Theorizing the root of my pain.

I spent a large portion of my day reading peer-reviewed literature on the subject of ITBS in such publications as J Sports Med and Clin Biomech. What I found there was relatively inconclusive with contradictory studies and results disproving common wisdom on both causation and treatment.

What got me on this search was the idea that IT band syndrome, while an overuse injury, is also a direct result of poor stretching habits. I stretch with the best of them, so this concept really bugged me. I may have been ambitious in upping my mileage; however, I was relatively pain-free and cardiovascularly capable of my distances. My training this year has been more well constructed than ever before, as I've bought into the practical advice of more competative runners. From regularly practicing yoga and stretching to adding variable workouts to create a more complete, stronger and faster runner - speed, hill, tempo, interval workouts. I've been keeping my pace on track and logging everything from how I feel before and after to how many hours of sleep I get at night and what I eat.

So the fact that I'm a "better and safer" runner than ever before makes my sudden injury seem contradictory. Until I found multiple studies referencing the impact of hip biomechanics on your IT band - your gait. A minor change can produce injuries you would otherwise have never experienced. For example, running on a sloped surface, changing shoes, shifting from pavement to gravel, etc.

I then looked back on my own recent history. It made sense. The Fall.

Three weeks ago, I fell hard. I completed my run that day. I only took two days rest. In under I week, I ran 20 miles straight on bruised and inflammed knees. Day-to-day I didn't feel pain in my knees, no limping beyond day one and two, however three weeks later and I'm not healed. You can still see faint physical bruising, and the entire knee is sore to the touch. I still can't kneel.

My theory: When I fell three weeks ago, I did more damage than I realized and didn't take enough time off to sufficiently make it through the inflammation and repair periods of tissue healing. As a result, when I started running again, my gait changed minorly to compensate for the trauma to my knees. The change in gait was enough of a biomechanical change to result in irritation or higher load, by whatever means, on my IT band. Thus I'm suddenly struck with pain. If this is the case, then I just need to stop running - allowing my knees to heal (because they're still bruised and sore to the touch) at the same time as my IT band - and when I get back out, I should return to a healthy gait and I actually should be able to rapidly return to my training program.