No, it's not like I'm back frolicking in the mountains, that will have to be far away, fingers crossed, best case scenario, September? A little bit? Pretty please?
But, I'm surely making progress and huge steps in the forward direction. Basically, a pun here. Because I'm only allowed the movement in forward direction at this point. Not sideways, no sudden stops, no downhill jumps. But, I'm running. And doing it, you guessed it, far ahead of the schedule.
Those 2 paragraphs have been started back at the end of April. Whoa, time flies when you're having fun. Let me set up a quick reminder and a bunch of medical gibberish.
December 24th: ski accident on Mt. Monarch going down black, but relatively benign, descend, my last of the day, when my ski hit a rock (supposedly) under the snow during a turn, and the ski was stopped, while the body (the legs, a.k.a. front thigh over the lower leg) continued forward movement. I heard a pop, lost balance as the left leg buckled under me, and screamed. By the time Larry made it to me, I pulled myself up by the poles. I made a physical/medical check on my body, there was no extreme pain, no bones broken. I tried to move forward, but the left leg would shoot an acute pain and buckle with each try. I got sideways, relying on my poles and right ski/leg, down halfway, and by then Larry called the paramedics. I was taken down on a gurney. As soon as I got into the car, I assessed the status, and my initial diagnosis was a partial MCL tear. I called doctor's office for an appointment (which was delayed due to holiday weekend until December 27th). Once there, I insisted (practically fought for) on MRI referral, got it done on the 30th, and read results on the 31st.
"Full ACL tear, partial MCL tear, posterior horn of medial meniscus tear". Surgery.
I saw a surgeon (Dr. Schumer) on January 5th, and on the 6th (a miracle due to a sudden cancelled spot in his schedule and my hard work on PT prepping the leg strength for what's ahead) I had a full ACL reconstruction (autograph from the tendon of my left lower quadricep muscle), a meniscus repair (sewing the broken off piece into the place and cleaning up surface around), and my MCL was left to heal on its own. 6 weeks no weight bearing, crutches, weight training, single-leg bicycling, and a brace wearing in a fully locked position followed. At 8 weeks, once I was allowed to bear weight, I hiked a trail half marathon (14 miles with nearly 2,000 ft of gain) in Utah, visiting my best friend Ronda. No negative effects from that adventure, I walked and hiked more and more, and around March 26th (11 weeks after surgery) I tried my first official 1 minute of running on the treadmill (while crewing Annie at Moab 50 M race). Once back home, I began TM intervals, quickly progressing from 5x30sec with 1min recovery walk to 1-2-3-5-10-15 min, and eventually 20 min intervals (still on a minute walk break) to account for a total 8 miles in the single push by the end of April. On the other days (alternating) I was walking the streets and flat trails, and gingerly tried jogs at will during those. By May TM was over with, and I fully transitioned to road and flat dirt path running, making 70-76-80-85 mile weeks.
June brought me to the real trails (which I tried in May as well), as I continued mileage build up, all the while the strength training and doing my own PT exercises way ahead of the schedule. The first real long downhill was scary, but with some mental gaming and self-assuring talks, I got back to my beloved mountains, single-track and all, keeping the average of my training at 80 and a tad above, and building my long run a mile a week, literally, hitting 20 miles by the first week of July.
July was a bit of a setback due to lots of traveling: crewing Annie at Hardrock 100, then spending a week in Norway with Larry, then catching a cold upon return. I still had 70 miles each week, and by August was back to full swing. My speed and strength on the trails returned to pre-surgery times. While I am very careful on the downhill, I had to learn how to push myself on the uphill, and instead of power-hiking 90% of it (I am a really good hiker), I implemented more of a "shuffling" motion, to adjust for the loss of overall loss of time in sections due to going down slower. My miles grew exponentially: 85-109-85-100-85. I got up Pikes Peak twice that month: once with my visiting friend Pam (who was training for her own big race in Europe), and once by myself 10 days later. Both times it was my longest run at 27 miles with over 8k vert gain. I was mostly concerned how the knee would hold up on the long rocky descend, and, while still tip-toeing, it was ok. A testament to my bettering of climbing skills, though, my Pikes Peak uphill section matched my 2nd fastest time ever. I was pleased (and I didn't feel that I killed myself to get it).
