Same workout as yesterday

Beautiful day at the lake.  Had the place to myself for most of the time.   About 85º, water temperature 88º. 

Same exact workout as yesterday.

Water running 6 x 60 (R/L) strides w/ 60 sec rest

Max HR 144, Avg HR 118

This workout seems to really get the hip flexors and is more fatiguing than the HR would indicate.  After a rest I swam across the lake and back.  Each rep without stopping.

Lake swim

2 x 160 yds  ~ 90 strokes

Max HR 129, Avg HR 118

Started the day with 21 pullups, ab wheel, and 40 pushups.

Now time to practice.   

At the lake, water running / swim

Love this time of year.  Had the lake to myself and did a decent workout.

Deep water running

6 x 60 (R/L) strides w/ 60 sec rest

Max HR - 160

Avg HR - 125

Lake swim

2 x 160 yds 

Was able to finally make it across the lake freestyle without stopping.   About 90x (R/L) strokes. 

Started the day with 23 pullups and some ab wheel... and a couple hrs of guitar practice.

Knee feels good and I think limiting leg activity to water and maybe occasional gentle seated bike might be what I need.  I don't know what to make of the comments on the last post.  A lot of ridiculous hyperbole, snide BS.    Bottom line, my knee is painless for daily activities, even when carrying significant weight up stairs.  The identified possible medial condyle defect ("emerging subfracture") is tiny, about 1/4" square.  I don't think it's unrecoverable for normal daily activities and may be recoverable with a significant healing period even for occasional running.   Dubious I'll be training for the 400m at the same level as before the injury, but that's ok.  Turf sprints once a week is really all I need + bike.  I don't think that is an unreasonable goal.   May try an under loader brace for biking, I'll ask the Dr.

Really light 141.3 lbs after workout.  12% bodyfat.  

Sympathy to my masters colleagues who had their first day of competition at USATF Masters Nationals canceled in OH due to air quality.  Fortunately, they have a 300m indoor track on site.  The air quality forecast for Friday is also not good.  That sucks, but they'll have to bring it indoors.  Not the first time.  It happened in '17 in LA when lightning forced us indoor at LSU on a 200m flat track for 200m semis. 

Bike sprint, pullups, fast

 I've been taking time off the bike until today, I couldn't stand it anymore I did a bike sprint but not full, effort.  I also have been doing the usual few exercises and I'm regularly able to do 21-23 pullups every morning.  Been walking a mile+ every morning including walking backward up hills.  

I'll see what the new ortho Dr. says about recovery next Tuesday.  

I'm fasting and purging for tomorrow's colonoscopy.  Yesterday ate a 'low residual' diet which was new to me.  Stuff I never eat, like simple carbs... specifically white rice and bananas.  That's the stuff I probably should have been eating before races instead of high fiber bread and cereals.  I should be able to drop close to 140 lbs by the time this is over.  I had to drink a 2 L of polyethylene glycol solution around 6 pm, then another 2 L at 1:00 am.   I'll be up most of the night.  Fun.

2.5 mile mountain bike sprint - Laurel Branch Trl

Time - 10:16

Avg speed - 13.3 mph

Max HR - 165

HR over 156 - 4:10

Avg HR - 150 (inc 1 min recovery at end)

I stayed seated most of the ride back, HR certainly wasn't up to what it normally is during this workout.  

Hard to tell if these types of rides are degrading to my knee.  The feels good afterward.  Sometime I get a slight soreness later in the night or next day but usually not.  Probably shouldn't do anything for a month with my legs, but I definitely would feel vulnerable to CV disease without pushing my HR, hard to do without legs.  Maybe be forced to swim only.  Water run at the most.  I'll see what the Dr. says but I'm sure less is more at this point.

Judging by the comments, some people don't apparently understand that 'jogging' - running with heel or midfoot strike is more damaging to my knee than high knee running, stairs, hills, or running with forefoot strike on the ball of the foot in sprint form.  FWIW, even when I raced 800s, my heel never touched the ground and I wore the same spikes as I would for a 100m race.  Anything faster than a 72 sec 400m is a sprint for someone over 60, and that would be about my slowest 400m split in any of the 800m races I ever ran, my slowest being 2:22.  Transitioning from high knee running gradually to full stride is the way I've been getting prepped for sprinting post injury.  

