The long snowy road to recovery

This has been one of the snowiest winters on record

 

“Adopt the pace of nature: her secret is patience” – Ralph Waldo Emerson

 

As I am sure many of you know, due to the lingering soreness in my right knee and the brutal winter, I haven’t been running much these days. Fortunately, my knee doesn’t feel as bad as it used to when I run, indicating it is healing. Slowly, but surely I am making progress. I just have to be patient.

Here is what I have been doing for the past several weeks to help my knee heal and to stay in shape:

The ankle weights I use

1) Doing leg lifts on the floor, face up, with ankle weights about 3 times per week. I tend to do about 4 sets of 20 reps for each leg. This helps maintain muscle and can stimulate healing of the injured area. Besides this I use resistance bands to strengthen my hips and do the bicycle maneuver to strengthen my abs. I do these exercises even when not injured, but usually a little less often, and fewer sets.

2) For the past few weeks, about once or twice per week I would stuff a 23 lb medicine ball into my backpack and walk around the neighborhood with it. It should go without saying that this gets tiring after a while, making a 2.5 mile walk feel more like an 8 mile walk. The idea behind this is that if I can’t run or walk very far, I should increase the intensity of short bursts of exercise.

3) Similar to the idea above, I would often juggle at home with my heavier balls, mostly my 1 lb balls, and sometimes my three 2.25 lb Exerball set. As my arm endurance improved, I eventually started joggling outside with the heavy Exerballs. Three 2.25 lb balls may not sound like much, but doing this for a little over 2 miles a few days ago was very tiring, and is a new record for me. Doing this while going up hills is especially grueling.

This mostly upper body cardio can be challenging, and inside or outside helped my heart maintain its endurance capacity. Unlike joggling with very light balls(1/3 lb or less, what I normally use), my arms feel the burn while doing this instead of my legs.

4) If the weather outside was too nasty, or my legs didn’t feel like running, I would do stair-climbing for 20 to 30 minutes. I continue to do this sometimes, but I am running more these days.

5) Besides this, I have been more strict than usual over making sure I get a recovery snack or drink immediately after a workout, even bringing energy bars with me for short runs which I don’t usually do. Delaying replenishing depleted blood sugar, and/or fluids and electrolytes may slow the healing process or even increase the risk of re-injury.

6) What I don’t do is about as important as what I do to help heal this injury. Basically, I’ve done no speed-work, little to no hill running(until recently), no squats(they bother my knee), no stretching, and nothing beyond 16 miles(did 16 nearly 2 weeks ago). Sometimes it’s a little hard to resist trying to run fast, but all the ice and snow outside makes it difficult to run fast for long. Besides this, no drugs, no pills, no herbs, no voodoo, no “therapy” based on pseudo-science.

Thanks to this regimen, and being patient(which isn’t easy!)I am happy to report that my mileage has greatly increased this week. And it seems all my neighbors and acquaintances I ran into while joggling around town were about as thrilled as I was. “Where were you?!” many of them were asking. I’m not back to where I was before, but I am slowly getting there. I can’t wait until spring!

Warning: If you are injured, don’t try out any of the exercises I am doing before seeing a sports medicine doctor or therapist or finding out what kind of injury you have. If you don’t know what kind of injury you have, doing any of these things may make it worse. Fortunately for me, this seems to be just a bad case of runner’s knee, nothing too serious. A sports medicine doctor I consulted a long time ago suggested the ankle weights exercises.

If you’ve had a similar injury and want to share some tips, please go right ahead!

Prolotherapy and knee injuries

If you are a serious runner, it is inevitable that you will either get injured or at least experience soreness from time to time. It happens to even the best of us. The most important thing you can do about injuries is do what you can to prevent them in the first place. Basically, don’t overdo it. Pain is your body’s way of telling you you are overdoing it. Also, strength-train your legs twice a week with ankle weights or resistance bands. Weak muscles may increase your risk of injury, besides preventing you from performing at your best.

The knee. Source – Wikipedia/Gray’s Anatomy

The knees of a runner are especially vulnerable to injury. After running a marathon, many if not most of the runners experience at least some knee soreness, and a significant number will injure or re-injure their knees.

Injuries to the knee may involve the cartilage(meniscii), ligaments, or both. The meniscii in the knees serve as cushioning to absorb shocks and allow for smooth motion within the joint. Ligament is tissue that connects bone to bone. ACL(anterior cruciate ligament) injuries are notoriously common among football players, as well as runners.

Minor ACL injuries can sometimes heal without surgery if physical therapy is undertaken. All too many athletes unfortunately can’t return to sport even after reconstructive ACL surgery.

Serious injuries to knee cartilage often require surgery too. These types of injuries seldom heal at all or may heal very slowly, depending on the age of the athlete. This is because knee cartilage receives very little blood flow to help it heal.

Prolotherapy is sometimes suggested as an “alternative” to surgery for knee and other injuries. At its most basic, it involves injecting an inflammatory agent(often dextrose, which is just another way to say glucose) into the injured area to bring about an inflammatory healing response. So if you hate needles, it may not be for you.

When it comes to prolotherapy and ACL injury, it shows some promise. According to the Department of Biometry, University of Kansas Medical Center, Kansas City, U.S:

In patients with symptomatic anterior cruciate ligament laxity, intermittent dextrose injection resulted in clinically and statistically significant improvement in ACL laxity, pain, swelling, and knee range of motion.

When it comes to prolotherapy and osteoarthritis(which is similar to “runner’s knee”), the Bethany Medical Center, Kansas City, reports that:

Prolotherapy injection with 10% dextrose resulted in clinically and statistically significant improvements in knee osteoarthritis. Preliminary blinded radiographic readings (1-year films, with 3-year total follow-up period planned) demonstrated improvement in several measures of osteoarthritis severity. ACL laxity, when present in these osteoarthritic patients, improved.

Prolotherapy still isn’t very widely available and is still getting investigated. Insurance providers seldom if ever cover this procedure. It has been studied for use in treating injuries in other parts of the body, with mixed to mostly negative results.

I’ve injured my knees in the past, but luckily they were all minor.