get a second opinion...right away...don't believe anything...

read the "lore of running"...some comments of Tim Noakes is that
1. virtually any injury can be healed
2. most of the time, you can avoid going under the knife
3. if a doc says you can't run or not as much as you want (ever) see someone who understands.

Believe.

Turtlegirl - What's the problem with your foot?



I'm no medical professional...but my Dr is. When I go to him with an issue, he always knows that I'm never going to stop, so he creates a solution. If he knows I have an IM coming up, he's not going say "don't run" because that's not an option. Rather, "skip the running LSD, but continue your daily runs with max cushioning and your short runs after a long bike...blah, blah, etc." Doesn't hurt that he's gone to Kona 5x (4 as a Doc)........

I guess what I'm saying is get a 2nd opinion. The body is a remarkable machine and don't settle for just one "opinion", seek out solution providers not limiters.

Good luck.

Second the opinion to get a second opinion. And, try to find a doc with a sports practice or background.

Nov 02 I had a serious shoulder injury (torn rotator cuff, soft tissue damage, muscle damage, etc.). The injury was classic for shoulder surgery, which would mean a 6-12 month recovery (for me, this meant I could not work because I was a police officer at the time). I sought out the best sports orthopedist I could find, and we came up with a non-surgical solution. Today, my shoulder is nearly as good as it was prior to the injury, and likely better than it would have been had I opted for surgery.

Find the right physician to treat your injury while maintaining your lifestyle. A lot of physicians -- particulalry orthopedists -- are oriented towards surgery first.

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*****
"In case of flood climb to safety"

Sorry to hear it. I'm recouping from a scary knee injury(partial MCL tear), so I can relate to the frustration.

Couple of suggestions I have personal experience with.

- Chi Running. It's not hype. Don't let the New Agey marketing put you off. It will change the way you run, your focus, and the wear and tear on your body. Take a class, you will definitely feel the results. A coach can tell you things about your form you might not even be aware of. Do it.

- Gradually strengthen up your feet. Run on sand or the beach if you can. Run barefoot if possible. Reduce youre mileage considerably and start to build up again. Try an 'unsupportive' shoe like the Nike Free. Your feet will get more sensitive as well as strong and alleviate all sorts of problems.

- Ask around and get a recommendation for an acupuncturist. They can work near miracles on soft tissue-related problems as well as lots of other things. I'm getting treatment on my knee and improving steadily.

Good luck.

I will add that in 1997, we saw one of the 'top sports specialist', orthopedic surgeon etc...really renowned. my wife had both ankle and shoulder problems (ex-swimmer, really flexible, lots of injuries).

he said: 'forget it...no more swimming or running for you'.
she worked hard...muscled up a bit...and did her tri 2 years later, first IM in 2001 and has done 6 now with sub 4h marathons. not bad for someone who will never run again

Absolutely. I forgot to add that a good Physical therapist is at least as important as your doctor. Seriously. I worked with a masochistic lady orginally from New Zealand who made me suffer like no one before or since (save, perhaps, for my wife ... but that's another story entirely). But it paid off.

The dr said that one of the reasons I was able to avoid surgery was because I, and my shoulder, was in great shape from multi-sport (back then I was doing a lot of mtn biking, adventure racing, lifting -- I was trying to make the SWAT team--, krav maga (Israeli martial art), etc).

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*****
"In case of flood climb to safety"

been there, heard that before. Four years ago had 75% of my medial mensicus removed from right knee. Tore the protective cartlege 3 months later. Two years after that, figured I'd get the knee looked at again since I was still running in some pain every day. I went to an knee doctor that was a runner and had the reputation for telling clients they could still run. After looking at my new MRI's he tells me its time to increase my cycling and swimming and lessen my running, as in no more than 4 miles every other day. Of course I don't listen well and now am running 50 miles a week and have done two Ironmans and two marathons since that last diagnosis. There is still a certain amount of pain every day when I run, but the funny thing is that the more I run (frequency wise), the less it hurts.
Moral of the story is, get a second opinion and even then, remember that they call it "practicing medicine" for what doctors do. It's not a knock against them, but the human body and what it can do is not an exact science, we just don't really know it's true limits.
Second moral to the story, get a very good PT and do the extra work to strengthen other supporting areas/muscles that could help out.

