I realise that I have been off the grid for a little while now. Since the end of November, I have been suffering with a knee injury. I explained about it in a previous post a little, so I won’t go into too much detail over that side of it. You can read about it from last year here – you only need to read the first few paragraphs to get the idea.
At the start of the year, the pain got increasingly worse on the outside of my left knee, and I made the decision to see a chiropractor that a friend had seen in the Spring of 2016 and had recommended to me. My knee wasn’t getting any better by itself, so I booked in to see him less than a week later.
The first session was the longest, as we discussed everything you could think of about my health and training, and some more stuff too! I was told it was all relevant though, and that he would explain why once I had answered all the questions. When I had, I was told that things like stomach or period pain could be relevant, as your stomach can’t actually give you pain, so it is referred in muscles and tissue around it, which can. I already knew about fascia (the connective tissue covering all your muscles), so I could understand how this could happen.
Fascia, as I mentioned before, covers almost your whole body under your skin, in lots of layers that should be able to move over each other without causing you any problems. If you imagine it like a sheet of cling film; when the sheet is laid out, you can move any corner or piece of it any way you want, and it will go where you want it to. Now pin a part of it down with your finger – it won’t move as freely and may restrict or pull on other parts of the sheet. This is exactly the same as the fascia in your body. More of that later.
So, after a long discussion and a visual analysis of my body, i.e. were my shoulders and hips square, etc; it was down to business. He used physical tests to check for weak spots and referred pain – that is, when pushing, moving or stretching the body in one way, it may cause pain in another area (almost like a map that your body is giving out to try to help find the cause). He then performed several chiropractic moves (a lot of sudden movements and jolts, or as he called it, “adjustments”) on various parts of my body to try and help relieve the pain. It would be revealed at the end of the session that he had actually done a lot of adjustments – and a hell of a lot more than he would usually do in one session.
I was advised to book another appointment 4 days later on the Friday, and then one for the Monday after that – a week later. I did as I was asked. I saw no improvement over the next session, but continued on with the course of treatment – you can’t expect miracles instantly! I carried out the stretch I was given for my hip flexors as there is an imbalance in my hips and the surrounding area as instructed. The left hip flexor – the same side as the knee pain – is incredibly tight and the aim was to try and loosen it up a bit. I was to do the stretch twice a day, on both sides to keep things even, for 30 seconds per side.
The most painful thing happened in the third session. I was to experience fascial treatment. As I explained before about the layers of connective tissue and how sometimes they could get stuck, I would soon find out how it felt when you tried to release the stuck points. Using what I could only describe as a normal touch on any other part of your body, he would find a point in my leg, ankle or foot, in this case, and then using a circular motion, move over it until it started to free off.
You’re probably thinking that it doesn’t sound too bad (unless you have been unfortunate enough to experience such treatment), however I can honestly say that I was trying not to leap off the bench in pain. It was like he was trying to separate the layers of my skin with a knife. I would to grin and bear it until it eventually it wasn’t too bad and we both agreed that it was freeing off. Then he would go off and find another spot to torture!
The next morning, I was in work (on a Saturday of all days!), and it was still really sore. It would be for a few more days, in fact. It was sore when I walked, in the points where it had been released, especially down the inside of my leg. I tried to jog a distance of probably 20m and the soreness was shooting up the inside of my leg. I took the wise decision to have the weekend off from running!
After about 2 and a half weeks of treatment, going back every few days, I reached my final meeting for the course of treatment. The sessions were getting a bit shorter each time and there was minor improvement. I was advised that the next time I should be expected back would be approximately 3 weeks time, if I needed to and that it would gradually improve over those weeks. It wouldn’t be an instant fix, where I woke up one morning and everything would be as right as rain – I wish it was that simple!
So I am currently 2 and a half weeks away from when I last went into physio. I have been exploring several possibilities in the time since then, and although there is a small amount of improvement, I am sad to say it is still not great!
I tried 2 weeks complete rest whilst I was undergoing physiotherapy – that made the pain worse! It is much better if I keep it moving, albeit at a slower pace than I am used to. Don’t get me wrong – I am glad that I can still move about and do some exercise, but I am definitely itching to get back up to speed. I just know that I have to be careful and rein it in when I need to. Taking extra days rest if I have done a longer run, or cutting pace and distance down can all help. I was very proud of myself this morning for not pushing on to do an extra 200m swimming and speeding through a few lengths just to make the total distance up to 2000m. I settled for a round 1800m, which I had taken at a steady pace and not aggravated my knee too much.
I went for an appointment at the doctors, as I was after a referral for an MRI scan, ideally, so that I could see, for my peace of mind, what was going on inside my leg. The doctor, despite being told that I had already seen a couple of physiotherapists, did a few tests on my legs just how the physio had, and recommended me for an x-ray. Not quite what I had wanted, but they wanted to rule out any bone issues. Fine, I thought, I will play your game! So I immediately went up the road to the hospital and got the x-ray done as a walk-in.
A week later, I still had not heard a word about my results, so I rang up. The best way I can describe the voice of the receptionist (without sounding insulting) is as a very overly cheerful-sounding, kind of air-head voiced lady. Imagine that as you read on. The conversation went as follows (almost verbatim).
Me: Hi, I had an x-ray last Friday and I still haven’t heard from anyone about my results.
Receptionist: Oh no, you have to ring up for those!
