Partial Knee replacement and running UPDATE 2013

Well, I sometimes get a bit too busy....... but it's time to blog again....
Update on my partial knee replacement I received on June 2, 2010.......

Wow, it's hard to believe how fast time moves on. Tempus Fugit.

Having being somewhat retired for a few years, at 61 I decided to back to work, so things have been a bit hectic. Luckily, I am imbued with a desire to get my daily workouts in, regardless. At times a challenge but at other times refreshing, I have managed a rehab schedule despite the demands of work and family. So lets update.

After going bone on bone in my late 50's, and holding a marathon schedule for almost 20 years, it became difficult to follow Linda down the frozen food aisle as even basic walking became untenable. After much consultation and investigation, Dr. Eric Heiden ( also of Olympic fame and a great human being) referred me to his partner, Dr. Phil Davidson, here in Park City, UT. It was recommended I have a Partial Knee Replacement (PKR), using Conformis knee parts, rather than a much more invasive Full Knee Replacement (FKR). A resurfacing technique that left the majority of my knee in place despite stage 2 and 3 arthritis in my lateral knee compartment and patella. The doc told me he'd get me running again. But still I had doubts.

Recap of recovery:

I found the Physical Therapists were behind the curve on PKR, as many of them have not had a lot of experience with PKR. They are great folks, but with FKR, there's no remaining knee joint issues, so those folks are treadmilling etc. out of the gate. I still had two of my 3 compartments (lateral and patella) that were far from perfect.  Recovery was very slow, and I did not push it, since I was dealing with small metal parts taking much stress. My attitude is and always has been to take almost twice as long as recommended recovery times, as I have blogged extensively that injuries set folks back soooo far, it's not worth the overall risk.

Phase 1.... Goal... get moving WITHOUT INJURY  1 year Year 1

To keep a streak going, I ran my 5th consecutive Triple Trail Challenge (http://mountaintrails.org/events/triple-trail-challenge/)  2 1/2 months after surgery, basically shuffling my way through it in ugly but determined fashion. I would not call it running by any stretch. The Mid Mountain Marathon took almost 7 hours of peg legging 26.2. Nothing special, just persistent. Many friends helped me achieve this goal.

At the 6 month mark, I was struggling to run 4 to 6 miles in a row,  at 12 minute pace. Things went slow. Also, my strength training was even slower, where I could barely lift single leg extensions at 30 lbs., well below what PT's wanted me to do. I did not injure, however.

At the 8 month mark, I finally broke through on an 8 miler, continuous. It was difficult, but I could feel my knee opening up a bit, but my gate was not at all smooth.

Then at 10 months, I broke through to a 12 miler, and for the first time, I felt I was actually "running", and not just on a fast low heeled shuffle.  My partial knee recovery was FINALLY starting to pay dividends. For the first time in over a year and a half, I internally felt comfortable calling myself a runner again.

Phase 2....Run long again      6 mos -1 year Year 2

Hard work, climbing out of the hole, continued. Running, biking, weight training 6 days a week. Runs were often not enjoyable, but necessary. but progress continued, I snuck in a regrettable 2011 Las Vegas Marathon (avoid it, IMO. I blogged the awful conditions), and slowly built miles.

18 months, long after surgery, became the watershed turning point in my trying to regain old form.
My gait finally opened up where strangers could not discern that I had a metal appliance for a joint in my knee. Form smoothed out, aerobic capacity increased, and I was a bona fide runner again, back of the pack and happy as heck. But now my second phase started. Slowly I introduced tempos and very mild speed. I had made a pledge before surgery not to push the envelope the first year, and only assess SPEED workouts at 18 months. But my assessment told me I was NOT ready for the harder speed workouts without risk. So I settled into a manageable routine of 25 to 30 miles a week. (see my blogs as I have never been a fan of big weekly miles, but rather trust science and evidence in using lower mile high intensity as my guide as a journeyman marathoner)
But my consistency without much speed work gave me enough of a base to run a Boston Qualifier at St. George 2012, 30 days after a moderated Mid Mountain Marathon, with a 3:48 effort. 

Phase 3.......adding in Tempo and Speed workouts 1 year Year 3

I am now midway through my third year since surgery, and I have layered in the more serious type workouts as I see how much my older body can take. Knee pain, although present, is basically a mere annoyance at times, nothing that actually keeps me from running. I am holding a traditional speed/tempo/long running schedule on Tues/Thur/Sat., on a periodization schedule averaging low 30's miles weekly.  I add as I can, and I am cross training less right now as I drop weight lifting to move down from 190 to 180 on my 6' frame. My goal is to TRY a sub 3:30 at St. George in 2013, but common sense and indicators will eventually dictate whether this is achievable or not.  I have great running partners, an understanding spouse, and a knee that essentially is now acting as a natural part of my body, subject more to the degradations of old age than the artificial parts that now make my athleticism possible. I also ski , and enjoy bumps more than is probably prudent.( Hey, I live in Park City, home to the #1,4 and 10 rated resorts!)
But keeping in mind I have many friends who have severe or even life threatening issues, my knee and it's progress seem inconsequential in comparison, and therefore its tribulations are kept in perspective relative to others trials.

If I can be of any help, or offer any advice to those of you out there suffering from a bone on bone situation, it would be to offer hope that there are solutions. The recovery may be trying and a lot of work, but if I can do it, so can you. Ordinary folks doing extraordinary things.
Aren't we so lucky to live in a society where we not only have freedom of choice, but have medical care available (for only some of us, unfortunately), that allow us to have such options. Yet sadly or selfishly,  some Americans feel all of us should not share in such good fortune.

Best wishes and feel free to comment or ask questions.  May you be as lucky in life as I have been.

Ed Knapp
runskiride@gmail.com
HatuHarriers on FB