Experience From - Jim Sisko , Jay Hodde , Steve Pervo , Blake Wood , Chuck Barbee ,
Jim Howell wrote:
"I have pain whenever I walk down steps, bend down to pick up something, or just drive my truck! In Dec. I went to a specialist on the knee who sent me for a MRI. The Dr. said I have a 'degenerative cartilage' damage and that If I continued to train/runthe long miles I do, it would only get worse."Sounds a lot like a problem I came down with after running Grandma's Marathon back in '89. The symptoms were pretty much the same, esp. going up and down stairs. After going thru physical therapy for four months I finally had an MRI that showed a tear in the medial meniscus. My doctor suggested surgery and I consented only because I was sick of being pain all the time!
"He recommended one session of physical therapy to get an idea to see if it might help, but I got the impression he was opting for surgery aka "scoping". From what I've heard from my fellow running friends, If I go under the knife, my running days (at least anything over 5or 10k's) is over."I had my knee scoped on November 10 and was back running a light schedule a month later! And now, over 7 years later my knee has not given me anymore trouble. My doctor advised me at the time to cut down on my running and that marathons were out of the question! I wasn't listening however since I was planning my training for the Boston Marathon 4 months later! I've run several more marathons and 50 milers and completed a 100 miler since then with no problems.
Jim says: (with major snippage to keep the length down)
With the unstable trail conditions, I might have hperextended my l. knee more than once. After my ankles came back into normal and I began running the folllowing week, I began to notice a slight pain in my knee after some of my long runs. The pain after the runs eventually got worse as time progressed. As this type of injury was new to me...Jim, I don't want to play doctor because I feel that you have seen the right people. Since they have the test results, including the MRI (you mention below), they know more than me.my fouth Marine Corps marathon and proceede to stagger to my worst time ever by over 40 minutes! Pure stubborness got me thru that race but I have not been able to run since!!! Ihave pain whenever I walk down steps, bend down to pick up something, or just drive my truck! In Dec. I
From my background in athletic training, and without the benefit of an MRI in front of me, the pain you are describing seems more like a slight cartilage tear or a loose body in the joint than "degeneration", at least in the classical sense.
I pick up this idea from the pain you have while bending and descending steps, AND the mechanism of injury (hyperextension while twisting).
"went to a specialist on the knee who sent me for a MRI. The Dr. said I have a 'degenerative cartilage' damage and that If I continued to train/runthe long miles I do, it would only get worse. He recommended..."But what does he mean when he says 'degenerative cartilage'? In the knee, there are two distinct types of cartilage. There are the meniscii, the "pads" which "float" in the joint and function as shock absorbers. And there is articular cartilage lining the ends of the bones, which protect the bone ends and also reduce shock. When someone says 'degenerative cartilage' to me, I get the idea that the articular cartilage is the problem. Your pattern of pain suggests the meniscus might be involved.
In your case, and with my limited ability to assess the situation from a far, it is my opinion that a second opinion would be the way to go.
"one session of physical therapy to get an idea to see if it might help, but I got the impression he was opting for surgery aka "scoping". From what I've heard from my fellow running friends, If I go under the knife, my running days (at least anything over 5or 10k's) is over. Charlie 'wrong-way' Wojcik has recommended hot immersions, retro walking on a treadmill, electronic stimulation, range of motion exercises, and ice baths for possible treatments."Not true. Scoping is relatively non-invasive and you should be able to run again, assuming the problem is correctable. The surgery itself won't prevent you from returning to the roads. The injury may.
Wasn't it Joan Benoit-Samuelson who ran the Olympic Marathon within a couple of weeks after arthroscopic surgery? She's still running.
I'm seeking a solution to this problem desperatly. I WILL NOT GIVE UP RUNNING....IT BRINGS ME TOO MUCH JOY IN LIFE TO QUIT!!If it were my knee, I would be forced to consider a couple of things before deciding which way to proceed. First, I would look at my level of pain. Can I run now, and do it comfortably so it brings me joy? Second, how long has the pain persisted, and what have I done to try to get it better? Have I rested? Have I been to the therapist? Have I tried and followed my doctor's advice?
Third, what are my alternatives? I can keep running with pain. I can continue the rehab & rest and see if time makes it better. I can try the scope and hope the surgery finds something that can be corrected.
Fourth, can I live with the pain? Does it hurt to walk or sit or drive? If so, my quality of LIFE is being compromised and the risk of a minimally invasive surgery is likely worth restoring my LIFE to normal function.
Jim, I would concentrate on getting pain-free during your every day activities before you worry about concentrating on the running. The surgery won't prevent you from running again, but may make both your running life and your LIFE more enjoyable and pain free.
Just some suggestions. Remember, that the above is my opinion and was formulated from very limited knowledge of the situation. It is not meant to replace the advice of your physician.
Jim, and anyone else who can use this info...
I had a very severe knee injury that began while training for the '94 VT50. After my first 4 hour training run on the trails, I noticed pain in my knee(s) when walking down stairs, driving or sitting for long periods.
My first thoughts on what this might have been was that running long and slow on the trails was foreign to my legs that had been used to running much faster on the roads. So I stopped that with no success. I then then read up on knee injuries and sent out a plea to this and the Ultra list.
What I found to be the real cause was my running shoes. For years I had always worn Asics, which are a little firmer and lower to the ground. I had switched to Saucony Jazz because of the closeness to an outlet and I really liked the way they felt, but they just didn't provide enough support and caused me to pronate excessively, which caused the Patellar Tendonitis.
To help this injury go away I took Aleve 3 x per day, wore a knee sleeve and put otc orthotics in my new shoes. I also started to do partial squats ( no weight and lower yourself until your knees are slightly bent) to strengthen the muscles supporting the knees.
Once I got this under control by running only 1 mile a day, then 2, etc, I was able to wean myself from the orthotic and slowly return to the trails.
Today (about 1 year later), I am back to running 60 mpw with at least 20 of that on trails. I am able to run hill repeats and some speedwork.
Maybe some of this will help you get back to running. It's the same old story...if your knees hurt, look to your feet for the cause.
see you on the trails,
Hawk wrote:
After a run I experience what I can only describe as 'sore kneecaps' - actually it feels like a sore muscle directly under the kneecap...
Sounds like chondromalacia, a classic runner's injury. There's some good info on this at the Runners World web site www.runnersworld.com, under "injury prevention".
This has bothered me for 4-5 years now, so it need not prevent you from running ultras if you take care. Here's what I've found to be helpful:
Thanks very much to the responses regarding running ultras after a person has had substantial cartalige removed due to surgery. The main tips that I received all should be very useful,some of which I have been already doing while others I will definitely implement into my training: