Saturday, January 29, 2011

The right brain

The spiral fascial line.
I am pleased to report that the mystery source of the knee pain that has plagued me for months appears to be solved, and I am just ecstatic that I found the right brain to help me figure this mess out.  The mark of a good healer is someone who can find the hidden issue at the source of the chain of symptoms you might be experiencing.  Up until yesterday, I had been treating the symptoms of my problem.

This new Miracle Worker is Dr. Justin Lau of Elite Spinal and Sports Care.  I know Dr. Lau and have seen him in the past for treatment of minor niggles including recovery after a car crash in 2009.  He is very good which also means he's hard to get in to see.  Two weeks ago, I was lucky enough to get in to see him.   A quick inspection was all it took for him to locate the massive knot in my left quad, and he worked the bejesus out of it.  It seemed pretty straightforward that a tight quad and IT band would pull on my kneecap and cause the pain that I was feeling.  He told me to run the next day and let him know how it went.

I ran the next day and my knee hurt.  Since I got the cortisone shot in my IT band, I have been running, every other day, for a few minutes at a time with walk breaks for up to 15 minutes total.  When I ran last week after Dr. Lau's treatment, the pain in my knee started up within the first 1/4 mile.  This pain was a sharp, biting pain that felt like it was coming from my kneecap.  I was disappointed, to say the least.

I sent Dr. Lau a message that day, and he told me that this was good information.  He explained what he thought might be happening.  It is very clear that my quad and IT band are tight, but they may be tightening to stabilize my body because of imbalances elsewhere.  He said on the next visit, he would work on my spiral fascial line only rather than my lateral fascial line.

I was in a holding pattern for a week, waiting for an appointment to see him, and I got really anxious about the lack of progress I was making.  My knee was now hurting me when I walked around a lot.  The time it felt best was after swimming, but it was now starting to hurt after I rode the elliptical.  What I did discover on my own during that time was that, when I iced my butt, I felt immediate relief in my knee.  So, the light bulb started to come on for me that the pain in my knee was somehow connected to my butt, which doesn't hurt.  I also found some little gremlins inside my butt muscle when I rolled around on a ball.

I was starting to get desperate and decided to try to rule out any structural reasons for the knee pain like a torn meniscus, or chipped patella.  If I needed surgery, I wanted to know sooner rather than later.  I was able to quickly get in for an MRI yesterday (Friday) after calling my doc on Wednesday.  Thanks, Kaiser!  The results are still pending, but I have a feeling they will be negative.


I got a call from Dr. Lau's office Friday morning offering me an afternoon appointment, and I snatched it up quickly.  Dr. Lau worked my lats, obliques and butt muscles (not sure which ones exactly, but it hurt like hell).  At the end of the treatment, I asked why he didn't touch my quad and IT band.  He explained that he wanted to see whether or not treating the other stuff relieved the pain in my knee.  It was a little experiment.  He sent me on my way and told me to run and report back.  He also gave me stretches for my butt, lats and the outside of my leg.  I wasted no time and went directly to the gym to run on the treadmill.  I had my bathing suit on underneath, expecting I would end up swimming soon after I started running.

I started at about an 8:30 pace and 1% incline, and it felt a little weird: like my hips were moving around a lot.  I watched the distance click off and just waited for that stabbing pain in my knee to hit.  I got 1/4 mile into it and felt no pain.  Awesome.  I thought I started to feel something cropping up soon after, and I was hoping to make it to 0.50 miles.  That came and went.  Then, the 1.00 mile mark passed, and I still felt great.  I wondered how long I should go.  Should I stop and walk a bit?  Nah.  I kept going for 2, and then 3 miles with no pain.  I got the pace up to 7:45 min/mile and that felt great.  Dr. Lau had mentioned that I needed to make sure I wasn't running artificially slow because that would throw my body out of whack.  I was built to run faster and running slower would cause more problems at this point.   He didn't mean that I should go out at 5:50 pace, which I probably couldn't hold for long now anyway, but I had been trying to run 9 minute pace thinking that was a good thing.

I got to that 3 mile mark and decided that was a good test run for the day.  I then jumped in the pool for 30 minutes of swimming.

Today, I feel no pain in my knee at all.  I suspect my body will go back to its old ways over the next couple of weeks, but I know what I need to work on.  As long as all goes well, I will start ramping my mileage up, gradually, over the next couple of weeks and be back to hard training in no time.  I watched the USA 1/2 Marathon Championships this morning and didn't feel a bit of sadness about not being there.  It was just cool to have qualified to race in it.  I'll be there next year anyway to run three loops of that course!  

I think (hope) I'm on the road again, but I still say that this holiday away from running has given my body a needed break.  I am not at all worried about coming back.  I actually think I will be a faster runner as a result of all of this.  And, I found another Miracle Worker in Sacramento.  We are lucky people, living in this town.  I'm looking forward to seeing everyone again out on the bike trail!

