Reviews | Runner’s Knee

IMG_20180408_170305

I was running. I was on the Moonee Ponds Creek trail. It travels, unsurprisingly, alongside the Moonee Ponds creek, and runs from the Docklands through the northern suburbs up towards Melbourne International Airport. It also connects to its sister trails; The Broadmeadows Valley Trail, The Western Ring Road Trail, and The Capital City Trail. My intention was to run twenty kilometers. A not undifficult distance, but one I had mandated myself. I had done so for good reason, July 28th was coming. I started strong. I had the day off, a benefit of working part time, and so had prepared well. I had had a sensible breakfast, waited the appropriate time for digestion to take place, and the days weather was cool but fair. Conditions were good. 

The first kilometer I was working out the kinks, letting stiffness leave my body. The second kilometer felt good. Very good. My body temperature was low, my breathing was easy, and I was flying over the cement with the easy grace of a gazelle. Then came the twinge. The niggle. The lone forerunner sprinting to the castle to let them know trouble was just over the horizon. I did what anyone with the twin drivers of motivation and denial would do. I kept running.

Throughout the third and fourth kilometers I evaluated and reevaluated the state of my knee. The niggle had grown into something more, discomfort, but only for brief periods. Mostly, when I was going up or down an incline. On those inclines I would worry, questioning if I should stop while not really wanting to, wondering if I was doing more harm than good. Then the flats would come, the niggle would subside, and I would convince myself that everything was fine, it was just my tendons playing funny buggers; a thing they’d never done before. 

My watch vibrated, letting me know the fourth kilometer was complete, whilst simultaneously informing how long it took me to run it. It was a good time. I couldn’t stop now. Definitely not. I rounded a bend in the track and headed up a slight hill. The niggle that had become discomfort now became pain. July 28th, I told myself, and pushed through the pain. I pushed through until I got to a flat, where now the discomfort continued. That was worrying. Flats were my reprieve. They were were my optimistic delusion lived. That discomfort chased my optimism away. 

My watch vibrated again, telling me I had reached the five kilometer mark. Fifteen more to go. Fifteen more kilometers and who knew what state my knee would be in by then. But, July 28th, I told myself. Won’t be possible if you damage your knee beyond recovery now, a second voice said. That second voice sounded somewhat like my wife, who, when it comes to my limits, is more realistic and knowledgeable than me. It’s a good voice to have in my head beside my own. I let my momentum stop along with my watch. On the five kilometer walk home my knee continued to be uncomfortable and sore. It would prove to remain this way for many days to come. 

Runner’s knee is a generic term used to describe a number of overuse injuries that result in pain around the kneecap, also known as the patella. The most common form of runner’s knee is called Patellofemoral Pain Syndrome or PFPS. It’s what I have/had and involves pain around the fat pad beneath the patella, the synovial tissue lining the knee joint, and the surrounding tendons. In other words, pain in front of, around, and beneath the kneecap. You can see why it’s the most common.

As suggested earlier, runner’s knee generally comes from overuse. In my case this is one hundred percent the reason. Just a few days before it’s onset, my wife — the one who’s voice exists not only inside my head but also outside it — had wisely suggested I cool it a bit on the running. I had been going hard. Monday’s involved a ten to fourteen kilometer run. On Wednesdays it was a “gentler” eight kilometers, before the big one on Friday, which would range anywhere between fourteen to twenty kilometers. I was also riding to work throughout that week, as well as going for walks during the day. I had been completing this routine for around a month, building up that longer Friday run until now, when I was set to complete the twenty. I’ve since learned my wife’s advice had already come too late, as runner’s knee presents around two weeks after the initial overuse.

The kneecap is different to a lot of the rest of your body, in that it floats within the knee. When not floating it rests within its home, called the trochlear groove. Then it’s able to slide up and down within the knee as you sit and stand and flex and bend. What helps with all this sliding and floating is articular cartilage, which is a slippery substance. There are also fluids and fat pads that help with the lubricating and cushioning. It’s a fairly robust system — unless you overdo it. Then comes inflammation, soreness, and a certain amount of hobbling when faced with stairs. 

