Tuesday, April 8, 2014

Road to Recovery

The Injury

Saturday January 25. 2014
Raced Mountain Mist 50km, posting a personal  best 4:23 and finishing 4th overall.  During the race I fell hard several times on some rocky terrain.  Unbeknownst at the time, I had torn the meniscus in my left knee.

Abnormal Recovery

Sunday January 26. 2014
Flew to San Antonio for a work conference.  Felt more stiffness than usual post ultra marathon.  Difficulty getting up after sitting down for just a few minutes.

Monday January 27 - Wednesday January 29. 2014
Though presenting at the conference, spent most of the time seated.  Wore compression to speed recovery, but had tremendous difficulty getting up and getting around.  Tried to work out the kinks on the hotel elliptical but did not run.

Discovery and Decisions

Thursday January 30. 2014
Realized that something was not right with my left knee.  Before traveling home, made an appointment with my family Doctor for Friday.

Friday, January 31. 2014
Went to see my family doctor (Dr. Jon Krichev).  He took x-rays and suspected an MCL issue but order an MRI for later in the day to confirm.  The MRI was at 5pm that same day.  

Saturday, February 1. 2014
MRI results were not due until Monday but still too painful to run.  Went to a spin class (wearing a knee brace for stability) with Rachel.  The spinning motion of the stationary bike (at UAH) was not as painful as walking or running.

Sunday, February 2. 2014
Another spin class at UAH with Rachel before the Super Bowl.  Nervous about the looming MRI results.  The pain is borderline unbearable.

Monday, February 3. 2014
Got on the elliptical during lunch before the MRI results.  Painful and slow but felt good to sweat a little.  MRI results came in the afternoon; torn meniscus.  I spent the rest of the night researching the injury and trying to analyze the MRI scans.  Scheduled appointment to meet with the Orthopaedic Surgeon Dr. Cantrell at The Orthopaedic Center (TOC) for Tuesday.

Tuesday, February 4. 2014
Met with Dr. Cantrell and he confirmed the torn meniscus.  He said that due to the location of the injury, it does not get much blood flow and would never heal.  I might have some days without pain but it would not go away.  They do not repair a tear, but remove it.  He suggested that I have the surgery; I knew it was inevitable and wanted to do it as quickly as possible and scheduled it for Friday afternoon.   Dr. indicated that I could not tear it any more so for the rest of the week leading into surgery I could cycle if I wanted, and just to use pain as my guide.  I went to a spin class at Blevins that night on my Trek. 

Wednesday, February 5. 2014
Spin class at Blevins on my Trek.

Thursday, February 6. 2014
With just 24 hours left before surgery, I got on the elliptical at lunch.  The pain is tolerable during exercise with the knee compression brace but after it gets worse.  Surgery was the right choice and I am now at peace with it.


Day 0: Friday, February 07, 2014
Surgery to remove a medial tear in the posterior horn of the meniscus in my left knee.  Used crutches to get into the car.  Slept the rest of the afternoon and night.  Rachel took great care of me.

Immediate Aftermath

Day 1: Saturday, February 08, 2014
Very sore from surgery.  Used crutches to get around the house.  Managed to feel well enough to go to dinner with Rachel as surprise for Amanda's 30th birthday.

Day 2: Sunday, February 09, 2014
Mostly icing and keeping my knee elevated/  Crutches to get around. Taking pain meds regularly.  Rachel is key to the entire weekend, taking care of me, waiting on me and helping me get around.

Recovery Phase 1

Day 3: Monday, February 10, 2014
Started physical therapy with Andrea at Nesin.  She was great last year to help with my PF and was the clear choice for PT this time.  Had to get outside; went to the church down the street and walked in the grass for 1/3 mile on crutches.  Almost cried in pain.  Dr. indicated that walking was fine for this week.

Day 4: Tuesday, February 11, 2014
Managed to walk 1 mile without crutches.

