Dealing with a @#$% injury while training for the Mt Mitchell Challenge

 In my first post of this series, I mentioned having surgery for torn cartilage in my right knee. I did not say that I have been waiting for the other shoe to drop. Many years ago I injured both knees (not running), and in min-November I pushed the left one over the edge. I put it in an awkward position while caving and experienced a rather sharp and sudden pain in the right rear quadrant (of my left knee) – pretty much exactly the same as my previous right knee meniscus tear, but not as bad.

After that, my mobility was seriously compromised. I could run uphill, but walking downstairs was a delicate operation. Any movement that involved flexing my left knee past about 45 degrees hurt. Walking fast on flat ground hurt unless I carefully shortened my stride and stepped delicately … like an old man walking across broken glass on bare feet.

This might have been the end of my Mt Mitchell ambitions this year, but I did not give up entirely. While slowly working my way through the tedium of referrals, MRI’s, and diagnosis, I essentially shifted all my training to an inclined treadmill or stair machine.

The orthopaedist finally confirmed the medial meniscus tear and was able to schedule me for arthroscopic surgery on 24 Dec 2015. That’s right: X-mas eve, but the alternative was to wait until sometime in January. This way I figured I would have time to assess my recovery before the 15 Jan bail-out date for the Mt Mitchell Challenge.

Long story short: It is 19 January, I have not withdrawn from the race, and I am back to training like a beast (a middle-aged beast with a delicate knee, but still …). Here are the key ingredients to my recovery so far:

1    1) Heed the medical advice: If it hurts, don’t do it.

2    2) Conversely, if it doesn’t hurt, go for it! After surgeries like this, the key priorities are to regain strength and mobility as fast as possible. They don’t encourage patients to sit around and become stiff and atrophied. For me, this meant spending a lot of time on a treadmill ranging from 5% to 25% slope. I have logged a lot of elevation gain!

      3) Be a good physical therapy patient. I have been diligent with a few simple strengthening and mobility exercises to recover symmetry between my left and right sides. Officially, athletes are usually released to “return to sport” when the affected side has 90-95% of the function of the unaffected side. “Function” includes isometric strength and various single-legged stepping, balancing, and hopping tests. “Return to sport” usually means basketball, soccer, etc. For me it means bombing down technical trails. Athletes are encouraged to return to normal running as soon as they can do it pain free. That’s where I am right now: steep downhills are still a bit uncomfortable, but I’m pretty close on single-leg agility.

Basically, this injury has been a serious set-back with respect to downhill performance, but I have been able to continue training hard for the uphill half of the Mt Mitchell Challenge. In the last several weeks, I have run fewer miles than planned, but more elevation gain than planned. I am now trying to push my long runs back up to where I think they should be at this stage in my plan. There is a 28 miler on my calendar this week, but I’ll probably aim for 24 and see how I feel. My top priority is to be able to complete a couple of challenging downhill sessions before mid-February. We’ll see!