What caused my post-marathon knee injury

Dallas Marathon 2014 finisher's medal

It was all for this.

I’m an amateur runner who’s been at it for about a decade now. I’ve always tried to absorb as many do’s and dont’s as I can from fellow runners and industry publications, to keep myself as injury-free as possible. I try to be smart, so I can run as much and as long as life lets me. But sometimes that diligence just isn’t enough. Sometimes, you get injured and not even your doctors really know why.

The Dallas Marathon in December 2014 was my first full marathon. That was 17 months ago. After, my knees totally crapped out on me. In fact, I could feel it beginning to happen around mile 20 of the race itself.

I still don’t exactly know what happened except that it completely sidelined me. Until now. Besides an eventually-abandoned attempt at 5K training a few months after the marathon, I’m only beginning to re-emerge and, so far, only on dirt trails. My ultimate goal is to get back to running wherever I want, whenever I want.

While I work on that, maybe my peek into the possible culprits will give you, fellow enthusiastic amateur, perspective and warning.

My training

I ran my first marathon in December 2014. The training for that took up the majority of that year leading up to the event. I enjoyed every last minute, even the ones when I wanted to die. I followed a training plan, but I fully admit that I played fast and loose with it some weeks. Cross training — what’s that?

I love strength training, but each week’s miles already overtook so much of my waking hours that I decided I didn’t have time for much else on the training plan. I told myself that wearing out my legs with squats and lunges while also racking up high mileage might cause injury. I decided that achieving the plan’s miles was the only thing that mattered.

Toward the end of training, I was struggling to just meet the miles. The last two weeks of the plan, I didn’t.

My shoes

Thing is, not only was I not building a solid infrastructure to support the crazy distance to which I was subjecting my body, I chose to do something else even cuter. I decided I wanted to run my first marathon in lightweight shoes. First, Brooks PureFlow. Then Brooks PureConnect. I don’t know why. I could have been subconsciously influenced by an old 2009 story I wrote about barefoot running. It seemed to make sense at the time. I had no business being in anything but a structured shoe, though: I’m the world’s worst over-pronator. I didn’t put that together until later, that over-pronation required a structured shoe, especially for a first foray into marathon training.

2014 Dallas Marathon

All of us awesome amateurs in the 12-minute corral freaking out before the 2014 Dallas Marathon gunshot.

My pride

When friends, family and colleagues saw that I was for real-deal training for a for real-full marathon, most everyone gave me smiles, encouragement and back slaps. It was humbling and inspiring. One loved one, however, gave me a well-intentioned but uninformed word of caution: You’re 38. You’ll be 39 when the race takes place. You’d better be careful, because you’re getting a little too old for this sort of thing.

Never in my entire life had I ever thought that 39 would be too old to do anything, as long as that 39-year-old body was properly trained and ready for it. I had had the privilege of interviewing so many amateur athletes for stories who were well older than I was, and many of them hadn’t even become active until later in life. And now, they’re beasts at their chosen focus: running, cycling, bodybuilding. I at least had a foundation from high school sports, and I’d kept my body generally familiar with movement into my 30s. I’d at least somewhat strengthened along the way. Then, newspaper colleagues introduced my sitting-at-a-desk-all-day body to the joys of actually, really challenging myself physically through running. Many of them were older. I’ll always be indebted to to those interview subjects and those co-workers for inspiring me.

Dallas Marathon 2014

Before the gunshot.

Normally I’d brush off such an uninformed idea as “you’re too old to jostle yourself at your age,” but this person meant a lot to me. I politely countered her advice, but still: It stuck with me.

It stuck with me, meaning: I’ll show her.

I was blind with defiance. Whereas before I hadn’t even considered that I wouldn’t get a finisher’s medal, now it was imperative that I finish. Having to skip the race, quitting in the middle of it, or, worse, having race organizers pick up orange cones all around me as I crawl like a sloth to a finish line that isn’t there any longer weren’t options.

My name would be Google-able for “Dallas Marathon 2014 finishers,” even if it took hell, high water, and the full six hours to get there.

At mile 20 of the marathon, my knees began sending me signals that I knew were red flags. I had been running at a pace that I hadn’t trained for, because I was completely paranoid about not making the time cutoff. By the time I hit the finish line, I had barely skated in under six hours. I got the medal, but I wondered if my knees would pay the price.