Anyway, hopefully my colon is ok.  Find out tomorrow.  

resistance - pullup PR, forward - MRI impressions

Doing my usual pullups and core work, hanging about 143-144 lbs, did 25 consecutive pullups today, a lifetime PR.  

The key findings in my MRI was that the posterior root repair as stated "remains intact."   Curiously, no mention of stitching on the medial complex tear although a mention of a "Prior repair of vertical tear in the posterior horn which remains intact."   This is relatively good news because a re-tear of the root would be unrepairable.  

Basically, all of these stresses were likely due to overly ambitious and premature training after the repair in an effort to get back to competition last winter/ early spring indoor season.   

All AI programs I've consulted on this say that I need a significant break from running 6-12 weeks and a slow cautious return.  That means even limiting my cycling and any leg-centered stuff, probably including rowing.  Swimming and water running seem the safest in the short term.   I will probably take a 10 day break from all cycling until I meet with the ortho a week from Tues. 

It seems that my natural knee health may be only barely salvageable, and this may very well be my last chance to get healed.  Certainly any further trauma will only shorten the time toward a TKR, however, my pain has truly been minimal, probably due to strengthening.  I have zero pain walking up and down stairs even when carrying significant weight.  Although, I do sometimes feel soreness or stiffness after a long hike.  There are also treatment options like subchondroplasty and injections which could be utilized as last option.  

I have been pushing very hard on the bike, HR into at least the 170s at least 3x a week.   I worry that a sudden cessation of hard cardio work will have deleterious effects on my CV wellness.   Same day I meet with my Dr., I'm getting a barrage of tests I purchased from this new test broker:  Goodlabs.  Incredibly inexpensive.  Should be a good CV risk assessment.    Also, have a colonoscopy on Wed.  

Fellow track mate Andrea asked me if I thought I might be ready to compete at worlds in March, I said I don't know.  It becomes a game of attrition at this point.  One guy I raced with in '21 just had a TKR and he's trying to run on it.  Very slow progress.  Another fellow world medalist in my age group had a heart ablation due to afib that caused his HR to spike to 250.  That would be scary.   He recently returned to race for the first time.  If I am to compete in March, I would need to start my first conservative running by Oct.  I have time.  

Looking back, if I had just done one short turf workout every 2-3 weeks all summer, that would have been probably OK.  But 2 track workouts with just 2 - 3x 90% effort sprints 5 days apart, I wasn't ready for that.  Should have stayed on turf and kept intensity to 80%. 

Again, I have time.   Now, knowing what to do with it.   Half jokingly (and half not) thought, maybe I should go non weight bearing, brace and crutches for a month?  Nah, probably overkill.  Then again, it couldn't hurt? Or could it... with the atrophy?  Motion and flexibility are good.  Should stimulate healing I would think.  I think they still try and stimulate healing with micro fracture technique... not that I'm going to do that.  But the body does respond to stimulus and to tasks.  

bike sprint, MRI

Did my first training involving legs since last Saturday's running.  Just a neighborhood bike sprint.   Got the knee MRI.  Definitely a mess.  

2.5 mile mountain bike sprint - Laurel Branch Trl

Time - 10:01

Avg speed - 13.6 mph

Max HR - 173

HR over 156 - 5:05

HR over 170 - 5:18 

Avg HR - 166 (inc 1 min recovery at end)

Slower and higher avg HR but lower Max HR from last time.

Knee continues to feel better and will allow recovery til I do make any running attempts.  

As expected, MRI showed a lot of problems.  It seems that the game should be to expect trauma and to allow recovery.  

