Posts Tagged cartilage
Microfracture Recovery: +10 months
Posted by Matt in microfracture on July 5, 2009
It’s now over ten months since my knee surgery and nearly a year since my knee pain got so unbearable that I was forced to stop running.
I remember thinking last summer that my recovery would be a success if I could run a few miles a day every other day. I’m now doing that: yesterday I ran 25 minutes at an agonizingly slow 7:00-7:30 pace. Given my history, that isn’t much at all but I’m glad to be doing it with little or no discomfort. Supplementing with biking, I feel pretty happy with the way things are going. A year ago at this point, I felt as if I were doomed.
Occasionally when running, I will feel something down in the joint area on the left (bad) side, but I think it’s mostly IT band. The IT band on my right side has been tight and nagging at me ever since my left knee blew up a year and a half ago. The IT band has been the most persistent soft tissue problem I’ve encountered, but I’ve managed to keep it at bay since April 2008 through endless stretching and icing. It’s probably because I’m still compensating on that side because of the left knee.
The size difference between my left and right leg isn’t noticeable to me anymore. Following the surgery and being stuck in a brace for 10 weeks, my left leg shrunk down to nothing. The size difference was incredible, which was what probably contributed to my limp that lasted for several months. Biking has really helped with regaining strength in my left leg, but it still doesn’t feel quite equal with the right.
Running still feels extremely awkward, but with running more, I’ll adjust and be able to go farther and faster. The question remains as to how much I can do safely. The doctor and PT didn’t place too many restrictions on that and even tried to get me back to running faster than I wanted. Both said that because of the location of the cartilage tear, I would have no difficulty returning to running. The PT said I shouldn’t do any really hard workouts or compete in races — it seems that those whose microfractures fail occur during really hard efforts. Of course, my teammate had the same surgery and was able to get through three years without anything going wrong, but I don’t know if that’s a chance I should take. For now, I’ll gradually add time every week and maybe try longer streaks towards the end of the summer. Sitting down with my college coach last week, he said I could be in shape to show up to practice and “hammer the freshmen” by the time the fall semester starts. I don’t know about that.
Interestingly, on my trip back from Rome, I read a novel about a CIA operative that also had to stop running and undergo surgery thanks to missing cartilage. Like me, he ran until the pain became unbearable. The author didn’t elaborate as to whether or not the character had microfracture, but it was mentioned that loose pieces were removed. The surgery was provided as a way for a hit man to try and take out the operative as he recovered at home. Of course, the character was nearly 40 years old, so at least he had another 15 years of hardcore running under his belt that I won’t ever get. Not to mention that the whole thing was fictional.
Microfracture: +9 Months
Posted by Matt in microfracture on May 18, 2009
Today marks nine months since my knee surgery. After some cycling, I put on my running shoes and shuffled out in the parking lot for a few minutes.
All I can say with certainty is that my knee hurts when I run. I went about twenty or thirty steps before pain started somewhere around the joint. I went about a minute, stopped and stretched, and then walked for a few more minutes before going again for another minute. It wasn’t any better the second time around, and the pain seemed to get worse. I haven’t had any serious knee pain in a very long time. It doesn’t hurt when cycling: I can mash the pedals and ride up hills out of the saddle or sprint to beat a light and I have no pain at all. It doesn’t hurt when I climb stairs, nor do I feel any popping or locking that I used to. It still doesn’t hurt when I put in the clutch to shift in my car.
While running for the first time since November or December felt awkward, the pain eclipsed any biomechanical weirdness. Run enough, and the biomechanics will smooth out. Oddly during a recent practice, one of my old teammates told me that my coach gave me as an example of good running form. I think that’s the first time I’ve ever heard someone comment on that. It’s like saying I’ve got great coordination — I struggle just to get my feet in the bicycle clips.
It feels as though the pain is in a different place than last July when the knee pain took me out. Since it’s been so long since last July when I experienced the knee pain while running, my perceptions of how things feel have been invalidated. That said, last July, I could tell that the pain came from a very specific place right next to the kneecap and that it was deep in the joint. This time it seems more spread out, more to the surface, and more lateral in its location. I had occasional pain similar to this at PT when the leg brace came off, and the PT told me it was my IT band. It could be my IT band, but when my teammate who eventually had microfracture first started feeling pain, he thought it was his IT band too.
