My Bionic Knee!

Hey everyone! After a very successful (and relatively short!!!) visit to OIP yesterday, I finally figured out what is wrong with my knee!

First of all, Dr. Himmelwright was AWESOME. He was very informative and energetic. It's like he was on 10 cups of coffee. I LIKE THAT! And he understands athletes. I LIKE THAT TOO!

(Oh, by the way, when he looked at my X-rays he said I have BEAUTIFULLY aligned knees. Woohoo!)

Okay, so this is my problem...

There are 4 ligaments that help stabilize the knee. They are pictured below. One of my problems is that my left Lateral Collateral Ligament (LCL) is a lot more stretched out than my right Lateral Collateral Ligament. Doc figured this out by holding onto my ankle and moving the lower portion of my leg out. It was very clear- I could see my left leg would move out a lot more than my right leg.

He said my LCL is getting inflamed, and it doesn't really flare up during activity, it's after activity (like when I'm simply sitting on the couch) that it flares up and bothers me. It's not that common to have an irritated LCL because it's actually the Medial Collateral Ligament (MCL) that absorbs more of the shock involved in running, jumping, etc. 

From what I read about injury to the collateral ligaments, it appears that they are usually injured due to a blow to the side of the knee. This isn't my case, as there was no one "event" that caused this. I think it's just an overuse injury.

To help heal this injury, Doc gave me a bad ass brace to wear for the next month. It is designed to lessen the load on my ligaments. I'm supposed to wear it whenever I'm working out, walking around, or being physically active. What the brace will do is pretty much give my LCL a break from a lot of the work it's used to doing. He says I can run, weight train, whatever... I'm just supposed to wear the brace.

My bionic knee. 

Our insurance company is probably loving us this year.

And by loving us, I mean hating us.

He's not fat, he's just big boned!

I decided I am going to try to lay off the running for a month and do more low impact stuff- like spinning, and maybe a few sessions on the elliptical or arc trainer. I really want to baby it as much as I can for a month to see if that heals it. I still have some more Googling to do to see what types of lower body weight training exercises are okay to do. Even though the doctor gave me the go ahead to do whatever, I want this to get better quickly and not become a recurring problem!

What if wearing the brace doesn't help and my knee still hurts after a month?

Good question! Well, then it is time for an MRI to rule out everything else other than my LCL (whose elasticity is not going to show up on an MRI) and a plica.

What's a plica? Another good question! It's something we all have, it's just mine is irritated and inflamed. Two irritation/inflamations!? Bring it on!

Instead of explaining a plica, I shall copy paste some information from this website, as they explain it better than I could, and I'm feeling lazy.

Here's the excerpt...

Plica syndrome is an interesting problem that occurs when an otherwise normal structure in the knee becomes a source of knee pain due to injury or overuse. The diagnosis can sometimes be difficult, but if this is the source of your knee pain, it can be easily treated.

Plica is a term used to describe a fold in the lining of the knee joint. Four plica synovial folds are found in the knee, but only one seems to cause trouble. This structure is called the medial plica. The medial plica attaches to the lower end of the patella (kneecap) and runs sideways to attach to the lower end of the thighbone at the side of the knee joint closest to the other knee. Most of us (50 to 70 percent) have a medial plica, and it doesn't cause any problems.

A plica causes problems when it is irritated. This can occur over a long period of time, such as when the plica is irritated by certain exercises, repetitive motions, or kneeling. Activities that repeatedly bend and straighten the knee, such as running, biking, or use of a stair-climbing machine, can irritate the medial plica and cause plica syndrome.

Injury to the plica can also happen suddenly, such as when the knee is struck in the area around the medial plica.This injury to the knee can cause the plica, and the synovial tissue around the plica, to swell and become painful. The initial injury may lead to scarring and thickening of the plica tissue later. The thickened, scarred plica fold may be more likely to cause problems later. 

