3-year-old boy passed the ball to me, I stuck out my left leg to trap the ball, the ball struck my foot, and my leg swung like a pendulum: I was unable to control my leg. At that point, I knew my Boston dream was over. In fact, it worried me that perhaps I had seriously damaged myself permanently.

After an MRI and another visit to the doctor, the heartbreaking truth was illuminated: there was no way I could run Boston even with a cortisone shot. An immediate partial meniscopy was recommended: “the sooner the better,” the doctor said. “Also,” he continued, “You have to prepare yourself for the possibility ….” You know the rest.

Meniscus tears and surgery

Meniscus tears of the knee are a fairly common sports injury. The meniscal cartilage is a wedgelike material that prevents the femur and tibia from grinding on each other and acts as a stabilizing tissue when turning and bearing weight. A C-shaped structure, when torn the location of the tear becomes the most important factor in deciding on a particular treatment option.

A tear on the outer edge of the wedge will usually heal well since this part is thickest and has a good blood supply. Small tears in this area may heal well on their own with stabilization and rest. If not, a repair can be done entailing sewing the torn pieces back together. This procedure has a very high success rate.

The inner two-thirds of the meniscus are thinner and do not have a good blood supply. Therefore, this doesn’t heal well either on its own or after repair. Unfortunately, this is by far the more common of the two types of tears. Torn pieces here may break off and cause trouble for the other knee-joint areas, resulting in locked knee or other issues. In most cases the treatment for this type of tear is a partial meniscectomy, where the torn areas are cut out and any rough edges of the meniscus shaved smooth. My particular tear was of this type and “quite significant,” requiring removal of 25 percent of my meniscus.

These are two generalizations of the many types of meniscus tears, and the choice of surgery will be based on many factors including the patient’s age, activity level, preferences, and goals.

Usually the partial meniscectomy procedure is performed arthroscopically using a thin tube with a camera attached and long, thin, surgical tools, all of which are inserted through small slits made in the knee area. This is outpatient surgery and can be done with general or regional anesthesia.

In my case, the surgeon made three slits in my knee: one for the camera and light, one to insert cutting tools, and one to act as a “drainage hole” where all the debris could be flushed out. I was nervous, but the surgery went well and was done in one morning. I opted for general anesthesia—not really wanting to see the activities of the “drainage hole.”

After surgery

The surgery was performed on a Monday, and I hobbled into work on Wednesday. The painkillers prescribed apparently worked well, since I don’t remember much about the two days in bed except that I did rewatch my entire set of Monty Python videos, all of which seemed extra funny under the affects of Percocet.

The following weeks revealed something that surprised me: depression. At the time, I couldn’t quite put my finger on it, but things around me just didn’t seem the same. I no longer had enthusiasm for things I once enjoyed, it became difficult to sleep, and sometimes it became even more difficult to roll out of bed in the mornings. I even began drinking wine most days of the week, which was something I never usually did (I am more of a weekend binge drinker). The rehab from surgery was excruciatingly slow. I started to believe that I would never run again, and this realization affected me immensely. I had had no idea how important running was to me. It was truly as if I had lost a very close friend.

This downward spiral continued for several months and reached bottom when I embarked on a two-week trip to Germany to watch World Cup soccer. It was one continuous party of German beer and sausages (and a little soccer). By the time I returned to the United States, my weight was up to 200 pounds (37 pounds over my Steamtown Marathon race weight). For some reason, I think I was worried about returning to running and so avoided the issue through overindulgence. I didn’t want to confront the fact that I might fail. But, eventually I knew it was time to find out on hearing my daughter ask, as I sat watching CNN Daybreak on television, “Daddy, why don’t you go running in the morning anymore?” I snapped out of my cocoon and decided ona gentle goal: the Atlanta Half-Marathon. I had less than four months to prepare and got down to work immediately.

The author knew there was a chance his
running days were over after he had surgery
to repair a torn meniscus in April 2006.

s oS & s & Z ‘6 ry s €

Back in training

I took to my trusty Hal Higdon advanced program and modified it for the halfmarathon. I realized immediately that it was going to take some time to get back into the swing of training—the only activity I had been doing for three months was stationary bike work and short runs on a treadmill. On my first pace and long runs, I cursed every beer and sausage I had eaten in Germany. I rarely pushed myself hard: the memory of my leg swinging limply from side to side after the meniscus tear was with me every step of every run. I ran carefully. Probably because of this relatively slow pace, the German beer gut was hard to evict.

However, by the time the Atlanta Half-Marathon presented itself, I felt pretty much ready, although I didn’t really expect too much in terms of a good performance. My goal was to stay on my Boston qualifying pace (7:30 minutes per mile) as much as possible. The Atlanta Half-Marathon course is challenging, encompassing five quite difficult hills. Keeping on goal pace was a struggle. I found myself on the point of breathlessness most of the way but was able, incredibly (I thought), to keep on pace and finish in 1 hour, 37 minutes. I was back, I felt, even though my finisher’s photo looked suspiciously like that of a Teletubby running across the line.

