As a half-baked attempt to rationalize my recent absence I have to admit that I had grown exceedingly weary of talking, writing, and even thinking about my knee. In the roughly nine hundred thousand minutes that have ticked off the game clock of my life since that Christmas night when my knee was folded into a trembling mess of torn connective tissue, there have been very few waking moments during which I have managed to be completely free of at least the awareness of my knee.
That said, there have actually been moments. Just a few months ago for example, in the midst of my one awkward excursion to a golf course every few years I actually shot a hole-in-one. Even for a reasonably proficient golfer (which I will never be), a hole-in-one is, on average, a significantly less than once in a lifetime event. But there was my blindly determined tee shot anyway, headed straight for the hole. The ball bounced twice on the green and then as it miraculously disappeared into the cup I jumped into the air with such unrestrained delight that I traveled to an altitude from which I already damn well knew the landing would be well beyond my knee's ability to comfortably absorb. I had, in that single wonderfully liberating moment, completely forgotten about my knee. The pain that shot back up to my eyeballs upon impact was a jolting reminder of my condition and although it was not enough to deter the celebration, my fleeting moment void of knee awareness was over. I winced a bit and continued to jump around like I had just won the lottery, only with slightly less spontaneity, from that point forward consciously crafting my leaps in the direction of my uninjured left leg for the remainder of the happy hole-in-one hop-fest.The rest of the rationalization for not posting recently, aside from my overwhelming desire to just try to forget about it all for a while, resides in the simple fact is that if there were any knee related developments worth posting, I certainly would have done so. But the fact is that my knee has barely improved at all since my last blog entry in January. I now regularly walk down stairs, but still not without a slight shudder of pain just prior to my left foot touching down. I can now run, but only as fast as necessary to be the Center Referee for my daughter’s U-9 rec league soccer games. And of course I ride, but I’m still not fully able to hammer while standing on the pedals - and trying to do so anyway leaves my knee with a lingering ache for several days afterward.
My single biggest constraint with the right leg is still the fact that I cannot put pressure through it when it is bent. The more pressure, the more bend, the more pain. Keeping my bodyweight down has definitely helped but still I can only bend to about 60 degrees before pain overcomes the knee’s ability to support my weight. On the upside, I would estimate that the failure point was closer to 30 degrees a year ago - and so I continue to work on it and I remain hopeful that someday I will have full use of my knee again.
A week or so after my previous post, I finally quit physical therapy for good. Yes, I do realize that it hardly makes sense given the improvements I was making, but after many months of struggling through lengthy PT sessions I was beginning to question the cause-effect relationship between therapy and improvement. In fact after I quit PT, I did nothing physical at all for a few months. I didn’t run, ride, or work out in any way. I didn’t even do any general stretching or massage. And my knee actually felt just a bit better - most likely due to the fact that it was not being pushed, prodded, and strained in therapy every couple of days. And as I got back to focusing on other areas of interest, my knee and the PT sessions to improve it began to lose some of their importance in my life. Don’t get me wrong here - I definitely believe that physical therapy is an absolutely critical recovery element. But after a year of it, I was beginning to realize that I had moved well down the diminishing returns curve and it was time to cut bait.
The one year anniversary of my surgery passed in February without any special fanfare or consideration. Since then I’ve just been living my life. I’ve been working and playing, and generally doing whatever is necessary to keep things together at work and at home. I’ve been coaching and ref’ing youth soccer for both my girls’ teams. I’ve been playing guitar in three different actively gigging bands. And at the end of July I once again signed up for the Tour de Tahoe.This year I had only 6 weeks to train for the TdT after 6 months off the bike so I knew it was going to be a challenge but I was determined to cram in as much preparation as possible. As I started riding every other day and eating more frequently, I quickly shed unnecessary weight, dropping back down from 165 to 148 in four weeks. And although my training rides were going well, I could tell I was not going to be quite as strong as I was in 2008. My average speeds were down by at least a mile per hour and my overall strength just wasn’t going to come back in time. And so it was that in a flash of brilliance so inconsistent with my deeply ingrained natural need to measure and control every detail that to this day I’m still not sure how or why I ever thought of it, I decided to do the Tahoe ride without a bike computer. I would have no idea how fast I was going, my average speed, my elapsed riding time, nothing. If you regularly ride with a computer, you know how nearly incomprehensible this idea is. I hadn’t ridden without some way to at least measure my speed since I was a kid. And that, as it turned out, was exactly the point. I have always had a bike and I have always loved riding. The reason that I rode as a kid was for the pure pleasure of riding. It is true that at this point I would feel less naked on a bike if I rode without pants, but riding without a bike computer leaves you with only one thing to focus on - the beauty and joy of the ride. And so that’s what I did. The six weeks of focused training rides were still necessary, and I still rode hard, even occasionally engaging in extended sprints with different groups of roadies, but I also backed off just a bit once in a while to enjoy the sights. At one point I slowed to ride with a couple on a tandem who were blasting 80’s rock tunes from a boom box tied to a basket hanging from the handlebars. It was an entirely different experience this year. No numbers, no stats, no results - except for the one simple result of a great ride on a perfect day with a bunch of wonderful people around a stunningly beautiful lake. Riding stats just don't get much better than that.
