acute knee injury

Question
Hello,

I am a 45 year old female middle-of-the-pack runner who has done 4 marathons in the past 2 years. #5 was going to be Sunday but I'm hurt and have to miss it.

4.5 weeks ago I flew over the handlebars and landed on asphalt, apparently on my left knee. It became quite swollen and sore. I iced/Advilled/elevated/rested and hoped to return to training after a few days.

No such luck.

On day 5 an x-ray showed a potential fracture of the patella.

On day 12 an MRI showed "deep subcutaneous edema", "an area of prepatellar bursal/hemobursal fluid accumulation", and "a borderline joint effusion". It showed no evidence of bone marrow contusion, no evidence of occult osseous injury, and confirmed that tendons, ligaments, menisci, and articular cartilage are preserved/intact.

On day 27 my family practice doc diagnosed acute bursitis and prescribed PT.

On day 28 I began PT, consisting of stretching/strengthening exercises.

Today is day 34 (almost 5 weeks since the crash). I can *mostly* walk pain-free but running is out of the question. I can hop up and down on that leg pain-free if my knee is straight, but I cannot descend stairs, or bend it very much without pain.

I continue to ice 3x/day, Advil every 4 hours, and sleep with it elevated. Aside from the PT, I have not done any exercise and have stayed off it as much as I can.

I have never had knee problems at all before this.

My question: if this is bursitis, can I expect to resume running as I was before? And if so, what kind of timeframe are we talking about? Or, what could it be if it's not bursitis?

I qualified for (and got into) Boston, which is in 28 weeks. I think I could take off another 3-4 weeks (which would be 8-9 weeks total) and then slowly get back into running and still be able to do Boston. Or I could take off 7-8 weeks (which would be 12-13 weeks total) and then try to ramp up more quickly. But I would skip Boston altogether (and/or take many many weeks off running) if I could just get my old knee back.

Sorry for my long winded-ness and THANK YOU so much in advance for your thoughts and help on this.

Answer
Hi Betsy
Thank you for your long winded-ness because that is the only way i can really diagnosis your situation.The problem is to appropriately make this happen is i need more information with many questions to really get pin point questions answered on your preparations for boston and your accident and many more to appropriately give you the quality information you need to proceed with further training for Boston.The only way i could do this is by phone to insure the info i articulate is fully understood  and how to implement the process for a successful outcome.I hope you understand Betsy since i don't want my reputation to be misinterpreted and put into practice without a full understanding of the program and process.You can call me here in Albuquerque NM any time to further this conversation.Just go to my web site for contact info.

All the best

John
www.rentacoachinternational.com