The pain really comes down to one of two sources: either the microfracture failed to produce enough fibrocartilage to protect my knee from the impact of running, or it’s something soft tissue that I can deal with. Since the doctor and PT were extremely optimistic that the microfracture worked and that the cause of my pain was most likely from my IT band, I will first try dealing with this as a soft tissue problem. That means loads of stretching to try to smooth stuff out. I am not without precedent: when one guy with torn cartilage and microfracture first started running in the early winter, he experienced a lot of pain like I am now. Now he is running six, seven miles a day and the pain is much more manageable or even nonexistent on some days. Initially, I thought he was crazy the way he talked about running in excruciating pain, but it appears as though the pain wasn’t from the torn cartilage. At least not if he is feeling better while running more.
I can say that I am feeling a lot better overall than even before the surgery. I can go harder and longer on the bike than I could before. I can go almost two hours before I start to feel tired, while last summer I would be exhausted if I went that far. I can now power up hills that previously left me in the lowest gear and I can take on someone who passes me, when previously I would struggle just to stay on their wheel.
I will try to run small amounts as much as I can and see if this pain is manageable, while hopefully not making things worse.
This weekend I…
Posted by Matt in general, microfracture on April 5, 2009
… rode outside for the first time since the surgery. This was a huge step forward and I had been waiting too long.
Over the past week or two I had been getting really restless. The hour on the trainer every day gave me a workout, but the weather was starting to turn. Spending nearly 95% of my time indoors over the past seven months was starting to really get to me. As goes the quote from “Office Space,” “Human beings were not meant to sit in little cubicles staring at computer screens all day,” which was pretty much what I have been doing. I would walk back and forth from the Computer Science office and that was about it in terms of getting outside. Something was about to give.
It gave this weekend. The Colonial Relays was this weekend, and on Friday I walked over from the office and watched some of the distance races. The hour or so that I was out there had been the longest I’d been outside in quite a long time. That night, I went back and talked to a few of my teammates and alumni that had come back to watch. It was a great change of pace and was good to see everyone run. I talked to a lot of people that I hadn’t talked to in months, some even longer than that. A lot of people asked me when I would try running again, since the doctors have given me the okay to start. I replied that I wasn’t sure, but it would be soon. In talking to my old teammates, I had forgotten what I had left behind. For quite awhile, I’ve been in my own really tiny world, working on my projects.
Until now, the only times I would be shocked back into reality was when I would be having a discussion with my adviser in the late afternoon. We would be having a discussion on the whiteboard in his office and I would happen to glance out the window and see all my teammates run by in a blur. It’s a real kick in the butt to see that and remember what I used to do. In the world of computer science, the atmosphere is mellow, but determined. In the world that I came from, it’s about getting on the track and suffering. Unfortunately, in the context in which I live now, I don’t think anyone says, “I really dominated in that conference paper.” You don’t sweat and breathe hard while thinking up and coding a slick algorithm.
On Saturday, I got up, ate breakfast and prepared to do what I had done since before Thanksgiving: get on the trainer and pound away for about an hour. I would open the window, turn on the fan, and listen to music while I looked outside at the law students coming and going from the library. But on Saturday, the sun was shining and it was getting warm. I couldn’t take it any longer: it was time to go out.
It was about the best feeling I’ve ever had. I was uncaged, released into the wild, my natural habitat. I hauled it out past the state park at York River. The weather said the wind was blowing 30 mph gusts from the west, but I didn’t notice a thing. I powered up hills where over the summer I remember being exhausted and downshifting into the lowest gear. I remember trying to upshift, only to look down and see there were no more gears to use. A dog bolted out from its house and chased after me for nearly a quarter mile, but I kept it at bay. I turned around right before the road ended at the river. As I got closer to home, I never got tired. I looped around campus and got to the track just in time to watch the 4×800.
Yesterday was the first day in months that I didn’t do any work before dinner. I still did a little before I went to bed, so I couldn’t call it a complete day off. I was outside at the meet all day and got a nasty sunburn. I guess that happens when you don’t have a built up tolerance from running or biking outside every day. I watched all the distance relays and hung out with everyone some more. By the end of the day, I was exhausted. On the bike, I’d gone 45 minutes over an hour, and despite feeling much easier than the trainer, was enough to make me not want to move for most of the afternoon.
