Tue 16 Dec (cont.): On to the park. Just the cooldown 5th lap (which were done really leisurely, as was 1) kinda tuckered out genuinely , and 2) trying to figure out how to access stored laps on my Casio watch... which can store 60 laps but no idea what key combos scroll thru recorded ones )... was divine, as proved in a gentle way, I were literally pushing the knee to its sane & constructive boundary. Haven't done much exerting since my running days ended due to this same knee issue (in both knees at the time) in 2023... so not surprised rocking up to the park trail, was gonna be more sightseeing than exercise... Huh -- so since most of the SE entrance trail is 100m of downhill... felt the knee protest from the usual cooling down in the car... but that faded after the level lap of the football field... and felt just as good if not better, climbing the steep 1st big hill, and down the long drop other side, to the stream bed and lowest elevation of the lot. That downhill portion's been near-constant airteeth for weeks, readers -- had never felt the knee sturdy / solid enough, to handle this part of the trail gracefully, not for months anyway. Sure at the end transitioning back to climbing was a bit gimpy... but once climbing, went back to feeling good. Again, huh Even the final climb up the 20% hill... felt more strain than the climb out the streambed... but nothing like trotting atop the structure. This was very, very good... So wow -- guess I need to get 6 hrs sleep and eat just what I'd been eating last night... to get this knee into the fast swimlane
Wed 17 Dec: Change of plan: had to see the PCP for a 6 mo checkup, and since this is December on Maui, the next window to get one would be March Right in the middle of my usual workout (walk-out...?) so kiboshed the structure and the park lap, jings I like my doc; has done more for me a la getting tests, appts, imaging, and general GP stuff, than all of the so-called PCPs I've had in 3 states over the past 20y. Mind you, liked my previous PCP... but whilst a geek about medicine and kind to people (the only acceptable kind of PCP)... he wasn't all that proactive... so liked him as best of a cadre of bad, I guess. This current one's on the ball, funny in the correct way, and gleefully proactive. Now the bottleneck in my healthcare exp (other than her scant availability... which isn't surprising given how she 'medicines') is insurance -- which for the first time since coming back to HI mid-'90s (initial return)... has actually been utilised like a normal human being in a non-Red state... well, one that's not CA Fair to middling review of my serum draws... staying mostly stable, but a jump in a reading I'm vulnerable on, and one that's explained by a flu shot day-of (wanted to 2-birds-1-stone; ended up mucking up the draw results if I didn't know what caused it). Also been eating a lot more chicken breast, which explained other out-of-pale readings. So not great, not horrible. Watch your Vit D... (cont. next post)
Wed 17 Dec (cont.): Ended up getting an xray of my knee -- finally. This is prelim for the actual consult with the ortho doc next yr... but since this morning was shot already, why not get it done (3 blocks up the hill, why not). So met with a cheery Local girl radiologist who answered some questions about the reasons for this first before the expensive pics... and also some side ones about how much actual rads she's expected to be exposed to with this old equipment, and what element provides the xrays (~30 - 35mSv, well below the 50 allowed; and a tungsten-rhenium alloy). Had no idea an alloy was used for creating xray imaging -- and just learned about rhenium in a YT video last night -- pretty rare element. Also, didn't know that lead, when exposed to high-energy electrons (beta radiation) such as in a particle accelerator... will actually emit xrays (high-energy photons). So lead isn't a de facto shield for all ionising radiation -- or in the case the video I watched had, needs two separate layers of lead, to fully protect your DNA from cancer risk. (cont. next post)
