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Ouch. Also: Ow.

Your Humble Blogger has an arthritic knee. Chondromalacia, in fact. Whoo-hoo.

I am told that my splay-footed gait is a substantial factor in this—my feet tend to roll inward on the ankle, so to compensate my toes point outward, knocking my knees together at enough of an angle to take the patella off its normally even keel and scrape it along the cartilage. What’s left of the cartilage. Anyway, to reverse this, I will need to wear a thing in my shoe, which shouldn’t be a problem once I purchase the funny thing (perhaps tomorrow morning).

I also need to forget how to walk.

More accurately, I need to train my muscles to forget exactly how I used to walk in order to reset themselves to my new gait with a thing in my shoe. Muscles have very good memories. They are creatures of habit. Like people, actually. The first step in the whole no-longer-crying-in-pain process is to confuse the fuck out of my muscles by stretching them to hell and gone twice a day. Once the muscles are sufficiently confused, I will walk around with a thing in my shoe and my muscles will develop a new habit that won’t involve cartilage-scraping. Or that’s the idea, as presented to me by an attractive young physical therapist with a calming voice, who I trust with my muscles, if not my cockles. Ahem.

So. Forty-five minutes or so in the morning and another forty-five minutes or so in the evening of holding absurd and uncomfortable postures has been added to my daily maintenance. Now, I don’t do a lot of daily maintenance on the body, certainly compared with other people. I wash, I brush my teeth, sure. I brush my hair, mostly for cosmetic reasons as I keep it short enough these days that not brushing it for a day wouldn’t be a health hazard. Also my hair is short enough that the cosmetic hairbrushing takes less than half a minute, most days. I eat, although most of my eating time is probably not accurately described as body maintenance. Taken all together, the half-hour of daily stretches for my chondromalacia patella probably doubles my usual daily body-maintenance time.

I do not have a daily exercise regimen. I pretty much don’t ever exercise as body maintenance; any exercise I do is part of some other task, either amusing myself, moving myself from one place to another, or accomplishing something I want done for other reasons. It’s a moderate amount of exercise, taken all in all, most of it walking around the library that employs me, but it isn’t deliberate. Other people go to the gym three times a week, or jog in the morning, or otherwise spend some hours devoted to exercise. Some Gentle Readers have been doing stretches of this kind for years, just as a maintenance routine. Some have more elaborate systems of dental hygiene. Some prepare special foodstuffs as body maintenance aids, or have some cleansing ritual. Some do a sort of mental body maintenance (I know a woman who does crosswords defensively against the prospect of memory loss; she doesn’t enjoy them, but then she doesn’t enjoy her treadmill walking, either) or meditation or visualization intended as maintenance. I don’t.

I do believe that it’s reasonable to put some effort in to maintaining the physical plant. I reject the whole mind/body split thing, but if I can use it’s terms for a moment, I’ll say that I am on good terms with my body. I certainly accept that the limitations on my body are limitations on me—I can’t fly, and I can’t both drink caffeinated beverages in the evening and sleep at night. If I eat the wrong things, my digestion will be bad; if I sink to the bottom of the ocean, I’ll drown. Eventually, I will die. I accept those things. Many of them are easier to accept, I’m sure, because I am so physically average in so many ways. I’m of middling height, middling weight, middling looks. I can run, but not quickly; I can sing, but not on key; I can see, but with glasses.

This, though, this sudden requirement that I spend an hour and a half or more every day on body maintenance. I don’t know. I’m having trouble accepting it. It seems like such an unreasonable demand. I mean, I like to watch movies, but it wouldn’t occur to the movie-watching aspect of me to hold myself hostage, that if I don’t devote an hour and a half every day and watch a feature film that I will put myself through incapacitating pain. Frankly, I’m disinclined to negotiate under these conditions. On the other hand, my Best Outside Alternative is… excruciating pain? Surgery, followed by either more rehab or vastly reduced mobility, and more pain anyway? This knee has me over a barrel, doesn’t it?

And yet… I am wondering whether what is really going on is just an ordinary adjustment to my having had abnormally low levels of body-maintenance in my routine for so long. What about you, Gentle Readers? How much time (over a week or so) do you spend doing things you think of as body maintenance?

