Left knee and Acupuncture: New hope from the East?

I had an acupuncture treatment for my left knee on Thursday afternoon. It went well and I can't wait to get back in for my second tomorrow.

Maybe I should bring everyone up to speed on what's wrong with the knee. First, I had about 1/3 of my patella tendon removed at the end of college. I wasn't functioning properly, hadn't healed over 2 years, and was sort of like a rubber band that had lost it's elasticity. Frayed. That's how the orthopedic doctor described it, and so we went ahead with the removal. Which isn't that bad of a surgery, as we all have twice as much tendon there as we need.

From 2002-2005, my first years in the Army, I couldn't run. I had to take the alternate physical fitness test, which didn't really matter much anyways because I was deployed for so long over that time period. That's when I started to run again, more and more miles each year until last April I had the re-emergence of the pain in the top of the knee cap. Frankly, I've tried everything to get it to leave. Massage, stretching, anti-inflammatory cream, some time off. I took May and June off this past year, but recognizing that I needed to race the TransRockies Run, I allowed myself to run through the pain. A note on that ~ I'm still shocked that Paul and I finished 4th at that event. I ran 115 miles over 6 days in Colorado's mountains with a really bad patella tendon.

Which begs the question: how bad could it be if I could do that? Patella tendinopathy/tendinitis sort of saps your quad strength. It disallows you from using your quad to support the knee. In turn, you have to use other muscles to compensate. I would put most of my weight on my right leg. I could use more calf and more hamstring to stabilize each step and bound. Over time, it degrades other, surrounding muscles. When I finally decided it was time to rest the knee, after the Team WWP season was over, I could barely lower myself to sit down in a chair ~ the left leg just wouldn't allow me to do it.

So, last October I went to see a traditional sports doctor. He took xrays, gave me the diagnosis that I expected, and told me to back off running and do an eccentric knee bend (at a decline angle) twice a day for rehab. We also tried two blood injections. Essentially, he injected my left knee at the point of greatest pain (top of the left kneecap) with a large needle/syringe filled with my own blood. The idea is that the pain is in the tendon, the tendon is not functioning properly and they don't carry much, if any, blood in them. Muscles heal quickly, mostly because they carry blood. So...if you can get/force blood into the tendon, it should heal the tendon quicker.

My two injections were very uncomfortable and felt like a bad bruise to the knee for the following 3 or 4 days, both times. And, they helped only marginally. It's really hard to tell if improvement is made, as it's made so gradually. The improvements are so small...micro level, at best. I know the knee isn't as bad as it was last October. But it's still not better. It's still not the same as my right knee.

Enter acupuncture. My wife Rachel has gone many times during her ballet career for a variety of injuries. For some reason, we never really talked about it. Maybe she felt that I would be skeptical: I'm on record that chiropractors are one-trick ponies that can help some ailments, but that they claim too much success. Of course, all that really matters is that someone finds improvement, so if you go to a chiro and it goes well, that's all that matters.

I have, however, never been skeptical about acupuncture ~ I've just never been exposed to it. It's the preferred medicine of choice for 1.2 billion people, likely more, so it must have something to it. And, more importantly, if Western medicine (the sports doc) chose to treat me by stimulating blood in the tendon ~ isn't that pretty much what acupuncture would do too ~ only with a smaller, more precise needle?

So I went in (Rach came along to see how it went), and the doctor couldn't have been nicer. He had been trained in Shanghai, and teaches Tai'chi and Kung Fu here in Wellington. He placed one needle in my quad and one in my shin, along my body's "meridian." The he found the point of greatest pain in the kneecap and placed two needles there. Going in was uncomfortable, but not painful, per se. However, once they were in it wasn't painful at all. He left me to lay there with the needles in for 25 minutes, with a bio-energy (heat) lamp on the knee. When the time was up, he came in, removed the needles, rubbed the knee, and put a herbal cream on it.

I have felt a micro improvement in the knee. It's not better, to be sure, but the acupuncture doctor said that it would take three treatments. As I mentioned, I go back tomorrow for #2. I'm hopeful that there is continued improvement ~ he said he had seen this problem many times before and had had great success with the condition. We'll see next week ~ I'll post how things are going and how successful the treatment is. I've still got my skeptical eye...I won't be convinced until we're done. But hope springs eternal.

And this is something I had known about, heard about, that was successful at pain management. I won't be able to evaluate that, as I'm going for a specific treatment for a more-or-less mechanical problem, but certainly if one is successful then there's potential for the other (where there's smoke there's fire). Perhaps Western medicine could learn from the East? Western medicine has tried to quantify and assess acupuncture to little success ~ it seems that it's difficult for an apple to study an orange. Are there applications for the wider public, for veterans from war? I'll get more into that next week.

