This afternoon, I find myself yet again sitting on the couch with my left leg wrapped in ice and elevated on a pillow, as I stare out the window at the blue sky wondering when I can run again. Ask any runner, and she will tell you: a forced break from training is always unwelcome. As runners, we like to decide when we take breaks and when we don’t; having hurt body parts decide for us is never part of the plan. But unfortunately, it does happen, and now, it has happened to me. It’s not the first time, and I’m sure it won’t be the last. Still, it is frustrating and not running is not something I do well.
My re-entry to training after last November’s ultramarathon has been a bit rocky. I spent December trying to recover from the ultra while maintaining my fitness. I continued to work on strength and flexibility, as I still had a lot of stiffness in my legs and trouble with knee flexion. In January, inspired by the Run the Edge Challenge to run 2,015 miles in 2015, I carefully selected a few races for this spring, including the Riga Marathon in Latvia, and gradually shifted my mindset back to training mode. I had a minor setback with a respiratory illness, but soon was back in my running shoes and slowly building up mileage.
February got off to a great start with a beautiful long run with M. and Frieda on the trails of Rock Creek Park. I felt hopeful and encouraged by the nice weather and good health. I had really built up some strength from deep squats that I hadn’t been able to do since I had knee surgery in 2007, and my flexibility was coming along. I added speed workouts back into my schedule, and began to focus my sights on my first race of the year, the George Washington Birthday 10K, scheduled for February 15.
And then it got cold. Really, really cold, as in almost Minnesota cold. Colder than any weather I have ever experienced in Washington, DC. Combined with a few snowstorms, the cold temperatures made for icy trails and generally unpleasant running conditions. I ran outside when I could and used the elliptical and – gasp – even the dreadmill when I needed to. My motivation waned, and I wasn’t the least bit upset when my first race of the year was cancelled due to dangerously cold temperatures and high winds.
In spite of the cold, I was trying my best to keep training, even if that meant working out indoors. Finally, last week, I decided I needed a mental boost, a little kick in the pants to get my running mojo back. When I lived in Minnesota, I never let a little cold weather stand in the way of my training… if I did, I’d have never trained at all from November to April. And so, last Friday, on the coldest day that our nation’s capital has seen in years, I decided to go for a long run on the Washington and Old Dominion Trail. I had plans to meet my former boss for breakfast at a little coffee shop just off the trail exactly 10 miles away.
I left at dawn and slowly made my way west. The windchill was well below 0 degrees. I dressed in several layers, put hand warmers in my gloves and toe warmers in my shoes, and carried a backpack with my packable down coat, a little towel, some makeup, my wallet, and my running traction aids. The trail was clear and mostly dry for the first five miles. I stopped a couple of times to adjust all of my layers, and again about halfway through to put the traction aids on my shoes once it appeared that the trail would likely be covered in snow and ice for the rest of my run. Each time I stopped, my left leg felt stiff, with a pinching feeling along the side of my knee. Once I got going again, I felt fine.
I reached the coffee shop right on time, happy to be inside with a warm drink and elated to have gotten through my run. I spent two hours visiting with my former boss over hot chocolate and breakfast sandwiches, and then he drove me home. The stiffness in my leg had increased, but I brushed it off as one of the usual effects of a long run in the cold. I took Frieda out, stretched and rolled on the foam roller, cleaned up, and sat on the couch for a little while to rest. When I next stood up, I could barely move. Later that day, M. and I made chocolate éclairs, and standing in the kitchen only made things worse. Thank goodness for the comfort of éclairs.
My knee had swelled up like a softball and remained this way for the next two days. Wearing a brace didn’t help much; nor did ibuprofen. By Monday, I felt better, but still not right. Running was out of the question. The swelling had subsided, but I couldn’t bend my leg more than 90 degrees. I spent most of the day yesterday calling doctors and health care providers to see when, where, and how I could get some treatment. I was able to see a chiropractor yesterday afternoon, and he performed some Active Release Therapy (ART) on my leg to help move the soft tissue around and break up some of the “junk” in there (his word, not mine, and according to him, there is a LOT of junk in my leg). I left feeling much better, though the knee was still a bit swollen and didn’t feel completely right. This morning, I saw an orthopaedic surgeon. He seemed perplexed that I would have such pain on the side of my knee when bending the leg or standing for long periods, yet no amount of poking or prodding in and around my knee reproduced the pain. Hopefully that indicates a soft tissue problem and not something in the joint itself.