There a number of ways to treat runner’s knee. Icing it is an excellent first step, and second, and third, and fourth, and fifth. This is because it’s a good idea to ice the knee up to five times a day, for around fifteen minutes at a time. Compression and elevation also helps, as does taping and bracing the knee. Then there’s the one major treatment that is all but mandatory when faced with runner’s knee. Rest. On one website that I went on in researching this affliction, it asked the question, “Can I run with runner’s knee?” The answer was, “In short, no.” 

I kept running.

Well, sort of. I had a week and a half off, and then I was back to running through the pain. That week and a half did do some good, as, even with me still running, the pain was less than it had been, and the recovery the days after a run seemed quicker. I did an eight kilometer run, then a ten a week later, then tried again for the twenty a few more days after that. This was not a good idea but July 28th was coming and I knew without the mental knowledge of doing that twenty I wouldn’t survive. I completed the twenty without too much trouble. It hurt at times, yes, but less so than on that first day. Given everything, it was pretty good. The next morning was a different story. The inflammation was well and truly back, not that it had ever truly left, and the stairs at work proved to be a mighty milestone I was proud to overcome. I iced it and elevated it and the day after that it felt pretty good again.

I did one more six kilometer run before July 28th, and this pattern repeated itself.

July 28th came. The day of Run Melbourne, a half marathon which weaves through the heart of Melbourne CBD, and that I had signed up for nearly six months prior. Twenty one point one kilometers of track that I completed with a persistent discomfort in my knee and began to pay for just over two hours after crossing the finish line. Beyond that the run itself was, surprisingly, rather pleasant.

I don’t usually give ratings when I do reviews but if I did I wouldn’t rate runners knee all that highly; but then I would also have to admit that its onset and continued existence was entirely due to the choices I made. 

Choices tell us a lot about the people making them. They tell us about that person’s motivations and their desires. They tell us about that person’s faults and fears. They can, when looked at from a point of distance, tell you things about yourself you might not have known or recognised previously. 

Most treatment plans for runners knees suggest four to six weeks of non-aggravating activities, coupled with strength training exercises, and namely, not to ignore the pain. July 28th was five days ago, so now that’s what I’m choosing to do. 

I went for a walk today on the Moonee Ponds Creek Trail. I had a sensible breakfast, waited the appropriate time for digestion to take place; the weather was cool but fair. 

Conditions were good. 

Talk soon,

Damian

December 24, 2016

24122016

This morning I went for a run. I had pre-planned it. The inevitable Christmas gorging is something I’m a big fan of partaking in and thought I should preemptively offset at least a bit of it, so that when my belly’s full from too much consumption and the twin demons of guilt and regret are making their way towards me I can say ‘Well, at least I went for a run.’

I got up at around 6:30am and by seven I was dressed in my running gear and closing the door of my house behind me. The sun was low, but bright and beaming. It reached somewhere towards thirty five degrees celsius in Melbourne yesterday so even with some of that heat dissipating overnight the morning was still warm. I started my watch to record the kilometers as I ran them and my feet began rhythmically hitting the pavement. I decided that I would run ten kilometers and by the time I reached the five kilometer turnaround point I was covered in sweat. The warmth of my body felt good, and cleansing.

On the way back it started to rain. Nothing too hard, just a light sun shower after the heat of the night before. Usually, I don’t enjoy running in the rain mostly because I find it frustrating when it gets into my eyes, but this morning, with my sunglasses negating that problem, the rain was clean and refreshing. I finished the run in good spirits, my muscles sore but my body hot and alert. As I usually do after a run I decided to do a cool down walk around the park next to my house. The rain, that until this point had remained in the shower category, turned into a thunderstorm as I did so. It was gorgeous. Even with the thunder and lightning dancing above me and the thick drops soaking my already wet running gear the storm still wasn’t enough to dampen our strong Australian sun. Instead I had a stunning view of green grass under a small patch of grey sky encircled, to the horizon, by blue and sunshine. A summer storm. The heavy rain was welcome and I finally started cooling as I made my way around the deserted park. I stopped briefly under a tree to simply watch the storm as the pattern of lightning followed by thunder continued above. The rain was torrential now but the dark mass it poured out of was still ringed by the stalwart light of the sun. I stood there, hot but getting colder, red faced and wearing black, and near laughed at the beauty of it. A middle aged coupled came towards me from around the corner of the path and they too were soaked, although seemed to share the energy a thunderstorm can bring. They approached and the man made a joke about the fickleness of Melbourne weather, we shared a smile, and they stood beside me under the boughs of the tree, all of us silently watching the rain.

