I crash, therefore I am.

I rarely crash.  I tend to ride within my limits and that gets me down the trail pretty rapidly, at least quick enough to be a respected trail riders among my peers.  But every now and then stuff happens.  Memorial Day was an example of that.

Just one of those things, really...never saw it coming and it had nothing to do with skill or speed or poor line choice or handling mistakes or whatever.  Act of God type of 'stuff' and WHAM!...all crumpled and dirty, wondering what happened.

Sigh.

"When pigs fly, you really can't blame them if they don't stay up there too long."
-  Unknown

The real impact was divided between my left shoulder, neck/head, and hydration pack.  Of course, my landing zone was the only section of rocks along this entire 6 mile trail, so I chose poorly.  I figured this was broken collarbone zone, but it seemed not to be...had no feelings of that kind of damage during inventory.  So FFW, who had his own OTB earlier, but was saved from larger damage by a bit of shrubbery, and I finished the ride a bit worse for the wear, but not in any real pain.

But things like this tend to dent us a bit.

"What does not kill me makes me sore, scarred, creaky, and arthritic."
- grannygear

Notice 'stronger' is not an option.  They lied about that part.  So now I am working my way back toward some sense of normalcy as I try and keep in shape with road rides and hill repeats...no dirt.  grannygear is sad.

But grannygear is also smart enough to know that angels carried him over the portals of greater destruction because this could have been a lot worse, so I will take it as best I can and move on.

The limps, scars, twinges, impingements, rusty hinges, swellings, bumps, lists to port, pins, bolts, screws, sutures, staples, bursitis, arthritis, and the heartbreak of psoriasis...all these we collect with great effort, expense, and diligence as we fight against time and gravity...and lose on both accounts.

“The entropy of the universe tends to a maximum.”


Oh yeah...that is me all over.  What may begin as a 'perfectly' designed human machine that we enjoy in our youth, all well 'ordered' and all, falls to disorder over time, self inflicted damage not withstanding.  Lately I am becoming the poster boy for entropy.  My right knee...martial arts class.  Lower back...trail maintenance work.  Left wrist...well, too many falls to remember over the years capped by the last crash a couple of years ago.  Now my left shoulder.  Entropy, entropy, entropy, as Gomer Pyle used to say.


Still, I would not have it any other way, at least no one that is a viable option, I mean I rather would not ever grow old and get broken, but that is not a box to get checked off, at least not in this lifetime.  But to live is to risk, is it not?  And each time I suit up, click in, and roll out I risk things a bit.


And this rolling collection of aches and pains, this poster child of entropy in lycra, this broken down old example of flying pigs and the immutable laws of the universe misses the simple thing that is a bicycle being pedaled across the dirt and all that has meant to him all these years.


We will be back, God willing, to risk it a bit more.

"Well, this will take a while to fix."

The pedaling wounded.

Well, coming back from this silly Hernia surgery has been harder than I figured.  I sure hoped to be ratcheting things back up by now, but I actually took a week off after some unexplained soreness last weekend.  So, it rained this week for the most part and made it easy to be lazy and off the bike, although I do love riding on misty days.

This Sat I will creep back in with a long bike path ride on one of the hardtails I have, then try again on Sun for a real mtn bike ride.

At about the same time, Ed the Tall twisted his knee doing some physical activity.

He was either:
A:  Running with the bulls in Pamplona
B:  Competing in the World Salsa Dancing competition in Brazil
C:  CIA stuff.  Black helicopters.  Shhhh!  Said too much already.
D:  Hiking and slipped on a rock.

Pick one ya like.  Personally, I would go for the Salsa dancing, but that is just me.  Doesn't he look suave'?  Either way, dancing injury or not,  he is less than 100% and is awaiting the medical poking and prodding to see what he did to himself.  Could this be number three in a series of ACL repairs?  I hope not for his sake.

The bummer is that Fall is some of the best riding we have.  And, we are scheduled to ride an Endurance Event in late Oct, either 45 or 70 some miles.  Hmmm...could be ugly.  How will this turn out?  Dunno.  We shall see.  One thing for sure, we are not likely to be fast by late Oct.

It makes me wonder about doing anything surgery-wise that is not an absolute necessity.  I was trying to get the repairs done before things got worse and I got older.  I imagine it will be OK in time, but I am impatient when it comes to getting back to exercising.  How DO people live a lazy, sedentary life?  Man, that would kill me.

So, if you are healthy and strong today, go do a good ride for those of us that can't.  Ed and I will appreciate it

"Brevior saltare cum deformibus mulieribus est vita", eh Ed?

Truisms part one.

