Marathon Scramble - HALP!

[Mike_d85]

I'm not sure if I should be posting here or at the respawn point, but I'm in a bit of a jam.

 

I've been training for a marathon on May first and I've run into some pretty awful knee pain.  From my research I'm looking at either runner's knee or IT Band Syndrome (most likely IT Band Syndrome).  Luckily treatment for both are similar: cut back running, swim, and lift (deadlift and squat).  My question is, how do I translate swimming distance into running distance?  Doubly so since I already had to cut short an 18 mile run (got maybe 10) and I am supposed to do my last long run (20 miles) this Saturday. 

 

My first instinct is to swap time running with time in the pool which means about 3 hours total for my long run (I would have to split it up with breaks and snacks).  That sounds insane, but so does running 20 miles.  However, I went for a 30 minute swim and it definitely kicked my butt waaaaaaay more than running a little over a 5k.

 

Is there a method to translating pool time/laps to running time/distance?

[Dilnad]

Actually I'd say the recovery between Runners Knee (Pattelofemorol Pain Syndrome) and IT Band syndrome are VERY different. Runners knee is actually bruised cartilage on the patella and needs to heal. IT Band syndrome is pain caused by a weakness in the glutes and hips. That requires an aggressive/active recovery. I've had both and just completed my ITB recovery. 

 

When does it hurt? How does it affect your running? How does your knee feel when you aren't running?. Feel free to ping me via PM for a quicker response here. I don't check much on weekends.

[Mike_d85]

1 hour ago, Dilnad said:

Actually I'd say the recovery between Runners Knee (Pattelofemorol Pain Syndrome) and IT Band syndrome are VERY different. Runners knee is actually bruised cartilage on the patella and needs to heal. IT Band syndrome is pain caused by a weakness in the glutes and hips. That requires an aggressive/active recovery. I've had both and just completed my ITB recovery. 

 

When does it hurt? How does it affect your running? How does your knee feel when you aren't running?. Feel free to ping me via PM for a quicker response here. I don't check much on weekends.

 

I mostly feel fine outside of running. 

I ran Wednesday night for about 2 miles and started getting stabbing pain on the outside of my knee.  I CAN keep running, but it seems exceptionally stupid to do so. 

I started hurting last night going to a hockey game I assume because I took so many stairs. 

I lifted (very light) weights this morning and felt fine.  I felt a little discomfort doing squats, but nothing I'd call pain.  I'd say it felt like working a sore muscle loose.

 

Once hurting my knee will feel stiff and irritated for a few hours and stairs will hurt (up and down).  I'll go to sleep with an aching knee and wake up feeling fine.

[Dilnad]

Pain on the outside of the knee is almost always IT Band Syndrome. I had it exactly like that. Usually bothered me the night after I ran and anytime going down stairs.... First off, stop running for a week if you can. If not it will slow your recovery but I get it. Next, Foam roll hamstrings, quads and hips EVERY DAY for a good 1-2 mins per area. Do not roll the IT Band. it does nothing. The IT Band has the consistency of a truck tire. It's connective tissue used to provide stability during dynamic movement. it is supposed to be tight and rolling it does absolutely nothing. It's a total BS misnomer. Next check out this routine...

 

http://strengthrunning.com/2011/02/the-itb-rehab-routine-video-demonstration/

 

Also Google the Standard Core Routine. The The ITB Rehab one day, standard core the next, then find some hip and glute routines for the third day and keep repeating this cycle EVERY SINGLE DAY!! Took me about 3 weeks to heal. It's not a quick injury but you need to build strength in the weak glutes and hips to overcome this. DON'T GIVE UP! It takes time,

 

I actually used a third routine not publically available that I got from Strengthrunnings Injury prevention program. Don't have a link as it's not a public vid but the ITB Rehab routine and Standard core, RULES!!

 

Keep me posted and keep fighting!

[Mike_d85]

Thank you very much.  I'll be buying a foam roller tonight (I should have already bought one).  Three weeks to heal... before a race in three weeks.  Why do we cut these things so darn close?

 

Also, for all you nerds playing along at home, here's the standard core routine: http://strengthrunning.com/2012/01/the-standard-core-routine-video-demonstration/

 

[Blonde-E]

Dilnad has some really good advice. If the pain is on the outside and not under your knee cap it's IT band not PFPS. PFPS will feel like a terrible bruise under your knee cap if you press down on it (don't do this on your own!) A safe way to feel the sensation is to kneel on the ground and bring you foot up behind you. Like a quad streatch (if it's really bad you will feel it while sitting in a chair like me right now ).

