Thursday, December 27, 2018

The Long Road

First, the bad news. I haven't written in some time. I've mentioned on Facebook and Instagram that I've been dealing with an injury. That's putting it mildly. I've been dealing with the worst running injury I've ever had, except maybe the stress fracture I got in 11th grade. It's been awful, insightful, and lengthy.

Then, the good news. Happily, things are looking up after many months. I can easily run 4.5 fast miles, and long runs are back up to 6 miles and climbing.

My PT encouraged me to write about what's happened, if for no other reason than to provide a chronology for future reference. Since this is a running blog, I thought that made sense!

Back in about June of 2017, after the Football Hall of Fame Marathon, I was running on the Towpath with my squad. I remember the day. It was a beautiful day. We were chasing each other back to the parking lot, pushing hard through the last mile. My knee buckled. It felt like if I hadn't twitched just right, it could have given out on me, but also that of course I would twitch right. There wasn't anything else to do. Alternately, I might have described it as feeling like my left knee was going to fly out of the left side of my leg, just for a brief moment.

Over time the buckling happened more frequently. Then, running down bridges got dicey. I figured out that if I took shorter steps and tucked my pelvis in as much as I could, I could reduce the frequency of the buckling. Sometimes it hurt more than other times. I had swelling around my left knee after any run. One day in August 2017, Cathy caught up to me on the Towpath. I was walking the last few miles back to the parking lot at the end of a long run. "What's this?" she said. It was pain. Lots and lots of pain. I foam rolled and stretched and backed off some. By New Years Eve (such a memorable run!) I was running 10 miles with precarious form, a buckling knee, and swelling, but not much pain. I thought I was on the rebound.

NYE 2017

I ran the Hermes 10 Miler with Candice in April. The last few miles were questionable. Then in May I paced Cathy to a sub-2 Cleveland Rite Aid half. By mile 9 my knee was having those moments, but now they hurt. I tucked and tried to ignore the pain. I could push through. It would be fine.

Hermes 10 Miler 2018

I continued more or less in this way until August. But, strangely, over time I noticed that foam rolling was doing less and less for me. There was no pain in my left quad or IT band. I didn't understand it. If my left knee kept swelling, how was foam rolling not helping? Stretching seemed to help, but only for very short periods of time.

In mid-May my massage therapist observed that my left leg appeared to be longer than my right, caused by having a hip out of joint. She was positive this was my problem. She referred me to a holistic well-being PT-ish person. He agreed with the massage therapist's diagnosis and "adjusted" me. My gait seemed to change after that, with my left foot insisting less often on turning out. This seemed to make sense to me, but at the same time, I saw a lot of red flags about this provider. This was late May.

In August I attended the third of a three-part trail race series. The August event was 5.2 miles or so. At almost exactly the half-way point, I stepping up and over a root, and something gave out. Suddenly and completely, I could not run. Even a little. My friend Candice passed me and asked if I was OK. I was not OK. She finished and came back to get me. She encouraged me to run even the last tenth of a mile. I couldn't do it. Very simply, this was the day I broke.

Part of our Full Moon crew, at the June race

I hobbled around for days, and I mean, hobbled. I awoke at night from the pain. My (new) massage therapist nearly bust into tears when she got into my quad a few days later. She wasn't sure if I had been out of joint, but she was sure I was a mess and was at a minimum over-rotating in my left hip. She referred me to a PT in my neighborhood.

*As a brief aside about how broken our medical system is, the PT said her company took my insurance. And they do. Just not my employer's version of that insurance. So I called the insurance's preferred provider to find out how I could be seen. They said it would be 5 weeks before I could be seen by the person who could then refer me to a PT, and no word on how much longer than that it would take to actually be seen by a PT. Not solely for this reason, but in part, I elected to continue to pay privately to see the PT in my neighborhood and not even bother with the insurance. I would see her 5 times before I'd even get a referral through my insurance. That's a broken system.*

My PT saw me for the first time in late August. She later admitted she did not know then what my problem was. There was a lot going on. And, I was really, really weak. She had me sit on the edge of a table and raise my left knee. She pushed down on it and told me to resist. I couldn't. She had me do a series of fairly simple exercises. I couldn't. There was pain and swelling. She gave me exercises to do twice a day everyday. I thought I was making great progress! Only later did she tell me how pathetic those first few visits were.

