Wednesday, June 11, 2008

Damn You, Knee!

After a failed long run on Saturday and another attempt at some bigger miles on Monday, I've come to the conclusion that my left knee is suffering from Iliotibial Band Syndrome (ITBS). On each run, at about the 6 - 7 mile mark, the outside of my left knee would start hurting, getting slowly to the point where I needed to almost shut it down to a shuffle - something you should be doing at the end of a 50k, not halfway thru a 16 mile run.

This pain started coming on the last couple miles of the Ohlone 50k and at that time, I was just hoping this was some muscle fatigue that would eventually go away. Well, minus the treatment and stretching, I really haven't done anything to help alleviate this condition. So yesterday, I did some research (along with bothering GB for advice) and found a good set of stretches to do 3x per day (e.g. Walt Reynolds's ITB Special & Running Times ITB stretches). I'll also add some ice treatment and more stretching following all of my runs from here until whenever.

Am I discouraged? Yes. Am I feeling down? Actually, not really. I've decided to look at it from a positive side - I really had no business completing that 50k with such limited training time, so I probably should have expected something bad might happen. Also, compared to other folks with this, I really feel like I have it easy. Once I start stretching it and treating it, I think I will be good to go (that could be wishful, optimistic thinking but that's ok - everything now for the rest of the year is bonus time.)

So now what? Well, I'm too stubborn to quit running so here's my strategy going forward for the next couple weeks: For the remaining few days this week, I'll keep the miles at 6 miles or less while doing the stretching exercises 3x per day and icing after the runs. Next week, I'll see how the knee feels and start increasing the mileage if it feels better. I'll also add some regular swimming starting tomorrow so I can keep myself in shape at the lower miles.

If none of that works and the pain is unbearable when running longer distances, I'll probably have to shut down the running for a couple weeks and stick to 100% swimming workouts while the knee heels.

Can't wait for this to go away (fingers crossed) and get those miles back up. I've been reading about some great (and inspiring) performances this past weekend (Rick Gaston, Bob Gentile, Mark Tanaka, Jean Pommier, Scott Dunlap, etc.) - I'm more than motivated to get out there and run.

Have a great end of the week and stay healthy.

[OK, I just got done reading Rick Gaston's Kettle Moraine 100 race report. After reading that, my injury feels more like a sliver. That dude is awesome. Way to go Rick. I'm gonna shut up for awhile.]


rick June 12, 2008 at 12:06 PM  

Mike, I feel your pain. I suffer from chronic ITB Syndrome. I got it on my first marathon and it's related to a hamstring injury I incurred in training. It's been with me since. Back in those days I would get one to two bad flare ups a year. It's the primary reason that I ended up giving up on marathons and switching to ultras. A bad flare up also got me into Triathlon, the swimming and biking was a good idea when I couldn't run. These days it "talks" to me but mostly it's ok. Even when it flared up towards the end of the Headlands Hundred last year I was still able to finish and the recovery didn't take as long, one week v.s. three. Here's what I do when it gets sore:

1) I stop running right away. I gave it time to rest. Back then it was 2-3 weeks, these days I found I can get away with a few days to a week depending on the severity and how long I kept running on it after the pain manifested itself on a run.

2) Get a foam roller. It will hurt like a mother but it's a great stretch. The great thing about a foam roller is that you can roll out not only your IT Band but the other supporting muscles as well; hams, quads. Sit your glutes on it as well. Tight glutes pull on the band. Go slow, bite on your dog's squeaky toy and just know it will get better as you keep on doing it.

3) I use a neoprene sleeve, you know the kind that fits over the knee and extends below and above it and has a hole in the center. It provides compression support on the tendon, shoring it up. I've used the dinky straps that are supposed to help but they are too flimsy and they focus on only one point.

4) If you have access to a gym workout that lower body. It's all connected, the stronger the surrounding muscles are the less work the IT Band has to do to stabilize you as you run, the less work it has to do the less irritated it becomes.

5) Find an ART Therapy specialist. Think of it as very painful massage and stretching. I had it done once for 15 minutes and I was tearing. They crank on those pressure points and while having you move your legs. It's the foam roller x100.

That's all I have for now. Send me an email if you want to talk about it further.

Bob Gentile June 13, 2008 at 5:32 AM  

Good points by Rick...I also recommend Trigger Point Therapy Workbook cause yes it probably is ur IT Band but other knots might be causing knee pain as well...

last year my left knee was really bothering me and guess what? it was NOT my Knee it was my QAUDS , I had trigger points/ knots in my quads pulling on my knee...the book showed me how to find them and message them out and POOF zero knee pain...really amazing stuff!

soooooo get this Book above it will be the BEST $15 you will ever spend, it's my best book in my library.

recover well my friend.

F. Lee June 13, 2008 at 1:57 PM  

Hey Bohi,
All good feedback to help you. Especially one that Rick mentions, #4. I think a lot of runners, in general, forget to do leg resistance work because of the fact that they are runners. I've started doing squats again, similar to what I used to do when I was running track @ Fresno St. It doesn't necessarily need to be heavy weight, but really good deep squats. I've also incorporated one legged squats/lunges. It absolutely hammers my legs, but I also know that it will help the pounding I put my body through when running, especially as mileage picks up.

Also, I mentioned this in my blog, but I when I do any reistance work, I push high reps and minimal recovery, to eleveate my heart rate and get some interval training. The further out you can push your anaerobic threshold the better off you'll be, assuming your IT band is healthy of course. You can probably get some really good work in on a spin the meantime.

209Mike June 13, 2008 at 2:37 PM  

Thanks a bunch guys. This is a treasure trove of information. I need to make sure I copy this to the "Please Don't Lose" pile. I guess now I better just follow through with this.

Victoria June 21, 2008 at 7:12 PM  

Ha!! Ha!!! You just quoted from Airplane on your other post! You have just entered the club I share with my brother and a couple of other nutty people. (The cornfields, Ted, the cornfields!)

Whoa. Anyway, I feel you on the knee pain. I just went to a physical therapist for the first time ever on Monday-- but it was really good to have someone analyze what my issue is and suggest some different strengthening stuff. I'm trying to cut back on the running without losing aerobic capacity--I'm back in the pool for the first time since high school--and build up other muscles at the same time. I understand the annoyance though. Nothing is more irritating than having big plans and an injured body part...

Stay cool-- it's HOT this weekend!

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