The injury that Leads to Joint Replacement Surgery is often suffered decades before
by Robert Forster, 2024
At the moment an injury occurs most of us will not realize the loss of health and function that will result from that injury over time. Whether it be accidental or sports related, or from over use in day to day activity, when we first realize we suffered an injury we don’t then see the cost in terms of enduring pain, loss of function and disability and the time lost to rehab and recovery. And and the same was true for a much younger me!
I remember the exact moment, 50 years ago, when in 1974 another wrestler put his full body weight into the outside of my knee in an illegal move that went against the joint’s natural mechanics. I remember feeling the crunch and hearing a snap that at age 15 had devastating implications for my second high school varsity wrestling season. He had damaged the medial meniscus of my right knee.
For that competitive season I would have to alter some of my training techniques and replace running with stationary cycling, barbell squatting with weight machines and compete the whole season with athletic tape from the calf to the thigh. While I was acutely aware of the temporary loss of function then, I didn’t realize it was a loss of health that would follow me the rest of my life.
After mixed results that season I won the District Championship and salvaged my sophomore year of wrestling. The torn medial meniscus was removed via surgery and I was back to “off season” training within weeks. What I didn’t know, and what was not known in the era of the popular coaching mantra “he is young, he will walk it off” – is that everyone who has a meniscus removed will, if they live long enough, develop reactive osteoarthritis in that joint.
I went on to wrestle at a NCAA Division I powerhouse and as an adult spent decades competing in week long mountain bike races, extended helli-skiing trips and I even retuned to Masters division wrestling competition from age 45-49 and won a National Wrestling Championship for old timers.
Over the years my physical therapy training and experience enabled me to maintain good joint function by minimizing swelling, muscle spasm and connective tissue dysfunction in the tissues surrounding the joint, even as the joint itself was deteriorating and growing wider every year. This is the natural progression of joint arthritis as the cartilage at the end of bone breaks downs and the end of the bones mushroom out creating more surface area to better bear the brunt of weight bearing activities.
Eventually it became problematic to maintain an active lifestyle. Although I could continue road cycling the requisite 5 hours per week to protect my health, the hard mountain bike rides with lots of climbing became problematic. I could not hike or even walk for any distance without pain and this prevented me from working at events like the Olympic Games where we are required to navigate from the practice track to the stadium on foot. I had to make the decision at 66 years old to have a total knee replacement at the end of September, 50 years after that fateful injury .
More on my recovery in next months newsletter.