Ya know, those little sayings like "A penny saved is a penny earned"?  Those truisms like grandpa used to spout out; little bits of truth and wisdom, hard learned over generations and distilled down into as few words as possible.

I have some of those that may not be so well known, but work nicely for my purposes.  Here is one.  If something all of a sudden begins to work poorly that has been working well for ages, ask yourself "What changed?".

Example - for the past two weeks I have been working my way through some knee pain in the right knee.  That is the one I tore up in martial arts training so I am not surprised if it complains every so often.  This was a bit different.  It was hard to pin down the why and what of it.  Did I push too hard on a ride?  I do recall twice where I was working too big a gear for a quick rise in the trail and I had brief, burning pain under the kneecap...oops, time to shift down here.  I thought maybe that was it but the pain that was lingering was not in that location.  It seemed as much muscular as anything with an odd bit for referred pain to it.  Since nothing came to mind as to a cause, and riding did not seem to hurt any more than not riding, I was trying to work my way through it with the uneasy feeling in the back of my mind, that, if I could not figure out a cause here, maybe I was just wearing out and this was the first signs of diminished abilities?  That scared me a bit as I had not increased my miles or efforts lately.

I stayed off the SS but standing on the geared bike felt OK; so did sitting and spinning, but afterwards...pain and discomfort.  Then, it hit me.  I had forgotten the old adage, "What changed"?

New shoes.  Yep.  About the time this began I had done a 4 hour ride on some new shoes I am reviewing.  Could it simply be a cleat/shoe alignment thing?  How simple!  Why did I not think of that right away?  Last night I slipped into my old shoes and that was that.  Immediate improvement even though I could not feel any significant change in foot position between the two.  What a dope I am.

Truism #1 - If what's always worked before does not work any more, ask yourself what changed.

More truisms to come.

Misery Loves Company

And if so, I will share mine with the world. Pain. Pain of the "Ow, that really hurts" kind. Likely related to my crash a couple of months ago, my every so often cranky back has become really PO'ed at me and has nearly shut me down. Breathing hurts. Forget riding.

SO, I take a pill and feel better, letting the illusion of healing wash over me for a while, but this is not good. I am betting on disc issues and I have been there before.

Sigh.

Go ride a bike for me.

Knee Injury: Chapter 3

Back home after the lovely news, I could not do any real training in martial arts, so I turned to the bike for help. Help in moving through the healing process, help in moving through the fog of disappointment. Riding was easy and cautious at first, but I built up to decent rides after a while. I still limped and had poor extension and flexion though. The summer went by with slow progress.

The follow up to the doc came and went. I wanted to know what my limitations were, my recovery path, more info on why this felt this way or that. Basically, I wanted answers. It seemed to me that that was his job. I have questions he has answers. Apparently I was misinformed. I walked out with more questions than before. Basically it was put to me this way: You should be able to eventually do anything you want to, if you have any stability issues come back and we will operate and we can order you a custom brace ($1000.00) to go along with your life.

Man, that was just not good enough. I guess if I was a sedate, average, slightly overweight Joe who sports program involves Poker Tournaments and watching NASCAR, I would have been satisfied with that. But I had planned to be fitter at 50 than I was at 40 and I was on track to that. It is said that God laughs at our plans. If this was it then so be it, but I needed to KNOW that. I suppose the doc could only say so much, but I felt like I got the best 5 minutes of his day and the options given me were the default check list they teach in medical school: Medicate, operate.

How could I heal and strengthen the damage done? How could I take the years of athletic experience, knowing my body, working through injuries and pain, and let my body heal itself? No answer.

I had read about an alternative therapy called Prolotherapy. It had been around for a few years and is not new, but involves the injection of what is typically a Dextrose solution into the damaged joint, ligament, tendon, etc, where it inflames the area and promotes natural healing to occur. The more I read, the more it intrigued me. It seemed to be an option to consider for the type of injury I had. What can be better than triggering the bodies own healing system? The worst that could happen was that it would not be effective and I would have spent money for nothing. You see, insurance does not cover it. You can get all the Ibuprofen and surgeries ya want, but no simple injections of sugar water.

I remember discussing this with a friend who was injured from a bike crash. He was running through the same HMO merry go round and we were comparing notes. I said that I was dreaming of a medical environment that when you walked in the door, they took a look at the whole of you. They really took the time to ask questions and considered all the options. I asked the Orthopedic at the last follow up about the Prolotherapy. His reply was "They will stick you with needles, make you sore, and charge you a lot of money". No discussion past that. Next patient?

Summer waned and I was ready for another plan. I made an appointment at a local LA sports rehab clinic that was nationally known for not just Prolotherapy, but a holistic approach to injury recovery. Also, I had the MRI re-read by another independant ladb. This time the results were quite different. Instead of a full section tear, the ACL was diagnosed as a "probable, partial tear". Really?

