Thanks to friend, runner, and now injury-blogger Jenny DeSouchet, I wrote this piece on a long injury I had while running at Princeton. Here’s how I handled it and what I learned through the process. I will follow this up with a more recent account of what I’ve learned in the past year after transitioning to ultras and how my attitude towards injury has changed, and how it hasn’t.
HOW MYSTERIOUS KNEE PAIN CHANGED MY LIFE
I was in my sophomore cross country season at Princeton, fitter than I’d ever been, gunning to be a scorer, top 5, for our team by the end of the season. Then during one Sunday long run , I was chatting away with my teammates, including steeplechase phenom Ashley Higginson, who I remember lost a necklace pendant on the run (we all stopped and scoured the tow path to look for it), when my left knee audibly clicked and I felt a sharp, persistent pain that wouldn’t go away. As injuries often go, we were seven miles away from Princeton’s campus. I did high knees and butt kicks all of the way back to deal with the stabbing pain. The clicking stopped, but the pain wouldn’t stop. Little did I know that this would be a ten-month ordeal until I felt relief and could run again.
At first, my trainer diagnosed it as Runner’s Knee: the common, and painful, ailment from overuse and weak thigh muscles, especially a weak VMO (vastus medialis oblique). I definitely had a weaker VMO on my left side, but after an entire winter of strengthening exercises and too many hours spent in Princeton’s archaic rec center pool, I had no improvement. If anything, the pain was worse. I couldn’t walk down stairs without grimacing. The Runner’s Knee/patellafemoral syndrome tape job didn’t help either. I was so hopeful it would help that I tried a ten-minute run the day my trainer applied tape. We’ve all been there. “Maybe this tiny piece of tape will miraculously heal me and I’ll be running 60 miles next week, racing in three weeks!” But of course, that’s not how it works. This is called the ‘denial of injury phase.’ It can last weeks to years. Mine lasted about three months until I had enough and moved onto phase two.
After indoor track came and went, I stopped showing up to the beginning of practice—most injured members of the team would do this to keep some semblance of routine and normalcy to a life without running. But I was already spending so much time in the training room, doing stupid little squats, getting e-stim (electronic stimulation) on my VMO, and swimming, that I couldn’t bear to spend another moment watching my teammates getting ready to run. How simple the life of a non-injured runner seemed: run for an hour, talk with friends, have fun, sweat, shower, and be done. I missed the ease, efficiency, and stress-release of being a healthy runner unlike anything I’d missed before in my life.
I masked my depression by hanging out with new, non-runner friends who valued substances over sleep. I wallowed in my inability to run and subsequently found myself partying harder than ever. I drank more liquid calories of alcohol than I ate in whole foods. I started dating a senior, a wonderful guy, but he was as far removed from the running scene as I was immersed in it, at least at my core. Almost every night was marked with outrageous parties, mainly with second-semester seniors who were done with their theses. Never mind I was a sophomore. Somehow, I was able to get through classes like a breeze. I attribute it to not being tired from training, and from a lot of caffeine. I stopped swimming altogether. I saw no point in keeping my fitness at bay, especially because I could stay thin by not eating. I created a life that seemed to be based around fun, efficiency, and anti-running. I went to the important outdoor track meets, like HEPS, the Ivy League Meet, which gave me the credibility of still supporting my team because it meant missing a giant day party at Princeton, called Lawn Parities. But deep down, I was beginning to despise running. It ruined my sense of normal. Not running was changing me, for the worse.
Trying to forget about my inability to run.
Not many of my running teammates, my true best friends, knew what I was up to. They cared about me, but also knew that I needed space from running in order to get through this mysterious knee injury. In my reluctance to acknowledge that running was even a thing, never mind an activity that I loved more than anything else—this is called the ‘denial of passion phase’—I applied for a summer internship in Bermuda. A non-runner friend encouraged me. “Who cares if you can’t train there? You need to look out for your future life, which isn’t all about running.” Had I been healthy, I would’ve never applied to an internship in Bermuda to study coral. I knew the summer would be spent mainly underwater, and Bermuda is a tiny island, so training would be very difficult. But as the spring sped by, in a blur of sleepless nights, I questioned if I’d ever run again. I got the internship, and as life would have it, this catapulted my passion for coral reefs and allowed me to spend the following summer in Palau, eventually publishing a journal paper on reef ecology in Palau.
Summer internship in Bermuda, studying the effects of ocean acidification on coral larvae.
