Fitness life

Sunday Update

October 29, 2023

I didn’t mean to take an unusually long break from writing here, but it has been a busy call week and I’ve had a lot to process, so it was probably a good thing.

brain dumping onto paper helps

The concrete: My knee is definitely injured. It continues to lock and catch and hurt; going up and down stairs normally is impossible and I wake up at night from the pain. I can walk and stand, but every time I have to bend it there are problems.

I was able to get an MRI slot for Saturday night, and now it’s done and I am waiting on the results. If it is *not* a meniscal tear I will be surprised (though I’m sure there are conditions that could mimic the symptoms). From my recent searches, I have gleaned that some meniscal tears heal with PT and time; others require surgery. I am worried that the ‘catching’ symptom I have might put me in the latter category but I don’t actually know that (nor do I even know if it’s a meniscal tear).

The emotions: And so, I am in a bit of limbo. But I know it’s not great. I have absolutely let go of the idea of running a marathon anytime soon; I don’t mean I’m not sad about it (I’m sad about that, and a lot of things) but it’s not something I’m even trying to salvage because it doesn’t seem realistic.

Honestly, I’m pretty sad in general. I am reminded of how I felt when I had infertility (which also involved stopping running) and there is a lot of anger around not feeling ‘in control’ of my own body (as if anyone ever is!) and I’m just . . . low. I can do all of the life things still, but it’s like I’m wearing grayscale glasses. (It also 100% does NOT help that calendar-wise, I am squarely in PMS-land right now. Ummmm great timing.)

On the flip side, I have learned a lot since then and have more perspective and truly more positive non-running things in my life, including 3 human pieces of evidence that my fertility issues did not last forever. I already have reached out to a therapist (found someone who specializes in injured athletes!) and have started thinking of other things I can do with my time, assuming I will not be running any time soon.

I am also looking forward to starting PT as soon I am recommended to do so — I need to get diagnosis and find out what ortho says first — and learning what my path to recovery might look like. I am not going to try to rush it though. I hope I can find people who will give me very specific and thoughtful instructions because I know I would respond well to that (#upholder).

The next steps: I admit I spent the most of the past week in more of a wallowing state of mind. It did not help that I was also on call (I did feel rather sorry for myself walking around the hospital with pain). But I have deemed tomorrow (Monday 10.30) the day I am going to officially move towards acceptance. I will not try to rush the process and will focus on the things I can do, both to help with recovery and to ensure I am still enjoying life and not just “waiting until things are fixed”.

More on some specific ideas of what I will try to do/not do later this week.

Finally: I know some are wondering, “did this knee stuff happen in the initial injury, or with the fall when you attempted a speed workout 7 days later?”

I honestly am not sure. My guess is that it was brewing — I noticed the knee starting to do the ‘catching’ thing prior to my speed workout, but it was infrequent and seemed to go away when I changed the angle. And then I probably made it worse when I ran hard on it and fell. (My hand is 80% better by the way – at least something healed up!).

I do remember questioning whether it was okay because it hurt when putting on my shoes (!), but upon taking a few steps running, nothing hurt other than the superficial bruise stuff and my sore back muscle, so I went ahead with the marathon pace workout.

In retrospect, this was clearly a mistake and I OBVIOUSLY wish I hadn’t done this workout. Or any running. But I didn’t know, and I didn’t know what I didn’t know, if that makes sense. I do believe I would absolutely be more cautious with injury in the future.

But, I also don’t feel guilt/shame about it. I thought: these are bruises. This isn’t internal. My coach did not say not to run. My husband initially expressed some trepidations about running with pain in general, but then when my first few runs seemed to go okay, did not express specific concerns about the workout. I recognize that I am in charge of my own body, but I just didn’t know.

(Now I know.)

So, I am not going to dwell on what might have prevented this injury. It is largely unproductive and will remain a mystery anyway – maybe it was inevitable anyway and maybe it wasn’t, but since I don’t have a time machine it’s pretty irrelevant. The takeaway is that after going through something like I did, a conservative and thoughtful return to activity would have been a much better choice, and that will be my new philosophy and strategy going forward.


  • Reply carrie October 29, 2023 at 8:26 am

    Ughhhh. This is all so relatable, and as usual I am so thankful for your transparency, honesty, and vulnerability. It’s funny (not funny? perfect?) that your journal page says “one day at a time” – such a helpful approach to living through uncertainty. The other thing I would add is: “more will be revealed.” What the MRI reveals, what you will need vis a vis your knee, what is here for your to discover about yourself, your body, your limitations etc. This is not easy and you are doing it.

