If It Worked

personal essay reflecting on knee injuries as an athlete

I somehow made it down the stairs before the pain hit. Standing in the middle of the dim kitchen I almost fell to the ground, clutching my right knee. The agony was worse than anything I had experienced before. I hobbled to the couch in the den, pushing the dogs out of my way to lie down on the worn leather fabric. The drawn shades hid the shadowed earth, the hands of the clock in the kitchen pointing to just before five o’clock in the morning.

Mom was waiting for me. We had practice at 5:30 in the pool at our local YMCA, hers for the adult Masters team and mine for the Y. I was a junior in high school and the day before had celebrated my seventeenth birthday. My birthday was a Thursday in late May, which meant I had spent my afternoon at my dance studio practicing for our upcoming recital in June. I had Hip-Hop, Modern, and Jazz on that night, four hours of bliss.

In our Modern recital dance, there was a move called a pull-through that only a few of the dozen girls could do, me included; sitting on my butt, my legs in a wide straddle, I would lean forward, sliding my torso on the floor until my hips rolled forward and I was lying on my stomach. This move was repeated three or four times in the space of fifteen seconds, and after going through the dance several times we were feeling the uncomfortable strain in our muscles.

Our teacher told us to bring in one leg, bending it completely, to lessen the pressure. It was awkward, and at first glance made me look like I had my lower right leg amputated. We ran though the routine a few more times with no incident. Then, one time, I felt something click in my knee. Nothing big, no painful rip; just a tiny pop, a little release. I danced for three more hours without a problem. I left the studio smiling, glad I had gotten to dance on my birthday instead of having to go to swim practice.

The next morning, as I laid on the couch, I wondered- what the hell did I do? Normally, since there is less muscle in this area, the knee is slimmer than my thigh or overly-muscled calf. From the bottom of my thigh to the top of my calf was a straight line. I could barely discern my kneecap from the rest of my knee.

I went to school that day, telling myself that nothing was wrong, that I tweaked my knee a little bit but it would be fine. I didn’t talk about it with anyone. I went to swim practice, continued to dance, the agony in my knee never lessening. Never did I back down in practices – the coaches would have to kick me out of practice, tears filling my goggles as I held back sobs. The same coaches whom I had known since I was a little eight-and-under swimmer, sharing a bus seat with them on my first swim meet. It took these two men seven years of watching me grow up, seven years of being good friends, to see the pain I could hide from everyone else.

My parents thought it had gotten better, until a few weeks later I confessed to Mom that I needed to see a doctor; the pain still burned fire every day. She scheduled me to see Dr. Vernace, an orthopedic surgeon who worked out of a nearby hospital.

Everyone else in the waiting room had white hair and sagging skin. I saw Vernace’s Physician’s Assistant, a humorless man named Ken. He was a white man with more salt than pepper hair and a mustache to match. He wore a crisp white lab jacket with the office’s name embroidered on the left breast. Every time I answered one of his diagnostic questions with a vague answer I could see the frustration increasing, the tension in his body rising.

Ken diagnosed me with Patellofemoral Pain Syndrome. He explained that the sensation I had every time I bent my leg was actually the underside of my kneecap grinding against the side of the groove in the bottom of my femur. He told me to do physical therapy to strengthen the muscles that weren’t keeping my kneecap in the right spot. Neither my mom nor I said what was going through our minds, sitting in the exam room. I had danced for five years, swum for twelve years, and had been lifting weights for three. Doing “therapeutic” leg lifts with two-pound weights around my ankle wasn’t going to do anything. Still, Mom got me an appointment at a nearby physical therapist’s. I went for several weeks, having the receptionist a check for one hundred twenty dollars for my three visits each week.

 Just like we figured, the pain didn’t go away. I would pull myself from the pool, bending my left leg to get my foot in the gutter so I could stand up without bending my right leg at all. My knee would be screaming like white fire, a burn that couldn’t be extinguished. The very ends of my femur and shin would light up too, a bonfire next to a raging wild fire. Once it was lit, I thought nothing could calm it- no ice packs, no prescription painkillers, not even my coach’s joking offers of amputation. I’d get my bag and limp to the locker room, desperate to get out of sight of my teammates.