 

Foam rolling and core strengthening are good. You can also try monster walks just before you run to activate the glutes and help keep things stable. My PT recommends them for all runners as part of your warm up. I do them with the band around my ankles not knees. Good luck!

[Mike_d85]

Thanks.  I'll throw those in the mix for my warm ups.  I probably don't do enough anyway (just walking, split squats and skipping).

 

I'm still assuming I won't be able to run 20 miles Saturday....  Anyone got any ideas on translating those miles into swimming laps?

[Dilnad]

Sadly, I'm on a new injury myself. Last week on my 11 miler I got some pain in the knee. A sharp pain like PFPS. Decided to keep running a minute or two then re-evaluate. Pain went away and I finished. During my training runs (Mon and Wed. Took Tue and Thu off because of it). Same issue. This time at 1.75 miles both days. Did some run/walking to finish those 5 milers. Yesterday it went out at (get this) 1.75 miles during the final long run (13 miler) before half marathon taper. Walked a couple mins, ran again about a mile. BAM. Next time 3/4. By the time we hit 5 miles I just throw in the towel. hopped into a warm McDonalds (34 degrees out) and called for Uber.

 

Within 2 minutes the pain is totally gone (but comes back quicker each time). I don't have any of the feelings of PFPS. No feeling like my knee can pop the wrong direction, no weak feeling. I feel 100% (until I hit 1.75 miles). I have no clue what the hell it is. Going to take off until Wed and do a test run. if fail I'll take the rest of the week off. My half is on Apr 30th and it's my second half so I can handle the mileage. Just gotta get the mystery injury healed.

 

As soon as the HM is over, I'm going back on my minimalist training with the VFFs. I was up to a mile (Oh the calf pain LOL). I'm sick of injuries. Time to go old school.

[Blonde-E]

 

Sadly, I'm on a new injury myself. Last week on my 11 miler I got some pain in the knee. A sharp pain like PFPS. Decided to keep running a minute or two then re-evaluate. Pain went away and I finished. During my training runs (Mon and Wed. Took Tue and Thu off because of it). Same issue. This time at 1.75 miles both days. Did some run/walking to finish those 5 milers. Yesterday it went out at (get this) 1.75 miles during the final long run (13 miler) before half marathon taper. Walked a couple mins, ran again about a mile. BAM. Next time 3/4. By the time we hit 5 miles I just throw in the towel. hopped into a warm McDonalds (34 degrees out) and called for Uber.

 

Within 2 minutes the pain is totally gone (but comes back quicker each time). I don't have any of the feelings of PFPS. No feeling like my knee can pop the wrong direction, no weak feeling. I feel 100% (until I hit 1.75 miles). I have no clue what the hell it is. Going to take off until Wed and do a test run. if fail I'll take the rest of the week off. My half is on Apr 30th and it's my second half so I can handle the mileage. Just gotta get the mystery injury healed.

 

As soon as the HM is over, I'm going back on my minimalist training with the VFFs. I was up to a mile (Oh the calf pain LOL). I'm sick of injuries. Time to go old school.

 

That stinks! I hope you recover this week! I know exactly how you feel. I spent a good part of a year recovering from a mystery glute injury that turned into PFPS, only to sprain my ankle playing soccer a couple months later. I just finished therapy from that and am looking at day 1 for half marathon training.

[Mike_d85]

This boat is getting full.

[Mike_d85]

Started to close the window and realized I forgot to mention.  I looked up the Standard Core workout on youtube on my phone and the first hit is someone in a Nerd Fitness t-shirt walking through the strengthrunning.com routine.  It didn't look like Dilnad to me.  It's probably a coincidence.

[Dilnad]

 

Started to close the window and realized I forgot to mention.  I looked up the Standard Core workout on youtube on my phone and the first hit is someone in a Nerd Fitness t-shirt walking through the strengthrunning.com routine.  It didn't look like Dilnad to me.  It's probably a coincidence.

You found the right one!!

That is Jason Fitzgerald. Owner of Strengthrunning.com, a personal friend of Steve's, The Official Camp Nerdfitness Running Coach, and my own guru. Most of the info I've shared with you is stuff I've learned from his Injury Prevention For Runners program.  I also have a couple of his books. He's tha bombzorz!!

[Dilnad]

Went to my phsical therapist yesterday. He found my right calf extremely tight and knotted up. My ankle dorsiflexion was horrible. Kind of wierd seeing as I roll both calved every day vigorously and the left was looking great. He attacked it with "The Stick" roller and then dry needled it. Told me to try 4-5 tonight. Guess we will find out.

