My decision was made based on only a few things: 1. I want to continue to train and push for success in triathlon, but I can’t do that without fixing my knee. 2. Three different periods over the last 10 years have been specifically focused on strength training to fix my knee and avoid surgery, but none of them have eliminated the pain completely or prevented it from coming back eventually. 3. I’m tired of being stressed about this knee. I’m ready to put this behind me and start looking forward.

Surgery wasn’t the route I wanted to go, but looks to be the best option for the goals I want to achieve. The operation is a meniscectomy. Instead of trying to repair the torn cartilage they’ll simply cut out a very small amount around the tears so when my knee moves and flexes the torn sides don’t rub any more. That rubbing is what causes the pain. It will only take about 15 minutes and they said that I’ll walk out of the building and be up walking around the next day. They want me on a stationary bike a few days later. The rehab plan will be slow and steady but by the time it’s finished I’ll have a fully functional, pain free knee to train and compete on!

After I made the decision I couldn’t help but feel a little disappointed but at the same time I felt a lot of relief. No more worrying about the knee pain coming back during my peak training time. No more frustration from holding back during a race when I know I could push harder with a healthy knee. I can focus on bigger and better things now. First, rehab the knee. Second, Kona in 2013!

Frus·tra·tion: A deep chronic sense or state of insecurity and dissatisfaction arising from unresolved problems or unfulfilled needs.

I am frustrated. My current state of mind is completely and accurately defined by the definition of that word. Frustration. The source isn’t my knee. I mean, technically the knee is the source, but the frustration actually stems from the inconsistent results in my plans to avoid knee surgery.

After what appeared to be significant gains, the pains are coming back. I’ve followed my rehab plan (even extended it from 2 to 3 months), I haven’t been too aggressive when working out and some days my knee feels brand knew and other days it feels like I’ll never run or bike again. I’ve been here before too. Many times, in fact, all the way back since I was running in high school. That is frustrating.

Today I called in and pushed up my doctor’s appointment to talk about how the plan went, what has or hasn’t changed and what the recovery process from surgery looks like (if it’s decided that I need it). Last time we met he told me to prove to him that I needed surgery. “Follow the plan and if you can’t get back to the pain free point you want to be at, we’ll know.” I never wanted surgery in the first place so I’ve followed the plan and put in the work and here we are. That is frustrating.

After 3+ months of rehab it’s time to make a decision. Choosing surgery means I’ll be able to compete again the way I want to at the expense of possibly getting arthritis when I’m much older. Is that risk really worth my desire (sometimes it feels like a need) to push myself and compete? -But not just to compete, to continue doing something that I really enjoy? Choosing not to have surgery, being realistic, means I will never be able to compete at the level I know I can with a healthy knee. It would mean no more Ironman distance events for sure, but would also mean an end to true competing at any distance and not even being able to just minimally participate in long distances. Having to make a decision that will lead to either outcome is frustrating.

Being able to take advantage of an opportunity at the time it presents itself has always defined me. The opportunity that is staring me in the face right now is the potential of success in triathlon and the ability to continue to participate in something that makes me happy, but ultimately leads to the possibility of arthritis at an older age. The fact that I had to add a ‘but’ at the end of the last sentence is beyond frustrating.

So, how are things going so far? Great! Aside from my knees being a little tired at times, I haven’t had any sharp or dull knee pains in weeks. The shorter runs I have done have gone well and the knee felt great during and afterwards.  My doctor’s appointment is scheduled for next week but I think I’m going to push it out another month and continue with this plan. Hopefully things continue going well and in another month I’ll be able to push the doctors appointment out 3 months!

Please be patient for it to download, this is an HD video and it’s about 3 minutes long.

*Edit* Having some issues with the iPad version of the site. If you’re viewing from there and the video doesnt run, here’s a link to the video on YouTube.

Four years ago, after knee surgery for the medial meniscus tear, I slowly got back into running. Very slowly. I spent more time on the bike and some time swimming, but running was a secondary activity for a while. I also changed my form using the Pose Method. By easing back into running, crossing training and changing my form I proved that the tear in my medial meniscus wasn’t enough to bother me or keep me from training for other events. Until this new tear on the lateral side, my knees weren’t perfect, but they were good enough to get me through many triathlons, some mountain bike races and a few marathons. I can’t complain about that (thank you Pose Method). I’m going to follow the same general plan for the lateral tear.

