Thursday, August 25, 2011

Moving Forward...

Urf, this is not gonna be a "happy" post, but more of a reflection on how much of a dumbass I am what is going on in my knee. This "little" knee injury has turned out to be a not so "little" knee injury after all.

After Sunday's 10 miler in the trails of Rockefeller State Park the shit really hit the fan. It hurt SO bad to walk on Monday that in agony I texted my coach with what to do just so I could WALK comfortably. He suggested Advil. Amazing what 600mg of Advil does when it kicks in. I had a brand new knee!

Unfortunately an NSAID is not a long term solution and only blunts the pain before it wears off.

Tuesday was slightly better.

Wednesday was even more slightly better.

So what is wrong exactly? Seems to be a combination or one of two things: Patellofemoral Pain Syndrome(PFPS) or Chondromalacia Patella (CMP).

Basically my knee cap, the patella, is not tracking up and down (it is tracking laterally) and the cartilage underneath the knee cap has gotten roughed up.

The CMP makes more sense because one of the symptoms is "movie goers knee." Yes! That is a real term! Basically if you sit in a chair for an extended period of time, then straighten your leg, your knee gives you the middle finger and makes a cracking sound called crepitus! Guess what? I sit in a chair all day and I actually went to the movies last night. It has hurt like a bitch the last three day standing up from a chair.

At night when I sleep, my leg is straight, so in the mornings when I get up the knee is fine and doesn't hurt.

I chatted with my PT and when she says she is out of ideas, that is not a good thing when she says this. She suggested I visit an orthopedist. This makes sense, because if I push on the inside edge of the patella bone, it hurts, which suggests a possible bone fracture. Only an X-Ray or MRI can confirm this.

Soooooooo, in the meantime, what the heck do I do? Well, I am off to a wedding in upstate NY this weekend so that means more rest, which I am totally in love with! I visit my general practitioner next week and when I see him, I am requesting a referral to see the orthopedist.

Now what if things don't improve and I am out of commision this fall? Well, there goes the NYC Marathon. YES! I know it is still a waaaaaays away, but I have already accepted that not doing this race is not going to ruin my year. I think I have done enough already! Don't you think?

My #1 priority right now is to A) figure out what's wrong, and B) to get healthy for next season for Ironman Mont Tremblant.

A marathon is a cute little thing to run (I kid! I kid!), but I have bigger fish to fry! I am hoping this "thing" goes away quickly, because I would REALLY like to hammer out the NYC Marathon and end the year on a high note.


  1. Interesting.

    Don't they sell those little knee straps to help the Patella dude move how it's supposed to? Maybe yours goes the wrong way for that little strap.

    Great mindset. Sounds like swimming is still allowed. How does biking feel? Does that mess you up at all since your knees are bent?

    You are fine on the marathon still. You still have a great base and you are not ramping up your mileage a lot for any run program yet, keep your cardio up if you can and you will be able to jump right back in. Heather and I trained for the Cleveland marathon with a 5k base in under 3 months.

  2. Right? I totally respect the marathon since that's what I came from, but with all this IM stuff 26.2 definitely feels like a "cute little thing" at this point!

    Hope you figure all this out -- being injured is the worst. But I think you've got your priorities (ie. getting fully back to top speed for IMMT) completely straight.

  3. Keeping my fingers crossed for you buddy! I hate to wish the sfx of horror on anyone!

    Just keep icing and resting and for the love of god stop running. Swim and bike only and only if it doesn't aggravate it.

    Also, your year will still end on a high point even if NYC is out because you are a (in the words of Emily) MOTHER F*CKING IRONMAN.

    Just saying.

  4. Ugh! I've had PFPS - I wound up on crutches for 2 weeks, and was not allowed to do ANYTHING for over a month - no walking, swimming, riding, anything. All while my physio guy tortured me twice a week.

    Eventually I was told I could do yoga, so I tried hot yoga, and honestly? IT worked! It helped strengthen both my knee and my back (which I'd injured years earlier and figured I'd have to put up with forever).

    It's five years later now, I don't do as much yoga as I should any more, but I've had no knee pain in over four years, and ran my first marathon this year. (Messed up my ankle, but that's a different story).

    Good luck - you've had a great year, work on getting well for next season!

