The Snapping Turtle Reigns On

I had my follow up with my doctor today for my hamstring and I'm pretty sure I will always go to a sports medicine doctor whenever possible. I think they're less cautious than I am. With Boston 17 days away, I was nervous about what he felt about me running it. My therapist is pretty positive about it, except that I really need to increase my mileage. Because the tendon behind my knee continues to snap back and forth very obviously, we were both feeling a little anxious about what the doc would say.

I ran twice yesterday. 2 miles at the therapist's office and one more that night after class. This morning I ran another two. My leg is fairly happy. However, it is not happy when it has to run up hills or jump a curb, so for now I'm limiting my runs to the treadmill. Tomorrow I will run 3, and Sunday I will run 5. If the 5 miler is successful, we're looking very good for the marathon.

The doctor poked and prodded and felt along the length of the muscle and was unable to find either a tear or a painful part. I demonstrated Fred's (the snapping turtle living behind my knee) capabilities for him. Laying on my back, I stuck my leg up in the air and straightened it. One of my hamstring tendons jumped out to the side.

"Hmmm." He grabbed the tendon and felt it while I popped it back and forth. I relaxed and he popped it back and forth a few times. He winced.

He had me squat, then do single leg squats on each leg.

"Well the muscle looks great. That tendon thing, that's a separate issue, obviously caused by the same thing though. That might not go away." Geezo. I'm not talking about a simple little clicking behind my knee. This tendon jumps out of place when I straighten my knee under tension or under a load. This thing is no joke. It's not that it's particularly painful, but it's incredibly disconcerting and it's one of those things I feel would probably hurt if I continued the motion.

We talked about leg strengthening and I told him how I attempted a straight leg dead lift, no weight, just the proper form. When I straightened up, my tendon snapped over and I decided it wasn't a good idea to continue. The doctor shook his head. I wondered what he was thinking but decided not to ask.

"Well that may or may not go away. If it becomes a problem, we can deal with it then. In the mean time, you need to get your mileage up for Boston without re-injuring yourself. This 5 miler is going to be a big decision maker. If you're hurting after that, we've got a problem. But if it's fine, I would get that mileage up. I'm not a running coach so I can't tell you how to do that, but I would want to get that mileage up.

"If you re-injur it, you're not going to be able to do Boston, but if you keep if healthy I think you'll do fine. It may not be your fastest marathon, but you should be ok. Now, if it starts hurting during the marathon, well, do the best you can and we'll fix you when you get back."

I laughed. That's probably the funniest thing a doctor has ever said to me.

"And if the tendon continues to be a problem, we'll address it then."

I just read some research articles and medical papers on this snapping tendon thing. The semitendonosis muscle and tendon sits on top of the semimembranosis, which is the one I injured. My doc thinks I possibly tore the fibers in the tendon that keeps the semitendonosis tendon sliding inline where it should be. It doesn't fix itself by the way.

The articles pretty much said the same thing, except that the only thing that helped these several documented patients (it's apparently very rare behind the knee but can be found more commonly in the hip, shoulder, elbow, etc) was an excising of both the semitendonosis tendon and the gracialis tendon (the gracialis is one of muscles in the groin). Excising? Removing a portion of the tendons. For crying out loud.

So Fred is going to hang out with me for awhile and see how things go. It does mess with my running quite a bit (as well as going upstairs, making right turns, etc) but it's also still new and getting back into the functional phase. So I guess we'll see. I go back to therapy on Wednesday and we'll discuss how my mileage is going and the new info about Fred. My therapist will also appreciate that Fred has a name. Yesterday she man handled my hip flexors and I refused to cry uncle. Actually at some point I may have more or less said "Bring it on". But I guess there's no faking toughness when you cry out and flop back down onto the table, defeated by a simple stretch.