I ran I ran I ran!

Alright, faithful readers. I have been a major slacker this week. I can blame Thanksgiving for some of it (cooking my first turkey was rather time consuming), but some of it was dread about reporting what I have decided to do concerning my marathon.

The PT surprised me on Tuesday by telling me that the pain in my knee from Sunday was not necessarily a big deal. As Jorge said (shout out to you, because I know you actually read this--thanks for that :)), sitting on the plane and sitting in a car until it broke down and then having to walk on a steep camber to get antifreeze is probably what caused my knee irritation to return. PT still gave me permission to run this week if I wanted to and if my knee felt up to it. =D

I ran 3 miles on Thursday morning around a nearby high school track-- no problems! So then on Saturday I ran 5 miles around a dirt track at my favorite running park. The path included some  hills and cambered surfaces, but still no knee problems. I can't wait to report back to the PT tomorrow!

This Sunday is the half marathon that I signed up for as a part of my training for the Mercedes Marathon. It's scary to think what I should be doing to prepare for this marathon and what I have actually been able to do. I should have logged 20-22 miles this past week...I did 7 and was very grateful for those 7 miles. The question is, do I want to be really stubborn and stick with this plan with a much greater chance of causing myself some serious injury and probably run a crappy race (if I get there), or do I want to take the time I need to build muscles in my knees that will allow me to run a marathon well? I think I have decided that I would rather do the latter. I am going to run the half marathon this weekend (or run/walk it if necessary) because I really want to. After this weekend, I'm going to get a gait analysis at my PT and maybe try on altering my form a bit if he thinks that will help to prevent injury. After that I will try to do some other half marathons up until the wedding. If all goes well, I'll start training for a fall marathon when Rob and I get back from the honeymoon :) (Sidenote: The wedding is really sneaking up on me--where has time gone!)

Since the whole point of this blog was to encourage me to follow through with the Mercedes Marathon, do I continue keeping a record of my "progress?" I can't help but feel like I've let myself down. :(

Return of the Knee Pain

Well... the rest of my week went mostly as planned. The only change I made was that I only biked for 40 minutes on Thursday because life got crazy and I ran out of time. I even got up at 5:20 on Friday morning so that I could do my run before Rob and I drove to Atlanta so we could catch our flight to Miami to go to his cousin's wedding.

We flew ATL-FLL on Spirit, because it seemed cheaper at the time. After needing to pay $50 for a carry-on bag (yes, FIFTY!) and gas to and from Atlanta, we probably didn't save enough money to make it worth it. Bonus, the Fort Lauderdale airport is about a 45 minute drive from his parents house. I am so grateful that they agreed to pick us up. We decided to go see Wreck it Ralph at 10:00. Let me say again, I was awake at 5:20 central, so by the time the movie started I was ready to fall asleep, but anyway... I made it through. I love me some Pixar, and while this one wasn't as laugh-out-loud funny as others, it was really very clever. Recommended:)

The wedding on Saturday was really beautiful. Congratulations to the new Mr. & Mrs. Franco. The groom was sick though--poor thing :(

The lovely bride with her dad.

Our flight back to Atlanta left at 7:40, so Sunday was another early morning for me. The flight went fine, but on our way home my van overheated and we had to walk a half a mile or so to the nearest gas station to get some engine coolant. I don't know what's wrong with it--I replaced the radiator last year because this one had cracked. It overheated three times on my way to work this morning. If it's not one thing, it's another!

Rob and I walking down the highway :)

Sunday is when my knee started being a problem again. I had planned to do 2 hours of biking (good gracious) and after about 40 minutes I was just too bored. So I decided to try the elliptical for a little while. After about 20 minutes my knee started feeling funny, so I stopped at 30 minutes. and today it is noticeably painful. I'm so discouraged...I'm on the verge of throwing in the towel and saying that I won't be able to do this marathon :( I'll see what the PT says tomorrow.

PT round two

Yesterday was my second visit to the PT. Let me tell you, going there inspires me to continue taking care of my body, because the last two times I have visited the therapist literally every other person there is an old lady who has no balance and no strength. I want to be a fit old lady (relatively speaking)!