Day 5: Wednesday, February 12, 2014
Physical therapy at Nesin.  Afterward, managed to walk 1 mile without crutches.  Enjoyed the company of the Beagles.

Day 6: Thursday, February 13, 2014
Walked 3 miles around the neighborhood.  Limping severely and favoring the left side.  Wearing compression brace for stability.

Day 7: Friday, February 14, 2014
Follow up with Dr. Cantrell.  He said that things were going well, about how he expected.  I asked if it was ok to start biking (on the trainer) at home and he said that was a good idea.  The trainer arrived in the mail so timing was perfect.  After work, took the dogs for a long walk around the neighborhood, logging 4.75 miles.  Just one week post surgery.

Recovery Phase 2

Day 8: Saturday, February 15, 2014
90 minutes on the trainer, wearing a knee brace.  Taking pain meds only once a day, just before exercise.  Missed the first running of Tick Ridge 25km.

Day 9: Sunday, February 16, 2014
60 minutes on the trainer, wearing a knee brace.  Still no running but its all part of the plan.  Had to travel to Detroit for work.  Was very painful to remain seated that long without being able to stretch.

Day 10: Monday, February 17, 2014
Attempted the elliptical at lunch wearing the knee brace at the hotel before my work meeting.  Still very painful and slow just with the elliptical motion.  Attempted yoga at Fleet Feet, but many poses not possible.  Still a lot of swelling in my knee and can't go into hands and knee position.

Day 11: Tuesday, February 18, 2014
Hit the bike trainer for an hour after work.  Much pain at night while sleeping.  Trying to keep my knee elevated but can't roll over onto my side or stomach without pain.

Day 12: Wednesday, February 19, 2014
Physical therapy with Andrea at Nesin.  Still lots of swelling, little range of motion.  Got on the trainer for 90 minutes at a good cadence after work.

Day 13: Thursday, February 20, 2014
Felt good enough to try the elliptical again at lunch and then sat on the trainer after work for awhile.

Day 14: Friday, February 21, 2014
Physical therapy in the morning with Andrea then walked for 1 mile with Rachel and the dogs after work.  Also got on the trainer for an hour.  It is still the least painful option for exercise.  Still wearing knee brace and no attempt at running.  Two weeks post surgery.

Day 15: Saturday, February 22, 2014
Two hours on the trainer followed by a 3 mile walk with the beagles.  Missed Black Warrior 25km for the first time in a long time.  Despite the mud and horse manure, I have always liked this race and have done very well at it over the years.

Day 16: Sunday, February 23, 2014
Just 16 days after surgery, I was able to bike outside for the first time.  25 miles at a steady pace with SE and DM.

Day 17: Monday, February 24, 2014
Physical Therapy in the morning with Andrea.  We are starting to work on some basic mobility and strengthening exercises.  Fast 20 miles on the trainer in the living room, making my way through all seven years of Hogwartz with Harry Potter on dvd.  The dogs are starting to wonder what I am doing.

Recovery Phase 3

Day 18: Tuesday, February 25, 2014
Plan was to start "running" some this week, which was cleared by Andrea and Dr. Cantrell.  I made it 1 mile in about 15 minutes, alternating a walk and a jog for a few seconds.  It was encouraging, yet discouraging at the same time.  Just a month earlier I was in the best shape of my life at Mountain Mist 50k and now I am struggling to jog.  Hopped on the trainer for 30 minutes to loosen things up after the "run".

Day 19: Wednesday, February 26, 2014
Physical therapy in the morning then later "ran" 2 miles around the block.  Much the same intensity as yesterday.  Still favoring the left knee and wearing the brace.  Added 90 minutes on the trainer before dinner.

Day 20: Thursday, February 27, 2014
Elliptical at lunch for 6 miles then 2 miles very slow on the treadmill.  Can't hold a steady pace, so alternating between jogging and walking.  Later got on the trainer for 30 minutes before dinner.

