Pumping Irony

Craig Cox, EL’s managing editor and resident geezer, explores the joys and challenges of aging well.

Recently in Knee troubles Category

A Compassionate Gesture

By Craig Cox / February 5, 2013

Saturday afternoon, I went over to Lake Nokomis and laced up my skates to crank out a few laps on that trusty old oval. Once out on the ice, however, I found myself rumbling over frozen tire tracks — left behind after last week’s rain and pond hockey extravaganza — and doing my best to avoid some fairly prodigious cracks and crevasses. It was a sunny and pleasant day, though, and My Lovely Wife would not be returning to pick me up for a half hour or so, which left me with little choice but to give it my best. Which is what I did until one of my blades found a crack in the ice and sent me sprawling, slamming my left knee and right elbow into that unforgiving surface.

It’s always embarrassing, of course, to get horizontal in this context, when you’re supposed to be vertical. But I wasn’t concerned about the impression I might be creating. My knee and elbow were throbbing in a way that had me wondering whether I’d done any serious damage. I hauled myself back up onto my blades, brushed the snow off my body, and took a few tentative strides to see if my lower extremities, at least, were functional. They seemed to be, so I pushed myself through a few more cautious laps without incident before MLW returned to fetch me from my foolishness.

The next morning I was plenty sore. My elbow was creaky and both my knees were complaining about the fact that I had scheduled a 12:30 tennis match with The Baseline Machine, now fully healthy and fresh off her first victory in her USTA league (she had made a point of calling me last week to inform/intimidate me). I nonetheless headed over to Martin Luther King Park at the appointed hour, slightly revved up for the challenge, despite my infirmities.

After only a handful of warm-up volleys, though, it was TBM who was in pain, clutching her right hamstring and hobbling around with some difficulty. She tried to stretch it out, but to no avail, so we spent the next hour with her at the net, volleying to and fro with little of our accustomed intensity. It was a pretty good workout, actually, as she had me scampering from backhand to forehand to backhand again — a regular tennis lesson. My creaky knee seemed to be enjoying itself and my bruised elbow voiced no complaint. In fact, I was whacking it around pretty good for an old guy.

At a break in the action, I thanked her for hanging in there. You plunk down 20 bucks for an hour on the court, after all, and you want to use it up. It was a compassionate gesture, I suggested. She said I was the one who was being compassionate, since I didn’t insist we proceed with the match after her injury.

“I’m actually keeping score in my head,” I admitted. “I’m winning.”

I received my punishment Monday morning, when I rolled out bed wondering how I was going to pull on my pants. Knees, elbow, back all rose up in protest at the smallest suggestion of movement. As is usually the case, however, everything gradually loosened up to the point where only specific tweaks and creaks made themselves known. And they were sufficiently boisterous by the time I was trekking home from the office that I skipped Monday night basketball in favor of some general recuperation.

The body has a remarkable ability to heal itself, if you give it the chance. While I was recovering, I stumbled upon a new study out of Lund University in Sweden showing that people with ACL injuries who decided against surgery had similar outcomes to those who went under the knife. Indeed, researchers concluded that more than half of all ACL reconstructive surgeries could be avoided if the injured parties were willing to undergo physical therapy. In other words, letting their body heal naturally.

Now, I admit that I’m no poster boy for natural healing. My right knee was “scoped” in 1998 after I blew it out playing basketball. And I do tend to push myself a bit beyond my limits from time to time (last weekend being a case in point). But I have learned as I’ve hit advanced middle age that you’ve got to listen to your body once in a while and be willing to take it easy when necessary.

After all, if you can’t show yourself a little compassion, how can you practice it with anyone else?

How Much Is Too Much — or Too Little?

By Craig Cox / December 2, 2012

A guy goes to see his doctor because his knee is hurting. He flexes his aching joint and tells the doc, “It hurts when I do this.” The doctor looks him over and replies, “So don’t do that.”

It’s an old joke, but it came back to me the other day when I heard about a new study suggesting that the best way to prevent osteoarthritis in your knees is to avoid too much — or too little — physical activity. Researchers at the University of California in San Francisco (UCSF) followed a couple hundred patients between the ages of 45 and 60 over the course of four years and found that the couch potatoes among them were just as likely to suffer from osteoarthritis as the marathon runners.

