My Honorable Husband injured his knee in 2005 and got incredible relief with physical therapy. He has no pain with normal activity, but if he walks for very long on a steep incline he has soreness and stiffness for several days. It terrifies him. He thinks he has reinjured the knee and is doomed to surgery. This means that the mountain hiking we both loved to do is severely limited.

Last summer in a chance (or perhaps providential) conversation with a woman in the neighborhood, I found out about a lady’s hiking club. There are about 25 women who hike in nearby state parks every Friday. It took a while to get connected, but on Friday I took my third hike with the group.

These ladies are serious hikers. Most of them are grandmothers, and they hike because they believe that if they stay physically active they will age more gracefully. The first two hikes were steep and aggressive. I met ladies who have hiked in the Alps and on the Appalachian Trail. I was glad in was in good enough shape to keep up.

Most of them are also interested in eating healthy. In so many situations, people give me strange looks when they see what I eat – like a meat and veggie bowl when everyone else is eating sandwiches. Not the hiking club ladies! There are certainly lots of sandwiches, but there are also a lot of salads and trail mix. There are even others who eat veggie bowls like I do. I’m probably the most serious about the Blood Type Diet, but several follow the basic principles.

On Friday we took a guided hike in a protected natural area. The weather was perfect, and the docent filled us with knowledge about truly native plants as well as plants that are encroaching in Central Texas. The walk, fresh air, and good conversation were rejuvenating.

I mentioned a few weeks ago that DD has a young man in her life who is an Exercise Sports Science major (He is also Type O). We were talking about running the other night and ESS told us something that may solve a mystery and facilitate a more complete healing of my knee.

He was talking about a professor of his who has run multiple marathons. He trained hard and ran long hours – always on the safe side of the road, facing traffic. Continuous running with his left leg slightly lower than his right, took its toll on his body. I’m not sure whether his bone growth was affected, or whether his joints were damaged, but ESS said that when he took off his corrective appliance, the class gasped at how crooked he looked. He urged them to run half of their time on one side of the street and half on the other.

This morning I went for a run. I was listening to J. Vernon McGee on my MP3 player and enjoying the cool temperature. About 20 minutes into the run I remembered what ESS had said and switched to the other side of the street. At first I didn’t notice any difference. Then I began to feel something. It wasn’t pain – more like a stretching sensation.

Now I am wondering…could running on the left side of the street have contributed to the patella femoral syndrome in my right knee? I worked hard on my quads all summer, so I rarely have pain anymore from everyday activities, but I still can’t do lunges.

I remember severely bruising my right knee in high school. After the injury healed, I would occasionally get a weak feeling in that knee, but it was not a problem until 2008. I never could pinpoint why I developed patella femoral. Now I’m wondering about running crooked.

I’m going to try running 1/3 on the right side of the road, 1/3 on the left, then 1/3 on the right. I’ll blog about the results of my experiment.

We spent an interesting day at the Charles Town Landing Historical Site. The original 1670 settlement has been restored. We learned about life in the colony and enjoyed the archeology exhibits. We walked a big loop trail that took us from one end of the compound area to the other. On one side there was a ship building exhibit featuring a Ketch sailing vessel built by hand by the docents. On the other side was a wildlife exhibit featuring local animals in their natural habitat.

We asked one of the docents to recommend one of her favorite nearby restaurants. She sent us to T Bonz. The food was delicious. I had a burger & vegetables. DD had a salad & eggs. We got a side order of broccoli and shared. Though there were plenty of beneficial choices, HH chose an avoid sandwich – steak, turkey and bacon. DD and I couldn't talk him out of it. I don’t know if his stomach bothered him. After all our warnings, he knew better than to complain.

Our last day in Charleston we packed a picnic and drove to the Isle of Palms. The kids and I went running on the beach, then jumped in the ocean to play in the surf. HH decided to be cautious because of his cornea transplant. He has healed beautifully from the surgery and his vision is better than it has been in years. He is still cautious, and he did not want to risk getting sand or salt water in his eye. He took a nice long walk on the beach. Then we pulled out the lawn chairs and ate our picnic while we listened to the water. So relaxing.

Then it was time to come home. I am getting ready to have an estate sale at my Mom’s house. HH is learning to take care of our house so I can spend more time next year developing my photography and publishing business. DD headed back to college for her senior year. SS finished grad school today. He is a physical therapist, and he is returning to Texas to practice. We are back to the real world, but the real world is a pretty interesting and exciting place to be.

We have had two more days of interesting sightseeing, scrumptious food and unusual exercise.

One day we toured a plantation just outside of Charleston. There were alligators walking free on the grounds! I picked up one bit of blood type trivia. Sickle Cell Anemia is an inherited blood disease that mostly affects people of African descent. While the disease has many disadvantages, one advantage is that it provides protection from malaria. On this particular plantation, for large parts of the year all of the activities, including management of the house, gardens, and crops, were entirely handled by black overseers while the white owners fled for less mosquito prone climates.

