MRI results

 I got the MRI findings for my left knee which has been terrible since racing the 5 mile last month. I’ll be seeing my ortho on Monday to go over this and figure out what is next. I’ve been running and so far it hasn’t gotten worse and maybe even a little better after the Medrol dose pack and the topical anti-inflammatory drugs. It feels okay while biking and maybe even a bit better post-ride (blood flow with no impact may be the reason for that). Findings in RED and then results from Google on what it means.

 

FINDINGS:

Medial compartment diffuse high-grade (predominantly) chondromalacia.

Medial compartment: The inner side of your knee where your thigh bone meets your shin bone.

Diffuse: The damage covers a wide area rather than a single isolated spot.

High-grade: Advanced damage (typically Grade 3 or 4), meaning deep fissuring or near-complete loss of cartilage down to the underlying bone.

Chondromalacia: The softening, breakdown, or deterioration of joint cartilage

 

Medial tibial rim microfracture with rim edema.

Medial Tibial Rim: The inner edge of the top of the shinbone (tibia) where the knee bears much of your body's weight.

Microfracture (or Subchondral Insufficiency Fracture): A tiny, stress-type fracture just beneath the smooth joint cartilage, often caused by repetitive pressure, minor trauma, or underlying joint wear.

Rim Edema: Swelling and fluid buildup in the bone tissue right around the fracture line, indicating a recent or actively healing injury.

 

Thin medial meniscal tear primarily affecting the outer margin, along the capsular attachment, sparing the free edge. May require probing at arthroscopy to appreciate.

Outer Margin / Capsular Attachment: The meniscus is a C-shaped piece of cartilage that acts as a shock absorber in the knee. The outer margin is the part anchored directly to the knee joint capsule. This area has an excellent blood supply compared to the rest of the meniscus, giving it a high potential to heal if properly stabilized.

Sparing the Free Edge: The "free edge" is the thin, inner rim of the meniscus that extends into the center of the joint. Because this inner edge is perfectly intact (spared), the main body of the meniscus still looks normal from the inside of the joint.

May require probing to appreciate: Because the tear is hidden far back along the outer wall and the inner edge looks normal, it can easily hide from view during a standard visual inspection. An orthopedic surgeon must use a physical instrument (a small metal probe) to lift, pull, or press on the tissue. Only by manipulating the tissue will the hidden separation along the capsule reveal itself.

 

About 1 cm. Interval grade 2 (intermediate grade) MCL sprain. No focal retracted component. No lateral meniscal tear. No high-grade chondromalacia lateral compartment.

About 1 cm. Interval grade 2 (intermediate grade) MCL sprain: The MCL is the ligament that runs along the inner side of your knee to keep it from buckling inward. A grade 2 "sprain" means the ligament is partially torn. The "1 cm" and "interval" descriptions outline the specific span or zone of the ligament that has been stretched and damaged.

No focal retracted component: This is excellent news. When a ligament tears completely, the two ends can snap backward like a broken rubber band (retraction). Because there is no retraction, it confirms the ligament is still connected and in continuity, which means it has a high capacity to heal on its own without surgery.

No lateral meniscal tear: The meniscus is the shock-absorbing cartilage wedge in the joint. Your outer (lateral) meniscus is perfectly fine.

No high-grade chondromalacia lateral compartment: Chondromalacia refers to the softening or thinning of the protective cartilage that caps your bones. "No high-grade" means the cartilage on the outer side of your knee joint is healthy and has no severe wear-and-tear.

 

Patellofemoral high-grade chondromalacia, most notably 4A, trochlear groove. Mild lateral subluxation and tilt. Prepatellar and prepatellar tendon swelling with periostitis at the prepatellar plate. Periretinacular edema. Effusion. Capsulitis.

 

Patellofemoral high-grade chondromalacia, most notably 4A, trochlear groove: Chondromalacia refers to the softening and breakdown of the cartilage protecting your joint. Grade 4A is the most advanced stage, meaning the protective cartilage has completely worn away in a focal area, leaving the underlying bone exposed ("exposed bone"). This is located in the trochlear groove, which is the bony V-shaped track on your thigh bone where your kneecap sits.

