Nearly a week after my race, the extreme soreness in my knee has not diminished one bit. In fact, I think it has actually gotten worse. The pain is sharp and constant. It is most intense after starting walking as well as bending and straightening my leg. I am walking with a bit of a limp and going up and down stairs is sheer agony. My diagnosis is patellofemoral syndrome or "Runner's knee." I have tried various pills that I took for the thyroid/adrenal situation. The stuff that slows my thyroid stiffens my legs and causes fatigue. The stimulants did not have much of an impact at all. This tells me that my glandular activity is still in relative balance and may actually be a little on the slow side but probably near normal. That's the only good news. There is the possibility that I am dealing with an extreme aldosterone/cortisol imbalance, represented by a severe elevation of sodium relative to potassium on the hair test. In layman's terms, that means that I am vulnerable to a number of inflammatory conditions. That may explain why my performances were still fairly good up until the injury despite feeling more sore than normal after relatively moderate training. For the record, most of my recent medical reports revealed potential for mild-moderate inflammation as referenced by a somewhat elevated Na/K ratio.
Today, I tried loading with zinc, which is known to lower sodium and raise potassium. The groin and leg pain has diminished somewhat but the knee pain has not. I'm not giving up on it yet but I do not have a good feeling. I can also try a B-complex with choline and inositol. I had called Nashville and politely requested that my appointment be moved up if at all possible but did not receive a return call, which was not a surprise. There are 2 other prolotherapy doctors in Georgia, one in Macon (3 hrs) and another in the Atlanta area (2.5 hours). I will call both of them tomorrow to see if they have any appointments next week or early in the following week. I can't take this pain any longer. The good news is that prolotherapy has been very successful for knee injuries even with ligament/cartilage damage so I'm not ruling out participating in Huntsville just yet.
Here's an article on the subject:
If the link doesn't work, just google "Runner's knee" "prolotherapy"
My future as a runner:
The last 2 times I trained all out for a marathon, I ended up sidelined but the first one may not have occurred if I had been wearing proper orthotics. I am seriously considering retirement from marathons altogether just because of the injury risk. It seems that 50-55 miles/wk is just about my sustainable limit. Maybe I can safely jack it up to near 60 for 1 week per month provided that I keep my paces slow enough but the increase would be offset by an occasional race or a down week because of other commitments. Realistically, my average safe volume for a 15 week training program would be 48-50 MPW. What kind of time can I expect with that training? I "might could" crack 3:20 but 3:10 or even 3:15 is out the question. With no hope of a BQ, is it worth the risk of major injury to train all out for a marathon? I say no. The race itself is actually comparatively easy. Heck, I have decided on a whim to do run 26.2 mile training runs and finished safely each time.
If I am to do another one, it will likely be a spur of the moment decision such as an upgrade from the half to the full at the expo without a major time goal. Much of my future depends on the results of the medical report. If it comes back that I had severe inflammation, I can fix that by staying on top of my chemistry and will be less vulnerable to injury in the future. If that's the case, I may try again in another year or 2 but another injury would become "strike 3." If my inflammation level is mild-moderate, that means that the damage was due to overuse and simple "wear and tear." If that's the case, I am simply not cut out for advanced marathon training and my dream of a qualifying for Boston dies here. Sad but true. I won't know for another 3-4 weeks. Regardless of how this shakes out, I had planned to cut the mileage drastically in the Spring of 2011 to focus on my strength, which is hard speed training geared toward middle distance runners. I want those PRs now because within a few years, I will be too old to improve at distances shorter than 5K.