Wed 16 November 2016
I started a 10-day trip today, to visit relatives abroad. To begin with I was travelling for around 24 hours straight. First I had a 4-hour coach ride, then a 9.5 hour flight, a 2-hour layover, a short 2-hour flight, and a car trip for around 1 hour.
I packed my foam roller for this trip, and did what I could to accommodate the periods when I knew I would be cooped up in a plane or car. I had to arrive quite early at the airport before my first flight, so after the 4 hours on a coach, I spent around an hour walking around all the gates while wearing a small rucksack which was my carry-on luggage, to give the knee a bit of a workout. I wore my new @asics running shoes for this, and probably walked 3 miles or so.
That walk proved to be a good move, and helped me cope with the long first plane flight. There were lots of empty seats next to mine, and I was able to fully stretch out both legs while sitting across 3 seats at once, which was also helpful.
Despite these preparations etc, the knee did get stiff from all the sitting, and each time I would get up to stretch and move around a bit, it was sore.
I arrived at my first destination for this 10-day break, late on the evening of 16 Nov local time, which was a full 24-hour day after I had set off from home. A quick foam roll on arrival left me feeling quite relaxed, and the knee felt relatively OK. Compared to other similar trips I have made over the last few years, this one seemed much easier physically, and I put this down to foam rolling, as much as anything.
Thu 17 Nov 2016
On my first full day away, the weather was unexpectedly warm and sunny, so I had 2 walks, one in the morning that was around 1.5 miles, and the other later in the day, at around 3.5 miles. I resumed the new exercises for the glute muscles (see blog #12), did foam rolling and all my other exercises as usual, and made sure to roll after the longer 3.5 mile walk which, unlike the shorter one, I did at a good pace. I did not do any jogging or running at all during these walks, feeling that this should probably wait until I was a few days into the trip, after having walked a few more miles etc.
When rolling, I continued to note that the affected left leg IT band just below the knee was still no tighter than on the other leg, and any minor tightness was easily and equally “rolled out” of both legs. This was a positive sign.
The new glute muscle exercises were working well – I could really feel the gluteus medius getting worked out on each leg, and my core balance gradually improved as I kept including these exercises over the next few days. The glutes on each leg seemed to be in a very similar state to each other, but I did find that some of the other nearby areas where I had had muscle issues going back to earlier in the year (see blog #02), got more sore on the affected left side of the body. My instincts had said I might find this, and it was one reason I wanted to do these exercises, as I thought it might help to trace any residual, possibly incomplete healing of those areas, and to address them.
My usual sleeping position while on my left side was still hurting the affected knee joint, and I had to keep using less comfortable positions instead, as over the previous weeks.
The soreness that had come on from the small amount of running we did in session 5 on Monday 14 Nov, had gradually worn off over the days that followed, as it has done on other occasions when I have done any running at all over the last couple of months – which has been rarely. By the end of this week of 14-18 Nov, that soreness had more or less disappeared as would typically happen, except when I would be sat for any length of time, which again as experienced recently, led to the knee getting stiff.
Sat 19 Nov 2016
Today involved a 500-mile car trip, as a passenger only. We stopped several times, and at each of those the knee had stiffened up quite a lot, and took some moving around to get it loose again. Once we arrived at our endpoint – where I was to spend the next 2 days – I rolled and stretched, and the knee felt much better right away. There was, again, no extra tension in the affected left leg IT band just below the knee joint.
I took a short walk later that afternoon, at a fairly brisk pace. The knee felt OK.
Sun 20 Nov 2016
Having rested fully from the previous day’s car trip – and having been getting plenty of sleep since arriving a few days before that – I was ready to take a walk and try mixing in some light jogging for short distances. The knee seemed relatively OK when I started the day with my usual foam rolling and exercises, including those for the glutes. I had decided that this point, around halfway through my 10 days of break, was the best time to experiment with mixing in some jogging with a significant walk. If it went well, great, and if not, I still would have a few days to recover before having to travel home at the end of the trip.
