A week today I will hopefully be nearing the finish line in Central Park NY.
For those interested here is the course description and the elevation profile. I notice it's all hills and more hills!
http://www.ingnycmarathon.org/training/coursepreview.php
http://www.ingnycmarathon.org/entrantinfo/elevation.pdf
It's a 10:10am start, they are 5 hours behind UK time.
This week I trained on Wednesday and Thursday, running 3 and 5 miles. Wednesday was thoroughly miserable. I got out of the car after being in traffic jams for 5 hours. I got changed and went straight out. It was pitch black, very cold and throwing it down with rain. Not a very nice session at all. The roads were flooded and I was running up to my ankles in water at times. I looked like a drowned rat when I got back.
Thursday I can't recall the weather, but it was certainly better. Both sessions I completed at pace, and without any pain. I was wearing the Pattstap both times, however 5 miles is hardly marathon distance is it!
On Friday afternoon I travelled to my uncles in Sheffield for some chiropractic treatment. My pelvis is badly tilted upwards to the right, and rotated backwards on the same side. All of my back muscles were very tight on the right and were pulling my pelvis in that direction. This was the root cause of my ITB, all down to my back. My uncle assessed me and said I was a "walking disaster". As a result I had a couple of hours worth of treatment. I had Chiropractic adjustments, a lengthy soft tissues massage on my back and also right leg/knee/calf, and finally 40 minutes on one of the machines that passes electric current through the muscles. He also demonstrated how my leg leg will not stretch very far backwards becuase of this. As a result I'm almost dragging it along, and hence it has wasted muscle and is not giving me as much forward momentum and power. He suggested some exercises to help with that.
My Unlce suggested I stay over that evening and repeated the treatment in the morning, which I did. He also gave me a larger heel insert for my shoes as he said my current one was not sufficient. I travelled home and went to see my orthotic maker. They agreed with my uncles assessment and are modifying my orthic from a 4mm to an 8mm lift in the left foot. I won't be using the new orthotic for the marathon of course, I will be using a copy of the originals that I have in my work shoes.
I wish I would have gone to see my uncle eight weeks ago when this happened. He would have given the me right diagnosis and set me on the path to recovery sooner. I have been getting sports massage for the last 8 weeks which has certainly aleviated my ITB symptoms, but not treated the cause. I am going to see him again later on Tuesday for a final session. He thinks that even these few sessions will make a big difference.
Today, Sunday I did my last longish run. In the plan was to cap it at an hour. I decided I would try and do almost an hour no matter what. I ran an undulating route, primarily descending for the first half of then all uphill for the last half. I ran what I think was my quickest ever 7 miles, averaging 7:44 per mile. Of course 7 miles is a long way off 26.2, but the treatment at the weekend has certainly helped and I felt smoother and more relaxed when running.
So maybe i'll get fortunate and not be too bothered my the ITB. 7 miles is too few to tell, but the ITB gave me no problems. I also wore the pattstrap as well. Next Sunday, the race day it will have been 7 weeks exactly since the injury struck on that attempt to do my first 18 miler. I only managed 15 that day, and of course have done very little since then. So, my endurance will really be questioned next week, but rather that than my ITB. Today is the last time I am going to dwell on my lack of 18-20 mile training runs.
Today was a confidence booster. I ran fast, much faster than the pace I will set off at in the marathon, which will be 9 minute miles.
I had no knee pain at all, not even a niggle.
Despite everything I am going to try hard to finish in under 4 and a half hours. It's quite a big ask, but if I remain injury free on the day, I'll be able to give it my best shot.
Not sure I'll be posting again before next week. I assume the hotel has internet access, The Crowne Plaza on Broadway (staggering distance from the finish line!). If it does I'll post my results next week.
Keep your fingers crossed for me.
Sunday, October 29, 2006
Sunday, October 22, 2006
3 targets
Just been reading daily tip 18 on the ING NY marathon website.
http://www.ingnycmarathon.org/training/dtip18.php
Basically saying, set 3 targets: An ideal sceanrio, plus two others.
The tip 18 says that in an ideal scenario you would finish in double your 1/2 marathon time + 15-20 minutes. My 1/2 marathon time was 1:52
That would make my ideal scenario finish of 3:59 - 4:04 hours. That scenario would be me in peak form, no injuries and no unforseen circumstances on the day.
I'm going to be realistic, and say that my chances of meeting scenario 1 have long long gone.
So, I need to set two more realistic goals.
Scenario 2: I've not trained any further than 15 miles (and that will have been 8 weeks before the marathon), before all the injury problems. So, I've not got the endurance training I needed. In this scenario though,I don't get an injury issues on the day, or none that affect my performance. In this scenario I'm estimating a finish of 4:30.