Another day we toured the USS Yorktown, a retired aircraft carrier. The kitchens on board were certainly not organized to provide WWII era soldiers with meals related to individual needs or blood types. Nor was the concession stand set up to provide healthy meal choices for tourists. We were glad we had packed a picnic lunch in our backpacks – turkey on oat bread for my husband, PB&J on Ezekiel bread for DD, salmon and English peas for me.

Last night we drove to Sullivan’s Island and ate at Seels. The rest of the family raved about the fish tacos. I thoroughly enjoyed my flounder with collard greens and sweet potato fries. After dinner we went for a long run on the beach. Running on sand works different muscles, I learned when I hopped out of bed this morning.

Tonight we had dinner at Jestine's Kitchen, a downtown restaurant famous for soul food. My meal was outstanding: meatloaf collard greens and okra gumbo. There is a hike and bike trail over the Ravenel suspension bridge where our son likes to exercise. DD and I power walked the bridge after dinner. We not only got a good work out, but we saw a beautiful view of the water and the downtown skyline.

I’m starting the third week at my parents’ house. My sister and I have made so much progress. We have one room and one closet left to investigate. I have eaten really well - only two avoid foods. I think that is somewhat extraordinary for being away from home. One of those was a dessert for my sister’s birthday. The other was potato chunks that came with one of the most amazing egg dishes. It was a Greek frittata. The eggs were topped with asparagus, artichoke, sun dried tomatoes, and feta cheese. It was an outstanding combination.

I have made sure to exercise every day. It’s best if I get up early and walk or run before breakfast. Once the day starts, it’s hard to find time as we get busier and busier with projects. Sometimes exercise comes in surprising places. This morning, for instance, I realized that I had gotten the day wrong for the heavy trash pickup. We suddenly saw the truck a block away and raced around lugging a picnic table, ping pong table, three computers & two monitors and a mattress & box spring out to the drive way. That will get your heart racing.

For the most part, I have eaten meat and veggie bowls. Meat choices have been ground beef, rotisserie chicken, brisket, salmon, and turkey breast. Vegetables have included peas, green beans, parsnips, mustard greens, sweet potatoes, turnip greens, carrots, black beans, pumpkin, broccoli and more. My niece teases me about the combinations I put in a bowl. I think adding hummus to green beans or barbeque sauce to turnip greens tastes good, but she laughs calls it “Aunt Suzanne’s food.”

We had someone majoring in Exercise Sports Science over for dinner this week. He made some comments about muscles that I found intriguing. The conversation started when I said that because I was so sedentary as a child, I had never developed my upper body muscles. He said that my muscles were fixed genetically; that I was born with all of the muscle tissue that I would have, and that what I did in childhood couldn’t change that.

I said I knew too many people who had been very scrawny, but through weight lifting had built up lots of muscle. Arnold Schwarzenegger certainly wasn’t born looking like he looks today! I also mentioned the constant battle that women over 50 fight with losing muscle mass.

ESS countered with information that was new to me. There is a difference between skeletal muscle tissue and muscle fibers. Skeletal muscles are the long cells that are attached to the bones. These muscles are determined genetically. The ones you are born with are the ones you will have for life. He gave an example of someone he knew who had a severe injury that resulted in the loss of a large part of the skeletal muscle on the calf of one leg. Years later after the injury had healed, the muscles were still missing and one leg looked very different from the other.

Muscle fibers (which come in three types and determine whether someone is a good long or short distance runner) can be built and can be lost. This ties in with what my PT son once said about the body not beginning to build muscle tissue until six weeks after an exercise program is started. The long skeletal muscles do the extra work for a short term increase in activity (like a New Year’s resolution to start an exercise program). The body waits until it perceives that additional strength will be needed for the long term before it starts construction of muscle fibers. It is the fibers that add bulk and tone to the body. Muscle fiber cells can increase; they can also shrink and be lost.

I asked about fat, hoping that what I had heard about fat cells was false. Unfortunately it is true. Fat cells can be created, but they cannot be destroyed. “This,” ESS said with a smile, “is why liposuction was invented.

When a person overeats, fat cells are created. Once they are there, they never go away. They can shrink or fill up, but they are permanent.

So what does all of this anatomical knowledge mean to those of us on the BTD.
1. Beware of any kind of overeating that adds more fat. You may tell yourself that you can lose the weight. In reality, you can shrink the cells, but the fat tissue is there to stay.
2. Take your children’s weight seriously. They will pay the price later in life for fat cells that they build when they are young. Children won’t understand this. It’s just another responsibility of being a parent. (I strongly feel that it is NOT a government responsibility, but a parent’s responsibility.)
3. When you start a weight program, do not be easily discouraged. You will not start building fibers for six weeks.
4. Especially for women, weight lifting is a lifetime commitment. To keep our bones strong, we have to keep those muscle fibers working.

