The Winter Doldrums or Where is Santa When You Really Need Him?

I just got back from Physical Therapy and like much of life, there was good news and bad news.  More on that later.

Following Tussey Mountain, we along with most of the mid Atlantic and Northeast suffered through Sandy.  My heart still aches for those folks in New Jersey and New York.  I just cannot imagine how they're coping.  We were without power for 12 days, and because I had no way to shower, I skipped on the running.  It turns out that was probably a good thing, because after our power was restored I set out for an easy 4 mile run just to loosen things up after the 50.  I knew immediately something wasn't right.  I was experiencing some major soreness (pain) in my right knee.  I forced my way through the entire workout and made it home, but it was not fun.  I rested a couple of days and tried it again with the same results.  (isn't insanity doing the same thing over and over and expecting a different result?) 

One of the benefits of working at a hospital is the ability to sometimes get a doctor's appointment without waiting.  I called one of our Orthopedic Surgeons who specializes in sports medicine and he agreed to see me that afternoon.  Following x-rays and a comprehensive exam by Dr. Pavlovich and his athletic trainer they determined it was just a Pateller Tendinitis.  Dr. P explained it was caused by repetitive motion and overuse, as are most non traumatic running injuries.  He showed me on a model how micro tears occur and assured me they will heal.  The good news was he said I could continue to run and not hurt it further.  I tried to do some short runs followed by icing and stretching, but the pain (or more accurately, soreness) persisted.  I'm thinking to myself, we need to get a little more aggressive about rehabbing this baby, so I called Dr. P and asked him for a PT referral.  This was two, maybe three weeks ago. 

My therapist is an athlete and fully understands my need and desire to get rehabbed and back on the road/trails.  She quickly identified a fairly significant difference in the strength of my right hip/leg from that of my left.  She told me all problems begin in the hip.  Ditto with the flexibility, even though I regularly stretch both pre and post run.  Vanessa gave me a series of exercises to do at home along with some new passive stretching and told me to see her in five days.  I rigorously followed her program which even allowed for an easy 3 mile run each day, followed by the ever present ice.  After my next visit, she saw some improved strength and flexibility and gave me some more aggressive exercises and told me I could mix in some 4 mile runs.  Even with a little 4 miler, it really seemed like progress.  After my next appointment she told me I could do a couple of 6 milers with shorter ones in between.

I was feeling "pretty" good and wasn't experiencing any symptoms until 2 or 3 miles and then the soreness would return, but was fairly minor.  I was feeling pretty good about things and decided to do 6 that Sunday.  There was some more soreness, but it wasn't too bad.  I did two 4's the next couple of days and then another 6 and was feeling "OK."  At my next PT appointment, Vanessa said I had improved objectively and told me I need not come back unless things got worse.  She gave me some more aggressive exercises and said to call if I had any problems.  I told her I was going to attempt 8 that Sunday and she said OK, with no negative body language.  I think that must have been too much too soon.  I muscled my way through the 8 with a good bit of soreness the last three miles.  I iced it and stretched and had no residual soreness that day.  I did an easy day on Monday and then tried 6 on Tuesday.  That's when it really began to bother me again.  I did an easy 4 miles on Wednesday and began hurting in the first 100 yards, but was determined to finish the workout.  Thursday was to be another 4 and I did fine for the first 2 or 2 1/2, but then it really began to hurt.  I thought I was going to have to walk home, but managed to finish the workout.

I decided then and there I had to go back to PT.  I called this morning and Vanessa had a cancellation and was able to see me.  I gave her a detailed report of how I felt with the exercises and what had happened  during my runs.  She performed some transverse massage and icing and gave me "the pep talk."  She explained that forcing myself through these painful runs only increases the inflammation and slows down the healing process.  She gave me some revised exercises to do, plus a new running recipe of 3 miles every other day with massage and ice on the off days.  I'm going to see her twice next week.

I'm resolved to not having a quick fix to this thing.  That doesn't mean I'm happy about it, but I fully understand that this type of injury often takes time to heal.  I'm promising myself I won't get down (ask me about that in a few days) and I'll continue with Vanessa's program.  Fingers crossed and promising myself not to do anything "too" stupid.

                                                               Happy Holidays To All,
                                                                                 Jim