Patellar Tendinitis

On Tuesday April 20th, 2010 I went to the Illinois Bone and Joint Institute where I saw Dr. Dugan who has expertise in sports medicine, is the team physician for the Chicago Wolves hockey team and more importantly was a competitive runner at one time.  I didn't care for his bedside manner but once I got past that (not sure if I ever really did), I realized he really did know a lot about running as he recited information to me that only runners really know.

I explained to him where the knee pain is, on the upper front part of the knee and then explained to him how it hurts to run down hill, go down stairs and to fully bend the knee.  I could tell he new right away what it was since he didn't care about my shoes, my running form or any of the things that really tend to indicate how an injury might start.

He asked me to lie on my back, which I did but thought it was strange.  He then proceeded to test my flexibility and said I was more flexible than the average person.  Then I informed him I didn't realize he wanted me to fully stretch my hamstring and when I did he said I was very blessed to have such flexibility.  He then informed me that oddly enough people who are not flexible in their hamstings tend to have similar knee problems as myself.

He explained I have Patellar Tendinitis, basically it is the overuse of the patellar tendon.

A CNN article which cites the Mayo Clinic explains why some people might get patellar tendinitis:

• Stress on the patellar tendon. Repeated jumping is most commonly associated with patellar tendinitis. Sudden increases in the intensity of physical activity or increases in frequency of activity also put added stress on the tendon. (No, I am not involved in any kind of jumping activity that might stress the knee.  However I wonder if I still bounce up a lot when I run instead of using my momentum to go forward?)

•  Tight leg muscles. Reduced flexibility in your thigh muscles (quadriceps) and your hamstrings, which run up the back of your thighs, could increase the strain on your patellar tendon. (Fortunately for me, it seems I've been able to escape injury all these injuries because I'm very flexible. So this for sure isn't a factor for me.)

• Malalignment of your leg bones. The way your leg bones line up could be off slightly, putting strain on your tendon. (If this were the case I would have experienced pain much earlier in my running career.)

• Raised kneecap (patella alta). Your kneecap may be positioned higher up on your knee joint, causing increased strain on the patellar tendon. (Again, If this were the case I would have experienced pain much earlier in my running career.)

• Intensity and frequency of physical activity. Repeated jumping is most commonly associated with patellar tendinitis. Sudden increases in the intensity of physical activity or increases in frequency of activity also put added stress on the tendon.  (His opinion is that in my case it is a matter of how long I choose to run for and how many miles I'm doing per week with lack of cross-training.)

• Being overweight. Additionally, being overweight or obese increases the stress on the patellar tendon, and some research suggests that having a greater waist circumference or higher body mass index may increase the risk of patellar tendinitis.  (I was a little surprised when this didn't come up as often as I thought it would.  I KNOW that I probably should consider running with 25 pounds less on my ass but am not focused on weight loss as much as I am on being physically active and eating well.  I figure if I do those two things, in the long run losing weight will be a healthy outcome despite it not being my main goal.  I'm not happy with the weight gain but I'd be more unhappy dieting.)

• Muscular imbalance. If some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis. (He didn't mention this but I've always known how improtant weight training is to keep muscles in balance.  I just hadn't gotten to that point in my training yet and had been putting it off.)

He gave me good advice about taking into consideration cross-training.  He asked if pulling back to only running 35-50 percent of my mileage and then increasing 10% per week until July was doable or if it would impede on my goals.  I told him I could do that but that it would be a devastating blow to where I pictured being in the coming months.  I told him that of course I would do it if I was in any risk of doing permanent damage.  I was then shocked to hear him say "probably not".  He said if I pressed forward I would "probably not" risk any kind of damage.  I feel that in my gut too.  He said cutting back would be to get to a point where I run comfortably and pain free.  Hmmmm what to do?

Well, I had decided before the race 4 days ago that I would indeed take a week off.  I of course am going to stick to that promise.  I think that I will also cut back on miles initially.  I also plan to do other things.  I'd like to take a swim class, start biking, play volleyball, lift weights and maybe do a yogalaties class or yoga on my own.  I had considered beginning marathon training in June and now I know for sure that is out of the picture.  I will continue to focus on 5k's most of the summer. 