Scenario 3: I've not had enough endurance training and injury strikes on the day, in the latter half of the race. It seriously affects my performance, but I am able to finish albeit with some periods of walking and ITB stretching. I finish in a time of 5 hours+.
I'll have to include the other possible scenario, because it is more than a possibility, given my current form. The ITB injury starts causing pain from 2-3 miles. By 6 miles it causes serious discomfort, by 8 miles I'm half-limping. By 10 miles I'm having to walk and stretch the ITB every few hundred yards to be able to run the next few hundred. By 12 miles I've had to retire.
It's not pleasant to think about that last one, but I think I've got to consider it as a possibilty, and prepare my mind for it. I'm going to be thinking positive from now on, and remembering all the good parts of my training. I will however be considering all of the above scenario's and planning in my mind for each.
http://www.ingnycmarathon.org/training/dtip18.php
Basically saying, set 3 targets: An ideal sceanrio, plus two others.
The tip 18 says that in an ideal scenario you would finish in double your 1/2 marathon time + 15-20 minutes. My 1/2 marathon time was 1:52
That would make my ideal scenario finish of 3:59 - 4:04 hours. That scenario would be me in peak form, no injuries and no unforseen circumstances on the day.
I'm going to be realistic, and say that my chances of meeting scenario 1 have long long gone.
So, I need to set two more realistic goals.
Scenario 2: I've not trained any further than 15 miles (and that will have been 8 weeks before the marathon), before all the injury problems. So, I've not got the endurance training I needed. In this scenario though,I don't get an injury issues on the day, or none that affect my performance. In this scenario I'm estimating a finish of 4:30.
Scenario 3: I've not had enough endurance training and injury strikes on the day, in the latter half of the race. It seriously affects my performance, but I am able to finish albeit with some periods of walking and ITB stretching. I finish in a time of 5 hours+.
I'll have to include the other possible scenario, because it is more than a possibility, given my current form. The ITB injury starts causing pain from 2-3 miles. By 6 miles it causes serious discomfort, by 8 miles I'm half-limping. By 10 miles I'm having to walk and stretch the ITB every few hundred yards to be able to run the next few hundred. By 12 miles I've had to retire.
It's not pleasant to think about that last one, but I think I've got to consider it as a possibilty, and prepare my mind for it. I'm going to be thinking positive from now on, and remembering all the good parts of my training. I will however be considering all of the above scenario's and planning in my mind for each.
Bad Day
When I started running today it was raining heavily. It didn't stop raining hard at all.
My 'waterproof' jacket turned out to have all the waterproof properties of a string vest. It was also a chilly day. So within minutes I was very wet, very miserable and very cold.
A couple of minutes later my GPS unit failed. The repair I made on it a few months ago has been good until now, but I'm going to have to replace it before the marathon. The only advantage is that the replacement model is much smaller than the original. You can see the units below, pictured with the heart rate strap and the watch.
The newer unit only takes one AAA battery instead of 3.
Anyway...I'm now cold, wet, miserable and I have no GPS. My route takes me off road, hopefully to ease the load on my knee which I strapped up before starting out. The offroad path is pretty waterlogged though.
So, a few short minutes later my trainers have soaked up twice their weight in water and it feels like I'm wearing concrete shoes. Then just to add to my misery, my knee starts playing up. I stop running after about 5.5 miles and walk the other mile home.
For the rest of the day the other end of the ITB, my hip, has been very painful.
My ITB just isn't getting enough time to heal, before taking another pounding on the next run. There is no way I should be doing a marathon 2 weeks today. The remainder of the training runs will have to be capped at 3 or 4 miles to try and help.
All in all, a very bad day.
My 'waterproof' jacket turned out to have all the waterproof properties of a string vest. It was also a chilly day. So within minutes I was very wet, very miserable and very cold.
A couple of minutes later my GPS unit failed. The repair I made on it a few months ago has been good until now, but I'm going to have to replace it before the marathon. The only advantage is that the replacement model is much smaller than the original. You can see the units below, pictured with the heart rate strap and the watch.
The newer unit only takes one AAA battery instead of 3.
Anyway...I'm now cold, wet, miserable and I have no GPS. My route takes me off road, hopefully to ease the load on my knee which I strapped up before starting out. The offroad path is pretty waterlogged though.
So, a few short minutes later my trainers have soaked up twice their weight in water and it feels like I'm wearing concrete shoes. Then just to add to my misery, my knee starts playing up. I stop running after about 5.5 miles and walk the other mile home.
For the rest of the day the other end of the ITB, my hip, has been very painful.
