By Tom LeCarner
After my last fit session, I rode several times with my new saddle, new pedals and new position. I felt good, but I was still feeling that all-too-familiar burning sensation after about 90 minutes of recovery-pace riding. I was beginning to get really frustrated. I thought that I had plateaued and really wasn’t making any improvements. I decided to take a few weeks off the bike; the decision was partially my own, and partially dictated by my schedule — final exams were coming up and I really had no time to do anything but grade my students’ work.
After two weeks of couch surfing, I had set up an appointment with Andy Pruitt to get a second injection of cortisone. The first one worked quite well, but the pain had moved up slightly and I wanted to have another injection to jump-start the healing process in that area of the knee.
The thing about cortisone is that you have to know precisely where the pain is coming from in order for the shots to do any good. Since it had been a couple of weeks since my last ride, I couldn’t really pin point the exact location of the pain. So, on the day of my appointment, I woke up at 6:00am and went for a ride. My sole intention on that ride was to go out and actually make my knee hurt; I brought a Sharpie pen in my jersey pocket so that, when the inevitable pain came, I would be able to mark it for Pruitt’s needle.
I went out slowly to warm up and then started to really hammer — well, hammer as much as one who has been out of form for nearly a year can. I kept on pounding the pedals, standing up on little riser climbs, sprinting through traffic lights before they turned — nothing — no pain. I rode for 75 minutes and when I got back to my house I was astonished; I was pain free. Typically after a hard ride, if my knee didn’t hurt while riding, it would be sore afterwards, not today. Here I was meeting with Pruitt in three hours and I wasn’t going to be able to tell him where to put the needle. I was partially elated that I was able to ride that way without pain, but also a bit frustrated. It was like when you finally take your car to a mechanic and it stops making the noise it has been making for weeks — frustrating.
After chatting with Pruitt about my morning ride, he was immensely encouraged by the news. I was cautiously optimistic at best. I didn’t want this to be a fluke. So we agreed that I should go out after a rest day and try it again to see what happens. So I did. I rode hard for 75 minutes, some rolling hills, some sprints out of the saddle — nothing. I felt great.
With two pain-free rides under my belt, I decided to put the knee to a slightly more rigorous test; I scheduled a ride with some friends that Sunday. Now riding with this particular group isn’t like riding with the crew from VeloNews mind you, but whenever you ride with others, you push yourself a little more, so I knew this would really challenge me and my knee.
I rode for about 90 minutes that Sunday and really pushed. We did a course with some rollers and we were keeping a decent and respectable pace of about 19mph. While the knee felt a bit swollen afterwards, there was, again, no pain on the ride or afterward. I iced it for about 15 minutes and it was all good. But the real test was yet to come.
Each year for the past four years, after final exams, I have gone to Fruita, Colorado for a few days of mountain biking bliss. This year was no exception; I was set to go for four days of mountain biking with my girlfriend, who is new to mountain biking. I knew that I wouldn’t be doing anything too treacherous, given that this would be Laura’s first real mountain bike trip, but I was still apprehensive about the whole thing. After all, I hadn’t ridden four days in a row in almost a year — not even on a trainer, much less on singletrack.
We got to Fruita at about 3:30 in the afternoon and went out for a quick afternoon ride to loosen up after the four-hour drive. I felt great, but the ride was short — maybe an hour long. The next morning we did a trail called Chutes and Ladders, which is a great mix of singletrack and tricky, rocky descents with steep, but short ups. We combined that ride with two other loops that day and were out for a total of about four hours — the longest I had been on a bike in seven months. My knee was holding strong, no pain, no swelling, nothing. Was this real?
The same held true for the next two days; we rode hard in the mornings for 3-4 hours and I never once felt that burn that had become so familiar to me, like an old “friend” whom you never really liked, but who always showed up at the wrong time to ruin the fun.
I’m back home now and for the first time in a year, I feel that I can say with confidence that my knee has healed. I’ve been on five hard road rides and a four-day mountain bike trip and haven’t felt the slightest twitch of pain. Yes, I’m back.
I began this project in November of last year. I was going to see a famous sports medicine specialist in one of the best facilities in the world for sports injury rehabilitation; I was filled with confidence and determination to get back in the saddle as quickly as possible. Perhaps it is because of my inherent impatience that my year-long recovery was so particularly agonizing for me. Prior to this, I had never had any sustained injuries in 15 years of cycling; I was lucky. Sure, I’ve had my share of falls and the inherent scrapes, road rash, bruises, but never anything that would keep me off the road or trail for longer than a couple of weeks. This time it was different. I wasn’t bouncing back like I had always done in the past. The knee kept on hurting; I kept on riding. I was stubborn, I was impatient and based on my past; I just knew that this thing, whatever it was, would clear up sooner rather than later. I was wrong.
I’ve learned a lot about injury and rehabilitation during the last year. I’ve learned that an improper and hasty diagnosis can turn a relatively benign sports injury (tendonitis) into something far more serious and debilitating (bursitis). It is essential that, if you’re having pain anywhere as a result of cycling, you see someone who really knows what they’re doing. Avoid your general practitioner; while she may be quite capable of diagnosing your tonsillitis, she very likely won’t know the first thing about your tendonitis. See a specialist. That’s one lesson I’ve taken from all of this and feel compelled to pass along.
Another lesson I learned is about bike fit. I did all the right things when I bought my bike. I went to a reputable shop, with an expert fitter. I ordered a custom made bike just for me and for a while, it was great. But you have to remember that just because your bike fits you well now doesn’t mean that it will a year from now. Your body changes with age, your muscles tighten and your fit must accommodate those changes or you risk injuring yourself. You need to get re-fit once a year to ensure that what was once a good fit continues to be so. I failed to do that and paid a very dear price — a year off the back.
I’ve also learned that rehab for serious injury takes time and patience. From the time I was properly diagnosed and started my program about Boulder Center for Sports Medicine, it took me six months to recover. If you find yourself in a similar situation, don’t rush it, take the time to do exactly what the physical therapist tells you and be patient; you won’t want to; you will convince yourself that you’re ready to go back out — you’re not. Listen to your therapist; I made a few of those mistakes along the way and it likely lengthened my recovery period by a few weeks.
I would like to extend my most sincere gratitude to Andy Pruitt, Sean Madsen, Tami Dick, and the entire staff at BCSM. Without their generosity and expertise I would not be where I am today; I’m confident of that. Additionally, I would like to thank my long-time friend Chris Matthews at Specialized Bicycles. I was supposed to ride the TransRockies race with Chris last year and while training for that, I developed this injury. It was Chris who came up with this entire idea and donated all of the Specialized equipment; your support and generosity cannot be measured; I’m forever indebted to you. Maybe next year we’ll try the TransRockies — or maybe something a bit less arduous first. Baby steps.
Lastly, I would like to thank all of the readers of this column. I have received many letters of encouragement and advice over the last six months and I appreciate all the support you have given me. There will be two additional columns for this project: the first is a 3-D fit session for my mountain bike, which many readers have enquired about. And the last column will be a feature story on Andy Pruitt and his background and history; please stay tuned for those, and I will see you on the road. Thanks for reading.
Editor’s note:Tom LeCarner, VeloNews’ copy editor, is a 41-year-old longtime cyclist and former racer who has been struggling with tendonitis this year. Specialized has offered to help Tom overcome his injuries with its Body Geometry equipment and treatment by Andy Pruitt of the Boulder Center for Sports Medicine. Tom will report on if and how he progresses in a regular column on VeloNews.com.