Tomorrow is Christmas and with that comes a certain kind of magic. On the other side of the world that magic is personified by blankets of snow, rugging up against the cold, and sharing warm fires. Here, nothing seems more appropriate that standing with strangers and watching a summer storm.

I hope you all have a magical day tomorrow.

Talk soon

Damian

December 13, 2016

p1040939

I finally remembered that at the end of my last post I promised to write about what I learned from NaNoWriMo the next day. It’s now twelve days later. In my defense, I’m a terrible person. Nevertheless, onward and upwards, and I’m going to write about it now.

I’m writing this for myself as much as you, dear reader. NaNoWriMo was quite an experience, one who’s lessons I’m keen to distill into a fine and pungent liquor I can guzzle down whenever I’m feeling less than motivated in the future in order to give me that sweet writing buzz.

Here’s what I learnt:

  1. I can write far more on a given day that I expected of myself. On my best day I topped somewhere around 6000 words, and averaged somewhere around 2,500. Were they good words? Depends on the context. On their own? Sure. The way I strung them together? Quite a bit less so. Which leads me to my next lesson.
  2. Good words don’t always have to be good. That last sentence is a pretty good example of what I’m talking about. The words I write don’t always need the best version of themselves in order for them still to have value. In the case of rushed, oh-god-I-just-want-to-reach-my-word-limit, type words their value comes from simply existing, by having something I didn’t have before. After smashing out words that way I then have some content that, however bad, I can slowly work on and improve until it’s of a higher quality. Without that, I literally have nothing. Bad words are still better than no words at all.
  3. Writing by myself is possible but writing as a group is better. I was lucky enough to share this NaNoWriMo season with an excellent group of people. We all worked individually on our own novels, there was no co-writing going on, but knowing they were out there slogging away at it, as well as having the opportunity to talk or message about the process, helped greatly. It gave me external as well as internal pressures, as well as people to bounce ideas off of and compete with. Writing is a solitary endeavor most of the time, having a writing group around you is a good way to alleviate that.
  4. Consistency is best. This is a lesson that I feel I was already aware of, like something in my periphery, but was really brought home by NaNoWriMo. By forcing myself to write everyday and seeing that page count climb ever higher it truly showed me that getting results isn’t a matter of one crazed burst of energy but by slowly and consistently putting time and energy into a project. I walked away with 61,000 words written in a month and I can attribute that to staying consistent (and also to drinking my body weight in coffee).
  5. Just start. I’m definitely someone who likes to know exactly how I’m going to do something before I start doing it. This often leads to me not starting a project or endeavor because I feel like I need more time to plan every aspect of it out in my head. Often that’s an impossible task, not to mention unnecessary. With NaNoWriMo I had the very basest of plans for my novel and it didn’t matter. I made it up as I went along and for the most part I didn’t hate what came out. Some of it I even really loved and have to ask would I have discovered it if I had tried to plan it all?
  6. I can write a novel. Easily the best lesson from all this. I haven’t written one yet by my measure, but I have made a damn good start. I’ll do a second draft of all those words I wrote, a slower and more considered one, and using all the lessons I learned I know by this time next year I can say that I have. I know this because of NaNoWriMo.

++++

These lessons aren’t just good for writing either. Two days ago I ran a half marathon, a little bit over actually as I ran 22 kilometers. I’ve done this twice before in my life and both times I spent months training for the event. This time I just went for it. I started and simply kept going. I did it at a consistent pace and by finishing got far more out of myself than I had expected. It wasn’t my fastest run but it also wasn’t as bad as I would have thought. I timed in at almost exactly two hours (I was .9 of a second over). Basically, I did the NaNoWriMo equivalent of running and since I started this whole thing by describing NaNoWriMo as a writing marathon it seems appropriate.

Talk soon

Damian