Wed 17 Dec (cont.): Oh - forgot to mention... had made a mistake setting the appt time, so showed up as noted on my calendar... 1.5 hrs early (normally set my notification for an hour prior... but must've really fat-fingered this one. Auto-setting-calendar-date text app? You're fired). So with this lead time, figured why not take a lap around the neighborhood around the clinic, just to get my knee some steps... As mentioned in other bodywork posts before... you must make your injured joint reasonably do the thing you want it to do, by doing them... often past your comfort zone. But also as hammered home several times in this novel of a thread... you can't gung-ho do this, or the recovery from impatience can be longer than holding back a bit. Had that in mind, walking this neighborhood, which is in Wailuku. Wailuku, is on a pretty steep hill. Its name in Hawaiian means 'crazy water' or 'crazy stream', and this is probably because the Iao Stream, which emits from the massive and picturesque Iao Valley... often floods -- catastrophically (a team of National Geographic surveyors once hiked into the Valley, and were never seen alive again after a massive storm trapped them). More grade = more speed = more mayhem. Not unreasonable, given that we live on volcanic shield volcanoes -- you gonna get used to land that isn't plumb.* Wailuku is a milder version of some pretty kooky hills here on Maui, and around the State... That said... the knee was not happy being off the comparatively-controlled environment of the park trail, where there are lots of places to rest. I'm in here in a 1940 - 1950s era housing development that cannot be expanded for the sake of sidewalks or pedestrian accommodation of any sort... because in 1940, you had to really be someone, to own a car -- so all streets were basically sized for Local walking traffic. But now that you need cars to get anything done on Maui, and cars are crossovers 1K lbs and a foot longer and wider than cars even 30y ago... walking in this neighborhood around rush hour, means you cover your own unprotected arse. And the knee didn't like that. After ducking back to the clinic after a lap to get a drink in the car, headed out again (45 mins left)... and got a call from the clinic. We can see you now I'm literally at the furthest point of the lap before heading back Because of course... (cont. next post)
Wed 17 Dec (cont.): So hobbling uphill now, back to the clinic... got in and were seen for the usual numbers... then dovetail into the above doc visit Afterward... my rule is no workout, no eat. So drove back across town to my healthfood store for brekkies, and drove back to the park. Figured more than equalled the structure laps with those two laps of upper Wailuku... so just did the park. Hmm. Yeah that ~30 mins walking on hard ground, the knee needed it... but wasn't going to say 'thank you sir may I have another' at the park That said... despite the pounding it took atop the structure yesterday... the knee felt at the bottom of the big drop to the stream, quite unbothered, if feeling a bit stiffer (which may be muscular vs. ligament or meniscus-related -- walked some pretty good grades in Wailuku). Walking up and out was harder, but not because the joint were crying out, but from muscular strain... so far so good. Was looking forward to exposing the knee to more varied walking... and today proved I underestimated how entrained it would get, to just a few weeks doing clinically-similar exercises (mostly, to make progress meaningful by zeroing out the very variables it needs to develop). So think I'm out of the testing phase now, and just need to keep eye on ball whilst doing the plethora of 'normal' stuff with this knee... whilst remaining consistent with exercise every day... thru pain, if necessary
Thu 18 Dec: Got up after another night of weird sleep -- there are SSE--erly winds we call Konas, that bring tonnes of moisture from Equatorial latitudes, not to mention Kilauea is also SE of us... so vog + humidity in the 90%+. Drenched in sweat normally (even sleeping atop the duvet) but wasn't as bad, maybe due to the fan being left at that same setting what annoyed the knee a week or so ago... Anyhow... got on road, hope not drenched and gritty still. Got lucky, as most of it dried by the time I rocked up to the structure. Today were a dial-back day, as hit the knee pretty hard w/ those trotting bits and felt they needed time to recupe. Getting out of the car, the same stiffness-becoming-pain getting out of car inner thigh... so did my warmup in the mall and walked my ramps to the top. Two and a half minutes w/ the trotting / shuffling, obvi wasn't a wise goal today, I thought... so set the watch and timed 1st lap, taking it easy but still walking with purpose. Stiff Konas today -- probably gusting to 30 wow... enough to shove me off-gait. Focused on relaxing and keeping knee and ankle aligned to a "T" imagined on the ground in front of me: a line betw. knuckles / ball of big and little toes aligned to the crossbar, and insides edges of feet, to the vertical. Some urchin's effing dog laid an egg in the corner, nice So-called adults coming up these days, zero class and can't be bothered. It's the top of a parking structure, loser -- doesn't go away because you ignore it And you wonder why I don't always speak in flowery tones about living on my home island again. Old days, long gone (continued next post)
