Tuesday, January 5, 2016

Progress?

I had a nice little cortisone shot to the proximal fib-tib joint yesterday afternoon. It wasn't as painful as rumored but the lidocaine burned a bit like a bee sting. Afterward I stood up and have to admit the knee felt quite a bit better immediately. Then, like 45 minutes later, the lidocaine had worn off and the knee felt mostly the same. I'm supposed to see the cortisone take effect over the next week to 10 days. We'll see what happens!

Cranked some core in the evening; 43 chin-ups, 9 minutes of planks, a bunch of ab variations, and 80 push-ups. I'll wait a couple days before I try running or biking to allow the cortisone to do its thing..

Wishing everyone a great 2016! Onward!

Wednesday, December 16, 2015

Jogs

The inflammation in my knee must have subsided finally, because I can move around with little to no issue. Per the doctor's orders, I'm supposed to run and log the kind of discomfort I have. Over the weekend I ran with long-time friend Ben Jenkins in the Ward Reservation. 5 miles very slow. My right hamstring was cranky but the knee didn't bark once. It felt great to run again.

On Tuesday of this week I ventured out to Andover roads with Alex. I did a number of PT exercises beforehand which I think helped a lot. We ran 8 miles including a loop around the Phillips fields. I felt surprisingly good aerobically. We rolled faster than I wanted from Phillips down to Shawsheen and it felt good but the right hamstring was the tiniest bit cranky again finishing up. No pain in the knee...

Friday, December 11, 2015

Visited the doc

I met with John Boyle out of the North Shore Center for Orthopedic Surgery and we reviewed my MRI and discussed what is probably the cause of the pain/issues that have been plaguing me.

What is definitive is that I have patellofemoral arthritis on the medial side of the knee cap. It's bone on bone for a couple centimeters. There is also some broken, floating pieces of cartilage in there causing an impingement. Apparently, a vast majority of people with this kind of arthritis are worn badly on the lateral side (outside) of the patella but my cartilage there looks fresh as a daisy. He told me very clearly that "going in and cleaning it up" would "almost certainly make (my) knee feel better".

But, given that most of the pain I experience is on the lateral side of the knee and actually behind my knee, he is suspicious that I have inflammation in the joint where the fibula meets the femur. He advised that I begin by trying a cortisone shot in that area. If the shot cleared me of the pain that prevents me from running, then the arthritis, though not good, is probably not the thing hanging me up.

So... step 1, if I want to pursue it, is a cortisone shot. I think I'm going to do it. But I don't know what to hope for. It would be cool if the cortisone shot took the pain away, but the implications of that would mean I have a complicated and difficult to treat inflammation of the joint there. But if the shot doesn't have an effect, surgery might be the only thing that could get me up and running consistently again. I'm wary of the possibility for other crap to result from surgery and in general I consider surgery a very last resort.

I guess the silver lining is I can still bike as aggressively as I want without any pain whatsoever. With or without surgery, maybe it's time to make multi-sport stuff more of a focus. When I consider the long-term, I get nervous that another 15 years of road running will trash my knee for the rest of my life. I've always understood that seriously training would yield some degree of arthritis eventually but I'm shocked at the degree of the breakdown in this one area of my knee. Ironically, the remainder of the knee looks super good. The primary joint in the knee looks "like an 18-year-old's". Completely healthy. My left knee is in super good shape, too.

So maybe I'll schedule a cortisone shot for next week. The doctor asked me to run for a few days to "make it hurt" and be sure the pain I'm experiencing really is on the lateral side of the knee before I go ahead with the shot. Meanwhile, OF COURSE  I'm sure that's where it hurts; I've been dealing on and off with this problem since I started this blog back in 2010.

That's all for now.


Monday, December 7, 2015

Injury update

Unwittingly, I included a bit of foreshadowing in previous posts about what is ultimately a flare up of a condition called patella femoral arthritis. I think I've described it in previous posts, but the basic condition is that due to an imperfect femur, my knee tracks poorly leading to breakdown of the cartilage between my kneecap and femur. Usually, it causes me no pain. And then sometimes it flares up and causes all sorts of pain. Usually, at the same time I develop something called a baker's cyst caused by poor drainage of the inflammation in the knee. The cyst bulbs out behind my knee and causes pain and poor firing of the calf and hamstring. The nerve pain caused by the pressure of the cyst can be felt down to my foot and up to my hip. All in all, it makes for the feeling of an unstable leg and the impossibility of running without a limp.

