Tuesday, June 10, 2014

Road to Recovery: Epilgoue

Back in January during one of the greatest races of my career, I suffered a medial tear in the posterior horn of the meniscus in my left knee.  I went on to complete the last 10 miles of Mountain Mist 50km after the trauma.  On February 12th I had surgery to remove the tear and chronicled the first 50 days of my post-surgical recovery in a recent blog post, which was through March 29th.  At that point, I felt like my knee was about 60% healthy.

During the month of April I continued to ramp up my training with a few structured workouts, while still keeping the total amount of running (and impact) to a minimum.  I supplemented additional time on the bike to maintain my overall level of fitness.  I ran a few races and even posted a decent 5km time of 17:42 on a negative split approach at Cookie Dash in mid April and a very good run segment at the Lake Guntersville duathlon later in the month.  

Sometime around the beginning of May, I realized that my pain level was about the same as where I should have been at 8 weeks post surgery.  In other words, excluding the setback of McKay Hollow, I had made no progress in about a month of healing.  I thought that even though I was ultra conservative with my comeback approach to that point, that maybe another month of recovery would be best.  So I decided to remove nearly all running and just cycle or do elliptical (non impact activities) and then re-evaluate in early June.

Fast forward to early June and the nagging pain that I felt 4 weeks early was still present so I scheduled an appointment to see Dr. Cantrell again (my orthopedic surgeon).  My visit to him took him by surprise as normal patients have completely healed within 4 months of surgery.  He quickly was able to locate the pain point, which is on the inside of my left knee; the same location as the previous tear.  He speculated that there was an outside chance that it was another tear, maybe bone marrow edema or maybe a tear of another kind.  He ordered an MRI, which I was fortunate enough to have later that day.

Just 24 hours later I was able to get back in to see Dr. Cantrell.  Hoping for answers, I was just ready to know what was happening so I could set a course of action to recover and start training again.  The MRI results ruled out any other type of tear (ACL/MCL) and also ruled out the BME.  There also were no traces of an obvious tear, but it was difficult to determine if there was an additional microscopic tear, as the meniscus had already been partially removed. 

At this point we discussed two course of action, which included a second surgical procedure (which the scoping may find nothing, or it may find another tear, which would be removed).  In this case it would either rule out another tear or remove it and the recovery would be another 2-3 months.  The second course would assume no tear and that it was just taking longer than normal to heal.

I suggested another month of non impact activities and continue to cycle.  My goal for the year was to run the New York Marathon in November, for which I qualified and was accepted.  If I ran it, I would need a 16 week training cycle, which would begin in mid July.  So from now until mid July is about a month to allow for any additional healing.  Dr. Cantrell said that if it was his knee, he would take the latter approach and begin to run on it then and see how things go.  He suggested anti-inflammatories to help get through some workouts as the training would begin, and then over time as the healing progressed, I could wean off of them.

So that's that.  I have happy that there is not an additional tear, but at the same time there is nothing there that should be causing the pain I have on a daily basis.  I am going to make the best of the situation and pray that when the time comes to start training for my goals, that the pain will be manageable and eventually that it will not exist at all.

Thank you all for the continued prayers; they have been helpful.  This is God's plan and I am making the best of it.