Xfit

Anything on your mind that isn't about RLS/WED? It's nice to realize that there is life beyond this disease and have an opportunity to get to know our online family in a different context.
badnights
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Xfit

Postby badnights » Tue Dec 30, 2014 8:44 pm

I had an operation on my knee in July (it got stepped on by a big dude in a broomball game last January, completely ripping apart two of the main ligaments and tearing the meniscus in a couple of places). I am not supposed to do any sports with twisting motions, including hockey (that's ice hockey) and broomball, for 9 to 12 months after the surgery.

(I asked the doc, how can I tell if I'm one of the 9-monthers, or a 10-monther, or 12? He just laughed, he didn't give me an answer.)

Hockey and broomball are what keep me sane, so I knew I had to find a replacement activity. I thought of cross-country skiing but that's a depressing sport for most of the year in Yellowknife (always dark when you have time to do it, and mostly below -30C). So I joined a cross-fit gym. Scheduled classes would be my motivation. I have only been doing it for a month now (I procrastinated about the skiing for a while). And just before xmas I damaged my knee. I think it was from going below 90 degrees on a repeated series of front sqauts with weights.

I thought, OK, I will avoid going below 90. Simple enough. A problem that I can solve, and with patience and care the swelling will go down.

Not so. Yesterday we did dead lifts for the first time since I joined, and my stupid knee swelled up more.

I don't know how to do things without pushing myself, I don't know what parts of cross-fit I can do and what parts I can't do, and I don't want to give it all up and spend the rest of the winter depressed. I am in a funk.
Beth - Wishing you all restful sleep tonight
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ViewsAskew
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Re: Xfit

Postby ViewsAskew » Wed Dec 31, 2014 12:40 am

My knee isn't nearly as injured as yours - I have a chondramalacia where the kneecap degenerates and isn't positioned correctly - and I've had the same problem. After one surgery and three rounds of PT, I came to a place where I could hike, bike, swim and do all the things I'd done before. I kept increasing my ride length. One day, about 7 miles from home and 20 miles into my ride, the damn knee started hurting. I should have stopped riding, but had to get home.

Three rounds of PT - no luck. Still hurt. Surgeon said is isn't bad enough to go back in. But, it hurts when I use it and using it can make it worse. So, I stopped. I am POSITIVE that my depression issues coincided with me stopping most forms of activity. A 1/2 mile walk to the store? I'm limping. A 2 mile bike ride? My knee is hot and swollen for a day.

My activities are less strenuous than yours - primarily biking, swimming, some weight-lifting, and hiking - but it sucks not to do it. Not trying to make this about me, lol, but just wanted you to know I hear you and understand.

I did learn a lot from the PT efforts. My first two attempts failed. The third worked. The therapist was highly in tune with me and NEVER let me do anything that caused any pain. She didn't believe that pain was helpful. She tried very hard to find activities that I could do that didn't hurt the knee. At the 9 week point, all pain was gone. In the second series of PT, a couple years later, the therapists used the typical activities. There was always pain, a bit of swelling and a lot of heat after my sessions. I went three times - to no avail.

After that, I read about a man who healed himself - he also has chondramalacia. He said that all of his research (he was a science writer, IIRC) showed that typical methods of PT focused on the wrong things and that they often didn't work. He suggested that if there is pain, we're causing damage and we have to find ways to move the joint gently and that cause NO pain. I've been trying that for the last 18 months. I just stopped doing anything that caused pain, but tried to move it gently and stop before I would have pain. It seems to be working. I can walk farther than I could a year ago. And I biked short distances this summer without issue. I'm just not sure how to ramp up for more - and it took 18 months to get to this point, which seems crazy.

I have no idea if that is helpful to you or not. You have a completely different problem with the knee, so it may not.
Ann - Take what you need, leave the rest

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badnights
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Re: Xfit

Postby badnights » Wed Dec 31, 2014 8:42 pm

Of course it's helpful! I love it! And anyway, posts don't have to be helpful, which you know yourself. If my story triggers something in you, then you tell your story.