The primary symptom caused by plica syndrome is pain. There may also be a snapping sensation along the inside of the knee as the knee is bent. This is due to the rubbing of the thickened plica over the round edge of the thighbone where it enters the joint. This usually causes the plica to be tender to the touch. In thin people, the tissue that forms the plica may be actually be felt as a tender band underneath the skin. In rare cases where the plica has become severely irritated, the knee may become swollen.

Diagnosis begins with a history and physical exam. The examination is used to try and determine where the pain is located and whether or not the band of tissue can be felt. X-rays will not show the plica. X-rays are mainly useful to determine if other conditions are present when there is not a clear-cut diagnosis.

If the history and physical examination strongly suggest that a plica syndrome is present, then arthroscopy may be suggested to confirm the diagnosis and treat the problem at the same time. Arthroscopy is an operation that involves inserting a small fiber-optic TV camera into the knee joint, allowing the surgeon to look at the structures inside the knee joint directly. The arthroscope allows your surgeon to see the condition of the whole knee and determine whether the medial plica is inflamed.

The majority of people with plica syndrome will get better without surgery. The primary goal when treating the plica is to reduce the inflammation. This may require limiting activities like running, biking, or using a stair-climbing machine.

Your doctor may suggest anti-inflammatory medications such as ibuprofen or aspirin to reduce the inflammation. Ice packs or ice massage can help reduce the inflammation and swelling in the area of the plica.

If all nonsurgical attempts to reduce your symptoms fail, surgery may be suggested. Usually, an arthroscope (mentioned earlier) is used to remove the plica. The small TV camera is inserted into the knee joint through one-quarter inch incisions. Once the plica is located with the arthroscope, small instruments are inserted through another one-quarter inch incision to cut away the plica tissue and remove the structure. The area where the plica is removed heals back with scar tissue. There are no known problems associated with not having a plica, so you won't miss it.

The information I copy pasted from the website describes a lot of what I'm feeling except it's on the lateral (outside) portion of my knee, not the medial (inside) portion. The snapping band like thing- I have that! Though I do not have swelling or anything like that.

And like the website suggests, if it doesn't get better via anti inflammatory cream (which I have) and rest (the brace), and the MRI rules out all other problems, I'll have my knee scoped to remove the irritated plica.

(Oh, Paul told me all the NBA players get their knees scoped to remove plica. So I'm in good company I guess!?)

What is the recovery like if you need your knee scoped for plica?

The doc said I'd be on my feet doing low impact activities in a few days and then I would just have to ease back into running. Sounds good to me!

So I am hoping that I can get this all straightened out in 1-2 months!

In the meantime, if you see me out running, or blogging about a run I went on, yell at me! Tell me to rest my knee and get my ass on my spin bike!

PS. The most amazing part of the day was that I was in and out of OIP in just under an hour and fifteen minutes. CRAZINESS!!

PPS. Sorry if there are typos and sloppy writing... normally I sit on a blog post and edit it a few times before posting, but this one was written quickly!

PPPS. I carbed up on Pringles and vanilla ice cream last night in preparation for the AWESOME BIONIC KNEE SPIN WORKOUT I'm going to do today!!!

Have you ever had your knee scoped?

My Dumb Knee

Well, I'm finally going to and out what's wrong with my dumb knee on Monday. Hopefully. We will see.

Here's the deal. My left knee has bothered me on and off ever since I ran the Bull Run 50 Miler in 2010 It was likely an overuse injury. I rested it for 2 months. I did a TON of swimming at the YMCA. I eased back into running. Things have been sort of smooth since then. However, from time to time, it still flares up and bothers me. When that happens, I go to Olivetti Chiropractic to get Active Release Technique. That usually does the trick.

Not this time! My knee has been bothering me for about two months and nothing seems to make it feel better. It used to only hurt when chilling on the couch or driving. Then it started to hurt AFTER a workout- whatever that may be... running, plyos, spinning, lifting, sprinting... At this point, it hurts while I workout.

I have an appointment for an X-Ray at OIP on Monday. I'm really excited to find out once and for all what the hell is wrong with it so I can treat it and get back to my normal routine. My normal routine doesn't even involve running a whole lot. (I think I've only been running like 20-25 miles a week. I know people who run that in a DAY!) But I want to be able to do squats and burpees and mountain climbers and all that "fun" stuff.

