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Friday before the weekend I had a PT visit with Jacquie.  My appointments are always at 7:30am, and begin the same each time.  I head in and warm up for 5 minutes on the exercise bike, then stretch and use the foam rollers.  At some point in this process Jacquie appears and asks if things have gotten better / worse etc.  Usually I respond that things are more of the same, a good day here, a bad pain day there.  I think it threw her off that I said they’ve been fine.  I’ve been biking minimally, swimming regularly, and doing stretches and exercises daily.  That’s not to say that I think I’m all better, my knee still throbs a bit before I stretch, or when I’m going down stairs, but things seems to be normalizing at the level of activity that I’ve been maintaining for the past few weeks.

To celebrate this minor victory and enjoy the (relatively) warm and sunny afternoon on Sunday, I rode to the grocery store to pick up the week’s supplies.  The store is less than a mile away, so if things got bad, I could just walk it in a pinch. 

I made it to the store in no time, and continued on another mile just for the sake of it.  I remember why I am drawn to jogging and biking, but often have to force myself to go swimming.  I love that cold feeling in my lungs as I’m riding downhill, and the warmth of the sun.  I had to reason with myself for a mile before practicality won the conversation and I turned around.  I woke up and swam this morning without incedent or stiffness.  I’m very relieved and reinvigorated…I really needed this boost of confidence that I’m progressing, as well as the reminder of what I’m getting myself back into shape for.

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There’s still snow on the ground, but my knees are feeling stronger and the sun is shining.  I think a short ride may be in the cards today.  Wish me luck!

because I sure as hell have missed you all.  It’s been a little batty lately.  I had a great Christmas and New Year’s, which feels like it was so long ago.  Emily and I went on vacation out to North Adams, MA to visit Mass MoCA, which you can read all about here.

I know you’re dying to hear about my knees, which are slowly improving.  I have been biking fairly minimally, and am still waiting until spring to jog.  Swimming has been improving, which has been a wonderful way to start my morning.  When I began a month ago, I could hardly make it one pool length without gasping for air as soon as I touched the wall.  Now I am swimming a full lap without stopping, and am building my lung strength (and moreso my confidence) and this week am planning to try for two laps without stopping.

Jacquie and I are meeting once every other Friday basically just to check-in, but for the most part I am self-sufficient for the time being.  I’m doing low-stress cardio (swimming & biking) and on my rest days, am doing fairly intensive quad, hamstring, and glute workouts with my theraband and foam roller.

New Year’s blogsolution: more frequent posts, shorter length, less complaining.

When I began this blog way back in March, I never really took into consideration what I would write about during the winter months.  Granted there are many folks who ride through the winter, and to them my helmet is off.  But me, once the freezing rain starts falling, I bring my steed inside, give it one last wash for the season, and retire myself to my indoor trainer.  Knee injury aside, I probably wouldn’t be riding right now anyway, so what to write about?  I could weave a tale about how exciting it is getting up early, watching the news on mute and putting in a few miles before work…but I’ll spare you.

In PT related news, I’m only going once every week or two, just checking in with Jacquie as we slowly build my quads without flaring up my patella tendon.  I’ve been swimming, which is kicking my ass.  I thought that being a reasonably in-shape person would transfer to being able to swim pretty well of f the bat, but this is no where near truth.  I can barely swim freestyle down and back without stopping, and feel sore in muscles I didn’t really even know I was using.  The instep of my feet, my fingers, and pretty much every muscle that has gotten lazy on the upper half of my body.  Basically I’m planning to keep doing what I’m doing until spring.  Biking on the trainer will keep those muscles in use, and swimming is helping me mentally.  I was getting a bit antsy and stir crazy not being able to bike or jog, so until the snow melts, I will just stick with what seems to be working right now.

I just got back from my first time swimming in almost two years.  I’m hoping to keep the strain on my knees to a minimum, and I totally forgot how exhausting swimming laps is.  I can’t tell if my knees are sore yet because everything is sore.  My legs were bouncy as I walked back out to the parking lot, and right now my fingers are complaining that they’ve worked hard enough today, why do they now have to type?  I walked over to the Sterling Center Y to get a membership last night, and am very impressed with their faciliities.  The pool is really 2.5 pools, in an L shape.  They have free laps in the mornings on the long portion of the L, laps with a coach on the smaller straightaway, and freeswim in the square on the corner.

