Well, it’s been far too long since I’ve posted. I guess in hindsight I took an unplanned hiatus. If you’ve read some of my earlier posts you may recall that I suffered a knee injury. I had been training for a half-marathon. One evening my dogs were boisterously playing in the hall and crashed into my knee. At the time I followed standard treatment for it – rest, icing, compression and elevation. The knee injury improved to the point where I felt comfortable running on it again. For several months I continued to run and workout. It seemed like I was continuing to do all of the things I had done before the injury.
Fast forward about 10 months. I had gained 20 pounds. My runs weren’t as long, and I took more walking breaks. Frequency had declined. My level of exertion dwindled. But, instead of getting to the root of the problem, my knee injury, I ignored it – doubled my efforts – and made my knee worse. I continued to live in denial for a couple more months, then finally decided to address the elephant in the room.
Active Release Therapy
My first step was a baby step. I went to see a Chiropractor that specialized in sports injuries and practiced Active Release Therapy. I had advised him that I wanted to see if I would respond to the treatment without having to go to the expense of diagnostics. Active Release Therapy, or ART, treats soft tissue disorders through various massage techniques applied with specific movements. It can be beneficial in treating various issues with muscles, tendons, ligaments, fascia and nerves. It’s appropriate for various sprains, strains, pulls and tears. I did get some pain relief with treatment, but wasn’t responding as quickly as my Chiropractor had hoped. It was evident that further assessment was needed, so I went to have my knee imaged.
MRI of Knee Injury
I arrived at my local radiology center for my MRI. They promptly outfitted me in a lovely moo-moo like gown covered in a quaint floral pattern reminiscent of a grandmother’s curtains. With all of the advances we’ve made in society are there no improvements to be made in the area of patient fashion? But I digress… The MRI itself was quick – I made like a statue for 15-20 minutes and they got what they needed.
The results took a day or two after that. In my mind I thought they were going to say I had torn my meniscus. I kind of wish that was the case. As it turns out, I had a chondral injury. Basically, the articular cartilage that protects the knee joint had chipped away in one area. Unfortunately, this cartilage can’t repair itself. I also had tendinopathy and an MCL sprain. A consultation with an Orthopedist was in order.
I went for a consultation with an orthopedic surgeon to discuss the chondral injury. First he ordered a series of X-rays to assess the overall status of both of my knees. He advised that I had a Grade IV chondral injury – essentially a full-thickness loss of cartilage. My bone was exposed causing some edema. I had two options to address the issue – micro-abrasion surgery or an Osteochondral Autograft Transfer System (OATS) procedure. He ordered Physical Therapy and told me, with regards to surgery, to contact him when “I can’t live with it anymore”. He also had bad news for me – no more running! I immediately asked if I would be able to run again after recovering from surgery and the answer was devastating – NO. Even after surgery the knee would be vulnerable and running was no longer in my future. I was gutted!
I began a course of Physical Therapy almost immediately after consulting with the surgeon. After my initial evaluation I started out with two sessions per week, supplemented with a twice daily home program. At my appointments we worked on strengthening my VMO (Vastus Medialis Oblique – which is the quad muscle that is most responsible for knee stability), hips and core. Each visit was a combination of electronic muscle stimulation, resistance band exercises, treadmill exercises, and balance exercises. Although I got off to a slow start due to pain, I eventually started seeing vast improvements and they really started to ramp up the difficulty of my exercises. As I progressed through my Physical Therapy regime I continued the A.R.T. therapy with the Chiropractor to also help manage pain and recovery.
So months later, I have been discharged from Physical Therapy but continue to do my home program to maintain my strength gains. I have A.R.T. about every 3-4 weeks to help manage pain. At this time I don’t think that the pain is great enough to warrant the expense and recovery time of surgery so that’s on the back burner. However, I will be consulting with a Regenerative Medicine doctor soon to see if they have any treatments to offer.
After a long stretch of disappointment and denial about not being able to run I have replaced my running routine with cycling. Consequently, I invested in a new road bike (a colossal improvement over my OLD hybrid bike – DECADES OLD) and have started building up endurance. I’m currently averaging 15 miles a ride and try to improve my speed and incorporate more hill climbs each time I venture out.
It took a few months to get to this point mentally. The knee injury was a hiccup that I didn’t imagine before it happened. The irony was that it wasn’t even caused by the running – it was a mishap with my dogs. The hard part for me, the part that made me depressed and still gets to me now and again, is that it’s not readily “fixable”. Although I still find myself resenting the fact that I can’t run again (at least with any frequency or distance) I am learning to fall in love with cycling. I’m embracing a future of cycling and Aqua-Bike events. In doing that, I am also opening up to a variety of other activities as well. I’m looking at my knee injury as a blessing in disguise. I’ll keep you posted about how the journey goes!