  • Reply Marie October 29, 2023 at 8:54 am

    So sorry to hear all of this – it is really challenging to have something that brings you such joy and a sense of accomplishment taken away from you (even if just for a while)! I’m dealing with something similar right now.

    Given your upholder tendencies – would now be a time to lean in to recovery/training-focused nutrition or something else running-adjacent? Sometimes training can be so time-consuming that it’s challenging to focus on both! Glad to hear you’ll be doing PT once cleared for it; that has made such a difference for me (physically and mentally) after injuries.

    Wishing you a complete recovery and many happy running days ahead!

  • Reply AnnaM October 29, 2023 at 9:13 am

    Sarah, I am so sorry. What a huge bummer. Of course glad you are okay but it’s okay to be sad about this too.

    Fwiw as someone with knee injury experience, I highly doubt the speed workout made it worse. It’s far more likely it just revealed an issue that was already there from the car accident. Let that one go! 🙂

    Looking forward to you crushing a marathon in the future.

  • Reply Kim October 29, 2023 at 10:34 am

    I just wanted to say I am so sorry. My daughter had a huge injury at 16. She landed on a log after jumping off a river rope swing. She broke her femur and pelvis. She was a cross country runner and lost an entire season. But she leaned heavily into PT and put all of her focus on it. She had to relearn to walk and then run. On the one year anniversary of her accident she ran a half marathon! She is running pain free about 30 miles a week now two years later as a college student. I do not think she would be the person she is without her accident. She is incredibly resilient, hard working, focused and has been able to share her story to help others. As her mom, I can relate to what you write here. I was devastated in those early weeks and found it difficult to get to acceptance stage, but she persevered and so did I! I wish you all the best in your recovery.

    • Reply Joanna October 29, 2023 at 10:59 am

      Thank you for sharing this – I (at age 38) broke my leg and tore my meniscus on 10/1 in an accident while chasing after our dog who got loose (she’s fine 😅) I feel like there is such a long road ahead but it’s good to hear stories from the other side

  • Reply omdg October 29, 2023 at 10:35 am

    Well, this totally blows. I know how much running means to you, and particularly your marathon training, and I can only imagine how you must feel right now. I do hope you don’t need surgery. Def let go of the guilt. You didn’t cause this to happen, you probably just made an existing injury from your accident worse. You’re pretty tough. You will get through this even though it sucks.

    *virtual hug*

  • Reply jennystancampiano October 29, 2023 at 11:09 am

    Ugh. I was holding out hope that there weren’t any actual injuries, but it does sound like there’s something up with your knee. I have no experience with meniscal tears, so no advice to give. You’ll obviously know more and have a course of action after the MRI.
    I know I already said this, but sometimes you just don’t know how bad things are until you try running. You had to try it out, I totally get it. You can’t go back and change it so you’ll just learn from the experience.
    I totally, totally relate to the feeling of wearing grayscale glasses. (I actually felt like that for the entire winter when I lived up north.) I think you’ll feel better when you can start PT- it always feels good to do SOMETHING, even if it’s not running.
    I also love the idea that you still need to enjoy life and not just be waiting for this to be over. The hard days are just as much your life as the great ones. I read Kim’s comment about her daughter’s injury, and how it made her the person she is. You’ll recover from this and go on to do great things, and look back on this as part of what made you the person you are. Hang in there- Monday is coming : )

  • Reply Lisa’s Yarns October 29, 2023 at 11:19 am

    I am sorry to hear this and hope that you can avoid surgery although that might be the fastest path back to health. I’ve had a lot of experiences with my body sort of letting me down from needing surgery on my hip (labral repair and reshaping of the ball joint of my hip) to RA and the myriad of issues that disease has caused. I’ve had to accept that my body is not as much in my control as I thought it was or want it to be. It does make me appreciate periods of health more, though. But what you are experiencing is really devastating as you were in such excellent shape. But you WILL get back there again. And you will have learned a lot through this process – even if those are lessons you wish you wouldn’t have had to learn. Reaching out to a therapist will be helpful. I hope you can find ways to move your body when you are further along in your recovery so you can get those endorphins!

  • Reply Grateful Kae October 29, 2023 at 11:44 am

    Sigh. I’m so sorry. I was also really excited to watch you crush your marathon because I feel like your training has been amazing and you’ve been running so fast. But, what can you do. This is just the way the cookie crumbles sometimes, unfortunately.

