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Friday, April 6, 2012

knee pain follow-up.

so i went to a sports medicine ortho thursday morning to figure out what happened to my knee during sunday's 15k. i spent a lot of time with dr. google prior to my ortho visit so i had some idea of what may have been the cause of my pain and subsequent DNF.  my suspicions were confirmed when i met with an actual doctor... i have ITBS (illotibial band syndrome), a form of runners knee.

what is an IT band?
  • the IT band runs down the outside of your thigh, connecting your hip to your knee, providing stabilization for the knee during walking/running.
what is ITBS?
  • ITBS is an inflammation of this band caused by repeated rubbing of the band over the knee.
what causes ITBS?
many things - these are what i think contributed to my problem...
  • running on banked surfaces (uh hello, central park)
  • excessive up and downhill training (hello again, central park)
  • tightness in the IT band (this is definitely my fault as i have a hate-hate relationship with my foam roller)
  • weak hip abductor muscles (how many times have i been told this? too many. time to strengthen these damn hips.)
how am i going to treat my ITBS?
  • 6 weeks of physical therapy with a sports physical therapist.  when my doc recommended this, i couldn't turn it down.  now i get to spend twice a week with someone who is going to help stretch and strengthen me so that this doesn't get in the way of say, idk, a marathon i'd like to run in october.  
  • RICE (rest, ice, compress, elevate).  i'm going to take the next month or so to slowly build up mileage.  no super long runs for me.  and icing.  lots and lots of icing.
  • Cross-training.  with less running on the horizon for the next few weeks, cross-training is going to become huge in maintaining my current fitness level.  i've spent time cycling and elliptical-ing this week and i think that has helped to keep me sane.  i'm also going to take up swimming even though i'm nervous that other people (lifeguards, mostly) are going to judge me because i suck.  
  • foam rolling. i have foam rolled EVERY DAY since sunday.  it hurts.  it's awful.  but i'd rather suffer through a few minutes of foam rolling than not be able to run a marathon in the fall.
see those 4 bullet points, (sh)IT band? they are going to take you downnnnnn.

on another note, here's a little tidbit of information i learned from my x-rays this past week: i have tilted knees.

normally, when a knee bends, the patella fits perfectly into the knee like so:

however, a tilted knee cap does not do this.  oh no, it slides to the side, very NOT like a puzzle.  

where do my kneecaps go when i bend my knee, you ask?

when i go for my PT, i might stop by the radiology dept to see if i can get my x-ray just to show you how ridiculously far away from my knee my patella slides.  it is absolutely absurd.  the OCD part of me is cranky and annoyed because i feel like everything should fit together perfectly and how dare my knees disobey order.  

stay tuned for all (sh)IT band related issues.  and for the chance to see my misbehaved kneecaps.  

anyone else ever have ITBS? how did you deal?  any suggestions for me?

also, who's training for a spring race and super excited/nervous?  i'm excited for you since i'm on a racing hiatus.  i might also be a little jealous.  but mostly excited.  i think :-P

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At April 10, 2012 at 11:58 AM , Anonymous Tyler said...

I've never had severe IT band pain, but I definitely understand the pain from foam rolling that you talk about. I have to roll out that sucker pretty often to keep it happy.

Good luck with the rehab!

At April 10, 2012 at 11:11 PM , Blogger Runner in Denial said...

Thanks Tyler! I wish i had foam rolled more diligently before and then maybe I wouldn't even be in this position. Lesson learned!

At April 11, 2012 at 6:47 AM , Blogger Teamarcia said...

Ugh. I sorry to hear about ITBS and the DNF. This was my first running injury. I got it 2 weeks after running my first Chicago Marathon. I had the brilliant idea that, since Chi was so hot and I ran so poorly, I'd ramp back up and do Vegas in Dec. So the following weekend I ran 8, then 16 the week after. It was in the middle of that 16 that it felt like someone shot me in the outer knee area. I had to get a ride home.
I didn't run for 2 weeks, RICEd stretched, strengthened and foam rolled like crazy. I also wore a Cho-Pat for a long time after. Knock wood, it's been fine since.
Listen to your PT and if you're running at all now, stop at the first hint of pain. ITBS will heal but you have to let it heal fully so it doesn't become a chronic problem. Hope this helps!

At April 11, 2012 at 3:53 PM , Blogger Runner in Denial said...

Thanks so much - it's nice to hear from someone who had this and recovered (I'm knocking on wood for you as i type this)! My PT said i could run twice a week, running no longer than 4-5 miles at a time. I've done two five-milers since then and haven't experienced any pain. But I'm keeping my pace slow and running on flat dirt paths that are close to home so if need be, i can just walk back.

How'd you feel using the cho-pat? I was looking at this yesterday when i was icing and trying to think of (more!) things i could do for myself.

Thanks again for the advice!


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