Far too many women in my family have stooped shoulders. My Mom was not extreme – though her shoulders were rounded as she got older. My grandmother was definitely stooped. One of my aunts was nearly bent in half. I have a neighbor who is also extremely stooped. I watch her take her trash can out to the street, and I wonder what I can do to prevent this from happening to me.

The last time my son was home, I asked him. He said that a common mistake people make with weights is to do exercises that build their chests and ignore their back muscles. He says that if anything men are more guilty of this than women, and that the result is stooped shoulders. If a woman does not spend at least as much time building her back muscles, the stoop will grow more and more pronounced as she ages.

I asked what exercises I needed to do for my back. He showed me several. But the most interesting one was how to use a basic fitness center weight machine as a rowing machine. He showed me how to attach the wide bar onto one of the cables. He put a chair about 6 feet from the machine and told me to sit down. I held the bar near the ends and began a rowing motion.

He said to hold my core tight, bring the bar to my chest, lean back a little, and release the bar in a controlled manner. I’ve been doing this 2-3 times a week for 15 minutes. I use 50 pounds of weight. I guess I won’t know for years how well it is working.

I love the movie Ben Hur. My favorite scene is the chariot race, but a close second is the sea battle where Ben Hur is rowing a Roman ship as a galley slave. As I’m rowing I imagine that scene. I’d rather be strong to the end like Ben Hur, than get dragged screaming from the deck because I lacked stamina.

We sang a little song when I was a child that went, “Make new friends, but keep the old, one is silver and the other gold.” I love all of my old friends from where we used to live. But I am excited to be making new friends out here in the Hill Country.

Tuesday I met one of these new friends in town for lunch. She is a Type A and her husband is Type O. We had fun comparing the foods we are just naturally attracted to.

We had lunch at a tea room. They had several kinds of iced tea, but all of them were black tea based. They had three kinds of green tea, but all were served as hot tea. It may not be summery enough for me to enjoy swimming yet, but it is way too warm for me to enjoy hot tea. I must have looked really disappointed, because the waitress said, “I’ll bring you a pot of tea and a carafe of ice.” I chose green tea with passion fruit (super beneficial on both counts) Oooh it was good.

I tried something new at the fitness room. I do a program on the elliptical trainer that goes up and down in intensity. When I am on the low intensity, I take my hands off of the machine and work on balance and core strength. I know it is a good idea, because my muscles are really sore. Ouch!

When we moved to our home in the Hill Country, we agreed we wanted a natural yard with native grasses and wildflowers, rather than a groomed suburban yard. However, there are limits, and I resolved to get rid of Johnson grass. It is a tall prolific grass that is impossible to walk through. It will quickly choke out all of the low growing pretty grasses. It took two years, but by cutting off all of the seed pods before they had a chance to open, I virtually eliminated Johnson grass from our acre.

This year the wild flowers have been beautiful. I have photographed 35 different flowers growing around my house. It is a joy to look out the windows or walk down the path to the trees. I have a lot of dandelions this year, and I may try harvesting the leaves after the flowers stop blooming.

I reached the conclusion that I don’t like thistles. The flowers are ugly, and the pointy leaves are not friendly. I decided to attack them in the same way that I attacked the Johnson grass, clipping off the buds before they have a chance to open into flowers and make seeds.

It takes me about an hour to cover 1/3 of our yard looking for thistle buds. I walk and bend and snip. Then I walk some more. It isn’t the type of intense exercise that is the most beneficial for Type Os, but is good for flexibility. It is really good for my soul to be outside in the spring air, away from the computer chair.

I’m not counting my thistle workout as my exercise for the day. I still need cardio and strength training. But I do like this time of year when yard work makes my lifestyle more active than it is in the winter.

Thistles remind me of sin. They may be ugly and unwanted, but they are also stubborn. They don’t give up easily. I can snip off buds one day, and three days later more buds are forming. I can never let down my guard.

Friday was a perfect Spring Break day. The weather was cool; the skies were bright blue; the sun was shining. DD and I went for a run. We ran for time rather than distance, and I ran a little farther than I usually do in 45 minutes. It certainly didn't spoil the run, but I couldn't help noticing all of the trash, particularly cans, on the side of the road.

The weather changed during the night. We woke to rain pelting on the windows. The rain stopped during the morning but it was cold and windy all day. Late in the afternoon my husband announced he and the dog were going to walk to the mailbox. I said that I’d go along, if we could walk the route that I had run on Friday.

I put on plastic gloves and grabbed a trash bag. We were off. Every time I saw an aluminum can I stopped and picked it up. HH walked one side of the street and I walked the other. We walked for a little more than an hour and picked up a half a trash bag of cans. It was good exercise, and it made our neighborhood look nicer. On Monday I will visit the recycle center and sell the aluminum.