The only other lap swimming experience I have is from a few years ago at Northeastern.  It was so luxurious, for $50 I had access to the pool, a coach 3 mornings a week, and never once shared a lane.  This morning I shared my lane with a really nice 60+ gentleman who chatted with me about how busy it was, and even though  it was cold, what a beautiful morning it is.  I agreed, and then proceeded to have my ass handed to me.  Slow and steady, I kept trying to think, I naturally try to swim to hard and fast, and get tired before I even finish one lap.  This guy had slow and steady down pat.  This unassuming guy slowly and steadily swam lap after lap after lap.  But I suppose those lifers are the same ones passing me when I’m jogging by the Charles, or biking down Mass Ave.  If my knees will keep up, I just hope I can keep going long enough to impress a 20-something in 2050.

Last week I saw another physical therapist, who Jacquie called in as a ringer to do a consultation with me.  Rob is a veteran PT at Orthopaedics Plus, but also has a small tear in his meniscus, and battles with patella tendinitis like I do.  His knee gives him much more trouble than mine does, but still he was able to impart some great advice and stretches that have helped him get back to normal.  I learned some stretches and exercises that will strengthen my quads and hamstrings without putting unnecessary strain on my knees.

With his and Jacquie’s blessing, I’ve begun riding again.  Sadly we’ve entered the cold and wet half of the year, so I scrubbed down my bike and have surrendered myself to my indoor trainer for the winter.  While riding on the trainer is better as far as my knees are concerned, it’s basically the biking equivalent of jogging on a treadmill.  Yea the motions are all the same, but all the things I love about biking are absent.  But I suppose this is just a necessary step so I can get back to riding and jogging the way I want to as soon as spring rolls around.

My goal is muscle soreness in all the right places without knee or joint pain.  After having been nearly dormant for the past 2 months, a morning of exercises and biking was enough to wipe me out and tire my legs, but I can tell I’m still putting strain on my knees.  Looks like it might be time for a bike fitting.  I’ve always considered it, but it seems a bit silly to spend more on a fitting than I did on the bike itself.  Which I suppose raises a red flag that I definitely need the fitting, as I never have been completely confident that the size and shape of it are right.  When I bought my bike, I never expected to jump headlong into cycling as much as I have, and the driving forces behind the purchase were the relatively low cost and relatively accurate size.

My second opinion doctor agreed with the first opinion.  That makes 3-2; 3 medical professions who think that the problem is solely weak quads and strained patella tendons / IT band vs 2 medical professions who think there is a small tear in my meniscus.  Good news?!  I guess we’ll just trudge along working on quad strengthening and loosing up some exhausted tissue in my legs.  As a part of this process, I’ll be receiving doses of dexamethasone via iontophoresis.  Don’t know what either of those things are?  That makes two of us, so let’s do some learning:

from the always accurate, never skewed Wikipedia:

Iontophoresis is a non-invasive method of propelling high concentrations of a charged substance, normally medication or bioactive agents, transdermally by repulsive electromotive force using a small electrical charge applied to an iontophoretic chamber containing a similarly charged active agent and its vehicle.

Still confused?

To clarify, one or two chambers are filled with a solution containing an active ingredient and its solvent, termed the vehicle. The positively charged chamber, termed the anode will repel a positively charged chemical, while the negatively charged chamber, termed the cathode, will repel a negatively charged chemical into the skin.

Ooooooooh, now it’s crystal clear.  What’s that you say?  You think that sounds a lot like a transdermal patch?  “Unlike transdermal patches, this method relies on active transportation within an electric field. In the presence of an electric field electromigration and electroosmosis are the dominant forces in mass transport”

So that’s ionto, the process, but what about Dexamethason,  the actual drug I’ll be receiving into my body via electrodes and wizardry?  Well, it’s an anti-inflammatory which packs 60 times the punch of a cortizone shot.  I’ll be attaching the negatively charged pad to my patella tendon, directly below my left knee, and the positive charge will be on a pad stuck to my left thigh.  This is, without a doubt,  the strangest thing I’ve ever had my body hooked up to, and it’s too soon to tell the breadth of the benefits yet.

Still curioius about dexamethason or iontophoresis?  (I know you are)  Turns out a Polish cross country skiier was disqualified and issued a 2 year suspension for her doping use of dexamethasone back in 2004.  Uhhh?

Into PT I walked today, proud to tell Jacquie the good news that the doctor had dismissed the notion that I had done some real damage, but rather than relief she seemed more upset. Adding a pinch of self-doubt to her diagnosis, she had one of the other therapists run a few diagnostic tests. After some pushing, pulling, squeezing, and bending he thinks I likely have a torn meniscus. Shit! I guess it’s just a lesson that I need to be a better patient and push for the MRI, question diagnose, and go with my gut.

So back I go to a specialist, Dr Evans to get a second opinion. My appointment is set for 3 weeks out, so I guess between now and then I’m just going to stick with the exercises etc. Oh and jump through more HMO hoops.

On the bright side, by the time I have my appointment with this second specialist, we’ll have a new president!