What I cannot do is stop running.  Not now.  Not when I feel I'm on the brink of a breakthrough.  I will test the waters for the coming weeks and pull back on frequency and miles when I need to and do something else.

I am a very lucky person.  I have been able to run pain free for most of my life.  I have enjoyed running and never feared getting hurt.  I still enjoy running but I'm a little more aware of the getting hurt part.  I will continue to listen to my body and work on healing.  I think I may go to a running clinic on May 15th that focuses on running form (which I don't THINK I have too many problems with) to aid in keeping my promise to myself.

As for those people who said to me, "you over did it", "mother nature is telling you something", "you are getting old", "don't push it", I'm sorry but I just don't think so.  I'll never move forward if I don't push myself and I sure as hell am not too old to be running.  I'll prove you wrong, yes I will!

 

Painful Victory

On Saturday, April 17th I ran my second race of the year! The anticipation for the race had started creeping up on me a week prior to the race but was full blown nerves and worries on Friday night. I had such a hard time falling asleep! All I could think about was whether or not I'd be happy or disappointed the following morning.  I just had to believe I could do it and not fear disappointment.  My head was spinning because I knew there was a possibility of disappointment.  I fully believed that if I ran to my fullest potential, I would improve my time.  The problem however was not believing I could run faster but improving my time while running injured.  Two weeks earlier I had started to aggravate my knee and about 3 days prior to the race I was seriously considering not running for fear I might do some damage to my knee. My gut instincts told me I could handle it and despite the fact there wasn't any improvement I moved forward and decided to race anyway.

I'm glad I did! I know I'm just getting back into running but I have to remember that I'm not new to this. I can trust my instincts and my body. Yes, it feels like starting over but no I'm really not.

On race day I feared that all my efforts on race day to produce the fruits of my labor would be for nothing because I wouldn't be able to run to my full potential or even close to. I was wrong. Very, very wrong! To gauge improvement and set goals I used my February FROSTY FOOTRACE 5K TIME of 30:20.1 (9:47/M pace). My hope was to run faster than the 30:20.1 I ran in February but my goal was 27:51 and to run an 8:58 pace. Sooooooo how did I do on Saturday???

My TAKE A STEP FOR KIDS 5K TIME was 26:57 (8:42/M pace). I placed:

• 67th out 472 total runners (top 14%)

• 23rd out of 309 women (top 7%)

• and 3rd out of 44 women in my age division (top 7%)

When I was done running I waited in line to get a print out of my time and place...

I kid you not, as soon as I looked at my print out and read the number 3 they read my name and I walked to the front to get my 3rd place medal.

I was in total shock and couldn't believe that I had actually won a medal after so many years! Furthermore, I was happy that I didn't get the medal by default but had actually EARNED it by competing against 44 other women in my division. It felt awesome! I felt validated and felt there was hope to recapture old glory.

The best part about it was having my children there. My son asked me, "Mom, did you win a medal because you were the fastest?" I almost said no and then I smiled and said, "Yes, I was one of the fastest!" I couldn't believe I was bragging and BRAGGING to my almost 4 year old son! And of course they all took turns wearing the medal! It was an awesome moment!

"Mamma, is this a cookie?"

"Mamma, can I have your medal?

"Mamma, were you the fastest?

Afterwards, my family took me for an out of the norm brunch at Denny's where the taste of victory was soon replaced with worry and pain. My darn knee!  It is upsetting that my celebration was so short lived and overshadowed by injury. But at least I got a little taste of success and once that happens....Well, we will wait and see, now won't we?

Click on KNEE INJURY to read about my Dr.'s evalutation.

People Running Everywhere

Have you ever watched a marathon? No, I don't mean on T.V. where they only show the herds of runners in corrals from an aerial view and then zoom in on the elite. Have you ever REALLY watched a marathon? In person? To see all the different kinds of people that run? Tall, short, Asians, Latinos, Blacks, redheads, 16 year olds, 80 years olds, people who are extremely fit, people who are fit, people who are trying damn hard to be fit and then people who are not so fit who are struggling with weight, who have trained like the rest but are battling other battles besides the marathon on race day and are taking a step in the right direction by just being there. I can’t believe how many different people there are running marathons and other races. People who you'd see on the street and never once think they looked like a (marathon) runner. It amazes me how strong people are. It amazes me how the human mind stereotypes what a runner looks like only to have people shatter that notion into a billion different kinds of runners.