I agree, I would place bets that your depression was triggered by stopping physical activities. It's even more important for us, if we're indeed endorphin-poor in parts of our brains, to engage in regular physical activity. But if you can't even do light activity without damaging it, what a dilemma! At least I can walk without making it swell up. Even swimming hurts it?

I find your info on PT fascinating. I thought they were all on the same page and knew this magical stuff about how far to push you etc. I think I had pretty good PTs in Edmonton, but I only see them when I go down to see the surgeon.

I would guess that if you continue as you're doing, you will be able to gradually increase activity in baby steps. Instead of adding a mile, add a quarter mile or an eighth of a mile to a bike ride, that sort of thing.

I don't even have access to a physical therapist right now. I missed an appointment without calling in (not to make excuses, but WED sucks) so I had to go back to my doctor for a new referral. I missed an October appointment and I'm still waiting to get back in. Even before this recent swelling, I wanted to ask them about something. I have had a lingering pain and some swelling below the knee, not in the joint, on the front of the leg to the inside a bit, right where he made the incision to collect my hamstring tendons (they attach in front after wrapping around the inside of the leg from the back).

In September when I last saw the surgeon, I was not concerned because the entire knee was still a bit swollen from the surgery. But now it's been 5.5 months since the surgery and the pain is still there, unchanging. If I listened to the pain, I wouldn't ever straighten my leg. But I act according to lessons learned in physio, i.e. I push through the pain and force it straight whenever I think of it, I try to remember with every step I take to straighten it through the pain. The threat being that otherwise I will limp forever. But what is true? Maybe I'm preventing healing.

And that's just the first part of what I need to ask a doctor or PT about. The second part is how much /what things I can do in cross-fit, to avoid swelling up. Yesterday's class didn't involved deep squats or dead lifts, and I didn't swell up. I guess I will just hope I don't damage it badly while learning what I can do.

I looked back over my papers and was interested to learn that the graft is still strengthening up until 18 months after the surgery ("graft continues to strengthen and re-model"), and the final phase of PT is for the period from 1 to 4 years after surgery ("re-modelling continues")! It takes a lot longer to heal than we expect or want.
Beth - Wishing you all restful sleep tonight
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ViewsAskew
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Re: Xfit

Postby ViewsAskew » Wed Dec 31, 2014 10:18 pm

I found the PT experience fascinating, too. The first time, I went immediately after surgery and it didn't help much. I went again a few month later - no improvement. But, then I decided to go on a Sierra Club hike in the Sierras - 1 week of daily hiking. I signed up for an easy trip - we could take easy or hard hikes each day - but I knew I had to get MUCH better. I went to a third therapist. She immediately had me to lunges - which have always hurt. As soon as I said that it hurt, she said we had to find something else. She didn't ask how much it hurt - she really felt that there should be NO pain. Of course, I was almost a year post surgery at that time and my surgery was much less invasive than yours. The PT who worked with me immediately after the surgery also told me I had to push through it. While I didn't heal immediately at that time, I'm not sure he was wrong. But, I have to wonder if there is some sweet spot - for example, you push through pain on a 1-3 level, but not pain on a 4-10 level, or some such.

The third PT worked hard to find alternate activities. She didn't want my knee to hurt or feel hot. She used one of the electrical stim machines (don't know which) after every session. I wasn't hopeful as weeks went by, but by week 8 or 9, I was pain free. I brought my bike to the last session and she cleared me to start riding again.

Fast forward 2-3 years. I'd been riding my bike as my primary transportation the whole time. It was 7.5 miles from my house to downtown. I was doing a lot of mediations at the time and I'd ride my bike to them and then ride back. I also was doing photography and art glass full time (I'd stopped consulting) and had a studio about 5 miles away. I rode back and forth every day. One day, I decided to ride farther - and to take the lakefront home. It added about 5 miles to my 15 miles RT to downtown. When it started to hurt, I was devastated.

I called the hospital, but they didn't have the records of who did my PT when it worked. I went to see whomever they recommended. I had a round of 6 appointments. No luck. He didn't believe in using the machine she used - he said it didn't help, even though I told him it had for me. He always told me that some pain was fine. He treated me as if I was a wimp because I didn't want any pain. The doctor ordered 6 more sessions. Same PT, same result. I then asked to be switched to someone else. They gave me the director. He had YEARS of experience. He really did listen, but for whatever reason, still no results. He also didn't use the machine. He did help me realize my gait was a bit off and helped me straighten my posture :-).