My ITB just isn't getting enough time to heal, before taking another pounding on the next run. There is no way I should be doing a marathon 2 weeks today. The remainder of the training runs will have to be capped at 3 or 4 miles to try and help.
All in all, a very bad day.
Thursday, October 19, 2006
Some Improvement
I received the Reebok Foam Roller I'd ordere on Tuesday. I got straight to work on it, doing a variety of strecthes, but making sure I paid plenty of attention to my ITB. 'Foam' Roller makes it sound as though it's a soft squishy little sponge. It's not. It is 1 metre long and it is about 6 inches in diameter, and it's hard foam.
You lie on top of the roller and work your way down over your various muscle groups. When you feel a tender spot, you stop and hold it there for 30-45 seconds until the muscle releases. It can really hurt, just like a sports massage. I used it several times Tuesday and on Wednesday morning before my physio appointment.
Mike, the Physio, commented that my muslces appeared to be much looser than normal! Also when he was deep tissue massaging my knee and ITB it hurt far less, hardly at all this week. The only area which still caused me a lot of pain (as he digs his elblow in) was my hip. That is still very tender.
Later on Wednesday I went out for a run. I wanted to try and push further than 4 miles. I didn't wear my GPS as the batteries had run down. I set out on a unplanned route and justmade it up as I went along. I had to guess my pace of course too. I picked a challenging undulating route as you can see. Probably a little tougher and steeper than I should really have attemted.
I put a strip of Leukotape 3 inches above my kneecap again, to ease pressure on my ITB. Seemed to do the trick as I felt no pain at all, and completed what turned out to be 5.5 miles. I averaged 8:05 minute miles. Not bad for such a tough course. Plenty of that route was offroad, and some parts are wooded with some treacherous footing.
I stretched out and used the foam roller to cool down.
I have continued to do 3 sets of the strengthening exercises and stretches each day.
The routine I follow now is: (repeated for each leg where applicable)
Use foam roller to warm up and strectch - Hamstring, Quads, Calfs, ITB, Back, Gluts
Then:
20 x short squat
20 x sitting. Point toes away, pull toes towards
20 x sitting. foot turned outwards leg raises
4 x 30 secs. lying, Bend knees, raise bum to form line from knees to shoulder
10 x 10 secs. Same as above, but straighten one leg in air, all weight on one leg
20 x lying on side leg raises
2 x 20 secs classic ITB stretch
20 x Walt Reynolds ITB special
This is quite a punishing routine to put myself through 3 times a day and takes over half an hour each time.
I'm happy with my progress and the way it appears to be recovering. I'm far from being out of the woods yet, but I feel as though I may make the start line reasonably pain free. I doubt i'll stay like that for 26 miles, but i'll do what I can.
You lie on top of the roller and work your way down over your various muscle groups. When you feel a tender spot, you stop and hold it there for 30-45 seconds until the muscle releases. It can really hurt, just like a sports massage. I used it several times Tuesday and on Wednesday morning before my physio appointment.
Mike, the Physio, commented that my muslces appeared to be much looser than normal! Also when he was deep tissue massaging my knee and ITB it hurt far less, hardly at all this week. The only area which still caused me a lot of pain (as he digs his elblow in) was my hip. That is still very tender.
Later on Wednesday I went out for a run. I wanted to try and push further than 4 miles. I didn't wear my GPS as the batteries had run down. I set out on a unplanned route and justmade it up as I went along. I had to guess my pace of course too. I picked a challenging undulating route as you can see. Probably a little tougher and steeper than I should really have attemted.
I put a strip of Leukotape 3 inches above my kneecap again, to ease pressure on my ITB. Seemed to do the trick as I felt no pain at all, and completed what turned out to be 5.5 miles. I averaged 8:05 minute miles. Not bad for such a tough course. Plenty of that route was offroad, and some parts are wooded with some treacherous footing.
I stretched out and used the foam roller to cool down.
I have continued to do 3 sets of the strengthening exercises and stretches each day.
The routine I follow now is: (repeated for each leg where applicable)
Use foam roller to warm up and strectch - Hamstring, Quads, Calfs, ITB, Back, Gluts
Then:
20 x short squat
20 x sitting. Point toes away, pull toes towards
20 x sitting. foot turned outwards leg raises
4 x 30 secs. lying, Bend knees, raise bum to form line from knees to shoulder
10 x 10 secs. Same as above, but straighten one leg in air, all weight on one leg
20 x lying on side leg raises
2 x 20 secs classic ITB stretch
20 x Walt Reynolds ITB special
This is quite a punishing routine to put myself through 3 times a day and takes over half an hour each time.