Mild lateral subluxation and tilt: Your kneecap (patella) is not gliding down the center of its track. Instead, it is shifting slightly outward (subluxation) and tilting. This "maltracking" is likely the main cause of the heavy wear on your cartilage, as it unevenly concentrates pressure on one side.

Prepatellar and prepatellar tendon swelling with periostitis at the prepatellar plate: There is significant swelling in the soft tissues and tendon directly in front of your kneecap. Periostitis means the highly sensitive outer lining of the bone (the periosteum) is inflamed, which is a common source of sharp or deep aching pain.

Periretinacular edema: The retinaculum is the band of tissue on either side of your kneecap that helps hold it in place. "Edema" means there is fluid buildup and irritation here, likely because it is being stretched or strained by the kneecap tilting outward.

Effusion: This means you have an excess accumulation of joint fluid inside the knee capsule, usually produced by the body in response to cartilage irritation and friction.

Capsulitis: Inflammation of the fluid-producing capsule that surrounds and seals your entire knee joint.

 

Quadriceps tendon is intact. Patellar tendon is intact. ACL, PCL, remaining posterolateral corner (fibular collateral ligament, popliteus tendon, conjoined tendon and lateral capsule) and IT band are intact. Remaining muscles are unremarkable. Remaining tendons are unremarkable. No AVN. No large loose body. Neurovascular bundles are unremarkable.

 

CONCLUSION:

1. Region of fat behind the PCL near the posterior medial meniscal root attachment to the tibia, suspected small lipoma. Less likely an ossified body. Consider x-ray. About 1 cm.

2. Medial compartment diffuse high-grade (predominantly) chondromalacia. Medial tibial rim microfracture with rim edema.

3. Similar very thin medial meniscal tear primarily affecting the outer margin, along the capsular attachment, sparing the free edge. May require probing at arthroscopy to appreciate.

4. Interval grade 2 (intermediate grade) MCL sprain. No focal retracted component.

5. Patellofemoral high-grade chondromalacia, most notably 4A, trochlear groove.

 

 

Week Ending 09/20/26

 My left knee continues to be quite painful, so I kept to lower mileage. Mixed in more biking and also got checked out by my orthopedic. MRI to follow and follow-up on the 28^th with results. I passed 3,000 miles for the year on Sunday and also reached 170,000 miles lifetime. Onward!

 

Bike – 138.3 miles (8 hours)

 

Running:

Week – 64

Month – 184

Year – 3,006

Life – 170,006

I broke out my long-sleeve biking shirt in deference to the cooler temps.

Found some nice wild grapes on the ride!

Picked up some rocks on the Rockingham rail trail.

Labor day

 Got in some nice running and managed to bag a couple of NH Town high points.

Town high points

 Next up was some town high points with Albee. Al was heading back from NY and stopped by camp on Tuesday night. We were up at 5 a.m. and on the road to visit the highest point in a few Vermont towns. I have run in all cities/towns in MA, NH, RI, VT, and CT and now I’m working on visiting the highest point in each town. With about 1,200 in those states, I’ve got plenty of adventures ahead of me. We started the day in light rain near the high point of Isle La Motte. This one was a bit tricky as much of the area is posted “no trespassing”. We did some easy running as we were along the edge of some fields (and even activated a game camera) and wanted to get into the woods as daylight was coming. The woods were very open if we could avoid some old, barbed wire fences. We found the high point and the benchmark (a steel disc mounted on a small concrete post) nearby. We headed out via some carriage roads and found our way past a B&B which probably would have been a safe place to park and enter the woods. Next up were a couple of high points that involved very short hikes (200 meters) zipping in and out of the woods along the property line. At that point we were in Alburgh VT and I had located a rail trail that looked promising. Al was up for a run so we hit the trail for a 4 mile stretch of the legs. The trail was dirt/grass but in good condition. I’d like to go back some time and explore more of it, it appears to be about 4 miles from end to end over the former Rutland-Canadian division/Island Line railroad. Then it was back to bagging as the sun broke out and it got windy. We headed to St Alban City for an interesting climb up a ski slope followed by a trail hike and a short bushwhack. The park was HUGE with trails seemingly everywhere. They also had disc golf on the slopes and in the woods. Our next high point was a change of pace with over 2 miles of “whacking” in a mix of open woods, ferns, and overgrown ATV trails. The 2 mile hike took us a little over an hour and featured a spooky looking hunters shack on the 1,111’ summit. It was getting a bit drizzly as we made our way up the terrible road to a solar farm near the top of St Albans (the town, not the city!). The true high point was within the fence at the FAA facility, so we made our way around the fenceline and did not test the security although near the high point the outer fence had been knocked down by a tree and there wasn’t any signage on the fence. Our final high point was Sheldon which could be easily accessed if the property owner allowed. Al checked in with the owner who was aware that the property sat on the high point and not only allowed us access but also suggested we park higher up on the grassy path he maintained. The hike was an easy 160’ climb over a quarter mile of mostly ATV paths. The woods were strewn with tubing between the trees as it is an active maple sugaring location. In all we visited 7 town high points before Al hit the road and I headed back to a rainy campground. I was glad to have chosen a lean-two or it would have been an extra-soggy trip.

