Adaptation

The use of trekking poles has made a big difference to the
ability of my knees to deal with long hiking expeditions.

I'm in a bit of a quandary about my new insoles, bought to alleviate the pain in my right arch.  As you would expect, wearing these orthotics feels a bit strange in my shoes when running, and although they have certainly eased the arch pain, they have also affected me in other ways.  Normally, after resuming very easy running for a week, I wouldn't expect to have the aches and pains I'm currently experiencing in my feet, ankles and legs.  This morning, I couldn't even manage a quadriceps stretch in my right leg because of the pain it generated in my right knee.  This is unusual, and a bit of a worry.  My right knee has been very troublesome in recent years and I don't want to aggravate it.  It is the same knee on which I had surgery in 1980 (see previous "Lack of patience" post).

On two occasions in the last seven years I have had to stop running for extended periods because of pain in this knee, and on both occasions, scans revealed significant damage.

"Large chondral crater of the lateral patellar facet"

"Marked patellofemoral joint arthrosis, particularly laterally. Subchondral
bone change. Patellar tendinopathy. Torn medial meniscus."

Extended rest allowed the painful inflammation generated by these problems to abate and then careful resumption of walking and running enabled my gait to adapt, but I'm keen to avoid a recurrence.

That's not me, but I spent many hours hanging in
inversion boots to alleviate a lower back problem.

Similarly, thirty years ago, the stress fracture of a small bone in my lower back (left minor pars articularis) led to the displacement of a vertebra and years of significant sciatic pain that severely impacted my running.  Time has stultified the tissue around the vertebra, providing local support, and my posture and muscle strength have adapted, to gradually take pressure off the sciatic nerve.

For both injuries, doctors and specialists said surgery was an option, but might not improve my ability to run and might cause future complications.  It was suggested, explicitly and implicitly, that my running career was over.  Yet, I'm still running!

I don't put this down to a tolerance of pain, or to single-minded determination.  I suspect that most people my age, if they had their knees or lower back scanned, would get a scary picture.  However, I believe that our bodies adapt, we consciously and subconsciously change our gait, and we take more care in situations likely to aggravate the injury.  Pain is still present, but we know what it means and how to manage it.

I toyed with the idea of walking instead of running this morning, and also thought about removing the new insoles to see if that made a difference to my niggles.  However, in the end, I decided an easy 5km wearing the insoles was the best course.  My thinking is that my body needs time to adapt to the insoles and gentle running is likely to aid that process.  There were lots of twinges in the first kilometre, but none crippling, and I persevered.

I remain keen to ditch the insoles as soon as I can and get back to the running form I'm confident my knee can handle.