. You watch Netflix to distract. You give yourself rewards for finishing. I need to do it but there’s little joy in it.

Instead, I take pride in my grit and determination, in my resolve.

See When exercise isn’t fun.

Why am I doing it? Not love of the thing itself that’s for sure. Partly to be sure it’s instrumentally justified in terms of continuing to do things I love. Canoe camping, hiking, biking. I want to keep these things in my life.

But it’s also instrumentally justified in terms of basic movements, like walking to campus, between meetings, getting in and out of chairs.

To suggest that we approach all exercise from this “loving it” perspective comes from an incredible place of privilege. I had that privilege. I don’t anymore and I’m sorry if I sounded insufferable, naive, and smug.

I saw it again today, by the way, in an online body positive fitness community of which I’m part. Someone offered the advice to another community member to do whatever brings joy to your heart. And the thing is I too reject the imperative that we all have to do joyless exercise to tame or unruly, overweight bodies to keep them in line. I also know though that life is complicated.

Just as Tracy rejects body positivity as just one more demand, I’m coming to feel that way about “if you don’t love it, don’t do it.” No one loves knee physio. It’s okay not to like it and to do it anyway.

It’s okay to be angry and sad and roll your eyes at people who say they just don’t feel like running this morning. You don’t get to yell at them that at least they can run and tell them to just go do it because you can never run again. Just say it in your head. That’s what I do.

It’s okay to think, “I’m tough and I’ve got this” instead of I’m doing this because I love it . Because that’s what’s true: I’m tough and I’ve got this.

Maybe that’s true for you too. I’m sorry for saying you have to love exercise. You don’t. Right now, a lot of the time, I don’t. And that’s okay too.

injury

Sam branches out, tries Aquafit, and returns to indoor rowing

A few months ago–about six months ago actually–when I first hurt my knee, I didn’t have a lot of choice when it came to exercise. Mostly life was all about managing pain. Compression ice packs, ibuprofen, and knee physio was my world.

I could spin, in a small spinny gear, and that was about it. It was good physio but it didn’t feel much like exercise. A few months in I tried the elliptical. Nope. Too much pain. Then I tried the rowing machine. Same. Ouch! No running and no walking so mostly I did physio, a lot of it. I also got some weightlifting in.

Now I’m making my way back. First up, I could ride on the trainer in big gears and I could ride while standing. I started taking spin classes at the university gym. Bike yoga was my favorite. 30 minutes of spinning, followed by 30 of yoga for cyclists. That felt like serious progress.

The knee brace has really helped with walking. I can a walk a bit now. Here in Germany I’ve been logging some 15,000 step days. That would have been unthinkable without the knee brace. I’m also riding my bike outside. I’ve been commuting by bike and I’ve had several longer rides on my road bike.

Last week, I decided to branch out again and tried the rowing machine at the gym. Surprise. All good. I did an easy 2 km for warm up. No 2 km tests just yet! I think rowing will be my go to cardio at the gym. It’s great exercise and I like tracking times and trying different drills. If there were a rowing studio here I might even go.

Then the following day I really branched out and went to AquaFit. Not my usual cup of tea but it’s easy to go in the morning or at lunch. All it requires is keeping a bathing suit in my gym locker.

Stock photo of aquafit. A group of women of different ages and skin colours in the pool doing aquatfit. They’re wearing one piece bathing suits and holding bright blue dumbbells above their heads.

In the shallow end it wasn’t perfect. If I jumped too hard I could hurt my knee and I needed to pay attention. It wasn’t as knee friendly as I’d imagined. In the second half hour though we were in the deep water and that was great. It was more of a workout than I expected. I’ll definitely go back.

I hadn’t been to aquafit since my last pregnancy more than twenty years ago. It’s one of those things that I think is fine for other people but not me. That’s odd because I love being in the water. And I’m not a snob about dance-y fitness classes with high energy dance music and show tunes.

I did the pregnancy aquafit classes at the Y with a crowd of mostly senior citizens. Maybe my attitude is ready just ageism? I was amused then by the women who came with their hair done and wearing jewelry. They told me I splashed too much. We decreed one section of the pool to be the splash free section. There were also some flirtatious old guys. They kept going on about my youthful good looks. I was about 7 months pregnant and didn’t mind being the babe of aquafit.

I recognized that I was kind of embarrassed by aquafit when I was happy that the lifeguard thought I was there for the Masters swim practise! Truth be told that was mostly about my bathing suit choice. Next time I’ll try to own it more proudly. Aquafit here I come!

A photo of three women wearing 1950s glamorous bathing caps. I think part of my problem with aquafit is the whole idea of glamour in the water! From http://www.glamoursplash.com/2009/04/1950s-swim-cap-glamour.html?m=1
accessibility · disability · fitness · illness · injury

consider pain: why the social model of disability fails (reblogged)

We don’t reblog a lot around here but sometimes something just strikes me as so right and so important I want to share it. As I’ve been thinking about injury, disability, living with pain, and trying to come to terms with my left knee, I’ve been thinking about the social model of disability. Here’s Andrea Zanin on what the social model of disability leaves out.

I’m hoping to get Andrea to guest blog here about her return to yoga and biking and other things after years ago coping with pain and very serious health issues for many, many years.

But we can start with this. Thanks Andrea.

Sex Geek

pain punctuationToday I am spurred to rant about the social model of disability and why it’s inadequate.

The social model says, essentially, that disability, rather than being a characteristic of an individual, is created by society. On its surface, this is super useful. For instance: if a building has stairs, and a person cannot go up them because they use a wheelchair, then the disability is caused by the lack of a ramp, and by the lack of universally accessible design more broadly. Problems are also caused by ableist attitudes, both interpersonally and within larger power structures.

So far, I totally agree. When the built environment is designed on the assumption of a normative set of physical or mental abilities, then all who fall outside that set have trouble navigating it. Which includes almost all of us, eventually, as we age. It’s good for pretty much everyone if we shift the…

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