LA Fitness Pool Photo: Miriam Diaz-Gilbert
A few days after finishing my thirty-ninth ultra on Mother's Day weekend — the 2024 Dawn to Dusk to Dawn 24-hr track ultra — I felt a little twinge in my left knee. I wondered what I had done differently during the ultra. I've been running with Asics Gel-Nimbus shoes since the early 2000s. The only thing I did differently at this ultra was running with the latest Asics Gel-Nimbus 25, a shoe with a thicker sole and so-called more cushioning that makes them look like Hokas.
The next couple of days, I went on short 3-mile recovery walks. Sometimes in pain and sometimes with no pain. I was happy I didn't have another ultra until October.
I made an appointment to see my physical therapist, who diagnosed a Baker's cyst behind my left knee. He gave exercises to do at home. But the discomfort increased. I went back to see another physical therapist. She released a knot behind my knee and hamstring. I got temporary relief for a couple of days.
During this time I was also focused on getting ready for a partial mastectomy of my right breast on June 3. Ten days before the Dawn to Dusk to Dawn 24-hr track ultra, I was diagnosed with intermediate grade early stage breast cancer—DCIS.
My partial mastectomy was a success and the next day I went out for a slow 2-mile walk. I continued to do my PT exercises and to walk three to six maintenance miles every other day. The the pain and discomfort persisted. I strapped on a knee brace. But the pain, when bending my knee, and getting up from a sitting position, morphed into stronger pain when I'd put the weight of my left leg and my foot on the floor every morning after waking up.
Having experienced a swollen knee after finishing my first 100 miler, the 2011 Philadelphia 100, that was resolved instantly with a cortisone shot in my then primary doctor's office, I made an appointment with a sports medicine doctor for a cortisone shot.
He squeezed my knee and I grimaced in pain. It was not swollen and didn't need to be drained. He told me the cause of my knee pain was aging, that I had arthritis in my knee, and ordered an x-ray.
The young doctor in his early forties seemed to dismiss my years of running and that I'm an ultrarunner. He agreed to the cortisone shot and told me it would take about three to seven days before my knee would feel better. Unfortunately, the shot did not work. I got no relief and the pain was affecting my quality of life.
I was not convinced I had an arthritic knee, and the x-ray confirmed my suspicion. No evidence of arthritis, only good knee bones.
But the discomfort and pain intensified enough for me to have my husband Jon rummage through our attic to find the crutches and foot boot, both useless during my bout with plantar fasciitis in 2016. I strapped on my knee brace and hobbled with the crutches and boot as I tended to my hens, and my flower and vegetable gardens. I quickly got rid of the crutches and the boot.
A week after the x-ray, I was back in the doctor's office hobbling and limping. I was in distress. He ordered an MRI without contrast (I have eleven drug allergies; gadolinium is one of them), and by some small miracle I got the MRI within the hour. At first the appointment clerk said the first opening wasn't for three weeks. I was at her mercy and reluctantly but nicely accepted the appointment while whispering, "It's a shame there are no cancellations." She heard me as she scanned her computer screen and unexpectedly announced, "Oh, we have a cancellation." "When," I asked. "In thirty-minutes." "I'll take it." It's always good practice to be nice to the scheduling clerk and to always ask if there are any cancellations.
The MRI took about twenty minutes. I was impressed with the big and tall technician who conducted the MRI. He seemed concerned with what he saw on the MRI. He asked me if I had a history of knee injuries in the past. I told him that I'm a lifelong runner and never had a painful knee injury that left me in pain hobbling and limping. He asked other questions as he walked me to the locker room area to collect my belongings. He offered to help out with a wheelchair. I declined and told him I could hobble my way out. He expressed more care and concern than my sports med doctor.
About an hour later, I got the results of the MRI on my patient portal: meniscus tear, bone marrow edema, stress injury, and a Baker's cyst. I now understood why the tech took such an interest in my knee. He saw what my sports med doctor had not considered and never mentioned to me as a possible cause of my pain.
I immediately researched what these terms mean, and how to heal my knee. I didn't hear from my doctor so I simply followed the advice from peer-reviewed medical articles and other hospital websites, like the Cleveland Clinic, and AI on Google.
I was glad I did. I messaged my doctor to tell him how I was taking care of my knee injuries. I told him I was doing my PT exercises, that I added RICE (rest, ice, compression, elevation), and that I was wearing a knee brace. I also told him I had ordered a recumbent bike. He never replied to my message, and neither did his nurse, the gatekeeper.
I advocated for myself and went about with the business of healing. I created my version of a home "fitness center" in the family room in our basement—I placed the recumbent bike I ordered from Amazon between the treadmill and the PT table.
Two weeks after the MRI, I finally got a message on my patient portal for a follow-up appointment. I told the doctor how I was healing my knee. He prescribed pool running/jogging to my rehab regimen. I had not heard of aquatic/pool running/jogging to help heal running injuries.