Sunday, January 16, 2011

For Buddy

I lost one of my best friends on Monday of this week: my 10-year-old Coonhound, Buddy.  The thoughts of the happiness Buddy brought to my life are just beginning to supplant my sorrow, but I wanted to honor Buddy by filling this space with memories of his happy soul.

Buddy in the cat bad.
Buddy came to me from Yuba City, California.  I saw him on line when I was looking to adopt a companion for my rambunctious puppy, Sadie.  From his photo I could see he was beautiful, mostly white with large black spots on his body in all the best places.  When I contacted his foster dad about him, I said I was looking for an energetic companion for my other dog.  I could sense the reservation in his email response when he said that Buddy might not be the best guy for that job.  

Buddy in the Sierras.
I learned that Buddy had been found wandering the streets of Yuba City and was nearly starved to death.  I believe Buddy might have been owned by a hunter originally.  The problem was that Buddy was terrified of gunfire.  I suspect he ran off after shots were fired never to be found by his owner again.  Or maybe he was dumped off somewhere when his fear was discovered.  Buddy had separation anxiety that eased over the years but never quite went away.  When his foster dad took him in, he weighed 35 pounds.  He got Buddy up to 55 before I became his dog mom.     

Buddy and Sadie.  Friends for life.
The picture on the right was taken the day I adopted Buddy and the day he first met Sadie.  From the very instant they locked paws, they were inseparable.  I love these pictures from that first meeting because they so vividly capture the joy in their doggie eyes.  The two of them spent no more than 5 days apart from then on.

Nobody really knew how old Buddy was, and you certainly couldn't tell by the way he acted.  When I first adopted him, people would say, "Oh, look at that nice old dog," to which I would respond, "He's one."  He had a predictable, easy-going temperament and that's what endeared him to everyone he met.  Buddy loved to dance.  He greeted everyone he met by rearing up on his back legs and gracefully falling forward, trusting that his partner would grab his paws and engage in his waltz.   

Buddy hiking at Dye Creek.
Buddy was remarkable in that when his nose took over his body, he had the energy of a new puppy, even up until a couple of weeks before he died.  As a scent hound, he was a slave to his nose.  When I took him out where I could let him run free, his nose would turn on and his ears would shut off.  You would hear his hound dog bay in the distance for what seemed miles away.  I would call his name until I was hoarse, but he wouldn't return until he was done with his job.  

The Dog Van.
Buddy loved to go for car rides and became ecstatic when he heard the word Bu-bye from me.  He really didn't seem to care where we were going, he just didn't want to be left behind.  For a while, I had a VW Vanagon that I got specifically for my dogs, so I could let them lay down in the bed in back and snooze while we took off for some grand adventure.  We went on many camping trips in that van up until I sold it this last summer.  
Buddy at the top of Fiske Peak.
One of my favorite camping rituals was our annual Thanksgiving trip to the Capay Valley here in California.  There is a small campground near a challenging trail that leads to the top of Fiske Peak in the Blue Ridge Mountains.  I started taking the dogs there for Thanksgiving in 2003.  We would hike to the top of the peak, sign our names in the 'guestbook' stored in its protective glass jar, and then head back down.  Buddy always led the way up and down the mountain.  He also ran more than three times what I hiked, chasing anything that he could track.  At the end of our day, the pups would lay in the creek to cool themselves down and I would take them to McDonald's for a cheeseburger on the way home.

Buddy was a very gentle soul and loved everyone.  His personality was in stark contrast to his sister, Sadie, who likes few people and even fewer dogs.  When we would encounter kids that wanted to pet my "dalmatians" I would send Buddy in as the greeter.  He loved kids and would gladly roll over anywhere and let them pat his belly, scratch his ears or even pull on his tail.  He didn't care.  The video above pretty much exemplifies Buddy's personality.

Buddy and his pink purse.
Buddy was afraid of bed snakes.  He would sleep on my bed at night before I would get into bed.  But, when I went to get under the covers, the bed snakes would start moving toward him and his eyes would become saucer-like as he leapt off of the bed and headed to his futon in his room.  He would remain curled up on his futon until he heard me stir in the morning.  I could hear his little doggie nails on the wood floor clicking as he made his way into the bedroom and settled in next to me on the bed, waiting for his daily morning feeding and walk.  

Clever Buddy finds the cat food.

There has always been some question about Buddy's intelligence.  His pal Sadie can without question do calculus in her head, but Buddy always acted like a simple boy.  I now know that this was truly an act.  For example, Buddy was a mastermind at getting food off of counters when I would leave anything within Buddy reach.  Sadie no doubt got most of the spoils of his efforts but his climbing skills were certainly a benefit to them both.  Just a few months ago, I noticed that we were going through cat food like crazy, but the cats didn't seem to be gaining a proportionate amount of weight.  I was laying in bed one morning when I heard a clanking in the cat's room and walked in just as Buddy was exiting the convenient staircase I had given him to access the cat food.  I wondered how long he had been at this.  Clever boy.

