Cautiously Optimistic

Yesterday morning I went for a run.

Seems fairly innocuous in a blogosphere full of runners, but it was my first run in 3 weeks, since my ill-fated and ill-advised first run after my marathon. 2.3 glorious miles. We may chase the runner's high as we cross into the mental/physical test of the latter parts of our long runs, but I found that runner's high the moment I stepped out of my front door. I've never bought into someone telling me what I can't do, and it's even more frustrating/motivating when that someone is my own body. Every step and every moment was a constant inventory of how my knee felt, but despite the concentration I ran the entire way with a smile on my face. No worrying about pace, splits, hydration, etc. - just a hope for little to no pain, and the joy of one foot in front of the other while the sun rose on a cool morning.

Overall it felt pretty good. My knee definitely doesn't feel normal or healthy, but it didn't hurt like it did the first time I tried running after the race, and it didn't hurt going down the stairs this morning. I want to get through about 5 every-other-day runs before I'm willing to declare myself as back in action, but for now I'll just keep on smiling (and stretching, lifting, rolling, etc.).

A Ray of Light

Wednesday again, which means it was time for my weekly visit to the Physical Therapist. I've been following my stretching and strengthening routines religiously the past week, and was thinking I was seeing some progress in terms of a reduction in the twinges of pain in my knee, but also wondering if I was just trying to convince myself of this rather than actually experiencing it. Regardless, I went for my appointment which started with a 10 minute warmup on the stationary bike, then we rolled through some new strength exercises to add to the regimen (a series of lunges), did some leg manipulation, and then the unexpected happened in the form of a simple question from my therapist ....

"Want to try some running?"

I think I may have flown from the table to the treadmill in a single bound, and next thing I knew I was running again. Nothing strenuous and nothing remarkable, but still, a wonderful little toe in the pool of running again. He checked out my gait to make sure nothing was out of alignment and see if I was favoring anything, and it at least looked good. He let me do a mile, after which we wrapped up the knee in some ice and talked about next steps. Overall it felt OK - no real 'pain', but I could definitely feel the running in my knee, versus before when nothing was ever localized or noticeable. Still doesn't feel quite right, but hopefully that will continue to come with time. Here's what's on tap for the next week:

Strength exercises every other day rather than every day
Stretching regimen once daily versus twice daily
Running (no more than 2 miles) every other day
Ice massage 2x daily, plus ice wrap after running

If nothing is causing pain, and improvement keeps going, today might be my last PT trip. Didn't schedule another one when I left this morning, but we'll see how it goes. Also planning to dive into the world of Yoga this weekend and see what that's all about.

Overall a pretty good start to the day.

Circling the Runway

A couple of weeks into my 'running' blog, and still no running. Added a knee strengthening routine to my flexibility routine as part of my PT this past Wednesday, but still not seeing a breakthrough in pain elimination. Doing the flexibility 2x daily, the strengthening 1x daily, and the foam roller and ice massage 2x daily. Grand total is 2+ hours daily, which is challenging to work into my weekday schedule. Also taping my kneecap to try and adjust the tracking alignment towards the inside of my leg. After removing the tape that the therapist had applied, I quickly broke out the razor and shaved all the hair off my knee. Used to do that all the time on my knees and ankles back when I played competitive sports and had to get taped, so it brought back some memories.

In addition to the PT, I did 30 min on the bike on Thursday, and 30 min on the elliptical on Sunday, neither of which caused me any noticeable pain. Hopefully these options, and some swimming once the pool opens, can keep my fitness level reasonably solid until I'm back running again. I'm not a big fan of indoor aerobic activity - none of the 400+ miles of training for my marathon were on a treadmill - but I'm going to have to learn to love it for a while. Don't necessarily dislike the machines, but I look for any excuse to get outdoors and enjoy some fresh air.

Right after finishing the marathon I had retired one pair of running shoes and bought a new pair that I had found on sale. I had them in the garage with my other shoes waiting to get broken in, but I was doing some cleaning this weekend and sadly I put them back in the box and moved them to the back of my closet. Rather than inspiring me I found them to be amplifying the frustration, so I've taken them out of the equation for now. Finding that Mondays are my peak frustration day, as another weekend passes without any sort of run, after so many weeks of long runs on the weekend. Heading back to the therapist on Wednesday for another progress review, and trying to remain optimistic.