All my best & Keep moving forward, Matt

Three more weeks to the first finish line; three others coming this season

Three more weeks. That's what I keep telling myself. The right foot is coming along, and the knee is nearly fully healed, so I'm treating this injury rehabilitation as my first "finish line" of the season. The first part of my year. And I'm giving myself until the beginning of March to get there. It's a good marker to transition back to training. It'll have been 10 weeks since breaking the foot, which is actually a cautious return schedule. Clearly, broken bones heal at different rates, some faster, some slower. Being that I'm young, healthy, etc., it's fair to say that I'm on the faster end of that scale. And the "average" person is fully healed in 6-8 weeks. So 10 weeks is reasonable. Considering where I'm at now (walking, not quite full range of motion, feels like a bruise), March 1st should be good.

Similarly, the knee is finally at the end. It's still noticeable, which might be what I'm just going to have to get used to considering that I've had 1/3 of that tendon removed (2002). It'll likely never have the same elasticity that my other knee has. I'm still doing my rehab exercises for it, twice a day, and they're much, much improved from 4 months ago. Again, "average" recovery time for patella tendinitis is 4-6 months, and by the beginning of March I should be right in that window.

Both of which are why I haven't been blogging as much about training. I do a lot of stationary biking, and there really isn't much to say about that. It's not horrible, but it's certainly not exciting. But it has given me a lot of time to think about what I want from this coming season and beyond: I want to focus solely on quality. In this past I've been really interested in quantity, in lots of races and lots of miles. This time I'm changing direction towards one race ~ a road marathon at the end of the calendar year. Although I can't be specific yet about what race I'll choose, I do know that's what I want. And I want to drop my personal best in the event by 8+ minutes, to under 2 hours, 30 minutes. In turn, I also want to drop my personal bests in the half marathon (to 1:10) and the 10k (to 31 minutes).

So I'll be a road racer this year. A healthy one. So, my personal racing goals for the year:

1. Stay healthy
2. Run a marathon under 2:30
3. Run a half under 1:10
4. Run a 10k under 31 minutes

Best guess as to how the year turns out...I start training in March, increasing mileage until April. In May and June I train for a late June 10k. Then, starting in July, I train in earnests for a late October half marathon and a full in early December. This schedule gives me plenty of time to build gradually, something I've never really allowed myself to do.

Until next week, All my best & Keep moving forward, Matt

Starting again, from the bottom...

Wow, it seems surreal getting back on the blog when it looks so good! I admit, I haven't been excited at pdating the blog for some time. It was getting to be a nuisance as it wasn't well laid out, causing me to have to spend about twice as much time editing it as I should have. That said, now that it's formatted properly, I feel a little more motivated to plug in new information.

Like the fact that I'm continuing to support the Wounded Warrior Project via my running and racing! I just can't give it up. Frankly, it sort of grows on you over time. You feel good at your contribution, and just can't let it go. Even from New Zealand. Even with your first child, a daughter, soon to be born. Even with a full class schedule. And, unfortunately, even when injuries have taken you down for the past 5 months. As a lot of you know, I've had problems with the patella tendon in my left knee since last April/May. After completing my running schedule last year (4th overall at the TransRockies Run), I did one more race here in New Zealand (3rd overall at the Abel Tasman Coastal Classic), and decided to take some time off to heal.

That started in October. I went to see a sports doctor, who prescribed rest, rehabilitation exercises, and blood injections to the tendon in question. Slowly, over time, with a lot of hot yoga and light strengthening exercises, it's come around. So well that, on the day after Christmas (Boxing Day in NZ), I went for a jog in a local park, tripped on a root...and broke my right foot! It was a minor break, nothing serious, but tough to take. The knee wasn't fully healed, the foot was broken...what else? No joke, I've even had my fill of the painful minor stuff too: three toenails came off after the TRR and one malformed when it grew back - it was ingrown and had to get pulled. Lastly, I've just had a plantar wart on my left foot!

All that said, I'm feeling like I'm close to getting back on the horse. I'm just over 5 weeks since the broken foot, and should be fully healed around the end of February. The knee is significantly improved as well, and should be good by then as well. Right now I'm still consumed by stretching and strengthening as I can, with some biking to feel a little like I'm still getting some cardiovascular work in.

Over the next month, I'll lay out my goals for this coming running season, as well as illustrate how I'll connect them to the WWP. I expect to be back to regular run training by March 1st, and by then I'll start writing once per week...

All my best & Keep moving forward, Matt