What Does Arthritis in my Knee Mean for Hockey?

So, it turns out that if you play decades of hockey, while being too overweight to sensibly do so, there is a knock-on effect on your health… I mean who could have predicted such a thing?! Yet, here I am with arthritis in my left knee. Well, osteoarthritis, to be precise, but that seems far too pretentious a word to keep writing, so I’ll stick with the more suitably down-to-earth, ‘arthritis’…

On a related note, I finally got the results back for that knee X-Ray I had in November…!

As you might have deduced, the X-Ray revealed that I have medial osteoarthritis in my left knee. The left knee, of course, being the lead leg in hockey… the one you push off with, when you change direction. Which means that arthritis in that knee is going to make hockey close to impossible. The ‘medial’ element of the diagnosis, just refers to the inside of my knee. Which is good, in a way: at least it isn’t the whole joint that’s knackered.

Honestly though, and overall, this news sucks, hard!

Okay, before I get on with the full-blown wallowing in self-pity, I’d better look into osteoarthritis. After all, the only information I’ve had, so far, was from a call with the physiotherapist attached to my GP’s surgery. Not that I’ve got anything against said physio, it’s just that the mobile reception here is terrible: who knows what I missed during the conversation?!

As expected, though, my attempts at a bit of additional research haven’t made things any better… Arthritis is the erosion of the cartilage, to the point that the underlying bone starts taking a beating. The most common symptoms are joint pain and stiffness, usually after exercise but, with time, increasingly constantly.

Well, time has most certainly passed, and I’ve been wearing knee supports while I play for decades.

Thankfully, I’m not yet in constant pain. However, the threshold for when I start feeling pain has been reduced to: my normal walking pace. Something that is particularly inconvenient at the moment, as I’m supposed to be improving my fitness before an upcoming liver resection surgery. Tricky to do, when the pain in my knee limits the pace I can walk, to below the point that my fitness watch will register it as exercise.

And I’m not going cycling on these roads, in this weather. If I come off my bike and injure myself, then that will delay the surgery, and I’m not risking that. Thanks to COVID, I’ve already been waiting for this surgery for a year!

The surgeons will just have to take me as they find me.

In the good old days, of course, a diagnosis like this would have resulted in an Arthroscopy. A quick operation during which the knee joint is washed out, and any debris removed. Apparently they don’t do this any more… Although, I’m fairly sure that they do. Anyway, I was told that an arthroscopy wasn’t an option, because it doesn’t actually result in much improvement. Furthermore, the potential risk of infection from the surgery is, supposedly, greater than the potential benefit.

I don’t think I’ll completely discount the arthroscopy option at this point. I’ll look into it a bit more, after I’ve recovered from my liver surgery, and maybe lost a bit more weight.

The physio did say that he’d refer me to the Orthotics department at the hospital. It seems that there is a type of knee support that is useful for medial arthritis. However, you need to be measured up for it, and you have to correctly strap it into place, each time. I haven’t heard back about this yet. But given that, due to the Coronavirus Pandemic, the waiting time for a lot of procedures has stretched beyond a year, I’m not expecting anything to happen soon.

The physio also said that there was one effective treatment for arthritis of the knee:

A knee replacement!

Well, damn!

50 is a young age to be considering a knee replacement. The NHS page on the topic suggests that they’re mainly carried out on patients between 60 and 80 years old. Even the partial knee replacement option is targeted at people older than me (55 to 64).

The good news is that it seems that knee replacements can easily last for 20 years. The bad news is that patient weight has an impact on the longevity of the implant. Basically, I need to lose weight again and, this time, keep it off for good. The other bad news is that patient activity has an impact on how long the implant will last. Hockey is specifically listed under, Sports and Fitness Activities to Avoid.

That said, I do know a guy from hockey…

He had a knee replacement a couple of years ago. Since then, I’ve definitely seen him on the hockey pitch. And I know for a fact that he’s enjoyed a snow boarding holiday on his new knee. Of course, he is implausibly toned and fit, in a way that I haven’t been since I was a teenager.

I explained to the physio that I wasn’t keen on the idea of a knee replacement at this stage in my life. He seemed to understand. Pouncing on that, I asked if there was any way I would be able to play hockey, moving forward.

And there is…

The physio made clear that there was nothing actually stopping me from playing as much hockey as I liked. Apparently, the damage to my knee is done. Continuing to play hockey is unlikely to make things much worse. Yep, there’s nothing to stop me, providing I’m willing to be in pain for for a couple of days after each time I play.

Game on!

And, up until a couple of months ago, that would have been that. I’d definitely be back on the pitch at the start of next season. However, my circumstances have recently changed.

It seems that I might survive my bout with cancer, after all.

Over the last couple of months, I’ve been speaking to the various medical professionals involved in my case. The current consensus seems to be that I’m getting to the end of the illness. The recurrence rate is slowing down. And when I do get a recurrence, it’s usually only one tumour. And, best of all, I’ve had confirmation that any tumours that I develop, can’t make more tumours of their own.

All of which means that I can expect to live my normal lifespan. So, I need to prepare for the possibility of 30 more years, instead of 3 more years.

Which is great news.

Or, at least, it will be, once I manage to get to grips with the idea…

I’ve spent the last seven years knowing that I had, at best, three more years to live. I know that these time scales doesn’t make sense, mathematically. It is, however, how I experienced palliative care. My expectations where managed to accept this reality, such that I could make my plans accordingly.

