Fitness Files: Adjust to ‘bad’ knees if you can
My group of retired teachers stood to leave our spring get-together at Mitzi’s. Mitzi sat, planted in a chair, leg propped.
Awaiting knee-replacement surgery, she grimaced in pain but called out gamely, “We’ll have our usual teacher’s retreat at my cabin, but I’ll sit. You guys do all the work.”
In 2008, my family’s Green Valley Lake cabin burned to the ground, but teachers continued August gatherings, crowding into Mitzi’s cabin.
Next day Mitzi emailed, “SORRY!!! Mountain trip’s off. Can’t manage stairs up to the cabin.”
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Exiting my Saturday class, I fell into step with a lady who complimented me on a recent column and then said, “I won’t be here next week, having a knee replacement.”
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With speedy runner Evie up ahead, a guy on a bike pedaled up to me and said: “I’ve been watching you. You’re limping. Are you thinking about a knee replacement?” He told me his doctor’s name.
Yowzers, is “knee replacement” the new appendectomy?
I count half dozen friends who’ve done one or both, and no, none are runners.
Should I join the crowd?
And is it ever a crowd.
Bostonglobe.com‘s Courtney Humphries wrote in 2012 that knee-replacement surgeries are “skyrocketing” and pointed to, as reasons, growing rates of obesity, active baby boomers now facing osteoarthritis, and the continuing improvement of artificial joints.
Dorothy Feltz-Gray, at arthritis.org, writes, “People younger than 65 are the fastest-growing age group opting for total knee replacement. Overall demand for the procedure is rising as well, with numbers expected to increase.”
Both authors caution us to think long and hard before signing up. How to decide? The considerations are age and lifestyle.
Gretchen Reynolds, writing on the New York Times wellness blog in November 2014, said the number of people ages 45 to 65 having knee-replacement surgery “soared by 205% between 2000 and 2012.” Among those 65 and older, the increase was 95%, yet surgical replacements were better suited for the older group because implanted materials wear out after a couple of decades — possibly necessitating a second surgery for the younger set.
Furthermore, older people who had “really bad knees,” benefited substantially from knee replacement, she wrote, gaining 20 points on a scale of improved knee function, while those with slight arthritis reported more pain and physical impairment, gaining only 2 points.
What is meant by really bad knees? Reynolds quotes Dr. Daniel Riddle, a Virginia Commonwealth University professor and study author, who says, “If you do not have bone-on-bone arthritis, in which all of the cushioning cartilage in the knee is gone, think about consulting a physical therapist about exercise programs that could strengthen the joint, reducing pain and disability.” Losing weight helps too, he added.
By Riddle’s definition, I may qualify. In 2007, an orthopedist glanced at my knee X-rays and said, “You have no cartilage in your knees.” End of running, I thought. Reading my mind, the doctor, said, “Lots of runners have no cartilage and keep running.” I went on to complete six marathons.
So “bone on bone” doesn’t necessarily mean “really bad knees.” The deciding factor is daily serious pain. I don’t have knee pain unless I run too fast. I have no knee problem at my new slow rate: 12- to 14-minute miles. At the gym, I’ve given up weight machines, which pain my knees, in favor of exercises learned at former physical therapy sessions. In short, I’ve altered my lifestyle.
The Globe’s Humphries offers the concept of “decision aid” to patients considering knee replacement. She quotes a man who, like me, is in early 70s and had a “bone on bone” X-ray. His doctor recommended replacement but handed him a pro/con video and brochure.
The patient studied the materials and determined he was not going to have a knee replaced until absolutely necessary. The video and brochure helped him to know how to make the decision.
I’m not considering knee replacement. With lifestyle changes, my knee does not hurt with daily activities.
Mitzi, waiting in line for hers, says that after having the left knee done, she can’t wait for the right to be replaced.
“If it goes like the last one, I’ll be pain-free for next year’s cocktails at the cabin,” she said.
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Newport Beach resident CARRIE LUGER SLAYBACK is a 72-year-old marathoner who brought home first places in LA Marathons 2013 and 2014 and the Carlsbad Marathon 2015. She lives in Newport Beach.