>Health and Nutrition>Opinion on pain?
Hi everyone . I hope no one minds that I introduced myself in another thread and start my time here by asking for opinions right away. I didn't want to start with this, but it's where I'm at.
I started my first official training program a couple of weeks ago, so of course, everything went wrong. A blizzard, the worst cold I've ever had and an injury all in two weeks time.
So my question is regarding my injury. On Tuesday of last week, I noticed some tightness in my IT band area on the left knee after a long, hilly run. On Wednesday, the pain was particular severe during my run but was present throughout the day. It should be noted that I was wearing two week old shoes and the long run was my first long run in those shoes. So, I switched back to my old shoes and went to the treadmill for some slow miles the rest of the week. It continued to get better throughout the week, to the point where I ran a very slow 5 miles on the treadmill Saturday with no pain at all, and another 5.5 today outside with no pain.
What is everyone's opinion on this? Should I keep taking it easy (slower runs, less miles) for a while longer or start building again? I know IT band issues and other knee problems can be debilitating for months and I don't want that to happen, but I don't really think this is an IT band issue if I can already run pain free for as long as I did. I want to run for life, not for speed, and while I have a half coming up, I have a solid fitness base so I'm not too concerned about this messing up training for that. Though, I would like to do well, of course.
5K: 23:45 10K: 49:50 Half:? Longest run: 20 miles
Did it pop up after the new shoes? And you don't have any problems in the old shoes? Could be the cuprit. Foam roller and stretches to break up the adhesions and try to keep the ITB loose, and if it's the shoes, then see if you can return them and get something different. My ITBS was caused by road camber, switching to the other side of the road and foam rolling and I haven't had a peep from it in two months.
My running blog
2014 Goals | sub-19 5k done! | sub-40 10k done! | BQ done! | sub-3 M
+1 on the foam roller or whatever other cylindrical or spherical object you have hanging around. I have used a rolling pin to great effect when I had nothing else. Don't just work your problem area, but the areas above and below. Go slow. If you find a painful spot, just hang out on top of it, putting as much bodyweight on it as you can tolerate. It'll eventually relax a little, but don't expect to get it all sorted out in one session. While you're at it you might as well work on the areas that aren't causing you problems as well. If nothing else you'll get a sense for the difference between the problematically tight and the not-so-much. From my own experience, you can make incredible changes and free yourself from pain just learning to work on yourself this way, but of course it's just treating a symptom. Something is causing this problem, and it may be something you have control over or perhaps not, but there's a little detective work to be done. Good on you for backing off, but if it were me and I was feeling pretty good again I'd push it a little and see what happens. If nothing then you know you're good and if the pain crops up again you at least get more data on the problem which may help you to solve it.
11/1 - Mendon Trail Run - 50k
Thank you for the responses. Well, while yesterday was beautiful with no pain, 2 miles in today it hit again and I ended up walking to my husbands work to hitch a ride home. I have an appointment with a chiropractor in two days. Which is two days too far away.
I don't know if I have a roller like object but I'll look around town, might have to order online. I had heard about them but thought this was resolving itself until this morning.
I appreciate the feedback, apologize if this doesn't sound like it. As you might understand, I'm pretty upset by all of this this morning. I'm not a fan of taking time off, having pain (of course), or just having issues with running in general. Running is my therapy so when something goes wrong there it's like having a therapist shooting you in the foot. Not very helpful.
The foam roller is the best to deal what you have other than getting PT. You want to buy a "cell" foam roller (these are usually black in color and do not compress and maintain their form/shape) or a PVC roller (they are sometimes wrapped w/orange or black rubber and harder but more expensive). Many running stores now carry these rollers. You don't want a soft roller (which is akin to someone massaging you with thick Styrofoam on their hands/fingers). And for about $4 you want to buy a lacrosse ball unless you can find one. I would echo blargendarb's comments about "Don't just work your problem area, but the areas above and below. Go slow. If you find a painful spot, just hang out on top of it, putting as much bodyweight on it as you can tolerate. It'll eventually relax a little, but don't expect to get it all sorted out in one session. While you're at it you might as well work on the areas that aren't causing you problems as well. If nothing else you'll get a sense for the difference between the problematically tight and the not-so-much. From my own experience, you can make incredible changes and free yourself from pain just learning to work on yourself this way, but of course it's just treating a symptom."