    About running after your injury…. I get it. As an outsider, it did cross my mind that maybe you resting longer was better. Or at least not resuming longer mileage right away. BUT, I 100% know that if I were in your shoes, I would have probably done the same exact thing you did. When I “was a runner” (back in the day for a few years), I know I got borderline obsessed with sticking to my training plans. I think it’s hard to remember in the moment that one run, or honestly even a week of runs, in the grand scheme of MONTHS and months of training, is really not likely to set you back at all. It can feel almost like a compulsion to check every single run off the list! Anyway, don’t beat yourself up. You did what I think many, many people would have likely done.

    Fingers crossed for the best possible outcome!! And use your new free time to browse those Pelotons online. lol. 😉

  • Reply Elizabeth October 29, 2023 at 12:18 pm

    Oh, Sarah. I’m so sorry. The unknown of what lies ahead and what your recovery timing and process looks like is so hard. You have written multiple times about doing everything in your power to avoid an over training injury, and you succeeded in that. But life still happened! UGH. I am so sympathetic. When I sprained my ankle at the end of March, I wore gray-scale glasses for days. It felt so frustrating. It is hard to have an emotional & physical well-being regulator taken away so abruptly and so completely. I think giving yourself time too wallow and then forcing yourself to move to acceptance and recovery is smart. Hang in there. I hope the news from the MRI isn’t as bad as you fear.

  • Reply Milly October 29, 2023 at 12:25 pm

    I hope your MRI shows you *just* need PT and time off. Sending all the good wishes there!

    I know buying a Peloton has surfaced a time or two on your blog…. I have one. I did the Sunny bike route with the app for 2 years and then I bought the actual bike 5 years ago. It’s by far the best thing I’ve ever bought, from a fitness perspective (still use it 5+ times a week)! If you find the idea of buying one floating through your head, maybe this is a good opportunity!

    It sounds like you have as positive an attitude as you can for such a crappy situation. You should be proud of yourself. This is hard and it just plain stinks.

  • Reply Paulien October 29, 2023 at 12:29 pm

    So sorry to read this! Just wanted to share my story to hopefully inspire you: I was training for my first-ever marathon last year, scheduled to happen mid-October before my 40th birthday. Training was going well, and i was loving it. Then one week before the marathon date i caught covid for the first time, and was really pretty sick with close to 40 degrees fever, cough and all that stuff. Obviously marathon did not happen.
    After getting better i started back up with running and krav maga (my other sports) and got covid again about a month later. And then again a month after that, and again a few weeks after that. I did not even believe it was possible, but this is at least the story the doctor and tests told me from testing positive and negative alternately a few times. Each time i had more fever, more cough and more trouble breathing, to the point where the last time between christmass and newyears i had to ask my father to go to the pharmacy for me in the night to pick up something to help me breathe because i had trouble with it.
    All this led to me not being able to even take a one km walk in january, and not able to do things like grocery shopping for myself. Now for the inspiring part: i got physical therapy twice a week, and slowly slowly slowly i got to do more. To the point where now one year later i can do sports again and am now running 10km regularly again. You will get there too!
    What helped me during that time:
    finding things i could do that were not physical, like building lego and puzzles. For you it might be other things.
    Accepting help with practical things i could not do, like vacuuming the house ( I had never been good at it but looking back i am so grateful to my friends and family for it and it made our bond stronger).
    Go out of the house to do things i could do sitting down, like have lunch or see a show.
    And i know it sounds cheesy, but focus on all you have that is going well and do make you happy. For me that was things like work, cuddling with my cats, practicing my flute more (as soon as the breathing issues where gone), and just simply appreciating the fact that i live in a country where physical therapy for this is completely free. For you that could be other things again.
    Sorry for the book-length comment, but hope it helps you feel better!

    • Reply Sarah Hart-Unger October 30, 2023 at 10:57 am

      thank you so much Paulien. YES this kind of thing puts a race into perspective. there are other things in life that are valuable. and no one race day or experience is ever worth risking health.

  • Reply Leneigh October 29, 2023 at 1:43 pm

    I’m so sorry Sarah wishing for good news for you on the MRI and a smooth recovery.

