Back in the Saddle

Yes, it's true! This weekend I did my first running since my injury. And it went well. I did a walk/run for 2 miles. But first, just to update on my previous post - I'm good. I was a little sad at having to withdraw, but overall I'm good. There's always more races! And I love despair.com. You should check out their stuff - some of it is outright laugh out loud funny!

Back to my run~ I was a little nervous. Things were not perfect - I had some 'heat' under the kneecap and slight soreness so I did ice afterwards, but the big thing is no real pain. Excellent. Some parts felt really good and I wanted to just keep running, but I kept telling myself, no it's better to take it slow and work on getting back to running long term. So I moved over to elliptical to finish the hour.

So I'm on to a new goal.

I'll transfer to the Tyler 5k and maybe if things keep looking up I'll be ready for 8 at the Trot. PT is going really well and things that I felt were really hard a month ago are showing me that I am actually progressing! Yay!

Hope your running week goes well!

Defeat...more than a state of mind

I did some calculations and in the interest of protecting myself at this crucial stage of getting back to running, I'll likely be bowing out of the Tyler Half.

My therapist and I talked last night after some examinations and I'm starting back running this weekend. But at no more than 2 miles on a track. Running only the straight sections and walking the curves. If I increase at 10% a week, which he fully believes I should stick to so as to avoid further injury during rehab, I am no where near even 6 miles in the seven weeks left until event day.

Since I am already registered, I could possibly walk the entire thing which might take somewhere near four hours. There might be a possibility I would run the first 4 miles and then walk from there. This would put me at about 3.5 hours. But I do know for sure I will not be running.

I'm reallllllly trying to keep upbeat because I was SO looking forward to completing this. But I have to remind myself there are other feats of festivus to be accomplished next year. Either way I'll still be at the finish line cheering and congratulating MM and MB!

Keep training and maybe we can do something in the early spring! And we might be able to do the Turkey Trot 8!

Cross-training

The last month I have done no running at all. I have been doing elliptical (in place of running), biking and swimming. I've also been doing core and leg strength exercises (as part of my PT) 6 days a week and two days of physical therapy with my PT a week. I do feel stronger and more stable in the joint, but I also do not feel 'whole' yet. I had really hoped that a month off running would make me feel...healed I guess. I'm both anxious and nervous to get back to running. Anxious because I had started to like it and really want to get out and start putting some miles on and nervous because I'm afraid of further injury. I just don't know how soon is too soon. Doc said I could try back this weekend, but need to do so on a treadmill or track rather than concrete as long as there is no pain. I've had no issues in my cross-training so I'm hoping at least that is a good sign. I don't think there is anything like running though so I know even though I'm working out I will be feeling like running is hard!

Hope your training is going well! Update us!

Physical Therapy

I went to my first physical therapy appointment last night. After an initial discussion and examination my PT (Jake) decided the best course of action is to work on core strength and range of motion exercises. Part of this is to try and prevent muscle atrophy so that going back to running will be easier after the healing process. He feels that if I pull back and keep up other cardio exercises that do not cause pain I should likely be able to return to normal recreational activities. The goal is to rehab without a surgical intervention.

Yesterday we did some biking to warm up and ultrasound. Then some quadricep strengthening exercises followed by core strengthening exercises. Lastly some calf exercises (to work on strengthening both above and below the joint.) I'll go twice a week for a while and he prepared a handout for me to do at home twice a day.

I like my PT, he is a marathoner and triathlete so he understands first hand the kind of stress my joints will endure and what is required for each sport. He is also very soft spoken and easy to work with so I'm optimistic this will be a positive improvement for me.

Drum roll please......The Results!

Today I got my MRI results and you, dear readers, get the low-down first.

First, a history...In 1996 I suffered a meniscus tear (cartilage in the knee between the femur and tibia) from a knee trauma during a soccer game. I couldn't even walk. Had a knee scope to remove the torn portion of the cartilege. Tears deep in the meniscus will not heal even if surgically repaired since blood flow is scarce to that area. It turns out removing the torn pieces will relieve the pain and prevent the tear from 'catching' in the joint but it is degenerative. The cartilage cannot 're-grow' and eventually in life you will wear away the cartilege on the end of the bone and likely suffer from osteoarthritis. In 2000, I suffered further tearing that left me unable to walk stairs and with daily significant pain so I had a second knee scope. Since then I get minor aches and pains and minor swelling, but no major pain.

Until three weeks ago. I have had pain while running that I am unable to work through. So I had an MRI last week. Eight years is pretty good to go without any big issues I think. But since I know there is no 'fix' for me, I was very sad to see this come up.

The results are...