Tolerabimus quod tolerare debemus,


Myself, I do about 20 minutes of stretching, range of motion, and light strengthening exercises each morning, and I either walk for 50 minutes or bike for 20 minutes (my commute, both ways combined) each week day. I have to do the commute, but if I didn't do the commute, I'd need to get the activity some other way. Call it 5.5 hours a week. That keeps my joints from getting stiff, my back from getting bad, and my wind from getting short. I ought to add some light weight-lifting twice a week and some more intensive aerobic exercise probably thrice weekly, but I haven't managed it. By the time I am fifty, I will have to, in the sense that I want to be fit and active into my seventies, and, Lord willing, beyond, and that's much more likely to happen with regular bodily maintenance that includes these activities. Dancing at least once a week would be a big help, too.

There are probably some people whose genetic makeup allows them to remain in good shape in the joints and muscles up into their sixties without working on it, but I think most people have to work on it once they reach their forties. In American society, that usually involves preventing weight gain, too, which I am blessed in not having to deal with (at least, not yet). For me, it was my mid thirties when I had to confront back problems or lose my ability to bend, carry heavy things, or walk long distances. As I didn't want to give up any of those abilities, I had to make adjustments in my routine. It's hard to start, especially when it's painful, and hard to stick to it daily, but it eventually becomes part of the routine, and then it's much easier. When you start to see improvement in your ability to do things and your lack of pain at other times, that also makes it easier to persist. I hope you will find that it makes a great difference for you!

I've been jogging, lately, more-or-less three times a week. This fairly new habit was triggered by a couple of things; first was the worsening of an unpleasant change that began in my thirties: if I eat as much as I want, I get fatter. This did not used to be the case. The second impetus to do the jogging was the realization that when I'm getting regular exercise, I cope better with stress. Just seems to work that way.

I make up for this increased body-maintenance time by brushing my teeth less. Not really. I did not just say that, Dr. Glazer!

I would like to add some weight training and probably will; I used to do it in college and liked it a lot.

Perhaps you can watch movies while you stretch?

Adding in an hour and a half of new body maintenance does seem like a lot. Is the new regime supposed to be permanent or is this something you do intensely for a while and then do less intensely over the long term?

I do a combination of utility exercise (walking to the subway or mowing the lawn with a rotary mower), fun exercise, and intentional exercise (I go to the gym 3-5 days a week, sometimes weights and sometimes cardio). Like Jacob, I do it as much for the stress relief/stress resilience than anything else.

Good luck.

I took up physical therapy a month ago, because my Achilles tendon pain made it impossible to seriously consider doing Scottish (viz. English-Scottish Ball this year, which hurt like blazes during and after). I was aiming to be in great shape for the calling I'm doing at English-Scottish Session at Pinewoods, and hoping to dance Scottish at the evening parties. And there's been an aerobic component to the therapy, yay, which is especially good because (a) it feels great and (b) I needed to be actually moving more anyway due to cholesterol issues, argh. Total for two sessions plus travel time is about 5 hours a week, plus some extra logistics if the session is before work, requiring me to shower and change between. And I've been doing my darnedest to put in another 45-minute session of walking/jogging (I know, I don't jog, I really don't understand--it feels *good*--is this just that my asthma is under control??) sometime between physical therapy sessions, and then there's five minutes morning and evening of stretching and some random stretches during the day. I guess it's not too surprising that I've been feeling really cramped for time lately. (Though for upper-body-work motivation, there's really nothing like shopping for new bras in front of a full-length mirror.)

Unfortunately, with a minor surgery and a west coast death in the family, I had two weeks off of pt, and now I only have three weeks before ESS, and I'm not happy with where I am in the process. Cross your fingers for me, wouldja? Heel-first dancing works great; Scottish-on-the-toes and skippier English, not so much. :-(

45 min in the morning and the evening? That can't be permanent? Surely that's just until the knee heals... But yeah, given we aren't hunter-gatherers any more, or working 12 hour days on the farm, and given we are living into our 40s and beyond, these human bodies need some maintenance. Me, I find a combo of running and strengthening exercises keeps things from hurting and weight from getting out of hand. Some weeks I'm more religious about it than others. But the running is an hour and change a couple times a week, the other regimen is maybe half an hour the other days of the week (and Sundays off :). 45 minutes 2x a day is extreme. But it's your knee, so do it. :)

The latest trip to the PT office has resulted in a reduction from two 45-minute sessions to one 45-minute and one 15-minute session, which appears to be totally reasonable. Until I remember that it's an extra hour a day over what I did three months ago.

On the plus side, the pain is down to an occasional twinge, so that's all right.


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