An X-ray showed chondromalacia patella, which is the diagnosis I have always had: softening and wearing of the cartilage under the kneecap. This was not news to me; it’s plagued me for nearly 10 years now, and something I have to purposefully monitor and address with extra physical therapy exercises when it seems to flare up. The doctor also found a small bone spur on the back of my knee. Osteoarthritis at age 35? I asked. Unfortunately, yes, he said. But condromalacia is basically arthritis, too. This, after reading so much of the research out there that running does not cause arthritis. Point of Confusion #1.
Finally- and most concerning to me- the X-ray showed a possible tear in the lateral meniscus. The only way to know for sure will be through an MRI, which I will have done in two weeks. In the meantime, the doctor gave me the green light to continue running, if I can do so without pain. The elliptical machine and cycling are also fine, he said.
What he also said, when I told him that I had added squats and lunges to my strength training routine in the last few months, was that those were the absolute worst exercises I could do for my knees. But my knees don’t hurt when I do them, I said. And I thought I needed to build strength in my glutes and hamstrings. His reply: Someone, and especially a woman, who has had the surgery history and injury that you have had, should never do squats and lunges. You’ve got to trust me on this. Your knees will be very unhappy in 10 years if you continue to do squats and lunges.
Great, I thought.
I had worked with an AIRROSTI (Applied Integration for the Rapid Recovery of Soft Tissue Injuries) therapist back in November who specifically told me that the pain and stiffness in my legs is caused by lack of strength in my glutes and hamstrings, and that squats and lunges were the best exercises to build that strength, and that stressing the knee- carefully- will also help make it stronger. We spent hours working on my squat- something I hadn’t done in years- and I finally reached a point where I could squat down and pick something up from the bottom shelf at the grocery store… huge progress for me. Yet these are the very activities that a doctor told me this morning I should never do. Point of Confusion #2.
For the last ten years, I have searched high and low for consistency in health care and someone who can really help me with my end goal of running pain-free. Why is that so difficult to find? Or is is that my goal is simply unrealistic? One health care provider told me last summer that I was born with a finite number of miles in me, and that once I have reached that number, I won’t be able to run anymore. Of course, everything in life is finite, but what he meant was that once I reach X number of miles (whatever that number may be), I won’t be able to run again. Have I reached my finite number of miles? This fall, my AIRROSTI therapist told me that there is no such thing as a finite number of miles, so long as I am careful, and that I can get through this little blip and be back in my shoes again. Point of Confusion #3.
In November, I ran a 50 mile race and while my legs were of course tired and sore from the distance, I didn’t have pain. Two days ago, I didn’t run a single step but spent a good portion of the day on my feet cooking, and I could barely move. Point of Confusion #4.
As I wait for my MRI appointment, I am hoping that continued ART therapy on my soft tissues will help my leg heal and that I will be able to get back outside for a few miles, or at the very least, on the elliptical machine. I’m not good at rest days, especially when they aren’t planned. Supposedly, I have a 5K/10K back-to-back race in five days, but the chances I’ll be able to run are increasingly unlikely. Surprisingly, in spite of these little setbacks, I haven’t fallen too far behind in my mileage for the Run the Edge Challenge, thanks to my purposeful walking miles with Frieda and my workouts on the elliptical trainer (both of which count toward the Challenge, according to the official rules). I suppose the silver lining in this is that my forced break coincides with the some of coldest and wettest winter weather I have experienced in recent years. It’s definitely easier to stay inside on the couch with a hot cup of tea and ice on my leg when there is a high likelihood of slipping on the ice outside. Still… I miss running.
Thank you for reading!