and the day after that...

"There is no gain without pain"? I am sure that's true to an extent. What I am concerned about is if my pain is simply a matter of getting adjusted to the use of these muscles and not just another manifestation of arthritis. Right now I am willing to believe it's all good.

Last night I had something similar to cramps in my right calf, actually close to the ankle. A tight, painful feeling that intensified when I stood on that foot. I managed to limp my way into the bathroom and turn on the shower. I stayed in there a while, with hot water on the leg, until it finally eased up. After that no further issues.

This morning I am feeling some back pain. Lower back. I am stiffer than usual today. I am chalking it up to the exercises, minor though they may be, and will be paying attention as time goes on to whether I adjust or not.

call from the trainer

On my way to the gym today I got a call from Carla, the trainer. She wanted to know how it was going. I told her about the pain in my knee Saturday, the cramps, and that I was adjusting and it is going well. We agreed that I would call her in a week or two, when I feel it's time to up the ante, when I am not pushing myself sufficiently.

Third day

Today I went to the gym for the third time, to work out. I had no trouble with the recumbent bike, probably because I pushed the seat far enough back and used the Precor instead of the Star Trac. The Star Trac wanted things from me that I could not give it, or at least could not figure out how to give it, in terms of information. The Precor just let me sit there and pedal, and eventually I figured out how to up the level to 2. Next time I'm going for level 3. Devilish!

I got there at about ten this morning. It seemed the height of the unemployed workers time! So many people on machines! It was funny to sit on the bike and look around me at so many others, on bikes, treadmills, elliptical machines, steppers, and each in her own little world, looking at the televisions or into the vast mirrors in front. All ages, all fitness conditions. When I got off the bike to get to the towel station to get stuff to wipe the bike off with I almost collided with an old man who was clearly slower than I was.

Thus it was that I had to work my way through the rest of the workout by grabbing the machine I wanted when it became available. When I got to the rowing machine I realized I could do more. I will increase the weight next time. I did better on using the lat pull-downs more evenly between my arms. I think I'm not ready to up that weight, or the leg press weight either, yet. 

The wall stretches are a bit painful on my left arm still. It will be a real turning point when this changes. I also found it a little painful to stand on my left leg while doing a calf stretch on the right. I hope this eases.

I plan to get there earlier Wednesday to see if I beat that particular crowd.

and the day after

At this stage of my new exercise routine I am posting in greater detail than I will later. I want to track what's happening now and compare it.

Last night I had leg cramps. First my right inner thigh, then my left foot, then my left inner thigh. Excruciating. It felt like forever before they eased and I worried that after I got settled in bed it would happen again (this has happened in the past) but it didn't.  It seems that the best I can do for such cramps is to get into a hot shower but it is too difficult even to step one foot on the floor when I am in that pain. Sometimes when it is easing off a little I can limp into the shower and take it from there.

I suspect the bike but it could have been something else that was worked yesterday, like the leg press. I expect these cramps did indeed come from my little workout, and I expect that my muscles will adjust and I won't have this kind of pain after a while.

Second time at the gym

Today I went to the gym to do the set of exercises alone for the first time. It took me a total of 35 minutes.

I started with the recumbent bike. I set it at the same seat distance as last time but realized immediately that my left leg as a lot stiffer than it was last Thursday. Yesterday I did a very small hike but it was probably enough to set off that joint.

After about three minutes that knee seized up suddenly. It didn't actually "seize" but it went into a sudden sharp pain. I had to stop immediately. I pushed the seat back farther and tried again. That took care of the problem and felt good enough that I continued until I had done ten minutes on it, and I kept it at level 2. My workout calls for five minutes but of course ten is better if I can handle it.

Next was the rowing machine. I wasn't sure I chose the right machine but I think so. I did the fifteen reps slowly, cleaned it off and headed for the next. Next, lateral pulldowns. I pulled them down with my right hand to the level where I could grab with my left without pain. I noticed that I tended to use one arm or the other to do all the work sometimes. I think I need to be careful about using both evenly.

