Nancy Mairs describes her urge to write as a calling out of, “Here’s the way I am… How about you?” To which numerous readers respond, “Me too! Me too!” (p. 304). I felt that urge to cry out in response to Andrea Avery’s essay on her life with Rheumatoid Arthritis. I do not have RA, but I am freshly 24 years old and already have moderately advanced degenerative joint disease (a fancy way to say Osteoarthritis) in my knee. Avery describes OA in her essay as the affliction of “weekend warriors” after years of wear and tear. That is certainly the typical case.
However, several recent trends have changed that demographic to include a surprising number of young women like me among the arthritic community. More girls are playing competitive sports. Of the girls playing competitive sports, an increasing number (especially soccer, basketball, and tennis players) are tearing their anterior cruciate ligaments (ACLs).
I was sixteen years old when I tore mine. And, like many young female athletes encountering knee injuries, I didn’t stop with the ACL. Rather, I tore the whole terrible triad: ACL, MCL, and medial meniscus. This injury resulted in my first major knee surgery (I have now had three total). My orthopedic surgeon offered multiple explanations for why girls tend to experience this sort of knee injury: because of the positioning of our hips we tend to put more pressure on the inside of our knee joint; girls tend to jump more straight-legged than boys, creating more force on the joints upon landing; our hormones make our ligaments more tight and brittle… and so on. At sixteen, I was devastated to miss my senior soccer season, but determined to train hard and get back on the field in time to start playing college soccer the following fall. And I did.
About a year and a half ago, I had my third knee surgery. During the post-op discussion with my orthopedic surgeon, I was informed that a lifetime of contact sports and distance running does not mix well with multiple invasive joint surgeries. Soon, there wouldn’t be any more cartilage for the surgeons to remove. My bones would start grinding away at each other, causing excruciating pain that would likely cause permanent disability. I was advised to take up cycling and swimming instead.
Generally, I stay away from high-impact activity now. But when I feel strong and pain-free, I sometimes rebel and go for a short run. I do it because, like Avery, I have a little voice in the back of my head wondering if I am accepting limitations I should be fighting, coping with prescriptions I should contest.
Right now, I am not experiencing much pain. If I engage in vigorous activity for prolonged periods of time, my knee will swell and get sore. As I climb stairs, my left knee often clicks or grinds a bit to remind me that my youthful exterior is a superficial mask hiding my degenerating joints. I certainly do not experience the level of pain or bodily distortion that Avery describes. On one level, I read her description of the debilitating effects of arthritis with a sense of trepidation. I fear that my “moderate degeneration” will quickly advance. I worry that I will lose the mobility and flexibility that I enjoy now.
While all of that resonated with me as I read Avery’s essay, the part that made me want to shout out in solidarity was near the end when she wrote, “Our bodies become scribbled over with the evidence of what happens to and within us” (p. 265).
About a month after my first surgery, I had my senior pictures taken. In one, I was dressed in my high school soccer uniform, muddied up so I look “tough,” sitting with one arm draped over my knee and the other arm wrapped around a ball. My older sister, who was with me for the photo shoot, suggested that I switch my body position around so I cover my knee scar, suggesting that I wouldn’t want that to be featured in the picture.
I was adamant in my resistance. I wanted my scar to be highlighted. That surgery was an important part of my senior year and that scar will be with me for the rest of my life. As Avery wrote, “My body is not who I am, but it has the potential to get in the way of everything I am and mess it all up” (p. 264). As Susan Cahn notes, a difficult tension exists between integrating illness or injury into your identity and distancing yourself from it (in fact, Barbara Ehrenreich rejects altogether the idea that her breast cancer should be incorporated into her sense of self). I didn’t want my knee problems to define me, but at the same time, these problems were and are undeniably a major part of my life.
Recent studies have shown that lots of young athletes who had ACL tears are now experiencing early-onset arthritis as a result of the invasive corrective surgeries. I once had a friend ask me if I regretted going on to play four years of college soccer and run a half marathon—asking if I would have not done those things if I knew the damage I was doing to my knees. That question was running through my mind again as I read Avery’s words: “Regret doesn’t have a place in my relationship with my body. It simply doesn’t get me anywhere. And so I insist on co-writing my history on my body” (p. 265).
Avery’s essay cries out to me, “Here’s the way I am; how about you?”
Me too! Me too! Thank you.