Today I went out again, but took it easier. I was definitely more tired today and felt more normal as compared with pre-surgery rides.
As for my knee, I was out of the saddle several times and really hammered up some hills without any real discomfort. I might have felt something this afternoon walking around, but I can’t be sure. I do know, that if my knee could handle what I did today and yesterday, I’m pretty sure I’ll be able to do at least some running. Sometime soon, the same thing will happen with biking outdoors and I’ll just start running on a whim. It won’t take much to push me over the edge.
I finally broke down and got a new bike. For awhile, I’ve been worried that the rear cogs are so worn that someday I’ll go up a hill and the chain will just rip off. I tried a few new bikes out at the bike shop, the first one being a Specialized aluminum frame. It felt like my old one, nothing really special about it. But, I tried a Giant TCR-0 with a carbon frame and it felt like a rocket. It was an unused 2006 and I think I got a pretty good deal on it since equivalent new models of just about every manufacturer go for about $1000 more. I’d been to bike shops quite a bit in the past few years and I don’t often see anything older or discounted. It seems most owners keep a limited stock. The components had been switched up and have a combination of Shimano Ultegra and 105. I really don’t need the way high end components since I don’t care too much about saving some fraction of an ounce of weight. As it is, the bike feels like a feather compared to the steel Bianchi. Since my shoes and pedals were a mess, I went ahead and replaced those. Hopefully I’ll be able to try out the bike before the weather crashes this week.
If I can bike or even run outside more often it will provide more of a balance to my life. I really can’t just hole up and work all day — there’s got to be a balance to the equation. The recent discussion about goofing off boosting productivity probably has some merit in it. Biking or running isn’t really goofing off, but it provides the same release.
Microfracture: +7 months
Posted by Matt in microfracture on March 27, 2009
It’s been over seven months since the surgery and there are days I don’t think much about my knee. It just works like it’s supposed to. No more painful popping. Sometimes it does pop on the inside, which I think is some kind of compensation due to the new tissue growth on the outside, where the damage was. It probably isn’t very smooth in there.
I still haven’t tried running yet. With a lot of work for school, the immense overhead of returning to running is just too much. With past running injuries, there is so much time that is needed for walk/jog, cross training, and way more stretching and icing to deal with potential comeback injuries. When work subsides some, hopefully within a month or two, I should have more time to try running again. With the biking that I’ve done, I’m fairly confident that my knee will tolerate some running. Otherwise, I’ve got a feeling that I would have some pain on the bike.
My bike got a flat from the resistance trainer this week. I find that odd. The tire rubs against a smooth surface on the trainer, so it wasn’t punctured. I have a feeling that the rubber tube degrades over time and eventually the glue and seams that hold it together come apart. It was probably a pinch flat: as air slowly leaked out, the underinflated tire was pinched by the rim, causing a small tear in a seam. I did notice this week that the resistance didn’t seem as much as usual although I had recently put air in the tire. This morning it was flat, and five minutes after putting in more air, it was flat again. After a tube change, the resistance seemed more normal, but I always get real paranoid about stuff like this when biking. Sooner or later, something’s going to give. It’s why I like running: no equipment to rely on.
It’s almost as if with biking, some of my stress-induced injuries that would occur with running get transferred to the bike. With running or biking, there is a single entity performing the activity with the same probability of some kind of failure. With running, it’s just me, but with biking, the bike and I are sharing the task. Sometimes I break down, and sometimes the bike breaks down. In most cases, the bike can be fixed a lot faster than I can.
I’m still considering getting a new bike, but haven’t looked into it too much. I would like a carbon fiber frame, but that jacks up the price significantly. I know Trek has a fairly wide range of relatively affordable carbon fiber bikes, but it seems that some are better than others, so I’ll have to do research. The aluminum frames I’ve ridden feel kind of twisty while the steel-framed Bianchi I’ve got is solid. The components on the Bianchi are about ground to dust so I’ve got to get something that’s fairly robust. I figure that shelling out a bit of dough will be worth it if it’s something I’m going to use every day. Like the computer monitor, I would rather pay a bit more for something that’s good and that will work well and hold up than get something cheap that will break down. If I start running again, I’ll probably not bike as much, but I would probably still do it to help ease the impact of just running and doing nothing else.
For now, I’ve got no reason to rush anything, and when the time is right, I’ll look more into running again. I do think that time is coming soon.
