Back to marathon running having been written off at 54

Mark Burrell

I am a marathon runner, but I thought I couldn't run based on what my surgeon told me in 1984. When I met my partner, Debs, things changed...

We talked about our pasts and exercise and how she had done some half-marathons and would like to do so again. That was November 2012 and in March 2013, with me aged 51, we ran the Fleet Half Marathon, and I went from no running to 1 mile to 5km (Wycombe and Basingstoke parkruns) to 10km and 13.1 miles in training!

At school I was an over-weight lad who hated running! However, as I grew up I shed the pounds and was racing 100cc karts in my early 20’s. It was whilst racing them at a circuit in the Cotswolds that everything in my life changed when I had a double end-over-end roll at 90mph coming into land on my badly twisted ankle! The short version is that not only had I broken my ankle and had two legs that were just individual single bruises but I had damaged the blood supply to my foot so the bone was in plaster, but not healing.

The orthopaedic surgeon spent quite some time deliberating whether to remove my foot but I wanted to wait and see if it healed itself. There was no operation that would fix the blood system so I just had to wait and, after 5 months, my body healed itself! After 5 months on crutches my left leg was akin to a pipe cleaner and had no strength at all. I had completely forgotten how to walk, so I had to teach myself in my bedroom and did, whilst falling over a lot. Going upstairs was a new found but easy but tiring skill. Going downstairs was a much scarier skill, indeed, as I found that you had to tip your centre of gravity forward and essentially “controlled fall” to drop your feet from step to step. So, I went downstairs backwards for an awfully long time. Remember that surgeon? He told me to “…never run again as your ankle won’t take it…” - so, essentially, for 27 years or so I didn’t. And then it all changed and Debs encouraged me to take up running… to half marathons and I kept saying that I wouldn’t do a marathon, but I have now done 4 and two ultra-marathons (50km and 60 miles!). And, I hadn't looked back since until my recent knee injuries!

My left knee injury

I injured my left knee in December 2012, when I tripped up a kerb when running, and then the next day I just bent down to stroke a dog and "bang!!!"

The left knee had troubled me on and off since December 2012 but the discomfort was intermittent and a flare-up usually took me to my physio (Vicki Styles at The Body Reset Clinic at Hartley Wintney) for some 'maintenance' and some KT tape support as required. All worked well for the London and Berlin Marathons in 2015.

Between the London Marathon April 2016 (where it was absolutely fine) and the Edinburgh Marathon May 2016 the knee became more and more painful and I could not run reliably or for a guaranteed distance or pace. Finally, the left knee went "bang" at the end of a sprint intervals session. I ran the Edinburgh Marathon using a run/walk technique of 8.5 mins run/1.5 mins walk right from the very start, although I still managed to complete it only 25 mins outside my marathon personal best!

The left knee just got worse and worse, first I couldn't run, then struggled to walk, then even massively painful just to stand on it.

This was May 2016 and the initial diagnosis was a Medial Collateral Ligament tear, so all the physio work was geared to fixing that...I ended up with three physios at the practice working on it (expensive!!!) as they were frustrated that the MCL was not responding. Then one said, having done tests like McMurray's again, that it was actually a suspected cartilage tear where the flap was poking into the back of the MCL and aggravating it, so it would never respond! MRI and X-Rays confirmed this.

By June, I had heard about Prof Wilson through running friends in clubs around Basingstoke, so I investigated and checked that my insurers would cover his work at both BMI Hampshire Clinic and Candover Clinic. I first saw him about this left knee in June 2016 with initial treatment involving a cortisone injection to take the swelling away, through physiotherapy and eventually an arthroscopy on 26th September (the long timeline mostly to satisfy my insurer that we’d tried everything). It was tortuous to get to the Op as my insurer had written me off as old and decrepit at 54, not worth operating on despite my potential for recovery!

I really worked the exercises hard and was back walking within days and running short runs on grass within 5 weeks, but then the right knee intervened just as we thought things were sorted with the left knee, I popped up again with a new problem in the right knee and went through the same process again!