“This suggests,” said lead researcher Thomas Link, MD, “that there may be an optimal level of physical activity to preserve the cartilage.”

Um . . . thanks, doc.

Just what that “optimal” level of activity might be, of course, probably depends on the individual. For some that might mean swimming, or bicycling rather than running stadium stairs three times a week. For others, we may be talking about a walk around the block. In fact, I don’t know if I could pinpoint what my optimal level of activity would be. I’m not sure from one day to the next whether I’m being too hard or too easy on my creaky knees. All I know is when they start to hurt, I take it easy.

Not sure I need a doctor — or a whole study — to tell me that.

In Praise of Anonymity

By Craig Cox / December 6, 2010

Wednesday’s workout left me with some nasty DOMS (delayed
onset muscle soreness), so I decided to take it easy Friday night — avoiding
The Pit in favor of some serious cardio work. I found a vacant Elliptical Death
Machine facing a TV screen showing Hardball
with Chris Matthews and settled into burning off the burrito I had for lunch. I
cranked the resistance up to 10 and waited for something to go wrong.

But unlike my last bout with the EDM, when my knee didn’t
seem to want to travel in a straight line above my toes — angling rather in a
(coincidentally?) elliptical pattern accompanied
by a mysterious jabbing pain — tonight it pumped up and down like a well-oiled
piston. There’s no explaining such things without an MRI, I suppose, so I
decided to just chalk it up to the added lycopene in the pico de gallo that
spiced up my lunch. So I cranked it up to 15 and then all the way up to 20 and
kept at it for a full 30 minutes while Matthews let Ron Reagan Jr. wax poetic
on how Obama was getting rolled by congressional Republicans.

Seeing the former president’s namesake on the screen
reminded me again how easily celebrity waxes and wanes in our culture, and I
was momentarily struck by the fact that I was probably never going to ascend
even to the modest level of notoriety that would earn some B-list politico like
Ron Jr. 90 seconds on CNN. This delivered a glancing blow to my ego, until I
recalled how I’d once been interviewed by someone at the Star Tribune, who asked me what I’d wish for if I could wish for
anything and I said something about taking batting practice with the Twins or
having lunch with Barbara Flanagan. The Twins, of course, never called, but
Flanagan, the legendary society reporter/schmoozer, did and we wound up having
a lovely lunch at a now-defunct bistro on First Avenue, after which I could
never make fun of her again.

All of which is just another way of saying how great it is that
the gym has these big flat-screen TVs lined up in front of the cardio machines.
They can just transport you out of your aching body in a way no other appliance
really can. Was my knee aching? My calves cramped? Who knows? I was back at a
table at Faegre’s in 1986 grazing on French fries and listening with great
interest to the gravely-voiced Flanagan describe her days on the crime beat and
how back then every editor had a bottle of whiskey in his desk drawer.

Nostalgia can be a wonderful thing, even without flat-screen
TVs, but my calf was beginning to cramp up, so I ambled over to the stretching
area and decided, quite out of the blue, to try rolling out some of the kinks
in my hammies and calves with a foam roller. For those of you unfamiliar with
the foam roller, it’s a cylindrical piece of fairly stiff foam, about 6 inches
in diameter. The idea is to kind of sit on top of it and pass your cramping
muscles over it, a motion that, I’m told, will smooth those knots right out.

Regular readers of these pages will know that I’m not the
sort of guy who tries a lot of new things in the gym. Just not the cut of my
jib. Find a routine that works and just keep doing it until you hurt yourself –
that’s my motto. But once you make up your mind to strike out in some
intriguing new direction, it’s imperative that you do so in such a way that appears that you do this all the dang
time. So, when I strode confidently into the closet where I assumed they would
store the foam rollers and found only a short, semi-circular chunk of foam, I
naturally picked it up as if it was the precise piece of equipment I needed for
my well-practiced routine.

I set the hunk of foam on a vacant mat and placed my
hamstring atop it in what I guessed might be a strategic location and with some
effort scraped back and forth between my gluteus maximus and the back of my
knee. After a few futile repetitions, I happened to notice a few foam rollers
tucked neatly into a nearby shelf and, taking the time to complete my
“routine,” I put the useless hunk of foam to the side and replaced it with the
real thing.