One year ago today…
Posted by Matt in microfracture on January 30, 2009
The day that my knee gave out. It was the day I went out on a freezing cold morning run and five minutes down the sidewalk I took a step and it all went wrong. It felt like my whole lower leg and quad just exploded. It was definitely a scary moment and I thought for a few seconds that whatever it was wouldn’t allow me to even walk.
Now it’s one year later on a similarly cold day and I’m on the other side. After a long period of pain and wondering what I had done to my knee, to the cartilage tear diagnosis and buildup to the surgery, the weeks of non-weight bearing, the months of wearing a brace, and finally biking again, I’ve come nearly full circle. A few of the guys on the team asked yesterday when I’ll be tying up the ol’ running shoes again. One even asked about racing plans. Not so fast…
My goal is to start once the weather gets warmer — the cold is probably one of the factors that led to my problems in the first place. The worst of all my previous running injuries started in the winter. I really also don’t care for freezing my butt off outside when I can bike inside. A part of me doesn’t want to start at all in fear that I’ll be in pain. I would almost rather just have the hope that I can run again versus the fear that I’ll never be able to.
I have a hard time believing it’s been a year since all this went down. I feel a lot better now than I did then, especially knowing what was wrong with me. I waited for months until the pain and irritation got so bad to go to the doctor, but there wasn’t a day that I wondered why my knee gave me such trouble. I remember clearly the day I hurt it, getting into the car and feeling unbearable pain each time I put in the clutch. Stairs were a nightmare, and even extending my leg when sitting down was pretty bad. At the least, I know what happened and I’ve tried to get it fixed. It’s possible with advances in stem cell research that I could get an injection that would regrow my lost cartilage to its pre-tear state. I could go back to running as if nothing ever happened. Now, I’ll be satisfied if I can get out the door a few times a week for a couple of miles.
I’m really starting to face the reality that I’m getting older. I know I’m not that old, but most of the doctors I’ve seen for various running injuries have told me that I’m not an invincible high schooler anymore. Stuff is going to wear me down more than it used to and I’ve got to pay attention. My coach calls them “old man” injuries. I even get called “old man” when I occasionally drop by at practice.
I guess this just boils down to the fact that I wish that I didn’t have to worry about coming apart at the seams. Ray Kurzweil goes on about how much of a PITA it is to give our bodies constant attention and to still have them break down on us — that a better solution is needed than just advances in medical technology. I really can’t stand to have to dedicate so much time to bodily upkeep when I could be doing something else. Imagine how many more interesting things we could be doing instead of having to sleep, eat, drink, brush our teeth, and handle other annoying bodily functions. They always seem to get in the way when I want to put my attention elsewhere.
Though uploading my consciousness into a computer as a program sounds like a radical idea, it would certainly take care of most of these annoyances. The question would then become one of experience: would existing as a computer program provide the same sensory experience, satisfaction, and overall quality of life as in a real body? I’m not sure. At this point I would have to say no, but maybe a few more years of aging will change that.
Microfracture: +19 weeks
Posted by Matt in microfracture on January 5, 2009
Not much going on with respect to my knee. I’m still continuing my leg strengthening routine with leg weights and biking with the resistance trainer. I was on my feet for a few hours again over the weekend and again noticed that I was more tired than before the surgery had I done the same thing. Maybe it’s the biking, but it’s hard to tell. Regardless, it’s a far cry from the daily fatigue I faced while running on the track and cross country teams. Some guys used to hate it, but at the time I really didn’t care — it was just something I dealt with. Now, I’m starting to realize how much effort it took to get through practice every day and how ransacked I got after nearly every workout and race. Tiredness for me now equates to about the level of tiredness I faced during the first few weeks of a new training cycle when I was on the team.
I still have occasional pain in my left knee, which is probably just the IT band again, but sometimes I think I feel something in the joint. I’ve been stretching more after biking to help keep everything loose before I get in front of the computer for most of the day. I spend about 15 minutes or so now, which is better than when I first started biking, where some days I wouldn’t stretch at all. I really should do more so that I can adjust better if I bike more or start running. If I start biking on the roads for any significant amount of time or add in running, I could be in trouble with not stretching enough. Plenty of typical soft tissue injuries could be in store for me if I don’t watch out.