Buddy loved to run and could go for miles and miles without tiring--as long as there was a scent to follow.  On a leash and at my side, Buddy lagged.  When I ran with my dogs, I would feel a little contorted with Sadie pulling on the leash moving forward, and Buddy dragging on his leash from behind.  I think buddy just wasn't built to be a hobby jogger.  His true running talent was reserved for the times when he needed to get a move on.
Buddy in his pillow nest.  The bed was made before he got in.  Really.
I still see Buddy on a daily basis when I walk past my bedroom and glance at the pillows where he would make his nest for his daily naps or on the futon where he would lay curled up at night in his room.  His hair still carpets the floor of the house and forms Buddy bunnies in the corners of every room.  I can't bring myself to vacuum it all up just yet.  My life will indeed go on but in a way that is richer for having loved Buddy.  

I miss you Buddy Boy.  

Thursday, January 6, 2011

A Natural

I find it hard to believe that someone actually used this term to describe me in relation to my swimming abilities.  The words graceful and smooth were also thrown in there.  I thought this might be a fluke until I heard it again, and then again from complete strangers.  I’m not sure when or where, but at some point in my life (perhaps a previous one), I learned to swim.
In my last post, I reported practically drowning the first time I strayed from my pool running routine and attempted to actually swim—without a flotation device.  I was pretty embarrassed after that but was also somewhat intrigued by the challenge.  For a couple more weeks, I kept tacking on 10-15 minutes of swimming at the end of my pool running.  Then, pool running was taken away from me as a form of cross training because it was aggravating my illitobial (IT) band.

With my cross training options dwindling, something miraculous happened when I gave swimming just a little more practice.  I became good at it, and it became fun--pretty much over night.  I have worked up to swimming (mostly the crawl stroke) for an hour straight and typically don’t want to get out of the pool at the end of the hour.  I feel awesome after a pool workout.  Granted, I’m not going fast yet.  I’m simply swimming steadily, lap after lap.  I have even advanced to the “Michael Phelps” breathing pattern of one breath every 4 strokes alternated with two to one when needed.  I can even do a flip turn.

Oh, right.  This is supposed to be a blog about running. 

Well, I have not run for nearly 10 weeks now.  I have attempted to run to test my IT band, and I still have pain on the outside of my kneecap that tells me that I’m not fully healed.  Someone asked soon after the Athens Marathon (where I did this damage) whether I regretted running it.  I joked, “ask me in a month when I’m still not running.”  Prescient, I am.

It’s now been more than two months since I incurred this damage, and I still don’t regret it.  There have been some mighty lows in this injury roller coaster ride, but it has also been rejuvenating.  When I feel really low, like I’ll never be able to run again, I feel sorry for myself and wallow.  But, those times have been few and far between.  Mostly, I remind myself that I haven’t taken a major break from running in 6 years, have run 17 marathons and countless other races in that time and just qualified for the Olympic Trials.  A 10+ week break is merely a blip.

This injury cycle has made me look at myself differently too.  Whereas I used to call myself a runner, I now realize I am more than that—I am an athlete.  I have chosen to concentrate on running as my primary sport, but I enjoy being fit.  I enjoy working out.  I like trying new things and becoming better at them. 

The future is still unknown.

I’m not sure anyone aside from the Miracle Worker and me fully appreciate just how much damage I did to my leg during the Athens Marathon.  It honestly doesn’t surprise me that I’m still recovering, though that doesn’t mean I like it.  I think it’s kind of funny that, last fall I was questioning whether or not I was tough enough to handle the pain of running.  I guess I am pretty damned tough—maybe tougher than I should be if I want to run injury free.  The thing I do know is that I do not want to run with pain.  I will take whatever break is needed to get there.  There is no glory in running through pain.

A couple of weeks ago, Lino (aka Miracle Worker) took a look at my leg and told me it was time for a cortisone shot in my IT band.  Coach Tom concurred with this.  While my quad muscle is healing nicely, the IT band has been in a constant state of inflammation and needs intervention to break that cycle.  Lino explained that there is so little blood flow to the IT band that it is really slow to heal.  The inflammation at this late stage in the game further inhibits the healing.  

I was lucky to be able to get an appointment through my HMO for yesterday to get this done.  The shot was not very painful, but the injection site is still tender.  I have easy cross training planned for the next couple of weeks with a few trial runs, including a short (1 mile) run tomorrow.  I hope that pain and running will no longer be linked for me in the near future.  I promise to keep you all updated on my progress.

Happy New Year!