 

How goes your recovery Mike? Try those routines yet? I had a great report on my hip strength when he checked it yesterday.

[Mike_d85]

What is dry needled?  Sounds unpleasant.

 

My recovery seems to be going great.  I haven't tried running yet, but I'm going to give a short 1.5 mile jog a try tonight.  I should have gotten a foam roller ages ago, I can't believe how much better that is than stretching or hitting angry knots with a lacrosse ball. 

 

I've been doing those routines every day since last Friday.  I looked up Jason's video since I couldn't figure out how to do a suprornated leg lift.  I wake up, do a strengthening routine, then get breakfast and a shower.  I've also been hitting the pool pretty hard. 

[Dilnad]

AWESOME!!

 

Dry Needling is where they stick a needle about 2 inches deep into the muscle and wiggle it a big until the muscle releases. It's a western technique akin to accupuncture but they put the needles in deeper and don't leave them in for more than a second or two. It's not that fun but not that bad and worth it. Immediately improved flexibility.

[Mike_d85]

I was really hoping you misspelled "knead".  I wish you'd just misspelled "knead".

[Dilnad]

Welp. Looks like I'm SOL. Went for a 5 miler per my PT and the problem is not resolved. 1.53 miles and out goes the knee with a sharp stabbing pain. I fear this one may be more of an orthopedist/MRI direction. Drove home feeling like absolute crap only to be cheered up by the officer who pulled me over and ticketed me for supposedly rolling through a stop sign. 16 days to the half marathon. Not looking good at all. LOL

[Mike_d85]

Well slightly better news for me.  I jogged to the gym to swim and part of the way back (~2mi total).  I didn't hurt, but my knee felt wobbly.

[Dilnad]

 

Well slightly better news for me.  I jogged to the gym to swim and part of the way back (~2mi total).  I didn't hurt, but my knee felt wobbly.

AWESOME!!

Only another runner can understand a grown man saying this but I know my shot at the mini is pretty much gone and I really want to just leave work, go home, curl up in a little ball and cry LOL

[Mike_d85]

 

AWESOME!!

Only another runner can understand a grown man saying this but I know my shot at the mini is pretty much gone and I really want to just leave work, go home, curl up in a little ball and cry LOL

 

Wow, it's like a mirror that shows me last week.

[Dilnad]

 

 

Wow, it's like a mirror that shows me last week.

Well glad I can save you. Don't know if I can save me. They don't even know what's wrong. Guess you're runnin this one for us both my man!

[Mike_d85]

 

Well glad I can save you. Don't know if I can save me. They don't even know what's wrong. Guess you're runnin this one for us both my man!

 

Great, that way if I only make it half way you still met your goal!

 

P.S. I am stubborn enough to limp for 25 miles.  I will Run, Fatboy Run this if I have to.

[Dilnad]

I might be back in the game <crosses fingers>

I said screw it and went to an Orthopedic Surgeon who made room for me in her full schedule yesterday because, and I quote, "I love runners and always make room in my schedule for them, especially with a big race coming up". She runs or works with a local hospital sponsored marathon training program (Not the one I'm in. I'm with Fleet Feet).  I got some good news/bad news from the examination and X-rays...

 

Inflamed Articular Cartilage on the Patella

Plica on the knee AKA Plica Syndrome. A loose piece of cartilage leftover from the early days of your knees growth becoming inflamed.

<Drum Roll> ARTHRITIS!!!

 

The good news being the arthritis is minor and most likely just an effect of being 48 years old and years of overweight. She said I probably had it before I was running (1.5+ years ago) and it's not likely to progress due to my controlled weight and increased physical activity.

 

The cure: A rather painful shot of cortisone deep in the knee joint and some NSAIDs for a couple weeks. She said I can try running Saturday and report to her. If I still don't improve in the next couple weeks, an MRI may be in order. She doesn't think that's the case because the X-rays showed problems so she assumes she has diagnosed them. It's usually when the X-rays show nothing and she has to take a guess that an MRI later shows a more hidden problem. <Crossing fingers>

 

She is hopeful I'll still run the Kentucky Derby Festival Half Marathon in 15 days.

[Dilnad]

2 days after the cortisone shot I managed a pain free 3 miler. Looks like this might be doable

[Mike_d85]

I ran about the same this morning with my new IT band brace.  I didn't think it was doing much, but around half way I felt my leg warm up and suddenly that leg felt stronger than it has in a month.