Showing posts with label itbs. Show all posts
Showing posts with label itbs. Show all posts
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My runs have been inconsistently pain-addled since Monday. On Tuesday I chose to repeat Monday's run. The overtaxed ankle muscle kicked about 6 minutes into the run. I slowed down, stretched and forged onward. I ran along the worn trail rather than the cement sidewalk, which helped slightly. But by the time I got around 2 1/2 miles in, I was having other issues.

You see, earlier that morning I'd gone out for a run/bring out the trash and accidentally locked myself out of the building. It was the wee hours of the morning, so I felt that ringing doorbells wouldn't have been greeted kindly. So I waited (too fearful that I'd miss the one neighbor if I went for a jog). Silly idea. No one showed for 3 hours. The guy I managed to snag lived in the place next door and I had to convince him that (a) I lived there and (b) that his key also worked for our building. I had to physically show him that it did.

When I got inside, I tore off my unused running gear and shoved it into my gym bag. Except the socks. I somehow missed the socks. When I took off for the run on my lunch break, I realized my sockless situation and grit my teeth. I thought I'd just run without socks. It's only aesthetically unpleasant, right? Wrong. My feet got sweaty, they shifted unusually in the shoes when I ran, and I ended up with severe shin splints up the outer calf of each leg.

The run ended with me jogging barefoot, combating three different aches and sharp pains in my legs. I felt like I'd taken a beating when I got back to work. The rest of the week involved more painful jogs like that. My Sunday run went well, however. All the pain in my legs dissipated by the 4th mile. I was running telephone sprints in the middle of the run, which I really think helped out a lot. Maybe it was my imagination, but maybe there is something to it. My gait and form change when I'm sprinting as opposed to jogging.
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7 Months Later: An Update

This is going to be quite the update, since my running journey has had quite a few ups and downs over the past seven months since I last updated. In order to make this more straight forward, I will cover the major events timeline style.

April 5th, 2010:
Appointment with a big name sport medicine orthopaedist. Confirmed that it was only IT band problems. Suggested rest and PT exercises. No other assistance or referrals. Very disappointing, honestly.

April 6th - June: Rest, completely stopped running.

June - July 11th:
Started running again, 1-5 miles a time, several days per week. Didn't have any problems with the IT band, feel good, taking it easy.

July 12th, 2010:
Began a 13 week training plan to get back in shape.

July 13th, 2010:
Registration for the BAA Half Marathon at 9am. By 1pm when I went to register, it was already closed. Signed up for charity fund raising to get a spot through Dana-Farber. I've got a spot in the race!

July 18th, 2010: First week of pre-training went well. Got in 4 runs with a "long run" of 5 miles. Total 17 miles, with pilates and yoga classes.

July 25th, 2010: Second week of pre-training less good. Only two runs in. I can't remember what happened, but it was some kind of craziness. Total 8 miles.

August 1st, 2010: Third week of pre-training complete. Five runs, 21 miles total with a 7 mile long run. Some swimming and upperbody. Not hitting my cross-training targets, but running is on track and feeling good.

August 8, 2010: First week of the sub-2:00 training plan. Hit all 4 runs which included a couple of easy runs, a tempo run at 8:54 min/mil on treadmill, and a long run of 8 miles. Total 21 miles.

August 15th, 2010: Second week totaled another 21 miles. Two easy 4-5 mile runs with mile repeats at 8:25 min/mile pace. Attended bootcamp class, pilates and did upper body. Another 8 mile long run.

August 22nd, 2010: Third week continued well with 23 miles total. The first three runs mid-week included a 9:09 min/mile tempo run along with three strength training sessions. This was a 9 mile long run week.

August 29th, 2010: Fourth week was a disaster. I had an appt with a personal trainer for the TRX, which started out poorly with not enough sleep. Later that day I donated blood. It went very, very poorly. I got dizzy/fuzzy and nauseous, my blood pressure dropped really low, they were drawing blood through a valve and it hurt, and they ended up keeping me an extra hour to recover. I went home early, and was disoriented and dizzy the next day as well. My Thursday run cut short after 3 miles when I felt like I was going to pass out on the treadmill. My long run on that Sunday lasted all of 3 miles before I had to turn around and go home.