This gives new meaning to the phrase, “It pays to exercise.”

Two friends have had knee replacement surgery in the past month. One is a single woman (Type O) whose surgery was in Texas and whose rehab was at a live-in nursing facility. The other was a married man (Type A) whose surgery was in England and whose rehab was at home. Both of them agree that rehab from knee surgery is excruciatingly painful.

Both of their doctors were very honest before the surgery. They said rehab would be pain worse than childbirth. Pain that would daily bring them to tears. Both of my friends thought that the doctors were exaggerating to make sure that they took their therapy and exercises seriously. Wrong; the doctor was painting an accurate picture.

The man described his experience using words like “torture” and “the rack”. The woman said, “More than once I was reduced to quivering and blubbering.” I’m not sure either of them would have had the surgery if they had known how horrible the recovery would be. I will follow up in a year, after they have had a chance to use their new knees, and see how they feel about it then.

But for now, they had two bits of advice for me, which are worth passing on to you.

First – keep your leg muscles strong now. If you don’t have knee problems, be thankful and build up the muscles in your legs so that your knee joint is supported. If you are overweight, all those extra pounds are adding stress to your knees. Think preventive. Be proactive.

If you have knee pain now (as I do) obey your physical therapist. Exercise those quads. Stay active and flexible. A lot of knee surgery can be avoided. When you strengthen your leg muscles, you take pressure off of the joint and give it a chance to heal. My husband had a tear in his meniscus. Physical therapy for several months and continuing to do his exercises has him 100% pain free without surgery. My patella femoral pain is more difficult to treat, but I have improved so much. The minor twinges I still get are a warning to keep up the exercises. Women my age have trouble building muscle because of hormone changes. I really have to work at it.

Second – If your knee pain is debilitating, and you are headed for knee replacement surgery, my friends recommend 3 months of work with a physical therapist or a personal trainer before the surgery. They say that the stronger your muscles and the more flexible your ligaments before surgery, the better off you will be in rehab.

I thought today that I was getting old.

I haven’t ridden my bicycle in a month or more. I ride once a week when the weather is mild. In the summer I get an early start before the temperatures get too hot. But I can’t generate any enthusiasm for riding in the cold. It’s just not fun. December and January have been cold months, and there haven’t been many good riding days. But this afternoon it was sunny and the temperature was 63. I put on my helmet and started out.

As I pedaled up the first hill, I didn’t feel stable. When I got to the top and started down it was worse. This is a long hill with a curve in the road about half way down. I usually enjoy the wild ride, braking only a little on the curve. Today I had no confidence. I applied the brakes all the way down. Now I was worried about myself. Was I getting too old to bicycle? Was I coming down with some dread disease – I’ve been reading a book about a man with Lou Gehrig’s disease, and his first symptom was instability.

The farther I road, the worse it got. I could hardly keep the bike on the road. I felt like I was leaning. I seriously considered turning back.

When I ride I listen to sermons on my MP3 player. I realized that I was having trouble hearing the words of the sermon. There was so much more wind noise than usual. Wind. I looked at the grass. It was waving back and forth; so were the tree branches. I found out later that the wind was 10 miles per hour with gusts up to 25. I was literally being blown off of the road.

In my neighborhood roads follow the curves of the hills, so none of them run north/south or east/west. One minute the wind was at my back, the next minute I was pedaling into a gust. But it was such a relief to know that there was a reason for the feelings of unsteadiness. Gradually I got used to the wind, and I began to pedal faster and enjoy myself more. The last hill before I arrived home I coasted down at full speed. It was exhilarating. I feel young again!

I came across a reference to an old hymn today. I’ve never heard it sung in church but the words are wonderful. It’s called “Be Gone Unbelief,” and the reason I mention it here, is because way back in the mid 1800s this hymn writer was acquainted with one of Dr. D’s principles.

Here is what he wrote:
Since all that I meet shall work for my good,
The bitter is sweet, the medicine is food;

Is that not remarkably similar to “For you, some food acts like medicine.”

Here are the lines that got me interested in the hymn:
His way was much rougher and darker than mine;
Did Jesus thus suffer, and shall I repine?

I’m usually the one encouraging friends and family to eat right. They call and ask me about vitamins or what foods might help a certain health problem. But right now, I’m the one getting e-mail saying “Suzanne, make sure you eat right…make sure you get enough rest…make sure you take care of yourself.” For the third time in four years, I am beside a hospital bed in December.

It’s sort of an interesting story…one that may apply to you if you are nearing menopause. My Mom broke her right ankle in 1997. She had surgery and they put a plate and several screws in her ankle. It healed beautifully, and never gave her any trouble. However, her August stroke paralyzed her right side. She can’t put weight on her right leg. She is either in bed or in a wheel chair. The bone began to deteriorate rapidly.