One strange result of my efforts to regain some riding strength again is that my legs are developing differently. Despite all the stretching and weight lifting and massage focused primarily on my right leg, it is my left side that is growing. My right leg has been thinner than my left ever since most of the swelling of surgery subsided but as of a few months ago, the difference between the two legs was not readily noticeable. Now, after being back on the bike for a couple of months, the asymmetrical development makes it look like I borrowed one of my legs from another body. I do realize that I still favor my right knee - getting in and out of the car or the bed or up and down from a chair or walking off the curb or in or out over the step at my front door. In all of these simple daily activities I still subconsciously employ my left leg to do the bulk of the work. Now it's apparent that I'm also pushing harder with my left leg even on intrinsically balanced movements such as pedaling.
Today I took my oddly asymmetrical legs out for the annual Oyster Ride, a one-way group mountain bike ride that begins in Mill Valley and travels over the top of Mount Tamalpais down to Point Reyes for oysters and beer. The route is only about 35 miles but there is a significant amount of climbing involved and some of the terrain is fairly technical especially in the last few miles of descent where erosion has cut deep ruts in the trail. Last year, just eight months out of the operating room, I did the ride with a reasonable level of caution so as to protect my newly reconstructed knee but on one of the final descents I was following another rider who went straight into an erosion hole and fell across the trail, sending me directly over the bars. I purposefully rolled to my left in the air and absorbed the full impact of the fall on my left side and back. My right knee never touched the ground.This year’s ride was unusually rough - exceptionally hot and full of flat tires and other mechanical failures among the group. For my part, I was primarily intent on avoiding another unscheduled dismount. I rode well toward the front of the group all day and on the descents I left plenty of room to any riders in front of me. On one of the more deteriorated sections of the final descent my chain got momentarily hung up mid-shift and I looked down for half a breath to check it. When I looked back up I was veering just slightly to the right where years of erosion had quite unfortunately created a long shallow ditch running along the edge of the trail. Despite reasonably good bike handling skills and expert use of high quality profanity to help fend off the impending disaster, my normally well mannered front tire began to slide defiantly away from me into the ditch as I launched into a hasty 30 mph departure from the bike and emotionally braced for impact. My mind briefly flashed to the ending scene from ‘Over The Hedge’ wherein Dwayne the Verminator accidentally gets caught along with his client in the Depelter Turbo. He cringes knowingly and says, “Prepare for a lot of stinging….”
After a short and relatively uneventful flight I landed on my left side and slid furiously along the hardened surface of the sun baked trail, gradually donating the first few unnecessary layers of skin from my knee, hip, and elbow and embedding bits of earth and rock into the exposed tissue as unwanted souvenirs I would be forced to take home from my ride. When I finally came to a stop I instinctively grabbed to check my right knee - which was fine - and then I turned over, spit the accumulated debris from my mouth, and took inventory of the rest of my body while the blood began to slowly seep through my new protective outer layer of dust. As can clearly be seen in this artist’s rendition of the scene (included here with the gracious permission of my 5-year old daughter) another rider who was apparently saddened by my fall then came to offer me a band-aid.
Tonight I’m limping just slightly once again, and the stinging parts of my body are smothered in Neosporin. It looks rather like I shoved a bean bag just under the large bright red section of raw open skin on my hip. Certainly nothing serious, but an interesting reminder of what a fresh injury feels like. I opened, for the first time in about 18 months, the box of gauze and tape that I had once used to cover my various surgical incision points. It seems like a lifetime ago that I was changing post-op bandages and requesting refills for the ice pump. My journey back to a healthy knee is not over, but it has been long and I’ve learned a lot along the way. For the most part I’ve kept a pretty positive attitude about my injury, although I still occasionally have fleeting bits of bitter anger at my slow recovery. Toward the end of one of my training rides for the TdT, discouraged and disappointed by my low average speed, I began to blame my aching knee for holding me back. Quickly my mind started to spin with anger and resentment and I wished for the days when my legs would push as hard as I asked them to. It was just then that I noticed a woman in the distance. She was jogging with a slightly awkward stride. As I rode closer I could see why - her right leg was a prosthetic from the knee down. In an instant, I was thankful for my own condition once again.Perspective, as it always has been, is everything.
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