Obviously running 50 miles on a badly bruised knee wasn't the smart mans move, but I was convinced I was dealing with moderate bruising rather than something more serious. After Caesars Camp I was in a significant amount of pain, to the extent that I had real trouble getting down the stairs on Sunday. My right quad was sore where I'd over-compensated for the left knee but the rest of my muscles felt fine. My knee was inflamed and I couldn't lock it straight. Every time I put pressure on it, it felt like it was going to give way.
Anybody reading this who has had a lateral meniscus tear will know that these symptoms point straight to that problem. Basically the meniscus is a piece of cartilage within the knee, which comes in two parts, the medial on the inside of the knee and the lateral on the outside. The meniscus form a tissue that sits between the tibia and the femur and provides strength under torsion/ tension, dispersing friction and impact through the bones.
Either one of the meniscus' can be torn during trauma to the knee and or over-rotation. Obviously when I came off of my bike, I landed with the full force of my body and bike on the outside of the left knee, turned on to my back and slid along the ground with the frame of the bike getting caught over the leg and wrenching my knee way beyond it's usual angle of rotation. Needless to say everything adds up to the meniscus being torn.
I went to see my good friend Joe, the physio, on Wednesday in a lot of pain. The knee was still badly inflamed/ bruised but he did a number of tests on my leg to find out what was going on. After a few minutes he stated I was exhibting 3 of the 4 signs of a classic lateral meniscus tear.
This is pretty bad news. The meniscus has exceedingly poor blood supply and therefore depending on where it is torn, heals either incredible slowly or doesn't heal at all. The answer is to get a scan to determine the type of tear and have that tear either sewn or the trimmed off completely if unrepairable. The meniscus doesn't grow back which means if you have it trimmed you are effectively on a count down to longer term problems with osteo arthritis if you keep running, given that the bones end up pushing against one another rather than the meniscus, eroding the ends. I know this part because good friend Mark Cockbain has recently announced retirement from ultra running after a glittering career, on account of two meniscus trims and associated osteoarthritis.
Anyway I was pretty damn miserable when I found this out and I resigned to waiting to be referred for a scan. Each passing day the pain subsided just a bit, I found I could straighten my leg a little more each day until Monday when I discovered I could lock the leg straight although painfully. On Monday things had improved again as the swelling from the bruise caused by the crash subsided. I went for a sports massage and went through the leg rotations and movements again. This time I felt no pain. His diagnosis? No way is there a tear and if there is it certainly doesn't need operating on as it will appear to be minor only.
So here I am, waiting for a scan. It is 12 days after the crash and 11 after the race. I have no pain in my knee and can lock my leg straight with very little pain at all. Walking is now fine and putting pressure on the outside of the knee generates almost no pain at all.
Either I could be back running by this weekend, or I could require an op that would put me out for 3-4 months and potentially affect my running for life. I am loathed to get too carried away until I see the scans....