Thanksgiving weekend I got a call from the rehab facility saying that she had a cut on her right ankle. They speculated that she had banged her leg on the wheelchair. They were treating the cut. On Monday she had no appetite and looked at me with sad eyes. On Tuesday she had trouble breathing and was taken to the emergency room. There they discovered that the wound on her ankle was not cut from the outside. A screw from the inside was pushing its way out through her skin.

She is in a lot of pain, and is now on serious pain medication. On Monday my sister and I have to make a decision about whether to take the screw out or leave it in. The orthopedist candidly says that he is not optimistic about the wound healing either way. An open wound leaves her vulnerable to cellulitis and sepsis. The screw leaves her vulnerable to a bone infection as well. Surgery to remove the screw carries its own risks with a 93 year old stroke victim.

I am staying with her at the hospital most of the day. Because she cannot hear or speak, it helps for me to hold her left hand during treatments, and to be her voice to hospital staff who can’t imagine what a vibrant woman she was 4 months ago.

Hence the e-mails from my wonderful family and friends reminding me to take care of myself during this stressful time. The hospital here does not have the variety of vegetables that the previous hospital had. This is like a college cafeteria with a pizza station, a pasta station, and a sandwich station. Their hot lunch on Wednesday was chicken fajitas, rice and beans. It was the best choice available, but not the best choice for a Type O. Since then I’ve packed my lunch.

At home in the evening I am fixing good food for my husband and myself. However, I am probably eating too much. I was about to write that I need to be careful in stressful situations not to overeat even beneficial food, but it dawns on me that my nutritional needs are higher when I’m under stress. Perhaps I’m not eating too much after all.

I’m not getting enough sleep. One night I stayed late at the hospital because Mom was not responding well. Last night, right at bedtime, I received a hurtful e-mail from a bitter and angry colleague. It took a long time to settle down. I’ll try to do better tonight.

I have been exercising early in the morning. I just know that no matter how good my intentions are, I’m less likely to exercise after a day at the hospital. My husband is wonderful. He is at home today doing dishes and laundry.

I mentioned menopause. What I see in front of me, is confirmation of what all the menopause and peri-menopause books say. If a woman over 40 does not exercise - specifically weight bearing exercise – she will lose bone strength. Those e-mails I’m receiving are good reminders to take care of myself. Perhaps there is a woman you should e-mail today and remind her to exercise to keep her bones strong.

We got up early this morning and packed a picnic lunch. I had asparagus and salmon. DD fixed gourmet turkey sandwiches for her Dad and brother, filling them with vegetables like they do at Subway.

We spent the morning and the first half of the afternoon at Shiloh battlefield. I had never realized that disease killed more men than bullets in the War Between the States. Open latrines polluted the water. Farm boys had never been exposed to diseases to measles and chicken pox. Fresh food was often in short supply. Often the men went for days eating hard tack (a dry biscuit made from white flour) and coffee.

Late in the afternoon we toured Helen Keller’s childhood home in Tuscombia. What an inspirational woman she was! She lost both her sight and hearing to what was probably scarlet fever or meningitis when she was 19 months old. Yet she lived a full life doing much to inspire and help others who were blind and deaf.

We had dinner at O’Charley’s. This is a chain of restaurants in the Eastern US where I can always find a beneficial meal. Tonight I had steak, broccoli, and sweet potato fries. All were delicious.

Our hotel had an arrangement with a local gym called Riviera Fitness. The kids and I left HH watching TV and went to work out. The equipment was first class. I spent half my time on the best elliptical machine I’ve ever tried. The other half was spent on weight machines.

One thing about a public gym is that the customers sweat a lot. Sometimes the equipment is sticky, and sometimes I wonder if it is sanitary. I noticed other people at the gym squirting a liquid on paper towels and wiping off the equipment before they used it. I realized that there were stations set up all around the gym with antibacterial spray and paper towels. I thought it was a great idea – especially with a bad flu season expected this winter.

DD and I are committed to getting muscle building exercise even while we are on vacation. The fitness room at the motel last night was good, but today we worked our exercise into our sightseeing. That was even better.

If you ever go to Memphis, I would highly recommend Mud Island Park. In the park is a reproduction of the Mississippi River on a 30 inch to one mile scale. The detail is incredible. It shows sand bars, bends oxbow lakes and more. Water flows down the river, and we smiled as several small children floated little boats and plastic fish from Missouri to the Gulf of Mexico. Mud Island itself is in the Mississippi River, so as you look at the water flowing through the model, you also see barges floating down the real river.