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Mike Plumb, TriPower MultiSports
Professional Running, Cycling and Multisport Coaching, F.I.S.T. Certified
http://www.tripower.org

I agree with the comments to get a second opinion. That is always wise especially if the doc is not a runner.

Mike, from what you have said you are on your way to wearing your knee completely out. The meniscus is like a shock absorber to protect the underlying articular cartilage. Without 75% of your meniscus will wear out the articular cartilage and develop arthritis. Running will accelerate this process. You might be looking at a complete knee replacement down the road, much sooner if you pound the hell out of it. That's reality.

Running won't cause arthritis in a healthy knee but will accelerate the damage in an already arthritic knee which I am sure you have.

I see MRI's on relatively young athletes just about every day who are ready for a knee replacement. That's not good if you have a lot of living yet to do.

I'm in the second (and third) opinion camp, too.

I'm also of the opinion that many professionals treat cartilage in the knee as a piece of felt of a certain thickness, and it will wear down to nothing after a given number of movements. I've had them tell me this very thing. They don't think of cartilage as a living, growing, healing-capable substance, hence, the idea that running is necessarily "bad" for the joint. They are wrong. You need to move on to someone else if you were dealt one of these people in the cards.

But, if you indeed have documented major cartilage loss, eventually, you will pay for it some time in the future whether you run or not. I've seen the articular surfaces in hundreds of knees during knee replacement (I'm there to salvage as much blood as I can, so the patient hopefully doesn't have to get a blood transfusion from a donor.) When that cartilage is gone, it really becomes bone grinding on bone...you can clearly see the roughened, reddened, painful, bloody surfaces that are supposed to be white/clear and shiny. You do need to realize this is an inevitability IF you have a major loss of cushion, and more running will cause it to wear out more quickly compared to less running, or no running.

I'm not saying don't run, I'm just saying, don't kid yourself as to what will happen sometime in the future.

Artificial joints are better than they used to be, but, you still don't want one any sooner than you must. With the new artificial spinal disc implant just approved, hopefully one day, a reliable knee cartilage implant may be available that would allow resumption of high running volume loads...I simply don't know...it's not my specialty. But, only you can decide how much risk you wish to assume by your volume of running, and you need to know as many facts as possible in order make truly informed choices. In the meantime, you sure are performing at a level that surpasses the vast majority of people in your age group!

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Quid quid latine dictum sit altum videtur
(That which is said in Latin sounds profound)

I would second the thoughts about the doctor's not necessarily being right. It is really amazing what the human body can do. Get at least one more medical opinion.

But, more to the point and to answer your question, based upon one whole season of triathlons (and 12 years of swimming, 6 years of marathoning and lots of reading) I think you can be at least semi-competitive in Olympic tris on 15 to 20 miles of running a week, especially if you can still swim and bike a lot. With that mileage, it's easy to do a good speed workout of some sort and two easier runs of varying distances, even ten miles or so from time to time. This is the amount of running that I did this season. I did not place in the top 1/4 of my AG overall, but this was because it was my first season trying to ride a bike quickly. If my bike were in the top half, I probably would have been fairly close to the top 1/4 of the AG.

CTL wrote: I think you can be at least semi-competitive in Olympic tris on 15 to 20 miles of running a week.

For Age Groupers, this is certainly true. I put in a total of THREE weeks of 20 miles or more last year...one of those weeks was during an Iron distance race. I never finished worse than top 4-5 on the run split or the AG results, except one race where I was sick and should have been in bed. Maybe there was one other race where a bunch of big dogs showed up where I finished slightly lower than 5th...don't remember.

Anyway, I'm of the opinion that minimizing the number of miles running is a good strategy for longevity. I could be wrong....again. I spend the vast majority (although it's not of epic proportions!) of my training time on the bike for this reason.

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Quid quid latine dictum sit altum videtur
(That which is said in Latin sounds profound)

that's my big fear - that my knees will go, just as I'm starting to get in to running



get a second opinion, find a doc who runs

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--------------------------------------------------------------------

After heart surgery, was told to limit my exercise so that my heart rate never exceeded 120. I spent twelve iving like, well---- an average American. When I tired of that, I went in search of a specialist who had some experience with athletes. I will be entering my third year of competition. Therefore:

1. Get a second opinion from a doctor who will look for solutions,

2. Leave no stone unturned in your search for resolution to your problem, and

3. Don't give up!

Good luck!