If you roll the entire area slowly for 45 seconds to a minute, and then go back very slowly and for every area of pain/tightness you feel, which is either a trigger or adhesion, you rock back-and-forth on that trigger/adhesion (fr 15 to 30 seconds). Then use the lacrosse ball after to focus on those trigger/adhesion spots by again rocking back-on-forth (the lacrosse ball is more effective but it is very intense so you'll want to use the roller first). In the beginning it can take from 3-6 days to reduce these trigger points, and if you keep the rolling routine up daily, that time will get cut down to 1-2 days on average. There are videos on runnersworld that depict proper form for rolling which is also important.
Thanks on that info, I never would have known to get a different type of roller. My husband and I are headed to a nearby town with an athletic store. I'm calling ahead today to see if they have one in stock (they are often out of almost everything).
Went to a chiropractor this morning. I know some people don't believe in their work but I do and mine is cheaper than going to a clinic. He looked at my shoes and realized I was rolling off the outside of my foot, causing the pulling on other muscles.
Good news is, it isn't an IT band issue! Actually, it was the lower leg and knee that were giving me trouble. He suggested I tape my foot for a couple of weeks to see if the extra stability helps. I ran 5 miles pain free today, but started to feel tight so left my running partner to finish her 6 miles and went to my car. I am worried I may never feel comfortable running with "tightness" again, it makes me nervous.
But I think I'll get a roller just as a precaution and extra step to stretching out (not every day, just sometimes).
Not that anyone is really reading this thread anymore, and it's not like my presence here is large enough that anyone would be terribly concerned.
But this just sucks. I'm really upset about this whole knee thing. I am doing everything right and yesterday is hit me again.
I went to the chiropractor on Thursday and he adjusted me and said it wasn't IT band, it was too low for that and I was tighter in my calf. I ran Friday, Saturday and Monday (4, 5 and 6 miles) with no pain. Tuesday, excited to be "over it", I went on my long run scheduled two weeks ago--9 miles. Flat, gravel, at a comfortably slow pace. 6 miles in I started to feel it but not in a bad way. Until an hour after when I stood up and almost collapsed.
I used the roller, and didn't feel the pain spots I was supposed to. The pain I felt was just rolling around on something hard. I ice and elevate.
I tape my feet for extra stability and have guidance shoes for my over pronating. I've been ok'd by the doctor and the HS track coach for my shoes.
I stretch before and after every run. I drink a lot of water.
I am aware of my form.
The only thing I haven't done is take pain meds.
I'm just so frustrated. The last and only other injury I have had was two years ago when I irritated my ankle. I switched shoes and slowed down for a week and it went away. This is the third week and all of these horror stories of having pain for months are freaking me out so much.
This is my favorite part of my day and it's being ruined. I'm in the worst mood I've been in in years because I either can't do a morning run or they are cut short from pain.
I know I don't have any friends here or anything, but I'm hoping someone reads this and understands. This sucks so bad!
Can you give us more details about exactly where the knee pain is? It sounds like it's below the knee? What made you think it origianlly was IT Band? Just because it was the knee? You mentioned that your calf was tight? Is it the upper part or the middle/lower part?
Don't get discouraged. You just need to figure out what's causing the injury first.
I can't help you with your particular issue Ann. I can only tell you that I kept fooling around with pain in my calf area for about 3-4 months. I would take 2-3 wks off when the pain happened and try again. Only to have the sharp pain come back. Finally went to the doctor. Long story short: small tears in my Achilles tendon. Lesson learned by me. When I know in my gut that it is more than just normal soreness I need to back off immediately and if it doesn't disappear, get an appt with the doc. right away. I lost about 6 months total time between my procrastinating and then finally taking the doctors advise with no running and lots of stretching exercises. I know this doesn't address your particular problem, but I can say, think of the ultimate goal: you want to keep running and not be sidelined with injury. Best of luck.
bjoiner, thanks for your response. The pain is on the outside of my left knee, right in the center of the outside, if that makes sense. So upon google-diagnosis, I thought it was IT band. But my chiropractor said it was my calf causing the issues (the middle/upper part). After writing my pity-party post earlier, I found noticed that if I hold my knees while sitting and just straighten my leg and bend again, there is something that moves (I don't know what, like a tendon) on the left knee that doesn't on the right. But that only happens when I can feel the pain in the knee. I did it again later and didn't have pain, and didn't feel the thing moving. This scares me even more!
