Dear Dr. S,
Thanks again for meeting with me last week to discuss the progress I’ve made in my rehabilitation from microfracture surgery. It’s been a long 7 months but the timing was perfect because just two days before we met I’d worked up to my first attempt at running! It was just five short stretches of one minute each, and though I was nervous with each step that I might feel that old pain rip through my knee, it didn’t happen, and it felt so good–almost like I was floating over the grass. It was a real joy to experience the feeling of running again.
I expected you to tell me that my knee’s response to those five minutes of running–the fact that I had no acute pain or swelling, just a general stiffness and some soreness when I walked up stairs the days after–was normal. I thought you’d say, “Your leg just needs to get used to running again. You’re definitely on track for a full recovery. Now I don’t want you to go signing up for any marathons or…”
“Ha!” I would have cut you off. “I’m not greedy. I’m enjoying all my other workouts and can totally adjust to being a low-mileage runner. Three good runs a week is all I need. I can do shorter races. For years I’ve been meaning to try to get in shape to break 5 minutes for the mile again…”
“Well, just keep up the good work,” I expected you to say. “And you’ll be back at it soon.”
Of course, that’s not how our conversation went. Instead, when I told you about all the workouts I’ve been doing and my knee’s response to those five minutes of running, you said, “That’s probably as good as it’s going to get. I don’t think you should run again.”
“But it’s been feeling so good,” I said and told you about my sixty mile bike ride when I’d stood up on my pedals and pushed myself up over the hills with no pain at all.
“Great,” you said. “Maybe you should think about biking a hundred miles. But running is going to be a lot harder on your knee than anything else.”
“But don’t my knee and leg just need to get stronger?”
You shook your head and said, “Your leg is strong, and I think you’ve healed well, based on what you’ve been able to do. But if you try to run again, I think your knee will hurt again, to protect itself from further damage. I know some people say they like ‘the feeling of running.’ But I don’t think your knee is going to let you do it.”
When I left your office, I wanted to break out into a run right there in the parking lot, to prove that my knee would be good enough to run again. Instead, I went to the pool. The first thirty minutes of my swim were pretty uninspired. Never run again? I knew that was a possibility, but I’d never accepted it as a real possibility. Never run again? Really? Then what am I swimming for? If it’s not to stay in shape for running, why am I doing it? I like swimming, but I don’t love it. I’m not very good at it. I’m a runner. But if I can’t run….
I’ve got to tell you, I was feeling pretty deflated. But then I remembered what you said about some people liking “the feeling of running.” I guess that means you’re not a runner. Because if you were, you wouldn’t have said it like that. And so it follows that though you may be an expert on knees and cartilage, you’re not an expert on running, and maybe you don’t fully understand the demands that running places on the lower leg. It’s not just the knee, it’s all the joints and tendons, the calf and shin muscles, the ankle and foot. This is something I’ve learned running mile after mile, doing all I could to get faster, whether it be pushing myself through hard workouts, or trying to summon up energy to finish a race. Sometimes “the feeling of running” means struggling, means pain, means wanting to stop. Those aren’t the feelings you were referring to, or the feeling I miss, but when it gets hard, that’s when I’ve paid the most attention to my body, when I’ve learned what makes it go, and I’ve spent enough time with those feelings to know that any weakness in my lower leg could lead to a stiff, achy knee. And because I haven’t been running, and because none of the other exercises I’ve been doing use the lower leg in the same way as running, of course, I’ve got weaknesses. But maybe if I re-strengthen the running muscles in my leg I will be able to run again. I mean, doesn’t that seem reasonable?
I’ve probably spent too much time since I’ve seen you reading about others’ attempts to recover from microfracture surgery, but I know that some people have worked through that initial pain to run again. I know that some say the healing goes on for up to 18 months. I also know there’s nothing like running to get the body in shape to run, so the only way to find out about my knee is to put myself on a program—something like run five minutes one day, rest for two, run seven minutes, rest again, build up to ten minutes, rest it again, et cetera, et cetera. That’s the heart of any training plan, right? Stress the system, then recover until you can stress it again.
So that’s my plan, Dr. S, but you won’t hear back from me any time soon because I’ve decided to wait another couple months. The main reason is because my brother–in-law and I have signed up to do a 90 mile bike “race” in 3 weeks and I need my knee to feel good between now and then to be in shape for that. If that goes well, I probably am going to do a 100 mile ride in September. I’m also going to be adding some more running-specific exercises to my routine. And let my knee heal a couple more months without any impact. But after that, once it’s fall, I’m going to try to run again.
I understand you might be right about all of this. But I think it’s too soon to know for sure. I mean, if it is, then it is, and it will be, and I’ll figure it out. But before I can accept that, I’ve got to try. I’ve got to try to run again. And good news or bad, I’ll let you know how it all turns out.