Iliotibial Band Syndrome (ITBS). The "IT Band," as it is often called, is a long strip of tissue-like material that runs down the outside of the upper leg, connecting the hip to the knee. Running causes friction between the band and the femur. Too much activity (along with a number of other contributing factors including length of the IT band, effectiveness of stretching, pronation of the foot, quality of shoes, etc.) can cause inflammation of the band, radiating dull pain to the outside lateral portion of the knee. Symptoms usually begin in the first 2 or 3 miles of a run. The sharpness of the pain increases with continued activity, and inflammation subsides when the activity is stopped. It often takes weeks to heal completely. ITBS is the thing that kept me from finishing the marathon last Saturday. I first had symptoms back in the spring when I ran the Monument Ave. 10K, and the problem flared up intermittently over the course of the marathon training. But I'd been in the clear since late August...until our 20-mile training run in late October. It's been problematic every since. But I rested it a lot during the 3-week taper leading up to the marathon, determined to run on November 15.
I started to feel it somewhere around Mile 3 of the marathon. It was exactly what I was afraid of. I suspected then that I wouldn't be able to finish, but I stopped and stretched every so often and tried to push on. I had to walk most of Mile 7 - not because I was tired or my muscles sore or my lungs struggling, but because the pain in my knee had begun to stab. I stretched for several minutes at the Mile 8 marker in an attempt to get my IT band to cooperate. It was effective for about a tenth of a mile. Finally, after stopping every 200 feet or so to stretch (and still limping along), I had to give up at the Mile 10 water station and resign myself to the fact that I'd have to tackle 26.2 another day.
I'm headed to see the sports medicine doctor on Tuesday to start rehabilitation. I hope to get back to training as soon as I can, though I'll make sure I'm completely healed first. I will say definitively that I will not let my first marathon attempt be my last.