September 5th, 2010: Fifth week, I knocked out a 5 miler, but that's about it. I was still suffering from exhaustion. I should have pushed through it, but I didn't. I had a bunch of social obligations and did many miles of walking over the week, however.

September 9th-16th, 2010: Vacation in Arizona. I got in three morning runs between 3-5 miles. I was really impressed I managed it given that the temperatures were around 107F on the day I left. Mornings weren't as bad, but I got dehydrated rapidly because its so dry. My breathing in general felt totally different in my lungs.

September 19th, 2010: I felt great when I got back. That weekend I went out for a beautiful 9 miler along the beach. I felt good, got myself home. And the next day came the pain. The IT band ache. I'd been taking anti-inflammatories post-run all along, rolling and stretching before, throughout, and after. But apparently I wasn't doing something right, and it was bound to happen.

September 20-26th, 2010:
Took it easy with some lighter runs, gauging how bad things were going to be on my knee. Not following training at all at this point.

September 27th - October 9th, 2010: I made the decision that I wasn't going to run for the last two weeks before the race. I figured that I wasn't going to improve my fitness levels in the next two weeks, but that I could aggravate my knee more and injure myself further. Therefore, it was better not to run and instead daily ice, roll, pain relieve, take it easy. My IT band ached horribly by the end of each day, just the 1 mile round trip walk from house to train, train to work and back was way too much.

October 10th, 2010: I went into my race with very little faith in finishing. Actually, I told everyone it wasn't going to happen. And said not to bother coming. If I was going to humiliate myself, I'd do it solo. The race gets its own post. :)

Now we're up-to-date.
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Visit to doctor's office was, as expected, uneventful. Am being recommended to a sports medicine/orthopaedic specialist in Boston. Will sort this out Monday. Hopefully get to see someone who knows what they're talking about.

Ran 1.5 miles pain free on Thursday morning.
Ran 2 miles pain free on Friday morning.
Ran 3 miles pain free on Sunday morning.
Woot.

I may just take up running 2 miles at a time twice per day. Which would at least put me at 28 miles per week. No endurance, but at least I'd be getting in the miles.
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A month later...

I'm finally getting my knee checked out as absolutely nothing (excess rest, rolling, stretching) has improved the distance I can run without exquisite pain and knee failure. So Friday I should have the start of an answer. Or at least a referral to someone who can give me an answer.

Other than that, I missed the Ras na hEirren because it was daylight savings time this Saturday. So my clocks didn't get moved forward Saturday night, and I woke up an hour late to the race. Oops. But probably just as well since every other weekend I've tried to run a 5k distance things went to crap pretty quickly. I got my t-shirt at least. Oh yeah, it was downpouring all day. (Which resulted in our basement flooding with a 1/2 foot of water, but that's another story). Not fun to run in anyway, so I avoided that wet mess.

I am seriously excited to get this knee business solved though.

On another positive note, it's only 57 laps in the pool to swim a mile and it really flies by. I'm becoming a better/faster swimmer every day. By around lap 30 my form just feels really smooth, natural and powerful - like I'm a fish! The kind of wish that has to breath at the surface though - which I've seen before at an aquarium, but I can't recall what it was, although it was cute. I'm even getting better with a really shallow side breath too, so I'm not slowing my pace by sticking my face too far up. It's just not as sweat-pain inducing as running though - not remotely the same level of satisfaction. I don't know how long I'd have to swim for to get that. Maybe 2-3 miles? Ha, if I didn't turn into a prune. Although if the knee problems keep up, endurance swimming could be kinda cool... 3-4 hours of swimming...
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We're not best friends.

The foam roller and I do not enjoy each other.

Yes, I know. This blog has really just turned a place for me to bitch and moan about the fact I'm not running. Rather than the rest of the year when I'm actually running, and thus don't take the time to blog. I have a lot of free time on my hands previously taken up but wonderful hours of hill sprints, tempo runs, long meditative jogs, even intervals and repeats on the dreadmill!

Anyway since the foam roller came home with me, my knee has actually hurt more. But in new places. I have strange instances of DOMS in my upper-hip/side. While I'd like to say that it is already making all the difference, I can't. I don't have a proper gauge, however. Perhaps I can test it via a fast 1 mile run on the treadmill - they say faster, shorter strides is less irritating. But every time I've run thus far, it's resulted in further injury or prolonging of pain. I will hold out. Work is preventing much crosstraining also. I'm stressed to the max.

