Monday, August 23, 2010

The sad story of my knee to date

Ok, it's not really that SAD, per se, hopefully it's just a temporary disappointment.

I enjoy riding my bike, but I have spent much less time on my bike since I started running more seriously again last year and training for foot races. In a way that's to bad. I did have some injuries with the intense bike training I was doing last year, but I have had many more as my body adjusts to running sometimes as much as 50 miles/week recently. The latest injury was in my left knee. It started with pain around and behind the kneecap. I know what that is, because I've had it before (petellofemoral pain), and some exercises leading into the half marathon I ran last weekend (Georgetown to Idaho Springs Half Marathon) helped me deal with it fairly well.

But on one of those runs, I also experienced some pain on the anterior of the medial distal femoral chondyle of my left knee (forgive the use of anatomical jargon here). That's basically means that pain was on the front of my knee, toward the inside - not under the knee cap. At first, I just thought this was due to inflammation from the patellofemoral syndrome, but instead now I believe it's another injury that happened, possibly because I altered my gait subconsciously to avoid provoking patellofemoral pain. I didn't think much of it, and the pain seemed to go away after the run within a couple of days. But then, I ran the GTIS half, however, and the pain came back in the last five miles, and picked up to excruciating at the beginning of the last fully mile of the race on the last steep downhill stretch. It was so bad and hit so suddenly that I had to pull up and sort of walk/limp gingerly, even stopping to feel my knee and check for swelling. There was no obvious swelling, so in my mind I thought i might have torn the meniscus or other cartilage in the knee joint. I test jogged and little and decided it didn't hurt very much, so I finished the race.

Fast forward two days, and the pain was still bad when I walked, particularly down stairs, despite my rest, icing, and pain mets, so I went to see a sports medicine physician. At the time I went to his office, the knee was not really all that painful (of course), but on probing around, the doctor was able to find the hot spot, and seemed to think that I had probably strained my medial collateral ligament and possibly had bruised the articular cartilage/bone. He sent me home with instructions to ice another day, then to use ice-heat-ice, for another day or two, and to wait a week before I started exercising, at which point, he suggested bicycling would be an appropriate exercise for the second week after the injury.

So, here I am at the start of the 10th day after the race and I've biked and walked a fair amount the last two days. I have full range of motion, but there are still twinges and oddly, at night when I turn the wrong way in bed the pain can still be almost excruciating for a short while. So, I have instructions to return in a couple of weeks if I'm still having problems, and the jury is still out. The knee feels ok, and I am walking normally but because I know it is uncomfortable to make running like movements, despite stretching and strengthening exercises to keep my flexibility, I can only rate the knee at about 70-75% of healthy.

The good news is the cycling is not a problem and last night actually seemed to help a little. At this point, I am so eager to get back to running again, that I'm willing to call anything positive "real progress," but I am not confident that my knee will return to it's former glory (which was only just passable, anyway!).  While there didn't appear to be an injury that would require surgery or expensive diagnostic tests I don't have the money to pay for, if the problem does not further improve over the next one-two weeks, I will have to consider going back for more rigorous diagnostic testing. So, I lay off the knee, bike only at low-moderate intensity with no hill climbs and sprints, and generally just try to baby the knee a little while not losing the flexibility I will need to hit the ground running whenever I am able.

What a pain in the arse! Just when I thought I was really starting to come into my own in my running... Still, trying to look at the bright side, the enforced cross training on the bike won't be all bad.

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