My right knee injury

My right knee had never caused me or my physio any issues, trouble or pain. But in October 2016, only three days after Prof Wilson said I could start running on grass again after all the issues with my left knee, I was two miles into a run at easy pace when the right "blew" without any warning at all - well just three paces of warning - leaving me with a catastrophic medial meniscus tear, identical in many ways to the left but more sudden and worse.

The event was on Saturday, then I was back in to Candover Clinic for MRI scan and X-rays - and I saw Prof Wilson on the Wednesday!

The investigations showed a flap tear of the medial meniscus. I needed an arthroscopy to allow the torn flap to be removed and other areas of the tear abraded. All the ligaments were in good condition. But besides the meniscus tear, joint cartilage on the outer side was in great condition, but my leg alignment was putting pressure on the inner side of the joint and damaging the joint cartilage there. Prof Wilson talked about doing leg re-alignment to take the stress off that medial side, but I really didn't fancy that, so we moved on to a simpler, albeit 'invasive' approach and I opted for another arthroscopy, with all the insurance company bother that caused Prof Wilson and me.

Was my running all over?...

At this stage, with my insurers really not wanting either of the knee arthroscopies, even though I was a relatively fit marathon/ultra runner and bloody minded/dedicated enough to really work the recovery hard!!

When the right knee blew, Prof Wilson knew what to do and the same initial process was followed, and I had another arthroscopy on 29 November 2016.

He found a flap tear of the medial meniscus which you can see in the left photo here. In the first photo it does not look so bad because the tear had reduced and was no longer displaced. But when he put a probe underneath the meniscus and displaced the damaged bit (see the middle photo), you could really appreciate the extent of it. After trimming away the displaced bit, I was left with a cleaned-up meniscus rim (right photo). If you are not squeamish you can see the procedure in the video in the right sidebar.

medial meniscus tear
medial meniscus tear
meniscus tear cleaned up

Medial meniscus tear

Medial meniscus tear

Medial meniscus tear cleaned up

After the left surgery and with a newly damaged right knee Prof Wilson told me " is damaged, don't worry about doing more damage, just carry on running if you can..." He reassured me that it was not the end of my sport and that he could deal with any consequences.

I was running again after 4-5 weeks, and with the work at the gym the right knee was immediately back strong, in line and reacting well to physio work and training. However, the left started to niggle again in January and I had a further cortisone injection from Prof Wilson to remove the swelling. This worked, partially, but I still had swelling and the left knee was stiff and felt like it needed "oiling" with some “3 in1”! So, 6 weeks ago I had an OSTENIL injection from the Prof that worked over the next week and has allowed me to run 3-4 miles around every other day as I start to build my running mileage and intensity back up.

Now I am happy to be back running and soon to be seriously training for the Berlin Marathon in September and the Chicago Marathon in October this year.

Follow-up from Mark October 2017...

"I can't say thank you enough. Last September and November you sorted my cartilage tears in both knees so well that I have just...
- Done the Berlin Marathon
- The Basingstoke Half Marathon
- And today the Chicago Marathon.. in relentless sun and 84degree heat! In successive weekends!
All down to your skill, and my bloody mindedness!! Happy and ready to do any testimonials you'd like, any time, anywhere."

Below is a video taken during the arthroscopy on my right knee.

Sometimes it becomes a bit unclear as the surgeon moves the instruments to different parts of the knee, but the rounded bit at the top is the rounded end of the femur. You can see that there is an area of damage to the cartilage, where it is a bit 'shaggy' rather than firm and smooth.

Underneath this area you can see the flap tear in the meniscus. Initially he just cleans it up a bit, but then uses the probe to reveal the true extent of the damage!

The torn bit is then cut away, and the meniscus edges cleaned up. So I still have a rim around the outer edge of the meniscus.

Mark Burrell

Neither knee hurts now in terms of pain, but I can "feel" them, so am conscious of them when running, but much of that is about rebuilding the muscle structure (especially my weak left quad) to provide the support the knees require. So, ongoing running, gym work and physio work for me!

Oh and here's a nice bit of date alignment -

26/9/16. Left knee arthroscopy
24/9/17. Berlin Marathon!

Mark Burrell

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