1 1/2 weeks until the half marathon. I will be cured! If only I were an important enough runner to warrant a cortisone shot.
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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.
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My first DNF

Well, today I hang my head in shame and frustration. It was meant to be a morning of PRs and training assessments. I lined up a 10k for my fifth week of marathon training. The timing worked out perfectly with an easy 14 mile pace run scheduled for Saturday. I felt confident that I would be energized and ready to race come Sunday morning. Six fast-paced miles to finish off a great weekend.

Let's start with a quick overview of the past five weeks, in terms of my long runs. Most everything else has been treadmill speed work, having not done hills in two weeks.

Week 1: 15 miler - felt good, achy same-day, fine the next
Week 2: 17.5 miler - felt great, finished off with a sprint
Week 3: 18 miler - felt okay, struggled to finish up, but ended strong; went on an easy jog and pitched into the sidewalk, severely bruising both knees
Week 4: 20 miler - felt good, knees hurt that afternoon but no swelling, healthy as a clam on Sunday without pain
Week 5: 14 miler - start out sluggish, strong and fast from 6-11 miles, endured finish; jogged in old running shoes to bus (0.6 miles) afterwards - exhausted

When I awoke this morning, I felt a nagging pain in the right side of my right knee, and on the left side of my left foot. It feels like one of those pains when you pull the muscle, step on it wrong or sleep on it wrong. Something that you can work out with a little physical activity or rest. So I tried jogging down to the T station, but the foot and knee were both nagging, so I mainly walked. Reaching South Station, I walked to the start line, not ran. Again, a light jog didn't make it feel better, so I figured I'd not irritate it further and save myself for the race.

The race started slow. I was feeling awful, and with the foot and knee pain, my first mile was a whopping 9:43 (gun time). Shocked at just how slow things were going, I pushed myself hard to make up for that extra minute once we passed that clock. I felt myself shift into a faster, rhythmic groove. Feeling good. This lasted approximately 1/2 mile. At which point the pain in my knee was no longer feeling like something I could run through and/or use to drive me. I started having thoughts about whether it would be okay if I just stopped at the 5k. Little did I know that I didn't even have another 1/2 mile left in me.

It got bad fast. The pavement turned to cobbled stone, a stronger stab of pain. I rapidly got back on even ground, a slight limp to my run. I tried gritting my teeth, telling myself to get lost in the music and focus on a running daydream rather than the pain in my knee. But it was persistant, getting stronger and lasting long through my stride. Until finally I just limped to the side and stopped. I figured if I rested for a few minutes, breathed through it, I could pick it back up again to make it to the finish line. I couldn't tell where the end was, however. How close we were.

And then a concerned runner asked if I was okay. Another girl paused as well, identifying herself as a nurse. I had tears running down my face from the effort of running and gritting through the pain, so honestly, I looked worse than it was. I said I was okay, just in pain, to keep running. She got a race volunteer. The race volunteer insisted that I stop and she called for help. It amounted to waiting an extra 60 minutes for the race to finish. It was bitter cold and a wind tunnel, so I said inside the first set of doors to the World Trade Center. Just waited. I tried exercising my knee, bending, tried walking. Rapidly reassuring myself that, no, I probably wouldn't make it the mile back. Although let me tell you, I kind of wish I had insisted more. It was so frustrating, just sitting there. Waiting. Watching all the runners go by and knowing that should be me. Ugh.

The injury isn't even visible. I don't have constant pain or anything blatantly obvious. I only limp some of the time, especially after sitting for a while. I'm just at a loss.

After some googling, its really coming down to one thing: my IT band. This freaks me out, since I simply can't get that kind of injury. I'm staying off it training-wise for the next couple of days. I'll swim tomorrow instead. I'll have one of the nurses or doctors check it out at work. I just need someone to confirm and not confirm what it is so I can work on fixing it. Being that there was no obvious cause and it just appeared this morning, I hope that this is just a fluke, not a longer-term injury. Damnit. I know I pushed myself really hard the past month in terms of distance, but I've felt great. Cardiovascularly I was ready, and my legs, while pained, are not being pushed beyond anything they can't comfortably do.