Septic arthritis and riding don’t mix.
Short story: If you get a chronic infection in your knee, don’t expect to be riding normally for at least 2 – 3 months.
This post is not to chase an “oh poor you” kind of reaction, but just to record somewhere searchable on the interwebs, the response I had to a major knee infection, and how it affected my riding, just in case anyone else gets this rather nasty thing.
Septic arthritis:
The Mayo Clinic has this to say about it.
This is what I have to say about it. Ouch!
I’ve made this bullet pointed list, distilled from my nl;dr ravings because I feel that if you are reading this it’s because you have been struck down by yourself, and you simply want a heads up on the headlines of what’s ahead.
Me:
70 years old, fairly fit, active but I have never been to a gym.
ACL right knee about 30 years ago.
First arthritis symptoms 6 years ago
Avid biker in my youth, and since I turned 60.
Bought a fs e-mtb 3 1/2 years, for comfort more than adventure. I/we mainly ride off-road trails, and the “e” bit lets me do the St James,for example. The Ghost Road probably won’t be an option – too hard.
Knee pain varies from mostly quite mild to irksome irksome. Biking helps, walking kills it – 5km is a long walk ending with a swollen knee for the following week.
Timeline:
- Day 1 :Right knee hurting more than usual, and I tripped over a couple of times with my right foot dangling. Put it down with too many times up and down the stairs. (We have a house on a steep slope).
- Day 2 : Swollen and hurting to the point where I avoided stairs. Had to stand around all afternoon at my birthday party and it hurt like hell. Painkillers to get some sleep.
- Day 3 : Doctor visit. Says it might be infected, prescribes antibiotic, recommends come back in a couple of days if it’s not improving.
- Day 4 : Sleeping pill to get to sleep because the Dichlorfenac was bouncing off the pain, a first for me ever.
- Day 5 : Doctor aspirates my knee, got some fluid for testing
- Day 6 – 7 : Worsening pain, increasing swelling
- Day 8 : I go to the emergency clinic to try to score some heavier duty pain killers. Their doctor took one look, told me to not eat or drink anything because she was calling the hospital to get them to look at. She had diagnosed septic arthritis immediately.
- Hospital does the quick blood tests and staffs an operating theatre at midnight to flush my knee out. My CRP was 300+ , the inflammation indicator where 10 is a warning, 50 is quite bad, and 300 is spoken of in tones of hushed awe.
- The swelling was rated as “severe”, for reference.
My knee, a few days after the second flushing, still swollen and v. painful. - Week 1 in hospital : Another flushing. Very grateful for the freely dispensed morphine. Just able to walk with crutches and nurse assistance.
- Week 2 : Or maybe a few days more. Much pain, stopped the morphine pills because i hate feeling dulled out and nauseous. Throwing up on the head surgeon during the morning rounds was the trigger. CRP dropped from 130 to 75, then plateaued at around 50 for a week, prompting the medicals to suggest a third, major open knee surgery. I told them that that would make me deprressed a difficult and that I would rather wait it out for a few days and thankfully they agreed
- Week 3: Gradually improved. Very grateful for the view.
At the end of the week I could bend 90 degrees and the CRP was down to 25 so they sent me home with an IV system to keep the antibiotics flowing for two more weeks. - Week 4: Still not able to take any weight on it, especially down stairs. Got an exercycle and after about a week I could make it do a full turn, but still bloody sore.
- Week 5 & 6 : Improving mobility on the exercycle with 20 minutes a day on and at the end of the week I did a 6km ride on the real bike.
- Week 7: Started physiotherapy with very gentle exercises only. Built up to 20km rides every second day with occasional backward steps keeping me off my feet for a day. Able to stand for a few hours doing some wood turning, but then another lockdown forced me to stop that so I did workshop things at home for entertainment. Stairs are great therapy, combined with a bad memory to make me go up and down ten times as often as a younger bloke with a decent mind.
- Now: 2 1/2 months after the first twinges of pain, I am able to contemplate longer rides, walk up and down stairs without making funny faces, and if i concentrate, I can stand up from the couch without making old man grunts.
All in all I don’t recommend septic arthritis. Dr Google describes it as “rare and needing to be treated as an emergency” hence the initial midnight surgery, and physios and other nursing friends have reacted to my description of my initial symptoms with much more urgency than my ex-doctor did.