- While sitting in a chair, cross my left leg over my right and let it lay there. Extend my right leg and hold it out to strengthen the quad muscles and increase bloodflow to the knee.
Ultimately, I was able to schedule an MRI at Foxhall MRI in NW for the following day (Friday). An MRI works by introducing intense magnetic fields that cause the nuclei in that part of the body to create their own magnetic fields that are then detectable by the scanner. The machine will take "slices" of the body part to get more highly-detailed images and can view the body part from numerous angles and axis.
I went in and relatively quickly got situated. The technician emphasized the need to stay still during each of the sessions in order to reduce the potential for blurred images. I had at least five series taken that were 3, 3, 5, 5.5, and 3.5 minutes in duration. I had to focus on my breathing to ensure my leg wouldn't move. Sometimes, it takes a mandate to not move your leg in order to believe that restless leg syndrome might actually be a thing. In any event, they handled the images and I requested a separate CD to keep as an electronic copy. The following are the applicable images followed by highlights of the injured area.
Although Dr. Johnson couldn't get me in the same day, I was able to schedule the follow-up for Monday. After waiting 45 minutes, Dr. Johnson arrived and viewed my MRI films. What he noticed was white with a black line on the medial (inside) side of my patella (kneecap) in the series looking up my leg from below. Everything else, MCL, ACL, LCL, etc looked good. He said that the white and black indicates fluid built up in-between the medial ligament and the patella. Typically, this occurs when there is some injury to the knee where the kneecap is pulled from its natural position (for example, a dislocation). Another ortho friend of mine named it as a medialpatellafemoralligament avulsion. Essentially, the ligament was pulled away from the kneecap and the resulting inflammation and gap allowed fluid to build which has been the source of my pain.
The good news is that there is no surgery. Also, I'm glad that there was an actual culprit as I would have been extremely flustered to go through all this just to find out that nothing was visible on the MRI. Dr. Johnson said it could take 3-4 months from the initial event for the injury to heal which puts me at the end of April and definitely takes me out of Comrades since I won't have a qualifying race and won't have really any miles in training. During the interim, he encouraged me to continue forward-motion activities (swimming, biking, elliptical). In addition, he said I should continue to do the seated leg extensions and can incorporate the occasional use of ice in a cloth but only for 8-10 minutes at a time.
Once any pain is gone, he said I can try to start running again. Very slowly. He provided the following suggested plan (dayweek):
Mon1 - 1/4 mile
Wed1 - 1/4 mile
Fri1 - 1/2 mile
Sun1 - 1/2 mile
Tue2 - 3/4 mile
Thu2 - 3/4 mile
..and continue in that fashion until I get up to two miles per run. At that point, I can increase my mileage by 10% on a weekly basis. For example, in the week where I am able to do 3 2-mile runs (6 miles), the following week I can do 6.6 miles. Obviously, back off if I feel pain and it's a small increase but will more or less amount to exponential growth.
So, in lieu of Comrades and the beginning of my ultramarathon career, I need to identify some races later in the season so I can accumulate an adequate amount of training.
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