Injury, again

As soon as I woke up the morning after the Bryce 100, I knew. I think one always knows, but we'll tell ourselves it's nothing, just a little post-race stiffness. My knee wouldn't even bend ... but that's normal, right? I continued to hobble painfully while visiting my parents and grandmother in Salt Lake City for a few days. Spring storms slammed the Wasatch Mountains, and my dad was up in the canyons nearly every morning, snowshoeing through deep, fresh powder in late May. I was terribly envious; I would have dragged through any amount of post-100 fatigue to join him. But my leg wouldn't work. The adductor muscles seemed to be healing and loosening, but the stiff and swollen knee was just getting worse. Yes, I knew I was injured. At that point, it was just a question of how much.

The drive from Salt Lake City to Colorado a week ago made for the worst day. I woke up to a bunch of pain, radiating through my thigh and calves. I worked my stiff knee into the same deep squats that helped alleviate my pain during the Bryce 100, although only temporarily and with decreasing effectiveness during the race. By Wednesday, the squats did nothing ... I was in pain as soon as I stood again. Instead I spent long hours in the car, with my knee at either the worst possible angle or pressing on the gas pedal. Ugh. The weather across Wyoming was grim, 37 degrees and raining, with snow dusting some of the higher passes along I-80. I made a number of stops, sometimes at random exits with range roads criss-crossing the Interstate. I parked in a pullout, pulled my hobble sticks out of a pile of drop bags, and gimped along in the mud. Motion did help with the stiffness and pain. I thought I was moving relatively well. But I'd started Strava on my phone, and it displayed my real speed in big block letters. 1.7 mph. 2.1 mph. 1.8 mph.

In 50 minutes I managed to cover 1.4 miles, which included stretching breaks and longer pauses to gaze over the wide-open spaces of Wyoming that I love so much. Pathetic, but I did feel better. After another few hours of driving with shorter gas station stops, my knee was again throbbing with pain. So I stopped again for another hour-long walking break at Happy Jack trailhead, near Laramie. There was more fresh snow here than I anticipated, making for some tricky conditions that in hindsight I probably should not have risked. But the way my pain drained away, wrapped in wonder at the expansive views and gratitude for the gift of motion ... it was worth it.

On Friday I snagged an opening with Beat's physical therapist, who referred me to an orthopedic doctor with CU Sports Medicine and Performance Center. After X-Rays and examination, the doctor diagnosed MCL sprain, possibly grade 2 with partial tearing, but likely not torn through. Thus, more imaging and surgery are not required, although it's a "wait and see" sort of thing that can't be ruled out for weeks. The most likely cause was the painful slip I took while running downhill through slimy mud at mile 9 of the Bryce 100. The forces that yanked my leg and pulled the muscles in my thigh may also have torn the ligament, which was almost certainly exacerbated by continuing for 94 more miles — although if the tear happened early, quitting the race might not have made a significant difference in the recovery outcome. Of course I can never know. Mistakes were made, either way. That's life. Suck it up, buttercup.

It is interesting to view an X-Ray of one's knees. My left knee looked abundantly healthy, but the doctor pointed out abnormalities with the cartilage in my right knee, indicating signs of arthritis. I told him about my diagnosis with grade 2-3 chondromalacia back in 2007, and he nodded. "That's it. That's what it is. It doesn't look like it's gotten worse." At the time, my sports doc told me this "angry knee" was something I would always have and always have to deal with, for the rest of my life. I believed his assessment, and that was one of the reasons I felt particularly motivated to fast-track through my "lifetime" ambitions of the Iditarod 350 in 2008 and Tour Divide in 2009, because I believed my endurance-racing timeline to be extremely limited. Surely by my 30s I'd be back to sedentary existence, which is an alarming but I think fairly normal assumption to make when you're 27, and everything about the future still feels so far away.

That I've been able to continue pursuing these incredible experiences, pain-free, for another decade-plus, is something for which I'm incredibly grateful. I credit the long-distance hiking and running with building the strength needed to support the joint. Physical therapy back in 2007 revealed all of the ways that "cycling only" had been bad for my muscle development and my entire body. Cartilage damage can always become worse, but I feel like this is good evidence that what I'm doing right now isn't necessarily causing damage, and is likely even better than the normal sedentary aging process.

Still, if there was only a way for me to stop being so clumsy and tearing myself apart in the process. Recovery for this injury is estimated to be six weeks. I'm going to continue working with Beat's physical therapist to recover my gait, as the knee is still inflamed and unstable, which makes walking difficult. Sitting or laying in bed generates stiffness and pain. The only relief I have found from any of this is — what else — cycling. On Friday the physical therapist recommended "flat, nontechnical" cycling, so I spent the weekend exploring urban trails and bike paths around Westminster. It was great fun — low impact, low effort, pain-free. I felt like I was flying, wending along the curvy concrete path at close to 20 mph (a speed I only maintained when no pedestrians were present, as I am quite frightened of pedestrians, which are so much more unpredictable than drivers in cars.) I prefer hills to this type of cycling, but it was a fun, and it was motion. I am grateful for any motion my body will allow, after the way I've treated it this month.

The doctor on Tuesday okay'd hill riding, so it's almost like not being injured, except for I still have pain and I can still barely walk. Before this injury, I was beginning to formulate ambitions for summer — mostly hiking, in the form of "fastpacking" weekends where I'd try to cover high daily mileage with an overnight pack, which would be great training for potential winter ambitions. I also planned to do more bikepacking, but even that will be iffy for a little while as I avoid technical terrain and distances that I can't easily extract myself from if the knee goes bad. So both of these will have to be shelved, for now. Perhaps another summer will get away from me, but I hope not. At least this summer still feels far away. We woke up to more new snow dusting the ground and 36 degrees this morning, May 29. As it stands, the mountains may not be clear enough for hiking before I heal up, anyway.

I don't feel particularly concerned about healing from this injury, as I've dealt with similar injuries before. I tore the LCL in this same knee during the Tor des Geants in 2014, and possibly (though never diagnosed), the MCL in my left knee during a 50K in 2013. Apparently I am susceptible to ligament strains, but the recoveries were straightforward enough. I do need to be careful, though. The joint is unstable, and another fall could easily worsen this tear or create another. When runner friends joke about keeping my runs to "under 20 miles" during recovery, I just shake my head. I still need to figure out how to walk again, and not like a busted robot. Running is this far-away motion I can scarcely imagine anymore.

At least bikes are a thing ... motion devices for the hopelessly clumsy. I love bicycles. I'm excited for a personal excuse to spend more time with them. Cyclist friends continue to shake their heads at this "non-runner's" flailing efforts in a sport for which I so clearly have so little aptitude. I suppose it's complicated, and most succinct way I can explain my motivations is that, for me, ultrarunning is a spiritual journey more than anything else. What I'm seeking is expanded perspective, windows from places that only exist far outside my comfort zones — and the more personally challenging the endeavor, the more time I spend outside my comfort zone. The difficulties come early and often in running, whereas in cycling, I can more easily settle — and because I'm human an innately long for comfort, I often do. And because I am human, in the thick of difficulties, it's all too natural to "quit running forever" ... but the moment I become comfortable again, my mind is clawing its way back. Surely as soon as my knee remotely works again, I'll be clomping down a dirt road in shoes still stiff with months-old Utah mud, as happy as I could possibly be.