It was interesting and educational, but the fun started after New Orleans when the river flowed into the Gulf of Mexico. There were paddle boats for rent. My husband had no interest in paddle boats, but DD and I got in a swan while SS got in a dragon. If you have never been on a paddle boat, you sit side by side pushing pedals like bicycle pedals. The pedals drive a paddle underneath and you steer with a bar that turns a rudder. The model shows the Mississippi River delta and coastline with its bays and inlets. It became a game for us to try to slip past each other and not get trapped.

For half an hour we pedaled and paddled furiously, trying to head each other off without bumping into each other. When our time was up we were drenched with sweat and laughing hysterically.

We had packed a picnic lunch to take to the park. My idea of a picnic is not a sandwich, but a bowl of canned vegetables and canned meat. Today I had peas and carrots mixed with tuna and olive oil. For dinner we stopped at a Subway. HH and SS had sandwiches. DD and I had salads. Sometimes Subway can give you lots of iceberg lettuce, but be stingy with spinach and beneficial vegetables. This Subway east of Memphis was generous with the other vegetables, and I enjoyed a beneficial meal.

I can do a pushup. A real one…from my toes. I want to shout it from the housetops. Now, you have to know my history before you can understand my excitement.

When I was in elementary school, I was the classic bookish girl – the non-athlete who was always chosen last for the kickball team. Actually there was one other girl who was as bad an athlete as I was. She and I were in weekly competition, hoping we would be next-to-last and not last.

I did not like team sports, and in my school that’s all there was. Today’s kids can run track or swim or participate in any number of individual sports, but in elementary school kickball was king. In high school there was volleyball, which I hated even more than kickball.

This was during the Cold War era and the US was focused on the Space Race. There were government incentives to encourage school children to study science and get physically fit. Oh I hated those yearly fitness tests. Because I didn’t like sports, I was always below the acceptable level. I did tolerably well at sit ups, but my 100 yard dash was pathetic, and I could not do a push up. Not even one. Not if the teacher insisted on correct form.

I’ve blogged at other times about how as a newly wed, my husband introduced me to running, which showed me that I not only had athletic ability, but that I relished it. Running is one thing, but upper body strength is something else. I still couldn’t do a push up.

When I first started the BTD, I learned so much from Heidi’s column. She was recommending the Royal Canadian Air Force Fitness plan. I downloaded it and used it for about a year. That plan built up my arms to the point where I could do a knee push up with correct form. But any attempt to do a push up from my toes brought total collapse.

Last summer DD and I used the weights in our neighborhood fitness room a lot. She left for college, and I left off going to the fitness room. I forgot one of the key concepts for women over 50 who want to remain healthy. Because your hormone levels are dropping, you will lose muscle mass unless you make a daily commitment to build it. If you want to get a shock – Google “menopause ‘pound of muscle.’” Here is just one quote,

“You lose about half a pound of muscle every year after the age of 35. Because muscle is more metabolically active than fat, it requires eight times more calories to maintain, even at rest. Therefore, as you lose more muscle you burn fewer calories. If all other factors remain constant, this translates into about four pounds of muscle lost and 15 lbs of fat gained every decade!”

I believe this is the root of my knee pain. I was focused on cardio exercise because that’s what like the best. I wasn't gaining weight, but I let the muscles in my legs lose their tone and strength.

DD came home for the summer after spending a year lifting weights with the football and basketball boys. She is so petite, that it amused them to see her lifting weights. They taught her a lot of new exercises and muscle building techniques. I was convinced that I had to increase the muscles in my legs unless I wanted to live the rest of my life with knee pain. So she and I have spent the summer focused on building muscle.

Several weeks ago, we were doing an exercise tape that included knee pushups. I was doing 10 – 12 with out much effort. I decided to try a real pushup. I couldn’t do it, but I didn’t completely collapse. I felt the same way I had felt when I first started knee pushups on the Royal Canadian Plan. So several times a week, I’ve done five knee pushups to warm up, then worked at pushing up from my toes. Every day was a little better. Last night I did it. Two pushups from my toes with correct form.

If anyone from my elementary school is reading this blog, they have now fainted. I have proved to myself that I can – even at 55 years old – defy my hormones and build muscles. If you are a woman over 40, I urge you to get some kind of a weight or muscle building program. The only alternative is pain.

Now I have a new goal. I want to do a pull up.

I like having DD home for the summer for many reasons. One of them is having an exercise partner. She is a planner. I am spontaneous. She plans our exercise for the week. I come up with alternates when something happens to throw the plan off.

One of our new exercise routines this summer is what we call 20-20. There is a walking path near the swimming pool in our neighborhood. It is a ¾ mile loop that goes down a hill, by a fish pond, and back up to the top of the hill. DD and I run the loop for 20 minutes, then jump in the pool and swim for 20 minutes. We have to start early. The neighborhood kids start arriving at the pool about 10:30, and it’s hard to swim laps when they are splashing.