Chris seems to think that after one more week of biking, we can start talking about working in some running! :) He even hinted that I may be able to run the half marathon I have planned on December 2 in Fernandina. I'm glad he said so, because I have been thinking the same thing. My knee has been mostly okay. I'm still icing it once a day, and for some reason the icing is what causes me the most aching and stiffness. Most of the time I don't even think about it anymore.

So far from this experience, I have learned that you can get a seriously good workout from "spinning". I always scoffed at those low-resistance stationary biking classes that some of my friends are obsessed with, but if you do it right it can really get your heart going! Last night I set the bike at "8" and alternated miles with a 100-105 RPM and 114+ RPM for 11 miles and I was sweating like a pig and huffing and puffing like the Big Bad Wolf. 

I have also learned that I have seriously underestimated the importance of stretching and strength exercises. Yoga moves are particularly awesome for improving flexibility, balance and strength--must continue to do those even after I heal.

Today and tomorrow I'm going to do 45 minutes of biking, plus the strengthening exercises the PT recommended and some foam rolling/stretching/yoga.

Rob and I are flying to Miami on Friday to go to his cousin, Linda, get hitched. I love that I was there when her soon-to-be-husband proposed to her, and now I get to see the result of all of their hard work and planning! I will take my resistance bands to do strength stuff on those days, but I will probably leave the foam roller at home this time. 

Sunday will be another excruciatingly long stationary bike ride (hopefully the last). I'm supposed to be running 11-12 miles, which means an hour and a half to two hour bike ride. Oh my gosh...I'm already dreading it!

Kitchen and Stationary Bikes

Today I was supposed to run 9-10 miles. Since I have not been given the "okay" to run again, I rode a stationary bike for an hour and 40 minutes, making sure to keep my heart rate between 165-and 175 (about what it is on my long-slow-run days.) Stationary bikes are far more mentally taxing than running, easily. My knee feels great, and my legs were shaking when I got off the bike-- so all in all it was a good day.

Rob is putting the finishing touches on our remodeled kitchen, which he completed himself. IT looks so good! We are going to Melting Pot tonight as a biking reward/Kitchen finishing celebration/ I just love Melting Pot visit. We can also make it a celebration of 2.5 years together, which will officially be on Tuesday :)

No meniscus tear. For real this time.

I had my first visit to the PT yesterday, and he did some of the tests that are typically performed to see if there is a torn meniscus (like the Dr. should have...just saying.) Chris (PT) said that I do not have a torn meniscus, but that I do have very poor alignment between my hips, knees and feet. His theory is that when I backpack, I usually irritate my knee just because of the way I move, but after most hikes I rest it so it doesn't get worse. After this hike, however, I continued to run and irritate my knee more and more, until my knee cap popped out of it's usual groove (hence the popping noise). In response, the muscles surrounding my knee stopped working as hard, so as to not further throw my knee out of alignment, and they got weaker (hence the feeling of instability). I am so glad I didn't pay for the MRI! I can visit the PT 10 times for the same amount of money that an MRI would have cost me.

He wants me to take 4 weeks off of running and do daily hip, quad, and ITB strengthening exercises, and that I can still bike for cardio as long as it doesn't make my knee hurt. If the 4 weeks is enough for me to heal and start training again, that will leave me 11 weeks to train for the marathon. I have contacted the race organizers to see what I can do if I don't feel like I can complete the race by February, and they said all I can do is defer my race until 2014. I'm going to do my best to finish it, going into it with a mentality that I might have to walk some of it... but the good news is that I can wait until the Monday before the race to decide if I want to defer it or just give it a shot.

Fingers crossed for me:)

Is running bad for your knees?

I had a confrontation with a friend last night, who is terribly concerned that my "obsession" with running will cause me to become a cripple later in life. Coming from a non-runner who is not a doctor, it kind of ruffled my feathers to be honest.

I started a regular running regimen in July, so I am really in my infancy as a runner. I haven't learned what to do or what not to do, or what the best practices for caring for my body might be. I am not a stranger to knee pain, however. My knees typically start hurting about 3 hours into any backpacking trip that I do. What I have always done when this happens is push through it. The joy of hiking overrides the pain in my knees. My friend's concern is that I run far more often than I hike, so my knees are doomed to simply fall apart.