The last machine as the leg press. I had to push the seat all the way back to get my legs up there. I wasn't remembering exactly how to do it at first, but then it came back. I took it slowly and I think it went well too.

After the machines there was the window and wall, the arm stretches and the calf stretches. I found that 30 seconds was as much as I wanted to handle on all of those. Each of those, I should say.

I wasn't particularly sweaty but I took a shower and changed so I'd be presentable at Trader Joe's, where I wanted to pick up some groceries. The gym is very close to TJ's so it makes sense to schedule them together when I need to shop.

I feel good now. I think this is the right thing to be doing.

The first training session

I met with Clara, the head trainer, today. She seems very nice and genuinely excited about working with me. She asked about my goals, then moved into the details of my arthritis, and finally we filled out the medical information form for liability purposes. Her conclusion? I'm really healthy inside, it's just the outside, the arthritis, that is holding me back.

While she was asking me about the pain she jotted notes about what exercises she thought would be good and she drew conclusions about what was going on with me in different areas. As we walked up the stairs she went behind me so she could see how I walk. She noticed my severe pronation, of course, and the fact that I am not standing or walking straight. Understandable, of course, because I am trying to adjust to the pain and difficulties of the arthritis. But she had ideas for how to strengthen what I need to compensate for the arthritis damage.

I tried a recumbent bike, then a standard one, and I noticed that I had less pain with the recumbent, so I'll go with that. Then I tried various exercises using Nautilus machines, and last she showed me a couple of things I can do at home with a window sill and a wall. My routine at this time:

Recumbent bike: 5 minutes, level 1 - 3
Row: 25#, 1 X 15 reps
Lat pulldown: 50#, 1 X 15 reps
Leg press: 120# with band around knees, 1 X 20 reps
Walk with band around knees, keep from slipping
Doorway or window: chest stretch - 30-60 sec, 1 - 2X/day each side
Calf stretch against a wall - 30 - 60 sec, 1 - 2X/day each side


She suggested I start out doing this twice a week and work up. She is going to call me Monday to see how I am doing, and we go from there. If I join - and at this point I am sure that I will join - I will get two more sessions free, then will have to pay for individual training from time to time.

When we were done she said she had to revise her plan as we went, because her assumptions were not necessarily correct, and that this may actually be easier than she thought at first. I am really hopeful.

Help with exercise

For years I have resisted going back to a gym, because my experience with the trainers is that they know nothing about arthritis. I would love to do some strength training that will actually help me with my knees, hip, and shoulder, but I don't know what's good and what will simply damage those areas. This may change, though.

A week or so ago I took advantage of an offer a friend had gotten in the mail. We both went to an arthritis seminar at a health club in Arroyo Grande (not far from here). The seminar was led by two physicians from a local hospital, who talked about treatments for knee, hip, and shoulder arthritis. They were surprisingly open about the options, not pushing any particular treatment. Because I had recently read a booklet and watched a video from the Foundation for Informed Medical Decision Making in Boston (a non-profit that gets no funds from any medical industry), I knew that there is no optimal time to have surgery, for example, and that many people do well without it, that treatment is as individual as we are. They even used the term "evidence-based medicine", which is what we all should be using all the time.

One comment got me thinking: one doctor mentioned that the health club has specialized trainers who work with physical therapists to help with pre- and post-operative therapy for patients. My ears perked up. These trainers probably know something about arthritis!

A few days later I got a phone call from the health club, Kennedy Fitness, offering me a four-day pass free. Naturally the reason they sponsored the seminar is that it gave them an opportunity to recruit new members. I said sure, I'd go for it, and the next day I went down to the club nearest me (they have four) to pick up my pass and talk to one of the people there. I asked for a tour and I asked about these specialized trainers. He didn't know much about them but said he'd have the head trainer call me to discuss options.

She didn't call that day or the next but soon I was talking to Clara. She said sure, she could probably help me out. I have an appointment with her today at noon. She will show me exercises that might help with my joints. I will ask her, too, once she sees how I am, what classes I might be able to take as well. I am hopeful, still!