Most fitness experts will tell you that no matter how dumb
you look trying to do stuff at the gym, most folks tend to ignore you, unless
you’re a celebrity or something. I always try to hold onto that thought when
I’m working out. Anonymity is not such a bad thing after all.

Plenty in Reserve

By Craig Cox / December 1, 2010

Winter has arrived in the form of wet snow and icy
sidewalks, so I’ve retired my bicycle for the duration and have been making the
1-mile trek across the river to my office on foot. I do this each morning with
some trepidation, but my knee seems to be improving. For the most part, it’s
holding up pretty well. No limping, no real stiffness, and my commute has been mostly
pain-free. I’m not quite ready to grab my tennis racket and get back out on the
court, but I’m relieved to know that my aging body has retained its self-healing
powers.

So, here’s my prescription for knee rehab: Forget the knee replacement. Dial back your
more physical athletic pursuits, but keep moving as much as you can and tap into
your physiologic reserve for as long as possible.

OK, that last part was not part of my original rehab plan. I borrowed it
from a recent Jane Brody column in the NYT.
Brody interviews Mark Lachs, MD, director of geriatrics at the
NewYork-Presbyterian Healthcare System and author of Treat Me, Not My Age (Viking, 2010), who describes how each of us
is born with more capacity than our organs and general biological systems need
to operate. We have, for instance, billions of brain cells we’ll never use and
way more kidney and liver and heart capabilities than we typically need to
function properly.

But we begin dipping into those reserves in our 20s –
when muscle strength peaks for most people — and it can begin to run pretty low
once your hit your 80s and 90s, Lachs says. This was not a big issue in the
good old days when folks routinely kicked off in their 50s and 60s, but Western
medicine now has ways to keep most of us vertical well into our 80s (indeed,
some experts are predicting that centenarians will become rather common among
my children’s generation) and, as Lachs puts it, “Millions of people have
survived long enough to keep a date with immobility.”

The good news is that you can tweak your routine at
almost any age and slow the depletion of your physiologic reserves. Lachs cites
a 2004 study in which a group of elderly patients recovering from a hip
fracture increased their walking speed, balance and muscle strength simply by
performing a few basic strengthening exercises. Something as simple a daily
walk can make a difference between mobility into your 90s or disability at 60,
he says. “Even the smallest interventions can produce substantial benefits.”

I like this approach, because it gives all of us hope
that we can improve our quality of life as we age rather than cave in to the
conventional thinking that says, “Hey! You’re old and creaky. Get used to it!”

I may be old and creaky, but next spring I’ll be back
out on the tennis court — older, yes; creakier, not so much.

A Healthy Pessimism

By Craig Cox / September 19, 2010

The problem with
optimism is that it gets you all optimistic.
And then you do something you have no business doing. Last week, my knee (yeah,
that knee) seemed to be gradually improving, so on Friday I figured it would be
OK to grab my umbrella and hoof it the short mile in the rain to work. I
probably could’ve climbed on my bike, but why not test the knee out and see if
my optimism was warranted?

Bad idea.

By the time I
got to the end of the block, it was already barking at me and demonstrating with
each excruciating step the difference between wandering around the house and
trekking a mile on an unforgiving sidewalk. I tried shorter strides, longer
strides, a little pitiful shuffling, then finally settled into a sort of
Bataan Death Limp that got me over the bridge and up the hill to the office.

Runners are
accustomed to hearing about the damage their knees can suffer from the constant
pounding on the pavement, but I’ve never heard the same said of walkers or bicyclists
or guys who are just standing around. After Friday’s little adventure — yeah, I
hobbled back home after work, too — I spent the weekend trying to undo the
damage by bicycling several miles and generally flexing the recalcitrant joint whenever
I found myself standing still. It doesn’t seem to be helping very much.

I know this
doesn’t make for scintillating reading; though it should prepare all my younger
readers for the stark realities of late middle age, when conversations
routinely seem to tilt toward pharmaceutical discoveries and
diplomatic descriptions of recent digestive functionality. That, at least, is
something of a public service. Besides, blogs are by nature confessional, and I
have to confess that this whole knee thing has now moved beyond the interesting phase.

