ITBS and knowing when to quit
In the past I have suffered a couple of times with ITBS, once through a course at Sandhurst and once up Brecon. I was given a lot of exercises to strengthen up my tight, weak hip flexors and the like, and thought nothing more of it. I got into running longer distances of a more trail style and really enjoyed myself to the extent I thought entering an ultra marathon was a sensible, reasonable and achievable thing to do. I knew I probably had some small tears in my right meniscus too, but they've fallen into the category of old age pains now, so I can live with those well enough.
The training was going well for me too, right up until about a month ago when I caught a bit of a cold off my wife and took some time off to recover. I knew it would take me about a week to get over it, so I stopped running. A good thing too, because I developed sinusitis and did something to my back during that week, which put me out for a bit longer.
Finally though, I was ready to get back out there and. I took it easy for the first time out, only about 3.5 miles round the village. All went well, so I went out the next day for a more usual 9 miles. All good too. "Fantastic!", I thought. "Things are back to normal and I can get back on with my training plan." The next run saw me reach 2.5 miles before I got a bit of a sharp pain in my right knee. Running through it didn't work and a half a mile further on I could barely take weight on that side while running. I ended up walking home and stoking myself up with 'brufen and ice packs.
Since then I have not run. I have cycled several times and that's gone well. I've stretched loads and things don't hurt any more, but I am worried that this will come back when I am out running around yorkshire this weekend with heavy kit and put me even further behind my schedule. I know I need to see the GP and get a referral for an MRI and a specialist, but that will see me downgraded and the real issue here is whether this will heal enough, or be strong enough, for me to compete in something that will have me doing 55+ miles a week by mid-June.
I've not really had experience of bouncing back from ITBS to this level before, so I would welcome any and all experience on what I can expect and how to tip the odds in my favour. Alternatively, if you think that it will not hold up for the time I have left, tell me. I amy not listen to you, but I'll take your advice in good faith.
Re: ITBS and knowing when to q
I've suffered with ITB problems a couple of times and both times have been whilst training long distance stuff.
I did a little bit of stretching as part of my recovery, but not much as I'm rubbish at sticking to any kind of stretching plan. After suffering the degree of pain you describe I'd take at least a week off exercise and ice the knee well on an evening (or as much as possible really). After a week, go out for a short run and see how it feels. If that goes ok, go for a bit longer, but on a route that allows a quick path home. If that goes ok, all good; just start building your distance slowly and take it very steady on descents. If your knee starts giving you jip, walk straight home and start again with rest and ice. I'm sure this is far from textbook and more stretching would no doubt be beneficial, but it worked for me.
Also, I'd leave the heavy kit at home until you're satisfied the ITB problems are long gone; a heavy pack will exacerbate any problem big time.
Re: ITBS and knowing when to q
Sadly I don't think leaving the heavy kit at home is going to cut it with my unit, but I know what you mean. I'll see what happens on a shorter run or two and then try and work up to the longer ones.
Re: ITBS and knowing when to q
How sure are you that you have ITBS? I was sure i had it for about 3.5yrs until it turned out to be kneecap tracking.
The symptoms of ITBS can be the same as all of these...
IT Bursitis
Unstable hip caused by poor Gluteus Medius recruitment
Kneecap maltracking
I have all of these and was misdiagnosed several times as having ITBS. My poor Glute Med. recruitment caused the Tensor to overcompensate and yanks on the ITB which in itself isn't tight. The yanking inflames the IT Bursa and the LC ligament but can only really be picked up by a detailed gait analysis, as the specialist has to watch your hip drop as you run on the treadmill.
The Bursa irritation will fade away if i go steady after periods off with injury but the kneecap tracking has to be very carefully managed and can exhibit all the symptoms of ITBS. My weekly milage, when i can get back on my feet, won't be able to exceed about 15-20 and my physio agrees this is sensible for someone with my problems. It took more time and pain than i care to recall to come to the realisation that i couldn't beat it by lowering my milage or running through it, i had to stop all exercise for a long time and reassess my situation drastically aswell as hitting an intensive program of exercises and stretches. I was warned by someone who had been through it all before that it takes an incredible amount of discipline to keep it going month on month, and it does.
With reference to knowing when to quit, the answer is to never quit; you just have to keep resetting your limitations and work within them. Every spill teaches you a lesson; i've got tendonitis in both knees now from trying to get back too fast, by the time i run again it'll be 1.5yrs since i last ran properly for one reason or another. It'll mentally destroy you if you let it.
Re: ITBS and knowing when to q
Agree with everything said so far but first you definitely need a proper diagnosis and from which you will be able to formulate a recovery plan.Then with time, rest, ice, physio etc. you should be back running again. It may take time but giving up is not an option!
Trust me, as somone who has spent a lot of time recovering from various ailments there are no shortcuts to be had either. Do not be tempted to push too hard too soon - it will only set you back further in the long run. (Excuse the pun!)
Re: ITBS and knowing when to q
Ah those four little letters...I have had flares of this every year since my first (and only) marathon in 2008, I am sorry to say. Physio, acupuncture, orthotics, deep tissue massage, periods of rest, ice, ibuprofen, changing from road running to off road, training solely off road, changing heel drops in my shoes...you name it, I have done it. Oh, except Pilates I can't fit that into my family schedule I'm afraid.
