Tuesday, September 9, 2008

Retrospective: Marathons of 1999


I entered the year still recovering from a hip flexor injury, the physical therapy continued and I was starting to gain some strength in the hip but a new problem emerged, left knee pain and it is my storyline for 1999. It was kind of funny as the hip pain eased the knee pain emerged, it may have been there for awhile but the hip pain masked it.

My first race of the year was again the Winter Carnival, I went out at a reasonable pace but completely ran out of gas at mile 12, my time was 1:56:07 which was a bit disappointing but I learned that even a 1/2 marathon needs respect as to pace, hydration and fueling. I did make it through with only a moderate amount of hip and knee pain although the next day I had to abort a recovery run early because of knee pain.

I continued to train for Grandma's and decided against other races to try and baby the knee, I was convinced that my knee was just tendinitis which I had dealt with off and on over the years, especially after playing basketball but the odd thing was it would seem to lock up or to catch occasionally and then the knee pain was excruciating. Usually this happened when I wasn't running, but when I was walking and changed directions, kind of odd.

The knee pain did leave to a great discovery, trails. I found out that pavement hurt my knee a lot but trails only hurt a little, so this was the year I probably completed my conversion from roads to trails. Every trail run left me satisfied and content, no people, shade from the sun, protection from the wind, and a lot of turns and twists and climbs to keep my interest.

Almost every run leading up to Grandma's was on trails. I did everything I could think of to get the knee healthy, rest, ice, etc... but nothing was working. In February, I thought about going to the Doctor but ruled it out as I didn't want to deal with them, I don't like dealing with Doctors, not sure why, just don't. In March I avoided it as well but I thought if it didn't get better I should go in. April came and with no change, I took the plunge and made the appointment. I scheduled it with a Doctor who I had gone to prior for running injuries as he liked treating runners and he had never told me to stop running.

Turned out he didn't tell me to stop but he did tell me that he was sure that I was dealing with a cartilage tear in my meniscus but to be sure that they would do a MRI. I went for a longer run on May 4th on the Luce Line, I made it 17 miles but the knee was hurting.

I was almost looking forward to getting a tear confirmed but I couldn't figure out when I had torn it. I had torn cartilage in that knee 15+ years earlier but that had healed up fairly quickly so I was a bit puzzled. The MRI came back and the diagnosis was confirmed, the Doctor who read the MRI said I had two options: surgery or to try and live with it and maybe I might avoid the surgery. He said the surgery wouldn't be too intrusive as the surgeon would probably use a procedure known as arthroscopic surgery. When I said that I couldn't live with it, he said that my next step was to meet with a surgeon so I could understand the surgery, the recovery and possible long term consequences of the surgery. The surgeon I choose was also a runner, we met on May 17th and he answered all of my questions, he said that this tear was the same one from 15+ years earlier as it was in an area where there is no significant blood flow so the tear would not have healed completely. Which is probably why when I didn't remember hurting it. He figured it could have been a simple movement that caused it or even wear and tear that caused it to resurface (I thought it was the PT on my hip, oh well, root cause doesn't really matter). The surgery would be outpatient, I would arrive in the morning and the surgery would be relatively simple and not take very long. He explained that I would receive a general and I asked what that meant and he said anesthetized (knocked out). I asked if could I have a local as I didn't want to be knocked out. He said no, he didn't want me to flinch and bend his instruments. He said I could also receive an epidural but that it was best that the anesthesiologist explain my options. I asked if I could have the surgery within the next few days or at least before Memorial day as I wanted to get in a decent long run after the surgery before Grandma's.

He looked rather oddly at me and said no, I will not do surgery ahead of your marathon, that is out of the question. You need at least 6-8 weeks to recover fully and you will need to take at least 3 weeks off before any running should be attempted. I said that I had to run Grandma's as I had done it since 93 and this was to be my 6th consecutive year. He said that he understood but this was a streak that was ending. I was really bummed by that thought and so I asked, since he wasn't going to let me have the surgery before the marathon, could I run it without the surgery. He gave me another rather odd look, paused and said only if that when the pain got intense that I would stop running. I said I could do that. He explained that he wasn't too concerned with the tear getting worse but didn't want me to damage anything else in my knee.

