Where Are They Now, Knee Edition

I've always loved the “Where are They Now?” articles. It’s like catching up with a long-lost friend from junior high on Facebook. You also discover the answers to really important questions, like Which Biggest Loser winner got chunky again? Does Joanie still love Chachi? And, hey, whatever happened to Cousin Oliver? I always assumed he wound working on really cheap Indie films, bragging to everybody on set about the time he saw Marsha naked. Or maybe he dabbled in some fetish amateur porn like the creepy director in 8MM. God help us if Sam the Butcher played Machine in one of Oliver’s snuff films. Anyway, that’s why I love these articles.

Obviously, the status of my knee doesn’t quite drum up the same level of interest as Cousin Oliver’s career. But that won’t stop me from sharing. It’s been 6 weeks since my last update, and over 13 months since my ACI surgery, so I think it’s time for a “How is the Knee Now?” blog entry.

Alright, let’s start with the big picture. I don’t have any functioning limitations. I get around just fine. I don’t have any daily pain. And unless you analyzed my walking form like the Zapruder Film, you probably couldn’t even tell that I had knee surgery.

But the knee’s not 100%. My ultimate fighting career remains on-hold. Interestingly, different things bother me now than before I went under the knife, which both worries me and gives me hope. Let me explain.

Before ACI, the knee occasionally ached below the knee cap and behind my knee, near the spot where the knee bends and your calf ends. Now? Those spots are pain-free, though I haven’t “tested” myself with athletic activities. Of course, my previous occasional twinges of pain happened during normal activities; I didn’t need to play sports to trigger the discomfort.

Instead, the medial – or inside – area where the knee bends kinda sometimes bothers me when I push off; going up stairs sometimes causes a slight tweak. Nothing major, but it’s enough to make me “think” before pushing off, which serves as a constant reminder that the knee still lacks strength and stability. Going down stairs is no problem. I previously thought I might’ve torn my meniscus, but Dr. T and Dr. Berman disagreed. However, something still doesn’t feel right.

What does this mean? Strangely, it could be good news, because the ACI areas feel fine. And it’s also possible that my knee might return close to normal if this un-related problem goes away. At least that’s my hope.

So what might be causing the slight irritation on this new spot? Possibly the lack of muscle strength.

Right now, my entire quad and the surrounding muscles are still pretty squishy. The teardrop shape that usually forms between the quad and kneecap? Let’s just say my quad isn’t crying. I mean, the knee no longer looks like it belongs to a starving African child. But it seriously needs to bulk up, like a scrawny high school athlete getting ready to play college ball.

This is especially true for the inside muscles that run from my knee to my quad. That part of my leg looks like a crescent moon. Plus, the area immediately above my kneecap resembles the chin of an elderly person. Thankfully I don’t have 14 different folds or wrinkles there, but there’s a bunch of saggy skin present.

I’m hoping that, as the muscles continue to develop and strengthen the overall knee, the twinges of pain around the inside of my knee disappear. That’s what I’ll focus on over the next couple of months; to see if the pain decreases as the muscle grows.

Ok, here are some more knee thoughts:

I still have crunching sounds in my knee. But it only sounds like popcorn when I squat or extend my knee quickly. No pain.

Whenever I almost “hyper-extend” my knee – basically straighten it out a tad bit beyond straight – the knee pops. It’s the exact same sound my knee makes when I first wake up in the morning, or when I stand up after sitting for a long period of time. Again, no pain.

My hamstring is pretty soft. I’ve started doing various dead lifts. Unfortunately, the major exercise to strengthen hamstrings – hamstring curls – seems to hurt my shin.

I struggle to isolate my right quad because, during 2-legged exercises, my left leg over-compensates. It just can’t help itself. My left leg has always been the dominant leg, even before the surgery. I continue to do 1-legged exercises, mainly the shuttle press and calf raises, along with a variety of step-ups. Lately, I’ve been doing step-downs and holding the bottom position (almost like a 1-legged wall sit) for 20-30 seconds. That seems to be helping. Of course, my leg trembles freakishly like it’s going into epileptic shock.

The knee feels better immediately after I exercise, i.e., when the muscle is tight/tense, which suggests to my un-trained medical mind that the lack of muscle strength is causing the twinges of pain near the medial meniscus. Again, that’s what I hope is causing the problem.

Sometimes when I walk my right leg is a bit “stiffer” than usual; my knee fails to bend the same amount as my good leg. Insert your own pirate peg leg or Heisman Trophy pose joke here. I wasn’t creative enough to come up with one.

I’m unable to “fire” my calf muscles, but that’s not from a lack of strength; more of a function issue. Calf raises just don’t feel normal. I think it’s because of the osteotomy; that raising onto my toes tugs on the shin bone, which irritates the bejesus out of the screws.

Let’s see, what else? The area surrounding the screws in my osteotomy remains sensitive. It doesn’t hurt if left alone, but god forbid I accidentally crack my shin against the couch or one of the 4-year old girls on my soccer team kick me instead of the ball.

The area on the lateral (outside) of my osteotomy bone wedge remains numb. Some of the nerve/nerve endings got severed or damaged during the surgery, which was expected. No real issues, though.

Because of the bone wedge, I still struggle to bend normally, like I can’t find my “bending focal point.” Hard to explain.

There have been other changes to my body. Before the surgery, I functioned just fine on 5-6 hours of sleep. I settled into a nice routine. I’d put the kids to bed around 8, spend an hour or so catching up on personal stuff, before plowing through the latest DVDs or stuff on DVR until 11-ish. Then I’d wake up sometime between 4.30-5.30am to exercise. And I felt great.

Now? I need at least 8-9 hours of sleep. No matter how hard I try, I cannot wake up early enough to exercise in the morning unless I hit the sack by 8pm. And since that’s never going to happen, morning workouts remain part of my dreams.

On the positive side, I continue to slowly regain what I call, “athletic mobility.” I finally can perform basic athletic movements, like dribbling a soccer ball or basketball. My difficulties now are with that third step explosion, the steps taken after performing the initial move. I can move easily enough to demonstrate the actual move, but can’t continue the move with any speed. For example, I can showcase a cross-over dribble to get past the initial defender, but lack the strength/speed to continue the drive all the way to the hoop. Call it the old man Iverson, only even slower.

I haven’t tried running, but I think I’ll be able to soon. As I continue to re-build my quad, I think I’ll be able conquer the slight hitch that rears its ugly head when my pace quickens beyond a leisurely stroll. I doubt I’ll ever challenge the Kenyans, but I would like to move faster than the elderly. Or at least be able to dodge traffic if a car decides to play Frogger while I’m crossing the street. But all of this is contingent on the twinges of pain disappearing as my quad grows stronger. Fingers crossed.