Friday, April 11, 2008

makin' it up as i go along...

Well here I am. Just over 8 weeks since I stopped running..

I know that some members of my family and some friends read my blogs (lurkers, the lot of them) so I won't put a figure on the sum of money I have thrown at my knee injury since then but let me add up:
- 4 physiotherapy sessions at our local sports injuries clinic;
- 4 weeks of paid parking at the bottom of Steep Hill instead of free parking at the top of Steep Hill;
- 1 initial consultation with a podiatrist which resulted in:
- full gait analysis with a podiatrist and the manufacture of custom orthotics;
- new neutral running shoes;
- and the purchase I resent most of all - a pair of flat black court shoes to wear to work, wide enough to fit my orthotics and with no heel so as not to interfere with orthotics magic..

And where am I? Well my friends, not a whole lot further, or better.. When I first went to the physio I was only really in some pain after running a long-ish distance - 8+ miles. Not good at all, given what I want to do with my running, but I was able to generally do the shorter distance without any major discomfort. The pain was primarily in one knee. Since going to the physio and doing twice daily exercises (and laying off running, breaststroke and downhill walking) the pain has become more constant and is now presenting itself in both knees. About 2 weeks ago I decided to stop doing my physio exercises to see if the pain diminished. It did, somewhat. But when I went back to the physio with this information he was convinced that I was just pushing too far or too hard and that I should keep them up, albeit with less vigour. 3 days after doing that I found that I was, once again, getting pain behind my kneecaps, so, once again, I have stopped the exercises. Only about 5 days ago but I do think that things are getting better. In the meantime I picked up my orthoses last week and I have been slowly wearing them in. They seem fine, are not causing me any discomfort and I am now able to wear them all day. I think it is too soon to tell whether they will help - they certainly do not appear to be a hindrance.

But this still leaves me with a mild pain in my knees, sometimes behind the kneecaps, sometimes on top of the knee, sometimes at the bottom, sometimes at the side. I don't really feel I am any further along the road to determining what's wrong or how to make it really better. Stopping running doesn't appear to have worked. I have given the physio quite some time and, if anything, it's aggravated things. The orthoses may well help - the gait analysis showed up a pronation that I've never known about and which my physio had noticed as well.

Now what though? Patience huh? It's not that I'm being impatient (although I am definitely an impatient person, hadn't you guessed that by now?) I would be patient with any particular strategy if I thought it was working.

So I'll tell you what I'm doing now and you can tell me what you think:
- I've cancelled next week's appointment with the physio. I need time to consider whether I want to go further down the road, and further down the road with this physio - however much I like him and think he is trying to help me;
- I've booked an appointment with an osteopath. I did suffer from runner's knee before my NYC marathon and he managed to help me then without stopping me from running (it helps that he's a sub 3 hour marathoner himself). I didn't go to him straight away this time because I thought that I might be helped more by a physio but now I'm beginning to doubt that thinking.
- I've started running. Yes.. I know. I got so fed up (and so excited by the thought of my new running shoes and trying them out with orthotics) that I decided to try - very slowly. I went out for 1.4 miles yesterday and today. Fine both times - no pain - and no increase in pain / soreness afterwards in the evening. I figured I could try this over the weekend and see what my osteopath says on Monday.

Then there is the appointment with Chris Griffin, the ChiRunning instructor in California in 2 weeks as well. My physio thinks that it is likely that the cause of the pain is biomechanical as I have it in both knees (although he does always mention the option of surgery as well) and my podiatrist agreed. ChiRunning should address biomechanical issues quite directly..

Am I crazy? I don't know. As long as I'm not making things worse by going on (very short) runs, I guess I'm not. Am I? And I guess I don't know whether I am making things worse..

I wonder how much of everything is mental as well. I find myself constantly checking in with myself - are my knees sore? If so, where? Honestly, I bore myself rigid and you as well, no doubt. I'll stop now.

But any thoughts / ideas / inspirations / experiences on your part would be very welcome...

And let me not forget - the wonderful Drusy is running the London marathon this weekend. Big shoutout for that wonderful lady who has trained so hard and so well, and raised lots of money for the Guide Dogs. I will be following it on TV all day and hope to catch sight of her.


Zach said...

I think you're taking the right steps, if you'll pardon the pun. I was going to advise to get a second opinion from a sports medicine doc, but your marathoner osteopath sounds close enough. Just remember, what doctors do is called "practice" for a reason.

Susan said...

Oh Petra, I know you are majorly frustrated. I was in that boat in 2005/2006 -- medical intervention seemed to only worsen my problem. Only time was able to help.

But I think you're in a differnet boat. I saw switch doctors, as you have already decided to do. It can't hurt, right? I agree with Zach -- they call it "practicing" medicine for a reason. Ha!

I am envious of your run. I feel I could probably do the same now, but I am too scared to do so. It has been 88 days since I ran last. Aargh! Going crazy!

Maddy said...

When you stopped the exercises the physio you felt better, but he was not convinced. - I think it was wise of you to stop the exercises and to cancel your appointment.

I bet those two runs were glorious!

I think you're on the right track!

Take care of yourself - you have a marathon to run in October!

lizzie lee said...

Petra, I am sorry to hear the count of 8 weeks. I certainly support going to a marathoner osteopath as they understand the feeling of being idle.