I finally just gave up and figured I'd eventually figure it out or would not. Sometimes I walked too much and it hurt and I figured that would be how it was. I participate in a chondramalacia forum and one of the people is the person I mentioned above - he had done a TON of research. He found that much of what they do in treating the condition isn't in line with the research! (Sort of like here - imagine that....) He found that pain was definitely an issue and that you needed regular movement that never caused pain in order for healing to take place. It took him about 18 months to heal, and now he has been fine for a few years. I started doing what he recommended - just walking a block and stopping. I stopped pushing EVER. It took a year before I was consistently pain-free with the little activities I did.

It doesn't surprise me at all that your surgery would take a LONG time to completely heal. What I've read about tendons and ligaments is that they are very, very slow to heal. I did have my PT go over ALL my activities and tell me what I could do. That was really helpful.

Would your doctor call in a script for the PT without an appointment with the doc?
Ann - Take what you need, leave the rest



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Re: Xfit

Postby Rustsmith » Wed Dec 31, 2014 10:42 pm

Depression first. My depression history is the opposite of the two of you. Until I turned 35, the doctors sort of blew off my complaints about my allergies and the headaches they caused. I finally convinced them to give me a referral to an allergist. She diagnosed me with both severe allergies and mild asthma. Turns out it was the asthma that made me such a wimp when it came to anything athletic. Once she got me lined out on both the allergies and asthma treatments, I was able to start running with our dog. That got me started running, which has now morphed into local and now national competitions.

Prior to starting running, I would go through extended periods of depression. Not the "I want to kill myself" levels of depression, but bad enough that I wasn't always pleasant to be around and it certainly cut down on my productivity at work. Then, once I started running the depression spells vanished and have not returned now for over 20 years. I made reference in another thread today to the most recent webinar by the Foundation on WED and depression. One of the points that was made was that exercise can be just as effective mode of treatment for depression as can the medications.

Now on PT, I have a good friend who owns a physical therapy clinic. I have successfully avoided PT's now for many years, but my wife went to see her after bombing out with a couple of near quacks in our area. PT's definitely are not all the same. This lady has been known to work miracles with patients who have failed miserably or have been declared untreatable by others. In talking with her at parties, I also know that she is of the opinion that if the therapy exercise hurts or is causing you pain later, then the therapy is being done incorrectly or is the wrong therapy. Now, pain in this case doesn't include discomfort or muscle soreness the day after. That approach also sort of tracks with the torture, er training sessions that my running coach has been known to create. And believe me, the last 100m of an 800m race is more painful than any other non-injury activity in sports (which is why only masochists like me are willing to run the event :D ).
Steve

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ViewsAskew
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Re: Xfit

Postby ViewsAskew » Thu Jan 01, 2015 9:17 am

Steve, I think the PT observation is likely true for ALL professions. We certainly see it with the doctors we see! They really are not all created equal. My mom has a degenerative disc issue; she saw a few chiropractors to no avail. When she moved about 15 years ago, people kept talking about a chiropractor who worked miracles. My mom finally decided to see him. She was amazed! She still goes to see him every few months. One session and all her symptoms and numbness goes away for at least 2-3 months.

Per the pain, it makes sense to me that pain would be bad! My guess is that it's really hard to tell at times if a patient is feeling minor discomfort because the body is being pushed a bit, or it it is really pain. Sometimes people do not want to move out of their comfort zones. I bet the best PTs see subtle signs and are better at communicating that and asking better questions. The woman I saw (by the way, all my fails were with men who really didn't listen to me), really listened to me. She also watched me carefully and at any sign of wincing, discomfort, or reticence, she immediately was cued in and asking me about it.

