X-ray Done, MRI Coming Soon...Hopefully

A week ago today, I visited my arm surgery doc to start discussing my left knee issues. In case you haven't followed along at home (if not, I don't blame you!), my left knee has been hurting for about two years now, and has gotten progressively worse. It's usually a sharp pain underneath my kneecap (lower, inner part) that most often shows up when my foot hits the ground when I'm running. Usually, it hurts badly for the first mile or two, then settles down the rest of the way. But if I try to run too often, it seems to last longer and, eventually, I'm forced to take a break from running altogether. Currently, I've been running twice per week, 3-5 miles at a time. Yesterday, during a 5 mile run, the knee hurt for about 3 miles. Getting close to that "take a break" time again, it seems.

Anyway, I had an X-ray last Friday, which showed nothing out of the ordinary. In fact, the doc said there was nice spacing around the joint (meaning I haven't totally destroyed my cartilage yet). He also wiggled my kneecap around and didn't feel much grinding or clicking. At that point, he gave me two choices: start physical therapy or get an MRI. I chose the latter, just because I want to know for sure what's going on in there...assuming an MRI will disclose that information. So now I have to wait for approval from my insurance company. I've met my deductible, but due to slow processing by said insurance company, that's not "official" just yet. So, I may not get approved anytime soon. And I'd rather not pay out-of-pocket for this MRI, especially after all of my recent medical expenses.

As for my broken arm, it's coming along fairly well. I'm still wearing the splint, and when it's off (when I'm showering or changing the sleeve under it), my arm feels very fragile and vulnerable. It hurts to bend my wrist in any direction. The incision is healing quite well, though, so I'm hoping that the scar won't be too ugly in the future. I go in for a checkup at the end of this month (Sept.) to possibly schedule my first session of occupational therapy, to try to get some strength and mobility back. I'm looking forward to having two functional arms once again.

Even though I could probably set up my trainer and do some indoor riding, I haven't done it yet. I'm pretty sure my bike needs some attention. Actually, I could probably get it into rideable condition for the trainer, but I'm sure it's not ready to ride outdoors. It'll need a pretty serious tune-up at the shop first.

So, things certainly haven't been boring here in Resurrected Runnerland.

But, honestly, boring sounds pretty good about now...

First Visit to the Sports Medicine Clinic

I just returned from my first visit to the Sports Medicine Clinic in Seattle. While more info will be forthcoming, I do have some preliminary info to share.

We discussed my recent running history. I told him how I trained for and ran my marathon back in May, then had my first run-in with the heel pain a couple of weeks later. Then came the 3 week layoff, then back into training (for Ragnar, primarily), then a six week layoff, then very minimal running the last 4-5 weeks.

He then observed my feet as I was standing (barefoot) and noticed that my offending foot pronates quite a bit. He then remarked at how tight my right calf and achilles are, and how that is likely affecting my foot movement during foot strike.

He then took xrays of my foot (unlike the PT I saw earlier this year). I don't have them to post here, unfortunately, but upon his diagnosis, he explained—and showed me— that I have a condition called Haglund's Deformity. There's a prominent growth on the top of my right heel that's causing irritation of my achilles tendon and, possibly, the bursa. While this may not be directly related to the pain I'm also feeling in other areas of my foot, it's certainly the genesis of this injury. The excessive pronation is likely the cause of at least the other pain, if not also this deformity issue. He also said something about a possible cyst there, although I wasn't totally clear about that. He said that surgery probably won't be needed. Oh — he also said that my six week layoff would have been enough time off if it was just tendonitis (not totally sure I agree), and that the recurring nature of the injury points to a structural problem (as the x-ray showed, and to which I do agree).

I asked him if he thought tinkering with my running form could have contributed to this and he confirmed that he has seen many runners who have been injured during that process. While agreeing that working to improving one's form isn't a bad thing, he said that our bodies do settle on a natural running form based on our biomechanics and structural issues (but again, no, he doesn't think over-striding and heel-striking are good). He did comment that I'm probably not a good candidate for Vibram Five Fingers, though.

He agreed that other contributing factors could be overuse and increased hill training (which really pushed it over the top back in August).

As you might suspect, he does recommend custom orthotics. While I've been averse to this idea before, now I say bring 'em on. Fortunately, he's not a fan of what he calls "bricks" (i.e. heavy, motion-control shoes, which I used to wear) and that I should be fine continuing to wear my neutral running shoes. I'll just have a bit more support to correct my overpronation in that foot.

The next step in the process will be an MRI to take a look at the soft tissues & tendons surrounding the heel (and ankle area) to see how inflamed they are. I'm awaiting a call from their office to schedule an appointment.

Thankfully (and as I suspected) there's no sign of any stress fractures. I just have a freakish heel bone and a wonky foot movement.

So that's all I know at this point. As you'd guess, I'm done running for the time being. After the MRI, we'll discuss cross-training options, and how long it might be until I start running again.

Not running is a major bummer, but I'm happy to be working with someone who (so far) I trust.