Torture on the Knees

Lynn at West Pinnacles

Lynn at West Pinnacles, circa 1990

Uphills strain my heart. I struggle up inclines listening to the pound of my jugular vein. On especially hot days, I have to stop once or twice to drink water, eat, and regain my senses. I call the dizziness that I feel when I stop the “white blindness” because for a second or two my vision fades behind a speckled curtain of receding blood pressure.

Lynn has little trouble getting up hills. She passes me easily, her walking poles clicking in sync with her effortless ascent. Downhills are another matter. I zip to the bottom, waiting or turning back to see what is taking her. She struggles. The reason for this is a rare bone condition. She recently wrote to me:

“Wait, let me get my camera,” said the doctor. “You’re a textbook case.”

The textbook entry for my case would be titled, “tibial torsion.”

That means that my bones are twisted below the knees. I can do all those ballet poses where you point your toes straight out. I can, in fact, twist my legs so that my toes point slightly backwards. What I can’t do is run with my feet pointing straight ahead.

One of my gym teachers, in grade school, used to chide me about this, as we did our running at the beginning of class. “Lynn,” she would shout, “point your toes straight.” But my toes stubbornly refused to point straight. They’re not built that way. If I stand so that my knees point straight ahead, my feet point sideways at a 60 degree angle, closer to that first position ballet pose than to pointing straight ahead.

When I was a child, my tibial torsion gave me no more inconvenience than to annoy my gym teachers. My mother also has feet that point out, if not quite as much as mine, and doesn’t seem to have suffered any ill effects from them. But sometime in college, a combination of running and the wrong downhill gate led to a knee injury, and after that, I kept injuring my knees, till gradually I had chronic pain in my knees, my hips, and occasionally an ankle. Doctor’s pronounced my problem chrondromalacia, also known as “runner’s knee,” a softening of the cartilage that was caused, they said, by the strain on my knees from my tibial torsion. One proposal was an operation that would break my legs and untwist them, but this seemed a great deal of pain for uncertain success, so in the end I went with physical therapy, a combination of stretches and strength exercises that reduced my pain to the point where I could lead a normal life, and even hike.

So, this is what it is like to have my leg bones and joints. I need to exercise regularly, so that I’m sure I don’t ever go back to the level of chronic pain and injuries that I once had. I keep knee braces and ibuprofen on hand in case I do injure myself. But mostly, I take downhill slopes slowly and carefully, because that’s when injuries are easiest. Joel got me some hiking poles that help with my balance on the downhill slope, and I often get ahead of him on the uphill parts, but always move more slowly when going downhill. Also, I try to avoid standing still for long; if I have to wait for something on my feet for some reason, I will pace, because movement feels more comfortable than standing for long. As long as I do these two things, I’m pretty much OK, and can hike for miles.

She did not like to hike when we first married. Doctors proposed dire solutions to the problem as the passage reveals. A sports medicine clinic told us that they might be able to fix the problem with surgery. The chances were a one in three chance of success, a one in three chance of making it worse, and a one in three chance that it would get worse. Her grandparents were eager that she should undergo the surgery, but we knew our probabilities and sought other opinions. A doctor at Kaiser looked at her legs. “I could send you to orthopedics,” he said, “but they will just want to cut. Why don’t we start with some physical therapy?

A few months later on Columbus Day weekend, we embarked on a great experiment. The trek involved a loop around the Pinnacles in what is now Pinnacles National Park. We started by going over the main body of the Pinnacles by way of the High Peaks, then descending to the picnic area at the Old Pinnacles Trailhead. We stopped for lunch, then followed the path back to West Pinnacles along Chalone Creek and through the Balconies Cave.

Lynn got through the eight mile walk by pacing herself. The most memorable event for her though, was an encounter with an older gentleman. This guy had helped pioneer modern rock climbing in the Berkeley Hills in the 1930s and 1940s. A hip replacement changed life for him — he no longer did rock climbing — but on the day we met him, he trekked in the North Wilderness by himself. The encounter was life changing for Lynn. She told me “If he can keep hiking with a hip replacement, I can do it.”

And she has.

The Balconies

The Balconies, Pinnacles National Park, circa 1990

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