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Posts Tagged ‘meniscal tear’

Yesterday I ran 9.5 miles, the farthest I’ve run since my injury last October.  Actually, I had planned to run 9, but accidentally ran 9.5.  I blame it on Strava.

My system has been to add one mile per week.  So, next Saturday I’ll run 10.  Beyond that is anyone’s guess.  I just want to hit 10.  For no particular reason other than 10 miles is a respectable distance, and a nice round number.

I don’t have the sense that the meniscus is healing.  I have just as much pain and inflammation as before.  I just think I’m getting much better at compensating.  Or ignoring pain.  One or the other.

A coolish humid morning in the Wissahickon.  5 miles on the bridle path with Shawmont club, and 2.5 miles on the white trail, over Fingerspan bridge, then 2 back.  There was a race being run, going in the opposite direction.  I miss racing.

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OK, so I’m 16 weeks post-injury.  I still have pain and effusion in my knee, and I’ve crossed off the spring races from my calendar but for the most part I’ve stopped whining and limping and feeling sorry for myself.  And today I had one of my mini-epiphanies..the kind where I suddenly have an exciting revelation about something that should have been obvious long ago…I think I’m going about this all wrong!  Basically, the problem is that I have no idea how to come back from this injury.  I did PT, I had a cortisone shot, I had ART/Graston therapy, and I saw a doctor about getting PRP injections (I haven’ t decided yet).  In other words, I’m trying things at random, hoping something will work, and expecting that eventually I’ll find the magic bullet and I’ll all of a sudden get better and be able to start running 30-35 miles a week again.  And I think this is wrong.  I need to be more methodical.  I need to train.  I need a plan.

So first I asked the Internet for a plan, but it was frustratingly silent.  The Internet has plenty of rehabilitation protocols for post meniscus surgery, and all sorts of PT protocols for knee injury that assume by 12 weeks you are all better and back to normal activities.  But nothing to tell me how to get from where I am now, able to run 5 miles, with pain but not too much, to running 14.5 miles, which was where I was before the injury.  So I’ve decided that I will use one of the half marathon training plans out there, and train myself back to running.

This will be a first for me, since I’ve never been one to train for a race, preferring instead to just run whatever I feel like and on race day just show up  and run the race. (Yes, I know, that could conceivably be contributing to my many injuries, but I can’t help it..training is annoying and takes the fun out of everything! )  So, anyway, I am leaning toward the 8-week Hal Higdon half marathon program, with an extra mile tacked on at the very end.  That will have me back to pre-injury long-run distance by the beginning of May if I have no major setbacks.  Knock wood.

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So. It’s now been 8 weeks since the injury.  The sharp, stabbing lateral knee pain caused by the meniscal tear is diminished but not gone.  But, as I sit here on the couch with my right leg tucked under me, my right knee is starting to do this weird  pain thing..and in another second I’ll have to straighten out my leg and massage my knee until the pain subsides.  This particular injury is turning out to be a real pain to deal with.  Not only has it stopped me from running, but i when I drive or occasionally when I am just sitting with a flexed knee, I get a really  intense pain that radiates down my calf. The doctor wasn’t sure why, but she gave me a cortisone shot and Whee!..completely pain-free within 20 minutes.  Until it wore off, after 48 short but very happy hours.  So now I wonder if I can score some cortisone on the street somewhere? But back to the radiating flexed-knee  pain.   I have developed a hypothesis, because, hey, it’s my knee and not having a hypothesis bugs me.  When I first got the MRI, after being off the knee resting for several days, the radiologist noted that along with the radial tear to the meniscus, and moderate effusion in the joint  there was a Baker’s (popliteal) cyst at the back of the knee that was “leaking” down into the calf.  The BC is thought to be a result of the meniscal injury, and apparently it’s the result of joint fluid sort of flowing into a bursa in the back of the knee through a narrow channel.  So, when one ruptures or leaks, as in my case,  synovial fluid is very irritating and can cause a lot of pain.    But when I exercise, I still get the ‘fat knee’ feeling, caused by effusion building up in the knee.  So, back to the weird part. The worst  instances have been when driving home from PT or from the gym.  Within a couple of minutes of driving I get this incredibly intense  pain and have to pull over, extend my knee, grit my teeth and and massage as hard as I can before I can drive again.  So, I’m thinking that when I flex my knee, the effustion in the knee space is injected into the Baker’s cyst and/or, the sitting position causes the leak to open up and inject fluid down into my calf.  Either that or something about the sitting position in a car causes the BC to press on nerves or blood vessels.  The car seat is definitely deeper than a normla chair, so the back of my knee is pressing in the edge of the seat in a way that likely doesn’t happen with my kitchen chairs, for example.  In any case, I feel like a good portion of the pain is from the Baker’s cyst and not the torn meniscus per se.   If true, it means that it’s all about reducing the effusion in my knee.  Now, if only  could figure out how to do that..  Sigh.

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