I drove the Mustang again yesterday for the second time since I’ve had the surgery. I’m planning on driving it again more now that I can handle it, but it still has me worried whenever I put my foot on the clutch. Each time I even touch the clutch I think about the popping and pain that ensued prior to the surgery. It’s like going down stairs was for awhile. I just have to overcome the fear, but at the same time I wonder if the clutch is going to wear down the fibrocartilage in my knee in the same way that running might. I will gradually drive it more and see how it goes. I may throw in the towel if I start to get discomfort.
Microfracture: +18 weeks
Posted by Matt in microfracture on December 30, 2008
Today, I saw the doctor for what is hopefully my last appointment. The doctor seems to believe the microfracture has stimulated some cartilage regrowth and is optimistic about me returning to recreational running. As I’ve heard before, he warned me that I will be susceptible to arthritis at an early age due to the procedure. He also suggested I try to find glucosamine in liquid form to help with the cartilage. Currently, I take the pill form, but he says the liquid form absorbs better and I can take it all in one go instead of three times a day with the pill. I don’t know as to whether or not glucosamine really works, but I figure it can’t hurt anything but my wallet. Better to try everything I can to help my knee.
The PT appointments have also come to an end and I am progressing with cycling to continue building leg strength. The weather has been warm on and off over the past few weeks, which really makes me consider going out on the roads instead of the resistance trainer. I’m confident about going out on a longer ride now and am pretty sure my knee could handle it. When I do decide to venture out, I’ll probably go when I’m in Williamsburg since it’s much more bike friendly.
Over the weekend, I was out walking around near the oceanfront for a few hours, which was by far the longest I had been standing/walking since the surgery. I got a lot more tired and the surgery knee seemed to stiffen up some as well. I also noticed my right IT band getting tight, but that might just be from biking. The same thing happened right after the cartilage tear — I was putting most of my weight on the good leg and consequently, my right IT band blew up. Now that I know the warning signs I can take care of it early with stretching and rolling on it.
The other weird thing I’ve been noticing is that the resistance trainer has a difficulty that is correlated with temperature. I had never used the resistance trainer much to really notice anything weird, but now that I’ve been using it almost every day, there seems to be a strong correlation between swings in temperature and difficulty. At first, I thought some days my body was just more tired than others, but I noticed that every day I felt more tired than usual, it was warm out. I used the same gear every time, so it couldn’t be that. With running, I always felt better when it was warmer, so this was definitely strange. The fluid inside must expand with the increased ambient temperature and cause more resistance.
I also notice that the trainer has some kind of warmup time, also correlated with temperature. When I first start, it seems really easy, and then after about 5 – 8 minutes, the resistance ramps up and stays that way for the rest of the bike. When it’s warm out, the warmup time is closer to five minutes, and when it’s colder, it’s more like seven or eight, and a few times when it’s been in the twenties (I use it in the garage with the door open), it seems like the difficulty increases only slightly in the first ten minutes. Again, this is probably the fluid inside the trainer warming up and reaching some threshold above which things cause a lot more friction.
Every time after I finish, the trainer is really hot to the touch. A lot of energy must go into that thing over the course of 45 minutes and it soaks it all up and tries to dissipate some of it with an attached heat sink. I know that every basic bike computer comes with a wattage computer, but personally I would like to modify the trainer into a dynamo and hook up a bunch of 100w light bulbs. I could see as I go how many I could light up (probably only a couple). Actually seeing the light bulbs come on would be a heck of a lot more motivation than some number on a computer. Of course, if I wanted to light up more bulbs I could just use 60 watt bulbs or even some CFLs. Or, I could see if I could generate enough power to keep a (low power) computer running. I could watch a movie, but it would only stay on as long as I was working hard enough. I could somehow integrate some of my research into this too. Not that I’m averse to suffering without distractions, but it’s just interesting to realize how much work goes in to keeping the lights and computer running.
Microfracture: +17 weeks
Posted by Matt in microfracture on December 23, 2008
No news is good news, I suppose.
It seems that my knee is doing fine with the exception of some minor tracking issues — it’s almost as if the joint is “looser” than before. I’m doing about 45 minutes hard on the bike every day along with some other free weight leg exercises I picked up from the PT. My PT appointments have gone down to once per week, which is good since it’s getting old doing that.