Typically, when
this sort of thing has cropped up in the past, I would simply back off on the
activity in question and it would heal up in due time. I waited out a nasty
rotator cuff injury that way several years ago. Couldn’t throw a pillow across
the room. Stopped trying to throw stuff for a while. Cleared up. Can now throw
lots of things across a room. When the bursitis in my knee first flared up a couple
of years ago, I stopped running and it cleared up.

So, I’m embracing a little pessimism. I’ve told my
tennis buddies that I’m out for the rest of the season, with an eye toward
getting back on the court next spring. That should give me enough time to rehab
this thing. Back to Dr. Needle on Thursday for more magical therapy. And no
more walking to work for the time being. Any other ideas out there — short of knee replacement? I’m all ears . . . though you should know that I’m a bit hard of hearing.

Pain Reliever

By Craig Cox / December 3, 2009

It used to be that the
second day after basketball I’d really feel the pain (it’s called DOMS, delayed
onset muscle soreness), but I was surprised yesterday morning to find that I wasn’t
hobbling around as much as I thought I might. It’s all relative, of course, but
aside from a mysterious twinge at the top of my left shin, I was feeling pretty
good. So I went through my usual morning meditation/workout routine and headed
off to work.

There’s plenty of research
to back up the notion that it’s better to exercise your creaky joints and aching muscles than it is to baby them. As Matt Fitzgerald points out in this EL piece from a couple of years ago, Swedish
researchers in 2005 found that “moderate exercise strengthened cartilage,
reduced pain and improved functional performance in a group of patients at risk
for developing osteoarthritis of the knees.”

My Lovely Wife, whose bum
right knee prevents her from running, relies on daily bicycle rides (yes, even
in the Minnesota winter) to loosen — and strengthen — that troublesome joint.
And her weekly yoga practice has allowed her to improve her flexibility to a
point where she can now get pretty close to a 90-degree squat for the first
time since she injured her knee more than 30 years ago. And I’ve found more
often than not that even moderate movement is a great solution to creaky joints
– and sore muscles.

This approach is echoed by Fitzgerald,
who explains that exercise “literally warms the muscles, making them more
pliable, and releases synovial fluid in the joints, lubricating them and
allowing them to move more easily.”

So, despite my
crazier-than-normal foray on the basketball court Monday night, I was able to
push through whatever soreness I did have yesterday with a moderate morning
workout. By evening, I felt good enough to hit the gym for a 3-mile “run” on
the Elliptical Death Machine followed by a half-hour of lifting. Then, just to
show off, I walked the 2 ½ miles home!!!

And I lived to tell about
it.

There and Back and Back Again

By Craig Cox / April 20, 2009

So, I skipped the gym on Friday but made up for it on Saturday. Not on the lifting front — unless you count flipping burgers on the grill (yum!) — but I got plenty of cardio.

Weekend mornings around here tend toward leisure: tea and the newspaper, speculation on whether The Boy (AKA Martin, 18) will rise in time for dinner, and perhaps a trip to the co-op to restock the pantry. But Saturday, My Lovely Wife had other ideas. So, we climbed on our bicycles and headed (into a fierce northwestern wind) for the downtown library, some 6 miles north — with a breakfast stop at the Citizen Cafe (“Food for the People”) on 38th Street, about a fourth of the way to our ultimate destination.

Properly fueled (try the Organic Scramble), we resumed our journey into the intermittently gale-force winds, and a half-hour or so later found ourselves rolling past the Metrodome, when my cell phone rang. It was my older brother, The Siding Mogul, inviting me to join him at the Dome later that evening for a Twins game. He always has great seats (who knew vinyl siding could be so lucrative?), so I happily agreed to meet him later — just a few blocks from where I was standing at the time.

We resumed our trek into the wind tunnel that was 3rd Street and eventually coasted to a stop at our new, cantilevered downtown library, where we intended to rest our weary knees and dive into a little local history research for MOQ, the quarterly zine we publish. I was happy to use the elevator to get to the Special Collections section on the fourth floor.

An hour or so later, we were back on our bikes heading south, past the Metrodome, wind at our backs, knees happily pumping away as we zipped over the Sabo Bicycle Bridge (just for fun), under the Lake Street light rail station, and along the Hiawatha Avenue Bike Freeway toward home.

