Tuesday, October 24, 2017

Meniscus Blues

The good news is that I am apparently pretty proficient at reading images from an MRI. The bad news is that I have a medial meniscus tear in the posterior horn on the medial side. How did this happen?!

Well, I think I have some idea. You may recall a couple of blog posts ago, I didn't exactly train for the Saint George marathon. Also, you may recall in my last post, the Saint George marathon was mostly down hill (especially at the end when my muscles were tired).

I think a combination of those 2 things has lead to a tear in the meniscus in my right knee. I noticed some pain after the marathon and didn't really bother worrying about it until a week afterward. I felt pain on the medial side of the right knee and it didn't really get too much better. I could walk fine but it seemed kind of irritated. I went to PT and to an ortho and he recommended an MRI. They actually handed me the DVD of the images afterward and in the time between the scan and my appt I became an amateur MRI expert. I knew going into my meeting today that I had some kind of tear and where it was.

Turns out it is a horizontal undersurface tearing involving the posterior body segment medial meniscus. I also have some grade 2-3 chondral fissuring of the lateral weight bearing medial femoral condyle. What that means is

1. I have a tear in the cushion between my 2 main leg bones. It is likely degenerative in nature and not something that would (or should) be solved surgically. The prescription is to diversify training (including yoga) and do more leg strengthening.

2. Also, i have grade 2 (mild) or 3 (moderate) degeneration of part of the cushion as well. If i get to stage 4, it could be problems. So the prescription is the same.

There is actually no evidence that the tear occurred because of the marathon nor is there evidence that the degeneration is due to running. In fact, it is quite likely that I would have similar or possibly nearly as sever degeneration just from being alive and moving. That being said, if I make some changes I should be ok and running again fairly soon. The tear may have been there for years and only got irritated by the marathon. This guy seems to know what I am going through. And this is also an excellent explanation as to why it hurts, how long it will hurt, etc.

What I am going to do is the following:
1. Skip Las Vegas this year. I did 2 marathons this year already, Las Vegas is in 2 weeks and I already limped into a marathon this year. I regret trying to cram these in anyway. I love doing them and I have like 9 left. Plus, cramming them actually may cause issues. So, i'll lose some money but canceling a marathon due to injury is not an unheard of thing for me (see Ann Arbor). My mom pointed out that maybe going to Las Vegas this year (due to the shooting) wouldn't be the best. Also, I was just literally in Las Vegas when I flew in for Saint George 2 weeks ago.

2. I do yoga now! I went once already and go again tomorrow. It's healthy and something I can do with Emily!

3. PT with Jaime for a while, leg strengthening

4. Purchase leg compression sleeve. Done.

5. Get good at swimming. I did 3 miles last week (a record) and hope to do 4 this week.

6. Gradually start running again and build up for possibly a half marathon in December or at the very least a half marathon at the beginning of spring season (February'ish).





Monday, October 9, 2017

Ain't it Grand!

I don't know how I did that, but I did that! If you read my last post, you know that I was essentially positive I was going to feel massive pain the entire race and probably not finish. I hadn't done a long run for the first time for a marathon (>16 miles) and I basically didn't run for a month (i jogged but didn't run since my 1/2 marathon in VA in the beginning of September.) So what happened?

I flew in to Vegas and had a quick look around. It was eerie seeing the Mandalay Bay where the shooting took place the week before. There were FBI and police EVERYWHERE. I headed down the strip and saw a make-shift memorial with lots of mourners out. From there I drove out to St. George. There aren't a lot of St George pictures because there wasn't much there. They had a Mormon cathedral that was pretty and had some of the only grass in town. I'm not a huge fan of the desert motif so that typically gets old fast for me.

As for the race, they bused us up 26.2 miles at about 3:45 AM and it was FREEZING at the start. They had some small fires but not enough for the 6,000 people there. After shivering for about 2 hours, it was time to start the race.

I told myself that if I ran above a 7 minute first mile, I didn't deserve to finish. And I took that advice. I ran a 7:20, 7:20 for the first two miles. Those would turn out to be my slowest miles of the race! The race is very NOT downhilll the first 15 miles. In fact, it had 1 very memorial uphill into the sun. But my biggest surprise was that after the first mile, I didn't have any posterior tibial pain. I told myself to check in at mile 4, 8, 12, and 16. If i took advil before 8, it was a bad day, if i took it at 16, that's a normal day. And as it turned out, i took it at 16 (Actually 15 but that was for water purposes). 

I got stronger and stronger as the race went on. I was able to fight through the typical late mile mental hurdles and finished with a 3:07! I was definitely helped by the downhill sections, but I could have easily broken 3:06 if i didn't jog the first 2. This is definitely a PR course. 

During the race, I just concentrated on the normal gait (as described in the chart below). This helped me concentrate on foot placement on my foot strike. 





I outpaced a guy at the end with a kind of gallop (since my calves were ceasing up as per typical at the end). It felt good beating folks again!

After the race, I quickly showered and headed on down (a 5 hour car ride) to the Grand Canyon! I hung out in the village that night and then went for a 3 hour mule ride on the edge of the canyon. I was given "Big Steve" who is a 1700 lbs mule. A guy on the trail walked up and announced that Steve looked like a Clydesdale. He was a biggie alright. Had a great time. Here is Steve and I on the very edge looking over.







Next up, its back to Vegas in a month with Emily! Its a unique evening/night time race which should be fun. It's the desert so it will likely get cooler as the race goes on (which should be ideal for me). We'll see!

Thursday, October 5, 2017

Ugh

The beginning of half season was so good! I killed a half marathon up in Virginia. I ran a 1:26 which for the first of the season is best ever! Then the next day, i turned my ankle at Special Olympics...

It's been a month since and I have been rehabbing ever since. I fly out to St George for the marathon tomorrow morning and I am having some serious doubts. I was unable to complete my long run 2 weeks ago. I thought I was better but did a tune up run last night (just 4) and it hurt. The only bright side was that it was on the anterior of the left ankle whereas previously I was feeling some posterior tibial tendinitis or soreness. This is my bad ankle... the one that i always sprain or develop problems in.

So now I am on hold to see if I can cancel flights and hotels this late in the game. I have a feeling the answer is no. I think I can be hook or by crook finish the marathon on Saturday. I do worry about doing damage or even at the very least not having a fun day. I have 10 of these left and I would hate to just do it to do it.

That being said, since the pain in the ankle is in a new place, it could be caused by me overdoing the stretching/band work I have been doing this week. If that's the case, it may be 100% on Saturday.

I've been to the Podiatrist (nothing broken, no permanent damage by running according to him) and physical therapy and I think I can finish. Oh, and I'm going to the Grand Canyon! So that should be fun. Just need to gut it out on Saturday. It may actually be my most difficult marathon challenge to date...