Day 21: Friday, February 28, 2014
Physical therapy in the morning and then 45 minutes on the trainer after work.  Still have a fair amount of swelling and pain.

Day 22: Saturday, March 01, 2014
50 miles on the trainer.  Ouch.  20 minute warm up, 8x short hill repeats, high cadence, 2x long hill repeats, high cadence, cool down.  Broke it up into hour long blocks, getting off in between.  2 hours and 37 minutes on the saddle.  Right off the bike went out to run. Minimal discomfort in my knee but not tolerable at a slow pace with the dogs.

Day 23: Sunday, March 02, 2014
Decent weather, so rode from home, up and over Cecil, Old Big Cove and to Flint River Greenway. Then with pals down on old 431 for a few and then back. Very windy.  26.83 mi in 01:28 18.3mph.  Still wearing knee brace for stability and a crutch.

Training Phase 1

Day 24: Monday, March 03, 2014
24 days after knee surgery I ran my first structured workout. Had been maintaining fitness in the bike (300 miles in the last two weeks) but it was time to test things out with racing flats. Surprisingly all of the doctors want me to start training again.  30 minute easy warm up then 12x1 minute ON followed by 1 minute recovery on the treadmill.  Managed to work down to 5:30 pace by the end. Wrapped up with mile cool down.  The joint is still sore and I feel it in every step but it is tolerable. The plan will be to lengthen the intervals tomorrow.  Feeling ambitious, I hoped on the trainer after work for 30 minutes.

Day 25: Tuesday, March 04, 2014
Day 2 of testing my legs and fitness. 25 days since knee surgery.  On the treadmill, 4 mile warm up + 4x400m (1:42, 1:40, 1:38, 1:35) with 60s recovery + 2x800m (3:07, 3:03) with 90s recovery + 2x400m (1:28, 1:25) with 60s recovery + 1 mile cool down.  Felt good by progressing the pace faster on each repetition. First set of intervals at 400m+ since mid December when I switched to trails and tempo running for Mountain Mist. Pretty pleased with the start.  Came down with a chest cold and lost voice during presentations.

Day 26: Wednesday, March 05, 2014
On the trainer, 30 minute warm up followed by 4x long hill repeats before cool down.  Then went to PT, followed by a 4 hour drive to Atlanta for work.  Stopped several times to get out and stretch along the way to prevent stiffness.  Chest cold seems hanging on.  Can't breathe very well.

Day 27: Thursday, March 06, 2014
With no work meeting until lunch, went to the local gym in the morning (Hotel gym was closed so headed to LA Fitness before meetings).  27 days post knee surgery and battling a head cold/congestion.  On the treadmill, did 4 mile warm up + 2x200m (0:48, 0:48) + 2x400m (1:34, 1:34) + 2x200m (0:45, 0:45) + 2x400m (1:30, 1:30), + 2x200m (0:42, 0:42) + 2x400m (1:24, 1:24) + 2x200m (0:40, 0:40) + 1 mile cool down.  All in all, totaled 2.50 miles of speed in 14:46 progressing from 9.2mph to 11.1mph with 5:54 ave pace.  This was very hard but from a fitness standpoint, but if I had any thoughts of racing on Saturday, I needed to test things out.  Could barely talk during the meetings, even though taking meds for the chest cold and cough drops for my throat.  After meetings, had long 4 hour drive back home in the car.

Day 28: Friday, March 07, 2014
Kept things very light; 5 miles on the elliptical at the wellness center.