Steve, how great that you found a way to resolve the depression. And that it turned into competitive running is very cool.
Ann - Take what you need, leave the rest



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Re: Xfit

Postby Rustsmith » Thu Jan 01, 2015 12:10 pm

Per the doctors, we forget that more than 50% of the physicians practicing medicine were in the bottom half of their class at medical school. The reason that I say more than 50% is because many of the top graduates go into research and many of them concentrate on their studies so much that they do not see patients. And, the same is true of my profession. I had to keep reminding my management that when they wanted an "outside" opinion, they were often asking for an opinion from someone that we had decided was not good enough for us (or one of our competitors) to hire, i.e. not at the top of their graduating class.
Steve

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Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Xfit

Postby ViewsAskew » Thu Jan 01, 2015 9:26 pm

I often think that about anyone I see for anything, Steve.

On the other hand (per the bottom 50%), studies have found fascinating things related to grades. For example, the most successful people in sales were usually C students. And, grades cannot account for personality in many situations. Or emotional intelligence (which is argued cannot be scientifically proven) and how that affects things. in my most recent profession, the best consultants - internal or external - have the highest degree of emotional intelligence and can see the relationships between people and how they affect the work that is accomplished.

So far, the best indicator of success in the working world is the big five personality traits (OCEAN - Openness, Conscientiousness, Extroversion, Agreeableness, and Neuroticism). Studied extensively, these seem to be the most reliable predictors of job performance. Conscientiousness specifically relates to overall job performance and the others impact specific jobs. Openness and conscientiousness strongly predict school performance.

But, we're unlikely to ever see that data! I want someone HIGHLY conscientious for a doctor, for example!!! Next, I want them to be agreeable so they will work with me and last I want them to be open so they will look outside the box.
Ann - Take what you need, leave the rest



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badnights
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Re: Xfit

Postby badnights » Fri Jan 02, 2015 3:28 pm

Steve, I was probably in low-grade depression most of my life, sounds similar to yours. It manifested as gloominess and self re-recriminations. But I did not have asthma to contend with well until into my 40's. (Probably smoking induced, though I quit at 38.) I knew a guy who couldn't do sports as a kid and who was made fun of because of his asthma. It's frightening, how cruel kids can be.

Ann, how does Neuroticism fit in?
Beth - Wishing you all restful sleep tonight
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Re: Xfit

Postby ViewsAskew » Fri Jan 02, 2015 11:55 pm

For choosing a doctor, lol? Not sure :-).

In terms of employment, it's often viewed as a negative. Most of the traits can be negative or positive, depending on the job. Some are almost always positive - such as conscientiousness. But, neuroticism is often seen as a negative in the work world.

According to what I've ready, N behavior is manifested as anxious, pessimistic, stressed, fearful, moody, and/or emotionally unstable. They may be upset easily or be very sad. In other words, responding with what we consider negative emotions when faced with difficult situations - loss, threat, frustration, etc.

Some degree of anxiety can be motivating. Some degree of pessimism can be helpful in seeing all sides. Some degree of fear may prevent people from making snap decisions. And so on. So, the question becomes degree, the job, and the culture. The individuals awareness of their degree of N is essential if it's to be helpful. The more awareness you have, the more likely you can turn any negative into a positive by using it only at appropriate times.

In terms of finding a doctor, I suppose a bit of N would be helpful - they might follow up on something another doctor would see as innocuous. They might also respond to patients in ways that make the patient uncomfortable.

For what it's worth, these Big Five traits are likely the only universal trails - universal to all cultures. At least all that have been studied. So, this should apply to anyone we're likely to work with.

Does that answer your question?
Ann - Take what you need, leave the rest



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Re: Xfit

Postby badnights » Sat Jan 03, 2015 5:54 am

Ya. I read your words as meaning neuroticism was a predictor of job performance! :shock: But they're saying that although it's a factor, the relationship might be inverse.
Beth - Wishing you all restful sleep tonight
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Re: Xfit

Postby ViewsAskew » Sat Jan 03, 2015 6:11 am

badnights wrote:Ya. I read your words as meaning neuroticism was a predictor of job performance! :shock: But they're saying that although it's a factor, the relationship might be inverse.


The basic is that these 5 traits are measurable and affect job performance (and other things). Only conscientiousness is highly correlated to job performance, as I understand it. Depending on the culture, however, the others may also impact it (either positively OR negatively). If that clarifies it.
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.


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