Jim's Left Knee Bone Spurs
oophs! i put this in the macro thread and maybe it should be here!? while not a real "big picture" issue i suspect it will cover several weeks.
Coach,
i have IMMD coming up and a lot of volume in the next several weeks. Swimming is my strength and running and strength training have been what i've increased (a bit). several weeks ago my left knee had pains as i'd begin a run but it would subside in about ten minutes. i've been fairly faithful with my training plan ever since but the pain has steadily increased. i visited a good local orthopedic and sports medicine doctor last week and after x-rays (I know him and he said my bones are strong due to all the weight bearing exercise and i have very good cartilage on my knees). i have two very small bone spurs on one leg bone at the knee. he drained about a cup of liquid from my left knee, gave me a steroid shot, exercises to do, and suggested a knee sleeve, R.I.C.E., and ibuprofen if needed. he said if i'd like he can give me another shot before IMMD but within 2 days of the first shot my knee is again swollen. I completed 3 hrs of the Thursday run (12.15 miles, ae mvg pace=15:05, AHR=121, Ave cadence= 133). i continue to use R.I.C.E.
My question is do i drop all running for a period and just bike, swim and strength training (i do that for 1.5 hrs twice a week)? This is my best chance at KONA. remember i'm a flat-lander; while IMLP was my mistake, i've done the IMMD course twice (1st in my AG in 2011, 20 miles into the run last cold and windy year
). Any suggestions?
Comments
This is what I non-running week typically looks like:
Mon - Swim only.
Tue - Move Wed bike here.
Wed - Swim.
Thu - Do a 60' to 90' bike with some Z3 / ABP efforts...
Fri - Swim
Sat - Bike As planned, no run.
Sun - Bike As planned, no run.
Once you get closer to the seven days, we can decide if it's worthwhile to bring back some running. At this point I don't see the upside. A healthy you is much better than one who's done all the running but has put his knee at risk.
Tks Coach,
It sounds like a good plan. I didn't get a steroid shot but a cortisone shot. my knee is still swollen and the feeling changes daily. i'm wearing a knee sleeve when biking but i don't know that it makes any difference but it may help with my placebo effect. i plan on getting another cortisone shot the monday or Tuesday before the 10/1 race as offered by my orthopedics Dr. i have an oly this weekend to see what benefit the 7 - 10 days off so far have gotten me (much legs up and iced twice a day along with occasional knee sleeve use). i plan on trying the knee sleeve from the start to the finish.
I understand Al T is doing IMMD. I'll be looking for other ENers who will be there. The IMMD athlete guide doesn't list EN as one of the teams at the race so I'll let them know we are in it.
have you heard of any "real benefits" from capsaicin lotion use on sore/swollen joints?Re the lotion, I would ask the Team in the Injury forum as I personally don't have that experience.
I believe we have 28 folks racing at IMMD, at least that's what Mariah tells me. Should be a really big contingent!!!!!!!!
~ Coach P
Coach, here's my Outer Banks Oly Race Report Summary
OBX OLY TRI REPORT – 9/17/16
The water temp was 81 so I could not wear a wetsuit but since it was not an IM event I was still able to wear a knee compression sleeve for that swollen knee, I also used a lighter knee compression sleeve on my right knee since I estimated I’d need to make more use of that strong knee during the tri. I also wore calf compression sleeves. I was being proactive about my knee issue but it has not really been an issue when swimming, primarily when I run. I think all the sleeves added weight to my already long legs and my “hydrodynamics” on the swim suffered. I think my legs were always a problem sinking and requiring more kicking to get to the surface. I should complete the IMMD swim in about 1:30. This Oly took me 0:40 min and there were few slowdowns from contact with swimmers and going off course more than usual. My average HR was 132 (3.2 HR zone); took 1156 strokes (27/min says my Garmin) Training Effort – 3.3
T – 1… since I already had most of my compression gear on I was only in T-1 about 10 min. long I know but to limit toe pain I use spray glide and a padded sleeve over my 2nd toe and it takes time to get in on and then my socks. Some of my nutrition goes in the small pockets on my Tri Kit.
BIKE… I’m working with arm coolers and put the rolled up pair on my aero bars along with a wrist sweat band before the race. The arm coolers I used were difficult to put on while riding so I stopped to just get them over my hands. I have arm coolers that go on easier and I’ll use those in IMMD. Toe pain was intermittent but started in a half hour. I plan on getting bike sandals and trying those before IMMD. I know the rule is nothing new for a tri but if my toes give me the pain I’ve experienced in the past few weeks I fear the bike will take over eight hours and make running on my bad knee take longer than the midnight deadline. It’s still a possibility. I will be trying bike shoes with a wider toe box (Bontrager and Specialized Audex Road have ones I’d like to try) but that will have to wait for next season. Fueling not really an issue but I’m trying E-fuel since they advertize less stomach issues and that was a possible issue for me at IMLP. I use Gatorade Endurance and it doesn’t seem to cause issues but I also use FRS, Nuun, water, and Redbull so nothing is overused. (ave moving spd 16.0 mph, Ave HR 122 [HR zone2.6], Ave cadence 75, Ave pwr 106 , Garmin “training effort” 3.1)
T – 2…about 4:30 to change shoes and give a quick massage to those aching toes. I use you idea of a “go bag” with my hat, bib belt, and nutrition.
RUN…this was the real test. Even though only 6.1 miles I started out slow. Found I could fast walk at 4.1 mph at least. I did it several times throughout the run and had no foot problems. I’m using Newtons I got about a month ago but they seem to be broken in now. The first 3 miles I didn’t push past 5 mph and all worked well; only minor pain. The pain was increasing but not bad for me but for the 2nd half I took 400mg of ibuprofen (forgot my chocolate wafel nutrition so they were basically taken on an empty stomach which I don’t like to do) and pain lessened and I saw I was usually able to run 6+ mph often on the last half; though in IMMD I wouldn’t try that until 24 miles. (Ave moving spd 4.6mph, Ave cadence 152, Ave HR 133 [3.2] TE of 3.3) chip time 3:52:17. I don’t due Olys often and have no old results.
My plan in week 18 is more 75-90 min swims, strength training twice a week, and 1 or 2 rides of 3-4 hours (wx permitting and 4 days of travel this week.).
Let me know if you need more info
Tks, jim
1. The swim should be wetsuit legal, so that will help with the knees.
2. The bike was solid. I'd rather you take all the time you need in t1 to get it right..or roll arm coolers into donuts pre-race, then slip over wrists exiting tent and you can roll them up as you ride. Let me know re those sandals...sounds pretty brutal. is it a spacing issue or do you need an arch support (some folks have experienced reduced foot pain with a cycling orthotic..just a thought).
3. I think your run was a success considering the knee. I say you passed the test. I would suggest 200 mgs Ibuprofen at mile 6 and mile 16 of the run...spread it out to make overall run better if possible.
Yes to more swims right now...can't hurt at all...the bike is take what you can..I'd prefer 6 hours of cycling max, broken up as you can...if that's 2 x 1.5h and 1 x 3h, I'll take it... All race pace stuff, focus on aero, foot solutions, etc.
Happy taper!!!
~ Coach P