Wednesday, January 22, 2020

The road is long...

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So the knee issues persist. If I sound like a stuck record, believe me no-one is more irritated by this than me.

In the last few weeks I've started seeing an osteopath in Bristol. The long and short of it seems to be that there isn't just one issue causing my pain, but rather a combination of many things.

The IT Band is perhaps the most obvious culprit - like many people, I am suffering from over-tight ITBs.  On the right-hand side, where I already have the 'literal' scars of four sets of knee surgery, this is pulling my knee cap out of place and stopping my patella running in its natural 'groove'.

Then I have tight hamstrings (the one on the right was used as a graft for the ACL reconstruction on my right knee).

I also have over-tight calves (but I suppose, who doesn't?!) and finally some minor issues with my right foot such as a slightly collapsed arch and some apparent inflexibility.  Then of course, there's the question of what's actually going on inside my knee. After four surgeries (2x meniscal sutures, 1x meniscal trim, 1x ACL reconstruction), it's a good bet that all is not well internally.  But obviously I want to try to avoid surgery #5.

If I was a horse, they'd probably put me down!  Thankfully as a human with the cash to pay for treatment, there's always hope...

Treatment at the moment consists mostly of stretching and massage with the osteo, and then lots and lots of homework. Primarily this comprises rollering my ITB and calf at least twice a day and lots of stretching.

The osteotherapy has also confirmed something I pretty much already knew - that my glutes simply don't work! This is something I've long believed to be true, but the drasticness (if that's even a word?!) of the situation has been starkly highlighted by the osteo.

Without beating around the bush, he got me to do certain exercises (such as glute bridges) and by poking and prodding determined that my glutes don't fire at all, and that all the work they should be doing is, in fact, being done by my lower back and hamstrings. 

This is not good. Especially as my particular problem (i.e. the hamstrings and lower back over-compensating) is going to make getting the glutes firing properly a long and tedious process.

Needless to say I am searching in vain for any and all methods to isolate the glutes and enable me to build them up to the point where they start playing a more active role in running and cycling - and hopefully knee stability.

In the meantime, training has continued, albeit with less running (and trying to use the treadmill a bit more for the soft landing).  Running seems to have taken on a familiar pattern - knee pain (sometimes with quite severe 'spikes') in the first 2km or so, then the knee seems to loosen up and is fine for the rest of the run, with mild tightness in the calf and behind the knee.

I'm also continuing to adapt to my new road and TT bike positions.  Hopefully it's a good sign that I'm actually feeling some DOMS in my glutes after long rides - maybe there are beginning to do some of the work!

I had a good 125km ride yesterday (Saturday) with a strong 20-30km 'breakaway' with fellow local triathlete Paul Horsfall.  We took turns on the front and were maintaining a 35-45km/h turn of speed for a good while.  I'm certainly feeling stronger on the bike at the moment, so hopefully this will translate into some good performances in the upcoming 10 and 25-mile TTs ahead of the main tri season.

Running too is still showing signs of promise.  Although the pain is still present, hopefully the osteo and home-based work will help sort this out (as will the reduced running in training schedule).  I'm also still managing to run faster for less effort (HR) than this time last year, so there is definitely progress being made.

So that's a rather long blog update! I guess I'd better get back to the foam roller! 

Till next time...

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Matt Fisher runs - so it's all his fault! He pretends to be a triathlete, but really he is a husband, father and company VP. But he has raced for the GB Age Group squad a few times and is a two-times qualifier for the IM70.3 world champs