We have determined, finally, that my Time Trial bike caused the knee damage, and running merely aggravated the problem, creating a different injury that was compensation for the original injury.
For some reason throughout the season, my left foot on the time trial bike became more and more crow footed. Why? I am guessing a muscle imbalance in my left leg that caused my left foot to pitch inwards to compensate. Over time, I became comfortable with this crow footed position, but it was doing overuse damage to my knee.
Luckily the knee held out until Placid.
However, once I was done with Placid and my body was recovering from the shock, my left knee had had it and revolted. First the pain started in the medial area (inside). It came and went and wasn't anything terrible.
Then I hopped back onto the time trial bike for the first time in over a month and belted out a 2 hour ride at race pace. Bad idea. This pissed off my knee even more. The next day I went for a 90 min trail run and this finally did my knee in. This was the run that the runner's knee fully developed and I went crying to my doctor and the orthopedist.
On August 31st I saw my primary doctor. He reffered me to the orthopedist. I got lucky! After my referral approval from my primary doctor, I called the orthopedist and was asked, "Do you want to come in tomorrow AM at 9:30, or you can wait until October." I got VERY lucky.
So after an X-Ray, a diagnosis, and immediately starting PT, I was on my way to rehab.
Or so I thought.
After a two week improvement via PT, I was readjusted on my TT bike by my coach, and I went out for a two hour ride on that bike. After 60 mins I was gritting the pain and stopped. I basically undid all of the improvement I had gained and was back to square one. The TT bike was the problem. Running pain was just a side effect. I am not blaming my coach for a bad TT fit. It didn't matter if I had the BEST fit in the world! My leg muscles were simply not balanced and strong enough to handle that strain to support the injured tendons in my knee.
So I quit running and biking for two full weeks and stuck to just PT. This finally worked!
I also requested an MRI to make sure nothing else was going on.
The results were a 2 on a scale of 1 to 10, with 10 being the worst. Things were finally healing!
So far this week I have ran 3 times, with a fourth time on the docket for Saturday. I am slated to run ~18 miles this week!
Some things that helped a lot during PT were:
1) Staying consistent with it
2a) Shaving my legs (for the next item)
2b) Kinesio Tape - this gave me a LOT of support without needing a cumbersome knee support device.
So now looking forward?
No more racing for 2011. Lake Placid was enough for this year, and while I am bummed that I am giving NYC another pass, its ok. The down time has been needed. Its been making me HUNGRY for next year!
And this is why I am staying with my coach till the end of time because he understands my injury and is conservatively building me back up for next season. Ironman Mont Tremblant is still a looooooooong ways away, and that is the #1 goal right now.
However! I would like to make a good campaign attempt at the NYRR running circuit this winter and into the spring, as well as some destination races to explore other city's venues.
Have a great weekend!