Now, to backtrack. While it's all fun and games, back in June I had serious pain that was continuing to plaque me on the medial side. I insisted on another MRI, and it showed that my meniscus tear didn't heal properly after the repair, in fact, the piece seemed to have flipped and settled inside the notch of the knee joint. I went to see Dr. Schumer, and he wasn't too kin on believing the read-out. He did confirm that my ACL (and MCL) have healed fully, properly, strong, miraculously at least 2 months ahead of the predicted/normal time, at the level his best professional level athletes do. Thank you very much for acknowledging all my hard work and dedication, even I didn't think I'd be where I was at the time. We decided to meet again in 3 months.
Well, that was today, September 18th, 8 months and 13 days post-surgery. Of note, the medial side of the knee is definitely feeling better overall, however, certain motions still send a weird sensation (for the lack of better word). Of course, I adjusted my running gait and avoid doing anything that could cause any pain (for which I developed some side kinks in muscles and tendons, but nothing that can't be remedied by a good deep tissue massage).
Dr. Schumer did some testing, during which there was distinct clicking on the medial side of my left knee, what could only be produced with this motion and at this sound by meniscus that is not is lose. He, finally, agreed with the read-out of my previous MRI. We took a very deep look (together) and the MRI images, as well as the images of the first MRI after the accident, and the images during the surgery (photos of the process). He showed me all the pieces, the stitches, and what could have potentially happened. He said my "posterior horn medial meniscus tear" was very complex, not to mention my meniscus was "fugly" (and he would have taken it out had I not insisted on return to a serious training and competition level). Plus, my cartilage(s) in the knees are fissuring, thinning out, and doing what they sort of should, considering my age and abuse of the body (despite never giving me trouble before). So, here's the discussion that followed.
1. a small hope that the sound of clicking is actually caused by some soft tissues, which post-surgery got dislodged around. The fix is easy, go in with a scope and clean it up, 2 weeks easy activity, then return back. A plausible idea, of course. Yet, we had to account for the real life, a.k.a. torn piece of meniscus flopping around.
2. Take that piece out - same 2 weeks easy recovery, return to sport, potential speeding up of developing arthritis in my knee (since half of the meniscus should be removed, the cushion between the bones is near zero) - knee replacement much sooner than anyone wants.
3. Try to repair, again - back to the same long recovery as the initial surgery, 6 weeks no weight bearing on crutches in the brace, then 3-4 months of bringing activity back.
There's no medical data that claims the difference (a positive one) between full removal of meniscal tear or its repair on the person's activity level. Thus, what's the fucking point? If a surgeon, who's job it is to "cut and dig", tells me I can keep going on as is, I chose that option.
At this point, the decision is to "let me loose" in the wild with my crazy running, and, unless I feel MORE pain in my medial meniscus, I am not coming back (not any time soon, anyway, because with my cartilage, it's inevitable eventually).
I have a few question, though, I sent him as a follow up. They consider the "smaller scale" decisions of my continuous training and goal setting. Should I stop increasing the weight and depth of my leg strength routine (as in squats and leg presses - I'm already far past the level prior the injury). What about that downhill technique, should I keep being careful, or slowly try (if my mental state and PTSD allow) to increase a little risk taking and boldness? (we all know how much I am prone to tripping and falling). How is this all bodes in with, say, carrying a 40lbs backpack for 40-50 miles a day over the mountains, for 9-12 days straight?
I'll let you know what the answers are. For now, I\m tapering for this Friday's 50k race. My goal on this first return to the official race line is - SAFETY. If I don't trip, don't slip, don't twist or pivot, and don't fall, it'll be a success. A good finishing time would be a nice bonus, as I feel very strong and ready.
I might add pictures (or not), along with doc's answers. I do have plenty of out-of-reach goals, considering the knee, the ripe age of nearing 54 in 2 weeks, and life in general. I'm also a realist, and would adjust them (a certain level), if that means I can continue being in the mountains until I am carried feet forward to my final rest place.
p.s. this post was quickly typed as I had a sudden cancellation in my work schedule by a client, and as I am tapering, I decided against going for a second run today. 😏😏
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