I'm happy with my progress and the way it appears to be recovering. I'm far from being out of the woods yet, but I feel as though I may make the start line reasonably pain free. I doubt i'll stay like that for 26 miles, but i'll do what I can.
Sunday, October 15, 2006
Sunday Run. Last chance at a long one before NY.
Today was my last opportunity to attempt anything like a 'long run'. All the advice says that in the last 3 weeks before a marathon you can't add to your fitness, just maintain it. The daily tips on the ING NY Marathon website confirm this.
Given my record has been about 4 miles pain free, for the last month, I wasn't hopeful.
I decided to run at a faster pace, and also to put a strip of tape around my thigh about 3-4 inches above my kneecap. I've ordered something called a Pattstrap from the States, which i've pictured.
All of the testimonials say that it really helps and reduces or elimates ITB pain. I don't think it's something you can use longterm, but if it can get me through the marathon...
Anyway, I tried to simulate one of these with a piece of tape. Not a very hi-tech solution and I had to tighten it up after 2 miles, as I don't believe I had sufficient pressure applied. I'm not really sure that a piece of tape worked that well, but I did manage a better distance today so i'm hopeful the real McCoy will do the trick.
I tried to pick a fairly flat route so as not to agitate my injury. I also read running on the opposite side of the road to the one I usually run on is better. This is because of the camber of the footpath. My ITB is very sensitive to camber at the moment anyway, so I was careful where I ran. I tried to stay on the flat, or run when the camber was higher on my left leg.
I decided I was going to run until it started feeling uncomfortable, but not painful. So I took my mobile phone along to call in a lift home.
I averaged 8:21 minute miles, and called a halt to my run at 8.5 miles.
My knee had started to niggle at only 2 miles, but didn't get much worse until just before I decided to stop and get a ride home.
At least I managed a better distance that before, but it's nothing like the 20 miler my schedule had me down for.
All I can do now is keep doing short fast runs and not to agitate my leg by running further. Since the run my knee has hurt, and i've been icing and applying heat as well as taking ibuprofen.
I've kept up my strengthening and stretching, adding a couple more exercises into my daily routine. I've also ordered a foam roller http://www.bodyhut.com/shop/prodView.asp?idproduct=1707
This is used to stretch out my ITB.
I'm hoping all these things i'm doing and buying are going to patch me up enough to make the distance, but when I'm only capable of running 1/3 of the marathon distance without pain, things are still not looking good.
Even revising my finishing time down to 4.5 hours is pretty optimistic I fear.
Given my record has been about 4 miles pain free, for the last month, I wasn't hopeful.
I decided to run at a faster pace, and also to put a strip of tape around my thigh about 3-4 inches above my kneecap. I've ordered something called a Pattstrap from the States, which i've pictured.
All of the testimonials say that it really helps and reduces or elimates ITB pain. I don't think it's something you can use longterm, but if it can get me through the marathon...
Anyway, I tried to simulate one of these with a piece of tape. Not a very hi-tech solution and I had to tighten it up after 2 miles, as I don't believe I had sufficient pressure applied. I'm not really sure that a piece of tape worked that well, but I did manage a better distance today so i'm hopeful the real McCoy will do the trick.
I tried to pick a fairly flat route so as not to agitate my injury. I also read running on the opposite side of the road to the one I usually run on is better. This is because of the camber of the footpath. My ITB is very sensitive to camber at the moment anyway, so I was careful where I ran. I tried to stay on the flat, or run when the camber was higher on my left leg.
I decided I was going to run until it started feeling uncomfortable, but not painful. So I took my mobile phone along to call in a lift home.
I averaged 8:21 minute miles, and called a halt to my run at 8.5 miles.
My knee had started to niggle at only 2 miles, but didn't get much worse until just before I decided to stop and get a ride home.
At least I managed a better distance that before, but it's nothing like the 20 miler my schedule had me down for.
All I can do now is keep doing short fast runs and not to agitate my leg by running further. Since the run my knee has hurt, and i've been icing and applying heat as well as taking ibuprofen.
I've kept up my strengthening and stretching, adding a couple more exercises into my daily routine. I've also ordered a foam roller http://www.bodyhut.com/shop/prodView.asp?idproduct=1707
This is used to stretch out my ITB.
I'm hoping all these things i'm doing and buying are going to patch me up enough to make the distance, but when I'm only capable of running 1/3 of the marathon distance without pain, things are still not looking good.
Even revising my finishing time down to 4.5 hours is pretty optimistic I fear.
Thursday, October 12, 2006
Pain Free II
I had physio yesterday. 45 minutes working just my ITB, and knee area. I was tempted to ask for an anasthetic as he was working it. Sports therapy is painful!
