My wife and I went for a walk along one of my running routes in the warm Spring sunshine. Seeing the trail brought back a flood of memories as we walked along. A recent Runner’s World Quote of the Day came to mind:
The secret of change is to focus all of your energy, not on fighting the old, but on building the new. –Socrates
Warmer than last week
It was a gorgeous January evening. In Portland, Oregon, that means dark, lower thirties, and oddly not raining. I was about a quarter of the way home on my nightly five mile run from the office when I had my first indication of potential problems. My right knee was giving me some “popping” grief as I’d come to call it over the years. This also had happened during a run the week before while visiting my family in a much colder Illinois. The popping wasn’t painful, but I knew deep down that the situation wasn’t good.
Eventually I’d need to have something done with my knees, but when? I had a fitness level to maintain. I had races to train for. Maybe if I could stay at this level I could PR in a marathon next Fall. A race bib drawer to organize. Oh, and let’s not forget about the socks! Excuses were more plentiful than old running shoes.
I did what I’d done a thousand times before: shortened my stride and paid attention to my footfalls. Onward I pushed becoming lost in thought as I ran on. I crested a hill on the sidewalk along a busy street. I saw the white pickup truck waiting to turn onto the street I was about to cross. I made it through the intersection and down to the ground I went.
What was that!
Perhaps I’ve led a blessed running career, but this was the first time I’d ever fallen while running. Tripped sure, but never made it to the ground. With the general adrenaline from the run and the shock of falling, I sat up in a near daze. My hand stings, did I scrape it? Sit up and check it out dummy! Nope, hand is OK, but thumb feels a little weird. Don’t see anything bleeding there. Why won’t my right leg straighten? What is that bump next to my knee? Maybe if I try and straighten and gently push up on that bump. That did it. Can I stand? Absolutely not! Call wife. At 39th and Woodward, please hurry! I’ll try and stand on left leg and lean against street sign. World is getting a little fuzzy. Feeling a little nauseous too. Sit! That seems better. A few minutes later my wife pulls down the street where the pickup had gone. I begin to hobble my way to the car grasping at the world around me with all of my might to stay conscious. My knee begins screaming.
In a series of what could politely be called lapses in judgement I asked to be taken home where I iced my knee — because that’s what us runners do when things hurt, right? After a couple hours of icing I scooted upstairs on my butt to go to bed where I laid awake all night in Aleve muted agony. Somewhere around 4:00AM my cognitive functions begin to kick back in and I decided that, when my wife wakes up, we will be going to the Emergency Department instead of the Urgent Care like I had explained to her the night before.
Journey to the bottom of my patella
By the time my wife stirred at around 7:00AM my right knee had swollen to the size of a melon and needless to say it didn’t bend. After an alternating pain-to-nausea-to-pain journey to the car my wife and I arrived at the Emergency Department — clearly where I should have gone the night before.
Again on the “blessed life” theme, I’ve been to the Emergency Department, as the injured party, just one other time as a very young boy. That was as a result of my sister, a boat (empty box), and rough seas which resulted in a broken collar bone. I don’t remember much of that trip other than the sky (aka ceiling) during the rough seas and the ambulance ride after things went wrong.
I had been surfing the internet the night before attempting to ignore the pain and learn what could have happened. Most of my searching was turning up “dislocated knee cap” and estimates of returning to activity gauged not in days, but months. Months! My endurance will fall through the floor if I’m not able to train for months! As I waited for the X-ray technician to review my film in the Emergency Department I was praying for any diagnosis which would get me back on my feet quickly. Sadly, the diagnosis I was fearing came down like a gavel and I was given the contact information of an Orthopedic Surgeon who could help me further. I looked up that surgeon in my health plan’s directory and a key word was missing from his office description: sports. I located another who had this magical word in their description and made an appointment.
At the first appointment with the surgeon I relayed the happenings of the fateful evening, and fessed up about the years of avoidance. He suggested that surgery was very likely especially due to my history of issues, but wouldn’t know until after another series of X-rays and MRIs. Dang, why did I have to go and mention the prior history! Off for more radiation…
At the next visit, with X-rays and MRIs in hand, there was no question that surgery was in my future. Fractured patella, torn meniscus, uneven cartilage wear, and a knee cap which was predisposed to dislocating were mentioned. I was wondering if I’d walk again, let alone run. Six procedures, including something called a tibial tubular osteotomy. Don’t look at images of this on the internet if you become nauseous easily — seriously. But the big question on my mind was “when can I run again?” That, I was told would be based on how my recovery progressed. This was not satisfactory for someone who had been tracking their running status for years. A date, a symbolic finish line, was all I wanted, but none was given. The surgery was scheduled and I was sent home to contemplate my possible non-running future.
Well I have to do something
Surgery day came and went. All very novel for me since this was the first time I’d had anything of this magnitude done. The first week after I was nearly drugged into oblivion on pain meds. The pain in my tibia, which felt like what I’d imagine a mending broken bone would, outweighed the pain in my knee. Clearly that must be a good sign.
The second week after surgery I was able to taper the pain meds some. However, I was beginning to become stir crazy cooped up in the house. For a person who really only watched a couple hours of TV and slept in the house, due mainly to work and exercise, this was torture. This plus the inability to move my leg without help from my hands had me wondering if I had done the right thing.
The third week after surgery the bone ache in my tibia finally subsided enough that I had the idea to begin carefully working my upper body and core. Like most runners these were always secondary, at best if at all, exercises for me. It was at least something “active” to do even if it was in the house. I did any upper body or core exercise that didn’t put any pressure on my legs.
The fourth week after surgery my upper body and core were developing inversely to the wasting in my legs. Physical therapy to the rescue! At my first PT visit I retold the story of the injury and my desire to run again. While at PT the homework exercises seemed way too easy — until I got home and tried them. Isometrics were never so hard! Also, the twice weekly visits to PT got me out of the house, but it still wasn’t enough. I missed the sky and freedom of the run.
The fifth week after surgery I received more homework exercises from PT. I now had more isometric exercises than I knew existed. Having never been a huge fan of isometric exercises to begin with I was doubting their effectiveness. However, I was determined to run again and if this was the path to that so-be-it.
The sixth week after surgery the weekly improvements began to shift towards daily improvements. The seventh week saw even more. I could begin putting weight on the leg. The eighth week after surgery I was down to one crutch with the leg brace. I was even able to visit the bike trail which features regularly in weekly runs.
I will run again!
I’m on the cusp of my ninth week after surgery, and eleventh week after the injury. At the risk of earning a scolding from my surgeon and PT trainer I can walk without any crutches or brace at home. After walking along my running route today I am confident that I will run again. I may be slower, I may be faster. All I know is that I must focus all of my energy on building the new, post surgery, runner that I will be.