Four Weeks To Go - Riddled With Injury

29th September, 2009

This week has been fairly depressing.

After the joy of the new trainers passed I somehow managed to injure my knee. Last week's short runs were all cut short by a nagging pain around the bottom and outside of my left knee cap.











I had to give up after 3 miles on Wednesday and then - perhaps stupidly - opted to go out again on Thursday and couldn't make it any further than about a mile and a half. Turning home I felt really, really dejected. I wondered if I hadn't stretched enough after my 10 mile run last Tuesday.

After resting for a few days (Friday and Saturday) I tried to go out for a long run on Sunday afternoon with my friend and running buddy, Natalia. Setting off in the Bois de la Cambre, we tracked down in to the woods - all was going well, but after about seven miles, we ran down a sharp slope and the knee pain came back. I tried to push on through the pain and keep going but eventually had to stop and we walked for a mile before trying to start running again. It was no use as the pain continued to get worse and after another mile or so we had to stop and walk the rest of the way home.

I felt very dejected as I've never experienced anything like this before.

Getting in to a negative mindset is awful. I began to worry that I won't be fit enough for New York. I really started to beat myself up about not stretching enough, not putting in enough miles or getting enough sleep and finally I started to think I haven't been taking the training seriously enough, perhaps the knowledge that I've already run a marathon has made me a bit complacent about training for the next one.












Work took me and my foul mood to the Swedish city, Goteborg, where I had a lot of time to think on my strategy going forward. The most important thing for me at this point is to be able to get around the marathon course in New York, preferably running the whole way. Using my best Swedish, I bought some ibuprofen and some ibuprofen gel for the knee and did a few stretches.














Through a friend, I managed to find a drop in physioclinic in Gotenburg. http://www.sportrehab.se/

After a good deal of prodding around and "provoking" me, the physio, diagnosed an "overuse" injury inside the joint.

If you over-exercise your knee you can aggravate the cartilage and another layer called the meniscus, which cushion the impact when you run.

At best, the area becomes inflamed and at worst it can begin to tear away from the joint. He didn't seem to think that mine wasn't torn (I would be in a lot more pain if it were) just inflamed.

The good news is that it isn't a problem with the knee cap or the muscles surrounding the knee or the tendons, as these kind of problems are more serious. He seemed confident it would heal, but said the meniscus area has bad blood supply and therefore takes - on average - longer to heal.

The anti-inflammatory gel wouldn't work, he said, because the aggravation is inside the joint, too deep to be reached with gel. So the bad news is he was VERY evasive about how long it would take and said I should "reassess" my plans to run the marathon and "throw my training schedule out of the window."

Me: "Yes but I am running a marathon in 4.5 weeks, I need to train."

Physio: "Well, you rest now, you may be ok for the marathon, you train hard now, maybe your knee problem comes back and you have to run the last 10k of the marathon in pain, you do yourself a great deal of damage, you get in to a vicious cycle."

And so I left with a downbeat feeling, some anti inflamatory drugs and a recommendation to rest before starting low level exercise like biking or walk-run-walk.

I am to take Voltaren for 10 days - which contains 25mg of diclofenac (picture below). It is a non-steroidal anti-inflammatory which could cause "severe stomach pain" according to the physio - YUM!