Just when I thought it could not get any more unpleasant I was turned on my side so he could push his elbow into my hip and work the top of the ITB. I completely lost the power to speak at all at this point. Just a series of high pitched whines emerged. Anything hurting this much, must REALLY be doing be good. Mike (Physio) reckons I might just make the start line pain free, but given it's just 3 weeks away, it is touch and go.
I've continued with the stretching and strengthening routing as described previously. I can manage more of those special leg raises now, about 30 at once. Good progress there.
Tried a slightly longer run today. Same strategy as Tuesday; fast not long. I picked another undulating route as you can see above. Nice downhill to start, nasty climbs to finish.
I had no knee pain whatsoever which is encouraging. It aches a little now though. I'm currently sitting with a hot water bottle draped over it.
I completed in a quick time again, finishing with 7:42 minute mile average over the 4.1 miles.
Im happy that I've run pain free, but it just feels like I am starting all over again - Happy that I've done my first ever 4 mile run. I know I can't do anymore than I am doing, but it knocks your confidence wondering if you think you can actually run that far. I'm not going to be able to do any long runs before the event. At absolute best and if my ITB recovers well, maybe I could manage an 8-10 mile the Sunday before.
I'm going to continue to concentrate on running all my remaining runs almost as fast as I can. Obviously I have no choice in this because of my ITB. However, I am somehow hoping that come the event, which I will run about a minute to a minute and a half slower per mile (9 mins), it will feel slow to me and hence will compensate for my lack of 18/20 mile training runs. I think I'm kidding myself really, as nothing can replace that kind of endurance training. However, I have to live in hope.
Tuesday, October 10, 2006
Pain Free Run.
Don't get too excited. It was only 3 miles. I've been reading all the articles on ITBS and as well as all the stretching and strengthening, some also suggest running "fast not long". My knee went at just over 3 miles in the last run, so today I decided to run just under 3 (2.9), but to run it quickly.
I ran a local route, starts on quite a steep hill, levels off and comes back down. Then it undulates back home. See the route above.
I ran it at 7:35 minute miles, which I was happy with, and pain free. I've been strictly keeping with my exercises and have another physio tomorrow.
I'll try another run on Thursday, perhaps a little further, not quite as fast, but still at a good pace.
Sunday, October 08, 2006
Todays run...walk
I did a 6 mile run today, although I walked probably a mile of it. I was perfectly fine up to just over 3 miles. At that point my knee starting aching. By 4 miles it was uncumfortable. By 5 miles I had already had to walk a couple of sections (hills). I struggled onto the end with a mixture of running and walking. As soon as I hit a hill I had to walk. It's amazing that as soon as I start walking, the pain subsides imediately. As soon as I got in I iced it for 15 minutes, as I did a few times today.
I also did my stretching and strengthening routing as below:
3 times a day
20 x Quad Muscle strengthen. Sitting on floor, one knee up. Other foot - toes pulled towards body, foot turned out to the right as far as possible. Leg raises
20 x Short Squat to Quad strengthen
5 x Short Squat towel Squeeze
2 x Standard Quad Stretch
5 x Classic ITBS Stretch
2 x Stepped ITBS Stretch
2 x Sitting, one leg straight, one bent leg over the other, grip leg and twist away
10 x 10 secs Glut medius strengthen. On Back knees raised, life bum up to make straight line down from knees, thru hip, to shoulders. Ensure using gluts.
Ice 15 minutes
Once a day: 400mg Ibuprofen
Hopefully I can build up my quad muscle and end this knee pain.
Back on the subject of the MDS, I found this article on the MDS website. Looks like next year New Balance are releasing an 'MDS shoe'. The interesting thing about them is that they are the 1100 OR trail shoes that I already use, just a different colour by the looks of it! Maybe there's a couple of other changes, but essentially this is what I've been using and been happy with for months. See the pic above.
That's it for this week. Hopefully I'll have better news next week.
Friday, October 06, 2006
Knee Injuries identified.
I had a physio session today to work specifically on my problem knee. I explained the pain and he did a few tests to identify the problem.
I'll post a couple of descriptions I've found. Firstly he showed me I had muscle wastage on my right VMO (Medial muscle just above knee cap on the inside. He measured the circumference of both legs above the knee and the right one was 1cm less. It's also really obvious when you look at it. My lef leg has a distinct bump where the muscle is developed, the right one has lost it's bump totally. Apparently this muscle wastes away very quickly when you have a knee injury.
Anyway, after a further test he diagnosed the following.