This time around, I’m going to continue easy biking and easy swimming just to maintain an aerobic base, I’ll continue with athletic yoga once a week and I’ll ease back into running starting with low milage only 3 times each week. At the Dr’s recommendation, I’m going to place a large focus on strengthening the muscles around my hips and core.  The goal will be to work up to 2 hours of nonstop running by the end of 60 days without any knee pain. I’ll be keeping a detailed log of my workouts along with a before and after assessment of my knee each time I lace up my running shoes.

Right now I can run easy for about 20 minutes without any pain. After 2 months, if I have followed the plan religiously, hopefully I’ll have seen progress. If not, then I know surgery is a must and I’ll have to go under the knife.

So, here we go. The sixty day plan beings tomorrow!

At some point about 10 years ago I tore the meniscus (a piece of cartilage that keeps your upper and lower leg bones from smacking into each other) and during certain types of activities, like climbing stairs and running, the tear separates and allows the bones to rub.  Sometimes that creates a really sharp pain, other times it’s just a nagging dull pain that lasts for hours.  Arthroscopic surgery repaired it and it got better, but it never totally went away.  Changing my running form to the Pose Method made the most difference – so much so that I regret having had the surgery.  With the new running form, things continued on ok until the beginning of May when I was tapering down for Ironman Texas.

Around the first of May I had just completed my longest period of training hours and was tapering down to race day.  During an ordinary 2 hour run I suddenly started getting sharp pains on the outside of my knee.  I ended up walking back as the knee became crazy stiff.  During the remaining time before the race I did everything I could to rehab it, but on race day it was still injured.  During the race, my competitive nature took over and I pushed my knee way over the edge.  My race results were good, but for the next week after the race I could barely bend my knee.

After the stiffness wore off I discovered a new pain on the back, right side of my knee.  Things were getting worse.  I decided to bump up the joint supplements and get involved in yoga.  Stretching combined with functional strength training would be my injury rehab leading back into training once I was ready.  Almost 2 months later, after feeling some change from the yoga, I decided to go out for a light run to test things out.  I got my answer almost immediately – the knee was still injured just as badly as it was on race day.  Damn.

This morning, feeling completely defeated, I made an appointment with an orthopedic doctor who specializes in sports medicine.  I wanted to follow my own rehab plan to heal up and then slowly get back into training.  I had a plan, some long term goals and really don’t want to go through knee surgery again – it took almost a year before my knee felt completely normal last time. Since Ironman Texas, all I’ve thought about is getting to Kona.

I’m ok with a long term plan for slow rehab and building strength.  If that’s the recommendation from the doctor, I’ll be really happy.  If things inside my knee are bad enough that surgery is a requirement, qualifying for Kona may have to be reconsidered.  And that will put me and my knee far beyond speaking terms for a long time.

Yoga and pilates is hard.  My experience with yoga before now consisted of a DVD at home with a few poses I used for stretching my calves and hamstrings and I had no experience with pilates.  The actually classes are completely different.  There is generally some type of warm up and then it typically flows into a routine of stretches/poses with a pace that constantly increases.  The hard part is not stretching – it’s understood that you only stretch to what your body allows.  The hard part is holding some of the poses for an amount of time and doing the routines over and over again.  There is no doubt this stuff is great for strength training and that it prevents muscle imbalances that can lead to injury.

I’ve done 3 sessions so far and I’m pretty sore everywhere!  Onward to being injury free and building a base for future Kona qualifying!

That said, I’m not going to immediately jump back into training for an Ironman, at least not directly.  My right knee is injured pretty badly right now so in the short term, I need to focus on healing it and getting my body back to a point of healthy balance and strength.  My wife is also pregnant so in about 6 months we’re going to have a new little baby to take care of – not exactly a great time to commit to the training schedule for an Ironman.

So what am I going to do?  The next 6 months I’m going to focus on healing the knee and doing a lot of functional strength training with things like yoga and pilates.  I’ll add in some biking and swimming for good measure, but I wont be following a training schedule.  I’ll do my best to eat healthy but I’m not going to stress myself out if I eat a slice of pizza or two one night or a bowl of ice cream another.  These next 6 months are all about recovery – both physically and mentally.

My family is priority number 1 so I wont commit to another training schedule until things are at a point where it’s safe to do so without risking divorce (haha).  I can’t deny my desire to race in another Ironman though and have decided the next step is to work towards qualifying for Kona.  Family permitting, the general plan at this point is to work up to qualifying at Ironman Texas in 2013.

Between now and then, I’ll heal my knee and race in a few Xterra triathlons (my mountain bike has missed me).  Then slowly work up to the training schedule for the next Ironman and every day I walk into my closet I’ll look at the finisher medal from Ironman Texas and enjoy the memories from the first half of 2011.

The 20 week training schedule to qualify for Kona begins in 547 days….

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