1) Abnormal appearance of the anterior and posterior horn of the lateral meniscus with diminuitive appearance and irregular shape.

Here is where I am missing cartilage (on the outside of my knee). This can likely be the result of my previous surgeries where is was removed. However, a recurrent meniscal tear here could not be excluded.

2) Very small foreign body between patella and femur

This is the likely culprit for my knee locking but is small enough that it isn't a real need to remove it.

3) Thinning of articular cartilage along lateral compartment with adjacent abnormal subchondral marrow

I lack cushioning here. Subchondral bone marrow lesions are involved in pain and progression of knee osteoarthritis.

4) Chrondromalacia involving the medial and lateral patellar facets

aka - Softening of cartilege of your knee cap or 'anterior knee pain.' The surface of the patella is softened due to many things including abnormal pressure across the joint surface. Causes swelling and pain when the knee is bent for long periods of time, kneeling or stair climbing. Commonly thought to be hereditary!

Diagnosis: Bad knee with wear and tear. There is nothing definitive on the MRI that says I need surgery. It could be a recurrent tear but the only way to know if it's just shaved from previous surgery or from a tear is surgery. (I honestly think there may be a small tear from the kind of pain I've had, but since biking, swimming, and elliptical have caused no pain I'm hopeful it was small or just irritated). We could go in and try and clean it up but there is always the chance that I come out worse than before. There is only so much shaving you can do.

So knowing there is no physical deformity that is going to explode if I run (and that my ligaments all look good), I'm going for physical therapy and will attempt short treadmill/track/dirt running. I'll go back to the ortho in a month and see how things are going. If I can manage running without pain there is no reason why I can't continue. And if things don't get better I can opt for surgery later.

Basically this is about choice. I can choose to give up activities I like doing and not pursue therapy or surgery. Or I can choose to do everything possible to keep up my pursuits at this point. So I've made my choice to keep going and try what I can to continue. This isn't like a bone deformity - it won't cause me long-term damage because the damage is already there. Either way my long-term prognosis is that at some point in life I will likely give up running for good. Eventually the pain may catch up and I will have to stop. But I'd like to delay that a little. Maybe 20 years. ;) In the meantime, we'll see what therapy and a little weight loss can do for me.

So wish me luck in therapy!

No running

Wow we need to get some posting going on here peeps!

Here's my update for the week. Monday night I went back to trying to run. I had no knee pain and did no running for the entire week before. The first .5 miles were fine and then BAM - sudden knee pain - the same pain from the week before in the same place. I only made it a few more minutes (I was trying to see if it would go away) and then decided to stop. I moved over to elliptical for 30 more minutes and felt defeated. So I've decided to see my ortho again and probably ask for an MRI to see if there is a structural injury (tendons or meniscus again, etc.). I want the expert opinion on how much running and when I should consider. I'll probably also get into a rehab clinic. So no more running until things are figured out. The soonest I could get in was next Wednesday morning.

Tuesday I went biking. Love it. Although it was HOT. Did 12.2 miles in 51 minutes. My saddle is killing me. My friend got a new saddle that she loves so we went to the store and picked one up on sale; I can't wait to try that out on Thursday. I also have a new cadence monitor which rules. It's the cateye cadence and it helps so much. I'm a techie and I wish I could afford all the very cool gadgets and disc wheels out there. Luckily, this was very reasonable. The nice RBM lady picked it out for me and didn't make me feel like a total non-cycling idiot like some of the hard-core reps at the Richardson location. Plan to swim tonite and it's a ride on Thursday.

Have a great week everyone-

Update

Saturday was my long run of the week. Met MB at the house to do 6 miles. We did 6 miles around the pond and it wasn't too bad. Time was 1:18 I think. I rather enjoyed it. I was a little slower than I had wanted to do but other wise the run itself was fine. Took 1 gu just for practice, didn't really need the calories. 1 water bottle.

The only issue was around 4.5 miles my right knee started to hurt. I spent the last mile and a half trying to decide how much it hurt. It wasn't really acute pain. It started small and gradually increased. No snapping or popping. But I really wanted to finish what was on my schedule. So I kept running. When I finished and stopped I realized it really hurt and it kept up over the weekend. It only hurts when I walk/put pressure on it though so I'm sure it's some kind of stretched ligament or swelling issue. (If you didn't know, I've had 80% of the cartilege in my knee removed so running causes scar tissue and swelling from lack of cushioning. Think bone on bone.) It doesn't hurt when sitting or not in use so I don't think it's any kind of tear or other injury issue . So I'll be taking some time off. I'm not sure how much. But at least today. I've been doing ice and ibuprofen therapy. Hope your weekends went much better than mine!