After eight months of ruling `this' out and `that' out it is conclusive: bone on bone.
The orthopedist and I had a good conversation. If it were just pain from day to day moving around for a typical 72 yo it might be managed adequately (simple palliative treatment) with shots and stuff. But for my purpose, i.e., an active lifestyle, it might make a difference. Or, then again, it might not.
It's been a lengthy sleuthing process with plenty of patience and diligence. From initially making the working assumption that it was tendonitis to more extensive actions: medical consultations, x-rays, an MRI and second opinions.
I've been fortunate to be the recipient of experienced opinions of many athletes and endurance cyclists (Joe Friel, Allan Duhm, Robert Baldino, to name only a few).
The decision making event was the recent `24 Hours In The Canyon' competition in Amarillo, Texas (June 2 - 3). It combined two good testing settings.
The first was a 110 mile out and back event held in the Texas high plains. Almost completely flat with the most challenging grade being 2%. I had good power, speed and endurance despite heat in the mid-90's and a steady 25 - 35 mph wind.
The second was a 5 mile loop in the Palo Duro Canyon. Do as many 5 mile laps in the 24 hours as you can. This was fairly hilly, with several sections of 4 - 7% grade. Within the very first lap the knee started to ache. As I completed more laps (7 total) the ache grew to a sharp pain.
I've been fortunate to be the recipient of experienced opinions of many athletes and endurance cyclists (Joe Friel, Allan Duhm, Robert Baldino, to name only a few).
The faulty knee presented in a somewhat odd manner. On the flats I can (and have) ridden for hour after hour after hour with absolutely no discomfort. With grades of 4% and more the discomfort went from growing ache to acute and sharp pain.
The first was a 110 mile out and back event held in the Texas high plains. Almost completely flat with the most challenging grade being 2%. I had good power, speed and endurance despite heat in the mid-90's and a steady 25 - 35 mph wind.
The second was a 5 mile loop in the Palo Duro Canyon. Do as many 5 mile laps in the 24 hours as you can. This was fairly hilly, with several sections of 4 - 7% grade. Within the very first lap the knee started to ache. As I completed more laps (7 total) the ache grew to a sharp pain.
Radiological evidence:
- completely severed ACL
- several torn meniscus (meniscii?)
- complete absence of cartilage in some areas of the knee
- numerous `bone spurs' (i.e., osteophytes)
- bone on bone
Fortunately there was no swelling or damage to the ligaments, tendons or other tissue. Excellent blood supply to the area.
Why did this even happen?
- family history of arthritis
- 30 years of long distance endurance running
- 69 years of happy bicycling
- 72 years of living
- I've not neglected my body or attempted to do foolish acts of self-destruction
- I have never fallen for the trap of trying to `impress others'
- I consider pain as a `friend,' i.e., my body telling me things I should listen to and act upon
- A wise refusal to dismiss criticism or disapproval from others for refusing to `drink the cool-aid' of `too much is never enough.'
- I've never been a hero and I'm happy to be an observant, judicious survivor
My expectation is that I will likely be sidelined from outdoor, on the road cycling for 5 - 7 weeks. But my rehabilitation will include disciplined and challenging indoor training on the recumbent (a recommended platform for knee surgery rehabilitation).
I've learned a great deal and have much remaining to be learned. Both from a `body' perspective and from an `acceptance of mortality' perspective. The latter is the most important.
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