Normally a patella rests and easily glides in a groove, between two femoral condyles, located at the end of the femur. My patella does not and, as a result, has partially displaced. This displacement is painful but temporary and is called a patellar subluxation.
The groove your kneecap rests in is often referred to as the patellofemoral groove. I’d rather call it:
the Melt A Paler Foot groove
the Alter All of Poem groove
the Ol’ Temporal Leaf groove
the O Moral Leap Felt! groove
the A Feral Poem Toll groove
the Tell a Floor Map groove.
One site I consult invites me to imagine my kneecap as a train and the groove as the train tracks that my kneecap train travels on. Subluxation occurs when the train goes partly off the tracks. How often does a train go only partly off of the tracks? And when it does, can it get back on the tracks immediately? This metaphor does not help me to understand what happens to my kneecap or to communicate that understanding to anyone else.
In discussing my experiences with subluxation, my physical therapist tells me, “this isn’t your first rodeo.” Until now, I didn’t know that I had been to the rodeo before. During the winter and spring of 2016, I experienced a series of minor subluxations which culminated in a a big POP in the middle of a flip-turn in the pool that kept me from running for 6 weeks and made my body forget how to walk. I thought that this injury was caused by a bone spur. Now that I know, subluxation makes so much more sense.
A sub par performance with no
sub-8 minute miles.
A substitution: speed out, stability in.
Now subject to more delays and derailments.
Submitting to the will of an extra bony anatomy.
Subliminal arguments between my right kneecap and the running path.
Subtraction and Addition: less grip and more gripe.
A subdued soul,
A submerged spirit.
Sometimes a pop. Sometimes a slide. Occasionally a slip or a crunch. More panic than pain. None of these descriptions quite capture the feeling of what has been happening to me and my right knee the past few years. Besides, do you know how many different injuries are described as being signaled by a pop or slip or a crunch? A lot. I need better words.
Up on the table, my legs are tense as the doctor aggressively pushes my kneecap around. I think he is performing a lateral patellar apprehension test which is used to determine if a partial displacement has previously occurred. When the patient is wary or resistant, there’s a good chance that they have experienced a displacement before and are afraid it will happen again. I am very resistant.
Or, am I suspicious? Untrusting? Uncertain? Afraid? Fearful? Scared? Nervous? Tense? Uptight? Alarmed? Concerned? Trepidatious? Skittish? Uneasy? Unsettled? Stressed? Strained? Panicked? On edge? A bundle of nerves? A scaredy cat? As nervous as a cat in a room full of rocking chairs? About ready to jump out of my skin? On pins and needles? Too tightly wound?
Here’s the best way I can think of to describe how it feels to walk around with a messed up kneecap that might suddenly, even when I’m wearing a brace, pop or pang or slide or shift: Sometimes in the winter, when the sidewalks are covered with new ice, or covered with old ice that is hidden by freshly fallen snow, or covered with ice that was melted snow that refroze overnight in jagged patches, I walk too carefully. My whole body is tense, waiting to fall. I ache in anticipation. My legs are tight. My movement forced, unnatural, very uncomfortable. I am fearful, apprehensive. Right now, in the first week of September, I am walking like it’s winter and there’s ice on the sidewalk.
I am supposed to ice my knee twice a day for 20 minutes each time. I try to do it twice, but usually only manage once. I don’t have any fancy equipment for this, just two sandwich bags filled with ice wrapped around my knee with a dish towel. I usually look at twitter or Facebook or the poem of the day on the Academy of American Poets website while sitting on the couch with my icing knee propped up on two bright yellow pillows.
R.I.C.E. stands for Rest, Ice, Compress, Elevate. Wouldn’t it be more fun to do if it stood for:
rude idiots can’t explain
red indigo copper ecru
ribbon ink carbon electromechanical
rancid icky curdled eggs
rapture is coming early
random isotopes create elements
respect is carefully earned
rudeness is considered evil
Metaphors produce distance. A sense of removal. They offer a space to reflect but can also signal a refusal to dwell in the discomfort and to, as Marie Howe explains in her interview with Krista Tippet, “actually endure the thing itself.” But, do I really need to pay attention to the burning cold of the ice cubes that are wrapped against my knee? For the first 10 minutes, as the cold bites my knee, how can I not? And then, for the second 10 minutes, when my skin has become numb, how can I notice anything?