Day 29: Saturday, March 08, 2014
Up very early to meet Dink at 6am to setup for the race. Temps were upper 30s during setup and 40 by race time. Wasn't sure if I was going to run but after a couple of easy warm up miles in sweatpants I felt ok so I gave it a shot. Just 4 weeks post surgery and have only ran a handful of times this week. Chased down the front runner by the 1/2 mile mark and put in a surge past him to create a small gap. Split the first mile in 5:36. After that we turned into the wind and I eased up a bit since I couldn't breathe much from the upper respiratory infection. Mile 2 was 5:56 and mile 3 was 6:06 and change for 18:21. Could have gone a little faster but on the comeback I did only what I had to today. Knee still hurts on every step but I think it is getting better. Just hope to be able to kick this infection soon so I can breathe and my voice can come back; haven't been able to talk since Tuesday. 4th win in a row at Care Center 5k.

After the race, went out on the bike for a few hours of planned riding,  Got a flat after an hour and my spare tube was flat.  Quite the malay.  Got things in order but headed back early on an under inflated tire, logging only 33 miles.

Day 30: Sunday, March 09, 2014
Six weeks since Mountain Mist (my last trail run) and four weeks post knee surgery.  From hairpin, up the road, out on MM, up War Path, down Rest Shelter, slush mile, up Death, blue and road back.  Still can't breathe well with the chest congestion, but I was able to run all of War Path and Death Trail climbs. It was painful on my knee to go down hill so I took that slow. Wore my knee brace for stability and watched my footing.  Overall pretty happy to be back on the trails just a week back to running regularly. I missed the woods.  In the afternoon, headed out on the bike with Jeremy and Justin Carter from Flint River Greenway, out Cherry Tree into New Hope and back. Steady pace considering the wind. Temp was 70 degrees. Rode point mostly and pulled for about 2/3 the ride. Felt really good on the climbs and much better than yesterday.

Day 31: Monday, March 10, 2014
Physical therapy in the morning and an hour on the elliptical over lunch.  Andrea is recommending that I only run every other day at most and not to push it to everyday just yet.  I trust her expert advice.

Day 32: Tuesday, March 11, 2014
Wanted to keep the repeats shorter to work on basic speed and my form.  2.5 mile warm up (7:55, 7:07, 3:30).  Then 2x200m (38, 39) + 2x400m (80, 80) + 2x200m (38, 38) + 2x400m (77, 78) + 2x200m (37, 37) + 1x400m (79) + 2x200m (36, 37) + 1x400m (74). All with 200m recovery.
2.5 miles of speed in 12:53 (5:09 ave pace).  Then 1 mile cool down.  Medically cleared to train doesn't mean it's not going to hurt. Lungs were improved, although I did find out today that I have an upper respiratory infection so that explains the shortness of breathe and wheezing. Calves are very fatigued. They just aren't used to the intensity. Knee is painful. Very. Need to ice and lay off it tomorrow. Dr. Cantrell said I am not hurting it further by running on it but I might piss it off from time to time until it's fully healed. I'm still favoring the left. Weather was windy at 5pm and 73 degrees in early March!

Also went to see family Dr. Krichev for my chest cold.  Turns out it was an upper respiratory infection and I needed to get on antibiotics right away.

Day 33: Wednesday, March 12, 2014
On the trainer. Knee is barking after track last night. Needed to take it easy.

Day 34: Thursday, March 13, 2014
Got to work in the morning and stayed for maybe 30 minutes before getting dizzy.  Had a horrific reaction to the Erythromycin.  Vomiting, diarrhea, cold sweats, no appetite.  Probably ranks as top 5 worse illnesses of my life.  No ability to move, let along exercise.

Day 35: Friday, March 14, 2014
So weak from yesterday. Had not eaten anything (that stayed down) in over 40 hours. Hoped that a little sweat would bring my appetite back after being sick. It did not. Hope that another night of rest and I will feel more alive.