Every time someone runs past I think, "I wonder what their story is? I wonder why they are running?" They all have amazing personal stories. Sometimes if you run besides them they will tell you their stories to kill time and sometimes they'll wear their stories proud on their shirts,"Just Married!", "3 Months Pregnant!", "In Memory of Mom". They are all amazing. Regardless if they take 2 hours to finish a marathon, 4 hours or the allotted 6.5 hours. The ones who are the most amazing are the ones who keep on fighting to finish before they start breaking down the course. I promise you, you will never think "I can't" again and you will never be as inspired as you are at that moment as you watch these people accomplish their goal, their own personal goals that make them all runners.

No matter if they are running 4 minute miles or 14 minute miles, they are all running and therefore they are all runners. It is amazing that something like running can unite so many people to come and PAY to run knowing that most of them are going to walk away with nothing but a t-shirt. AND of course the pride of knowing they finished, broke a personal best time, had an amazing mile split or caught up to that runner at the very end. It is truly an amazing experience. And I hope it to be an amazing experience for me on Saturday as well.

No, I'm not running a marathon tomorrow but I am running my 2nd 5k race of the year. My race in February was my baseline and I have been looking forward to this race to see if I have improved at all. I am already really proud of myself. In 2009 I only clocked in 51.2 miles for the entire year and this year after only 3 months of running I have clocked in 133.3 miles!!! That alone is a personal victory for me. However, I want much, much, much more. I am currently about 1 minute slower per mile than last year and have not shown significant improvement in my pace since my first race. I hope that when I hear the gun go off that my adrenaline will help pump me to the finish line. It is almost nearly impossible for me to replicate the feeling that comes over me after the start of a race. I'm really hoping that I will see the improvement during the race.

Along with hope comes fear. I fear disappointment. No one puts more pressure on me than myself. When I want something and I work hard to attain it, nothing is more disappointing than failure. I hate failing at anything. I get upset if I fail to get the kids to the library on time for story time. You can imagine how devastated I feel when I don't achieve a personal goal that I have been working very hard to achieve. I don't plan on winning a medal or coming in 1st. I don't even care how I do overall in comparison to everyone else. I just care about my time. I'd like to finish in 27:51 and run an 8:58 pace. It seems like a very difficult challenge at the moment and I'm trying to prepare myself to accept I may have to wait later in my running season and extend my goal to the next race. BUT I'M GOING TO TRY and I will remind myself that no matter how slow I am, no matter how much I weigh, no matter how much my thighs rub against each other, no matter how much knee pain I may feel, I am a runner. I can persevere!

I hate when runners complain about their injuries all the time and blame their poor performance on everything that went wrong. I will try to not be like that and I will look past my aches and pains. I will run the best that I can and accept what I can accomplish tomorrow. My next race after tomorrow will most likely not be until May 23rd and I will try to remember that I will have another shot for self improvement on that day.

If you have a couple of minutes watch this video by Jeff Kline. He's a personal trainer and coach and owner of PRS FIT. He inspired my recollection of thoughts on all the different people who run and what makes them runners.

Look for my next post about running accessories I absolutely have to have!!!

Reaching Out from Jeff Kline on Vimeo.

The Persistence of Time

When I think of time I think of it in many different ways. In general when I think of time I always think of Dali’s beautiful painting, La Resistencia de la Memoria (The Persistence of Memory/Time) that depicts time as being irrelevant.  For the most part I do agree with his assesment of time.  However, right now I live in a world where time is very significant.

But usually on a daily basis I think of time as how it pertains to running and when will I be able to run.  What time do I have to get up to squeeze in a run?  Do I have time to get a run in before dinner is ready?  What time will I have to get up to run at sunrise?  What time will I have to run before sunset?  What was my pace? What was my overall time? Was it my fastest time? How much time to I have before I have to be back home???

