Runner's Knee and the Sports Medicine Dr.

Early in my running, I ran as hard as my lungs and legs would let me. Other than being tired, I had no injuries. I figured that it would always be that way. When my knee pain began after my first half-marathon in 2005, I was pretty freaked out. It hurt when I wasn't running and I was convinced that I had irreversibly damaged my right knee specifically. I decided to see a sports medicine specialist to assess the damage. First they asked me some questions. My favorite dummy moment of the day was when the Dr. asked if I had any inflammation, I brilliantly responded, "no, but it does get warm and it feels like blood is rushing to my knee." Next they took x-rays of my knees and did a physical exam. The Dr. twisted my legs in a variety of awkward directions, asking if it hurt. Lots of "no's" until he pushed down on the top of my patella with both thumbs and asked me to bend my knee. I literally yelped, the diagnosis: runner's knee (go figure). The problem (patella-femoral syndrome) was described to me thusly: "your outer thigh is stronger than your inner thigh which pulls your kneecap laterally into your femur, causing pain." So my legs, or at least half of my legs, were weak. The good news: there didn't appear to be any permanent damage. They gave me a list of exercises that I could do to strengthen my chicken thighs and a prescription for naproxen to cover the "inflammation." I scheduled a follow-up visit and went on my merry way.

Running continued as before. The naproxen worked well and I did the exercises with roughly 80% compliance rate. I noticed about 50% improvement, which is exactly how I described it to the Dr. at my follow-up visit about 2 weeks later. This statement was unsatisfactory for him and he referred me to a physical therapist to assure that I was doing my exercises correctly and completely. I was disturbed that the Dr. expected 100% improvement after such a short period of time, specifically with an injury developed over a relatively long period of time. Unable to shell out more lettuce for regular PT visits, I left feeling dejected, hopeless, and skeptical of the care I received.

My battle with runner's knee continued with zero improvement until recently when I ditched the cushy moon boot running shoes for thin soles or no soles at all. I noticed improvement about a month into regular barefoot and minimalist running. While there may still be many chapters I write on this subject, my runner's knee is currently resolved.

Recent research incriminates the shoe as a potential cause of leg injury.

The rest of the story

Not long after the minor victory at Rex Lee 2008, I was accepted to school in Savannah, Georgia, where I currently reside. My running continued only occasionally and with the previously mentioned pain.

It was in this apathetic limbo that my brother Jon told me about a book, Born to Run, and his experiments with barefoot running. Barefoot running was at that point little more than an eccentric subculture of running to me that deserved little attention. I put it somewhere on par with swimming at the North Pole, cool yes, but practical or necessary?

After hearing Jon's enthusiasm, my inherent reservations about barefoot running dissipated and I decided to try it for a few months to see if it would help out my 90 year-old knees. Nothing miraculous happened immediately with regard to pain, but I was floored by how much I liked it. I felt excited to wake up early so I could go out and do it again each morning. That was exactly what had been missing for several years.

So excited was I that I ran as often as possible for longer distances than I had ever trained for previously. I purchased Vibram FiveFingers to keep my feet from turning into hamburger. Feeling frisky, I signed up for The Tybee Island half-marathon. A couple of weeks before that race, I developed shin splints for the first time in my life. I rested my legs, laying off the running altogether until the race. 3 miles into the race, they came back with a vengeance, preventing me from finishing.

The fad seemed to have failed me. All the claims I heard about no more injuries didn't ring true. But there was one issue I couldn't resolve-I completely loved running barefoot and/or with VFFs.

Which is where I am now. I love running this way and even if I can't achieve any racing goals, I'll keep running barefoot/minimalist. My shin splints are resolved for the time being and I am back to regular running. I have new goals and enough experience now to feel more confident that I can work through the inevitable problems that will arise. My knee pain has gradually diminished after months of putting the new style to the test. More manageable pain (aside from the shin splints) has taken its place.

The End. Which is to say, the beginning. While I will post more detail about my shod-to-barefoot change over, individual races, etc., the rest of this blog will be about my path to Boston and beyond. Enjoy.