Day 36: Saturday, March 15, 2014
Drove down to Guntersville for a run/ride combination. Still felt very weak from the pukefest on Thursday and very dehydrated. Ran 1 mile warm up and couldn't run for more than a few hundred feet without stopping. So knowing that it was an awful idea (but with very low expectations) I tossed down $25 and pinned on my bib.  Ran behind a young kid for the first 4 miles pacing off of him. The course rolled along but the pace was pretty even 1, 2, and 3 but slowed a lot on mile 4 so I decided it was time to take off. Mile 5 has two Cotton Rowesque hills and I mustered enough strength to put some time on him and then ran my fastest mile at the end. Far from my best but given all the circumstances, I'm happy with the effort.  Small race, maybe 100 people but with a long 36 year history. Glad that I was able to hold it together and not throw up and run a race I've never run before. 6:08, 6:15, 6:11, 6:22, 6:15, 5:55, 1:27 = 38:37

Post race, easy out from the rec center in Guntersville with SE, TO, GD, PE, DT and a couple others. Windy on the way out. Came back much faster and added on some rolling hills and climbs toward the end that dropped the ave. Started running low on gas toward the end. Really low on energy from illness on Thursday. Still fun ride in the pretty country.

Day 37: Sunday, March 16, 2014
Still eying McKay Hollow Madness as my true comeback race, I wanted a little more exposure to trails so on a rainy and cold day, headed to Green Mountain for the DD4C run with RG and PE. Easy loop climbing from the start running the CW direction of the big loop. Paul had a nasty fall late and gashed his nose. I have not seen that much blood in a long time. We walked in the last mile from there so he could make it to the hospital.

Training Phase 2

Day 38: Monday, March 17, 2014
With MHM just a few days away, I needed to get aggressive with my training.  While anything I did this week will probably not help on Saturday, I needed to try.  4 mile warm up then 20x200m hill repeats at 10% grade (58, 58, 58, 58, 57, 57, 57, 57, 55, 55, 55, 55, 54, 54, 54, 54, 52, 52) all with 90s recovery. 1,320' of climb in 2.5 miles. 1 mile cool down. Still a lot of knee pain. Lungs are 80% after respiratory infection. Touch of dehydration from the antibiotics reaction.

After the run headed out to the airport and off to Dallas for work.

Day 39: Tuesday, March 18, 2014
Busy work day and travel back home so no time or capacity to exercise.

Day 40: Wednesday, March 19, 2014
1.75 mile warm up 7:38, 5:26 from INGR over Edgewater then 3x2k on the greenway around the lake 7:32 (6:00), 7:29 (5:59), 7:10 (5:43) with 2 min jog recovery. Then 2.75 mile cool down 7:49, 7:29, 5:27. Very windy on the second repeat which required more effort than the first or the third. Rest day yesterday during work travel seemed provide a little hop in my step today but still have pain in left knee with every step. Praying for patience while the man upstairs provides healing.

Day 41: Thursday, March 20, 2014
Needed some mental confidence, so headed out to the trails for an easy loop.  From Burritt, six mile CCW loop climbing Natural Well.  Felt decent; no longer dehydrated but still not 100% post sickness.  Did not wear knee brace.  Looks like I will be ready to roll the dice on Saturday and see where the chips fall.

Day 42: Friday, March 21, 2014
Beautiful afternoon, so took the beagles for a short trail hike.

Day 43: Saturday, March 22, 2014
My favorite race of the year and my goal coming off of surgery six weeks ago.  For the full race report, click here.

Started out running comfortably hard on the road section and then down into the sinks. Rob caught up as we climbed up Panther Knob and we ran an honest pace together for awhile. I lead the way up from 3 benches, out on Mountain Mist and then up War Path. It was painful going down Rest Shelter as the jarring on my knee made me very tentative on each step. I slowed down just past Kathy's bench and as we made the hard right, I stepped aside so Rob could lead. I felt like I was holding him back. First 6 miles of splits were 6:49 (road), 8:38 (Panther Knob), 7:59 (3 benches climb), 7:58 (Mountain Mist), 8:33 (War Path Climb), 8:04 (down Rest Shelter).

