If it Ain't Broke, Fix it!

Why I Train 20 Hours a Week and Still Plan to Have Knee Surgery

If it Ain't Broke…

Last week, I trained for over 20 hours. And it was wonderful! Cycling, running, and strength training. Physically, I'm obviously in good shape. And yet, despite being so active, I'm considering knee surgery.

Yes, you heard me. I'm on the verge of having my torn meniscus surgically repaired, even though I'm more active than I've ever been in my life. To anyone who doesn't know the whole story, it probably sounds absurd. But to me, it seems more and more like the only logical thing to do.

A Not So Bad, Bad Injury

Four months ago, I was diagnosed with a torn meniscus in my right knee. But it quickly turned out not to be a catastrophe. No sharp pain, no swelling, no immobility that sent me to the couch. My knee just felt... "off". You know that annoying feeling when something just isn't quite right? That's what it felt like, and still does. A mechanical, lingering discomfort.

So I did what any smart, self-respecting endurance athlete would do in this situation: I doubled down on conservative therapy. Rest, physiotherapy, specific exercises, foam rolling, alternative sports (hello cycling!) and, after a few weeks, a cautious introduction to running. It worked. In fact, my knee has improved to the point where I'm back to running 50k weeks, and even faster and longer runs are possible.

But here's the kicker - the knee just doesn't feel alright.

The Constant Buzz of Discomfort

After every run, I still feel that nagging sensation in my knee. It's not debilitating, but it's there. Imagine a low hum that you can't turn off, just loud enough to annoy you, but not loud enough to stop you getting through your day. That's my knee.

Except for a few particularly bad days, I have been able to ignore it. I've got used to it, to this new normal of being active but with a strange feeling. However, underneath, it's nagging. A constant reminder that something isn't quite right, that my knee isn't the same knee I had before the tear.

That's where my conflict comes in.

The Mental Tug Of War

On the one hand, I'm experiencing an athletic high. Training 15-20 hours a week isn't something I take for granted. My body is holding up, and often I'm not even aware of my knee when I'm running, let alone when I'm on the bike. I really enjoy the endorphins, the thrill of speed, the sweat - they all make the knee issue seem insignificant. At least while I'm out there.

On the other hand, I can't shake the feeling that I'm pushing my luck. That the knee could be a ticking time bomb. Or worse: A never-ending story. It's frustrating and, frankly, exhausting. Knowing that I could go on like this for months or even years – always fit and active, but never feeling quite whole – drives me mad.

The Hope of a Clean Slate

That's why I'm considering an operation. I don't need it to run, cycle or lift weights. But I need it for peace of mind. I need to know that I'm fixing the problem and not just dancing around it.

There's a part of me that believes that by tackling the problem head on – by going under the knife – I'll be able to dive fully into the next chapter of my running life without the constant, low-level worry about my knee.

The Long-Term Vision

Surgery isn't a guarantee. I know that. There's always the risk that it won't fix everything, that the recovery will be longer or harder than expected, and that the removal of parts of the meniscus will cause other problems later on.

But the alternative - carrying on with this ongoing unease and mental friction - seems even worse. I would rather not keep managing an injury when I could potentially move on from it.

So what's the plan?

Ask the Levelhead! Of course, he has thought this through dozens of times and has now come up with a plan.

First, I'll get a new MRI report. The last one was when the injury was fresh and acute. A lot has probably happened in the four months since then, and a recent MRI is a better basis for a surgical decision than an old one. It might also help to see how the mechanical irritation in my knee is happening and whether it is harmless or whether I am wearing away the cartilage bit by bit (which would be bad. Really bad.).

Secondly, I will discuss the new MRI results with my orthopedist. He encouraged me to try conservative therapy (as did my physiotherapist), but also said that if there was no progress after 8 weeks, surgery should be considered. 20 hours of training can probably be considered 'progress', though.

And then, I will also discuss the new MRI findings with a knee surgeon. He has a different view of the situation and can weigh up the risks against the benefits of surgery better than anyone.

All this will take place in October. If I decide to have the operation, it will probably be in December or January. If I get the green light from my orthopedist and/or surgeon to continue training, I will do so. Because I am not in an emergency situation. But I don't want to be complacent either.

That’s my plan. What would you do?

---

Everything Not Running

Most of you already know, but joy compels me to mention it again: Hundert-Meilen-Herz, my second first book, has been in stores since this week.

Of course, on the day it was published, I went straight to the nearest bookshop to see if it was on the shelves. It was.

But that also means it's your turn! If you speak German, then get Hundert-Meilen-Herz. If not, then Runhundred is the book for you. The story is the same in both cases, namely what happened to me at the legendary Western States 100 and why that race changed my life.

You can get both books from Amazon, Willpower and anywhere else they sell books.

You will love this story. I promise.