Thursday, May 27, 2010

Graduated PT

So, I "graduated" from physical therapy last night. The knee was just a little sore yesterday afternoon, but I've made so much progress, both Clint and I decided that I probably don't need to keep going to PT. I'll just have to keep up with rolling and stretching my IT band on my own.

It's really pretty amazing how quickly my knee improved once we hit on the right thing. We didn't start working the IT band until last Wednesday, and now, one week later, my knee almost feels normal and I'm back to riding. Pretty cool! I definitely wouldn't have progressed so quickly on my own.

Monday, May 24, 2010

Real Progress

I'm making real progress on the knee. Ever since we started focusing on the IT band at PT (and at home), it seems like my knee has made significant improvement every day.

This weekend was a pretty good test. I rode the trainer on Saturday since it rained most of the day. I did the bulk of the ride at a Zone 2 pace without any problems. On Sunday, I spent most of the morning cutting up the tree that fell in our backyard, and clearing out the vines and brush that fell with it. Immediately after that, I rode my mountain bike for a while over at Waterford Oaks. I probably rode harder than I should have, but my knee still felt OK on the bike. I noticed it felt a little tired after I stopped, but that feeling went away quickly.

I picked up a new book last week, The Knee Crisis Handbook. It hasn't been quite what I expected, but it's pretty decent. I just read through the section on stretching and made an interesting observation. Recall that I'd been working pretty hard over the Winter and early Spring on improving my flexibility. I saw that I'd been doing every stretch in the book, except one, the IT band stretch. I'd also been self-massaging most of the muscles acting on the knee, except the IT band. So, my new theory is that, by regularly stretching the other muscles acting on the knee, my IT band became relatively tight and started pulling my knee out of whack. I think that's why my knee has responded so quickly to the PT work to massage and stretch the IT band.

Friday, May 21, 2010

Knee Test

I went back to PT last night. He had taped my knee the previous session to try to move my kneecap a bit, and it caused me some new pain while riding. Based on that result, he worked on my IT band quite a bit (ouch!). He also wanted me to give my knee a good "test" on the bike.

I was a little skeptical about riding harder, but I decided that that's why I went to him instead of someone else who might not push me. So, I got up this morning, rolled my IT band (more ouch!) and hopped on the bike. I warmed up for about 10 minutes and then ramped it up. I didn't push super hard, but I went a lot harder than I've gone in the last 2 months, more like a low-end tempo pace. Anyway, I did that for about half an hour, then cooled down. No problems! (Except that I felt out-of-shape.)

Honestly, I'm pretty surprised at how it went; even yesterday morning I was still feeling pretty achey. I don't know if the improvement was from loosening up the IT band or something else, but I'll take it. If nothing else this has given me some encouragment that I may not be that far away from resuming a more "normal" riding schedule.

Wednesday, May 19, 2010

Knee Story

So, I went to see a phyiscal therapist last week for my knee. I saw Clint Verran, who is also a serious runner and fast cyclist. I actually raced against him in cyclocross last year. I figured that he would "get it".

Anyway, like my doctor, after checking some other things, he also focused in pretty quickly on my meniscus. With two qualified people now telling me the same thing, I think it's probably a pretty safe bet that I have a meniscus tear. Given that I'm not having problems with the knee locking, giving out, etc, it seems like I shouldn't need surgery for it, so that's good.

I did some research on meniscus tears after I got home, trying to figure out how I might have done it. While mowing the lawn yesterday, I sort of pieced together how it might have all gone down.

Way back at the end of 2004, I remember going for a run in cold weather (maybe it was around Thanksgiving?). I probably hadn't been running for a while, and I doubt that I warmed up (that's sort of how I did things back then). I remember that my legs (calves?) eventually got really tight, and that I felt a little pop when I was stretching after I got home. Probably I was still cold while stretching. I remember some pain at the time, but I don't think it lasted long at all, so I sort of discounted it. I think that's probably when I tore it though. I also don't remember ever having knee problems before then. According to my limited training logs from that time, it looks like I struggled with some nagging pain off and on for about 4 months!

Over the next several years, I would occasionally have issues with my left knee, usually when I would try to do something out of the ordinary. I documented a few of them (Vail hike , MCB run). It seemed that I'd finally gotten rid of the issue when I tweaked my position on the bike a little, and I also started being more careful about building up to unusual (for me) activities (like hiking at Yosemite last year).

Fast forward to the Spring of 2010. I'd been working hard on improving my flexibility and eliminating muscle imbalances, and it had been a long time since I'd had left knee issues, which I'd come to call "bad old days" pain. I'd become a little less cautious about protecting my left knee. So, as I'm increasing intensity lifting weights, and adding volume on the bike (there's probably at least a minor training error in there), I also added a new flexibility exercise. This exercise called for assuming a deep squat position with feet straight ahead; knees a little wide because the arms were touching the floor in front...