On the plus side:

"Intact root attachment.... prior repair of vertical tear in the posterior horn which remains intact. Intact anterior root"

On the minus side:

"recurrent macerated tearing along the free edge of the posterior horn/root junction creating a small free edge flap with intact posterior root. Degenerative undersurface tearing of the meniscus at the posterior junction and partially extruded body segment without flap displacement ...  Prior repair of vertical tear in the posterior horn which remains intact. Intact anterior root with reactive edema or root sprain. Diffuse chondral loss throughout the central and posterior weightbearing femoral condyle at least 75% chondral thickness with stress related marrow changes diffusely throughout the femoral condyle associated within

evolving subchondral fracture in the posterior weightbearing aspect measuring 0.7 cm transversely with evidence of remotely healed subchondral fracture in the more anterior weightbearing femoral condyle. Partial chondral loss in the tibial plateau centrally at least 50% chondral thickness with mild stress response peripherally and posteriorly... Full thickness chondral loss in the central, with highgrade partial chondral loss in the inferior medial trochlea with chronic stress response and preserved cartilage in the lateral trochlear facet."

Summary impression:

1. Prior medial meniscal repair posteriorly with recurrent free edge tearing of the posterior horn/root junction, undersurface tearing of the peripheral posterior horn extending to the body segment with intact root attachments demonstrating degeneration/sprain and progressive arthrosis in the compartment at least moderate severity with increased stress response throughout the femoral condyle associated with a evolving subchondral stress or insufficiency fracture of the posterior weightbearing aspect, likely a pain generator.

2. Intact lateral meniscus with degenerative fraying along the free edge and relatively superficial focal chondral loss without significant compartment arthrosis.

3. Intact cruciate, collateral ligaments without acute injury or tear, early mucinous degeneration of the ACL.

4. Patellofemoral arthrosis, moderate severity with chronic stress response related to highgrade chondral loss in the trochlea.

5. Moderate size joint effusion with chronic synovitis more pronounced suprapatellar fossa, medial compartment. Small loose osseous bodies in the posterior superior medial femoral recess measuring up to 0.5 cm.

Seems that the worst cartilage loss is not on the tibial or condyle surfaces, but behind the kneecap on the medial trochlea.   Anyway, it sucks.   

Weight pulls, sprints

Saturday workout was cut short by a storm.  I went out to do some weight pulls and felt good enough after warmups to do a few sprints.  But did one too many.  Ran a 50m, then a fast 100m, then did 2x50 yd 90lb weight pulls.  Storm then came.  Was bummed I couldn't do more due to the rain and lightning, so I ran a hard 50m in the rain. Shouldn't have, knee hurt after.  Should have just quit while I was ahead.  But I ran a 13.8 100m in trainers, not bad for not having sprinted twice in 2 months.

Stretches, drills, bands

2 x 50m high knees

50m - 7.10

100m - 13.85

2 x 50m weight pulls on turf with 90lbs

50m - 7.40

Went swimming afterward.   Won't try running again for a while.  

MRI on R knee today, should get the report this week.  Not optimistic.  

Was 142.5 today before dinner.  12.6% body fat.  Going to continue with the weights and stuff.  The campus weight room was just renovated with many new machines.  They finally got a glute machine you can load up with plates.  That'll be good.  Should open this week.  

Lovely this morning, 6:00 am...

hot bike climb

Went out in the heat today for a bike climb, 92º and exceptionally humid, dewpoint 78º, heat index 107º.  Hottest part of the day.   I got Dr. Scott an endurance runner a few yrs younger than me to motivate me.  We finished together.  

This was the hardest I've ever pushed my HR.  The overall time was not exceptional, but the effort was due to the conditions.   Faster than last time.  I did very little sprinting off the seat.  Scott did more than I did.  

Roark's Cove bike climb

Total time - 23:11

Avg speed - 6.1 mph

Max HR - 190

HR over 170 - 14:59

HR over 180 - 4:15

Avg HR - 166

Had a nice swim afterward.  Scott lives right at the top of the hill and on a lake.  Got to hang with friends for a few hrs.  Roya joined us.

It was supposed to rain today, even possible severe storms, but nothing came.  Nice lightning and thunder in the distance. 

Roya's day off tomorrow so we'll go swimming.  I want to hit the track during the heat and do some weight pulls.  Could be hotter tomorrow, and certainly will on the reflective turf field in full sun.