Wednesday, July 2, 2008

Heal Already! Living With a Nagging Injury • iii

Third and Final Part. (Read Part One and Part Two.)
The second most annoying thing about nagging injuries: The variables.

Sometimes, I get to feeling a little better. I might even be able to do a hard ride and not suffer too much afterward. Was it the fish oil capsules a friend recommended to me? The glucosamine I started taking this week? The new stretch I’ve been trying? Or maybe it was just the cumulative effect of all the original stuff I’ve been doing for weeks and weeks – did I finally accrue enough benefit from the stuff the PT prescribed, so that I just now turned a corner?

Maybe it’s even some maddening, nebulous combination of the above. Probably is, actually.

Finding what I call “the end of the knot” (so I can pull on it and finally unravel the problem) can be really, truly, infuriatingly hard. Sometimes it seems foolish to even try; by tomorrow, I’ll probably just have another guess as to what caused my improvement. It takes a vast amount of will to keep at the project of figuring out what will help. I admit to three separate days when I was nearly in tears, wondering if I really cared for this sport enough to keep at this whole through the looking glass experience. I was barely a breath away from burying my bike under a bunch of junk in the back of my garage and resigning myself to long walks for exercise. Grim times.

And just going to the “expert” doesn’t usually dispel the darkness. Sure, I always walk out with hope springing eternal that the new diagnosis or exercise they’ve given me is finally the end of this. However, as I’ve said, doctors can be a bit glib about getting to the very bottom of a problem. Well, to be honest, it’s not very efficient for them to sit with me, digging endlessly through the layers of complication. So, I try to strike a balance: I do a little research on my own. I try out some stuff friends recommend. And when I get completely mired in the variables I’ve introduced by myself, I go back to the physical therapist (who is a great guy), do a brain-dump of the whole thing, and see if maybe I have managed to introduce some tiny new wrinkle that will help him finally solve this thing.

Now, here's where I admit that he actually seems to have done just that, about ten days ago. I went back to him after a long stretch of trying to solve it myself, and did one of those brain-dumps. I just blurted out, with no small relief, all the ups and downs and each and every desperate measure I've tried. He actually listened very carefully (you can't imagine how good that feels after weeks of obsession), and then he started trying a little of this and a little of that, all the while explaining some new levels of skeletal detail.

While he was chatting away explaining stuff, he almost off-handedly tried something that felt really different to me. I made him show it to me, went home and expanded on it, and voila – nearly instant and apparently reliable improvement. I won’t bore you with the fine points; if you have chondromalacia or ileotibial band issues, feel free to post a comment here and I’ll be glad to give details. The point is, I think… for today… that I’m out of the woods. Like the twelve-step people say: “One day at a time.” Fingers crossed!

And maybe that’s the upside of all that maddening confusion: You just never know when the next stinkin’ thing you try is actually going to be the end of all your worries.


Anonymous said...


Having similar knee issues to you, I'd love to know what you were able to solve.

There are days when my body feels great, but my right knee feels like it needs adjustment. This is the knee with a partial ACL tear and problems with the medial meniscus.

When these days come up, I avoid the climbing I need until things settle down in the knee.

Any new tips?


Velosopher said...

Dave, I'm sorry to say that, as I understand it, the things I do won't really help a knee with damage to the ACL or the meniscus. My problem is chondromalacia -- wear and tear in the cartilage on the back of the kneecap (patella) and the cartilage on the femur, where the patella tracks as you bend your knee (5,400 times an hour on the bike!). Here are the basics:

In a nutshell, the PT has been showing me different ways to strengthen a muscle (the vastus medialus oblique) on the inside of the quads that help the patella stay on track, and to stretch another muscle (the ileotibial band) on the outside that tends to be too stiff, and pulls the patella *off* track.

If you want to know more than you ever cared to about loosening the ITB (and, to a lesser extent, on dealing with chondromalacia), you could check out this page on BikeForums.

Hope this is helpful in some way.