If you look up typical causes for meniscus tears, you usually find something like: "knee joint is bent while the knee is twisted". Pretty much exactly what I was doing. Probably (I hope) I didn't introduce a new tear, since I didn't feel any pain while doing it, but I think that's the culprit for this re-aggravation. I ran this by Clint and he agreed that it could have caused my problem.

The bad news is, based on my past experience and my current rate of progress, I may still be out of commission for a while. But I think the good news is that I've done this before and I have recovered before, so I feel like I can do it again. Now that I know (and accept) what is wrong, I think I can probably successfully work around it once I'm recovered.

Tuesday, May 18, 2010

Brighton Stage Race

This weekend was the Brighton Stage Race. At the beginning of the year, I'd planned that this would be my first race, but, obviously, it hasn't worked out that way. The Rhinos were the sponsoring club this year, so I decided to go out and help.

I ended up marshalling one of the first corners on the TT course, where it came out onto the road. It was pretty uneventful: only two cars went through over the whole 2+ hours I was there. But, you need someone there, just in case.

It was kind of interesting to watch the entire field go through. I mean, I watch other racers when I'm at races, but not every single person! It was a pretty non-technical corner; the only thing that made it a little tricky was that there was a little sand at the edge of the road, and then the road itself was a little loose. After watching a few people go through, it became clear that the best line was to start wide and turn late, getting most of your turning done in the dirt, and then go more-or-less straight through the sand and onto the road. Something about the trail visually sucked you to an inside line though. Nobody crashed, but quite a few people were surprised at the lack of grip in the road.

Anyway, I'd say almost all of the Elite racers took the correct line, about 75% of the Expert racers did, less than 50% of the Sport riders did, and almost no Beginners got it right. Although, by the time you got to the slower Sport and Beginner riders, they were going slow enough that the line really didn't matter. For the record, I probably would have ridden the corner wrong if I'd been racing.

Near the end of the race, a racer rode up to my spot and started waiting for his kid to come by. A bunch of kids had just passed a few minutes earlier, so we figured that he missed him. Anyway, it got me thinking that, hopefully, I'll still be racing in another 10-15 years. In that context, missing a season because of injury isn't such a big deal, just a bump in the road.

Thursday, May 13, 2010

Getting Better, Again

Looks like I'm overdue for an update. The knee is getting better, again. I took a week almost completely off, then resumed my super-easy rides. The last couple days, my knee has been quite good, almost no pain/discomfort, but I think it will still be awhile before it's "normal" again.

I will be out volunteering at the Brighton Stage Race this weekend. I had targeted this as my first race of the year, so it's a little disappointing to see it here while I'm nowhere close to racing. But, it will be fun to be at the race. And I know that I will get better, eventually.

Otherwise, things are good. The new baby is keeping us busy. He's approaching 6 weeks old, supposedly the peak of fussiness. He'd definitely fussier than he was, but he's still pretty content most of the time.

Thursday, May 06, 2010


Now we're in May, and still no riding. It's one thing not to be riding when the weather is crummy, but it's much more frustrating when it's nice out...

On the other hand, Sarah and I have discussed that even if I wasn't hurt, with the new baby, I'd probably still be frustrated because I still wouldn't be able to ride as much as I wanted to. Or maybe I'd be sick by now after having run myself into the ground.

Basically, the doctor confirmed yesterday that I don't have any "structural" issues with my knee. I would have been surprised, but it's gone on long enough that I wanted to start checking other things off the list.

While I was waiting around in the office, I started thinking about why I am so frustrated. Certainly, part of it is not being able to ride, and knowing that my mountain bike season is slipping away. But I think the bigger part of it is that I made a conscious effort to be careful about training to avoid injury this year, and I still got hurt. In hindsight, in some ways, I wasn't careful enough. I think I recognize those issues now and can fix them in the future. In my defense though, the onset of this injury was very different than any of my past injuries. It never really hurt on the bike, it just got a little tight at times. It wasn't until I got off the bike that I experienced real pain, and by then, it was probably too late. Anyway, I need to try to not beat myself up about that.

So, I've mostly been resting my knee, just keeping up with a little light activity. I'm also trying to keep my leg mostly straight while I'm sitting at work. That has helped a lot. So, it's actually feeling pretty good right now, but I can tell it's still not right.

Monday, May 03, 2010


So, it's been a little while since I posted. Last week was going well, for a while. My knee felt very good early in the week and I was starting to pedal just a little harder (like, easing it up to 13mph...). Bad idea. The knee pain is back, and maybe even a little worse than before.

Between the re-emergence of pain, and, like I wrote before, the fact that this injury seems so different than others I've had, I'm headed to the doctor this week. I'm not optimistic that I'll get much good information, but I'm hoping he can at least help me rule some things out.