Runner's Knee
(Chondromalacia of the patella)
Description:
Pain around and sometimes behind the kneecap. One of the most common injuries among runners, runner's knee most often strikes as runners approach forty miles per week for the first time. Even after taking a few days off, the pain seems to come right back, sometimes even intensifying, after the first few miles of the next run. The pain often feels worst when running downhill or walking down stairs, and the knee is often stiff and sore after sitting down for long periods. You might hear a crunching or clicking sound when you bend or extend your knee.
The sure-fire test for runner's knee: sit down and put your leg out on a chair so that it's stretched out straight. Have a friend squeeze your leg just above the knee while pushing on the kneecap. She should push from the outside of the leg toward the center. At the same time, tighten your thigh muscle. If this is painful, you're looking at runner's knee.
Likely causes:
It's actually not your knee's fault at all. Blame your feet and thighs; for one reason or another they aren't doing their jobs properly. Your knee moves up and down in a narrow little groove in your thigh bone. It's a nifty design: when your legs and feet are working efficiently, your knee moves smoothly and comfortably with every step. But trouble appears when your kneecap moves out of its track, or rubs up against its sides. That trouble becomes pain when you factor in nearly 1000 steps per cartilage-grinding mile. Over time the cushioning cartilage around the knee becomes worn. That smarts. And that's runner's knee.
How did your knee get off track? Probably because of relatively weak thigh muscles and a lack of foot support. It's your thigh muscles that hold your kneecap in place, preventing it from trying to jump its track. Running tends to develop the back thigh muscles (hamstrings) more than those in the front (the quadriceps), and the imbalance is sometimes enough to allow the kneecap to pull and twist to the side.
Your foot, meanwhile, may not be giving you the stability you need. It's likely that your feet are making a wrong movement every time they hit the ground, and you're feeling the constant pounding and repetition of this mistake in your knee. Maybe you're overpronating (rolling your foot in) or supinating (turning it out too much) when you run.
Runner's knee is further aggravated by simple overuse. If you have steeply increased your mileage recently, you might consider holding back a bit. Likewise, back off on new hill work or speed work. Runner's knee can also be brought on by running on banked surfaces or a curved track. Running on a road that is banked at the sides, for example, effectively gives you one short leg, causing it to pronate and put pressure on the knee. Try as much as possible to run on a level surface, or at the very least give each leg equal time as "the short leg."
Remedy:
This is an easily treatable injury with a little patience. First, relieve the pain by icing your knees immediately after running. You can use commercially available cold packs or simply put a wet towel in the freezer before you run. Wrap the cold packs around each knee for about fifteen minutes to bring down the swelling. Take an anti-inflammatory like ibuprofen or aspirin after running, too, but only with food and never before running. Before bed, put heating pads or warm wet towels on your knees for half an hour.
Stabilize your feet. Make sure you have the right kind of shoes for your foot type (review our tips on shoe shopping). Consider buying a commercially made foot support in the footcare section of your drug store. If, in combination with thigh-strengthening exercises, the foot supports are not enough to get rid of the injury, see a podiatrist about whether you might need orthotics.
Ok, so I have runners knee. I can't describe how much the test hurt. Pushing down on that kneecap was agony. He worked my knee for a half hour or so, but then identified what he thought was the underlying cause. When I run I have been getting pain in the side of my knee, and also some deep in my hip. When he rubbed over the side of my knee it hurt worse than the kneecap almost. Turns out that this is your ITB (See description). It runs right up your leg, widening, until it reaches your hip. Full description here:
Iliotibial Band Syndrome
Description:
Pain on the outside of your knee (not usually accompanied by swelling or locking). The pain may be sporadic and disappear with rest, only to reoccur suddenly, often at the same point in a run. Depending on the individual, this could happen at four miles, two miles or just 200 yards. The pain often goes away almost immediately after you stop running.
Likely causes:
This is an overuse injury. The iliotibial band is a band of tissue that begins at the outside of the pelvis and extends to the outside part of the knee. The band helps stabilize the knee. If it becomes too short, the band rubs too tightly on the bone of your leg and becomes irritated. The tightness is usually the result of too much strain from overtraining.
Remedy:
Patience. This one takes a while. Give yourself plenty of rest, reduce your miles and ice frequently. You can keep running, but cut your run short as soon as you begin to feel any pain. Cut way back on hill work, and be sure to run on even surfaces. Look into some deep friction massage with a physical therapist.
Try some leg-raise exercises to strengthen your hips and be conscientious about the iliotibial band stretch. You might supplement that stretch with this one, doing it gently but often:
To stretch the IT band of your right leg, stand with your left side facing the wall. Cross your right leg behind your left, while putting your left hand against the wall. Put your weight on the right leg and lean against the wall by pushing your right hip away from the wall. Be sure that your right foot is parallel to the wall during the stretch. You should be able to feel the stretch in your hip and down the IT band (in this case, along the right side of your right leg). Hold for five seconds and do this ten times. For the left leg, do as above, but stand with your right side facing the wall, and put your left leg behind your right.