  5. Aw, sorry dude! I hope the doctor has some sort of quick-fix explanation and you're back to running soon. I'm glad you have a good perspective on IMMT being the goal race in case NYC doesn't happen though.

    PS. Maybe stop wearing the size 8 pink sequinned heels? Those teenage girls shoes will do this to your legs EVERY TIME!

    PPS. :)

  6. Really sorry to hear about the status updates on your knee. Morgan's advice is right on, definitely don't run right now. Only swim or bike if you don't feel any pain. Basically, only do something if it seems like it is pain free. Swimmming might be the best call right now.

    Reading your post, it felt like I was reading exactly how my knee injury went back in April. The symptoms and the pain you are feeling are almost exactly the same. Walking never gave me much pain, so that is a little different.

    I think it's a good call you are seeing a sports doc to get his diagnosis. My hope is that you don't have a fracture. My guess is that you have the same injury that I have - strained meniscus on your left knee. And that rest and rehab will be the main solution.

    Unfortunately, I would probably start to not think about NYC marathon anymore, because this injury might take a while to heal.

    This is the patella strap that I bought after talking with 2Slow4Boston. I haven't actually tried it out yet (since I can't run), but sometime I might try it. I may even try it on the elliptical next time I go to the gym.

    Good luck with the appointment, and hopefully you will be back to normal soon.

    And about Lord Huron, Outside Lands was the first time I heard of them, they are awesome! Arcade Fire is indeed awesome too, it was the 3rd time I've seen them (Coachella 2007, Coachella 2011, Outside Lands). That cover you sent me of the other band for The Suburbs was a good one! I really like seeing the music video when the song is playing.

  7. Oh no... I hope it is nothing too serious and you will be back running again soon! But I think you are thinking about it the right way to take it easy so that you are healthy for your IM

  8. You should have started the post with, "I am not a doctor but did stay at a Holiday Inn Express last night".

    Just get your ass to the Doc so he can tell you to "rest for 6 weeks". Fight him for that referral of he is being difficult. In the meantime, take it easy and quit running on the damn thing jerkhead!

  9. If you had consulted with me I would have told you to go to Johnny's in Mount Vernon for the best pizza you have ever had (bring cash that is all they take) then go to the Doctor get the referral be told to stop what you are doing for a while and rest (you love that already) and then go back to see him so he can tell you its great and looks good and you can start to run again and crush NYC.....told you to consult with me first.

  10. Jon,
    I haven't commented around here before, but have been following you most of this year. I even did IM Lake Placid with you (well... a bit behind you). My wife has had similar knee issues. Her knees are actually far worse than what you are describing. Here is the advice she gives:
    Your patella is not tracking properly which is causing the cartilage to rub, leading to inflammation. The most likely cause of the improper tracking is an imbalance between the outer portion of your quad, VMO and outer hip/thigh muscles. Complete rest is a bad idea because it will lead to more atrophy.

    You need to ice (if you haven't been doing already) after every workout to reduce the inflammation. You also need to do targeted exercises to strengthen your VMO and outer thigh. Look up "skater or plyo lunges" for an example of these. You should probably continue to run, but shorter distances on even, cushioned surfaces (i.e. even dirt trail). On the bike, hill workouts where you are cognizant of engaging your VMO.


  11. BAH, indeed. I've befuddled my PT a few times and it doesn't feel good. Ice that puppy and stay off of it!

  12. I hope with some extra rest and ice you can get your knee to behave itself!

  13. Man, this just plain sucks. Hopefully you get some good advice from the specialist though.

    Like a couple other people mentioned, look into the bands. I had horrible knee problems after my first full marathon in 2005. So bad so that I didn't run for nearly 3 months (probably not what you want to hear).

    I used the Patt Strap ( when I started running again. Wore it for about a year and haven't had problems since. I probably didn't need to wear it for a full year, but after a while, it was my mental crutch to reassure me everything was going to be alright.

    Good luck!

  14. I have actually heard of movie-theater knee. A guy I ran with a few years ago claimed he had it (he seemed to make it up after going to a movie) so we gave him a hard time. He quit running (though was never super into it anyway). Guess we should've been more understanding.

    Massage it with some movie theater butter and get well! :)


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