All along the way, I’m thinking: Am I going ride all the way back to the Metrodome in a couple of hours? There’s always the train, of course. And the forecast spoke of rain. But the train is so packed at the Metrodome station that I’m always forced to walk to the next station up the line to avoid the chaos. Wouldn’t it be nice to just jump on the bike and pedal home? But, then I’d have to buck that wind going in, though it would be at my back going home. You get the idea.

We fired up the grill and enjoyed the aforementioned burgers, MLW departed for her daily bike ride to the coffee shop, and I was left to ponder the imponderable (see above). I was supposed to meet The Siding Mogul “around 5:30″ and it was already closing in on 5. I could walk the four blocks to the train station and be there in plenty of time, but I grabbed my rain jacket, stuffed it into my basket and started pedaling instead.

The wind was still an affront to all bicycling humanity (at least those of us heading north) and I could feel my hammies burning after just a few blocks. Though I’ve made the trip downtown hundreds of times over the years, I really had no idea how long it might take me to cut through the gale, so I was checking the time at every opportunity. Around 38th Street, my phone rang. It was The Siding Mogul letting me know that he was running late.

I caught my breath, downshifted into a more comfortable gear, and pedaled slowly on. It was barely 5:15. I rolled up to the Dome a mere 15 minutes later, slightly stunned by how quickly I’d covered my third 6-mile leg of the day. The Siding Mogul was nowhere to be seen, of course, so I locked up my bike and spent the next half-hour smugly congratulating myself on my athletic prowess and the brilliance of my transportation choice.

The Siding Mogul did have great seats. The Twins pounded on the Angels. And three hours later I was back out on the sidewalk unhitching my steed for the gallop home. Bonus: It was not raining.

In fact, it was a gorgeous evening, and I flew down the Bicycle Freeway with much more joy than effort, covering the fourth of my four 6-mile trips that day in what felt like record time. Only when I closed the garage door and strode toward the house, however, did I begin to feel the creakiness in my left knee.

The next day, the back of my knee was swollen and tender, and I confined myself to my desk chair for most of the day. And it was raining today, so I left the bicycle in the garage. It’s supposed to be sunny tomorrow. But I’m thinking 5 miles, OK? And I think I’ll skip the stationary bike at the gym, if you don’t mind.

Up to My Ankles

By Craig Cox / February 11, 2009

Footloose? I don’t think so.

A mysterious pain in my left ankle has had me scratching my head lately. This, of course, is the sort of thing that happens when you reach a certain age — you go to bed feeling fine and wake up with a crick in your neck or a cramp in your thigh, and you spend the morning feeling vaguely troubled about your body’s treasonous behavior until something somewhere else on your anatomy shifts or stretches or otherwise compensates, and the pain disappears. I’ve been waiting for this to happen to the ligament/tendon/muscle on the top right-hand side of my left ankle for a week or so, but no such luck.

This is the ankle I broke on Christmas Day, 1987, when my older brother, Michael (who never really liked me), drove me out of bounds after I made a nice sideline catch at the first-down marker during our annual football game. The altercation snapped a couple of bones, which a surgeon later repaired with a couple of well-placed screws. But the ankle has never been particularly mobile since then, and this latest development has me wondering whether the entire mechanism is starting to break down.

This would be a bad thing, because my stiff, immobile ankles, I’ve recently learned, are uniquely positioned to sabotage my calves, knees, back and even my shoulders. That would explain my creaky left knee and tight left calf, I suppose. Next up: back and shoulder troubles? Neck problems? Maybe it travels all the way up to seize my left brain, destroying my facility for detail while leaving me annoyingly creative.

So, I’ve been dorsiflexing like crazy lately, trying to stretch out my Achilles tendon and give my ankle some room to maneuver. It hasn’t relieved the pain yet, nor does it seem to have had much effect on my tight calf, but it does give me something to do while I wait for my tea to brew.

The next step, according to this video from trainer extraordinaire Bill Hartman, is to work the calf muscle and the fascia on the bottom of my foot with a tennis ball (if I can find one in the garage). All of these muscles and tissues are connected, it seems, so I can’t just dorsiflex my life away and expect anything to change.

I’ll try to remember that when I hit the gym tonight.

Image courtesy of Wikipedia.