Around the middle of the morning I set off walking. At first I did around a mile, but only at a brisk walking pace. I then continued and began to do short stints of jogging and slow back to walking after very short distances. These felt quite fine. The body seemed to want more of this, so as the walk progressed, I just extended the distances of the jogs each time. I didn’t track this in any way, just did what felt right. By the time I had done over half the overall distance, I was jogging lightly for most of the time and only occasionally slowing back down to a walk. There was no pain at all, and it actually felt really good to be doing this. It was not as fast as I would have run normally, but that did not matter.
I tried to judge what my running form was like while jogging. As far as I could tell it was reasonable, but I did find it difficult to really know. I wondered whether there was any hip drop, but could not confirm this one way or another. I doubted it.
By the time I finished, I was jogging slowly all the time and was not walking at all. I probably covered something like 3.5 miles in total.
I had not prepared for this much of a workout, and was not really dressed for sweating, but as it was a nice sunny day, I had broken a light sweat. I felt pretty good after this though. I was wearing old clothes, so decided I would do foam rolling in them first, and take a shower afterwards.
Rolling also felt good, and the affected left leg IT band muscles just below the knee joint, again shown no extra tightness, compared to the other leg. At this point I was thinking that, now that the previous extra IT band tightness had been gone from that left leg for several days, and the body had seemed fine with this first bit of adding in jogging, maybe the knee was finally on the road to proper recovery.
After a shower, I relaxed a the rest of the afternoon. Within 2 hours or so, the knee had stiffened up and was quite sore. This persisted throughout the rest of the day.
Mon 21 Nov 2016
I awoke to find the same soreness I had been experiencing on the day after any running done over the past several weeks. I was limping badly as on previous occasions, and things like going downstairs were especially painful.
I wondered whether I had done too much too soon. Maybe, but to be honest, I think I would have been sore even from just a small amount jogging. The main thing was, the knee was clearly not settling down.
This was another travel day, a return trip of the same 500 miles from Fri 19 Nov. Each time we stopped, the knee was very stiff. When we arrived at our destination, after foam rolling and my usual stretches and other “later in the day” exercises, I took a walk of around 1.5 miles, going pretty slowly as the knee was quite sore. The walk did loosen it up a bit, as my instincts had told me it might.
Fri 25 Nov 2016
I did not try any more jogging after Sunday 20 Nov, and took only brief walks now and then over the several days after that. The soreness gradually improved each day. I kept doing the glute exercises as best I could (not at all on Mon 21 Nov, a few on Tue, more on Wed, and so on).
By this day Fri 25 Nov, the general soreness had retreated as usual, but the knee did still get stiff quite easily if I sat down for any length of time. Also, as I have sometimes found over the past few weeks, I seemed to still have a constant limp when walking, even when the knee was not sore.
I took a more brisk walk during the morning of Fri 25 Nov, during which I was limping a bit for most of it. As with all my other recent walking, I am fairly sure I was using the more correct gait as John had instructed me in our early sessions at MOTI, and I could feel both legs’ sets of glutes being worked equally, with each step.
By now I was also finding that bending the left knee was giving more marked pain, both on the outside part of the joint (where, since first starting to have these troubles, there has always been some degree of more acute pain than elsewhere in the joint), and even on the inside. The inside area felt like muscles were being strained or stretched more than they liked, which is different to how the outside area has always hurt.
It’s worth noting that the general soreness that comes on by the next day after any jogging or running, has always been throughout the whole knee joint, and not just near the outside area where the more specific pains have been. That soreness has always felt like I sprained the knee, even though I have not. But the pains just from bending the knee were there, even once the general soreness had dissipated, which by the end of this week, it had.