Basic treatment... varies. You rest. You can have it drained. You can have a cortisone shot. Those things aren't permanent and the likelihood of recurrence is high unless you can do something to basically restructure the tracking of the knee. It's also complicated because as the cartilage breaks down, the treatments, exercises, etc. that worked before won't necessarily work the next time. I used to be able to "pop" the cyst by rolling on a lacross ball and all would be well! ... except I still had arthritis. In this most recent bout of cyst-li-ness, I haven't had success trying to roll it out. Stretching doesn't appear to help. I've been hitting the inflammation with lots of anti-inflammatory drugs. I tried a few different braces which definitely don't appear to help. Certain shoes help.

Anyway, rather than whine about it and get down on myself, I've decided to really pursue an end-game solution. I made an appointment with a knee specialist recommended to me by a couple of folks who have dealt with similar stuff. He's one of those mega-endurance athletes and "gets" runners and what running means to them. I hear he can do some pretty cool stuff that's minimally invasive. It's too early to say this, perhaps, but part of me thinks that if surgery could stave off further damage down the road and allow me to race competitively for a few good years, it would be worth it. Plenty of runners I know have had minor surgery on a knee or hip and come back stronger because of it. The appointment is Thursday and I'm excited to see what he has to say/recommend. And I'm really pumped to find out he is in my network and completely covered outside of a $20 co-pay. Amazing, really. I thought I was limited to the nice but generally uninspired sports medicine department at Lahey... guess not!

Fortunately, I'm able to cycle without pain or sign that it's prolonging the inflammation. Now, I'm off to Breakaway for a group workout on the compu-trainer. Probably won't be training Tuesday-Thursday, outside of standard core work, for this week as Day 1 of winter track starts tomorrow and I'm excited to get everybody off to a good start for the holiday season!!

Tuesday, November 24, 2015

Training 11/23 - 11/29

Monday - 10 miles / 60:47 - pretty quickly cut it down to 6 minute pace and kept it there. 6:00 seems to be about "tempo" or "up-tempo" right now. Aerobically I felt great but the calf got tight around 7 miles which was annoying. I stopped for a minute to try and stretch it out which worked for about a mile before it returned. I was worried I had done some damage but it resumed status quo of being tight but not painful by this morning. The test will be to see how it feels on Tuesday's run. I'll be taking it nice and easy Tuesday and Wednesday.

Tuesday, November 17, 2015

Training 11/16 -11/22

Monday - off. My cat was having some bizarre health issues so La and I spent the evening at the vet instead of on the roads.

Tuesday - 16 miles / 6:28 pace mostly in Andover. I ended up feeling pretty good and ran some of my favorite roads. This is the farthest I have run in maybe 7-8 months. I'd like to have at least one run a week between 16 and 18 as I really feel like my fitness comes around when I incorporate these longer efforts. Treating it like a workout so the next day or two will be nice and easy.

Wednesday - 6 miles / 42 minutes from the apartment. Afterward I did a bunch of lunges, dead lifts with 50 lbs, lat pull downs, sit-ups, curls, shoulder press. The run felt very comfortable aerobically.

Thursday - 8 miles / 56 minutes with Alex from the apartment to the Phillips Sanctuary and back. The Sanctuary course is in really nice shape for private school interscholastic champs. Felt really good aerobically but high hamstrings are thrashed from the lunges and dead lifts from yesterday.

Friday - .25 mi / 1:56 to the gate and back. Calf had been tight since yesterday and it once I got moving it just seemed too risky. A day off made sense anyway after the last 3 days of build.

Saturday - 4 miles slow with a buddy from my UNH days. Gorgeous day for a run. I did my hip exercises today which should have me feeling good for a long one tomorrow.

Sunday - 11.7 miles / 91 minutes in the Fells with the Narcissi brothers. Drizzly day but good company. Always nice to get a little lost in the Fells and end up with a fairly long run, at least in terms of time. 4x25 push-ups after

In summary:

46 miles on 5 days running is another step in the right direction. The calf bugging me on Friday was annoying but totally manageable on Saturday and no discomfort to speak of on Sunday. Feaster Five will be a test of fitness on Thursday and I might try to jump into a local fun run on Saturday.