So, here's the update. Going ok from summer last year to about Feb, big flare up when increasing my miles...only 8 to 13, not that extreme. Got second opinion on my running gait and new podiatrist said I am hyper mobile in my hip and knee joints which is apparently the reason why my knees slide in when running therefore pulling my hip and ITB. Orthotics would never really work, my feet are not the problem...(£65 original assessment fee and two sets of orthotics at £45, money gone...thanks) Solution, no long running. Propriception (?) exercises to bolster my stability..thought I'd worked hard on that. Hey ho. I foam roll the band everyday, I use a tennis ball to massage my gluteus, I stretch and do yoga. I use k tape as well.
The result...I have a groin (psoas) strain, my hip is tight all the time, my knee still flares up. Race calendar scrapped.
More sad than sad, still running though propped up by Voltarol and Deep Heat. Going to Lourdes next....
Re: ITBS and knowing when to q
Well, there's an update of sorts... Things were feeling fine before I left for sunny Catterick on Wednesday, so when I arrived at my chosen destination, complete with car laden with kit and bored from the drive, I thought I would go out for a bit of a run. Now, the knee had been fine for a week, but then I'd not been running on it for a week.
Anyway, long story short, 3 miles down the road, it flared up again and I had to turn back. As I came back through the gate at a medium hobble, I was asked if I wanted directions to the med center. Joy. I also got told I looked like crap, but that was later. Cue painkillers and a day of rest on the range with the lads.
Friday was a different story though, despite lugging about 35 kilos around all day (and all day Saturday) the knee felt fine and has continued to feel fine even to today's 14 mile bike ride. I'm going to try a short run tomorrow (no more than a couple of miles), but I think the main source of exercise for the next couple of weeks is going to be on the bike. Which is like having sex fully clothed. Well, sort of.
Anyway, it's all exercise right? I'm still very concerned that I'm not going to be able to complete the race though. I'm going to try like hell though
Re: ITBS and knowing when to q
Quote:
Originally Posted by
jameseyb
Well, there's an update of sorts... Things were feeling fine before I left for sunny Catterick on Wednesday, so when I arrived at my chosen destination, complete with car laden with kit and bored from the drive, I thought I would go out for a bit of a run. Now, the knee had been fine for a week, but then I'd not been running on it for a week.
Anyway, long story short, 3 miles down the road, it flared up again and I had to turn back. As I came back through the gate at a medium hobble, I was asked if I wanted directions to the med center. Joy. I also got told I looked like crap, but that was later. Cue painkillers and a day of rest on the range with the lads.
Friday was a different story though, despite lugging about 35 kilos around all day (and all day Saturday) the knee felt fine and has continued to feel fine even to today's 14 mile bike ride. I'm going to try a short run tomorrow (no more than a couple of miles), but I think the main source of exercise for the next couple of weeks is going to be on the bike. Which is like having sex fully clothed. Well, sort of.
Anyway, it's all exercise right? I'm still very concerned that I'm not going to be able to complete the race though. I'm going to try like hell though
You have mail.
Re: ITBS and knowing when to q
Quote:
Originally Posted by
mr brightside
With reference to knowing when to quit, the answer is to never quit; you just have to keep resetting your limitations and work within them. Every spill teaches you a lesson; i've got tendonitis in both knees now from trying to get back too fast, by the time i run again it'll be 1.5yrs since i last ran properly for one reason or another. It'll mentally destroy you if you let it.
:)
That is up there with some of the best advice i've seen dispensed on here.
Re: ITBS and knowing when to q
Quote:
Originally Posted by
Danbert Nocurry
:)
That is up there with some of the best advice i've seen dispensed on here.
Agreed. Fine post mr brightside :thumbup:
Re: ITBS and knowing when to q
Mr. Brightside,
Received! Thanks for the tip.
As for not quitting, I'm completely sold on that already, but there are times when even my high pain tolerance is tested and if my knee plays up halfway through this race (assuming I can train enough to compete) then all the codeine in the world won't help me for the last 30 miles. Well, it might.
Anyway, off to the physio when I can get an appointment so I will report back when I find out what's wrong.
Re: ITBS and knowing when to q
So, physio...
After a fair amount of watching me try and balance, stretch, move, etc my physio is pretty sure that my knee problem is due to the knee not tracking properly, probably due to the nearly month off that I have had so far from training. He's given me a load of exercises to do, advised me to keep on with the cycling to keep general fitness up, and gradually work in running from shorter distances upwards.
Apparently there is nothing structurally wrong with my knee that he can find (well, no more than normal and the last time he saw me) so this is just an injury to be worked through as opposed to damage that would mean a retirement. All good news then.
Speaking of which, time for me to get started on some exercises. Stay tuned for updates in the amazing saga of the tall person's knees.
Re: ITBS and knowing when to q
Quote:
Originally Posted by
jameseyb
So, physio...