 

Biking in Vermont

 Earlier this year I biked across Vermont on the Lamoille rail trail. About 10 miles from the finish, I crossed the Missisquoi rail trail. That got me thinking about riding the Missisquoi as well. I’d run sections of the trail while on my quest to run in every city/town in VT which I completed in 2021. The Missisquoi was like the Lamoille with a gravel surface but clocked in at 26.1 miles in one direction (the Lamoille is the longest rail trail in New England at 96 miles). I had booked a campsite at Lake Carmi state park which was about half-way through the rail trail. I had to laugh at the write-up about Lake Carmi calling it “the fourth largest lake located entirely within the state of Vermont”. Wow, they were really digging for some superlative! I’d decided to bike an end-to-end-to-end (52.2 miles) which would eliminate any logistics for getting to the start but would make for a long day as I’d only been biking one day a week (2 hours). I’d met up with Tom Anderson, a former CMS and GLRR teammate and rival from college days when he ran for Keene State, and he was interested in doing the ride as well. I chose the day after Labor Day for the ride with the following day in the event of foul weather.

 

I headed up to Lake Carmi on Labor Day with a couple of enjoyable runs along the way. I was not pleased to find that the lake itself was closed due to algae blooms. So much for swimming. I settled into the comfortable lean-two and was a bit surprised to wake up at 4 a.m. to steady rain. I had not seen that in the forecast. I made my way to St Albans and got in a short run as my knee was really bothering me, but I did not want to take a “zero” day. Tom was a bit late, which turned out to be good as the steady rain got lighter (and would end by about 30 minutes into the ride). I put on a bunch of layers, but Tom chose to just go in shorts and t-shirt. It was 65 degrees and humid even after the rain ended and we got a few brief views of the sun. At 8:40 we were off!

 

I warmed up quickly as the pace was solid. Tom could easily ride 5 mph faster than me (or more) but he was aware going in that my goal was 13 mph for the round trip which would bring us home in about 4 hours. I was on the pedals the entire time, no coasting. As the trail is a former railroad bed the climbs and descents are minimal (never exceeding 2%). Tom would do a couple of pedal strokes and then coast as I caught up. We’d repeat this for the whole ride. The trail was scenic with views of farms and mountains and long stretches through corn fields. There were a few road crossings of busy route 105 that required caution but otherwise it was a beautiful trail. Tom told many stories as we rolled along and I conserved oxygen just giving nods, laughs, and the occasional “yes”. We reached Richford in 1:56, so a little ahead of schedule, and stopped for less than a minute to get a picture and turn around. I had a couple of “chomps” to avoid running out of fuel but did not drink any water for the ride (never really got thirsty). I started to get tired after 40 miles when my lack of long bike rides began to show. We didn’t slow down, but my effort increased. I began counting down the miles as every half mile was marked and every half mile was a small victory. We ended up coming back in 1:56 for a total time of 3:52 which worked out to 13.5 mph. I was happy with the effort and Tom seemed to have a good time (despite me holding him back). It turned out to be a nice day and by 1 p.m. I was on the road back to camp for a LONG hot shower and some relaxation time.

 

at the turn

at the finish

I'm fourth from the left and Tom is fifth - 1984 NCCA XC Champs (11th and 10th pl)

Week ending 09/13/26

I dropped my mileage down this week in hopes of making inroads on the knee injury. Not sure backing off helped at all as my knee feels terrible. Still, it was a fun week with camping in VT and running with many friends! 