Ughhh. That saying, “Time is never on my side” couldn’t be truer. When I think about everything I have to go through to squeeze a run in it amazes me that I actually get it done most days that I set out to do so. Believe me; no one is more shocked than me. From the minute the alarm goes off at 5:40 am the grueling race begins. Depending on how long of a run I’m planning that morning I know I have to get moving out the door between 6 and 6:15. I then have to be back in time to get showered, dressed and help get the 3 kids fed, washed up, teeth brushed, dressed, hair brushed, and in the van by around 8:40 to be at school by 9. It’s an amazing race to say the least and I am very blessed to have a wonderful husband who helps get them out the door too!

If I can’t get up in the morning to go for a run I will try to do it between 9:15-10:45 while the kiddos are in preschool. It’s a win/lose situation because I feel a little less pressed for time and more awake but I have to push a jogger which isn’t as nice as running freely. My last chance to get a run in is usually in the p.m. but it breaks one of my golden rules. I won’t allow my running to come in between family time. I consider the evening to be for dining with my family and relaxing with my husband. Unfortunately, it is my FAVORITE time of day to run in. I tend to feel amazing running as the sun sets on a cool almost cold evening when I can barely see the hustle and bustle of everyday life, when the darkness blurs the mind-numbing clones of houses in my subdivision. I tend to run more relaxed, with energy, faster and overall better. But rarely do I take pleasure in that kind of a run unless I absolutely need to get away and out of the house.

So, early morning runs it is! Some people think I’m crazy and others think it is great. The fact of the matter is that I don’t have a triple jogger and wouldn’t want to push one anyways so unless I run at the crack of dawn, I just wouldn’t be able to get it in.

I know that some my question my sanity or think “I’m hardcore” but really I am not. I wish I was hardcore and could run several times a day and have varying workouts.  But for me it is all about time and finding time. The other day my friend and I ran on a horribly windy day where pushing a stroller down a hill was as hard as pushing it up it! It was crazy, I admit it. But had I not done it, I wouldn’t have had any time for me that day. I wouldn’t have had the chance to make myself a stronger runner. The same goes for running in the cold and running in the heat (which I absolutely struggle with). Your body has to learn to run and deal with the elements, especially here in Chicagoland. If I decided not to run on a day which was too cold, too windy, too hot or too wet I wouldn’t have logged over 117 miles in since this January.

I also often wonder if people think I’m being unfair to Maya (my almost 19 month old). She is the one that has to sit in a jogging stroller while I’m running in freezing temps, rain, wind etc. I assure you I have a top of the line stroller with all weather gear that helps keep her happy. I could never run with a screaming child. It would kill the moment for me. Luckily she either babbles, takes in the sites or sleeps. I do my best to keep her happy in there and for no more than she needs to be. I ALWAYS want to make sure she is safe. But actually, today I wondered if someone was going to call DCFS on me!

Today was one of those days where I knew if I didn’t try to get a run in when the kiddos were at preschool, it just couldn’t happen. My husband has been out of town and won’t be back until tomorrow night. I had decided that I would suck it up and not run because it was hailing, thundering and absolutely pouring out there. I went, dropped the kids off and then headed home to clean. As soon as I pulled in the drive way I realized that it had cleared up to a fine drizzle. I ran in the house threw on my impermeable gear, put Maya in the jogger with the rain cover and went on my way. I had to deal with the wind picking up and wished I was wearing goggles but hey, at least I was getting my run in, right? All was good until about half way through I start hearing voices coming through the emergency speaker system in our town and then of course the emergency sirens come on. I first decide not to panic as it is a Tuesday. When the sirens don’t stop, then I start to panic! I am a worry wart by nature and this situation brought on a lot of horrible thoughts. What if there was a tornado coming? What if there was another hail storm coming? I had heard on the news that there were “micro-bursts” in the area and now I was just totally panicking. I felt like such a horrible mother! Then, finally the siren stopped. After a couple of minutes I realized I was probably right at first thought and that it was just the monthly test siren.

The whole incident made me realize how desperate I am for time. What I’ll do to get a run in for the day. I’d never put my children or myself in danger but I know that at times it must seem that way to others. I know I got a lot of strange looks in the sub today. But hey! I’m a busy mom of 3 young kids who has no time and has to make time. I take what I can get. What motivates me? Time. Knowing I get “me time”, knowing that in the long run I will live longer, be healthier and have more time with my husband, children and grandchildren to enjoy life and knowing that perhaps I can fight time with making time.

Here is one of my favorite Nike advertisements. It says it all!