The first time I went to the sports medicine doctor, in April of 2016, I didn’t know what was wrong with my knee. Based on some of the symptoms—swelling, feeling a pop just before the injury, difficulty going up and down stairs, stiffness—I let Dr. Google convince me it was a meniscus tear. An x-ray revealed that it was actually an osteophyte, or a bone spur, on the interior of my right knee. Most likely, the medial collateral ligament had rubbed against it, causing inflammation which led to pain and stiffness. Freaked out by the words “bone spur” and “osteophyte”, I didn’t think to ask how a bone spur developed, if it would go away and what this meant for my running.
Osteophyte, more commonly referred to as bone spur, and less commonly as:
O, the pest, yo
yo, the poets
oh, to set type!
hot eye post
they step too
oh, toes type?
set too hype
he poots yet
hot pot eyes
O testy hope!
Words can intimidate, alienate, overwhelm. My brain used to shut down when confronted with medical jargon and technical, overly-complicated terms for describing the body. I’m trying to overcome this by engaging with these words creatively. Rethinking acronyms and rearranging letters. Making them strange and deranged, weakening their power over me.
Since this last rodeo, I am better at paying attention and not letting the explanations overwhelm me. This time around, I remember to ask what this injury will mean for my running and how and why it happened. I’m not afraid to talk about my shitty insurance or ashamed to request that we limit the number of visits because only 3 are covered each year. And when my therapist tells me that if my knee doesn’t improve this week I will probably need to get an MRI, I don’t completely shut down but ask, will my full body be in the machine?, and when she answers that she’s not sure, I continue to breathe normally.
MRI officially stands for Magnetic Resonance Imaging. But, it might also stand for:
Magical Realism Included
Musty Rusty Incubators
Myopic readers irritate
Miniature Rhinos Incite
Monster Roosters Incant
Mutant rats infiltrate
Moody Radicals Impinge
Moldy Reed Infirmary
Musk Rat Infatuation
Massive Recalls Impending
If you asked me to make a list of the top ten things that scare me or that I can’t imagine having to go through, a full body MRI would be on it. If that list had been written 15 years ago, the top item would have been my mom dying. But she did, in 2009, and I survived. So maybe, if I do have to have an MRI, one in which I am fully encased in a coffin-like tube and I can’t move or escape for an hour, I will be able to survive that too. Besides, there are drugs and headphones and I don’t think I’m nearly as claustrophobic as I worry I am. I like to think, I’ll lie there, with my eyes closed and my headphones on, imagining tiny little rhinos running around and starting a revolution or extra large roosters softly singing “The Girl from Ipanema.”
My physical therapist has given me several exercises to do to aid in recovery: isometric quads, functional knee extensions with tubing, passive knee extension stretches, squats and supine heel slides. My favorite exercise is probably the supine heel slide because I have liked the word “supine” ever since it was one of my vocabulary words in high school, along with restive, chimerical and harbinger, and because the movement, sliding my heel up towards my butt and then away from it while lying down, seems to help the most in loosening up my leg.
Since I can’t run, I’ve started memorizing poems every morning. I sit at the dining room table and repeat lines over and over again until I own them. “Bedeviled,/human, your plight, in waking is to choose the words/that even now sleep on your tongue, and to know that tangled/among them and terribly new is the sentence that could change your life.” Choose the words/that even now sleep on your tongue. Choose the words/that even now sleep on your tongue. Choose the words that even now sleep…
Some words make me worry too much, so I look for words that make me wonder instead. I memorize poetry. Remix poetry. Craft poetry. See poetry everywhere and in everything. I switch out meniscus tears and patellar instability syndromes and bone realignment surgeries for goldengroves unleaving and musical battles with goldfinches and sentences that are waiting to wake up and change my life.