How (Most) Running Shoes Cause Pain and Leads to Injury

In 2014 I tore my meniscus in my right knee. I was also diagnosed with “severe” arthritis. That was my wake up call. I was not done competing in the Ironman and did not believe I had to quit. “Certainly, other runners have arthritis and still run”, I thought.  I was troubled when Dr. Braden told me that arthritis was bone on bone and eventually I’d have to have my knees replaced.

I told him perhaps in other people. Not for me.

I had knee surgery in January of 2015 to repair the torn meniscus.

Right after that was my quest to figure all this out. I discovered some stats that troubled me yet led to my discovery that I’m sharing with you today.

Did you know that the United States has the most running type injuries than any country in the world? The country with the least running injuries was Africa. Why is this so?

There are several reasons.

Four Exercises to Protect Your Knees

knee painDid you know that a source of your knee pain may not be the knee? This one muscle may be causing a lot of your knee issues and it’s not even connected to your knee. It’s way underrated but very important.

I’ll confess that in late 2013 and all of 2014 I virtually stopped doing any strength training. I paid a heavy price for that decision. In 2014 I tore my right meniscus running  that I eventually had to have surgery to repair. The cause was an extremely weak glut. My left side of my body; legs, butt and core, were always weaker than my right side. Thus my right side had to work overtime to compensate. When I placed a great deal of wear and tear to my body through training for the Ironman the right side simply gave out and I eventually tore my meniscus in my right knee.

Having knee surgery and the possible outcome of never running again caught my attention. Since then I’ve dedicated a great deal of attention to rebuilding the strength in my entire body.

Pilates and Glut Strength Training

Below  are four exercises that focus on building strength in your gluts (butt) and thus stabilizing your knee. Two of the exercises are done using the Pilates reformer machine. The benefit of the reformer is you’re not loading your entire body weight on your back, it specifically targets the one muscle and isolates it and you have to engage your core simultaneously as you target your gluts. In the absence of a reformer you can use a large stability ball to raise your body from the ground.

Number of Reps and Sets

Always starting anything for the first time start easy and build up. If you’ve never used a Pilates reformer then you may not be able to do one leg at a time. You may have to start with both legs. Your goal is to always do one leg at a time to specifically target the muscle. When you use both legs at a time, like in dual leg squats, the stronger leg will alway overrule. This is why it’s best to work toward one leg routines.

On the Pilates you may start with 3 sets of 5. As you extend as illustrated you’ll want to make sure you feel it in the glut. If you feel it in your  quadriceps then they are being recruited and you’ll want to stop and refocus making sure your glut is doing the work. In the extension phase hold the pose for 5 seconds before you raise up via the glut and hamstring, keeping the core extremely engaged and body flat, and again hold for 5 secs. In time increase the number of 5 second reps.

The same holds true with the other three routines. Start with 3 sets of 5 reps and work up to 10-15 reps.

 

If you want to keep the knee you’ll have to quit running

knee tearI’m not even sure how to write this blog. I have many thoughts and emotions and writing this will allow me to get them out of my head and onto paper.

I had been suffering from a very painful knee since July 2014. It got really stiff and I was unable to straighten it for about a month following Ironman Boulder in August. My friend and doctor, Robert Braden, DC, finally was able to figure out the routine I needed in order to return the knee to full flexion so I could straighten it and be able to run. I was able to resume most of my training and it allowed me to successfully finish my 13th Ironman in Tempe, Arizona on November 17, 2014.

But the pain continued.

After that Ironman I was committed to really stepping up my running, my weakest of the three disciplines in the Ironman; 2.4 mile swim, 112 mile bike and a 26.2 mile run. I hired Bobby McGee, a world renown running coach, to help me improve. I started to really run well in the month following Ironman Arizona and had seen a reduction in my run time at about a full minute per mile.

But the pain continued.

Finally, Dr. Braden recommended that I have an MRI on my right knee. He knew I had a torn meniscus but wanted to see the extent of other damage that may be part of my pain.

I had the MRI on December 16, 2014 and went and saw Dr. Braden on Monday December 22nd to review the results.

As soon as I saw Dr. Braden I knew it wasn’t good. I could read it on his face. He knows me really well and how hard I’ve worked to be able to finish 13 Ironmans after I turned age 50. He loves athletes and will do everything for them and encourage them to keep participating even though other professionals would say quit. His eyes told it all as he read the results.

Then he said, “If you want to keep the knee you’ll have to quit running.

Bam, just like that my dreams and goals of crossing finish lines were over.

The MRI results from Alison Nguyen, MD read:

FINDINGS:

Minor joint fluid with no Baker’s cyst. Moderate osteoarthrosis, notably involving the patellofemoral articulation. No acute fracture or focal bone contusion. Bony fragmentation of the tibial tuberosity without marrow edema compatible with remote Osgood-Schlatter’s disease (sagittal PD image 11).

MENISCI: Medial meniscal posterior horn complex multidirectional tear (coronal PD image 15, sagittal PD image 20-22). Intact lateral meniscus.

LIGAMENTS/TENDONS: ACL, PCL, extensor mechanism, MCL, and LCL are intact. Intact medial and lateral patellar retinacula.

CARTILAGE: Moderate chondral thinning along the posterior weight- bearing portion of medial knee compartment (sagittal PD image 22). Severe patellar apex and lateral patellar facet chondral thinning centered at the patellar upper to mid pole level (axial image 5-7). Severe chondral thinning along the central and lateral femoral trochlea (sagittal fat-sat image 8).