He finished up with Ultrasound, and I've booked in for next Tuesday.
He has given me all of the strecthes to do every day, several times, and also instruction to ice it 3 times and day, and take Ibuprofen for the next week.
He's pretty hopeful he can get me to the start line if I follow the routine. I can see me downing ibuprofen on the start line to get around.
So, I'm settling for a finish, and not a 4 hour finish. I need to rest my knee as much as possible, and if I do (or can) run, only every other day. He suggested I did nothing until next week though.
I may try and run at the weekend, but at the first sign of pain, stop.
I'll post a couple of descriptions I've found. Firstly he showed me I had muscle wastage on my right VMO (Medial muscle just above knee cap on the inside. He measured the circumference of both legs above the knee and the right one was 1cm less. It's also really obvious when you look at it. My lef leg has a distinct bump where the muscle is developed, the right one has lost it's bump totally. Apparently this muscle wastes away very quickly when you have a knee injury.
Anyway, after a further test he diagnosed the following.
Runner's Knee
(Chondromalacia of the patella)
Description:
Pain around and sometimes behind the kneecap. One of the most common injuries among runners, runner's knee most often strikes as runners approach forty miles per week for the first time. Even after taking a few days off, the pain seems to come right back, sometimes even intensifying, after the first few miles of the next run. The pain often feels worst when running downhill or walking down stairs, and the knee is often stiff and sore after sitting down for long periods. You might hear a crunching or clicking sound when you bend or extend your knee.
The sure-fire test for runner's knee: sit down and put your leg out on a chair so that it's stretched out straight. Have a friend squeeze your leg just above the knee while pushing on the kneecap. She should push from the outside of the leg toward the center. At the same time, tighten your thigh muscle. If this is painful, you're looking at runner's knee.
Likely causes:
It's actually not your knee's fault at all. Blame your feet and thighs; for one reason or another they aren't doing their jobs properly. Your knee moves up and down in a narrow little groove in your thigh bone. It's a nifty design: when your legs and feet are working efficiently, your knee moves smoothly and comfortably with every step. But trouble appears when your kneecap moves out of its track, or rubs up against its sides. That trouble becomes pain when you factor in nearly 1000 steps per cartilage-grinding mile. Over time the cushioning cartilage around the knee becomes worn. That smarts. And that's runner's knee.
How did your knee get off track? Probably because of relatively weak thigh muscles and a lack of foot support. It's your thigh muscles that hold your kneecap in place, preventing it from trying to jump its track. Running tends to develop the back thigh muscles (hamstrings) more than those in the front (the quadriceps), and the imbalance is sometimes enough to allow the kneecap to pull and twist to the side.
Your foot, meanwhile, may not be giving you the stability you need. It's likely that your feet are making a wrong movement every time they hit the ground, and you're feeling the constant pounding and repetition of this mistake in your knee. Maybe you're overpronating (rolling your foot in) or supinating (turning it out too much) when you run.
Runner's knee is further aggravated by simple overuse. If you have steeply increased your mileage recently, you might consider holding back a bit. Likewise, back off on new hill work or speed work. Runner's knee can also be brought on by running on banked surfaces or a curved track. Running on a road that is banked at the sides, for example, effectively gives you one short leg, causing it to pronate and put pressure on the knee. Try as much as possible to run on a level surface, or at the very least give each leg equal time as "the short leg."
Remedy:
This is an easily treatable injury with a little patience. First, relieve the pain by icing your knees immediately after running. You can use commercially available cold packs or simply put a wet towel in the freezer before you run. Wrap the cold packs around each knee for about fifteen minutes to bring down the swelling. Take an anti-inflammatory like ibuprofen or aspirin after running, too, but only with food and never before running. Before bed, put heating pads or warm wet towels on your knees for half an hour.
Stabilize your feet. Make sure you have the right kind of shoes for your foot type (review our tips on shoe shopping). Consider buying a commercially made foot support in the footcare section of your drug store. If, in combination with thigh-strengthening exercises, the foot supports are not enough to get rid of the injury, see a podiatrist about whether you might need orthotics.
Ok, so I have runners knee. I can't describe how much the test hurt. Pushing down on that kneecap was agony. He worked my knee for a half hour or so, but then identified what he thought was the underlying cause. When I run I have been getting pain in the side of my knee, and also some deep in my hip. When he rubbed over the side of my knee it hurt worse than the kneecap almost. Turns out that this is your ITB (See description). It runs right up your leg, widening, until it reaches your hip. Full description here:
Iliotibial Band Syndrome
Description:
Pain on the outside of your knee (not usually accompanied by swelling or locking). The pain may be sporadic and disappear with rest, only to reoccur suddenly, often at the same point in a run. Depending on the individual, this could happen at four miles, two miles or just 200 yards. The pain often goes away almost immediately after you stop running.
