I love running.

I typically run 3-4 miles a day 5 to 6 days per week. It’s only about a half hour of time, and it’s well worth it. I get ‘in the zone’ when I run, and I can tune out the rest of the world and enjoy just being. It feels great physically and mentally each time. It’s helped me immensely to stave off the obesity issues that have plagued some of my relatives. I’ll confess that I have a bit of sweet tooth, too, and it’s nice being able to indulge a little more than I might otherwise be able to. My blood pressure has been excellent as well since I’ve been working out regularly.

Just over a week ago I headed out for a ‘routine’ 1.5 mile out/1.5 mile back run. All was well and going according to plan until I was approximately 1.3 miles from home. My left patella (knee cap) began catching uncomfortably every time I bent my left knee. At first I tried to ‘run through’ the sensation, but within a few steps my athletic stride was reduced to a slow walk during which I could not comfortably bend my left knee at all.

I greatly hoped that my knee would be better the next day, but it was minimally improved. Four days after the injury I was evaluated at a sports medicine/orthopedics clinic. I was told that I was having problems with my patella (knee cap) tracking properly. One of the reasons appeared to be that my iliotibial bands (bands of connective tissue that run from the hip along the outside part of the thigh to the knee) were very tight. I was given various exercises to perform regularly that would stretch the tight parts in my legs and also strengthen key muscles that could help prevent this problem from recurring. (I had a less severe version of this problem occur in my other knee about 15 years ago. But after a physical therapy consultation, the symptoms disappeared with some regular stretching and have never recurred.)

I decided that I was going to do whatever I could over the next couple of days to see if I could get my knee working again. If it did not improve soon, I was to return for an MRI and possibly surgery.

I stretched and stretched and started walking very slowly on the treadmill. Within 2 days I completed a slow 3 mile walk outside with minimal symptoms. The next day I walked 5 miles outside with no problems whatsoever! I realized that my enthusiasm could get me in trouble. So, I’ve kept my walks to about 3 miles since then, and my knee has recovered very nicely thus far.

What about running–is it in my future? I honestly don’t know, but I’m going to do all that I can so that my legs and knees will be as stable as possible. I’m not going to try running or jogging for a few weeks, but eventually I will.

Why don’t I just swim or bike? Well, I love to run. All I need is some running gear and and good pair of shoes. I can run practically anywhere. I’m just not interested in biking or swimming. And my running buddy, a very energetic young dog, loves to run at least as much as I do! What about walking? Well, I’m enjoying walking quite a bit right now. I realize that it is a healthy activity and that it is more ‘knee-friendly.’ But, it’s just not the intense cardiovascular workout that I prefer.

So, am I being inflexible, rigid, or irrational? Shouldn’t I ‘know better’ than to risk ruining my knees?

I don’t think what I want to accomplish is irrational at all. My knees would probably be carrying around more weight if I hadn’t taken up running. I highly doubt that I would have found a cardiovascular activity that I would have liked and stuck to as I have with running.

I was just thinking about this issue and then found this New York Times blog post titled, “When Repeat Injuries Can’t Dim an Athlete’s Passion.” It’s well worth reading. An excerpt:

Our behavior, said the expert, Dr. Jon L. Schriner, an osteopath at the Michigan Center for Athletic Medicine, is “compulsive”: we let our egos get in the way, persisting beyond all reason.

I disagree. Yes, there are some who compulsively exercise. But is my running a compulsion? Well, if I apply psychiatric criteria, let’s see: Does my running practice cause considerable distress or impairment in my functioning? Not at all. I enjoy the activity, but I can skip it without becoming anxious or irritable. It helps me to function better physically and mentally. I have more energy, I’m healthier, and I’m less stressed because of it. It doesn’t interfere with any of my relationships. My wife is very supportive of my running.

But another expert recommended by the college, David B. Coppel, a clinical and sports psychologist at the University of Washington, has another perspective. There are several reasons some people find it hard to switch sports, he told me. Often, their friends do that sport, too; it is how these people identify themselves, part of their social life. And then there is another, more elusive factor.

“There is something about the experience — be it figure skating or running or cycling — that really produces a pleasurable experience,” Dr. Coppel said. “That connection is probably not only at a psychological level but probably also something physiological that potentially makes it harder for these people to transition to other sports.”

This makes more sense to me. I think there are additional reasons that athletes strongly prefer particular sports, too.

In the end, it’s the job of health care professionals to be consultants to their patients. They should certainly be honest with them about the risks associated with particular sports and exercise routines, but at the same time, they should work with their patients to a reasonable degree to help them to achieve their own health goals.

I suspect that the more athletically-inclined physicians, NP’s, and PA’s are more likely to be open-minded about working with us ‘crazy’ or ‘obsessed’ athletes than are those who cannot personally relate to participating in athletics. As irrational as some of us may appear to those not personally invested in fitness routines, what we want to achieve is very important to us, and we are willing to accept certain risks to get there. In our minds, there’s a method to our madness!

Fortunately I’m working with a sports medicine specialist who understands my goal of eventually getting back to running. If this hadn’t been the case, I probably would have scheduled an appointment with someone else.