I’ve torn my meniscus. I’m grinding away my tibia and fibia. There is a piece of bone floating in my knee. Well, at least I’m in Mexico.
I wish I had the ability to block these thoughts from my mind, especially while in Mexico, when pain creeps in to my body. The gift and the curse of ultrarunning is an intense physical body awareness. We know when all systems are working fluidly. It feels amazing to cover long distances while managing our bodies perfectly. And I feel, if we stay in tune, we also know when something is not right. Depending at what point we are in our season or training, we might try to ignore pain, or write it off as nothing too serious. Until it is.
Since the holidays I have battled a stride altering, sharp pain in my left knee. My training right now is about daily fitness and nothing more. I do not need to run everyday, but I choose to stay fit through a variety of exercises including swimming, climbing, body weight core exercises and group training classes. Running is one activity I obviously love to include as an option and my frustration of not being able to incorporate it drove me in to see my PT, Heather North, RPT. My knee pain baffled us both. It only hurt while running. It moved around. I could not palpate it. She adjusted, needled, massaged and e-stemmed to the point of my exhaustion and sent me off with advice to run daily and pay attention to all sensation.
While in Mexico to celebrate Darcy’s birthday I followed the doctor’s orders and reported back to Heather via email. I had the luxury of enjoying a fun girls weekend, soaking up sun and even rode a wave for a split second. Meanwhile her brain was smoking trying to figure it out and had a nervous wonderment if my pain could be bone related (femur stress fracture).
When I returned to Boulder and sat on her table once again we charged through my symptoms, pulled out anatomy books, and reviewed all possibilities. She, thankfully, ruled out the stress fracture for now, and we moved on to a new-to-me injury reality. Nerve. Of course nerves have been involved in previous injuries; nerves tell us pain. In this case, my femoral nerve, the one that flows through a small channel in my hip along with a lot of other anatomy, is pinched. Heather offered that this could be compared to the common Sciatica, where the pain refers to the low back and butt. Mine is on the front in the periphery femoral nerve and refers to my knee.
This all likely started in June. For two weeks after the Cayuga 50mile championships I had to manually lift my left leg to lasso my underwear around my foot. My hip flexor was kaput. It is my belief that scar tissue is taking up some of the valuable, limited space in that region between my hip and pelvic bones and possibly binding the nerve. I’ve managed the hip through some amazing summer (JMT and Kings Trails) and fall (Conservacion Patagonica) adventures. Now it is time to heal it knowing that the injury is in my hip, not my knee.
This incredible shift in my mental view of this injury has been a huge adjustment in my treatment and recovery. Now when I run, I am not thinking that my knee is grinding away bone on bone as the pain builds. Instead I think about my hip, visualize that nerve bound up in there. I work to open my stride behind me, keep my feet from reaching, tuck my pelvis and give space to that otherwise limited area. And wouldn’t you know it, the pain in my knee subsides.
Our treatment plan includes more running, tweaking my form, hip opening stretches, no squats, lunges or other quad builders (she doesn’t want me to maintain or increase muscle mass in that area for now). Instead, I am to focus on strengthening my glutes (all runners should) and stabilizing muscles. E-stem a couple times a day and nerve flossing will probably be the biggest aids to my recovery.
I feel like I’m having another in-body learning experience. To gain an understanding of nerve injuries as compared to tissue (ligaments, tendons, muscle) feels like a whole new ballgame. I love this sport for all that it teaches me. And I’m thankful for all of the insight gained by going through these experiences.