Sunday, November 23, 2008

the next (same) hurdle

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.

5 comments:

annabelle said...

Wow, that was prompt, unless you haven't even listened to my voicemail yet. Sorry to hear about your IT band. As someone who's been operating at less than 100% due to an injury, I do empathize. You'll get there!

Ben Greenfield said...

Man. Just found your blog, and that sucks (your IT band injury, not your writing!).

Anyways, I've struggled with some similar problems, and I've found a few really effective management and treatment tips. Here's a few:

-Wear a knee strap about three inches above the IT band. Make sure to put it on when your leg is *straight*.

-Cortisone only temporarily relieves the pain and let's you run through it and possibly do more damage. But ultrasound and ice-stim (physical therapy modalities) can actually help heal it quickly.

-Use a combo of foam roller, massage, and "The Stick" or "Muscletrac" to beat the tightness out of your lateral thighs. Make sure to get the attachment, up by the outer butt.

-Don't run through the pain, period. Interestingly, when you can return to training, try uphill running at a fast pace. It's the most pain-free.

Good luck.

Ben Greenfield at http://www.runwithnopain.com

lauren said...

i agree with ben. foam roller is where it's at. also, some of my friends suffering from IT problems have found certain yoga stretches to exacerbate the situation, so be careful there and always accommodate your body's needs. still proud of you chris!

cbaldwin said...

sorry edwards! that sucks...but excited for your training and your effort. I'm a victim of the ITB as well...knee strap - yes, roller - yes, physical therapy - yes. but it's a chronic struggle. call me soon, man...

Anonymous said...

IT-Band issues. Had it. Don't anymore. Next time you're running and your IT-Band aches, hurdle something. I found this to work by accident, and haven't had any IT-Band problems since. I know it sounds stupid and too good to be true. That's why it's good. And it's free.