Sat 26 Nov 2016
This was my day to travel home. It included a 1-hour car ride, a 2-hour flight, around 1 hour of layover, an 8-hour longer flight, some lugging around of baggage, then a 2-hour coach ride. The longer flight was full on this return, and I could not stretch out as I had done on the outbound trip. The knee continued to get stiff from all the sitting around, and the other pains that had been there over the last couple of days before this, also persisted.
Sun 27 Nov 2016
I arrived home late on this morning, following the longer flight, which was overnight, and the final coach ride. I took care of some errands first thing after getting back, and then went to the MOTI store to buy another foam roller, as I had decided to leave behind the one I had taken on the trip, so I would not have to haul one over to there again, for any future trips. MOTI did not have the same roller in stock, so for the time being I bought the more “advanced” version for a deeper roll – the one with the more uneven surface – until they could get the same, smoother one back in stock from their other branch, later this week.
Mon 28 Nov 2016
The knee continues to be painful when bending, and it gets stiff when I am sitting for any period of time. Now that I am home again and have a known set of references such as my own stairs and living accommodation layout, it is clear from how it feels as I move around here, that it is in worse shape than before I went away on this trip.
I have decided it’s time to ask my GP if he will send me for an x-ray of this knee. I don’t know if we may have missed something, and this seems like a prudent thing to do at this point. The knee does not seem to be responding and is getting worse, and my instinct is that this may be due to structural anomalies of some kind. They could either be from damage in the joint itself, which in a worst case scenario could even be permanent, or perhaps more likely, it is caused by the other muscle issues I suffered from on the affected left side of the body, going back to the start of 2016 (see blog #02).
If, for example, I still have left rib area and/or vertical fascia (sp) muscle problems around the left part of the waist – which doing the new glutes exercises seem to suggest may be the case – then perhaps these are still pushing my running and walking form towards hip drop, or they are affecting the knee joint more directly, in a similar way to hip drop. If so, then even walking and running with the correct gaits may not work properly to enable recovery, until those other structural issues are fixed.
One reason I am thinking along these lines, is that experience has taught me that to some extent, the structure of anything determines how it can and will behave – and sometimes, if you just try and change the behaviour without addressing the underlying structure that gave rise to that behaviour, it won’t work. I don’t know whether that is what’s going on with my knee, but I think we need more information about this.
I am even wondering whether I might have picked up a stress fracture somehow. If not from the running over the last 15 years, this could conceivably have come about from table tennis, as once in a while I stomp my foot down when making a shot. I am fairly doubtful about this, but it is one possibility. I am also concerned about potential bone and/or cartilage wear on the affected knee. If I have understood x-rays properly, any of this kind of trouble should show up clearly. I do have a lot of miles in my joints from all that running, and have never had an x-ray of them.
For now I have deferred my upcoming appointment with John, until I have seen my GP on Fri 02 Dec. I am told my GP is good with knee issues, and in the past I have always been able to work with him in relation to any medical issues, so I believe he will agree that we need to take a look at this using the standard x-ray technology that is available.
Tue 29 Nov 2016
I am now fully rested from my trip. The knee continues to behave as recently. I took my usual local walk for the first time in a while, and as well as limping a bit for all of it, doing a usual short, steeper downhill section made me limp more, as it has done for the last few months.
Fri 02 Dec 2016
Today I saw my GP about the affected knee. I had printed off all these blog pages and handed them in at his health centre the day before, and he was able to scan them prior to our appointment, for background information. I filled in a bit more details for him, and he did a brief examination. He agreed with John’s assessment that it does not appear from visual inspection there is any joint wear, but he also agreed with my feeling that we need to do an x-ray on this, so he placed an “order” for that on the NHS system.
Later in the day I went to the BRI and had x-rays taken of the knee, in 3 positions: head-on while standing and with the knee slightly bent, side-on while standing with the knee slightly bent, and lying on my back with the knee bent at 90 degrees from top leg to lower leg, so each part of the leg at 45 degrees from the horizontal.
The NHS specialists will assess the results of these and pass their appraisal to my GP, who will contact me in around 10 days. In the meantime I must wait.