I am past my fourth Prolotherapy injection now and the entire approach has been remarkable. The time spent with the doctors was very different. I never felt rushed and the exams were insightful and intuitive. They looked at my whole posture, leg strengths and weaknesses, any nerve issues, recommended strengthening exercises and some corrective inserts for my shoes on the damaged leg. Supplements were suggested to aid in the natural healing process, but not required.



My knee feels much more solid now and the pain in the joint is still present, but should fade away as the injections wear off and healing continues. I do not know if the Prolotherapy will be the magic bullet or not but I do think it is helping a great deal.

The most amazing part of the experience at the rehab clinic was the whole approach to the examination and healing process. The moral of this yet to be finished process is be careful of what you accept as fact regarding your body. I learned that MRIs are very often misread and one techs read will differ from another. Shop around for your care and consider your options carefully.

If I had listened to the doc the first time, I would be healing from an ACL surgery right now that I may not have needed. Time will tell. I will report back in a few months.

Knee injury: Chapter 2

Mid Spring, 2007: So, off to the doc I go. I went to a local sports/Ortho clinic and saw the same doc that tended to my shoulder issues a year or so back. He poked and prodded, asked some questions and then did a test to see if the knee showed any sings of looseness due to an ACL tear. Nope, not really. "Your knee feels pretty tight", he said. Still, to see what happened he took xrays and scheduled an MRI. The xray showed no fractures, but some bone bruising. So far so good.

The MRI happened and the follow up was scheduled.

Back at the docs, imagine my surprise when the words out of his mouth were "You have a full section ACL tear". Whaaaaat!!? "See here", he said, pointing to the MRI (which just looked like some photography experiment gone wrong), "We really don't see any attachment here and here".

I was stunned and depressed. No way had I thought this was headed there. I got back up on the table for another push me/pull you exam. This time he said, "Well your knee is looser than the other one". Now this was the one that 4 days ago was tight. What is up with that? SO what are my options, doc? Hard to say. I would have limitations, certainly, but how much was unclear. When will I be able to play hard again? Martial arts? Cycling? Heck, I was wondering about a simple hike, if I would live wondering when my knee was going to give way or begin to be unstable, etc. So basically, take no risks. Great. We discussed the surgical options as well.

I ended up with a knee brace, some suggestions on what NOT to do (extreme sports, etc), and a prescription for vitamin I and physical therapy. I walked out with more questions than answers and the answers I had were not the ones I wanted. Bummer.

The PT person gave me a slightly more thorough exam, range of motion, etc. She reiterated that my knee felt very tight and was surprised at the MRI results. She did not feel the knee showed any sings of classic ACL damage. No signs of meniscal damage either. A few exercises later and I was on my way.

I hit the Google again and did a lot of reading on ACL surgeries. Autograph, allograph, patellar tendon graft, etc. Also, the success rates, dangers, typical results, etc. What an education. Did you know that the one of the highest percentages of ACL injuries happen to early teen age girls? Especially soccer players? Me neither. I also spent time on knee injury forums, I read about alternative medicine approaches, etc.

See, the deal was this. if I had blown my knee out so badly that it swelled up and laid me out, or it was giving out as I went down stairs or lived life, or it was obviously REALLY screwed up, I would have scheduled the surgery cause it would never get better beyond what the operation would provide. I would always have serious compromises with a missing ACL. One thing for sure, no matter what, I would never be the same again. One bright light was that cycling is not ACL dependant, but life is way more than bikes. I was too young and fit to be this limited....too much was uncertain.

But, I was not that bad. I had no instability, some pain but not a great deal, no swelling, clicking, popping, catching, etc. I knew I was a bit screwed up, but I dreaded the thought of rushing into surgery to "fix" a knee that was not as bad as the results of the operation might make it. Would I heal enough to live a more careful but reasonable sports life if I just left it alone? A loose knee can lead to arthritus and joint damage later in life. And, if I did the surgery, should it be Autograph (using my own body tissue as the 'fix agent' of Allograph where cadaver tissue is used? The allograph is becoming more popular since it does not involve cutting parts of a 'good' section of your body, typically a section of patellar tendon or hamstring tendon, to make the repair. The recovery is shorter that way, but there are no guarantees of the quality of the cadaver donor. Even if the tissue is not diseased or compromised, it may be not be as strong and fit as your own body would provide.

Well, 2 weeks and I see the doc again, with more questions that I know what to do with. Either way, life feels a bit darker right now. God is good, but he doesn't always tell me everything I would like to know.

