As it turns out, my fabella bone had worn a nice little groove in the cartilage of my femur causing pain when running. It took a long time to figure out exactly what was causing my pain, and even once it was figured out, it wasn't a sure solution as it is often a constellation of problems causing the pain.
On January 2, 2016, I was doing a 13 mile run on the snow/ice
covered roads in Des Moines, IA. About 8 miles into the run, I jumped
from the street to the sidewalk and my right foot slipped on the ice
then came to an abrupt stop. It hurt, but I continued the run. I
stretched that evening then went to bed with very little pain. The next
morning I could hardly get out of bed my right knee was in so much pain.
I took it easy for 3 days and my knee was about 90% better and I
resumed regular training. I had an MRI, X-Rays, and Ultrasound of my
knee and all came back normal with no significant pathology but a
possible strain and/or tendonitis in my popliteal tendon.
I went down to
Clermont, Florida, in February for the QT2 Pro Camp and put in three
really solid weeks of training but left camp with a very sore knee. I
had a second read on the MRI and it confirmed what the original read
suggested. Strong in-tact knee with no major pathology but some possible
tendinitis of my popliteal tendon. I continued through physical therapy
and training and was managing the inflammation and pain. I was
training, but was not training at the full volume I wanted to race a
full ironman, but adequate for 70.3 fitness.
I delayed the start of the
season until New Orleans where I was unable to actually finish the race
because I was left stranded on the side of the road at mile 46 with a
flat tire and a broken valve extender. Next on my list was to race
Eagleman and before the race I had stem cell injection in my knee to aid
in the inflammation and healing of the tendinitis. I was back to
running with little to no pain but just before the race I tweaked my
knee again during a training run and decided I need to get in contact
with the folks at the Steadman Clinic in Vail, Colorado, where I had two
previous hip surgeries (both with great success). I scratched the race
at Eagleman to figure out what was wrong.
We did another MRI in Vail,
and the same results showed up. No major pathology of the knee but some
possible tendinitis of the popliteal tendon. I was fine to keep training
and racing, it was really just a matter of pain management and it
didn't bother me swimming or cycling and I was able to run on flat
surfaces with little to no pain. The popliteal tendon attaches the small
popliteus muscle to the femur behind the knee and is used for stability
primarily when running on hills. I was careful to keep most of my
running flat while letting the tendontiis calm down and managing the
inflammation. I was icing regularly and using Voltaren anti inflammatory
cream to manage the pain and inflammation.
I was all set to race in
Mont Tremblant for the 70.3 and had a front pack swim, came off the bike
with a pack of guys in second through sixth place and ready to run. On
the first big downhill of the run about 1 mile into the run, I could
feel my knee slightly give way then it started causing me a ton of pain.
I had not been doing much hill running in training to keep the
tendinitis at bay, but what I felt during the race was just too much pain. The pain grew more intense and I finally gave up on
the run at mile 3, got some ice at medical and withdrew from the race. I
flew back home to Iowa that night disappointed and in a lot of pain. I had a follow-up appointment after the race scheduled for Monday evening in Vail with Dr. Matt Provencher. I flew back out to
Vail on Monday and saw him in his clinic that evening. Dr. Provencher
did an exam of my knee and I tested positive for fabella syndrome. Dr. Provencher and Dr. Robert LaPrade agreed to add to me to their already full surgery schedule, on Tuesday June 28 at 7 AM to remove the fabella.
These are both world class
physicians who have worked with some of the top athletes in all sports.
Dr. Provencher was formerly the medical director of the New England
Patriots and Dr. LaPrade has done surgery on many of the most famous
sports stars around. I arrived at the hospital in Vail
at 5:30 AM and the doctors were there early to greet me and we started
the surgery at 6:30 AM...ahead of schedule. The operating room was
crowded with PA's and fellows eager to see the results of this rare
combined super surgery of Dr. LaPrade and Dr. Provencher. What they
found during the surgery was I had a small tear of my meniscus (which
was not present on the MRI taken just 3 weeks before). My popliteal
tendon had severe tendinitis (from the fabella) which they debrided. They did a small
release on my IT band to allow more movement and less friction in the
area as a preventative measure. My peroneal nerve was also highly
inflamed so they did a neuropathy to move the nerve away from the
inflamed tendon. They also removed the fabella bone which was about the size of 3 dimes stacked on top of each other. My
fabella bone had rubbed a groove in the cartilidge of my femur and had
caused severe peroneal nerve irritation along with popliteal tendonitis.
The surgeons extracted the fabella bone and now I have no posterior
lateral knee friction. I just had this surgery one week ago on Tuesday morning and I spent last week in Vail doing rehab at the Howard Head Physical Therapy Clinic.
So what now?
I believe my best racing is still ahead of me and will take on this rehab with all the zeal of vigor of a champion.
Cheers,
TJ