    • Reply Elisabeth October 29, 2023 at 4:08 pm

      I am so sorry that you’re going through this, Sarah. Obviously for the physical part, but even more so the psychological and emotional piece of it. Unfortunately I understand that part so well (if not the running), because I’ve been there. This is a long story (sorry!), but in the last four years, I’ve torn my left Achilles, suffered a heel fx from that repair, tore my right Achilles during rehab for that, tore that Achilles again during the first repair, and suffered a spontaneous left femur fx during the last Achilles rehab, all of which required surgical repair (including placing an IM nail, with resulting 12 week rehab unit stay). I’ve done a TON of PT and two years later, I’m still in PT due to the femur fx (but I’ve been so fortunate to have the same PT during all of it and he’s been the best thing that could have happened to me during this). Through all of it, the psychological piece has been the hardest part. There was so many questions with no immediate answers – how long would each recovery take, how long would I be in pain, would I ever be out of pain, how long would my Mom have to do so much for me, how would I support myself after I lost my laboratory scientist position during the femur rehab (they had to cut me after one year on leave), had I lost myself with the loss of my career, etc. I had already been seeing a psychologist before this started (PDD/MDD), and obviously continued to work with him (+ the psychiatrist he eventually sent me to), especially as my mental health got pretty bad during the worst of it. However, I really leaned into working on that and with their help, my Mom’s, my greatest friend’s and my PT’s, I have made it through all of it. I am now nearly as physically functional as beforehand and my mental health is much improved (especially after I accepted the same position in an adjacent lab department at the hospital). I am glad that you’ll have at least some answers after you see your ortho, are planning some other activities to fill your time, are asking yourself to be patient, and have reached out to what sounds to be a well-fitting therapist. None of it will be quick or easy, but you seem to be doing all of the right things to do the best you can in a bad situation. I’ll be thinking about you, sending hugs to you, and hoping for good answers. Please reach out if you ever want to talk about any of it.

      • Reply Sarah Hart-Unger October 30, 2023 at 10:53 am

        oh my GOODNESS you have been through truly the ringer. I am so so sorry about everything you have experienced. It sounds like you have build some amazing coping strategies and I will be thinking of you, too. Please keep me (all of us) updated.

    • Reply Elisabeth October 29, 2023 at 4:17 pm

      My apologies for inadvertently making this a reply (facepalm here)…

  • Reply Sophie October 29, 2023 at 3:09 pm

    I’m so sorry to hear you have to stop running and may have a long recovery, I’ve been following your running progress and cheering you in from afar. So tough adjusting to no running and being in ongoing pain right now, but impressed you’ve sought out an appropriate therapist and are being proactive about what you can do to boost your mental and physical health. Thank you for being so honest on the blog about all your emotions etc, you are so resilient Sarah- you’ll get through this. Thinking of you

  • Reply Noemi October 29, 2023 at 3:16 pm

    Wow, so many comment already. I just wanted to say that I’ve been thinking of you so much since your first injury. You and I are so similar I think in our expectations of our bodies and our desire to push through healing times. Reading today’s post my heart was sinking for you. I’m so sorry you need to take an indeterminate amount of time to work through this. I know I would handle that uncertainty very badly.

    I do hope that once you get a diagnosis and start PT that things feel better. That at least you’ll have a plan to start and that working towards those first goals will help you feel more like yourself.

    As you know I’ve had some nondescript pain in my lower back and the side of my leg for a while now, and I think I finally went to get it checked out so I could start PT and have someone tell me what to do. When left to my own devises I will ALWAYS just keep pushing myself. I need someone who knows my specific issues to tell me what I should do, otherwise I’ll just keep pushing. I hope the MRI results give you some clarity on a path forward.

    Thinking of you so much!!! {{{HUGS}}}

    • Reply Sarah Hart-Unger October 30, 2023 at 10:56 am

      thank you Noemi – I definitely think PT is a good idea for you and I SOOO agree with being told what to do. It also takes honestly about what you are feeling and I think I was minimizing my pain so that my coach (who is virtual) didn’t know to tell me to STOP. I also had access with Active Release Technique in the past which I believe some PTs (I had it done by a chiropractor many years ago but I think other movement specialist like PTs can do it as well).

