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Giza aka Douglas Muth's LiveJournal
A long-overdue health update on my feet and knees 
19th-May-2011 08:47 pm
White Mage - Drawn by Mahrkale
Cheetah pawsI've been meaning to write an LJ post for awhile about my overall health, but I've had so many things change along that front that I figured I'd let them settle down first.

First, the issue with my knees. About a year ago, I began feeling pain just below the kneecaps on both knees. I started wearing knee braces to rest the knees, and would try removing them after a few days of being pain free. But this only made the pain come back, and even worse: I would feel sharp stabbing pains in the sides of my knees. That scared me lots, because I had no idea what was wrong with my knees, and I was afraid to do anything that might aggravate them further. So I continued to wear the knee braces just in case I had something degenerative going on.

It took a few trips to the knee doctor, some MRIs, x-rays, and 2 months of physical therapy to finally get to the bottom of things. If you've ever heard a healthcare specialist say, "everything is connected", this is a classic case of that. The pain I felt under my kneecaps turned out to be patellar tendinits. Apparently the space between the bottom of my kneecap and the top of my tibia was a few millimeters too short for someone my size, which meant the tendon was shorter. This in turn predisposed me to things like that. Combine that with hitting the bicycle hard at the gym (more on that shortly), and I set myself up for issues with that tendon. And the stabbing pains in the sides of my knees? Seems I had not been working the supporting muscles on the sides of the knees, and the knee braces caused them to atrophy a little from underuse. So when I tried going off of the knee braces, I gave myself overuse injuries and a little scar tissue. Oops.

On the subject of the supporting muscles in the knees, the physical therapy I had at Zarett Rehab rocked really hard. The people there were very knowledgeable and taught me exercises such as Russian Single-leg Deadlifts to work all of the muscles in the knee, not just the patellar tendons. They also discovered some weakness in the muscles in my hips and lower back, and gave me exercises to do for those muscles as well. This should keep the muscles in my knees and feet from getting overtaxed. After several weeks of physical therapy, they then helped me wean myself off of the braces by way of having me walk longer and longer periods every day without them. At this point, I've been off the knee braces for two weeks, and have been taking walks in the evenings. It's really nice to be able to walk across town again. :-)

I said something earlier about the gym, and have come to the conclusion that gym machines are fairly evil. The problem with them, as I learned first hand, is that many machines only target a single muscle. Let's say you're using a leg extension machine. This will work the quads... and little else. This means that the supporting muscles don't get worked out, and can lead to problems down the road, especially if the quad were to get injured, causing you to limp, and causing more strain to be put on those other muscles. Muscles can start having issues one after another that quickly.

I've quit my membership at the gym, and am going to look into taking up yoga at some point. In the meantime, I'll keep doing my calisthenics 3 times a week, and walk seven days a week. I still have some discomfort in the knees and the tibialis anterior, but since it's a 100% soft tissue injury (e.g., the joints are fine), that will heal with time.

Leopard's pawThe second major issue is my feet. I began feeling this awful burning pain in them at Anthrocon last year. It limited my enjoyment of the con and was quite scary. So after the con I saw my doctor, then my pawdiatrist. Originally, it was pointed out that my feet had high arches, which meant that more load was borne by the ball of the foot and the outside of the feet. The first step to try and treat this was prescription orthotic inserts. But, the pain continued. So I was sent off to physical therapy. Unfortunately, I had an HMO at $OLDJOB, and could not choose which facility I was sent to. So while the people at the rehab facility I went to were really nice, I didn't get the best care I could. (My pawdiatrist used the word "McDonald's to describe them)

Fast forward a few months to December, when I changed jobs, and got a much better health plan. I was then sent off to Zarett for my injuries (yes, physical therapists can treat multiple injuries during the same visit, as I learned) and while it helped with the knees, it did less for the feet. Oddly enough, I discovered just a couple of weeks ago that removing my shoes while seated at my desk makes the pain and discomfort go away. Walking is fine, too. It's only standing and being seated with shoes on that cause me issues.

At this point, I've had X-rays, seen a pawdiatrist, physical therapist, neurologist, and had an ultrasound done. Yet, nobody can really tell me what's going on. The closest the physical therapist could say is that it was very likely a chronic injury spent by walking around with high arches for 30-plus years, but even he wasn't sure what the specific injury was. As he said, "Chronic injuries are frustrating for both the patients and us".

Overall, the pain in the feet is less than what it was last summer, and with things like fractures, arthritis and neuropathy all ruled out, that means I shouldn't have any serious issues going forward with my life.

TL;DR I got old, so I punched old age in the dick.
20th-May-2011 01:55 pm (UTC)

Yeah. I think the whole "swelling" thing was also ruled out by my podiatrist, too. I know my Primary Care Provider checked for that as well.
20th-May-2011 02:12 am (UTC)
Good for you!

You know, sometimes when dealing with the medical field, I kind of want to learn to be a doctor so I can properly figure out what the HELL is going on with someone's or my issue.

The engineer way of doing things, "dammit, do I have to learn and figure this out myself?"
22nd-May-2011 03:23 pm (UTC)
My biggest engineer frustration is that there's no way to get instant feedback on some things. It would be nice if I could have an MRI taken of the tissues affected each day, and then compare the state of the tissues versus my activity levels, to see what works and what doesn't.

I wouldn't be surprised if some day in the far future we have personal MRI machines, just like the average kitchen has a microwave today.
23rd-May-2011 01:44 pm (UTC)
Well, the way costs are done in Japan, they get a LOT more MRIs than we do out here. Its far cheaper the way they have costs distributed and done.

I'd be happy if MRIs were cheap enough for people to get them once or twice a year. That would teach us a lot about how our bodies change.
20th-May-2011 06:14 am (UTC)
I've had several older friends with similar foot-issues that went away by not wearing shoes.

Independently, they all ended up wearing these and swearing by them: http://www.vibramfivefingers.com/index.htm

Something about walking naturally just worked for them. And these are "shoes" that aren't shoes and let you do that.
20th-May-2011 01:57 pm (UTC)

You're not the first person who has recommended them.

Do you know if any of your friends had high arches and/or prescription orthotic inserts? My concern is if I'm wearing something not specifically made for my high arches that I could continue to have problems.

Foot mechanics are complicated. :-P
20th-May-2011 09:10 pm (UTC)
Not sure on all counts, it's been a while. One of the guys had arch issues, but I don't recall if it was high or flat. I will have to ask again.
20th-May-2011 01:37 pm (UTC) - Welcome to the tendonitis club.
Mine is in my wrist, which forces me to have to make a fist on my right hand verses being able to have a flat palm with the left hand.

Since working at home, I leave my shoes off. I can feel the difference with my left foot. I hope things go well with the new therapist. I'll be happy to work on your feet at AC.

I'm going to a dentist today to find out if I need oral surgery before AC.
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