Friday, November 13, 2015

Training 11/9 - 11/15

Monday: 4 miles easy on the treadmill. Intermittently I stopped and did a wide variety of strength/core stuff including push-ups, burpees, crunches, leg raises, shoulder press, lat pulls, bicep curls (for the obvious reason..), hamstring curls, quad extensions, lunges, dead lifts.

Tuesday: 5 miles easy in the dark during rush hour. Time to start running closer to 6:30pm. This 5pm stuff is too sketchy.

Wednesday: 6.2 miles with Newbould and Alex. 7:10 pace

Thursday: 7.4 miles with Alex in the murky darkness. 6:31 pace somehow. Sketchy visibility and traffic conditions per usual!! I signed up for a 5k on Saturday. That should be... interesting. I'm going to try to take it out around 5:10 and see what happens.

Friday: Easy 5 miles in 34 minutes on the treadmill. I felt fine but wanted to keep it short for tomorrow.

Saturday: I ran the inaugural Penmen for Patriots 5k at SNHU in Hooksett. I got there early so I spent a lot of time warming up on the course. I ran 3 laps, the first 2 alone and the third with Chris Mahoney who happened to be at the right place at the right time. I felt good on the warm-up in lots of layers. Meanwhile I noticed how every time I crested the one long, gradual uphill on the 2-lap course the wind gusted harder, and harder.

The race eventually started and I went to the front to try and clear out any fakers in the race. I also wanted to give myself a chance at a good, fast time despite the windy and cold conditions. In the end, I think going out in 5:04 might have cost me a bit of fight toward the end of the race, but at the same time, I don't think it would have changed the outcome. Chris and a young college grad named Joe were right there into mile 2 and hung through into mile 3 where Chris made a small jump and Joe responded. Vocally, I had been lamenting how I wished we were all on alpine skis in order to experience the 40mph gusts and cold that we were running into, and I guess I got complacent when the move was made.

I gave chase into the last uphill but with the two of them fighting for supremacy I knew my bid at the win was lost. When the leaders turned and saw the home stretch, I watched Joe turn on the after burners and the race was over. I had a tiny inkling that maybe I could catch Chris, but I didn't even attempt so it was more of a mental "what-if", and the gap in finishing time shows it. My finishing time of 16:56 (watch) was slow, but so to was the finishing time of the winner who last year this time was racing XC in the 25s for 8k.

Anyway, this was a good opener because I took it out hard, earned a few bucks, and had fun racing. It also helped scare me by showing that ... maybe I truly am in high 16 5k shape?

It's clearly time to focus!!

Sunday: 3.8 miles nice and slow after dinner. Good core and stretch session after. Felt very good. Long on Monday, hopefully.

Week in Review:

I ran every day this week. That is huge for me. I can already feel the benefits of the consistency in terms of energy levels and feeling generally better each run. Granted... Saturday was the only substantial mileage day and I'm looking at 43 miles on the week which is normally the bare minimum when I'm training at full steam. Feaster Five and Mill Cities Relay in the next few weeks have me feeling motivated about getting off to a good start for the winter season. Goals for this week: 50 miles, a fartlek or interval session, 2-3 core sessions.

Thursday, November 5, 2015

Training 11/2 -11/8

Monday - Off? Locked myself in at work and tied up some loose ends. Home around 6:30 and starving. Bed by 8:30.

Tuesday - 4.2 miles / 6:28 pace on the track before coaching. Better than nothing. Before running I tried out the 10 minute core workout posted on Level Renner this week. My 'T' sure isn't low but I liked the idea of mixing up my routine a bit. It was harder than I expected! No rest between exercises catches up to you. I think I needed to warm-up first. I'll try the session again on Thursday.

Wednesday - 7ish miles. 3 miles up to the track. I threw on some soccer cleats to break them in for a teachers vs students soccer game on Friday and ran 10 minutes of diagonals on the football field. I had some time so I decided to run some 400s on 1 minute-or-so standing rest: 73, 72, 71, 72, 71, 71, 71, 70. Afterwards I led runners through some drills and ran 4 hard 100m strides. Lower mileage, higher quality running for a change! No cool-down.