So all I had to do was finalize my training plan, I would attempt at least one more long run, preferably two, then head to Duluth and git er done. So on May 22nd I headed out on the Luce Line for a 20 miler, well the first 10 miles weren't a complete disaster but the last 10 were a hobble, wobble painful run/walk but I made it. Great thing about the Luce if you run out 10, you got to come back 10. So now I knew if I could get one more long run, I would be set. I wanted to get out the week after Memorial Day but I kind of did something stupid and ran on pavement on the day before my final long run, I only went 5 miles but I was too sore the next day to attempt a long run. The day after that aborted attempt, I went out and I was only able to get through 14 miles, well Grandmas was less than two weeks out so it was going to have to be enough.

We got to Duluth and my plan was real simple, run until it hurt, walk, run, repeat. I was hoping that I would be able to at least to mile 18 before the pain got intense.

The race started and off I went, my other plan was to run on the shoulder or grass and to avoid the asphalt. Did you know that there isn't much of a shoulder that you can run on down Highway 61? I discovered that and said oh well, nothing I can do about it, unfortunately the knee pain got intense around mile 8. So the modified plan had to be; walk, run, pain, walk, run, pain, repeat until Canal Park, man this was going to be a long day. As I ran along Hwy 61, I kept stopping and looking out into Lake Superior, I was mesmerized by the sheer beauty of the lake. In all my previous Grandma's I don't think I ever had fully absorbed the majesty of this great lake. I was never so happy to see the turn off of 61 onto London road, just 8 more miles to go.

Along London road, I ran on the grass, the surface wasn't level but boy did I like the extra cushioning. I even stopped and had a beer, I figured what difference would it make and maybe it would even mask a bit of pain. I continued my struggles down the road, but again I looked around and noticed beautiful homes that I had completely missed before. Another thing I discovered as I made my way into downtown Duluth. is that they have sections of the road that were brick, bricks are really, really hard and they don't provide a level surface, ouch. I also confirmed that asphalt is a softer surface than concrete. As I hobbled my way onward through downtown, by the DECC, around that stupid boat I was never so happy to be nearing a finish and yet I was so satisfied with what I had seen and experienced that I didn't want it to end. I made it to the finish in my worse ever marathon time of 5:09:46 but I made it, yes the streak was intact, 6 consecutive Grandmas.

My surgery was delayed a bit but ended up getting scheduled for July 15th. My surgeon did ask me about Grandmas on the morning of the surgery and was surprised when I said I finished, he said didn't your knee hurt, I said yes, he said didn't I tell you to stop when it started hurting? I said that I did, I walked until the pain was manageable, he said NO, you were supposed to quit. Oops, but I made it :-). The surgery went well, I did do the epidural and was able to watch the surgery on the monitor, pretty cool. I went back 5 days later for a post op check-up, I asked about when I could start running and I was quickly instructed that under no circumstances was I to begin running for at least 3 -4 weeks and that I should expect that it might be 4 to 6 weeks before I could and should resume. I said what about 2-3 weeks, he gave me a funny look but I decided to follow his advice, I took two more weeks off before I attempted a run. On my first run I only went a 1/2 mile as it was tender, the next day I went a mile and I concluded that maybe another week off would be a good idea. I thought that maybe it was like post-marathon soreness on the first run and all the soreness would be gone on the second, good plan, but after the second day I had to conclude that it was different and that it was a bit more pain than soreness.

A week later when I tried again, it was weird, I would run and it just didn't seem right. It took me two or three runs to figure out that the problem was it didn't hurt. I was so focused on expecting pain that I didn't know what it was like without any pain.

Twin Cities
I was working in August to ramp my mileage back up with the hope of having a good day at TCM. I needed to ramp fairly quickly but I knew that my goal was to simply run a pain free race and to enjoy the day. I avoided stressing the knee by only running trails and didn't do any speed workouts or hills and all was going well through August. I decided to run the Woodbury 1/2 marathon as a test to see if TCM was a go and I hoped that it would help me to start figuring out what my pace might be. It went ok, I started as I always do at too fast a pace and kind of died after mile 8 but I got through it and the pavement and hills didn't seem to cause any major issues.

As September began, I was starting to think that maybe I could push it a bit more and that if my training continued to go well that I would even beat last year's time. I had a plan to add 3 miles a week to my long run and I seemed to be handling it well. I was starting to get even cockier as I was running with no knee or hip pain for the first time and I felt great and then it happened. I was running a quick 6 miler after work in Lebanon Hills and the day was so nice, not too hot, a light breeze that I was just kind of zoning out when a deer jumped out, about 10 feet in front of me. A bit unusual in the afternoon but I was struck at how graceful it's stride was when the next thing I know I was flying forward and heading for the ground. I had stepped into a hole and my left foot had completely bent in half (at least that's the way it felt). I thought to myself, idiot, eyes on the trail but the deer was so interesting to watch. I cleaned myself off, decided that I hadn't broken or cracked anything and no blood was visible so I started to run but the foot that I had stepped into the hole, hurt, kind of like an ankle roll but this was in my arch and it was a bit more painful. Different than I was use to but I got through the run without any increase in pain and figured it wasn't a big deal. Two days later I headed out for a long run on pavement and everything went fairly well, I again kind of ran out of gas (normal issues - pace, fuel, hydration) after 15 miles but worked my way through another 4. My foot was tender and kind of ached throughout the run, I just figured it would continue to heal and that the pain would be gone soon.