A couple of months later, I headed out the door for my first post-race run. No dice. They ached. I went to a nearby sports medicine place, where the doctor said my menisci were torn. Surgery in September 2015 revealed that they actually weren’t; my cartilage simply looked like crabmeat and needed shaving down. Was it the marathon that did it? He said no, absolutely not. It’s genetics — you just have crappy knees. 

Ok. Well, I want to come back strong so I can start running again. What should I do during recovery?

Eh, do some squats.

“Some” squats. Ok. How many? How often?

Just as many as you can do. Whatever.

Injury No. 2 … or was it?

I was just about all the way recovered from surgery in December 2015. On Christmas day I played with my toddler niece, getting more physical than I had in a long time. It was great. That evening, sharp pains shot through the underside of one kneecap and through the back of my other knee.

I went back to my doctor, and he confirmed my Google searches: loose bodies. He said that it wasn’t related to my previous injury, just more of my knees being crappy. We’ll need to do surgery — let me know when you’re ready for another.

My husband, Brian, suggested that be our last visit. Besides this tale, there were other red flags that raised our eyebrows with this guy, including a nasty post-op infection and literal 30-second follow-up visits.

I ruminated a few months over having another surgery. I decided to make an appointment with the orthopedic practice at Baylor Hospital here in Dallas.

Before my first visit, just a couple of weeks ago, the weather was getting nice. That and the fact I’d gotten properly fat in the past year and a half prompted me to take a walk at a nearby nature preserve, to begin moving in some small way again. I ended up jogging a bit — and being totally delighted at the near-absence of pain. It had never dawned on me that running on dirt might have been an option this whole time. I went to my appointment and told my new doctor the whole story.

I don’t think this is loose bodies, he said. You should have gone to rehab after your surgery, or you should have been outfitted with a thorough at-home exercise program post-op. Your quads and hips are totally weakened from surgery and were never built back up. That will cause all sorts of pain. Let’s get you into rehab first, get you strong, and see if that helps.

I haven’t had my first rehab appointment yet, but I’ve been trail running and squatting like mad ever since. I was so excited at the prospect that this could be the answer.

So, my advice for avoiding 17 months of dormancy due to injury:

  • Let your training talk to you. If you’re not on track and are starting to skip or badly struggle toward the end, that’s a sign. Either you or your body isn’t ready. Maybe you’re caught up with other, more pressing things in life right now. It just might not be the right race at the right time. Wait for the next one. Seriously.  You’ll be that much more beast at the next race.
  • Properly outfit yourself with the shoes and other gear your body requires. If you’re beginning something much more strenuous than your body is accustomed to, then awesome. Do it. But balance it out with conservative, wise measures. You can get weird, funky, or experimental later, when you and your body aren’t so new to that beastly level of activity.
  • Don’t listen to other people. Just don’t. Unless what they’re saying supports your goals, and if you know that what they’re saying is coming from a place of jealousy, ignorance or naïveté, just keep doing what you’re doing. That includes listening to your body when it’s trying to clearly tell you to slow down or to stop. Don’t let that other person’s bad juju influence your choices — whether it’s to keep going or to quit.
  • Strength-train. Just do it. Do it when you’re training for a race. Do it post-op. If your doctor won’t help you figure it out, find someone who will, or figure it out yourself. It’s so important, especially for us women. You have to have strong, solid scaffolding upon which to build your body’s Beast Empire. Make time. Don’t skip this step.

Injury or just training pain? My least-favorite running mystery

A new pair of Brooks PureConnect: Hopefully, the fix to my pain

New Brooks PureConnect on top, old on bottom.

Back in the summer, the inside of my right knee got an attitude with me. I babied it with some ice. I stopped tucking it under me and sitting on it funky in my cubicle. I got better about warming up. I chest-bumped it, all “Get with the program, knee! This marathon is happening, like it or not!” It eventually stopped hurting, and I kept on a’runnin’.

Fast forward to a couple of weeks ago. An old sesamoid injury in my left foot began flaring up. By flaring, I mean the bottom of my foot underneath my big toe felt shattered every time I took a step. But that injury is an old friend; familiar.

Then came inside ankle pain right above it. Not familiar.

Was I running in the wrong kind of shoes (the lightweight Brooks PureConnect)? Was this just part of getting my body ready to do something it’s never done before?

I didn’t care about my knee injury as badly because I had time. But when I had to take I-don’t-know-how-many ibuprofen during my 19-mile run that turned into an 18-mile run this past weekend because my foot was shot, with just five weeks to go, I knew I had to figure something out. This was an unknown that could flush all my training for the Dallas Marathon — my first full — down the crapper.