The knee felt quite good. It was definitely different, though. At least twice a day the supporting bones around the knee seemed to click in and out of place— something I had never known before, and something quite disconcerting. Also, when the weather was cold, the knee would be almost too painful to bear. For some reason the cold weather really adversely affected it. After I ran a few miles, the pain would subside only to return when I stopped—only a hot shower was able to rid me of the grief. This, too, was very disconcerting.

All this aside, Boston 2007 was coming up, and my 2005 qualification was good to get me in. It was hard to think about requalifying, so I decided to ramp up the training and prepare for the spring race, in order to avoid requalification the following year.

So, on the first week of December, I embarked on Hal Higdon’s Advanced I program. I decided to do only one speed session a week (as opposed to the two sessions in the Advanced II program). Then, on the very first day of my new training program, I walked into my company’s changing room and there, lacing up his running shoes and donning a Boston Marathon jacket, was a man named Dean Jackman. Sometimes in life things just seem to “click,” and so it was on this fateful day for us both. Dean had run Boston twice and was a sub-3:10 marathoner, and since he was training for two local marathons scheduled around the same time as Boston, we immediately began training together. Lunchtime pace runs at work and early-morning Saturday long runs on the infamously steep North Turkey Trail of Raleigh’s Umstead Park, and the rest was history. We kept each

other motivated and focused on our training schedule through winter and into spring. More important, Dean somehow put up with my inane banter on earlymorning runs. By the time my new running partner/friend and I had finished 18 weeks of training together, I truly felt that I could not have been in better shape given where I was before the training. It was a lucky break for us both. The only negative was my inability to keep myself on a strict diet, and because of that I did not lose much weight. In fact, I was still 15 pounds heavier than before my Steamtown Marathon qualifying race.

However, before Boston I didn’t feel there was much more I could do. The nagging thought in my mind was constant worry over whether my knee could handle the course; in fact, my main thought was whether I could run any marathon course again. On Monday, April 16, 2007, I would find out.

Boston

Boston. Is there anything more that can be said of this event that hasn’t been said? Actually, I believe so, considering that 2007 brought with it some of the worst conditions the marathon has known in its hundred-year-plus history.

In the days before the marathon, there was an electric feel to the city—a real buzz I had not experienced at any other marathon or ultra. For me, it’s not just the history but also the fact that Boston faithfully requires all participants to qualify in a fairly challenging time (except for the several thousand charity runners and others who receive qualification exemptions). It’s what sets it apart from the others—most high-demand marathons turn to lotteries and charities as a way of filtering their entrants. I dearly hope Boston keeps its high standards in this regard.

For several days before the race, the national news services had latched onto the event after discovering a nor’easter would almost certainly hit the Boston area and most likely during the marathon itself. Race organizers sent out a weather alert to all runners the Wednesday before the Monday race. By Friday, the storm had packed a big punch through the Midwest and was causing havoc all the way up the East Coast. All the major media outlets prophesized a doom-and-gloom scenario for the race: “It could be the worst conditions ever experienced in the one-hundred-plus-year-old race.” The day before the race (Sunday, April 15) saw torrential rain throughout the city and high winds gusting well over 50 mph. It was not a matter now of whether the storm would affect the race but of how much it would affect the race. By Sunday night, the worst predictions were being touted: “heavy rain, 20- to 30-mile-an-hour winds with gusts of 50 to 60, temperatures in the 30s with the windchill in the 20s, and possible flooding on the course.”

After a sleepless night, I rose at 5:45 A.M. on race morning, not daring to look out the hotel window but instead putting on my race kit plus several layers of extra

clothes, topped off with a disposable rain suit. I took all the extra gear I could fit into the race bag including my race shoes, choosing to wear a throwaway pair of old shoes to the start area. On leaving the hotel to catch the shuttle to the subway, a gust of wind blew my cap clean off my head and through the parking lot. I was then, literally, blown several feet back by the wind. As rain pelted my head in the predawn darkness, I smiled knowing this would be an interesting day. The bus driver opened his side window and shouted to me, “Are you sure you want to do this? I can take you back to the hotel if you like.” I replied, “No thanks, I’m fine. Isn’t this what’s life’s all about? It’s a glorious day, glorious!”

Thirty minutes later | walked from the subway stop toward Boston Common to catch one of the school bus shuttles. Already about a thousand people had lined up quietly in the heavy, wind-laden rain, which made for a surreal scene. It took over an hour of torturously slow queuing up to finally board a bus, by which time Thad drunk the only small bottle of water I had chosen to bring with me. This would prove to be a big mistake.