We chatted a bit and then he put some distance on me through Slush Mile and I thought the race was over. But somehow he came back to me before Natural Well and we climbed together up past the well, up through Panorama Bluff, back down to Natural Well and out to Burritt. I just tried to stay with him no matter what, so as his pace varied, mine varied too. We made the turn and headed back for the bushwhack around the ditch and then climbed back up the slight hill toward the fast drop back down Arrowhead. I still stayed with him and my confidence was growing as the race progressed. We ran past the cistern and then down Big Cat. I could tell that Rob was not attacking the downhills like he usually would. Later he mentioned that he still felt fatigue of 72 miles at Delano in his legs. We sharpied and climbed back out onto Natural Well. Splits for next section were 8:24 (Slush mile), 11:35 (Natural Well Climb +) 9:21 (Natural Well atop), 8:30 (Through Burritt and the turn), 9:14 (Natural Well), 8:14 (down to the cistern)

I said that I would set the pace for awhile and figured that we would just take turns; I lead the first 6, he lead the next 6 and then we would figure it out at the end. I didn't feel like I picked it up that much, but I guess I was preserving energy while pacing with Rob and just took off. I dropped down into the bottom of McKay, crossed the stream and then ran every step of Cry Baby. I was feeling good, but Death Trail loomed. Splits after I took the lead were 8:19 (flats), 8:50 (across the creek, up Cry Baby).

I didn't crush Death Trail by any means; I ran where I could and power walked the rest. Just a nice steady climb to the finish. My DT time split was 9:53. I stopped and kissed Rachel at the summit and ran it in for 1st OA. 2:13:54. About 11 minutes slower than last year; course was maybe 3-4 minutes slower with the course changes.

Feel very fortunate to have won this race twice now. Finished the race all 7 times it has been run (rain out in 2010) with career finishes of 5, 4, 2 (Riddle), 3, 2 (Mader), 1, 1.  I hate to dwell on it, but I have only been running for the last 3 weeks and still in a lot of pain. The 3 weeks before that was post surgery and the two weeks before that was no running after the meniscus tear. So 8 weeks since Mountain Mist and this was my longest run by 8 miles. I still have a long way to go but this is a great motivational lift.  http://www.strava.com/activities/123037238


Day 44: Sunday, March 23, 2014 to Day 49: Friday, March 28, 2014
Work travel to Toronto from Sunday morning through missing a flight home on Friday night and having to drive from Atlanta.  Totally aggravated my knee by racing McKay Hollow.  Probably set my recovery back at least 2-3 weeks.  Was able to jog a few times on the treadmill while in Canada, but it felt like I was 4 weeks post-op, not 7.

Starting Over

Day 50: Saturday, March 29, 2014
6 miles easy warm up then tried first structured workout after McKay. 7 weeks since surgery but after McKay, knee feels like it did a month out when I first started picking up the intensity. 20x1 minute on the treadmill with increasing pace with 1 minute recovery. 4x7:30 pace, 4x6:59 pace, 4x6:31 pace, 4x6:07 pace, 4x5:46 pace. 5k distance in 20 minutes (6:27 ave pace). Then cool down. Knee is probably 60%. Mid foot striking is less painful than slow heel striking. Will need to take things slowly.  Still need to take pain meds before any intense workouts to curb the pain.

Moving Forward

Of course the story doesn't end at day 50.  It is now early April and I have had good days, followed by bad days.  Some days my knee hurts pretty badly and I can't run on it with any intensity and other days I don't hardly notice it.  I would say that it is now 75% and improving.  I am glad that I took a slow approach to recovery by walking, then cycling and then starting to mix in a few runs before training kicked in.  I don't regret racing McKay Hollow and setting myself back; that was totally worth it.  Now I just need to continue to be smart moving forward.

I am very thankful for the care I received and continue to receive at Nesin with Andrea and for the loving support of my Rachel; she has been amazing even when I try to do things that we both know I shouldn't try to do.  She helps me up from the couch when I can't stand up because of the lingering pain and she never complains.  I don't know what I would do without her.