Injury and Rehabilitation

The evening after my second half marathon in the fall of 2018, I developed some soreness in the outside of my right knee. I remember waking up in the middle of the night, barely able to bend my knee without burning pain radiating up my leg. I wasn’t too concerned at the time. I figured I just needed some rest after the hard effort.

The next morning, it felt a lot better. Unless I walked up stairs or did about anything else that involved putting weight on my leg with my knee bent. (Come to find out, that’s a lot of things.) I took a few days off from running, thinking that would clear things up.

After that rest, I went for a short run. Aside from a little tightness around the knee, there were no issues. Oddly enough, as soon as I stopped running, the pain flared up a bit and it hurt to go up the few steps into my house.

A couple days later, I set out for an hour-long run. Again, no issues until I stopped running. The pain came back, worse than before. For the next few days, I struggled to step onto anything higher than a sidewalk. I remember pulling myself up the stairs via the handrails at the sports arena when we went to a hockey game. I remember struggling to make it down to the field and back up again when I went to watch my daughter’s cross-country race. I avoided going downstairs in my own house.

Anxious to get back to running, I’d test myself every few days. It never really got better. In fact, it got to the point that I could run about one mile before the pain flared and I’d have to almost limp home.

After a couple frustrating weeks of this, I finally called my doctor and set up an appointment. By this time, I had researched my symptoms fairly thoroughly and was certain I had what is simply called: IT Band Syndrome, commonly abbreviated as ITBS–keep in mind, if you tell someone you have ITBS, they might think you’re telling them you have irritable bowel syndrome, so maybe think twice before abbreviating. (Note: This often gets referred to as runners’ knee, but that phrase is more accurately used as a shorthand for another running-related injury called patellofemoral syndrome. If you’re experiencing knee pain from running, it’s important to get an accurate diagnosis, so you can receive the correct treatment.) I went to my appointment, told my doctor what I thought my issue was, and asked for a referral to a physical therapist. She confirmed my diagnosis and gave me a list of local physical therapists to choose from. I selected one that I already knew was reputable and effective, based on her work with multiple members of my family.

The appointments went well. I had them first thing in the morning, prior to work. Some weeks had two sessions per week, while others had one. My physical therapist analyzed my flexibility and mobility, and identified several weaknesses. Owing to decades of spending most of my waking hours sitting, I had weak hips and glutes and overly-dominant quads. Basically, I was using the wrong muscles for everything. She had me take two full weeks without running. In the meantime, she applied manual therapy protocols (read: she took her really hard and pointy elbow and ground my muscles into a pulp) and assigned exercises to do to both rewire the way I perform certain motions and to strengthen weak areas. One key thing she identified was that my hips were rotating inward whenever I bent my knees. I was encouraged to be mindful of this, and to keep that slack out of the chain as I went about my daily life.

I did my assigned exercises and she gave me permission to start running again, carefully and sparingly. After close to three weeks without running, I was ready to lace my running shoes back up and get back out there. I was allowed to run so long as the pain stayed away. I drove to my local track to do laps, that way I could stop and end my run at the first sign of pain. That first run back felt great… until it didn’t. I was only a handful of laps in before the pain flared-up and I called it a night. It was frustrating, and made me wonder if my treatment was even helping.

But I remained hopeful and patient. I was told I could run every other day, occasionally running two days in a row. The runs became longer and longer. The first run that I was able to complete on my own accord, without pain telling me when to stop, was a great feeling.

I graduated from physical therapy and have kept issues at bay ever since. My goal is to perform my pre-hab exercises regularly, but I have to admit that I tend to put them off until I feel like an injury is about to manifest… and then I’m doing clamshells as if my life depended on it.

In hindsight, my injury shouldn’t have been a surprise. As a mid-30s person who has been sedentary most of his life, going from the couch to two half marathons in the span of only about two months was probably asking for trouble. I’m lucky I got to learn my lesson early on. Hopefully it will provide me with just enough caution to keep myself in check going forward.

I credit the work of my physical therapist along with a certain program of exercises designed by Coach Jay Johnson for helping me through that frustrating period of time and setting me up for a positive running experience in the future.

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