On December 31, 2017, I went for a 7 mile run with drills and strides. In my training log I wrote “-7 degrees feels like -23 degrees.” That is cold! The roads were snow covered and the treadmill was calling my name, but I wanted to be outside.
The next day, January 1, 2018 I faced similar conditions. It was -13 degrees, and I continued to have poor footing due to the cold snow. By the end of the 30 minute easy run, I had developed a nagging knee pain. I shrugged it off until I went to run again the following day. I decided to use the treadmill this time, but the knee pain became intensely sharp and stabbing less than 5 minutes into the run. My body told me to stop, so I listened. Even though there was no swelling or specific trauma, I knew it was serious.
If you experience mild pain while running that doesn’t change your stride or gait pattern and/or the pain dissipates as you get into the run, then it is usually ok to run. However, if the pain changes the way you run and/or the pain gets worse as you continue, then you should stop. I believe in the saying “motion is lotion” and movement is good for most people, but we should not push through certain injuries because it will make them worse (i.e. fractures and acute ligament or meniscus tears).
I had an idea of the diagnosis, but I went to an orthopedist for confirmation. One of the perks of being a PT is that we can get into many doctors a little faster than most people! After 4 x-rays, the orthopedist said my knee looked great with perfect alignment. He also found no problems in my training schedule that could have caused the injury. After a few more tests, he determined I most likely had a meniscus injury and cartilage damage. This made sense as I had been twisting my knee in the snowy conditions and my muscles had been cold. The orthopedist ordered 4-6 weeks off running, then gradually work back into it.
I took 4 weeks off running and engaged myself in other hobbies and pain-free forms of exercise. It was tough mentally, but it was so cold and snowy I really didn’t miss running outside. I had fun mixing it up with swimming, aqua jogging, using the stationary bike, and strength training. I also enjoyed a new activity: painting.
When injured, it is essential to avoid continuously provoking the pain. It is similar to a scab - if you keep picking at the scab, the scab will be prolonged; if you keep instigating the pain, the injury will continue to be a problem. I iced my knee daily, avoided walking on any uneven surfaces that could have tweaked my knee, and always made sure I had good traction in any snow/ice. I also made a big effort to pick up my feet when turning so I didn’t twist my knee and irritate the meniscus.
After the 4 weeks, I gradually began pain-free running again. I started with walk-jogs, and then I steadily progressed back into speed workouts and long runs. I gave the injury adequate time to heal and prepare for my return to running. As a PT, I am paying a little extra attention to keeping my legs strong to protect my knees.
How do you cope with injury? It's not easy!