Sunday, February 24, 2013

ITB Blues.

So the last running related post I did on here was my marathon recap. Nada since then. Nada, unfortunately being a word that can also be applied to the amount of real running I've done since the marathon, in early November.

I can count on two hands the number of times I've ran. Since early November. Three plus months ago.

I haven't wanted to write about it, because it's just a bummer, and also because I've been slightly in denial. But I feel I can share now, because today, for the first time since the marathon I ran more than a mile without any knee pain. In fact I ran three. And I am super, super hopeful that this means I can finally return to my beloved city streets on a regular basis (that sentence also reads like I could be an on-the-mend prostitute, rest assured, I don't mean those kind of streets).

I did what all runners do with any kind of injury. I googled the shit out of it. Although from my own running history I kind of immediately knew what the likely culprit was:

Back when I was in my wee, early days of running, I trained for the Monument Ave 10k and promptly got injured. My sports med doctor called it a hip strain. And it was, kind of. But it was also, as my physical therapist, could quickly see, the symptom of a larger problem, ITBS, or iliotibial band syndrome. I did PT for several weeks, lots of clam shells, lots of stretches and strengtheners. I got a foam roller and learned about its magic. And it got better.

Nearly two years later however, ITBS reared its ugly head. It's an overuse injury, which means it doesn't start out screaming at you. It starts out quiet. I noticed it during my long training runs a month or so out from the marathon. Pain on the outside of my knee. At the time it was relatively dull and I could run through it. I'd be sore around the area for a couple of days, mostly going up and down stairs. But I could push past it. I had my eyes on a shiny marathon medal and a 26.2 sticker, and pesky knee pain wasn't going to stop me.

Plus there was the whole last minute calf strain thing, which pushed any other aches and pains out of my mind. And then there was the marathon. I'll just quote myself to describe how my knees were doing at around mile 20.

"The walk/run strategy was okay other than the first 30 seconds of starting to run again. Every time I did that I had to brace myself and hold my breath for just excruciating pain as my running muscles started up. Both of my knees felt like they had shards of glass in them and the transition from walking to running made those shards of glass really, really pissed off."

Oh yes. That. A normal person would, I don't know, stop doing an activity if said activity made it feel like there were shards of glass grinding around inside their knee. But this was on marathon day, so clearly I was not in any way a normal person. I put it to the back of my mind. I remember it very distinctly, how my knee felt every time I started to run. I think I knew then, what it was costing me, that I was doing something very bad to my body. But of course I kept going. I had to. Even now, knowing what I know, I wouldn't have stopped. I would have been just as much of an idiot, because when you run a marathon you have to stop being smart and start being stupid. Stupid during a marathon is the language of your heart. Brave, heroic, but incredibly stupid.

I tried to run about a week after the marathon, and honestly I don't remember that run being all that bad. Maybe because my body was such a wreck that there were too many aches and pain to differentiate from, but it wasn't until the next run that I knew something was wrong. I went out for a run, and right around the mile one mark, the side of my right knee started hurting. Within a few minutes it went from dull pain that you can run through to sharp, bold pain that demands stopping. I could even feel a tender to the touch spot on the side of the knee when I went to examine it.

And that is the story of the next handful of runs I attempted. I would wait a week or two, think it was "better", and then try to run. I would get a moment of hope at the beginning of the run when I was pain free, but like clockwork, ten minutes or so in, the knee would start to hurt, really hurt. I would walk/run for a few more minutes, until even that was too much. And then I would end up walking home, defeated. After all of these runs I'd have pain in the knee for the next couple of days whenever I went up and down stairs or if I kept my knee in one position too long.

I increased the time between my runs, hoping that might help. The longest I went was three weeks. Three weeks. Without any running. It broke my heart, but the worst part is that the time didn't seem to help at all in recovery.