Likely causes:
This is an overuse injury. The iliotibial band is a band of tissue that begins at the outside of the pelvis and extends to the outside part of the knee. The band helps stabilize the knee. If it becomes too short, the band rubs too tightly on the bone of your leg and becomes irritated. The tightness is usually the result of too much strain from overtraining.
Remedy:
Patience. This one takes a while. Give yourself plenty of rest, reduce your miles and ice frequently. You can keep running, but cut your run short as soon as you begin to feel any pain. Cut way back on hill work, and be sure to run on even surfaces. Look into some deep friction massage with a physical therapist.
Try some leg-raise exercises to strengthen your hips and be conscientious about the iliotibial band stretch. You might supplement that stretch with this one, doing it gently but often:
To stretch the IT band of your right leg, stand with your left side facing the wall. Cross your right leg behind your left, while putting your left hand against the wall. Put your weight on the right leg and lean against the wall by pushing your right hip away from the wall. Be sure that your right foot is parallel to the wall during the stretch. You should be able to feel the stretch in your hip and down the IT band (in this case, along the right side of your right leg). Hold for five seconds and do this ten times. For the left leg, do as above, but stand with your right side facing the wall, and put your left leg behind your right.
He finished up with Ultrasound, and I've booked in for next Tuesday.
He has given me all of the strecthes to do every day, several times, and also instruction to ice it 3 times and day, and take Ibuprofen for the next week.
He's pretty hopeful he can get me to the start line if I follow the routine. I can see me downing ibuprofen on the start line to get around.
So, I'm settling for a finish, and not a 4 hour finish. I need to rest my knee as much as possible, and if I do (or can) run, only every other day. He suggested I did nothing until next week though.
I may try and run at the weekend, but at the first sign of pain, stop.
Wednesday, October 04, 2006
Last nights run
I ran last night. After 4 miles I pulled up and walked the other mile and a half home. Knee is still hurting. I even ran 90% of the run on grass, to lessen the impact. I'm going to have to take a few more days off, maybe nothing until the weekend. I stopped just as it was beginning to niggle, rather than turning into more serious pain. I think this was the right thing to do.
I'm more or less resigned to the fact that I will be (hopefully) running in the marathon just to finish now, and not to try and complete in 4 hours. I don't think my knee has even one long run in it, let alone 3 or 4 before the marathon. If I just rest it now, it might get me through the actual day, then again maybe it won't. I'm going to have to hope my residual fitness will carry me thorugh the day. However, when my longest run will only have been 15 miles, that's 11 short of the marathon. I can't tell you how disappointing this is after all the training I've done. Just that one extra long distance walk has screwed up my marathon by the looks of it.
I'm more or less resigned to the fact that I will be (hopefully) running in the marathon just to finish now, and not to try and complete in 4 hours. I don't think my knee has even one long run in it, let alone 3 or 4 before the marathon. If I just rest it now, it might get me through the actual day, then again maybe it won't. I'm going to have to hope my residual fitness will carry me thorugh the day. However, when my longest run will only have been 15 miles, that's 11 short of the marathon. I can't tell you how disappointing this is after all the training I've done. Just that one extra long distance walk has screwed up my marathon by the looks of it.
Tuesday, October 03, 2006
Update and revised schedule.
I ran for the first time in a week on Wednesday. Unfortunately my knee still got sore after just 2 or 3 miles, so I stopped after about 4.5. I had also ran off road to try and minimise the impact. The pain wasn't quite as sharp, but it's still worrying for it to come on so early.
I flew out to Ibiza on Friday night. I ran at midday on the Saturday in San Antonio. It was quite hot, about 27C I believe. I ran around the promenade and coast form San An town into San An bay, and back to my hotel. It was a 5 mile round trip. Again my knee was sore after about 3 miles. All the footpaths are concrete tiled, and not tarmac which won't have helped as concrete is about 10 times harder. My knee was sore for the whole day, but was improved on the Sunday. I flew back on Monday night.
It's now Tuesday and I'm going to run again later today and see how I get on. I've revised my schedule because of the injury and it means I am not going to get more than one 18 or 20 mile run in, and maybe not even that if my knee is still bad this week. If it is still hurting my marathon could really be in trouble. Already any hopes of doing 4 hours are looking a million miles away. Just finishing it may be impossible.
Revised schedule above.
Subscribe to:
Posts (Atom)
