Editor’s note: Tom LeCarner, VeloNews’ copy editor, is an avid cyclist who has been unable to ride and train for most of 2008 because of knee pain. He is being treated at the Boulder Center for Sports Medicine, using Specialized Body Geometry equipment and services at Specialized’s expense and reporting on his progress in regular columns.
Unhinging my Indy Fab from the trainer and emerging from the basement three weeks ago was surely a highlight of my winter season (if you can even call it a “season”). But, alas, after nearly two months of the basement doldrums, I was given the green light to get back outside. Given the bipolar weather patterns of Boulder, Colorado, I knew it was only a matter of time before I’d get a sunny and (relatively) warm day. That day came, and with the excitement of a young boy on his first Schwinn Sting-Ray, I kitted up, grabbed my helmet and shades and headed out for what I was certain would be a “casual spin.”
Of the many lessons that I have learned during this nearly year-long injury ordeal, the most important one is what we in my Tae Kwon Do class refer to as In Neh (pronounced ee-nay), which translates as patience. Yes, patience is something that I have historically had very little of. So, with that profound lack of patience I set out on an almost completely flat ride of about 15 miles with almost zero wind — an ideal scenario for my first ride outside.
The first four of those miles are almost entirely downhill. So, I soft-pedaled at about 24 mph down the hill until I reached the flats. Just then a group of kitted riders from a local club turned up the same path I was about to go on, so I jumped on the back and thought I’d catch a little draft from the group—no problem, they were cruising moderately at about 19mph.
This went on for a few miles on beautiful flat roads through sunny Boulder, and as I rounded a corner, that all-too-familiar burn crept up in my knee—like a prodigal son, the same burn that had been noticeably, and wonderfully, absent from my basement rides for weeks was now back in force. Why now? Why on my first outdoor ride? I was pissed. I pulled off, sat on a bench for about 15 minutes and stretched my hamstrings — and sulked. I got back on the bike and rode home with my tail between my legs at about 13mph. Oddly, the pain was absent on the ride home.
At my next physical therapy session I reported all this to Tami, my physical therapist, and she (predictably) reprimanded me and informed me that I need to redefine the entire notion of “soft pedaling.” Gone (for the moment) are the days of averaging 21-23mph on three-hour weekend rides. Recovering from pes anserine tendonitis is a lengthy process — as long as a year depending on how severe the injury; apparently mine is pretty severe.
While there are myriad opinions on how to define training zones, the following descriptions are somewhat typical:
Zone 1: 60-65% of MHR (Maximum Heart Rate)
Zone 2: 65-75% of MHR
Zone 3: 75-82% of MHR
Zone 4:82-89% of MHR
Zone 5: 89-94% of MHR
Zone 6: 94-100% of MHR
With each of these zones, there is generally a written description about how you should “feel” while you’re in that particular zone — phrases like “high volume, low stress” or “developing aerobic capacity” or in the higher zones, things like “high intensity lactate threshold training.”
Well, when you’re on the road to recovery after a repetitive-use injury, you come to understand that those zones no longer apply to you. Indeed, I have been given an entirely new set of training zone definitions to help me stay on track and reduce the risk of reinjuring my slowly healing knee. If you’re reading this and are having similar issues with your knee or other critical cycling body parts, you might want to consider paying close attention to these new definitions.
Keep in mind, these are actual descriptions given to me by BCSM. There is no heart rate associated with these, but if you look at the descriptions, perhaps you’ll see why:
- ZONE 1: Recovery – warm up, cool down
- In this zone, you are embarrassed to be seen doing this in public.
- Going nowhere fast
- ZONE 2: Over distance – improve aerobic efficiency and endurance, burn fat.
- Feels too easy to be getting any possible benefit from this.
- conversational pace
- doing a workout and not feeling tired at the end
- ZONE 3: Endurance – moderate effort
- Feels like training
- Still able to communicate well, though noticeable breathing
- Steady sustainable workout.
These are the first three of five zones that are listed on my sheet. I am not allowed out of the first three for the moment, which is to say I’m stuck somewhere between being “embarrassed to be doing this” and “feels like training” depending on the day. Nice. Nothing like riding a $9,000 custom bike and having a 67-year-old retiree on a recumbent blow your doors off.
I’ve been allowed these three zones and that’s where I’m staying. Just being outside for the moment is reward enough. I have progressed some since that first ride. In six subsequent rides I have increased my distance by roughly 10 percent each ride (another wise guideline), so I’m up to about 24 miles now, without any pain, but still maintaining an average speed of about 14-15 mph. Yes, it’s slow, but hey, I’m outside and improving slowly; that’s what matters most. I tried standing on the pedals once, on a slight uphill rise, and that didn’t go over well with my knee either. I sat back down, and all was fine.
My therapist has been giving me a number of at-home exercises that help to strengthen and recondition the tendon and I’ve been doing those, as well as the stretches found in my last column. At this point, I won’t be going to PT weekly anymore; we’ve cut down to twice monthly. I’ve reached a critical point in my recovery; I will work from home on my routine, slowly build my miles back up, icing my knee for 15 minutes after each ride, whether painful or not, but I will continue to get my weekly deep-tissue massages.
Also, I am going back to see Andy Pruitt next week to consider whether a cortisone injection might be appropriate to jump-start the healing and provide some relief, which might allow me to actually stand on the pedals a bit sooner. The issue with injections in the early phase of recovery is that the pain is often diffuse, which is to say spread out over a large area, and finding the “right” place to inject proves impossible. At this point, however, the pain is in an area about the size of a quarter, so it might be a good option for me now. We’re also kicking around the idea of dry-needle therapy, which, from what I’ve heard is as painful as it sounds, but apparently provides some excellent trigger point relief for injuries like mine. I’ll keep you posted on that one.
So that’s where I am. I’m doing exactly as I’m told. The upshot of this is that I can ride with my girlfriend, who is less experienced than I am, and she never feels like she’s holding me up. In fact, she pulls me up hills on occasion now — the proverbial silver lining, I suppose.
I am forcing myself to learn In Neh as quickly as possible — and yes, I recognize the irony in that. See you on the road.