I researched shoes and paid Luke’s Locker in Dallas a visit with the intent to buy a more cushioned shoe. A helpful guy there straightened me out. He said that if I liked running in a light shoe and that it’s only been recently that the pain had begun, it wasn’t the lightness of the shoe. People run marathons and ultras barefoot, after all. And if I gave my body a heavier shoe now, it might be mad at me in a different way.

When I told him I’d been running in my Brooks PureConnects since April, that was it — the foam sole was packed down from use, and that pair was simply done. I walked around in the store in a new pair, and hello, huge difference.

I bought them. Hopefully, that will do the trick. My biggest concern is that I won’t be able run the race because of injury, or that I’ll injure myself on the day-of trying.

I’d gotten really familiar with what I need to run a good half: what clothes to wear in what temperature, what aches I know will go away and what should be minded, how much hydration to carry for what distance.

But, marathon training is a new frontier. That comes with working through a whole new set of unknowns.

Who bought Vibram FiveFingers for the health claims?

The rubbered, uncomfortable tale of Vibram FiveFingers comes to a close.

Vibram FiveFingersThe maker of the funny minimalist shoe is settling a class action lawsuit brought on a couple of years ago over claims that the shoe decreased injuries and strengthened the foot. Ends up that you’ve got to have scientific backup for claims like that if you’re using them to sell stuff. There’s a lot of reporting on the matter, namely Washington Post, Runner’s World, and, where I first learned about the announcement, 0n The Dallas Morning News‘ Health Blog.

Way back in October 2009, I blogged about receiving a pair of the digit-y foot coverings. I said in the post that I’d report back on my thoughts after giving them a go, am I’m just now realizing that I never did. I’m trying to remember why. I think that I tried them, hated them, tried to find redeeming qualities about them. I likely decided to let some time pass and allow a few more tries help me discover a reason not to completely pan them. Then next thing I knew, this particular personal assignment simply slipped through my fingers. Now, years later, here’s what I remember.

I was excited about the barefoot and minimalist shoe thing enveloping running culture. I tried barefoot running and wrote about the phenomenon, and I decided that I loved the idea of it more than the practice. Also, that book Born to Run had recently come out. It set the running world on fire for a time and further fueled interest. The Tarahumara Indians are beastmode personified, and we were all right to be inspired by their story.

I tried the FiveFingers. Well, first I had to successfully cram each and every little bitty toe into its corresponding toe pocket. That was my first clue: If I can’t quickly throw on whatever it is I’m wearing for a run, you’ve lost me.

I went running in them. It’s easy to see how a runner would think the shoes aided in muscle strengthening. A day later, my calves screamed at me. But they screamed at me a day after my first try at barefoot running, too. It wasn’t the shoes themselves delivering that benefit; they were simply along for the ride while I tried running in a way my body had yet to become conditioned.

I even went out socially in them. Later they became something of a symbol of slight douchebaggery, but they hadn’t just yet. They were still a curiosity in 2009, and I enjoyed the stares they received.

Have you ever worn a pair of socks with toes in them? At first they seem fun, even cute. Then you wear them around the house and think, This is one of the most bizarre-feeling, uncomfortable things I’ve ever done to my feet. This totally blows. Bottom line, that’s what FiveFingers felt like on. I couldn’t ever get used to feeling each of my toes cradled in its own lonely compartment.

Basically, you had to already love barefoot running itself to care for wearing FiveFingers. For all practical purposes, it mimicked being barefoot but offered a layer of protection against gravel, stickers, gum and other scary detritus. That was the real value they offered. I ended up appreciating how the shoe influenced major shoemakers to offer lighter, pared-down options. I’ve bought just one pair of heavy, cushioned and overly structured shoes since then, and the rest have been fairly minimal. The lighter shoes have performed well in a variety of activities.

I don’t know of anyone who owned a pair of FiveFingers who thought they would give them health benefits. If foot strengthening and injury avoidance were their motivation, it was the barefoot/minimalist running aspect they believed would deliver, not the Vibram FiveFingers.

Still, I appreciate that a company isn’t allowed to use empty claims to play a huckster game. Be straight-up with your fellow human beings. “If you like barefoot running, you’ll enjoy our minimal FiveFinger foot coverings even more” would have done just fine for the target audience.

One thing I’m not going to miss is forcing all 10 individual toes into 10 individual, teeny weeny rubbery spaces.