Something about sore knees and dysfunction

Something about sore knees and dysfunction

My knees hurt.

Given they’re parts of a set of legs that have well over 120,000 kilometres on the clock, this probably shouldn’t surprise me.

I’m fully aware that running promotes joint strength, mobility and stability, but it doesn’t change the truth: they hurt.

Last year, I was rendered immobile by a stress fracture in my left foot. The stress fracture was likely caused by a subconscious change in form caused by – you guessed it – pain in one of my knees.

The dysfunction reverberated in three different sites of my body. The net result: I was immobile for about six months. I couldn’t run and, for a couple of months around Christmas time, I couldn’t really walk either.

When the acute, non-loadbearing, high-pain phase of the recovery subsided, I was left with a tough reality: my knees were worse than when I’d been forced to stop. All that the rest had served to do was exacerbate the problem.

While my conversational Italian was improving in leaps and bounds from all the Duolingo modules I was mowing through while watching others mow through their Tuesday and Thursday intervals, my knees hadn’t enjoyed the rest at all.

I needed to do something. I needed a way to start running so I could build the strength and function to run some more.

My friendly sports doctor, who shares my name, agreed that some shots of cortisone might get the functional ball rolling. A steroidal anti-inflammatory, cortisone would likely give a level of temporary and immediate relief. It wouldn’t solve my problem, but it would mask it for a while and give me a window of opportunity to develop strength and mobility.

The results were wondrous. On the Tuesday morning before the painkilling injections, I tried to break into a jog and got about 50 metres before wincing to a stop. Two days after the injection, I survived three kilometres. Sore, but something.

High-intensity intervals, scenic long runs, tough marathon-pace runs, and all the other running that gets you genuinely fit was ages away, but I was running again. It felt good. Fat, flailing and flabby, but good.

It turns out that I haven’t been the conscientious rehab patient this time around that I have been in the past. While it’s been great to be running, there hasn’t felt like there’s much future in it. The cortisone makes it semi-bearable but still quite painful and doesn’t allow me to do the amount of running that would get me fit. It’s hard to rouse yourself for a run when it’s been hurting to walk down stairs and you’re about to get that and a whole lot more. The target marathon pace that I was busting out for 30-something kilometres 12 months back, is now quite challenging over a single kilometre.

As the cortisone has worn off, I’ve faced a couple of alternatives: more cortisone, stop running, or a third option.

For many, that’s a simple decision: stop running. While this may be the reality at some point in my life (hope not!), it denies the God-gifted pleasure that I derive from running, and running with others. There aren’t easy substitutes for me. One therapist told me it might be time to consider cycling. That was about 15 years ago. I’m so glad I didn’t listen.

The problem with cortisone is that it doesn’t heal, it simply masks dysfunction. There’s an essential problem with the degradation of the bone and a reduction of synovial fluid in the joint. Cortisone hides the problem, but it also accelerates the degradation; long term use is ill-advised.

It turns out there’s third way. It requires a small second mortgage of the house, but it functions in a very different way. Called Synvisc, it is a synthetic synovial fluid. It doesn’t hide dysfunction, it promotes function. Lasting for 9-12 months when successful, it restores rather than masking. It’s not a band-aid, it’s a balm.

This isn’t a promotion for Synvisc – I’ve read a bunch of reviews on the stuff and they clump in two distinct camps: roaring success or a dismal failure. No, this is about something else.

Most of us have suffered pain. Pain far worse than dodgy knees. Pain of the mind and heart. Physical, emotional and relational abuse. Deep scars caused by our own actions or the actions of others towards us. Many times, that pain was other-inflicted rather than self-inflicted. Regardless of who caused it, though, one thing remains: each of us get to choose how we treat our pain. While we may not have had a say in the genesis of the pain (or we’d never have chosen it), we get a say in its treatment.

When we seek to numb our pain via another some dysfunction, though, our heart reacts a little as a balloon does when pressure is applied: we just bust out with pain in an other area altogether. It’s true physically, but also emotionally.

And so our choices are threefold: never return to near the place of pain, hide the pain through ‘anaesthetics’ that mask our dysfunction, or a third alternate: seek ways of restoring genuine wholeness and function.

The third way is not necessarily the quick fix, but it’s the way of restoring genuine function. It goes to the place of pain and seeks to make it a place of healing.

I have never known this to be solo work. And while breakthroughs certainly come, I have also found it to be slow work. That’s the way of most worthwhile healings. I need help far greater than me to bring about the sort of strenuous wholeness that I need and know I need. I need a Savior who can save me from myself. Who is able to do what I can’t. Who is able to restore me from the inside out. And who is able to make my broken story altogether bigger and greater by writing me into His own. I need Jesus. The one who can make all things new, who can fix me. I need ‘deep draughts of God’ as the psalmist writes.

The deep healing of the heart that Jesus offers is always available, but you’ve got to want to go there. It won’t cost money and there’s no need for a second mortgage, but it does require that you let go of your right to that hurt and your attempts at anaesthetising the pain in exchange for something altogther more glorious.

On Monday, I had two injections – one in each knee. It’s a potential short-term remedy for a long term problem. But it’s not an eternal problem. I’ll get a new body one day – it’ll run and not grow weary, walk and not grown faint (Isaiah 40:31). Meantime, I do not lose heart. Though outwardly I may be wasting away, yet inwardly I can be renewed day by day byt the Holy Spirit at work within me (2 Corinthians 4:16).

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