Spring Has Sprung and so has my Knee

Ah, spring -- when a middle-aged man's fancy turns to thoughts of old injuries.

It's becoming increasingly apparent that every spring is going to involve what Paul Fournel calls (and I'm paraphrasing here), "a revival of an old argument with a cantankerous knee." I successfully tried running through the whole winter at base/moderate levels, my cardiovascular capacity climbing while my legs retained some of their strength from last cycling season. But, for the fourth year in a row, once we hit March and April and I start adding intervals and hills, my left kneecap starts getting that lovely mortar-and-pestle feeling.

By now, fortunately, I know not to panic. Mostly.

If I stretch a lot, increase intensity slowly, and in the meantime just accept the aches and pains of an aging human body, I'll probably be strong and fit by May. (We'll see; moderation is still not my strong suit.) Even so, every year, it's a little annoying and worrisome.

Ah, the rites of spring.

The Last Word on Knees

I've become something of a connoisseur of articles on knees. You know -- that concatenation of bone, ligament, muscle and tendon that separates your shins from your thighs? Endurance athletes tend to have a lot of trouble with 'em. I'm certainly no exception, as Velophoriacs know too well from early posts here, detailing part of my odyssey with knee issues.

In my Firefox bookmarks folder, I must have over forty articles on knees: Physiology, strengthening, stretching, self-massage, blah, blah, blah. But ever since I recently bought a nice pair of running shoes and started fooling around with trying to run again, I've done a bunch of research on knees in the running literature. That's when I found this gem. I was surprised; I'm disappointed by Runner's World's tendency to print quickie sidebars entitled something like, "Five Tips for Joint Health." Useless. Nonetheless, this full-length piece is the best (and most enjoyable) summary of all the thinking, past, present and cutting edge, about knees I have read so far.

If you have any good ones yourself, feel free to post in the comments section.

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.

Heal, Already! Living with a Nagging Injury (ii)

Part Two (Part One can be found here.)

So I actually did manage to be patient and follow the physical therapist’s strengthening and stretching regimen pretty religiously for a few months. And slowly -- very, very slowly -- I got better. It was very much two steps forward, one step back, but at least it wasn’t the other way around.

By March, I was riding a little harder and longer, and by April, I had almost forgotten I’d been injured. I’d been promising myself for months that, once I got to May and the insanity of my final semester of a multi-year grad school program was done, I would reward myself by riding as much and as hard as I wanted. I was salivating for this. Seriously.

By early May, I had gotten confident, strong and very happy. I was riding a little more intensely each week. I was building up carefully. I got to the point where I was doing climbing repeats on the steepest hill in town, and loving them to death (when I wasn’t heaving pieces of my lungs onto the blacktop.) It was going to be a great spring, after all. I was going to be at the front of the pack. I was going to shine.

And then one day I did one extra repeat on that hill, and felt a little twinge in my knee.

What? Did you expect a happy ending? Come on.

Now, the number one very most annoying thing about a nagging injury is that it’s impossible to tell the difference between healthily pushing the limits, and dangerously aggravating it. Often, I’ve pushed a little beyond my safety zone, felt a little ache here and there, and found out the next day that I had done a good thing. Instead of more discomfort, I would actually feel stronger. Then the next week, I might push it exactly as hard (or so it seems), and that night feel the hot irritation that signals the beginnings of re-injury. Then I have to pull back, and maybe even lose weeks of progress.

It was just that way on the very day of my last class in graduate school. I felt great after repeat number two, and so went for number three for the first time. That’s when I re-injured myself, and pretty good, too. It’s now seven weeks later and I’m still in the throes of recovery, progressing, backsliding, angsting over Web research, calling my PT. Yay!

Next: Repeat After Me: "My Knees Are My Teacher"

The Mojo of the Perfect Ride

So, the ride on Sunday, the day I posted that piece about anticipating a terrific spin on a gorgeous spring morning, ended up kind of crappy.

It happens, you know? You get all pscyhed, and maybe you psych yourself out a little. By the time I got out there, I was a little tired and cranky, and my knees hurt (I'm working through a recurring injury) and I worried would they ever fully heal, and blah-blah-blah-I-ruined-my-ride. That's all there is to it.

But yesterday. Oh, yesterday.