Partial Vindication

By Craig Cox / November 28, 2008

Three items to report on this glorious autumn morning (blue sky, a wisp of a breeze from the west, 33 degrees), two of which vindicate my urban walkophile-ness:

1. I couldn’t help but notice while I ambled, capless, along my route this morning that the three bicyclists (pedal-philes?) I encountered were bundled up against the elements, their heads wrapped in helmets and various versions of the traditional balaclava (I almost typed baclava, which would be a different form of headgear). By the time I spied the third cyclist on the bridge, I’d already unzipped my jacket and loosened the scarf around my neck. Nothing against the two-wheeled commute, guys, but the wind you create as you slice through the lower atmosphere just makes you colder (he said, smugly).

2. Walking up the hill on the eastern edge of Minnehaha Park, I was startled by a huge bird that glided through the understory just ahead of me. For a moment, I thought it was an owl, but when it landed on the branch of a tree overlooking the glade about 30 yards away, I could see it looked more like a red-tailed hawk. I got a little closer before it once again took flight. I spotted it again a few minutes later and got a better look. The signature red tail was in evidence, and the sparrows, starlings and grackels in the vicinity were sounding the alarm. I got to within a few yards of the tree it was occupying before it unfurled its massive wings and glided back across the glade, where it could seek its breakfast in peace.

3. My ancient left knee has been only slightly annoying these past couple of days. The walk always seems to loosen it up and my labors on the EDM at the gym allow me to work the joint without doing further damage. But, it seems to be losing some range of motion. When I’m sitting zazen lately (always in the seiza, or kneeling, pose; I can’t even imagine a half-lotus), I’ve had to add a pillow to my little bench so I don’t have to bend my knee too much.

The pain, however, is not in the front of the knee, as you might expect. It doesn’t really feel unstable, like it’s going to buckle. It’s more like a dull ache in the back of the knee. This could be a sign of arthritis, says fitness guru Marc David (but that only happens to old people, right?), or it could be a small tear in the cartilage, or a “baker’s cyst” that fills with fluid when you’ve torn your meniscus or simply when your arthritis is flaring up.

I haven’t done any baking in quite a few years, but the latter diagnosis sounds about right. When I tore the meniscus in my right knee back in 1998, the back of the knee was aching in a similar manner. Back then, of course, I was young and foolish and kept playing basketball until I could no longer walk. Today, I am old and wise (ha ha). I’ll take my glucosamine and exercise with more care — which is just another way of swearing off running.

Back on the EDM tonight after work, a little stretching (maybe), a 20-minute grunting session with the lifting machinery, and a quiet walk home.

So Far, So Good

By Craig Cox / November 25, 2008

I spent the weekend putzing around the house and avoiding the gym, but I was on my feet too much, and my tweaky left knee by Sunday evening had morphed from its usual benign tweakiness to a state of painful immobility that had me wondering whether I was going to be able to walk to work on Monday.

This may seem like an odd concern, I’ll admit, given that the Dark Times have presently descended upon the city and our frosty, sub-freezing mornings and their seasonally appropriate northwesterly gales were certain to greet me the next morning. But, it’s too cold for bicycling and the Crapmobile is, well, the Crapmobile, and the change in season has me in its thrall. I just want to get out in it every morning.

My knee’s still a bit stiff when I awake on Monday, but I count as a good omen the fact that, when I slip on the frost-covered steps heading toward the street I do not go airborne. A block later, everything is loosening up nicely. I’m not really clear on why challenging your tweaky joints has the effect of making them less tweaky, but that seems to be what occurs on these occasions. For the half-hour or so that it takes for me to trek across the frozen lawn of Minnehaha Park, over the Intercity Bridge and up the hill to my St. Paul office, all my appendages are willingly cooperating with one another.

It all feeds this minor delusion I entertain — that as long as I keep moving, I’m going to be OK. Or, as my old friend, Dan, puts it: “I want to live forever. So far, so good.”

Page 1 of 212 »

Pumping Irony

Recently in Knee troubles Category

A Compassionate Gesture

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How Much Is Too Much — or Too Little?

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In Praise of Anonymity

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Plenty in Reserve

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A Healthy Pessimism

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Pain Reliever

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There and Back and Back Again

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Up to My Ankles

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Partial Vindication

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So Far, So Good

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