My chiropractor thinks I may have a small tear in my meniscus. It can't be a bad tear because if it was, I wouldn't be able to bend my knee, stand on it, or run on it. If it's a tear, it's probably small and requires a few weeks of rest. Sounds good to me!

I'm going to be "good" and neglect my lower body today at the gym today. My lifting workout will consist of upper body only. I'll "lift like a dude", too. Low reps and high weight! Tomorrow I will fill you in on how that went!

As for yesterday, I did some fun circuits that focused more on core and upper body. I will share it with you to prove that it is easy to train around an injury. Just because I have a bum knee doesn't mean I have to stop working out and lay around all day!

These circuits started in my backyard but I had to transfer to inside my house because I was getting ANNIHILATED by mosquitoes! I don't get it! I was covered in bug spray. Yet I had 4 mosquito bites within 10 minutes. They love me.

Okay, Here are my circuits!

It took me exactly 48 minutes to complete. This morning, my abs are sooooo sore! 

How have you had to train around an injury?

Any suggestions for other knee friendly exercises I can throw into my circuits?

Ouchy-Wa-Wa!!!! (aka Plantar Fasciitis)

So it seems like my body is just falling apart these days. For about 2 weeks before the mile, I was battling my old knee pain that likes to come back and visit me once every few months. It's gone now, but because I just declared that it was gone, it will probably come back tomorrow. That's how it usually works.

Then, the day of the mile, I stepped out of bed and felt a pain in my heel. It was very mild, and did not affect my race in anyway. Later that night when I ran back to my car, I really started to feel it. I felt it the next day right when I got out of bed and on my four mile run, too.

I was pretty sure it was plantar fasciitis. Everyone has probably experienced this ailment, if even to a small degree. Have you ever woke up in the morning, and as soon as you stepped out of bed you felt a sharp pain in your heel? That's your plantar fascia, and if it hurts, there's probably a strain on it or it is inflamed. This has happened to me before, but the pain has gone away quite quickly- before I even thought anything was wrong.

Source

However, this time, the pain did NOT go away. I couldn't even walk on it! So I did some Googling, and learned a lot about PF just from this one video:

I also learned that the best ways to heal PF quickly is to:

1. Nip it in the bud right away. Whatever activity you're doing that's causing the pain (for me it was running) STOP IT! The sooner you stop, it's more likely to be a less severe injury.
   
   
2. Stretch multiple times a day- especially before getting out of bed in the morning. When you rest your feet for awhile (like sleeping) the plantar fascia is mending itself from the wear and tear of the day. Then with the first few steps in the morning, the plantar fascia becomes torn again. So stretch before getting out of bed!
   
   
3. Ice multiple times a day.
   
   
4. Go see the amazing Dr. Olivetti at Olivetti Chiropractic.
   
   
   
   
   
   
   
   I am so thankful Dr. Olivetti can help me through all my sports injuries! He performs Active Release Technique on me from time to time when I'm feeling knee pain, Luckily, ART also helps plantar fasciitis. But OH MY WORD IT HURT SO BAD!!!! My heel hurt to begin with, and then he started chipping away at it with this terrible sort of new age-y tool. (My description, not his.) HOWEVER, IT WORKS. All the pain is WORTH IT because guess what? In a two days I didn't have anymore pain on my plantar fascia! 
   
   
   He attributed this to two reasons:
   
   
   1. I stopped running right away and didn't further damage my foot. (Don't be a hero, people!)
   2. He performed ART on my foot and calf. Calf tightness can cause PF, and that's probably my root cause.
   
   
   I went to see Dr. Olivetti again yesterday. He performed ART and it hurt a lot less this time. He said it is a really good sign that it's feeling better. I'm supposed to ease back into running, so we'll see what happens! I'll see him again next week, and hopefully my healing has continued and running short distances doesn't aggravate it.
   
   
   If not, I'll just have to get more JACKED at Planet Fitness!!!
   
   
   
   
   Have you ever suffered from plantar fasciitis?