I continued to try and build base over the next week with the plan for one more long run, I went on my birthday, I thought to myself what a great present to me, a long run. I decided to stop after 15 miles as the foot was too sore and TCM was now less than two weeks away. I was worried could I run 26 miles, would my knee be ok, would my foot be ok?

TCM came and I was sure I was ready, I had rested well and avoided running but had done some biking and I had convinced myself that the foot was healed. I reset my goal to just take my time and enjoy it. Unfortunately within the first mile I knew I was in trouble, my foot hurt. I couldn't seem to push off. I thought just marathon start paranoia, you know everything is hurting, ignore it and I did. Except I couldn't, I hobbled around the lakes and I told myself, you ran Grandmas with the knee issue you weren't going to let this foot get to you. I hobbled on down Minnehaha creek, I was having trouble putting my heal down, actually I just couldn't manage the pain when my foot bent so I basically was just running on my toes. I continued on, but the pain wasn't getting better and I was really struggling with running on the toes, then I hit the moment of truth as we turned onto Cedar to begin going around Nokomis, I decide to walk the small incline to give the foot a break. It hurt worse when I walked. I resumed running but it was hard to run on my toes, my knee was really starting to get torqued by the awkward motion. So now my foot was throbbing, my knee was throbbing, my calf was tightening, things weren't quite going to plan. I hobbled forward over the Cedar bridge and turned left to go around Nokomis, I saw the 1/2 way point and I then I saw my wife. I walked over to her and said I am done. The look of surprise on her face was quite interesting. She thought I was kidding, I explained what was going on and she still looked amazed when I said let's go to the finish and turn in the chip. I had officially given up, I felt like such a wimp.

As we drove over to the finish, I was thinking I had made the wrong choice, I should've stuck it out, sure it was throbbing a bit but I only had 13 miles to go. As we got out of the car to turn in the chip, the foot really hurt to walk on it, I needed ice, I hate ice, not good, ok,maybe I did make the right choice. I turned in the chip and asked my wife to get ice for me, she came back and said they needed my number and that I should go into the medical tent. I had always avoided the medical tent not sure why but I think I always figured it was for real runners and I have never considered myself to be one. So I hobbled into the tent and they sat me on a table, someone asked me what was wrong and then gave me some ice and said that the Doctor would be right over. Never knew they had real Doctors in the medical tent, kind of makes sense. Turns out the Doctor that came over was a podiatrist, Dr. Sperling. She always had a magnet in the goody bag with her info, I almost felt like I knew her and thanked her for sponsering the race. She asked what my issue was, asked when I hurt it, how I hurt it and then she proceeded to look rather closely at it, bent it, asked if this hurt and that hurt. She was quite good at finding the exact spot where it hurt. She turned and looked at me and said you need to go in and get this looked at more closely (x-rays, etc....), I think you have a torn tendon. Turns out I was able to get into her office the next day. She confirmed her initial diagnosis and then gave me the bad news, no running whatsoever for at least 4 weeks. Ouch.

I went back to see her a few weeks later and she again said the same thing, take 4 more weeks off, it's not an injury you should hurry, that meant 6 weeks without running. I finally got out for first run on November 12th and it felt great, no knee pain, no foot pain. Yes, I was back.

I continued to run trails for the rest of the year and I thoroughly enjoyed every run.

1999 marked my 6th consecutive Grandmas and my first DNF ever. I was ok with both decisions and I felt I made the right decision in both cases, to push through the pain at Grandmas and to pull out at TCM. Neither decision was easy and I learned something about myself in both cases. At Grandma's I learned that I could manage pain while running and the importance of running to me. At TCM, I learned that I had not completely lost my perspective. After Grandmas, I really wanted to run without pain and the decision to drop at TCM was right for that goal, now my decision to start the race might be open to second guesses...................

1 comment:

Londell said...

That is more in one year than some get in a lifetime... You deserve all the rewards as you work hard and though many issues... and live to tell the story...


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