My tale begins with a game of hopscotch in the fifth grade. I’d sailed over the 5 and 6 squares and was coming down on the 7-8 pair, one foot over each, but as I hit asphalt, on long, skinny legs near the end of a growth spurt, both kneecaps popped around to the outside, and I fell down screaming. It was the first of a lifetime of knee woes; I was born with a tendency to dislocation, because of a congenital problem with my patellae.
As soon as I straighten my legs, my patellae slid back into place and I must have done that instinctively the first time they popped out. The next day, our family doctor advised my parents to apply ice and keep me horizontal until the swelling went down, and told me to be careful.
It was the late ’60s, and the cocky New York Jets quarterback Joe Namath was a cultural icon at the time, always in the news for another nightclub sighting, MVP award or knee surgery. Joe triumphed on the field despite his knee problems, but I on the other hand was sidelined. Both knees kept dislocating, and I learned to avoid running, dancing, high heels, stairs and careless stepping off of curbs. I hated being a spectacle, so I tried to stifle the yelps and learned to straighten that leg on the way down.
Advantages emerged. After I was knocked from behind during somebody else’s tussle in the girls’ locker room, I didn’t have to take phys ed anymore.
Now I realize I should have been exercising those legs—walking, bicycling, lifting weights, giving my quadriceps every chance to bulk up, especially during those key developmental years. Instead, I was wearing sensible shoes and reading. Broadway Joe, meanwhile, was playing with titanium implants on Astroturf. Surely, I was a good candidate for the miracles of modern medicine, too.
Just before my 17th birthday, then, an orthopedic surgeon performed the “Hauser procedure.” He shaved off a slice of each femur, with tendons attached, and grafted them back on, a bit to the inside. Then he encased my legs safely in a pair of ankle-to-thigh plaster casts, and I spent the summer on the couch with Ursula Le Guin and Ray Bradbury.
When the casts came off, though, my legs felt naked, vulnerable, flimsy. I took a few terrified steps across the examining room, afraid to let go of the table. Annoyed, the doctor sent me home with a note excusing me from phys ed for another year, by which time I would be out of high school.
Surgeons have since abandoned the Hauser procedure, which doesn’t resolve instability and leaves a tendency to hyperextension. My college student-health center, thank the merciful heavens, knew about physical therapy. By the end of my freshman year, I was a regular in the basement gym, sharing the Jacuzzi with the football players and racking down the weights for my turn on each machine. I was working out with weights decades before that kind of fitness routine became fashionable for women.
Thirty-five years, two teetering pregnancies and a few minor surgeries later, both knees still dislocate—and the right one has serious range limitations—but I’m still walking to the drugstore and even hiking, as long as I stay in shape. I use the elliptical trainer at the YMCA for safe, no-impact aerobics, and then I cruise the circuit weights, with special focus on my quadriceps, the four-part muscles above the knees. The vastus medialis obliquus (VMO), a teardroplike muscle on the inside of your thigh, works together with the flashier VL (vastus lateralis muscle) on the outside to hold the patella in place as the joint bends, so I take advantage of the thigh adduction and abduction machines, and my physical therapist showed me how to set the hip machine for a slow, careful quad workout.
Now we are in an era of knee replacements. One friend’s husband is not only running and skiing again but rock climbing with his new knees. My goals are less lofty. But I began thinking that if things got bad enough, I could get a knee replacement. I kept that comforting thought right next to the chronic ache behind my right knee.
Then this past January I stepped on a patch of ice, and my right patella was out in a flash, tearing a medial ligament as it went and knocking me on my butt. My doctor sent me to an orthopedic surgeon, a specialist in reconstructing damaged joints, who surprised me. A knee replacement, he said, wouldn’t address the problem, which is my inborn joint geometry and my stretched tissues.
Joy: no knee surgery, even on my beleaguered right knee, which deserves my loving respect, not the grudging accommodation I tend to give it. Despair: doomed for the rest of my life to watch every step, and to make time for the gym every other day. Oh, but wait, going to the gym is a benefit, isn’t it? Sort of like the flats that freed me from the yoke of fashion, and the afternoons I spent in high school recording times for the also-rans on the track team. I clocked runners who knew they were never going to win but tried their hardest race after race, always eager to know if they’d bested their own records. I marveled at the time; now I understand.
I also know now that my knees are more than a fair trade-off: They’re a blessing. They taught me to listen to my body, and to keep an eye out for other stragglers. They taught me to wire plastic flowers to my crutches and enjoy watching other people dance. They remain my inoculation against the lure of easy answers. I only hope that my 15-year-old son, who dislocated his knee for the third time last week, will one day feel the same way.
As for Joe Namath, I read in the newspaper recently he was seen striding across the field on plastic knees. I’m so glad both of us are still walking.
