Knee injury imaging and update

50 days have passed since I awarded myself the worst birthday gift, a major running injury at the end of what was meant to be the ultimate training run before the 50K Road Nationals. So, short of running stories on this blog, here is a medical update after finally getting x-rays and an MRI done this week.

After 6 weeks of running in circles in my mind, figuratively speaking, and obsessing about the likelihood of my ability to run again, I was quite anxious for this peek view inside this critical articulation. Per my previous post, I was fearing that my meniscus was shattered beyond potential repair. Walking still hurts and I can even feel pain in certain positions while sleeping.

Bottom line, it's not straightforward, there is both good and bad news, but it looks like I could still have a few strides left, which I had really doubted about.

The good news first, starting with what my Sports Medicine doctor felt was the most important: there is no trace or arthritis, the cartilage looks healthy, there is that after logging 2.5 rounds around the globe (101,048 km or 62,783 miles). The health of my knees was part of the top questions I was getting from people doubting that so much running was any good for our bodies and, so far, I was telling them that healthy cartilage actually meant to regenerate the more you used it. Part of the theory that, as humans, we were... born to run. I was also adding that, for that mechanism to hold, it did help to have a neutral footing and stride, to preserve joint alignment. Well, jumping diagonally over a puddle might have tested this alignment beyond my limits...

The second good news is that the ligaments are mostly intact. That MRI shot in particular shows that cruciate ligament well straighten through the articulation.

On another image though, my doctor saw some indication that the attach might have suffered. The MRI didn't have enough images to tell for sure though.

Going on with the less good news is that there is synovial effusion but it is limited. At least this explains the loss of full flexion which prevents me from sitting on my heel for instance. This should pass and reduce eventually as the inflammation disappears. I think that effusion corresponds to that white area, as I recall from my appointment.

And now to the more serious issues which, at least, explain the persisting pain. Let's start with the most obvious culprit, not visible on the x-rays but clearly on the MRI: two bone edemas, one at the top of the tibia, one at the bottom of the femur, proving that both bones did touch, yikes! The x-rays show a silverline though, no fracture at least. For my doctor, this could have easily happened given what the compression must have been. Phew!

And, with compression comes the worst news: while the interior meniscus definitely shows some tear/degeneration after 25 years of intensive running, it was still highly functional in its shock absorber role. Yet, that huge pinch between the displaced bones created a fissure, as I could guess from browsing the Internet and alluded to in my previous post. Because of the very limited number of images of the MRI, the presence of a fissure could be confirmed but the size of it not established.

The meniscus is fibrocartilaginous so it can't repair itself. It's not vascularized and there are no nerves so the fissure itself can't be a source of pain. Yet, the mechanical rupture could prevent the knee from functioning properly, hence be painful. But we'll know if that's the case only after the bone edemas heal. Which should take a few more weeks.

Meanwhile, no impact which makes it a challenging for me to do cardio training as I don't particularly enjoy going to the gym and even less so in group class formats.

And that's it for now. Some hope but more patience needed, and even more so as healing slows down with age. That part of aging which sucks... For so many years, I didn't want to believe others saying it, at least you've been warned! ;-)

0 to 60 in... a bad twist!

As someone who likes running for the speed of it, it's really impressive to follow the outstanding progression of one key metric in the automotive industry: the time it takes for a car to reach 60 miles per hour, from a full stop. Last week electrek reported on Porsche boasting a mere 2.1 seconds for its Taycan Turbo GT with is Weissach boosting package. What $230,000 can buy you these days... No wonder this unsustainable race to power has create another environmental catastrophe, or a boon for the tire industry as a matter of fact. Indeed, electrical cars burn tires 20 to 30% faster than traditional ones.

As for me, the number 60 triggers great memories of my 60-meter dash runs in middle school. Being among the youngest and shortest throughout all my school years, 1 year ahead of my schoolmates. my speed on that distance help me regain some stature and self confidence. I switched to and focused on soccer afterwards, only coming back to the track mid way through College. Then to distance running after building a family.

60 is also a major milestone I passed a month ago as some of you have seen on Facebook. After missing on most of the M55-59 age group after contracting an injury at the end of 2018, a tendon which took almost 4 years to heal, I was excited to see how to make age just a number, as I successfully did in my 40s and early 50s.

The beginning of the season wasn't great already with a minor but annoying pain deep in the calf. To be on the safe side, I did rest for 6 weeks in January and resumed training mid February, 3 weeks before the 50K Nationals on Long Island. Having missed the Jed Smith 50K annual test, I didn't have much ambition for that Championship, still aiming at breaking 4 hours given a reasonable fitness level.

There was special excitement for my birthday on this leap year. For many years I had teased my dad, an OB-GYN, thinking he had decided to declare my birth a few hours after a February 29 just to shield me from the ambiguity of a 2/29 birth date. He didn't find that particularly funny, I'll never know for sure if I turned 60 or 15 last month. March 1st was a Friday this year and it turned out to be a busy day: 10 hours straight at work, then rushing out to squeeze an ultimate 10K training run before some tapering, then attending a concert at Agnès' school. It was pouring rain, not the best conditions to test the speed, although you never know which weather you'll get in New York in March, so I did suck it out. 50 yards from the house, I was at full speed when I saw a big puddle and decided to jump over it laterally. Oh my, how much I regret that decision... Upon landing, I thought I had lost my lower leg. Such an intense pain, like a wire had gone though the knee to cut the leg.

Going to the concert right after this was a painful experience as I could barely hold any weight on my left leg. But the next day was horrible, after the knee warmed down and a big inflammation kicked in. Like with any bad event happening to you, or to me anyway, I got into pure denial that this could be serious.

I first thought that I had just twisted my knee given all the ligaments around the need were so painful but the knee still seemed to function. And that it would just take a couple of weeks to pass. But then, after the swelling decreased, and seeing a PT last week, who checked the ligaments were all good, the pain still subsides and it seems like an MRI is now in order to see how much damage has the meniscus suffered and if surgery is required. Dang, triple dang. Just for that stupid idea of avoiding a puddle.

Source: vishalpai.com.au/meniscal-surgery

I've so many bad feelings about the situation that I'm thinking of writing another post just to spit them out! Not that you care but as part of the journaling of my running experience. And some sort of therapy.

So, here you are for those wondering about my silence and 3 DNSs so far this year. I so much wish this would be just a nightmare or an April Fool joke but I spent a month pitching myself and, unfortunately, it isn't. And it sucks. Although, every day, and thinking about too many friends, I remind myself that this isn't cancer at least. And all the energy and hours I'm saving from not running go into my first job, my employer should be happy at least.

With that, not much to relate anymore in this blog from a running journey standpoint. Hopefully some better news in a few weeks. Or months. Not years. Or worse...