To them, I was their friend, but I was also the girl put on the end of relays at meets because, in the majority of races, I’d go off of whatever the previous girls’ had given me, a lead or other teams to chase, and I would win it. I was born from two nationally-ranked swimmers and took after Dad: the shorter the event, the better. The fifty-yard freestyle was my favorite, although it was the most difficult- only two laps long, if I messed up my start, my turn, a single stroke, I could end up with a bad time. My second best event was the one-hundred yard freestyle. Four laps long, it allowed a little more grace for mistakes. Starting at the beginning of my junior year, I was the fastest girl in our program of over 250 swimmers.

By the end of it, I was barely able to stand with my weight distributed on two legs. I had to drop out of my Modern dance in the recital, and I could barely do the other four dances I was in but I wasn’t going to quit. I was good at swimming, but dance was my thing, a personal love I had never felt in the pool. After each performance I limped from the stage, unable to join in the bubbly happiness of the other girls. They went out to dinner with our teachers, and I went home to a bag of ice and a bottle of Aleve.

In August, Vernace scheduled me to have an MRI. I was told to take off any metal object, since Magnetic Resonance Imaging is basically a giant, incredibly powerful magnet that uses radio frequencies to produce an image on a computer screen. Any metal on my body would be violently ripped off the instant the machine was turned on.

Vernace called a few days later- I had torn my meniscus, and needed surgery. Inside the knee, there are two small C-shaped pieces of cartilage that sit between the femur and shin bones, behind the kneecap. These are called the meniscuses. They protect the bones, acting as a cushion as I walked, ran, and danced. The one on the inside of my knee was torn, and the severed part had to be removed before it floated around my knee and caused even more problems.

Surgery was scheduled for the second Friday in September of my senior year of high school. I sat in a tiny, curtained-off cubicle of a prep-room, surrounded by other patients, nurses in patterned scrubs, other cubicles, other injuries, other lives.

My parents sat in stiff chairs on either side of me, teasing me when I groaned about the IV the nurse put into my left arm. Vernace came in later, talking with my parents and marking just above my right knee with his initials, JV, in thick black marker. I followed the nurses down a winding hallway to the operating room.

I woke up in a public recovery room less than an hour later with tears streaming down my face. Two nurses hurried to my side, asking me what was wrong. “I’m just glad it’s over,” I guessed, pulling Kleenex from the box they set on my lap to wipe my face. Mom and Dad came in, stood next to my bed. The nurses explained that my meniscus actually wasn’t torn, but I had a band of tissue called a plica removed; it was an extra bit of fibers on the side of my knee that had inflamed and no amount of ice or physical therapy was going to make it better. The nurses wouldn’t let me leave on crutches. They sat me in a wheelchair for the minute-long trip to the car.

I was supposed to be fully healed in a few weeks. By November, I had to stop dancing; I had signed my name to a Division One school on full scholarship to swim and I couldn’t risk hurting myself further. The agony, the fire, flared up even worse when I danced and I lost the one thing I had all to myself, the one thing I truly loved. My dance shoes were shoved to the back of my closet where the shadows hid them from sight.

I continued to train through as much pain as I could handle, having sets altered so I could do as much of them as possible. I rarely finished practice, leaving the pool deck in tears. I felt like the coaches and other swimmers were staring at my back as I dragged my aching body to the locker room. My head would be bent, eyes watching my feet move over the blue-gray tile in an uneven gait. It was the same in college, though this time the pressures I put on myself were worse. I was supposed to be a good swimmer, one to help my team win meets. Instead, I was the girl who tried so hard to make it through a single hour of a two-hour practice only to fail. Every single day.

December of my freshman year, Mom took me to one more doctor. His name was Lawrence Wells, a kind black man with glasses who worked out of The Children’s Hospital of Philadelphia. He ordered another MRI. A few weeks later I was back in the brightly-colored exam room, looking at the results on his computer. He showed my mom and me the top of my knee, a dark gray and black image. Scrolling with the mouse, Wells went further into my knee layer by layer, until he pointed out a bright white mark halfway through.

There is definitely a tear, he explained. The tear just wasn’t all the way through the meniscus, which is why Vernace missed it- part of the cartilage was still attached, the tear being a major rip instead of a severing line. Since mine was still connected he couldn’t just remove the loose part- instead, he would go in and try to sew the meniscus back together, urging it to heal itself. It was called a Meniscal Repair. If it worked, I would undergo a surgery that was described to me to be as intensive as a reconstructive ACL surgery. If it worked, I would be in a hip-to-ankle straight-leg brace and on crutches for at least six weeks. If it worked, I would be fully recovered in six months. A year and a half after the initial injury, I was in pain every single day. Wells told me the pain would go away, but I couldn’t believe him. It wasn’t a common surgery, and it might not work.