Which brings me to the googling portion of this story. And the asking for advice portion. All of which led me to the same conclusion. ITBS. My case was textbook. I read dozens of similar stories from other runners, all of them frustrated by the same thing, but the inability to run. Some scared the crap out of me, with tales of not being able to run for six months to a year. Others gave me false hope by promising that one simple stretch would completely fix the problem.

I knew what I needed, physical therapy. PT has helped me through two running injuries now, and both times the staff at Physical Therapy Solutions have been miracle workers. It's such a holistic approach, with so many different angles, from stretches to strengthening to massage to ultrasound therapy. The only problem is that I'm a student and have crap insurance, and physical therapy would have to come out of my pocket.

But then, in a moment of clarity, I realized that yes, physical therapy, would be ideal. But I've already done the PT thing for ITBS when it was manifesting in my hip. I can't give myself ultrasound treatment or TENS, but I have the tools for almost everything else. I know by now what works, what needs to be done, and so why was I sitting on my butt, twiddling my thumbs and waiting for my knee to get better? Why wasn't I being proactive and doing things to achieve that?

So a couple of weeks ago I started. I have thrown everything including the kitchen sink at it, including:
   -daily Advil (trust me, I am a nursing student, and know NSAIDS should only be used for a short     term approach)
-strengthening exercises like my old friend, the clamshell
   Dramatic reenactment: I do not look this happy when I'm doing it
-I've been using my stick roller massage thingy (that is its technical name). One thing PT taught me is that massage for rehab should not be relaxing and pleasant. It should hurt like hell. I cannot imagine the amount of scar tissue and adhesions that have built up around my IT band since training. And I can feel them when I roll over them, because it does not feel like that when I roll over muscles elsewhere in my body. In this case, pain is a good thing.

-I've been using ice (probably not as much as I should because I forget)

-I've been using homeopathic gel with arnica (yes seriously). A lovely friend from nursing school gave me some Traumeel before the marathon when I had my calf strain, and I swear that stuff made a difference. So I thought, why not try it again? It's all-natural and it's not harmful. I may not be a homeopathic buff or even really believe in it for a lot of things, but for inflammation and sports injuries it makes sense to use plant based remedies that people have been using in that fashion for centuries. Plus when I apply it I have to massage those muscles again, which is also good.

-Finally and last but not least, I have been stretching like crazy. My eye doctor of all people, recommended a stretch using a counter top. You can see a demo of it in this very low budget Youtube video

I really like stretches that make you suffer a little, because then it feels like you're actually challenging your muscles. This one is killer. I can feel it all the way from my butt to my knee. I know some people say that the ITB cannot be stretched because it's mostly fascia, and okay, fine, that sounds scientific and true. But whatever this stretch stretches, I feel it right along where my IT band runs.

And that's the whole kaboodle. I was literally at the point where I would try anything, so I tried almost everything.

I cannot say if one of those things worked. If so I could never say which one. Maybe it was the combination. Maybe it was none of them and my IT band just randomly decided to stop being a jerk. For whatever reason, something changed, because today I ran three miles with zero knee pain. Not a twinge. And it makes me so happy, because God I've missed it. It was sunny and beautiful out today, and I can't tell you how much I've needed. The gym five days a week is bleak. I never realized how much I needed running not just for the mental and physical exercises, but for the very basic fact that it gets me outside, where there is sunshine and not just fluorescent school or hospital lighting. 

I don't want to get too excited, because I know this injury may very well not be over. ITBS isn't like a strain that just heals. It tends to stick around and rear up at inopportune times. I'm not going to over do it and jump back into running too fast. My post marathon idea of running a spring half marathon is pretty much out the window.

But I am cautiously optimistic. And I am humbled. I knew going into the marathon that it wouldn't be free. 26.2 miles can't possibly be. I was prepared for a cost, but I didn't know it was going to be three months without running, three months without gorgeous Sunday afternoons, without my city streets racing past, without fresh air in my lungs. I paid dearly for the marathon. And I just hope that it's done now. That I've paid my dues and I can get back to running.

Because I love it. Because my life isn't the same without it. Because today, running three miles felt like coming home. 

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