I might be getting old, but it doesn’t mean that I can’t do more. Now it’s time for me to get back into training mode. It is not the time to slide down that slippery slope of what others might expect of me at my age and let this left knee injury stop me from doing what needs to be done to stay in good shape.

At some point in the injury recovery process, it becomes time for the person who is feeling the discomfort/pain and doing the work, to take responsibility for ensuring that they are moving in the correct direction – for them. Doctors and other medical staff are too overwhelmed by the number of patients, an ongoing pandemic, and other priorities to do this adequately for us.

It is up to us to sit down and think about what is going on. To look at what is working and more importantly what is not. Then put together the different scenarios that could happen based on reality, not the horror stories or an overactive imagination (of which I have a very vivid one).

That is where I am in the injury process – reviewing what is going on.

Reviewing What I know

I know the following:

• 1. I injured my knee on May 10^th when I hyper-extended and twisted while rototilling a new flower bed. The left knee was fine before this injury.
• 2. The knee isn’t responding to physical therapy and is still painful most of the time.
• 3. I cannot run and there are things that I avoid doing around the house because of the knee injury
• 4. Due to my lowered physical activity and limitations, I am losing general fitness, beyond what I have lost in my running
• 5. There is a good possibility that my knee will require arthroscopic surgery for a torn meniscus
• 6. Thanks to modern technology I know what the medical providers are saying and doing.
• 7. An MRI has been ordered
• 8. That I need to be proactive about scheduling it
• 9. My MRI results will determine what the next steps will be
• 10.  I need to remain proactive regarding the next steps and continue to do the work that will strengthen the body and get it ready for whatever comes next
• 11.  Be flexible but not afraid to ask questions about why or how something needs to be done.

I experienced arthroscopic knee surgery on the other knee in 2011 and learned a lot about the process from the several mistakes that I made then. What I learned:

• Be proactive
• If something is not working don’t keep doing it
• Do the work that is necessary and yes, sometimes it will hurt
• Don’t look forward to surgery, but don’t avoid it if it is necessary
• ASK QUESTIONS – When the medical professionals start talking in jargon or attempt to hurry through something, stop them and ask for clarification. Ask them to write it down if you need to so that you can go do more research to understand what they are saying better.
• Read the online medical record before your appointments and after to ensure that they are accurate and reflects what you have been told or what you have provided for information. Know what the medical professionals are saying about your case.

Medical Professionals

After writing my post about how the knee was grumpy the other day, I went online to review my medical record. I like to check the accuracy of the notes, learn what the providers are saying in writing and see if any changes have been made to my treatment plan.

The good news is that the PT did what she said she would do and recommended that I get an MRI due to the lack of progress on the left knee (although she got the date of the injury wrong, it was 5/10/22, not 6/2/22). I will ask that that be corrected next time I go in. Even so, my Primary Care Physician concurred and ordered the MRI. Now it becomes a waiting game for them to call me to make an appointment. If they haven’t called by the time I finish working out on Tuesday, I will call and ask about it.

This is one of the good things about technology and online medical records, patients have more information about what is going on and can be as proactive as we decide to be.

Eureka Moment

I have been diligent about doing my PT work and after each session, the knee was always sorer than when I started. I figured it was all a part of the process of strengthening it.

Then the other night as I settled down for bed, I got to thinking about all the things I do over the course of a day and realized that the last PT exercise for most of my sessions was for my hamstring — sitting, leaning forward, and stretching the hamstring without rounding my back, while hold holding it for 60 seconds for 2 sets.

Eureka time! It occurred to me that this exercise was mimicking how I hyper-extended the knee while rototilling. To do this exercise correctly, you must hyper-extend the knee and then because it hurts I flinch and that makes it hurt more. As an experiment, I stopped doing that exercise a few days ago and while the knee is still not right, isn’t quite as painful and is starting to make a little more progress than it had been.

Sometimes the exercise designed to help one area can cause problems in a different one. I don’t think that the PT thought through the effects this hamstring exercise would have on my knee injury. They say do the exercises as assigned and expect some discomfort, and I am rather literal when it comes to attempting to rehab, so I kept doing something that I probably should have discontinued a while ago. A simple exercise can make a huge difference in how your body reacts to what you ask of it and if you continually re-aggravate an injury, it probably ain’t gonna heal too well.

Losing Fitness

This “eureka” moment also got me thinking about the assigned physical therapy and how even as I continue to do the assigned exercises, I am losing fitness. The PT exercises resemble what I would normally do in the evening as maintenance work in the past. Rather than something I would do to improve my fitness or strength. So, I am going to move PT work to the evening maintenance shift and move towards improving my overall fitness in the morning.

I have worked hard to get and keep myself in semi-decent shape over the last 10 years. Sometimes I wonder if the PTs are not used to dealing with patients who work out regularly. Therefore, they tend to gear their exercise load levels towards the low end of the scale since that is where most of their patients start. It is less a workout and more a starting place for most patients. I am going to up the ante and begin to do as much working out as the body will let me and be mostly smart about how much I abuse the knee.

Still Learning

I am learning that I must go ahead and do what I think is correct for me and my goals. Not the general population or what is considered appropriate for the stereotypical 65-year-old guy with a bum knee. I might be giving myself too much credit for what I can do, but I would rather go in that direction than not challenge myself to maintain most of the level of fitness that I worked so hard to attain.

Nothing is set in stone and I know that I will need to be flexible regarding what I can do versus what I want or plan to do. However, I also know myself, and doing the same basic body-weight routine twice a day just doesn’t cut it. It is boring, the body doesn’t get all that much fitter and I can use more of that time to focus on working to improve my fitness levels in other areas beyond running, versus the slow degradation that I am feeling is happening now.

Keep Moving Forward

Well, that is my thought process when it comes to this left knee injury process for now.

Yes, I know that things will come up, that I will need to change things on the fly, and that flexibility, along with a positive attitude over the next few months will be necessary. But at least I feel, like I am heading in the correct direction, have a handle on what is going on, and strongly believe that the medical team I have will get me there.

The big thing is that I know that I need to stay proactive with the medical community (they are still overwhelmed with everything else going on) and be patient as possible while they attempt to help me get through this process. But I also know that I need to be my own advocate when I don’t believe things are being done in a timely fashion or that something isn’t working for me in the process.

Now, to keep working on getting the knee and the rest of my body ready for whatever comes next. It is time to get back to training, not wallowing.