But, as far as my injury was concerned, I was still at ground zero. I saw five different doctors by the time the school year ended in June, which elucidated nothing. Two cortisone shots later, the second one administered right before leaving for Bermuda, and my knee pain was worse than ever. I avoided stairs at all costs.
Even getting in and out of the boat to go SCUBA diving wasn’t great for my knee. BUT I got to SCUBA dive!
In Bermuda, I was distracted by the magnificent, and ever-changing marine world. I became scientific-SCUBA certified, and performed the diving and lab work for an eventually published project on ocean acidification on baby corals. The natural world had never felt so infinitely fascinating, and troubled. It was here where I saw the effects of climate change on our oceans firsthand. It was also in Bermuda where I continued to party hard. Running was so far past my potential, even though I was still working to fix my injury. I solicited the help of a nutritionist who thought maybe I was allergic to nightshade vegetables, somehow related being a celiac. She said eating them could cause intense inflammation. But after a month of not eating nightshade vegetables and of drinking a very expensive box full of anti-inflammation powder drinks air-mailed by my unflappable, loving and supportive parents, my knee was the same. I gained weight, welcomingly, as I stopped looking in a mirror. I began to swim again in a jaw-dropping beautiful channel in front of the scientific research campus I lived at. I tried running a few times during the anti-nightshade vegetable phase, only to be disappointed when the pain would worsen within an hour after a ten-minute run.
Friends and swimming can make not running more tolerable.
Feeling newly alive with coral reef stoke, by the end of the summer, my party-hard mentality simmered down. I was swimming and contemplating a life of scientific research, exploration and travel, sans running. Bermuda gave me the perspective I needed. But it was far from a done deal.
Fall came and I was still not running. My teammates, fitter than ever, as all cross country seasons commence, were still supportive, but more aloof towards me. That’s what happens when a teammate is injured for multiple consecutive seasons: she or he is forgotten about. For some, that can be debilitating and alienating to an extreme. I used it to my advantage, hanging out with non-runners once again. Skipping practices and meetings to go to a music festival during pre-season. But deep down, my passion for running was back, stronger than ever. I needed a solution. At last, I got an MRI. I should’ve gotten an MRI the previous winter, but the diagnosis of Runner’s Knee didn’t justify an MRI. My MRI result: I was missing a 5mm chunk of cartilage underneath my kneecap, which would explain the sharp pain: nerve pain from bone on bone rubbing. The term for this is chondromalacia, which is also often called Runner’s Knee. Knee injuries are so common and yet complex that many diagnoses get muddled together. It takes an MRI to plan an effective course of treatment.
Starting my junior year with a knee brace.
Against the advice of all of the Princeton sports doctors, I decided to get a PRP injection (platelet rich plasma) in my kneecap. I’d read it helped runners with symptoms similar to my own. My other options were: continue to wait or get my knee scoped. Against surgery at all costs, PRP was my only choice. My PRP experience was sketchy. I went through an acupuncturist, who somehow was able to take my insurance by categorizing the shot as yet another cortisone injection. PRP is usually an out-of-pocket expense, since it’s not widely used yet, that costs anywhere from $500 – over $1,000. My injection took place in a random strip mall office in suburban Trenton. How it works is: a nurse or doctor draws blood from your arm, puts your blood in a centrifuge to spin it down, which separates the platelet rich plasma from the other components. Platelets and the liquid plasma of the blood contain lots of factors that are essential for cell recruitment, multiplication and specialization required for healing. When injected to an injured area of bone or soft tissue, it spurs a healing event with few side effects because it is your own blood. My injection worked LIKE A CHARM. I was numb in my left leg for a day, but the local numbing eventually wore off. After wearing a full leg brace for three days, on day four, I tried to run. No pain. It is the closest feeling I’ve ever had to magic. Within a month, I was back to 50-mile weeks of running. I competed in my junior indoor track season and outdoor track seasons. I had my best cross country season my senior fall, after spending a summer doing coral research in the island nation of Palau, which is even smaller than Bermuda. I made training work and fearlessly didn’t let running dictate my academic and travel life. To this day, though, those ten months have left a mark. I realize that I’m happiest while not partying, and that almost any ailment, from a broken heart to a bum knee can be treated by the wondrous natural world we live in. I also learned to never throw in the towel, even if you’ve let it sit by itself for a period of time.
Racing healthy: steeplechase my junior track season.