While I was doing my stretches on Sunday morning I caught the last ~45 minutes of Running the Sahara on Showtime. Probably old news to the running community, but I had never heard of it and was fascinated/amazed by it. 111 consecutive days of running, 4300+ miles, the equivalent of around 170 marathons .... absolutely incredible. However, I found myself very disappointed in the attitude and behavior of the main runner Charlie. Clearly it was a very mentally, physically, and emotionally stressful undertaking, but he came across as a bit of a jerk at several points, which is really unfortunate in the grand scheme of the accomplishment and the opportunity to inspire and to promote running. Possibly/hopefully it was just a function of editing, and reflecting the fact that in the midst of all that repetitive running they had to look for the more dramatic moments to keep the story compelling. With the time I've spent reading runners' blogs I've found an incredibly positive, supportive, and caring group of people, and I don't this the movie reflected that larger reality. In any event, I would highly recommend anyone watch the movie, especially if you have an interest in running.

Second visit to the Physical Therapist

Made my second trip to the therapist this morning for a progress review on my ailing knee. Flexibility seems to have improved overall, but still fairly tight. I'm still experiencing pain in the same place as before, and during the same activities, so it looks like I'm still pretty far from being cleared to run again. Today we added a series of strengthening exercises to the stretching exercises, so now I'll be doing therapy 3x daily. Hard to find time to get it all done, but I'll figure it out.

In addition to the stretching and strengthening, I'll be taping my kneecap for the next week to try and force a slight change in alignment, and stretch some of the connectors from the IT Band to the kneecap. It’s a pretty simple x-shaped tape job across the kneecap, pulling it slightly towards the inner part of the knee. I’ve got some pretty ‘wooly’ legs, so taking the tape off should be vaguely reminiscent of Steve Carrell in The 40 Year Old Virgin. Kelly Clarkson!!

Planning to start resuming aerobic activity tomorrow morning, as long as it’s not causing me any pain. No running on the horizon yet, but I should be able to bike and do some elliptical work. Got my yoga DVD in the mail as well, so that should be starting fairly soon. My newly revised plan/wish, so I can try and contain my frustration level, is to resume running once we get into May. That’s not based on anything I’ve been told, or any sort of progress I’m seeing, but it helps me stay focused on a short-term goal, and helps remind me that I’ve still got 6.5 months from the start of May to train for my next marathon, which should be plenty of time. Gotta stay positive.

Plodding through PT- Day 6

Day 6 of PT on my knee today, and I'm not noticing a great deal of change in terms of overall discomfort. I am seeing some improvements in terms of flexibility, but I'm still having intermittent pain on the outside of my right knee. It's not getting any worse, but I was hoping it would have started getting better. The pain was not particularly severe to start with, so I guess the improvements will be hard to clearly recognize, but I'm trying to remain optimistic. I'm currently doing a twice-daily therapy routine at home, consisting of a series of repeated stretches, then some foam roller abuse of my right thigh, followed by direct ice-massage on the knee. I'm being as vigilant as possible to make sure I get as much benefit as possible, and hopefully return to running as soon as possible.

I think with today's Boston Marathon I'm in a heightened awareness of running, and my inability to do so, which is proving very frustrating at the moment. In an effort to isolate the variables and figure out what is/isn't working with the therapy, I've eliminated any cross-training (bike, elliptical, etc.) and held off on starting yoga until I see my therapist again on Wednesday. Much of my daily work routine is about root-cause analysis and causation/correlation analysis, so I'm trying to apply those same principles to my attempts at healing. I'm desperately itching to get back to running, but I've come back too soon in the past, and don't want to undo any progress I've made.

Trying to send some good mojo to all the runners in Boston today. Really feel badly for those runners who got stuck in Europe and couldn't make the race. Amazing how global events become linked in such varied and interesting ways.