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Lou Battaglia

Why didn't I retire last year?

yeah, spit that out right now, otherwise, you'll be creating your own limitations based on his poor advice. call your best local running store and ask for a recommendation to a doc who specializes in athletes.

now matter what, i know my doc would never say anything like that to me...in fact, he's the one telling me to get off my ass and that I can do anything I want, as long as i train smart.

these docs are out there...take the time and check your resources to find one.

spit it out.

kittycat

1. How's your weight? Being too heavy will over-stress your joints.
2. How's your running form? Are you a heel striker? Might be a good time to learn to run more *forward* on your foot.
3. How's your strength? Are your muscles strong enough to off-load some of the stress that might be finding it's way to your joints?

Never believe someone that tells you that you can't do something.

Silly... Listen to Francois...

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-
"Yeah, no one likes a smartass, but we all like stars" - Thom Yorke


smartasscoach.tri-oeiras.com

I did NOT want to hear, in early '00, that I had a tibial stress fracture. I also did not want to hear my doctor say that at my age (then 51) if I kept pounding out the miles I would continue to get injured, and that I should spend much more time on my bike. When I told him I didn't own a bike, he looked at me very strangely. To keep in some sort of shape during the Canadian winter I started swimming, and one day I realized that if I was swimming, and would return to running,a nd would get a bike, well, maybe I ought to try that triathlon stuff. As it turns out, that stress fracture was the "best bad injury" I ever suffered, pushing my into triathlon which is the best thing that ever happened to me.

I'm sorry about your situation and I would echo the other responses to get a second opinion. However, there bountiful oly, int, and sprint races out there, more than you could ever enter. and if you live anywhere near Ontario, there are also lots of races between sprint and oly in length, plus three betwewen oly and 1/2IM distance. That would be great if, in fact, you couldn't ever run/race at the 1/2 marathon distance - maybe 15 km would work well for you!

Good luck with this, and keep the faith!

Hey,

Don't get bummed yet. Find yourself a sports specialist who is familiar with ENDURANCE ATHLETES. I put that in caps because I know a lot of great sports docs who spend most of their time taking care of basketball/football players. Even better, find one who is actually a runner/triathlete themselves. There are different factors to consider in different sports, and you want to make sure you are talking to people who know what kind of stresses you will be under, and what is actually involved in your particular sport(s).

Depending on where you are in the country, I can point you to some pretty good people. PM me if you'd like a couple of names, or just drop me an e-mail.

Phil

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Dr. Philip Skiba
Scientific Training for Endurance Athletes now available on Amazon!

I had already scheduled Drs. appointment #2, for today!--this one is a triathlete/marathoner that gave me the cortisone shot and said to do my half! But he's the surgery happy one, so that's why I went to a more conservative guy yesterday...I'm trying to get at what keeps causing my issues (be it plantar faschiatis, quad tightness, piriformis, it band, blah blah blah) which is a malfunctioning hip or S_I joint, I think. Its really apparent in yoga, which I did last night. I also started with a personal trainer to go along with my phyical therapists' program to strengthen my muscles that aren't pulling their weight. I'm trying not to give up and do the hard work to get my body to do "the right thing".

I"m trying the "athletic" doc today to see what he says. I've read enough ST's posts to know not to listen to just one! :) Its just awful though to hear that you might never be a runner and have to constantly limit the miles.... :(

Hopefully his won't be as cynical...poor tri-bike is getting dusty in the corner!

I'd be cautious with

1. surgery. very often you can avoid it.
2. cortisone. If I remember well that stuff 'eats' your tendons.

Also cortisone only masks the pain. It doesn't go to the root of the problem

Depending on where you are, I am sure plenty here know a good doctor that can help.

yep, that's why I went to the conservative doc.



anyone suggest someone in the DC area? anyone? bueller?

Find a third one, in between :-)

I asked Santa for 2 new knees...no luck. :(

Santa is such an Ass! :-)
he doesn't even need his knees as he has his reindeers ;-)