I would like to add here that the doctor confirmed my home address and telephone numbers and DID NOT tell me at any point to ring for my results. I was waiting for a letter or a phone call. I decided to let this one slide.
Receptionist: Okay, so I will just have a look for those results for you. So, there is nothing wrong with your knee, and there are no abnormalities! Okay then?
She genuinely sounded like she thought that was the end of the conversation and that I would be hanging up now….
Me: Uhm, should I book another appointment then…? Because my knee isn’t right still and….-
Receptionist: Oh no, the doctor has looked at your x-ray and has referred you onto a knee clinic!
I am still not sure if I was meant to have guessed this information, but she clearly thought that I was somehow privy to it already! I had to laugh, really.
Receptionist: So, they will be in touch with you to arrange an appointment soon, but I can’t tell you when that will be. Okay?
I had to leave the conversation there. So, if I haven’t heard anything back from them by Friday, which will be a week from when I spoke to the lady about my results, and two weeks since I had an x-ray, then I will be phoning up again to find out what is going on! Watch this space – I really hope I hear from them soon.
Another thing I organised was a bike fitting. This may seem strange to some, as I have had my bike for at least a couple of years now, but I tried to ride it a week before the fitting and I had to stop after 7 minutes, because it was causing great discomfort and pain in my knee. I was worried that the physiotherapy had straightened my body out and got it functioning in a normal manner again exercise-wise, and that now it wasn’t compensating for itself on the bike, it was revealing where the cause of the pain was. I also didn’t feel like the ride on the bike had been the same since I had made the transition from a mountain bike style cleat/shoe to a road bike cleat/shoe towards the end of last year, and despite several attempts to adjust the bike to where it needed to be, I was convinced that it was someone else’s turn to have a go.
It was a very in-depth meeting that lasted almost 2 hours. I explained everything from my injury to my training, and the chap doing the fitting seemed genuinely interested and attentative (unlike, I must say, my doctor). He took in all the imformation I gave him and asked plenty of sensible questions about it all. I felt like I could be onto something here. He had all these different bits of kit to test and measure the way I was riding the bike – he had popped it onto a turbo trainer in the back room of the shop – and would make an adjustment to the saddle, pedals or my shoes according to what he found. It was fascinating!
Amongst several other things, there was a laser pointer which helped us both see when my knee was moving out to the side, and when it wasn’t after some adjustments and things. Also, a special toolwas used for measuring the angle that my leg was sitting at at the bottom of the pedal stroke. The laser was used for checking across my foot and leg as well. One thing would be checked, I would hop off the bike, an adjustment would be made and then I would pedal for a while to see what the difference was.
To cut a long story short, I have high arched feet. This causes them to roll in when I run, or participate in other sporting activities. I have a different design of running shoe to support the arch in my foot, so it wasn’t a huge surprise when I was told ths, actually. When your foot is locked into postion in your cycling shoes, which are in turn attached to the bike, they can’t move. This means that if the cleats, pedals, saddle, etc. aren’t set up in the correct position, that it could cause pain in your knee, for example, where it is moving to the side to compensate. I was offered up a wedge in the front of my shoes and also some insoles.
We agreed that the insoles were the best option and pretty much eliminated any movement in both knees. The only drawback – they were custom ones, which would need to be moulded to my feet, so they would be mine and at a hefty price tag for a pair of insoles! I had them fitted there and then, as I could see the improvement they were making before they were a true fit to my feet, and it’s my knee, so I wanted it to be right. You would not believe the difference it makes to riding again for me! Time to rebuild my cycling training again. I am looking into using Zwift, possibly, which is a sort of online virtual training partner in a video game format for indoor cycling.
I have ordered some orthopedic insoles for high-arched feet for my work, running and everyday shoes in addition, to see if there is a difference in using them with more support throughout the day. I hope that this will be a simple solution to getting back on the track.
I have also been using kinesiology tape (or KT tape). The brand I went for was Rock Tape, purely because that was the brand that the shop next door to my workplace had in stock. I am aware that there are other good brands of tape you can get. It had come highly recommended from a lady at the running club, who had had a knee injury and pain in the almost the same point before. That was enough for me, and I rushed out to get some.
The idea behind it, from what I can gather, is that the tape lifts the skin and creates a small space between the skin and the muscle, helping with better blood flow, reducing pressure from swelling or from injured muscles, and allowing smooth muscle movement. It is different from athletic ‘strapping tape’, and still lets you have a full range of movement.
I’ll be honest – I hardly notice that the tape is there, and I think it has been helping with a small amount of pain. I have to give testament to its durability, too. It stays on for probably 3-5 days (before the edges and corner start peeling up), and it gets some abuse on my body. I have sent it through the swimming pool, showers and a bath, for a run and a cycle, and it has still lasted for 4 days before it started to peel away. I will continue to use this unless ill-advised by the clinic (if I even get to hear from them soon!).
That’s about all I have to say for now. I am continuing with my stretch on my hip flexor, running at a slower pace and not as frequently to try and minimise impact, cycling with a corrective purpose now – my body will have to adapt to the changes made to the bike positioning – and using the kinesiology tape and insoles to try to improve everyday use and pain.
I will keep the site updated when I get some more (and hopefully better news).
For now though, thank you for reading and being patient! I hope to be posting on here soon with some better news! I have a couple of races (London Winter Run and Wokingham Half Marathon) that I will pop some posts on for when I get a chance, so there should be some more content soon.