Alternatives to Boston

Interesting CNN article about some 'road less traveled by' options for those that didn't qualify for Boston (and even some that did). Doesn't diminish my desire to experience Boston either as a spectator or participant, but still a good read....

"Forget Boston: Runners find alternatives to big race"

Me and PT and my angry right knee

Made my first trip to physical therapy today to try and get my knee to rejoin the rest of my body in the quest for marathon number 2. At this point I'd just settle for being able to run again, but have to keep the larger goals on the horizon. Interesting trivia I learned today from my therapist:

- I am indeed as horribly lacking in flexibility as advertised, however, not the worst he's ever seen.

- My IT bands are extremely well defined when my knees are flexed, to the point that "we could take a picture of them for a textbook". Not sure if that's a good thing or a bad thing, but the therapist thought it was interesting.

- My vastus medialis (teardrop shaped muscle on inner part of thigh) is also very well defined (another textbook photo opportunity apparently), but noticeably stronger on my left (good) leg than my right.

- My right IT Band is noticeably tighter than my left, but both are much tighter than 'normal'

- My quadriceps, hamstrings, and calves are all below 'normal' in terms of flexibility

- They have a lot of patients that are runners .... go figure

We went through a series of flexibility assessments, followed by some stretching instruction, followed by ultrasound treatment, followed by ice massage. Overall prognosis was pretty good, and the fact that he wasn't appalled by my generally petrified-wood degree of flexibility was a relief. Left with lots of do-it-yourself home stretching exercises to be done twice daily, along with foam roller torture and ice massage. Still no running for another week, at which point we'll have our next session and see how things are progressing. Best case I'm probably 1.5 weeks from trying to run again. In addition to the PT routine, I'm still planning to give yoga a try in the next few days. After some online research I ordered the "Athletes Guide to Yoga" DVD so I can keep the comedy of my first yoga attempts contained within my own home. Don't think the world is yet ready for my unique yoga stylings.

Trying to get back on the horse

3 weeks and 2 days since my first marathon, and so far only one aborted run with a very angry knee. I've been living vicariously through numerous runners' blogs over the last few weeks, hoping that my post-race issues would work themselves out with rest, but finally had to make an Ortho visit yesterday to have my right knee looked at. Good news is that there doesn't appear to be any significant structural damage, and the pain appears to be a combination of IT Band tightness and some tendonitis around the kneecap. Heading to my first PT session tomorrow to try and get things working right again so I can get back on the trail. Like so many things, I didn't realize how much I wanted, or perhaps needed to run until I wasn't able to just lace them up and head out the door.

My training for my first marathon was a battle against the elements, and against a calf strain that I had to deal with for the last 2.5 months of my training. I figured winter training for a Spring marathon in North Carolina would be ideal in terms of temperature, hydration, etc., but we ended up having one of the coldest winters on record, and several of my long runs were in 3 inches of snow, freezing rain, or trying not to break my neck as I navigated frozen puddles on roads. The calf strain was a struggle, but introduced me to compression sleeves, Biofreeze, The Stick, etc. Overall the first marathon experience was very positive, and race day was great. I'm aiming to run the Outer Banks Marathon in November, but really want to get my body back in mostly working order before I dive into training, and try some new things this time around to address and hopefully prevent more injuries.

Interestingly, my knees were one of the things I worried about before I started my training, but my knees gave me very few problems until after the actual race. Self-diagnosing via the internet is never a good idea, and depending on the website I looked at the prospects ranged from a couple of day rest to never running again. Unlike my usual approach to things (injuries and life), rather than just charging ahead I've decided to let the experts set me on the right path, hence the Ortho and PT.

My goal with this blog is to track my experience the second time around, both for myself (a bit of mirror-looking) and for others who can hopefully share from my experiences, offer me some advice or insight into improving my running, or just be entertained by my attempts to broaden my mind and experiences through new training approaches. My biggest issue, which has always been the case, is that my muscles are horribly inflexible. Rather than rubber bands, they more resemble pieces of rope dipped in water and left in the freezer overnight. Improving this is priority number one over the next few months. That is one of the main things I'm planning to spend time talking to the therapist about tomorrow, and hopefully they can get me moving in the right direction. Should be an interesting ride.