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!


  1. I'm really glad as it seems from Dr. Lau's experiment that he's found the root of your pain! I'm sure that was hard to stop running after three miles of unaccustomed pain-free running, but you are right to ease back in your mileage as you re-strengthen.

    Sorry you weren't there at the Championships this morning! I had the proverbial cat bird's seat there this morning, really enjoyed it and just posted a video I made to my blog. It seems to me that the tight course turns (designed as I understand it) to emulate the London 2012 course slowed-down the runners, and will benefit runners with more lateral conditioning.

  2. i am not sure why i found this post so intriguing i think the whole idea of our muscles and where they can effect us is so interesting

  3. Good stuff Jaymee. I was reading Lauren Fleshman's latest post last night. She says about her current injury: "Without a confident diagnosis, its not only a matter of passing the days. How many days will it take? Four or forty? I find myself setting expectations in my mind of when I will be healed, only to scratch out that day on the calendar and talk myself off the edge of total exasperation back toward positivity." It's great that you have a good diagnosis and can look forward to 3 laps of Houston in 2012.

  4. First of all, it's so great that you found yet another Miracle Worker who could help. YAY. Secondly, it is fascinating the way tightness in your back/butt can lead to a knee problem. As a complete medical non-expert I find it hard to understand why this concept that "the body is one interconnected system" continues to operate on the apparently suspect "holistic" edges of medicine. It makes so much sense!

    After your amazing performances last fall, your body probably did need a break in order to come back stronger than ever and kick even more butt in 2011 :) Looking forward to reading about he comeback. - Heather in Berlin

  5. (I should clarify that the remark about the apparently suspect edges of medicine comes from my experience here in Germany. Maybe it is different in the US, but it is hard to find a doctor here who actually subscribes to this theory instead of just being like "you need to run less" or "get orthotics.")

  6. Sorry to hear this thing has lasted as long as it has but it's exciting that you're able to finally put some of the clues together and fix it at the source. Looking forward to reading all about the journey back and seeing you surpass the point where you left off.