He didn't give me any other advice except to say that because I'm on Medicare, I would be able to use any fitness center pool for free through the Silver Sneakers program for seniors 65 and older. I researched the Silver Sneakers program and unfortunately, my Medicare supplement plan does not cover it.
I remembered my husband and I are lifetime members at LA Fitness since 1983 when we joined Jack LaLane (it's been through so many corporate ownerships and name changes) and paid-in-full our membership. One of the best investments we've ever made. It would cost me not a dime to use the pool at LA Fitness.
Next, I researched aqua running/jogging, also called pool running/jogging, and found a YouTube video about how to run/jog in a pool with a buoyancy belt. I ordered one on Amazon. It arrived the next day and off I went to the pool at LA Fitness.
The closest LA Fitness near our home has a 25-yard pool. My first pool running/jogging session was 12 laps on July 22. I increased the laps to 24, 26, 30, and 40. I also continued to do my PT exercises at home on the PT table with a strap and a baseball, my exercises on the recumbent bike, and short slow walks on my treadmill or outside. I did not run.
Thirty-seven days after my diagnosis, my rehab regimen, and 20 sessions ( 2 to 3 times a week) in the pool, my knee was healed and ready for our hiking adventures in Great Sand Dune, Mesa Verde, and Black Canyon on the Gunnison national parks in Colorado via our Cruise America RV rental. While in Colorado, I ran/jogged in the Montrose/Gunnison KOA pool after a long day of hiking.
The day after returning home from Colorado on August 21, I went for a slow 5-mile run at an average 16:23 pace, and I collected 30 running/jogging laps in the pool. It's been fifty-seven days since my knee injury diagnosis. I have healed my knee with my knee brace, by doing my PT exercises, RICE-ing, exercising my knees on my recumbent bike, and doing pool running/jogging laps. I have increased the pool laps to 42 (.66 miles). I slowly increased my miles and have begun adding running. In the last six days, I have logged a mix of 26.5 slow walking/running miles.
I was glad I didn't have an ultra coming up until October. In fact, I have the Hainesport 12-hr ultra on October 12 and the Badger Palooza 12-hr ultra the following weekend.
I spent July happily rehabbing my left knee with RICE, a brace, PT exercises, the recumbent bike, the TM, aqua jogging in the pool, and very slow walking. According to my Garmin, I managed 133,710 daily living steps/46.46 miles! Movement is key.
I spent August doing the same but increased pool laps, and hiked, climbed, and rock scrambled in three national parks for a week before adding running miles, slow and steady.
Age has finally caught up with the knee part of my body as I approach 66. I've been racing since 1988, What took so long! But age didn't stop me from healing.
My rehab regimen and discipline has paid off. My knee is feeling good and healed, but I'm going to play it smart. I think being smart is the key to my ultrarunning longevity. I've been racing shorter distances since 1988 and ultramarathons since 2005.
If I hadn't had a knee injury, I would not have discovered pool running/jogging or gotten a recumbent bike. There's always a silver lining!
Discipline and consistency are key to anything we do. I was so focused on healing so that I could start to train again, that I did not miss running. And I rested my body. I still ice after every walk and run. And I sleep with my knee brace.
I'm happy with how I approached healing my knee. Being sensible, patient, disciplined, and trusting the process are vital. I've gone from an average 23:38/min pace during a 2-mile walk to an average 16:16 min pace during a 6-mile alternating walk/run miles.
If you are nursing an injury, stay steady, disciplined, and consistent with your rehab.
Trust the process. Be patient. Healing will come. Keep moving smartly with purpose.
I will continue to do my PT exercises and run/jog in the pool as part of my ultramarathons cross training.
And I realized that healing my left knee was more challenging than my other health challenge —my short bout with breast cancer. I'm so glad I healed my knee. And I'm so glad my breast cancer was caught early after a fall, that I had a successful partial mastectomy, and that I was declared cancer-free in June. If I hadn't fallen in March while training for an ultra, who knows. One thing I know for sure; early detection will save your life!
And if you feel a twinge here or there in any part of your body, see a physical therapist, see a sports medicine doctor, even if they don't always get it right, and definitely advocate for yourself and take control of your healing. You know your body best.
Now at age 65, I look forward to running Hainesport 12hr, ultra no. 40 and Badger Palooza 12hr, ultra no. 41 with a healed knee.
©2024
I am the author of Come What May, I Want to Run: A Memoir of the Saving Grace of Ultrarunning in Overwhelming Times. Our adventures in several national parks make an appearance. You order it from the publisher, Wipf and Stock Publishers, Amazon, Bookshop, and Barnes & Noble. It's available in hardcover, paperback, e-book, and Kindle.
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