Complicating all this, I had knee surgery when I was 14, which left me without feeling on the left side of my left knee. There was some concern that because I lacked the nerve endings on the side of my knee, my body and brain had no way of communicating about repair. Just...awesome. And if I'm being super honest, I was terrified that whatever happened when I was 14 happened again, and what if it was something that can't happen twice without ending your running life? I worried about this. A lot.

Weeks of PT focused on my quads, calves, hamstrings, hip abductor and adductor, glutes, lower back, and IT.

In mid-September I tried to run 1.5 miles. It was....weird. Probably it had happened before and I hadn't noticed, but I could feel the tendons rolling all over my left leg. That's right. Tendons rolling. In my leg. While I ran. My IT band was too loose. I didn't know that was possible. Literally never heard of it. This is why foaming rolling did nothing.

My PT told me I could build up, half a mile at a time, after each distance had gone well at least twice. Over time and attempts, I felt the tendons rolling less often. Be early December they had stopped rolling all together. Rebuilding went mostly smoothly. Mostly. One day while attempting 3.5 miles, something in my knee felt like it shifted right, and I was done. It hurt, badly, for several days. Other times I have inconsistent aches and pains, but those worry me less.

By mid-October I was joining friends for short runs again. Candice was really great about it the first time I tried to go and just couldn't. I was so disappointed. But I kept trying, and we got there. 

With Dena and Candice in October

Most disgustingly, through some back and forth between my PT and massage therapist, I learned that at some point, my left quad realized things were going badly. The response? It threw down an extra attachment point. You know, the attachment points at my hip and knee just weren't doing it, so now I got an extra one--three, actually, close together--mid-thigh. Not only is getting these bumps to release difficult, but my muscle between them had atrophied. Just f**g great.

By the time I learned that tasty tidbit, I had a lot of questions. Was my hip ever out of joint? How much work will it take to get my mid-thigh anchor point to release? Have I torn my meniscus in the process? Time will tell. Will I run a full marathon again? I don't know, but I sure hope so.

While recovering, I have joined a gym. It's taken a while, but I am finally getting into something of a routine for strength training. I'm not good at it and I don't enjoy it (there I go sugarcoating), but I need to do it. I've also spectated some races, because if I can't run them, why not cheer?

Cheering on Candice at Autumn Leaves.
As of today, I have built back up to 6 mile long runs and I ran a fast 4.5 earlier this week without pain during or after. I am clearly on my way. I have zero swelling post-run. My knee has not buckled in months. Tendons have stopped rolling around. The extra anchor point is, at least, much smaller, although I'm not sure it's totally gone. I'll take it. This is HUGE progress.

Love these girls. They have been nothing but patient and encouraging as I've slowly rebuilt.
Lessons Learned
Lesson #1. Guys, for the love of all things, cross-train. You know those Runners World videos you see and think "oh that seems great!" and then don't do? Do them. Think, "hey, I've been running for years without cross-training much and it's been fine. Why bother?" Wrong. Do it. Think once a week yoga is enough? It isn't. Really really. Work on strength.

Lesson #2. I used to think Physical Therapists weren't very helpful. Why? After having my first kid I had some lower back pain. I went to a PT who handed me a single Xeroxed page of exercises I could easily have guessed from the Internet. Not. Helpful. This time around, I was lucky to find a great PT who really worked with me to ID the problem and build a plan to fix it. I am eternally grateful to her.

Lesson #3. If you can find a massage therapist and PT who work well together, keep them. This turned out to be helpful. If not, ask your massage therapist for language to give the PT about what they believe is going on, and vice versa.

Lesson #4. Last, but definitely not least, if your squad is willing to encourage you and work with you to rebuild, keep them. They are freaking gold. I really don't know what I would do without my running crew here, from the ones I see every week to those I see once every few months. Nothing but supportive.

I'm not sure what my running goals are for 2019 yet, except to continue to rebuild from this awful setback. I'm signed up for a few races, but am still holding back to see if I think I can really train for something big. I can honestly say right now I'm thankful to be running at all. It makes my heart so happy, and I appreciate it all the more after not knowing what would happen.