It's important to note that I have NEVER tried to do anything to alleviate or prevent knee pain, aside from wearing a knee brace on hikes after the pain starts. I truly believe that had I done strength training focusing on the muscles surrounding my knee, I wouldn't have developed this, what I know have decided really IS a torn meniscus--insert foot in mouth HERE. So which view is correct? Is running inherently bad for my knees and will ruin them no matter what I do (so I should therefore just stop running) or can I take steps to prevent future injury by focusing on strength and flexibility?

When running, the knees of a runner absorb a force equal to EIGHT TIMES their body weight. For me, thats 1,040 pounds every step. It seems logical to assume that such impacts over hundreds of miles and years would add up to a person who has joints that simply do not function anymore.

"But over the past few years, an emerging body of research has begun to show the opposite, especially when it comes to running. Not only is there no connection between running and arthritis, the new studies say, but running — and perhaps regular vigorous exercise generally — may even help protect people from joint problems later on."

"In fact, a "normally functioning joint can withstand and actually flourish under a lot of wear," says Fries. Because cartilage — the soft connective tissue that surrounds the bones in joints — does not have arteries that deliver blood, it relies on the pumping action generated by movement to get its regular dose of oxygen and nutrients. "When you bear weight, [the joint] squishes out fluid, and when you release weight, it sucks in fluid," says Fries, explaining why a daily run or any other workout is useful for maintaining healthy cartilage."

Read more: http://www.time.com/time/health/article/0,8599,1948208,00.html#ixzz2BdjSXFFi

This article cites a couple of longitudinal studies that show the natural assumption that running is bad for your knees is untrue. Now I know, a person could google until their fingers turn blue, finding articles that say the exact opposite. To me, that shows that it is inconclusive...and if this is something that I love to do, and there isn't sufficient evidence to tell me that running is going to ruin my life, I'm going to keep doing it. As soon as my physical therapist gives me the "ok." My training will be more purposeful now, knowing that my knees are a weakness, I will work to make sure that they are strong enough to withstand that 1,040 pounds of force.

Thoughts on this? Particularly from other runners?

This is why I hate going to the Doctor

1. It's inconvenient and time consuming
2. Most of the time I feel like I leave knowing nothing more than I knew going into it.

I understand that the body is a very complicated thing, and sometimes it can be very difficult to diagnose problems. Knees can be particularly tricky, because there are so many cogs to that particular machine. Still, I just spent 2 hours of my time waiting for a doctor to come in, jerk my knee around for a little bit, and tell me that it's not a ligament problem or a fractured/broken bone. He then tells me that I need to come back to get an MRI to see if I have a torn meniscus. MRI's are expensive, even with health insurance!

So, I turned to the next best choice: Wikipedia. Below is what I learned:

1. "The 'Cooper's sign' is present in over 92% of [meniscus] tears. It is a subjective symptom of pain in the affected knee when turning over at night.

Doesn't happen to me.

2. "In meniscal tears, pressing the joint line on the affected side typically produces tenderness"

No tenderness on either side.

3. Bending the knee (into hyperflexion if tolerable), and especially squatting, is typically a painful maneuver if the meniscus is torn.

I did a BUNCH of squats on Friday with no pain.

4. "Currently, the clinical tests we use to detect early meniscal lesions have variable diagnostic accuracy.  A few years ago, the Journal of Bone and Joint Surgery published a study which examined the diagnostic accuracy of a new, functional meniscal test, The Thessaly’s test.  The results of this study indicated that the Thessaly’s test, performed in 20 degrees of knee flexion, had a diagnostic accuracy of 94% in detection of medial meniscal tears and 96% in detection of lateral meniscal tears. Other, more traditional tests, performed in this study, had much lower detection rates.

How to perform: The patient stands on a single leg (the effected leg) with their knee bent to 20 degrees.  The examiner helps support them with UE support.  The patient then rotates his/her knee internally and externally.  Complaints of pain, knee locking or catching is considered a + test."

No complaints of pain, knee locking or catching for me.

I'm confused. Why didn't the doctor I went to see try any of this with me? Why didn't he ask me about pain at night, why didn't he have me do the Thessaly's test?

Anyway, I'm not getting an MRI. I would rather buy a GPS watch with that money. I biked yesterday and will bike again tomorrow. Running on Thursday, Friday, and Sunday. Yoga and foam rolling will continue as well. And I really don't like going to the doctor. The good news is that I know it isn't a ligament tear! YAY!