Garbage Knees

I’m 26 and I have garbage knees. 

Why? In middle school, high school and college, I had 3 injuries to my knees: 1 partially torn ACL (anterior cruciate ligament) on one knee and a sprained ACL and MCL (medial collateral ligament) on the other. I got these injuries 1) while in dance class, executing choreography; 2) while playing volleyball, coming down from a spike; 3) running up some stairs in my dorm. 

See, The ACL is a small, rubber-band-like fiber, no bigger than a little finger, that attaches to the femur (thigh bone) in the upper leg and the tibia (shin bone) in the lower leg and stabilizes the knee. When it ruptures, the reconstructive surgery is complicated and the rehabilitation painful and long. It usually takes six to nine months to return to competition, even for professional athletes. The MCL spans the distance from the end of the femur to the top of the tibia and is on the inside of the knee joint. The MCL resists widening of the inside of the joint, or prevents “opening-up” of the knee.

Apparently, young girls are the most susceptible to this type of injury. Females rupture their ACL’s at rates as high as five times that of males! When I was in middle school and first injured myself this way, there was another girl who lived down the street from me with the same big old knee brace on. Funny thing is, she and I also played the same instrument in the band, Bass Clarinet. We’d be sitting there, legs outstretched. One of us always on crutches at some point. 

Girls and boys diverge in their physical abilities as they enter puberty and move through adolescence. Higher levels of testosterone allow boys to add muscle and, even without much effort on their part, get stronger. In turn, they become less flexible. Girls, as their estrogen levels increase, tend to add fat rather than muscle. They must train rigorously to get significantly stronger. The influence of estrogen makes girls’ ligaments lax, and they outperform boys in tests of overall body flexibility — a performance advantage in many sports, but also an injury risk when not accompanied by sufficient muscle to keep joints in stable, safe positions. Girls tend to run differently than boys — in a less-flexed, more-upright posture — which may put them at greater risk when changing directions and landing from jumps. Because of their wider hips, they are more likely to be knock-kneed — yet another suspected risk factor.

… An ACL does not tear so much as it explodes, often during routine athletic maneuvers — landings from jumps, decelerations from sprints — that look innocuous until the athlete crumples to the ground. After the A.C.L. pulls off the femur, it turns into a viscous liquid. The ligament cannot be repaired; it has to be replaced with a graft, which the surgeon usually forms by taking a slice of the patellar tendon below the kneecap or from a hamstring tendon. One reason for the long rehabilitation is that the procedure is really two operations — one at the site of the injury and the other at the donor site, where the tendon is cut.

Luckily, I never had to have surgery. I have had to go through quite a bit of physical therapy and living in a long blue brace which you strap on from mid thigh to ankle. The brace is necessary to walk and sleep and LIVE comfortably. My knee would feel all loose and jiggly like nothing was holding it together. Allowing it to move at all was very painful. To shower I’d try to keep my leg super still and I had to use both hands to stabilize my knee when getting in and out of the tub.

I’ve had a huge giant needle jabbed into my knee and I’ve seen my knee swell to the size of a healthy melon. What they say about crumpling to the ground… so true. It’s like one minute, you’re in the middle of an 8 count and the next you’re just on the ground. It is as if someone has magically caused your entire leg to disappear from underneath you. 

In physical therapy, we would focus a lot on strengthening my legs. You need stronger hams and quads to take the burden off of your knees. So when I go to the gym now, I mostly focus on my legs when it comes to strength training. 

My past injuries don’t have a huge impact on my life. I run on the treadmill and go to spin class. I played flag football. I went back to dance classes. I “get low” in the club (and elsewhere *wink*). I rollerskate. I go hiking. Jump double-dutch. Play-fight. Take the stairs, etc. By no means am I benched behind this mess. Still, there are times when I feel like I might fuck my knees up again. And that feeling makes me hold back from whatever I am doing. There are times when I am taking the stairs and I can hear my knees creak like old attic floors. Damn, I’m 26!

The concern for the future is for long-term effects. I’d hate to have things stiffen up on me or lead to osteoarthritis or even knee replacement. Those are extreme cases, however. As I’ve mentioned, I stay active so hopefully that won’t become an issue. 

In the meantime, I am going to try and incorporate some of these exercises from the PEP Program. The researchers there have developed a new conditioning program resulting in 74 percent reduction in A.C.L. tears. 

Source: The Uneven Playing Field