Week - 51

Month - 120

Year - 2,942

Life - 169,942

Looking back - Sept 2021

5 years ago  (September 2021) With a little vacation time in hand, I started the month off with a couple of trips to Vermont.  My first trip involved 421 miles of driving over 10.5 hours with 15 miles of running in 9 towns.  The second trip a couple of days later included 387 miles driven in 10 hours along with 17 miles of running in 11 towns.

 

 

Gorilla & VW                                                                     Quiet farm road in Vergennes

I got back to racing at the Hollis Fast Five (5km) on 09-06-21.  The point to point race is a bit unusual, the net drop of about 250’ makes it one of the fastest 5k’s out there.  I’d run the race three times in the last 11 years and ran between 29 and 69 seconds faster than my fastest time that particular year.  So, I figured 5:40 pace would be about right.  It was kind of warm and VERY humid but this was a 5k so it shouldn’t be a factor. I counted how many in front of me at the first turn and had myself in about 20^th, so that seemed right.  I felt pretty comfortable and slowly started reeling people in.  I hit the mile in 5:29 which was a pleasant surprise.  I continued to pass one or two people and was closing in on the top 10 by two miles (10:57 – 5:28).  I got two more guys in the final mile (5:41) and was in 8^th place.  I could not hold it and one of the guys I passed in the last mile went by me in after the last turn.  I cannot complain with a 9^th place finish and a 17:16.6, not a bad sign for attempting to break 18 on a flat course

1        Cameron Cook         26M    Dover NH      15:33.9

2        Vojta Ripa     32M    Amesbury MA          15:46.9

3        Jessie Cardin 25F     Stafford Springs      15:55.0

4        Michael Studer        10M    Westford MA 16:03.6

5        Jacob Wormald        26M    Nashua NH    16:05.6

6        Mark Rabasco          27M    Pittsfield MA  16:26.5

7        Jason Viera   42M    E Greenwich RI        17:04.8

8        Ian French    39M    Londonderry NH      17:16.1

9        Dave Dunham         57M    Haverhill MA  17:16.6

10      Eli Lemire     15M    Weare NH     17:21.1

50      James Pawlicki        46M    Lynn MA                 20:36.7

        Posing with NE Delta Dental CEO Tom Raffio

 

Next up (09/12/21) was the GBTC XC race at Great Brook Farm in Carlisle (MA).  I’ve run in the woods of Carlisle since my Billerica days but have only raced there twice The course featured three progressively longer loops with a great mix of ups, downs, grass, dirt, roots, rocks, and even a little bit of mud.The small field of only 32 lined up for the master’s race (everyone over the age of 40).  I like when we get to run without the open runners, it is so much easier to see the competition.  Off we went and by the first turn I counted 15 guys ahead of me, I slowly moved up and by the end of the first loop (1/2 mile) I was in 12^th place.  I caught a couple more to take 10^th place in 19:12.  HFC ended up beating us in the 40+ team scoring 23 to 33.  I was fourth man on the 40+ team and third man on the winning 50+ team, we beat HFC 24 to 31! 

 

1 16:37         TJ Unger                 43      HFC

2 17:03         Aaron Price   44      BAA

3 17:27         Lee Danforth 43      HFC

4 17:49         Tim Van Orden        53      CMS

5 18:15         Paulo Amaral 41      GLRR

6 18:26         Jason Cakouros       56      HFC

7 18:35         Steven Brightman    52      CMS

8 18:52         Arthur Besse 49      CMS

9 19:08         Rbrt McCormack      60      HFC

10 19:12 Dave Dunham     57      CMS

11 19:14 Steve Neri 54      HFC

12 19:47 Justin Renz         49      HFC

13 19:53 Steve Bosic         52      SRR

14 20:01 Dan Verrington   59      CMS  This was the 300^th time Dan and I raced each other!

17 20:25 Doug Deangelis   55      CMS                                

20 21:14 James Pawlicki    46      CMS

                             

I decided to complete my quest to run in every city and town in VT.  I had 6 runs of 3 miles each that would get the final 13 towns I needed.  I was out the door on Monday (09/13/21) at 4:30am for the nearly 3 hour drive to my first stop.  In all I ended up driving nearly 500 miles and was back in a little less than 12 hours.  Good friend Eric Morse met me in Winooski for the final 5km run in Gillbrook Nature area which gave me my 255^th Vermont city or town (or gore & grant). In all I drove 19,799 miles in 75 different trips to Vermont and ran a total of 690 miles (I only counted the first time I ran in a city or town).