I know that every knee is a world and all of us are different, but I had a similar case last year. And the pain started by mile 8-10.... and was unbearable. Also I had a terrible pain in my insteps. Never knew the reason, or how the pain was totally gone, but if any help there were 3 things that happen at the same time. 1) I got rid of superfeet. 2) I bought 54" shoelaces and I could play with the "tightness" by the insteps. The pain in this part of the feet has disappeared, and I will never know if this was related to the knee pain. 3) glucosamine /chondroitin/MSM. So because one of these reasons, or the combo, my knees and feet forgot the pain.

I wish you the best. take care
lizzie lee

IrishBlue said...

Bless your heart. You sound very frustrated. I think you are taking the right approach. I also switched from a non-running doctor to a sports medicine doctor who runs marathons. His approach to my foot problem was very different and seems to have worked.

Like Lizzie, I've started taking glucosamine /chondroitin/MSM in a drinkable form and I swear by the stuff. My joints feel so much better. I also take some motrin before and after a long run. Just some ideas.

Jon (was) in Michigan said...

Are you crazy? I don't think so.

I took a ChiRunning class from Danny Dreyer in Ann Arbor. Damn good stuff. I had a hard time with it because I was running in traditional (read: high heeled) running shoes.

I had suffered from shin splints forever. In every training session from day one. I went to a sports med doctor, an orthotics expert, I got ART, I had xrays, I did stretching, I did icing, compression, weight training, and more stretching. Years of pain. You know what finally worked? Buying the FLAT shoes like Danny recommended.

No problem since.

I trained for and ran a PR in a marathon last fall with ZERO shin pain. None in training, none in the race. ALL my training was on asphalt and concrete. And I did it all in a pair of Adidas Adizero PR racing flats. Good stuff.

Trust me. If anything can help you, ChiRunning can. But you need to start slow. I mean like, beginner running slow. And get the flat shoes. I don't like the shoes at the ChiRunning site, but the Adizero PR's or Adizero PRO's are good. Also, some folks use Puma H-streets. Find something with a flat, flat, flat heel.

Everyone will tell you that you can't run in flats all the time. Ask yourself, how much do you like running now?

Good luck!

Anonymous said...

I have the same symptoms as you!! I have an intensely irritating pain in my right knee. Sometimes, the pain cannot be pin-pointed. Sometimes, it's at the side, or at the top. Seen a sports injury doctor. Did some X-rays, a detailed MRI, and countless sessions of physiotherapy. The pain got worse after each PT, and so I stopped doing it.

The doctor told me it's most likely a mis-aligned knee cap, and I will just have to wait patiently for it to heal. It's been 6 months though!

I am just so sad - about my knee pain, and about not being able to run.

Anyway, I have scheduled an appointment with another sports injury doctor. Will see how it goes. :(

Road Warrior said...

It's so unfair that your recovery is taking so long and the progress hasn't been quick enough.

I'd recommend going back to the guy that helped you before. If it worked once, it'll work again.

You're going to get through this and kick some royal Chicago butt!

Drusy said...

Petra, what a bummer! How frustrating and expensive...
But I'm with the other comments, ditch the doc that hasn't been helping and go back to the osteopath. You need to run! A psychiatrist would be more expensive!

ShirleyPerly said...

Dear Petra, I'm sorry I hadn't stopped by sooner. Yes, it sounds to me that it's time to try someone new and I'm glad you already have someone in mind. Look forward to hearing how things went today!

jen said...

I can really understand what you are feeling Petra. It is so frustrating to be doing everything you're told and see no improvement. I know you love to run and you miss it a lot, so this is a rough time.

I think you are on the right track with a solution- the other doctor sounds like he could offer some good insight. And I don't think it's bad that you are running a little if it doesn't hurt, and I know it brings you a lot of happiness which can't be bad. :) Hang in there, it might take some more time but you will get past this, I promise!

Can't wait to see you in a week!!!

peter said...

I don't have anything useful to say about your predicament except Good Luck and hang in there! Chicago is still a far ways off so you have time to work on getting better.

Steve Stenzel said...

Dang...good luck with that thing....

CewTwo said...

You have been my inspiration many a time. You continue to do so.

By sharing your predicament, I can learn not only from your frustration, but also from the suggestions of others.

I've had shin splints but was helped by a running mate. They soon disappeared. I do overpronate but that is not odd in a Clydesdale Class runner (200 pounds +).

Thanks for sharing. I may have to get some glucosamine on the way home...

MarathonChris said...

Well it appears you already have a lot of good advice.

I think your instincts serve you well and you should go with it!

Hope the Chi Running goes well and look forward to your report. It is something I have considered (I bought the book) but haven't had the chance to catch a session here in town.

Hang in are doing all the right things :-)

Jade Lady said...

Petra, I know 8 weeks of not running must be hard. 2nd opinion is a good idea. Many of us feel docs should know it all and that they're always correct - but if what he/she is telling you doesn't add up, it's time to look for answers elsewhere.

Good luck, and I hope that you'll find relief in the near future!

lizzie lee said...

Petra, haven't heard from you. I hope everything is going better...

CewTwo said...

Petra, my dear! We all get busy from time to time. You were never off of my radar.

It will be good to see you in Chicago!

Hang in there and remember that I do want to hear the skinny on California!


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Tracy said...

i think you're doing the right thing too..i'm sort of in your boat as well- i'm recovering from PFPS runner's knee in layman's terms. It started in my right knee but progressed to left too. i did go to orthopedics and a sportsmed doctor and got new shoes and insoles, so the pain has lessened (i have to do PT exercises tho to strengthen my hips) and am starting out running very slowly. keep strong! good luck!

Anonymous said...