So I did.

But, now, I’ve got to stop doing that and starting creating a future for myself… I need to have plans for an additional 25 years, or so. A future that might involve grandchildren. One that could involve a retirement with my wife. Either way, a future that’s going to require knees that actually work…

Which means I can’t just wreck my knees on the hockey pitch, without thinking about it first.

And there are definitely a couple of things to think about.

Firstly, when I wrote about my bucket list, I said that it contained two items. The second of these items was to play Masters hockey for Wales. As such, I’m not just going to give up on hockey without a fight. Frankly, I think that doing so would drive me deeper into depression. Which brings me onto my second point…

I need to lose weight again, so I can see how my knee copes when I’m lighter. Knowing that I’ve had this tumour inside me for the last 12 months has not done me any favours. The fear of the damage it was doing, coupled with the uncertainty of when it would be removed, put me back into depression. And, for me, depression is always partnered with poor eating habits. And, inevitably: weight gain.

Which is how I’ve managed to regain all the weight I lost during 2019. Something that is depressing enough in its own right! Worse still is that the motivation I used to lose that weight in the first place, was the prospect of playing hockey for Wales. Something that is completely beyond my reach now… Unless there’s an age when all the Wales hockey players have had knee replacement surgeries.

And, if there is, I need to keep up with my hockey, for when I get to that age myself…

So, I’ll re-lose the weight by the start of the coming season, and see how I feel. I might, for example, be able to cope with the Back to Hockey sessions, without too much pain. And, if I can, then there’s a chance that I could be able to play the competitive matches on the Saturdays, instead. But this might not be realistic, as I wouldn’t be able to train, midweek, which may well disqualify me from team selection.

Which brings me on to Walking Hockey.

This is a pretty recent innovation. It’s based on the concept of Walking Football, which has been around for a while now. Football that’s played at a walking pace, where jogging or running is a foul. Except it’s for hockey instead of football… The clue is in the title!

England Hockey even has a page about it. So, all I would have to do is persuade the Hockey Club that what it really needs, is a Walking Hockey team. No doubt, if I suggest Walking Hockey to the Club, they’ll zing the idea straight back at me. “You want it?” They’ll say, “You make it happen…!”

Which is a bridge I’ll cross if I get to it.

Because, even for Walking Hockey, I’ll need to be lighter. And, while I’m already dieting, effective weight loss needs a combination of diet and exercise. And if I can’t walk to gain fitness, then I certainly can’t run. So how can I exercise with arthritis in my knee? Fortunately, knee arthritis doesn’t stop you swimming and cycling…

No, not at the same time!

Unless I get into Mountain Bike Bog Snorkling…

Hmmm, maybe later!

Swimming is obviously tricky at the moment, what with all the pools being shut for the Coronavirus lockdown. And, while Taunton does have an Open Water Swimming group: are you kidding!? It’s literally snowing as I’m typing this…

During the summer, on the other hand; who knows? The biggest problem is that Taunton is a surprisingly long way from a beach. And there aren’t even that many clean stretches of river and canal around here. Meaning that an open water swim, from here, involves an expedition. Still, I’ve joined the Taunton Open Water Swimming Facebook group, and I’ll probably give it a go at some point.

Cycling, as I’ve mentioned, is also not something that I’d consider during winter. But, I’m well on board with cycling during the other three seasons. In fact, as soon as the weather warms up a bit, and the coronavirus restrictions ease, my dad will drag me back onto the roads, whether I like it or not… Fortunately, I’m perfectly happy cycling, and dad’s good company.

I also have an Exercise Bike, which could theoretically be used for things like Zwift. Unfortunately, the bearings on the bike are done for, so it’s in for repair. When I get it back, though, I’m confident that it will come in useful.

Which leads me on to the one remaining question: is there anything I can take to help ease the arthritis in my knee? Maybe some kind of supplement? Cod Liver Oil, perhaps?

No, no, no! I hear you cry. It’s not Cod Liver Oil for joints, any more, it’s Glucosamine and Chondroitin…

Oh, come on!

Do you even hear yourselves?!

For 20 years, everyone knew that Cod Liver Oil was good for joints. Every Health Food Shop worth it’s name was selling Cold Liver Oil as the way to look after, and repair, your joints. For decades!

Well, they don’t any more, do they?!

No! Now it’s all about how Glucosamine and Chondroitin will look after, and repair, your joints. These days, Cod Liver Oil is marketed under, ‘Immunity Support’ and ‘Heart Health’, like we’re all supposed to pretend that it was never promoted as Joint Repair in the first place.

Please!

Ahem…

What I’m getting at, is that there aren’t any supplements that have been shown to be beneficial for arthritis of the knee. To be fair, there is currently some potentially promising research on Chondroitin. But it’s pretty limited. And it’s definitely too late after the arthritis is already in the knee.

So, sadly, no: there aren’t any supplements that I can take to ease my knee arthritis. I can use Ibuprofen to mask the pain during exercise. But that doesn’t prevent any further damage, it just stops me feeling it while it’s happening. Which is not necessarily a good idea. And certainly not good for day to day use. For special occasions, sure! But not for training purposes.

All of which leaves me in an uncomfortable position of denial. I can, absolutely, delay having to deal with the consequences of the arthritis in my knee until the start of the next hockey season, in October. But, very shortly thereafter, the truth will be unavoidable… Whatever that truth may turn out to be.

But, one thing’s for sure: I’m not ready to give up on hockey yet.