Three hours after leaving the hotel, the bus crawled into the athlete village area in Hopkinton and then spent a further 10 minutes trying to navigate to the disembarkation area. I decided to leave the bus early and walk the final block or two, having already changed into my race shoes within the dry sanctuary of its confines. Most of the other people on my bus were running in wave two. Since I was in wave one, it already was time for me to walk a mile more to the starting line. I trudged through the athlete village and failed to find any water stations. Panic sank in on the realization that I had been up and about for over three hours, had drunk only one small bottle of water, and had no time to stretch or prepare. I had to find water if I was to have any decent chance of survival in this marathon. As I sloshed through the village, drinkable water was impossible to find. The only place I knew of its existence was in one of the two large, impenetrable tents that were jam-packed with people (and somehow had a deeper level of mud than the outside fields). I decided to take a chance and walk to the start, on the way changing into my race kit in the still-pouring rain before leaving my bag at the baggage drop. Things got better 10 minutes later at the start line, where I found a water table and immediately gulped several glasses of Gatorade with the hope that it wasn’t too late.

In the dozens of marathons I have run, I’ve never experienced so many goose bumps while standing in the start corral. The culmination of two years of preparation for this moment was now being realized. The thought of my condition almost exactly a year ago after knee surgery came into play as I decided I would push as much as possible on this day. The problems of the morning subsided. It was my own fault that I had not thought to bring extra bottles of water in case water was not available, and I should have risen earlier to catch the buses to Hopkinton and so given myself more preparation time. But none of that seemed to matter as I

The major media outlets
prophesized a doom-andgloom scenario for Boston
2007, saying “It could be the
worst conditions ever experienced in the one-hundredplus-year-old race”

stood in the 6,000-level start corral surrounded by well-conditioned athletes.

And so, with a surprising lack of fanfare, the 2007 Boston Marathon was started. By now the doom-and-gloom scenarios for the weather were dissipating. The heavy rain was backing off and the temperature heading toward 50 degrees Fahrenheit. Looking around, I thought that most people were thoroughly overdressed; I too was wishing that I had not worn a long sleeve.

I was expecting the first half of the course to be relatively easy, but the continuous rolling hills took their toll, and by 10 miles, my calves and thighs began to cramp—something that had never before happened to me in a marathon. I knew I was in trouble but continued to keep to my 7:30 goal pace quite well. Then just after mile 16, I finally came face to face with the infamous Newton Hills as I turned the corner at the Newton Fire Station. My first observation as I looked to the top of the first hill was of an American flag being blown continuously at full stretch. However, although the wind was troublesome the entire race—heavy full-frontal gusts up to 50 mph—my main problem was the excruciating pain from leg cramping. I believe the lack of prerace hydration coupled with being overdressed (I didn’t want to strip down further during the race because of the uncertainty of the weather) was the major cause of the cramping. In any case, pushing through the pain was certainly challenging—I had to call up deep-down resources to continue a respectable pace.

Finally finishing in 3:21:00 (1 second short of a Boston qualification time), I found that time quite satisfactory given the challenges of the day. But missing the qualification time by one second was hard to swallow. It was as if someone were saying to me: “We’ll allow you a good time for the race but will cut you short one second of requalifying to keep you on your toes.”

However, my comeback was complete and the Boston monkey off my back. I met with my wife and daughter after the race, and we later celebrated at Boston’s fine Aujourd’hui restaurant. While there, I established a new goal: a sub-threehour marathon.

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Summary

I am now extremely careful on all runs, constantly checking my condition and closely monitoring my knees and legs. Each run is considered important and has a distinct purpose, whether it be a recovery jog, a maintenance run, a long run, or speed work. Mileage and speed are increased sensibly—any hint of problems and I’ll slow down or skip the workout. Stretching is given a high priority, too; although Ican’t say that I stretch every day, I do a lot more than before my injury.

My goals too have changed. No longer am I really interested in running lots of 100-milers, seeking instead to run one or two high-quality marathons each year. This approach has given me other benefits. I feel fitter and more energetic than in the past. My highest goal is running into old age instead of chalking up the 50-states marathons. Continuing hard running after a significant injury collected during a 100-miler is not something I will ever do again.

If there is one piece of advice that I hope all runners reading this will take, it is to never take prescription anti-inflammatories and especially cortisone shots. As obvious as this sounds, fix the root of the problem without masking the symptoms and causing more damage. A runner caught up in the throngs of, for example, training for the Boston Marathon can easily succumb to the lure of an easy fix. Don’t do it! I learned the hard way and am grateful for a second chance. Also, if there is any

The author overcame the
odds to complete his Boston
comeback—and is still running
strong today.

Photo courtesy of Kevin Polin