Thu 18 Dec (cont.): Since the structure itself is built on a slight incline (or has settled that way since early '90s)... my CW lap begins with the long side slightly uphill, and the far side is, of course, downhill. I choose to try trotting on the downhill, since it would load the knee more if done gently but firmly thru a bit of pain. And today was no different... except... Trying to trot those 15 steps from yesterday... rather than doing a full-gait jog (at least what the pain would allow) 10-rest-5... decided to shuffle a bit more (shorter steps, less vertical impact) and run the whole far side that way. Well-well... whilst it didn't feel good and nothing close to normal... I could do it. In fact, did it the other 3 laps, and even extended the run to cover the final bit of the short side to the start / finish (basically a straight line to where I climb up the ramps -- also exit and descend to my car on the same side). Didn't have to kibosh due to intractable pain... tho got close on lap 1. After that, felt like work but not painful enough to stop running the whole long side downhill. Walk down the ramps was comfy too... wow When driving to the park... no matter if the time in the driver's seat were just 5 mins / 300 secs... would ache getting out, and from the SE start point, a hobble down the 20% hill to the trail. No such flailing today -- the first time since using this entrance, it's not raised your scribe's age to fogey-cripple-old The rest of the trail were same. Still sore, still can't take my full weight multiplied by the height of a stair riser w/o airteeth-y pain... but hiking was fine now. Which means it's finally ready to someday do vertical laps again... which hopefully would be the last step in getting this knee back to normal (I'd even take 98%). Hopefully. No idea if this is just some other phase in the knee's roller-coaster recovery journey, or if this is really reaching cruising altitude
Thu 18 Dec (addendum): Noticed today... for the first time since the incident, the knee isn't swollen. Thinking back to today's structure lap as well... remember that 'cool' feeling of something happening in the knee under load? Didn't feel anything like that either -- which used to be daily, familiar even. Funny how your mind snaps back into what you used to consider 'normal' when you're getting over something... like being so sick you think you forgot what being healthy feels like... but once you are, you jump up and have an appetite and do things you found impossible at your worst. Something like that, my mind jettisoning the need for awareness in the knee... because it wasn't being called to exist. Hidden by that swelling, which'd been companion since Sep... are veins and musculature developed getting this leg into shape, now visible. That guitar-string tension of the muscles of inner thigh, namely the semitendinosus, semimembranosus, gracilis, adductor magnus, and sartorius, are sooo much more relaxed at rest -- which confirms my suspicion: When the leg was injured, atrophied muscles across the knee (only used to 2y of 15 - 20 mins of level walking per day rather than 2 mi of running per day) were insufficient to splint the knee immobile in an emergency. When the incident happened, all available muscle fibres were forced to go at or near-100% contracted -- which were guaranteed to create TrPs. Thus my slow progress 2 mos, just trying to do enough with the knee, to build muscle to stop this reaction. So a catch-22: the reason the joint ached was because the muscles were forced to full tension and not letting the joint function... but in order to fix this, you must move the knee in exercise -- meaning the only way forward, is thru pain. Have counseled dozens of clients on the table, seeing this condition in their lower body... but it's highly useful to both of us, when I can feel -- and rehab back to health thru my own efforts -- the same condition in my own leg. Can luckily still grow muscle, which is not always the case, esp > 60yo. For those people, my work is only palliative. But the process isn't easy, either -- and for the median cool-in-HS people out there... certainly not going to follow my path to the letter, too much work. If you want an excellent source material to rehab yourself out of injuries you thought condemned you to the cripple house for life... check out 'Pain Free', by Pete Egoscue. Vietnam operator, horribly injured -- VA and civvie medical authorities had no way to help him walk again, so developed his own methods. If you're determined to get back on the horse and no pain's gonna stop you... read that book. Also recommended: 'The Egoscue Method of Health Through Motion', which describes the exercises and methodology. The xray from yesterday was seen and results published -- apparently have no derangement visible using xrays only. Which means MRI should be next. Can't wait