I think a few more weeks to a month at most and I’ll be confident about starting a return to running program. By that time everyone will have returned for the spring semester and I could try hooking up with my old coach or the athletic trainer about stuff to watch out for as I start running again. Both of them dealt with other athletes with microfracture so they could provide me with guidance as I go. It seems that the PT was/is rushing me back to running so I can be released from them, but I don’t get why they just don’t cut me loose. Rushing this is a really bad idea. My pre-surgery past self would have tried rushing back to running as quickly as possible, but I really don’t want to wind up back at square one and require another surgery right off the bat. I’m sure my coach and the athletic trainer wouldn’t mind talking to me a few minutes per week about how things are going.
I return to the doctor next week so I will see what he says about everything now that I am over four months post-op.
Microfracture: +16 weeks
Posted by Matt in microfracture on December 16, 2008
Today, I ran.
I hadn’t run a step since the surgery until today at my physical therapy appointment. I wore my running shoes that I had last worn on July 8, 2008: the last day I ran, the day I went to the orthopedist for the first time. Basically, I went fast enough on the treadmill so that I couldn’t walk anymore, which was about 5 mph. That’s half the speed of my normal maintenance runs before the surgery, but at least it was something. It was the typical first step of walk-jog: five minutes of walking, one minute of running. I did only three times instead of the usual five and I’m supposed to do no more than every other day.
The first minute didn’t feel too good and my knee felt kind of sore in the joint, especially in the microfracture area. I wouldn’t necessarily call it pain, but I could feel something. The PT said to try again and it felt better the last two times, as if it had loosened up. Certainly, it felt better than the last time I ran, which consisted of excruciating pain in the joint. I could tell my left leg was really weak and the joint/cartilage/bones were taking some of the impact that should have been absorbed by non-existent soft tissue.
The PT thinks I am good to go with the walk-jog program, gradually increasing the running and decreasing the walking until I am doing 30 minutes continuously. I feel that I’m not quite ready to proceed with that until I can get more leg strength back. Running today really emphasized the strength issue and I would be a lot more at ease if I waited another month or so until I didn’t feel like I was running on stilts. My right leg seems okay, but it’s the left one I’m concerned about.
For now, I may do a really conservative walk-jog effort once or twice a week just to get used to the feeling of running, but that’s it. I’ve been hammering the bike and hopefully that in conjunction with some strengthening exercises will bring my left leg to the point where I can really start the walk-jog program. I will go based on how I feel, even if it means not running again to salvage doing everything else without pain.
Microfracture: +15 weeks
Posted by Matt in microfracture on December 9, 2008
It’s been fifteen weeks since the surgery and it looks like one more week until I try running. I’m still a little concerned about starting so soon, but my leg is feeling stronger and the joint moves much more smoothly than even a few weeks ago. I doubt it will be much more than five minutes of walking followed by a minute of running repeated several times. The physical therapist might want me starting off with even less than that. Excluding the knee, I don’t even know if I can take that much.
When I’ve returned to running following my previous soft tissue injuries, doing 5-6 minutes of walking followed by a minute of running was hard. Even though only five minutes out of 36 was running, I still struggled and felt desperately out of shape. This was only being out for a month or two and hammering an hour to two hours on the bike every day. I can see why a lot of people don’t like running — when I haven’t done it in awhile, I feel terrible and it really sucks. But, when I get past the initial suffering, it gets a lot better. Previously, this would take about a week or two if the injury I had didn’t come back. Running becomes enjoyable and becomes nearly as easy as brisk walking or biking. I like the freedom it gives me compared to the bike or indoor machines. I can go anywhere, explore everything, and not have to rely on some machine (bike) to do it.
I’ve been gradually going farther on the bike and have just been sticking to that as of late. I go hard enough to leave a pool of sweat on the floor when I’m done. I get a lot of weird looks from the sorority girls who dominate most of the machines when I’m in the rec center. I don’t really fit in there, I guess. At home, I’ve used the resistance trainer with the road bike, which I prefer to the stationary machine. The weather is supposed to be nice the next few days which got me thinking about going out on the roads for real, but I’m still kind of paranoid about accidents. I’ll get out there eventually, as long as I can hold up with some light running and the FUD subsides.
Of course by this point, getting around is now second nature. I don’t have problems with walking correctly and I don’t think about going up or down stairs much anymore. I can squat down on my knees without much issue, but I do take care in doing that since it isn’t supposed to be that good for you. In all, things are going well, but caution is the watchword.
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