We scheduled the surgery for March, after my end-of-season conference meet. I left the building with a careful smile- maybe this really was the end, maybe the pain really would go away. I went back to school a few days later, heading with my team to Florida for an intensive week-long training trip. I still couldn’t do an entire practice, but something in me was different. Maybe it was the sun hanging over the outdoor pool or the beautiful weather. Or maybe it was an emerging belief that maybe this was the end.

Conferences were at the end of February at George Mason University in Virginia. It was a four-day meet with every event, from the fifty free to the mile. Even with my lack of good training, I was able to get best times in all of my events, and was on two medaling relays. My times ranked me the second fastest female swimmer in UNCW as a freshman.

Two weeks later, during spring break, I had surgery. I woke up in a semi-private recovery room with my brother and Mom sitting beside me. The instant my eyes open my body cringed; I was already pumped full of pain meds and the little bit of morphine a nurse gave me only dimmed the pain radiating from my knee. My leg was wrapped in layers of ace bandages, the brace on top and locked straight. Instinctively I kept trying to bend my leg, pull it into a more comfortable position the brace prohibited. The drugs fogged my mind and I kept trying to bend my leg, frustrated every time I couldn’t.

I spent the rest of the week on the same couch I laid on almost two years before. Mom drove me back to school and stayed with me for another week, driving me to classes and helping me up the three flights of stairs to my room. After she left, I had to manage on my own with the rarely available help of the girls I lived with. I was on crutches for seven weeks total, in the brace for longer. My thigh muscles withered away to the point a friend said my leg looked like it belonged to a starving Ethiopian child. Twice a day, I’d go to the athletic trainer to do physical therapy, slowly bending my knee and trying to put some muscle back on. Any time I bent my leg, my knee feeling like a piece of old machinery, stiff and sore from being stuck in one position for too long.

 

That summer was the first summer I hadn’t swum since I was four or five years old. My friends complained about difficult practices, about the early mornings. They said how lucky I was, to not have to do it. I asked if they’d rather have two knee surgeries.

The pain dramatically lessened around the six-month mark. It never went away completely, instead coming in angry jabs when I bent it too far or sat still for too long. I still wasn’t making a full practice, but it was closer to two hours than I had been for years.

Now, eight months since surgery, it’s still not over- I can’t stand for long periods of time, can’t run, can’t cross my legs for more than a few minutes. Kneeling is out of the question, as is lifting heavy weights with my legs. I feel pain every day, but it’s so minor compared to what I felt before- an angry sizzle of a match when it’s put out.

On the wall above my bed are pieces of paper, printed with the times from each swim meet. Compared to last year, my times are more consistent, their average lower. I’m able to do every yard of every practice with only a few changes.

I’m still waiting for the day I can dance again. A half-dozen pairs of ballet toe shoes are hanging from a hook on my bedroom wall, reminding me to keep hope. I will dance again, even if it’s after I graduate, after it doesn’t matter anymore. I will dance, and I will dance, and I will dance.

 

 

 

 

DIXIT, SAMEER, JOHN DIFIORI, MONIQUE BURTON, and BRANDON MINES. "Management of Patellofemoral Pain Syndrome." American Academy of Family Physicians. 01 JAN 2007. http://www.aafp.org/, Web. 2 Nov 2009.

 

"MRI of the Body." Radiology Info. 10 JUN 2009. http://www.radiologyinfo.org, Web. 3 Nov 2009.

 

Teitz, Carol. "Torn Meniscus-torn knee cartilage not limited to athletes or sports." UW Medicine. 01 JAN 2005. http://www.orthop.washington.edu, Web. 2 Nov 2009.

Reviews

[awkward turtle]

woah. this is an intense story. inspiring, too. it reminds me of a cousin of mine; she's been swimming since a very young age (i believe she's a sophomore in college now) and she has achieved some amazing awards in all kinds of swim races. but, when she was between the ages of 10 and 14, she was in and out of the hospital with tons of various ailments more times than i can count. still, every time she got out, she jumped right back into what she loved. i congratulate you on your determination and perseverance. i hope you do dance again! and when you do, i hope you write about it because you write wonderfully.