IMPRESSION:

1. Medial meniscal posterior horn complex multidirectional tear.

2. Moderate osteoarthrosis with chondral injury as noted above, most significant along the patellofemoral articulation and medial knee compartment.

3. Remote Osgood-Schlatter’s disease.

Basically the cartilage is wearing out because there is bone on bone, thus the “moderate” and “severe” diagnosis. If I continued to run I would wear the knee out, have severe pain and then have to have it replaced. Damn it! That would suck I keep telling myself.

What the Ironman Triathlon meant to me

I love this sport! It fits my personality so well. It’s a sport that demands a great deal of discipline. As I’ve said many times, “The 140.6 miles don’t care if you’ve trained or not.” It’s a distant that demands a lot of endurance training to be able to move for 14 hours without injury. For me I was training 15-22 hours per week.

Ironman is such a big part of my life. I identify with it.

It taught me a lot about myself. During many long training routines, the longest being my 7 hour bike rides, I had to keep my mind quiet and focus on completing the session. In the quiet you learn about yourself. If you have any insecurity or weaknesses, they keep popping up in your mind telling you that you need to quit. For me those were rare occurrences. I have a great deal of confidence in myself because I trust the Lord and I have great joy and gratitude in my life. Most of the gains I’ve made in self development have occurred in the 7 years since July 4, 2006, the date I entered my first Ironman.

I loved seeing myself crossing the finish lines in my mind well before I actually did it. I learned that when you focus on a dream and goal and exercise faith, God will deliver the result to you.

I learned to respect everyone because I realize that the Lord blessed all of us with the will and body to achieve anything as long as we co-create with him.

I loved crossing those 13 finish lines. The anxiety before the swim is almost unbearable yet as soon as the gun goes off the fear goes away and then 13-14 hours later I would cross the finish line! During each race I would have unique experiences along the way. From the cold 52 degree water in Ironman St. George to the hot windy conditions in Ironman Arizona. The steep hills in Ironman Wisconsin to the fans partying in the streets  of Ironman Coure d’Alene. To the 29 degree ambient air temperature of Ironman Lake Tahoe, snowing the night before, to the 93 degree hot temperatures on the marathon in Ironman Boulder.

I loved helping and encouraging other younger athletes. The 20 year olds would call me “pop” and “dad” as I would occasionally pass them on the bike. The funniest was the three young ladies in Ironman Arizona 2012 that rode with me for over 60 miles. We laughed and teased each other for several hours. Then in a magical and “Only a triathlete would understand” moment, I taught them how to pee on the bike while riding!

My last Ironman in Arizona I broke the rules and took my cell phone with me so I could communicate with others as I raced including my wife who finally knew where I would be and when. After that I said that I would take it with me on every race after that.

I lost my wedding ring in Ironman Arizona 2014 on the swim. That swim was my best and yet hardest because of all the extra athletes the organizers allow to race as compared 7 years ago when I started. In my first Ironman in Arizona 2007 there were only about 2,400 competitors. In my last, Ironman Arizona 2014 there were about 3,200 athletes. The extra 800 bodies in the water makes the swim more like an MMA match than a swim. Lots of punching and kicking to go along with swimming.

My whole fitness gains were motivated by the vision I had of crossing finish lines. Motivation is so critical in anything we do in life. By signing up to race, sometimes a year in advance, you had the motivation to continue to train and eat correctly. That taught me a lot about creating motivation in all aspects of my life.

My Sadness

When you see a rich big dream of finishing 50 Ironman triathlons and completing one with a son and one with a grandchild and being the oldest to ever finish an Ironman, to now not knowing if that dream is even possible, really hurts. I have joy in my life and I’m very grateful for all that God has blessed me with yet I’m sad. I’m sad for me. I’m sad for my dream. I’ve not had these feelings at any time in my past athletic life. I can’t even remember the last time I was really sad but this last week has been a butt kick for me. I’m humble and I’m seeking the path that now is before me. What is the fork in my road? I know I need to take the path less traveled but I don’t even know what that path is.

Today while walking I wondered if perhaps this might me a blessing to me. I want to keep my knee of course and race at the same time. I’ve walked the marathon in 4 of my 13 events so I know I can walk and finish. Perhaps I can now train harder for the swim and bike, pushing those in the race with the knowledge that I can recover as I walk the marathon. For most it will be swim – bike – run – finish. For me it might be swim-bike-walk-finish.

 What is next?

I’ve scheduled an appointment with a surgeon, as recommended by Dr. Braden, to explore my options to repair the knee. Dr. Braden believes that surgery to clean out the affected areas would allow me to perhaps race one more year without compromising the health of the knee. I’m looking forward to learning more about that.

I’ve scheduled 3 races in 2015. Ironman St. George 70.3 (half Ironman) in May, Ironman Coure d’Alene (my 3rd trip there) in late June and Ironman Arizona (my 5th time there) in November.

I’ve applied to race the Ironman World Championship in Kona, Hawaii in October 2015. I will be notified in April 2015 if my application has been accepted. It’s been on my vision board for a few years to actually race in Kona and live and train over there for a few months prior to the race. I really believe that I’ll be selected and be able to race in Kona. That would be a pinnacle of my Ironman career.

The lesson for me

I honor the feelings of humility. I honor understanding that my joy is based on understanding that God is in control and all outcomes in my life, both abundant and like this, hard, are for my benefit. While I love being titled “the Ironman”, perhaps now something even more abundant will define me.

I hope so.