Yesterday (Monday) was one of those rides that remind me fully why I push through agonizing injury recoveries, why I rode on rollers in a dim basement all winter, why I struggle with the crazy demands of this sport-hobby. High 70s, mixed clouds and sun -- the kind where the clouds roll away every ten minutes, and you feel like you've been given a new gift of sunshine each time. I rode a new route -- always enlivening. It took me through areas I knew somewhat, but there was that nice challenge of trying to mentally map where I was as I rode. I got a little lost, but I always knew basically where I was -- another wonderful feeling.

Best of all, the scenery. Eastern Mass has some of the loveliest little back roads in all of New England -- you just have to go looking for them. You won't see them from the big routes people use to commute, no matter how wide the shoulder and comfortable the road surface. I found a long, gently rolling street with zero traffic, no stop signs, and the most beautiful land on either side. I found a small pasture with two goats grazing. (I took a cell-phone photo for my wife. She loves goats.)

I happened upon a road I knew well, and decided to change my course spontaneously -- another reliable source of fun. I took an unplanned detour and waded in the icy waters of beautiful Walden Pond, while I snacked on my wife's home-baked bread. When I got back on the bike, my legs were like new.

I rode further than I have for weeks -- the knees were strong and fluid. By some miracle, they seemed to have healed themselves overnight, and I woke up knowing I could go a little long today.

You can't anticipate or create a perfect ride. You can't plan velophoria. You can only listen when the knees whisper, "Go!"

Like Riding a Bike

What has happened to me? I’m addicted.

It started about nine months ago, innocently enough. I’d been looking for a couple of years for a new sport to get into. But I’d had no success, mostly because of my knees. They’re 44 years old. The rest of me feels more like I’m in my early 30s, but my knees are as old as my driver’s license says I am, and then some.

Volleyball? No. No burn, and kind of dull, and too much jumping for my joints to stand. Basketball? Fun! But… the knees. Softball? Did that for many years, kind of done now. Running’s been out of the question for decades. Swimming, great workout, but I’m sorry. It’s b-o-r-i-n-g.

Then I began thinking... In my teens, I was quite taken with road cycling. I did youth hostel tours around the country. I logged crazy miles in Central Park, yes right there in the middle of Manhattan, getting up early on weekends to enjoy the empty bike path, devoid for the day of aggressive cab drivers. I drafted local racers just to see if I could. I spent spring afternoons disassembling my bicyle down to the ball bearings and re-building it – me, a very non-mechanical intellectual Jew from Manhattan. The bike had offered me, a thoroughly undistinguished athlete, passage into the land of the modestly accomplished.

But that was ages ago, I thought. Still… They do say that biking is good for the knees.

The only road bike my local bike shop rented out was a 20-year-old Univega, which seemed appropriate. About the same vintage as my first road bike, and about the same cheapo provenance, too.

It was a little too big for me. It had been 26 years since I’d ridden a bike more than a mile or two, and that maybe twice. I swung a leg over and ventured onto the neighborhood bike path. I rode eight miles or so. And I had a blast.

Eight miles is not much by my current standards. But more important than the distance: About 60% of the way through my out-and-back route, I found myself in an eerily familiar state, a kind of body-trance. My legs dancing rhythmically ‘round and ‘round and ‘round and ‘round. The annoying mental muzak, which usually runs non-stop in my head, settled to the bottom of my awareness and my mind took on a luminous clarity. Total synchrony of purpose: body and mind one reality, indistinguishable, with liberty and justice for all.

This feeling, friends, is the very definition of velophoria. And it was eerily, sexily familiar, after 26 years of absence -- yet also fresh. In case you haven’t figured it out: I was back in love.

It was the beginning of the end. Or maybe just a new beginning. It depends on whether you ask my wife or me. I haven't stopped riding since, through the turgid New England winter and back again into the warmth. I've spent scandalous numbers of hours deciding what new gear to buy -- and spent more on that gear than I have on anything in years. I obsess about injuries that keep me off the bike. I research training ideas or bike repair tutorials. I've shed pounds, felt happier and more confident, and discovered a new part of the world. I've met lots of people, on the bike and on Internet cycling forums, and even made some friends.

End or beginning, I'm hooked.