Knee Injury: I thought the ACL was a group of liberal lawyers?

No, that is the ACLU.

I don't know much about them, but thanks to an unfortunate moment in the Spring of '07, I have learned a lot about the ACL, as in, Anterior Cruciate Ligament, a part of the interior of the knee that helps stabilize movement during sports, running, walking, etc. This is a journey into the realm of self education, treatment, and self awareness of the limitations of the medical industry in evaluating this type of injury for a practiced athlete. It is my journey, and it is not over yet.

Time log...early Spring, 2007: I am sure that anyone with an awareness of sports has heard of an ACL injury. Very common in football, soccer, skiing, etc, it usually happens when the knee joint is stressed beyond the limits of the ligament's tensile strength and a full or partial tearing of the ACL results. Once torn, the ACL has a very poor record of healing on its own. It seems that the synovial fluid that encapsulates the knee joint has very little blood flow and consequently, very slow healing abilities. Also, the fibrous nature of the ligament tends to shred and breakdown till little connection from bone to bone is left.

That leads to a loss of stability that can limit the sporting activity of the injured person and, unless repaired can lead to increased stress on the cartilage (meniscus)and other parts of the knee. Can you say, arthritis?

The repair is a pretty involved process requiring surgery and a long healing process to follow. Figure 6 months of sports related downtime and one year to full strength with no guarantee against surgery related issues such as lingering knee pain, reduced flexibility, etc. Not a rosy picture.

I knew none of this while I was laying on the practice mat a few minutes after the injury happened. I just knew anytime your knee pops and it hurts, that is not good. The injury happened during some practice of Judo techniques. I was caught up in a poorly executed hip throw that levered off my knee instead of higher up on the thigh/hip. My foot stuck on the mat and I was forced over to the floor. I had no tremendous pain or swelling immediately afterwards. Remember this point. My knee felt a bit loose and did not like being pivoted on or really any quick movement, so I was walking around with a limp, but I was walking.

Off to the local sports orthopedic center, but not before I spent a bunch of time on Google reading about knee injuries. I was not textbook for an ACL injury, I learned. I had no serious pain or swelling post injury, I had no real instability (knee giving out or buckling), or any clicking or 'catching' during knee movement that would point to ACL and/or Meniscus (the cartilage 'socket' that the knee uses as a cushion). I figured a ligament strain, but what did I know.

Turns out maybe I knew a lot, but I did not know that yet and I would not know that for a while.

Next chapter...to the doc.

Cycling Cycles

I bet if you look back on most cyclists lives, you will find times where they ride a lot and times when they taper a bit. Other things come along and catch your interest: kids, marriages, health challenges, etc. I used to ride 4-5 times a week 'back in the day'. Now it was once or twice a month...maybe. Not burn out or lack of interest, just stuff that comes along in that 24 hour day we have. Time and time again, I would come back to the bike and wonder why I left it for so long.

It happened again a few years ago. One of those detours came along in the form of a new challenge...martial arts. My son was taking some classes and I always watched with interest. I found myself thinking, " I am in good shape (Mtn Biker!!) and I may still be young enough to do this...maybe".

Four years or so later I achieved a black belt and was instructing part time. Great journey, but it really had cut into my riding time and passion. At 45+ years old, I only had so much energy, and training 4 days a week at the studio was about all I had to give. Then, while training in another form of martial arts to continue my education, I turned the corner (figuratively speaking) and ran smack into a torn knee injury. I still remember that feeling after the *pop* and the pain as I laid there knowing I had just really screwed up.

I always protected my knees. I never snow skiied, jogged, etc. Bad on the knees you know....cycling be good on the knees...must have good knees. Then there was that *pop* to remind me that I may have missed a lot of skiing for nothing.

MRIs followed, Drs visits (man, what an education that all was), some therapy and then time to heal as best I could and that meant little or no martial arts. Time to ride. See how the knee feels...not too bad. ACL injuries and the like are very forgiving to cycling so off I went. I had put on 10 lbs of weight, a combo of muscle and fat that really helped when you are fighting on the mats. Before the month was over, I had dropped 10 lbs.

My knee was still screwed up (more thoughts on that journey later) but I had fallen in love with riding again. Just as in the past, the cycle of life had come back to gears, wheels, sweat, and the giddy thrill of wind, speed, and the sweet satisfaction of a good ride.

And again I found myself asking, "why did I stop doing this?" Who knows, but I know one thing for certain, as long as God gives me the ability to climb up onto the saddle and pedal, I will keep a bike or two around, cuz sure as shootin' I will be distracted again and it is good to know my bike will wait for me with a understanding between us that I will be back.