How I started running

As mentioned before, I started running at the age of 20. I was living in the Dominican Republic at the time as a missionary and a fellow missionary introduced me to running. I took to it quickly, being skinny and fairly light on my feet. Interestingly, it took a social situation, running with a good friend, such as this missionary, to lead me to the conclusion that running could be an enjoyable experience. Up until that point, running seemed like something that was only to be done when thoroughly coerced, as was the case in gym class or running from John Law. Each morning we would get up early and run several miles before starting our day. I did so in "short" shorts and was mocked mercilessly by locals. I found it humorous, and to this day feel a necessity to reduce the seriousness of my runs in some way.

Upon returning to The United States and college, running continued to start or end many of my days, usually running by myself at this point. I religiously ran the same course on Y-mountain in Provo, UT, which was almost exactly the length of a 5K. I still love that trail and wistfully remember running in the dark during snowstorms, scaring up deer, and in turn scaring the heck out of myself. I ran it as hard as I could every time I went, believing that each time I went out I needed to make it hurt. These runs built my speed and hill abilities to a point I haven't yet returned to.

After running this course for some time, I decided to try my hand at a local 5K, The Rex Lee Run in 2005 (I'll post a more detailed race report later). I did fairly well coming in under 21 minutes and felt inspired to take on longer races. I ran a 10K shortly thereafter at almost the exact same pace, a half-marathon later that summer, and a marathon relay with friends that fall.

A lack of long-distance training left me woefully unprepared for the half-marathon and nearly limping across the finish line. At that point I began to have knee pain and almost instantly lost interest in running.

In fact, I didn't run much at all over the next 2 years. Between getting out of shape and dealing with discouraging knee pain, I didn't feel motivated and I didn't feel hopeful that I could ever run and like it again. At times I would run for short spurts, but confronted the same pain again and again. I prepared for The Rex Lee Run 2007, but got violently ill right before the race. Defeated, I considered swimming, biking, and other knee-friendly substitutes, none of which ever came to fruition.

Determined to feel like I had felt before, I forced myself to run through the pain and prepared to run in The Rex Lee Run 2008. I ran the race completely unprepared and while underwhelmed with my performance, I felt that this was a small turning point for me.

This post is now too dang long. I'll leave the story there for now and bring it to the current time in another post.

My running philosophy, currently.

Let's get something out on the table from the start: I am an exceedingly average runner. This blog will consistently bore those looking for X-games-type thrills and pomposity. My philosophy on running is based on my desire to enjoy running as much as possible and only secondarily on surpassing old milestones. Even the namesake goal of this blog is not going to interfere with the main purpose of my running: PHUN. After all, what good is a hobby/pastime if you can't enjoy it? It may not be complete ecstasy 100% of the time, but if you don't come out with a net amount of joy, then the time has come to look elsewhere for diversion.

Second, running may be the focus of this blog, and while it affects how I approach many situations, it is not the main focus of my life, thus my high amateur status as a runner. Therefore, the posts will be replete with daily life sprinkles on my running stories.

Now for a few of my beliefs:

• running should be fun
• don't overdress for the occasion, i.e. run with as little footwear as possible
• don't run on Sunday
• running is primarily cooperative, secondarily competitive
• look ridiculous when you run
• eat food that doesn't make you feel like garbage
• never pass up opportunities to run in the rain
• don't overdo it, and don't underdo it either
• treadmills are immoral
• don't bounce-glide
• lots of little steps are better than a few big 'ol steps
• mix up your runs

Understand that this is an evolving list. Look at upcoming posts tagged under "Background" to see how this process has changed over time for me.

What it is, what it is

I have a goal to run in The Boston Marathon. For some this may be a readily achievable goal, for others it may not be possible. I consider myself somewhere in between those two extremes. I was not a runner until the age of 20, at which point I ran and enjoyed it (my definition of "a runner"). For the past 8 years, I have run with varying degrees of success and failure/injury. The goal of simply A marathon has continually been on my to-do list for most of that time; but now, I'm setting my sights higher and beginning more diligent progress-tracking towards each subgoal. It may be that I am actually among those who can not physically run in the race. Right now, I feel confident that I can and intend to do everything in my power to do so. At any rate, it should make for an interesting story, as strange/funny things tend to happen on my runs. I will enjoy this jibber-jabber; if you like it too, then that's just icing on the sweaty cake.