IT Band Blues

On Sunday, I took the train down to Brooklyn to meet up with my friend Andrew for our 17-miler. It was cold and pretty grey out, but we got the chance to run over the bridge and along the bottom tip of Manhattan just as the sun set so that was nice. However, the run quickly entered a downward spiral, with the wind picking up and the temperature dropping. Around mile 7, my knee started to bother me a bit and I had to pop an Advil. Of course, it didn't get any better and as we entered the park at mile 11, it became clear that I was done for. I hobbled 3/4 of a mile to the subway and froze the whole way there.

The next day, the mile walk to the subway nearly killed me. The 10 steps down to the platform actually did kill me. I was in less pain when I broke my arm snowboarding. The walk from the subway to the office was even worse. Monday night, I ended up working late just so I could take a car home and not have to face the brutal walk.

The final self-diagnosis is iliotibial band syndrome (ITBS). The IT band is a superficial thickening of tissue on the outside of the thigh, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running. The continual rubbing of the band over the lateral femoral epicondyle, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed, or the band itself may suffer irritation.

I haven't dealt with this type of problem since freshman year of college, but I have noticed tightness in the area during the past few bike rides so I guess I should have seen this coming. Anyway, the pain yesterday had me very, very worried that I'd have to scrap the marathon and take 2 months off to recover. Luckily, an aggressive icing regime has killed most of the pain. I've done a lot of research the past two days and it seems that I may be ok if I start a really good habit of stretching out the band, doing self-massage and wearing an IT band strap on my leg. So, at this point, I think I'm going to play it careful but try to keep on track for the marathon.

Most of my research indicates that a) I'm a prime candidate for this problem (flat feet, bowed legs, over-pronation, mileage, biking and running, etc.) and b) I'll really have to be vigilant to deal with this.

So, here's the plan.

1. Stretch my IT band 3 x 10 minutes per day.
2. Start wearing an IT band strap above my knee to reduce movement of the band over the lateral femoral epicondyle.
3. Ice my knee 4 times daily.
4. Hold off running for a few more days.

In the end, I think I'm going to have to keep up some regime for long-term management of this issue because I'm sure that, given my predisposition towards ITBS and the fact that I'm upping my mileage for the Ironman in October, I could be in for more problems...