Getting old sucks!

It's a truism that getting old sucks. The problem is that the only alternative to aging doesn't seem that attractive to me.

Yes, I know, it's been a year and a half since I updated this blog. I'm still taking ballet classes. Two years ago I was taking as many as four classes a week. But that was causing an increasing number of issues like tendonitis, so I backed down to two classes a week. For quite a while that seemed like a sustainable number.

Then, in early February of this year, I went to do a simple grand plié during barre. Something felt off. At the bottom of the plié it felt like I had something soft behind my knee, like a pillow, that was preventing it from bending as much as it usually did. There was no noticeable swelling and it didn't hurt, but it limited the depth of my plié in both first and fifth. I figured I might have not gotten enough warm-up before class or something. It didn't seem to affect me other than in class.

During the next class or two it got worse. I gave it a break by not going to class for a week, but I started to notice I had a limited range of motion in that knee even outside of class. Skipping classes didn't seem to be helping. At one point it became painful to get out of bed. Eventually I sought the opinion of my primary care doctor, who said, "It doesn't seem to be swollen". She offered to give me a referral for physical therapy, but she declined to order any sort of diagnostic tests.

Then, for reasons I still don't understand, my primary care doc stopped responding to emails. A week would go by before someone else would respond. Each time it was someone new, and they'd always reference my PCP's suggestion about PT. Finally I'd had enough. I changed primary care doctors and demanded some sort of diagnostics that would explain why my knee hurt.

The new PCP agreed that he didn't see any swelling, but he ordered both diagnostic blood tests and X-ray imaging of my knee. The blood work raised the possibility of gout, though I have none of the normal symptoms (it usually that affects the small joints of the toes or fingers first, rather than large joints like a knee). The X-ray didn't show anything definitive, but it looked suspicious enough that he ordered an MRI.

The MRI was conclusive: I have a partial radial tear in the posterior horn of my medial meniscus.

Oooh, all that medical jargon sounds bad!

The short version is I have a small tear in the cartilage in my knee. For more detail, allow me to refer you to the website of James McCormack, a physiotherapist in London. I don't know anything about him as a physiotherapist, but his website does an excellent job of describing the condition, common causes, and some options for treatment. Click on the drawing here to visit the webpage describing this injury.

The weird thing about this is these usually result from some sort of a precipitating incident, and there was none that I am aware of. However there are other causes. In the words of a surgeon I consulted with, "You got old."

The good news is that no one is suggesting surgery, not even the surgeon. Supposedly there is a good chance it will heal on its own, given time and proper care. When I asked whether I would make it worse if I continued taking ballet classes, the surgeon said no.

So for now my knee now governs how often I take classes and what I'm willing to do in them. I've backed off on jumps, and I'm extra careful not to put any sort of twisting force on my knees.

One of the things I noticed was that I was starting pirouettes by pushing sideways with my working foot before raising it to retiré. I noticed this because it hurt. The rotation should come from the arms, not pushing off with the foot. I've also become much more conscious of keeping my standing leg fully extended with firm muscular support. All this is actually improving my pirouettes! I'm now more balanced and more stable, especially with the injured leg as the standing leg.

After the better part of a year, my knee has now improved to the point that on good weeks I can take two classes without any issues; three seems to be too much.