After a fair amount of watching me try and balance, stretch, move, etc my physio is pretty sure that my knee problem is due to the knee not tracking properly, probably due to the nearly month off that I have had so far from training. He's given me a load of exercises to do, advised me to keep on with the cycling to keep general fitness up, and gradually work in running from shorter distances upwards.
Apparently there is nothing structurally wrong with my knee that he can find (well, no more than normal and the last time he saw me) so this is just an injury to be worked through as opposed to damage that would mean a retirement. All good news then.
Speaking of which, time for me to get started on some exercises. Stay tuned for updates in the amazing saga of the tall person's knees.
If you've got the VMO recruitment exercise remember the importance of clenching to 100% in your reps. The last 3% of muscle tension is the bit that counts and the bit that will shove your kneecap back in the right direction.
Re: ITBS and knowing when to q
Quote:
VMO recruitment exercise
Which one is that? Sitting flat on the floor with a rolled up towel under the knee and pushing down, or something else?
Re: ITBS and knowing when to q
Just to add, I went out for a run on Sunday and within a mile I had the pain back again. I am extremely upset with my knee and want the damn thing replaced with a better design that actually works properly. Thanks to the weakness of my body I am now having to face the harsh reality that I might not be able to actually compete in the race I was training for.
Re: ITBS and knowing when to q
I feel for you Jameseyb, it's so disheartening to see the same injury crop up again and again no matter what you do. I know that turning in your number will feel like failing but I would ask myself whether I want to push to do an event which in all likelihood I wouldn't be able to complete, or in my case couldn't even train properly for or concentrate on getting rehab and simply getting back to the basics of enjoying any kind of running.
It might depend on what type of person you are but I felt a sense if disappointment but also relief when I traded my number for a forthcoming event. I no longer had to think 'will I make it or won't I'. I felt more in control.
Re: ITBS and knowing when to q
Yeah, I know that, but I use running (and cycling to some degree) as a means of clearing out my head and working off the stresses of the day. The fact that I can't do that is putting a lot more of the stress onto me and because I feel like my body is letting me down, it means I'm just getting more upset with myself. Cycling's just not the same. Maybe that will change when I get my new road bike.
I hate quitting.
Re: ITBS and knowing when to q
Quote:
Originally Posted by
jameseyb
Which one is that? Sitting flat on the floor with a rolled up towel under the knee and pushing down, or something else?
Aye, that's the one.
Quote:
Originally Posted by
jameseyb
Just to add, I went out for a run on Sunday and within a mile I had the pain back again. I am extremely upset with my knee and want the damn thing replaced with a better design that actually works properly. Thanks to the weakness of my body I am now having to face the harsh reality that I might not be able to actually compete in the race I was training for.
It won't go away in a week or so, i can promise you this, i ended up off for 6 months. The time off is necessary for tissue repair and the recruitment exercises need time to kick in. Please trust me on this- every time you think f**k it and go out for a run you go back to square one. You may not need 6 months off like me, but you need an extended break from all exercise and to be totally and utterly focused on your rehab exercises.
I've been through all the emotions you're describing, it's like breaking up with a girlfriend for the first time, it's bad for weeks on end and you are waking up every day filled with a new negative emotion; but you deal with it because you have to. Gradually the process will get easier, i took up a program of intensive race marshalling to get me out on the hills. By going at it pissed off and half arsed you only cheat yourself out of more time that could be spent resting and healing; take it from me- years can go by like this, years of nothing but wasted time and pain.
I now have more patience than a saint, and a greater level of discipline than a Wing Chun master after my ordeal. The fact you can still cycle pain free probably means you can see the back of this with the discipline of a yellow belt. Best of luck.
Re: ITBS and knowing when to q
Thanks master! I'll give it a try, but being without my primary means of exercise is going to be tough. It took a long time for me to get rid of the excess weight I had and get to this level of fitness and I hate to think of what will happen to me in the interim. I guess I can also look forward to failing next month's PFA too unless I can stretch my knee out to 1.5 miles just that once. Oh, and an 8 mile OFT.
Happy days.
Re: ITBS and knowing when to q
Having had this problem myself earlier in the year and getting so fed up with it and all the conflicting information that you can find on it, I bought an e-book on the subject. It turned out to be basically a systematic review of all the evidence that exists on ITBS, the causes and cures. Sadly the only two things that have actual proven clinical results are surgery and long term rest, and by long term it means at least 6 weeks of complete rest followed by a lengthy transition phase back into full training. The conclusion on all the other treatment methods was that they probably won't hurt and they might help, although no-one has produced anything concrete yet. Because of this I figured the best approach was to just try everything I possibly could - foam rolling, stretching, hip strengthening exercises etc, and stick to the routine, doing something every single day, and building my runs back up very slowly (starting at 1.5km and increasing by about 0.5km per week). It's been a long process but I think I'm pretty much over it now.
The most important thing with any injury though is to find out the cause of it and treat that cause rather than just treating the symptoms. For some people it's a weakness in a particular muscle, or a tightness, or a defect in gait etc. For me I'm pretty sure it was the motion control shoes that the running shop 'prescribed' me to correct my overpronation, but don't get me started on that.....