 

 

Next up was SEA (State Employees Assoc) 5km race which was the finale in the CARS.  It was certainly unusual running this race in mid-September since the race is typically held in April.   I was hopeful that the final CARS series race would also be my fastest 5k of the year.  The series was pretty much wrapped up with little chance of any movement (I was in 6th in the overall category, first in the 55-59 age group, 1st in the age graded masters, and our team was in 2nd place). 

 

The field was especially small this year (130 finishers) and only a couple of guys moved up to the front.  They were starting us in four waves with the first being under 7:00's.  Off we went and I found myself in 5th place during the first loop. I Checked my watch at the half and was a little ahead of pace but not crazy fast. I hit the mile in 5:38 and 2 miles in 11:22 (5:44) and not much changed.  The leaders were out of sight. I can't complain as I closed with a 5:46 mile and was well under 18.  I ended up 5th overall and first in the 50+.  The big surprise was that I moved up to 5th in the overall in the CARS and took home $50 for that.  I also got $100 gas card for taking the age graded series (with Ernie very close behind).

 

                        Kicking for the finish                      Duct tape & Spit = Jim Pawlicki, Doug Deangelis, me

1             16:13     5:13       Cameron Cook    26   Dover, NH        MOPEN
2             16:35     5:21       Warren Bartlett   24   Loudon, NH                   MOPEN
3             17:03     5:29       Drew Tuttle                   26   Alton, NH                   MOPEN
4             17:31     5:39       Michael Eddy                 16   Madbury, NH                   M1519 
5             17:41     5:42       Dave Dunham                57   Bradford, MA                  M5559 
6             17:47     5:44       Erik Paddleford               46   Concord, NH                   M4549 
7             18:00     5:48       Jim Angell                      57   Hopkinton, NH               M5559 
8             18:24     5:56       James Brady                  20   Newbury, NH                   M2029 
9             18:32     5:58       Ernest Brake                  60   North Sutton, NH               M6064 
10           18:36     5:59       Sam Wood                     35   Laconia, NH                   M3539 
11           18:55     6:06       Matt Deschuytner 34   Canterbury, NH              M3034 
12           18:57     6:06       Doug Deangelis    55   Newbury, MA                  M5559 
13           19:39     6:20       James Smith                  63   Concord, NH                   M6064 
14           19:55     6:25       Michael Barry                65   Northwood, NH               M6569 
15           19:56     6:25       Nicholas Brady      23   Boston, MA                  M2029 
16           20:47     6:42       James Pawlicki    46   Lynn, MA        M4549 

 

I couldn’t decide where I wanted to race now that the CARS series is over.  I’d only been to Nahant twice and the little island off of Lynn/Revere seemed nice.  The course had a tough hill at ½ mile in and another from 1.5 to 2.25.  The field of 165 shot out and I found myself in fourth place in the early going. I moved up into second place on the first climb and was a step behind the leader at the mile.  Every time I edged a bit closer, he upped the tempo.  As we hit the second hill I pushed the pace and took the lead.  I could hear his footsteps fall off behind me.  I tried to really push on the downhill, it was tough seeing the finish arch ½ mile in the distance.  With ¼ mile to go he came back and flew by me.  I had nothing left and lost nearly 10 seconds in that last ¼.  I As a bonus I picked up a $50 gift card. 

 

Pl  Time        Pace   Name            City/State     Division

1  17:30        5:39   Peter Siess    Amesbury MA          MOVRAL

2  17:39.7 5:42       Dave Dunham         Bradford MA  MOVRAL

3  18:39        6:01   Steve Dickenson      Nahant MA    MOVRAL

4  18:58        6:07   Tomas  Martinez      Beverly MA    M1929

5  19:16        6:13   Alexandra Buonfiglio Revere MA   FOVRAL

13 22:16       7:11  James Pawlicki        Lynn MA                 M4049

 

 

My shoe blew out during the warm-up at the SEA race!