The board of our neighborhood association decided to upgrade the equipment in the fitness room. They bought a new elliptical trainer and a new treadmill. They also got two different types of stationary bicycles that target different muscles, plus they bought a really nice weight machine. When DD and I go to the fitness room, one of us uses the weight machine for 20-30 minutes, while the other does cardio on one of the other machines. Then we switch. I’m seeing some nice results in the muscle tone on my arms.

Not too many people used the old equipment, but more and more neighbors are taking advantage of the fitness room now that we have good machines. Yesterday I was on the elliptical and DD was lifting weights. Another lady came in and chose the treadmill. A few minutes later a fourth lady arrived. She evidently saw that one of us was using the equipment she wanted because she left, saying she’d come back later.

We ride our bikes at least one day a week after dinner. It’s starting to cool off by then, and we have the added bonus of watching a sunset change colors as we ride home.

God, in the Bible, often uses physical principles to make a spiritual point. For instance there are many verses about endurance and stamina. Those verses encourage me when I exercise. They keep me pressing on when I’m tired and would rather take it easy. But while God commends my efforts to strengthen my body, the higher meaning of those verses is to strengthen my character and my faith.

Today I read a verse in proverbs about food choices. “In the house of the wise are stores of choice food and oil. But a foolish man devours all he has.” That is Proverbs 21:20. I first thought of the BTD when I read it. Doesn’t it perfectly describe modern society? When I shop if I buy only choice, healthy foods, my family and I will eat wisely. But if I bring junk foods and avoids into my home, stress may overcome me and I may devour everything in sight.

The spiritual principle is also there. Just as I don’t want to make leave myself vulnerable to making poor food decisions in the kitchen when I am hungry or needing comfort, I don’t want to ignore God until a crisis strikes, and then cry out for help.

Just as I want to make wise and beneficial food decisions ahead of time at the grocery store, I want to develop a relationship with God and absorb His teachings ahead of time so that in a crisis I understand His will.

Patella femoral pain syndrome. I now have a name for my knee pain. SS took a course in joint dysfunction in the spring. He asked me lots of questions during the semester about what hurt and what didn’t because he was wavering between two knee problems that have similar symptoms.

The good news about Patella femoral is that it rarely, if ever, requires surgery, and it is the least debilitating of all the knee problems. The bad news is that it is the slowest and most difficult recovery.

If I have been sitting for a long time my knee hurts when I get up. However once I’m moving around, I feel little or no pain. My knees hurt going up and down stairs, particularly if I don’t keep my toes pointed straight ahead. (I am SO glad we built a one-story house.) It doesn’t hurt to run, swim, or ride my bike, but exercises that involve lunges are very painful. Not surprising to me at all is that it is aggravated by poor arch support and the tendency to pronate.

In May SS gave me six exercises to do. He said that with some physical therapy, you have to push through the pain. Patella femoral is not one of those conditions. He said that if any of the exercises made my knees hurt or pop to stop immediately. Two of them caused pain, so I just did the other four until he came home last week.

He watched me do the exercises and said my form was good on all but one of them. Someone will have to spot me on that one until the muscle he is trying to isolate gets stronger. The two exercises that hurt were for my quads. SS said that strengthening my quads is the single most important thing to do. He modified those two exercises in such a way that I’m working my quads, but not hurting my knee. Other muscles that impact Patella Femoral are abductors, hip external rotators, hip extensors.

It was gratifying to me as a Mom to watch him work, and to see how his manner was both firm and gentle. He found it helpful to spend an unlimited amount of time watching me move and modifying the exercises. He says he never gets to spend that much time with a patient in a clinic situation. I’m probably biased, but I think he will make a wonderful physical therapist.

He tells me that inflammation is not a factor in Patella Femoral Syndrome. I would concur that there has been no swelling or stiffness in the joint. However, since inflammation is such a big issue for Hunters, I can’t help wonder if there isn’t some low level of inflammation that contributes to the pain. Or perhaps physical therapists and naturopaths use different definitions for inflammation. I’m going to look into inflammation protocols.

What I am most curious about is which came first – the chicken or the egg? Or in my case - did arch problems cause my quad to deteriorate to the point that it couldn’t support my knee cap, or did weak quads and hip muscles cause me to walk awkwardly and affect my feet?

I suspect there may be a genetic component to this problem. My father told of his army days when he was marching across Italy and his feet and legs hurt so bad that he thought he couldn’t take another step. He stopped by the side of the road, stuffed dry grass under his arches, and felt immediate relief. My Mom’s knees hurt if she sits for too long. The pain has caused her to stop attending both Sunday School and church. It’s just too much sitting.

I’m hoping that if correct the underlying muscle weakness, I may find a permanent solution to both my knee and foot problems.

You probably know more about my knees that you ever wanted to know. I got off on this tangent because of a thread on the Forum. DD and I have tried some new recipes, and I’ll get back to blogging about beneficials and avoids next time.

