Since I was very little I have suffered from spontaneously dislocating kneecaps. Essentially if I put my foot down the wrong way or slip, my kneecap slips to the side of my leg and then pops back in causing enough pain that, as I have gotten older and my joints less flexible, I pass out, which is less than ideal particularly when the last two occasions it happened I was crossing roads.
When I was little it was extremely sore and it put me out of commission for about half an hour as I recovered sitting quietly, half in shock and usually embarrassed too as I was a bit of a tomboy who wanted to run and jump and climb trees with the boys and collapsing in a puddle with a scream was not considered cool in any way. We went to a few doctors who either weren’t sure what was wrong or assured my mom I would grow out of it. I even went to one physiotherapist who had the bright idea of dislocating the knee himself to see what exactly happened – what happened was my best friend went mental at him and tried to punch him out and I never let anyone touch my knee again in any capacity, including Brett.
Over the years I have grown increasingly paranoid about it and this is the one thing I have always been madly superstitious over; believing that if I talked about it, thought about it, dreamed about it or saw someone get their knee hurt in any way on TV; it would happen again and it would be agony. Also as I have gotten older, it has happened less frequently (I type madly knocking on my wooden table and praying I am not jinxing myself), but when it has happened it has been much more serious. What once took half an hour of sitting still to stop hurting, took crutches and extensive wrapping and over a week to heal and remained uncomfortable the last time round.
That was 4 years ago and on that occasion a good Samaritan pulled me unconscious out of Kloof street by the arm, tearing my deltoid muscle almost completely in my right arm – so in addition to the crutches I was in a sling for 6 weeks. But at least I didn’t end up under a car. During that time I sold my manual car and transferred to an automatic; a necessary evil as I couldn’t drive the manual at all with one arm and one leg and also in the long term, the doctor suspected that sitting in traffic for 2 hours a day to and from town going from clutch to brake was what had cause my knee to weaken to the point that it collapsed again.
Last year, one of my closest friends and I decided to do a Healthy Weight programme at the Sports Science Institute and although it did nothing for my weight, I did learn a lot about my knee issues as for the first time I met people who had actually heard of this before. I got some advice on further exercises I could do to strengthen my muscles to support the ligaments that don’t work quite as they should and they warned me that in pregnancy, there was a hormone that was going to exacerbate this issue a lot. So on top of the general nervousness I had felt about the pregnancy weight putting additional strain on my knees, I found out that there was actually a hormone that was going to make make them even less likely to hold me up.
In the first 3 months I had enough to worry about without focusing on the issue of my knees, but as I continued to grow (I look more like 6 months pregnant than 3) the anxiety has grown as well until eventually I bit the bullet and decided to go see a physiotherapist again. Now, as you can imagine, after my first visit to a physio I was truly terrified of them as an entire profession, but the fear for what would happen to my baby should my knees go and I take a fall down my stairs finally outweighed the fear of the physio. Having had a good experience with the people at the Sports Science Institute, I decided to go see a physiotherapist there.
My physio’s name is Damian and he is a sweetheart. He took my threats of bodily harm should he touch my knees (without my explicit permission) to heart, listened to my years of horror falls history and kept me calm and talking and I even let him touch my knees lightly to test their strength and see if he could identify the issues. Last week’s session left me shaking like I had just survived a traumatic accident, a reaction to my letting another human touch me on my knees. I felt quite ill for hours afterwards, even though I wasn’t hurt in any way and nothing bad happened at all. In a dual effort to activate my inner thigh muscles and to try to get past some of my terror at the thought of someone touching my knees, Damian taped up my left knee (the worst culprit) in some special way and I was meant to keep it on the 6 days until my next session. Although it came off on its own the first night I went to bed, that entire evening I was in a constant flinch from the unfamiliar feeling of pressure where I have always felt there should be none.
From what I understand there are 2 potential issues – either the ligaments that are meant to hold my kneecap in place are too loose or damaged to do so properly or the muscles on the outside of my thighs are too tight and pulling the kneecaps outwards and my inner muscles are not strong enough to resist that pull. Either way it is not great and they cannot do the necessary tests they need to while I am pregnant (scans etc), but in the long term I may need to consider surgery to prevent what is essentially arthritis caused by the kneecap rubbing on bone due to the damaged ligaments and cartilage from the ongoing issues. So for now, Damian is teaching me exercises to strengthen the muscles that need to be strengthened in an attempt to support my knees for when the full dose of Relaxin (yes, REALLY) hits me.
I went for my second session yesterday (very reluctantly I might add) but it was without incident and I barely recoiled at all when Damian touched my knees; I think it is more a trust thing though and suspect I may still suckerpunch anyone else who tries to. I now have what I have nicknamed Mickey Mouse Ears on both knees and I have made it 24 hours without ripping them off and I am only hobbling about half of the time at the strange feeling it has. My next appointment is in 2 weeks and I need to be disciplined enough to do the exercises regularly so that when next I go there is some improvement.
Another side effect of my loose joints is that I am already suffering, some days beyond measure (like yesterday), with joint pain pretty much all over. My lower back feels like my spine is trying to escape while my hip bones feel like they are on fire most of the time. Damian is giving me exercises to do to help ease that too, so here’s hoping it will help. I learnt I can’t do pregnancy yoga as my job is now to try to tighten my muscles and ligaments as opposed to stretching them, but I will be considering Pregnancy Pilates once I have been signed off as physically stable enough.
I also need to consult my Doctor in my appointment next week as to the safety of massage in pregnancy as from a physio point of view, Damian says his training says any pressure or massaging of the lower back or shoulders and neck release the same hormone that induces labour (pretty scary stuff) but he pointed out clearly that he does not specialise in pregnancy and I should double check with someone who does. I have been desperately waiting to get out of the first trimester as I thought that once out it was safe to go for massage and my body hurts so much I cannot picture another 6 months without one!
So for now I just have to be super careful – I have to think about every step I take, move deliberately (although that is simple enough with my Mickey Mouse Ears right now) and I have to live with the fear that my knees can go at any time and I can fall and hurt myself or the baby. Some days it is so bad I go down the stairs on my bottom and I don’t want to drive in case my knee goes while I am driving. I need to make it past the anxiety stage though and somehow balance the fear in a positive way to make me more cautious without turning into a total Agoraphobic. Every day is a learning though, and I am feeling more positive knowing I am doing something about it.