Not Runner’s Knee

Every once in a while during my training, I used to get occasional knee pain that I always attributed to “runner’s knee,” which is technically patellofemoral pain syndrome (PFPS). However, the past 6 months have told me that my most recent knee pain is different. My iliotibial band has felt tight and the pain doesn’t start right away in the run. It waits a few kilometres in to really flare up.

My RMT (ie. massage therapist) and chiropractor reluctantly agree that it’s my IT band, hips, and lower back that is causing the pain. My RMT is also my training buddy and friend, which is how this all got started. I started to complain during runs and she “checked me out.” Massage definitely helps and this summer when I took 4 weeks off of running, it all felt much better. However, the reprieve was short-lived and it is back again. Last night I went running with a buddy and, like clockwork, it started up a couple of kms in. We ended up doing the whole 5 mile run and the pain didn’t get too overwhelming, but it definitely didn’t feel good.

So this morning, I decided to check out Runner’s World just so that I could read once again about what it is. They said it really well in this article:

The iliotibial band, a thick band of tissue that runs from the hip to the knee, can cause irritation when it runs over the femoral condyle, the knobs at the bottom of the thighbone. Knee pain from a problem with the IT band typically doesn’t start until a mile or two into a run. “Because the pain is generated from friction, it releases chemicals that cause inflammation, and that takes a little bit of time,” says Sharon Flynn, M.D., a sports-medicine specialist at the Oregon Medical Group.

An IT problem or patella pain may originate in the hip, according to Michael Fredericson, M.D., an associate professor at Stanford University and head team physician for the Stanford cross-country and track teams. Runners who have IT band issues and patellofemoral pain–two common knee injuries among runners–are often weak in the hip abductors and external rotators. Strengthening the hips can help alleviate and prevent pain. “People talk about pronation of the foot, but really the whole body pronates to some degree–that’s how your body absorbs shock,” says Dr. Fredericson. “Controlling that comes down to alignment.”

Of course, prevention is always the best way to avoid these types of situations. However, since I’m already “in it,”I’m trying to figure out how to get OUT OF IT. My RMT said to “ice” my legs after I run, which I have reluctantly been doing every time I run. Seriously, getting into a freezing cold shower is so hard to motivate oneself to do. However, I very carefully put each leg separately into the ice cold shower and count to 30 and repeat 3 times. Sometimes if I’m feeling very brave, I will even ice the whole back side of my body. Trust me, it’s cold and uncomfortable, but it’s just another thing I do to stay in this crazy sport of triathlon. Runner’s World “Injury prevention” page has an article of the benefits of ice baths that tells how cold water reduces swelling and tissue breakdown. It makes a lot of sense, but it’s just not that comfortable.

Another way I am trying to deal with this situation is strengthening my lower back. Side bends, core strength workouts, and lower back strengthening exercises are in the cards for me, despite my aversion to such things. Alas, I must do them.

I am also going to purchase a new pair of shoes because the ones that I have are finished. I’m also going to run on the treadmill for a bit to see if that makes a difference. Hopefully in a matter of weeks I will miraculously be cured!

In other training news, I am fully enjoying being back into training. Last week I genuinely meant to get out onto my bike, but another flat tire put that thought to rest. It turns out that my tire is very worn and I need a new rear tire… I guess that makes sense. I’ve put thousands of kilometres on my bike , Sky, and she’s probably going to have to sustain many more thousands, unless I come into some major money and can afford the tri bike that I’ve always wanted. So I got my flat fixed and was planning to hit the road on Sunday, but it downpoured all day and the thought of putting my bike on the trainer without snow on the ground was just too depressing. Instead, I enjoyed every single moment spent having a lazy, rainy Sunday.

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