We have had our nephew and his family visiting for several days. We’ve been doing a lot of swimming and walking. I get in a rut at times – routine house hold duties, job hunting, computer chores. Sometimes I forget that we moved to the Hill Country in part because of the many opportunities for outdoor exercise. We have had a lot of fun with our company, and every day has been filled with physical activity. But it did distract me from blogging and delay the second part of my experience with foot, knee, and hip pain.

After Fred died, I tore apart one of my shoes and tried to copy what he had done. I could never get it exactly right. Some days my knees would feel good; some days they would hurt. I tried department store variety arches, but they did not help. I talked with several people about getting custom orthotics made by a podiatrist, but they were made of hard plastic, rather than the comfortable soft material Fred had used. I called dozens of shoe stores, but no one could give the kind of personal service that Fred had always given. They didn’t have his compassion, his work ethic, or his knowledge.

Eventually I found a shoe store – a national chain called Foot Solutions – that sold several brands of soft arches that were a much higher quality than the department store brands. They measured my feet and recommended Lynco arches.

There were advantages and disadvantages to Lynco arches. They worked really well in athletic shoes, but not in dress shoes. They gradually compressed so that they didn’t provide the support, and had to be replaced. That would have been fine, except the changes were very subtle, and I didn’t recognize them until my knee began to bother me again. Then I would look at the bottom of my shoes, see that the heels were worn down. Then I would remember to buy new shoes and new arches. It would take several weeks to feel right again.

While the Lyncos kept me pain free most of the time, they weren’t perfect. Sometimes stairs would bother me. I learned to use the T-Tapp technique of “No Duck Feet”. If DD and I did an exercise video with lunges, my knee would begin to hurt and continue hurting for several days. But I could hike, run, ride my bike, and do all normal activity quite comfortably, so I didn’t worry.

I began having a little more knee pain last December. I should have recognized that I needed new shoes and arches, but I missed the signals. Instead since SS was home from Physical Therapy School, I asked him why my knees hurt when I did lunges. He did some measurements, and had a theory about my knee pain. He gave me some exercises to do. The pain got slowly worse until February or March when I looked at the bottom of my shoes, saw how badly worn they were, and exclaimed, “Oh that’s what’s wrong.” I got new shoes and Lynco arches. Yet for some reason, the pain did not go away as quickly as it had for the previous 10 years.

I was better. I was not uncomfortable for most of the day. But something was still not quite right.

I had heard radio advertisements for a store called Ideal Feet. They claimed that their arches would make your feet feel better in 10 minutes. I went in and got measured. Their arches are more expensive, but they do not have to be replaced. If they stop working, the company will replace them. They have arches for athletic shoes and dress shoes. I believe they are helping, though I still can’t do lunges.

In the meantime SS took a class in joint dysfunction this spring. He called several time to ask questions about symptoms. He has put a name to my condition. I’ll write the last part of this blog about knees next week.

I am by no means an expert on knee pain, though I am hopeful that I am now on a strategy that will end my knee pain permanently. I jumped into a Forum discussion last week on knee pain, and promised to write more detail about my personal experience. It would make me happy if my failures could prevent someone else from wasting their time, or if my successes could bring someone else relief more quickly.

When my Strong Son was almost two years old, I developed pain in my right knee and hip. The only thing I knew that caused joint pain was arthritis, and I was very distressed to think that at 33 years old I was developing symptoms of a debilitating disease. Being into Health Food at that time of my life, I first tried a ton of vitamins and supplements, none of which helped. I went to a chiropractor who did not help my hip or knee at all, but did give me neck and shoulder pain.

Eventually on the recommendation of a friend, I went to see Fred – an elderly shoe salesman at a local store. Fred had sold shoes his whole life. He had gone to shoe factories to see how shoes were made. In his desire not only to sell shoes, but to help people feel better, he learned to make custom arches for his customers. He had me walk up and down the store, and told me that carrying a big active baby on my left hip for two years, was causing the pains in my right hip and knee.

He built arches for a new pair of athletic shoes. There was immediate relief, and over a period of 4-6 months all of my symptoms disappeared. Needless to say I went back to Fred for all of my shoe purchases. Because he used soft material, his arches had to be replaced a couple of times a year. He didn’t charge for the arches if you bought shoes from him. After he retired, I continued to drive to his house to get my shoes fixed. He would go to other shoe stores and pick out shoes for me that he knew would work with my feet.

Oh how I wish I had asked him to show me what he did and how he did it. I guess I was reluctant to ask him to reveal the secrets of his trade. Or I assumed that he would always help me with my shoes. One day in about 10 years ago, my right knee was starting to get a little sensitive, and I called for an appointment. Fred’s wife told me he had died suddenly. As far as she knew there was no one else who provided his kind of service.

Now what was I going to do??