  • Reply coco October 29, 2023 at 5:51 pm

    I started to wonder how have you been since you didn’t post for days. I know it must be hard to process these feelings and you are doing it so well… in the sense that you acknowledge your feelings, let them be, observe them as long it’s needed, and ready to move on when they are ready. I often try to rush through those feelings, just to get over with it, but deep down I know it means they’ll linger for longer. So kudos to you for doing it rightly, I wish I can be this wise.
    I haven’t run 10 days and honestly it was not the end of the world… I know… I realized that I can be as lazy as a cat, doing zero activities for a long time, and probably wise to do so as I’ve put a lot of stress to my body with so many miles. Rest is needed and often overlooked by runners as we get anxious when we can’t run. The pause is good to realize that running is hobby, not necessity as much as I thought it is.
    Hope you figure out the diagnosis soon and have a path way to recovery.

    • Reply Sarah Hart-Unger October 30, 2023 at 10:52 am

      that’s a great point + reminder coco. Thank you <3

  • Reply Sarah October 29, 2023 at 8:57 pm

    I am writing this from urgent care – I fell off my horse this morning and am checking for any facial fractures. Earlier this week I was not feeling great, and I can’t help but think my fall may have been a result of pushing myself. But – I know that is the price of having a hobby that brings me joy and meaning beyond my roles of wife/mom/career woman/daughter.

    I agree with everything you wrote: it’s fruitless to try and figure out which incident caused the injury. Ultimately, if you were not someone who occasionally pushed through discomfort to prioritize your hobby, you would never be training for a marathon in the first place!

    I know you will come out the other side much stronger (in every sense) and with a deeper gratitude for running

    • Reply Sarah Hart-Unger October 30, 2023 at 10:52 am

      oh my goodness – thinking of you and hoping your face is okay!! scary but i get you wanted to keep doing what brings you joy. 100% get it.

  • Reply Helen October 29, 2023 at 10:14 pm

    Yeah the catching makes me think surgery as well, unfortunately. My daughter had an injury and I had done some reading and saw most times surgery isn’t necessary unless something is actually in the way. Because they don’t even repair the tear is my understanding, just shave off things in the way. Best of luck whatever the outcome!

  • Reply Alison October 29, 2023 at 10:55 pm

    Awww, I’m lamenting this unfortunate situation with you. How incredibly disappointing to have worked so hard and not be able to race right now. Sounds like you are properly acknowledging your feelings and I hope that helps with the acceptance. I have no doubt you will get back to this fitness level once you are recovered and be able to rock your next marathon, even if it’s further in the future than you had planned.

  • Reply KGC October 30, 2023 at 6:32 am

    I’m sorry this happened to you. I am finally coming back from a plantar fascial tear that sidelined me from any real running for close to 2 years. I have done many rounds of PT (with different providers), dry needling, shock wave therapy, and plasma-rich growth factor injections and finally something in that mix seemed to do the trick. But I was VERY UNPLEASANT to live with for a long time when it became clear that I would have to stop running entirely to heal, which was something that no provider told me from the beginning (“Sure, you can keep running,” they said. “As long as you work on PT and cut back a bit, you shouldn’t have to stop entirely,” they said). False, for me.

    I do really think that runners have a mental block about rest and I have a totally different perspective now that I was forced to stop entirely for a time. I hope you will continue to view this as a pause or just a different season of life, because it is. The highest likelihood is that you will eventually heal and run again but it may be a months or a year, rather than weeks. In the meantime, the hard part is finding the alternative to running since it is really difficult to re-create the endorphins!

    Lastly, I am really starting to think that there’s something to a really good gait analysis and consideration of footwear for running. I won’t get into it here (because controversial) but if you were having some knee issues even before this all happened then there might be something there to work on to maximize the potential of being a lifelong runner. Best of luck!!

    • Reply Sarah Hart-Unger October 30, 2023 at 10:51 am

      my heart goes out to you experiencing all of this!!! and I HATE when drs say “oh yeah you’re fine” and it might not be the case. I had a sports med dr tell see that in ~2008 and no, I was not remotely fine for a long time and the false hope did not help. very much hope someday you will find the right thing that will work and/or a great alternative!

  • Reply Miriam October 30, 2023 at 8:33 am

    I am so so sorry. My heart breaks for you! Hoping for good news from the MRI and the best possible trajectory ahead. Much love!

  • Reply Elisabeth October 30, 2023 at 8:52 am

    I’m sorry – for all of this, Sarah. Wishing you a speedy recovery and lots of love and grace and rest.

  • Reply San November 3, 2023 at 8:13 pm

    I am so sorry, Sarah that this will take a bit longer to heal that you expected. Patience is hard when all you wanna do is the thing that you can’t do, but you’re approaching it with grace.

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