As I’ve lamented previously (and frequently) I’ve regained the weight I lost last winter. *sigh* And I’ve found it doubly difficult to consistently do core workouts & other ‘pre-hab’ to prevent my knees from derailing my running. And here I am, with achy knees that are getting worse.

While I’ve chalked up the achy right knee to my techty right glute & IT band, I’m beginning to suspect there’s some structural damage in there. If I seek treatment for this, the first question I will hear is “What happened?” At least with the left knee I had an idea of what caused the damage – even if I failed to realize I’d damaged the knee for a couple of months & spent most of that time running (and attempting a 50K) on the poor thing.  This time? I got nuthin’.

The knee started hurting last September, after my attempt to hike Section J of Washington’s Pacific Crest Trail. The pain was almost immediate. The problem is that I have no idea why it started hurting. That was a rare hike in that I didn’t fall or trip or otherwise injure myself. The starting weight of my pack was 37 pounds – a little heavy, but not terribly so.

After a few days, I was back on the trail in the southernmost section of Washington’s PCT. I went on the hike despite the knee hurting. (I needed to get back out there to get the taste of failure out of my soul.) I fell once on this hike: I stepped on a wet stick, causing my foot to roll out from underneath me. But because my knee was already hurting, I cannot know if this fall twisted my knee — a twist is what damaged the cartilage in my left knee — and did structural damage. Thus, if my doctor asks “What happened?”, he’s going to get an even longer story than he did last time.

The pain’s largely been manageable. I’ve been running, and while the knees hurt — straightening my legs after they’ve been bent for a few minutes is unpredictable — they haven’t hurt while running. Between the weak glute muscle, the tetchy IT band, and the extra forty pounds of fuel I’m carrying, I was basically asking for trouble. And then, I broke one of my hard & fast rules: last Thursday, I ran on pavement.  

That was a terrible idea.

Since last Thursday, the pain has sharply increased. I skipped this morning’s run because of it. I’ll try running – ON DIRT – tonight. I’m trying to use the pain as motivation. At a minimum, I need to work on knee capsule stabilization & strengthening my right glute. (I work them both, but I can’t work my left more than I work my right; if I do, this problem will never resolve.) I need to work on lower leg strength & flexibility. And I need to burn off some of this extra fuel I’m carrying. (While I describe myself as being forty pounds overweight, my goal weight is thirty pounds lower. If I can get there, and it feels good, I’ll consider trying to lose another ten.) I’m working on behavior modification to keep me from eating things that tempt me but do not serve my body well. I can’t magically repair damaged cartilage, but I can mitigate the damage it does to the rest of my life.

I’ve also gone back to therapeutic dosages of ibuprofen. I avoid the stuff as much as possible, as its anti-inflammatory capacity means it prevents your muscles from gaining the full benefit of workouts. But I need to reduce the inflammation in my knees or I won’t be able to workout. I’m at 400 mg /dose right now; the safe maximum is 3200 mg/day, meaning I still have room to increase the dosage if I need to. (I don’t have issues with my kidneys, and I’ve not any problems with my stomach when taking 800 mg doses of IBU in the past. But I’ll keep an eye on my body feels, as I’m sure my ability to process this stuff has changed over the decades.

As I often do, I’ve already signed up for more races. I’m signed up for the 2nd running of Run with the Goats (it’s really a beer run, and DNFs are highly encouraged) and Twilight 12 Hour — you guessed it! It’s a 12-hour overnight run. Those are both in April, and the week before the Run with the Goats is the Deception Pass HM, which I’m also considering signing up for. If I do the Deception Pass HM, I’ll about three weeks “off” before I need to start training. During that “break,” I plan to work on core & flexibility. If I spend that time focused on something other than running, my hope is it’ll be the start of a habit.

From the middle of December last year to the middle of March this year, I managed to lose ten pounds. There’s no reason I can’t do that again. It stings that I’m losing ten pounds that I already lost, but complaining about that fact won’t change anything. I’m hopeful avoiding pain is sufficient motivation.