Saturday, November 14, 2009

Patella Femoral Syndrome

So that's what's going on in my left knee. A minor case of patella femoral syndrome. My IT band on the outer side of my left leg is tight, so it pulls the knee cap slightly over that way. That leads to additional rubbing of cartilage on cartilage, and the pain I've felt.

Just backing up a few days. I took most of last week off running. I'd gone to Runners Roost to have my new shoes checked out on the slow-mo video. They'd said they were fine, but the sales lady took literally 2 seconds to tell me that. I took a drive up to Road Runner Sports in Thornton for a second opinion. I tried on several new pairs of shoes but with so few miles on my current ones, and with them getting the thumbs up there too, I decided to stick with my kayano 15s. I did get some custom insoles made to help distribute the foot strike more evenly across the foot.

I went for a very easy 3 mile jog Saturday and felt pretty good, so decided to attempt the longest run on the CIM training plan - a 22 miler on Sunday. It was partly a test. If I couldn't get through a good portion of it, then I'd consider canceling my December marathon. Things started off well - far better than the week before. The plan was to run around 8 min/mile pace, which is my marathon goal pace + 40 seconds. About 5 miles in I could feel some tightness in the knee but it was very minor. Still, it was constantly on my mind. I tried different running styles - standing tall, leaning forwarders a little, exaggerating the heal strike on the left foot, all to see if I could get any cues of how to help. After 10 miles I could feel a little pain so started thinking about calling it a day. I decided to run one more mile to the half way point where I'd left some gatorade. I'd stop and take inventory. So that's what I did. I stopped for less than 30 seconds to switch out bottles (I use a lower back carrying sleeve). I stretched my leg and rubbed the knee cap and started back up. No pain. Nothing. I figured it would come back in a mile or two, but it didn't. So I kept running. The next 'bail' point was 17 miles - that's where the loop I follow gives me the chance to turn towards home. No need - I felt fine, so I kept going. My pace for the first 21 miles was 7.48 min/miles. For the last mile, wanting to practice for a race, I picked it up and ran a 7.21, so overall 7.47 average. Faster than I'd intended, but best of all - my knee felt fine.

Monday was a rest day, and I could feel some tightness in my legs and knees - not unusual following a 22 miler. Tuesday it was much better, but I decided to take another day off to be safe. I'd casually chatted with a doctor at the running store but decided to book an official appointment with my doctor for Wednesday. That morning I almost canceled because everything felt fine, but went anyway. That's when I learned it was a minor case of patella femoral syndrome. He sent me upstairs to the physio, also a runner, who gave me some exercises to loosen the IT band and strengthen the quads to counteract. He also offered to tape my leg the Friday before the race which would help.

I was very glad I went. Knowing that it wasn't a bone on bone issue, and something that was very fixable made me feel great. I took Wednesday off, and then ran a gentle 10K on the treadmill Thursday to minimize impact. I iced the knee straight afterwards. It felt great, but it's normally the next morning where I can feel it. Nope - I woke up and couldn't, so ran another 6 miler on the treadmill Friday. Again - everything good. Very encouraging. CIM is literally 3 weeks away, so the taper is beginning.

While things appear to be slowly getting back to normal, it definitely messed up my training schedule for CIM. No track, no fast or tempo runs, lots of rest days, just easy and long miles. The weekly mileage has been around 25-30 instead of 60-70, and that with the majority in the single long run. My expectations now center more on just completing it at a reasonable pace, chalking up marathon number 2. Gone are the goals of the sub 3.10 time that I'd been harboring. Those will still be there another day.

After 70 degree temps this week which I missed either with rest days or treadmill running, today it's cold. It snowed last night and there's a bigger storm due in this afternoon. Today was meant to be speed work, which I don't want to risk yet, so I'll switch things around and do my long run for the week - 17 miles - today, and likely take a rest day tomorrow. The Broncos have an early game anyway so that works out.

Just over 3 weeks to CIM, and then the rest of December off...

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