Thursday - 10 miles steady. 4 of them with a couple of Merrimack College guys. 650 pace or so.  Felt pretty good.

Friday - no run,  but I did score a hat trick in the faculty vs soccer team game. Faculty won 3-1.

Saturday - 11+ miles with JVG and Narc. First 30 minutes in Maudslay and the remainder on roads. Great run! Probably averaged 7:00s.

Sunday - Random workout. The original plan was 45 minutes in the woods easy. But, after hitting the deck and rolling the L ankle twice I'd had enough and got out to roads as quickly as possible. I just wasn't in the mood for a slog on pavement so I went to check out the newly resurfaced Phillips Andover track. I have to say it is beautiful and especially so by comparison to its former condition! I went with the standard 5k run alternating 400s "hard" and 200s "easy". The hard efforts ended up being on the slower side for this workout but it was still fun to open it up: 78, 76, 76, 75, 75, 75, 75, 75, 36 * just to get to 5k. 200m jogs averaged around 50 seconds. 7 miles total.

Week in Summary - A pretty good week by comparison with the past few months. Might have eeked out 40 miles but I think if I really counted I came up a short by a few. I only did one core workout so I missed on my goal there. For this coming week I hope to see more of the same. I'd like to fit in a tempo run and maybe another session of 400s or even 800s if I'm feeling bold. Onward!

Monday, November 2, 2015

Training 10/26 - 11/1

Monday - 0, many a thing to do in the afternoon/evening. Should have run!

Tuesday - 7 miles with a variety of tempo intervals and surges. The idea was to practice surging off a good aerobic pase. It looked like this:

300 tempo, 100 fast
400 tempo, 200 fast
600 tempo, 200 fast
800 tempo, 400 fast
600 tempo, 200 fast
400 tempo, 200 fast
300 tempo, 100 fast * I ran 13-mid for 100m!

Wednesday - 0, meet in Barrington RI with the HSers. Home by 9:30 pm and all I wanted to do was eat and catch the highlights from the debate. Not a great running week, so far.

Thursday - 0, Wilderness trip meeting went late and doctor's appointment later on. Not a good week!

Friday - 4 miles very slow in Ward. Felt pretty terrible from an energy standpoint. Seriously long stretch followed by a light core session for the first time in weeks.

Saturday - 9 miles / Franconia ridge hike with my friend April. Perfect weather; high 40s at the base and not much below 30 at the top. No wind to speak of and sunny and clear all day. 7 hours with lots of breaks to take it all in.

Sunday - 8 miles at Maudslay with the Spaniard. Hips/quads sore from the downhill yesterday. Good spirits. Met the race director for Saunder's which was cool. We were the jerks avoiding the $5.00 parking charge at the main entrance by parking a mile down the road.

Week in review - in summary, not much to write home about. The hike along Lafayette, Lincoln and Little Haystack was definitely the highlight. I need to do more of that! The HS cross country season wrapped up this week which will afford me a lot more personal time than I've had. Lauren has one more month of grad school and once that's done I'll have more liberties in terms of training. Basically I'm trying to run as much as I can, where and when I can. I know I'm only a few weeks away from being fit enough to race if I can just get the miles up. At least I'm healthy! Hopefully for next week I'll be talking about how I ran 6 days with a couple days of quality and 2-3 core sessions. Looking forward to my 5th Feaster Five and Mill Cities Relays. Cold weather racing is where it's at!

Thursday, October 22, 2015

Training 10/19 - 10/25

Monday: 6.1 almost exclusively on trails with Alex before nightfall. Felt 'meh'. Glad I got it in.

Tuesday: 3 miles, 17:58 before coaching.

Wednesday: 0 - off. Run down! Needed the rest.

Thursday: 8.3 at 6:28 in the dark with Al. Pretty low energy today so I was glad this went as well as it did. Pretty humid!The roads /people immediately around the new apartment are sketchy and high traffic but not bad about a half mile out. It's tempting to drive out and park just to avoid the Lawrence cronyism we experienced tonight.

Friday: 0 - Off.

Saturday: 10 miles / 62 minutes morning cruise with Al. Felt good for a morning run, which is rare. Hit the old stomping grounds around Ballardvale.

Sunday: 8.5 miles with Joe in Hampton. 90% winding mountain bike trails. 69 minutes.