You_vs_cant I'm so sorry you had to deal with pain for so long. I'm not going to lie, while I appreciate your comment here, stories like yours are what are scaring me so much. There is a part of me that thinks this will go away in the next week like my other injury because I am careful to avoid injury. But another part of me imagines 6 months of this, or giving up running completely from pain or permanent injury and it breaks my heart! I think it's awesome that you came back after such a long fight with pain! Way to go! Thanks for the responses. I am still upset about it, I know I shouldn't be as emotional about it but running is kind of one of the few constants I have right now and it's not being as constant!
So as a disclaimer, I'm in no way a doctor so you can take what I say with a grain of salt. That said, I've had a lot of personal injuries over the years (part of the sport, I guess) so I know a little of what you're going through. Actually, my injuries were so bad that just a year ago, I assumed that it was the end of my running career. - then I found my Physical Therapist! I've been learning a lot about how to stay injury free, hopefully some of this might help you. If it's possible though, I would HIGHLY recommend finding a physical therapist who specializes in sports. It's always a bummer when your doctor doesn't get it. (I had a podiatrist once ask me if I had to run. --um, YES!)
Some of the things I've learned over the years
- Usually knee issues have very little to do with the knee. Usually the problem lies either above (IT for instance) or below (Tight calf muscles) The knee just happens to take the brunt of a bio-mechanical issue somewhere. (Sometimes there is actually something wrong with the knee, but I think that it's usually the exception and not the norm and you'd probably notice it more often)
- Foam rolling is awesome. I know people have said this above, but I'm pretty sure foam rolling has saved my running. I would do this before and after every run and at least twice a day until you're back in the game (and even then, I would keep it up)
- Stretching helps, but be careful. Actually, I think stretching also saved my running. The trick I've found is to do it GENTLY and often rather than occasionally and with great force. The other thing I've found is that everything is connected - from the bottom of your foot all the way to the hips. I tended to stretch the part that I THOUGHT was tight more than other muscle groups. I would recommend stretching everything! - but again, gently.
- Sometimes it's not a tightness issue, but a weakness in the opposing muscles. This is where a good all-around strength training plan comes in. Running tends to cause muscle imbalances. You need to spend some time to correct these.
I'll send you some exercises that I've found helpful a little later. (I have a meeting in a couple of minutes)
In the mean time, definitely try this soleus stretch and let us know if that feels really tight or not.
bjoiner, thanks again for your response. I tried that stretch. I definitely felt tight in both calves doing that, but neither was "more tight". It felt good to do, though. I plan on purchasing a foam roller, they didn't have one in last we visited but ordered more so I can get one on Saturday.
I do have a question for you, because I want some extra input. I track everything and I have found a pattern. I have pain after my long run. The day after I have pain off and on and usually don't run at all because I can't go more than a block or two. The third day, I can go for a short while (20 minutes or so) and then I stop the minute the pain comes back because they day before is so miserable. Then, I seem to be "healed" until the next long run a few days later.
So my question is... do you think it wise to wear a knee brace during my long run?
I know it doesn't fix the problem. I know braces don't heal injuries. But, I'm basically losing two recovery runs after the long run because of pain. Maybe, if I can hold off the pain on those runs it would help? I'm just trying to figure out how to keep training on this. I mean, I haven't stopped running yet. I've taken a day off here or there, I have ran many less miles than anticipated. I have looked into more cross training (I actually cycle three times a week at least anyway and walk to work every day). I really wish I could swim right now, but I'm allergic to chlorine. Thanks again for listening. I feel like I'm being so whiny. I am normally not this insane. I promise.
Couple of other questions:
How long is your typical long run and how long have you been running that distance? In other words, have you bumped up you mileage recently or are you doing your normal routine?
Do your shoes (both your new ones and your old pair) have a lot of support? If you really are running more on the outside of the foot (supination) you may be better off in a more neutral shoe. This is they way my foot plant is, and I find that shoes with a lot of pronation support kill me. I like a neutral shoe with a better insole (like super feet).
I had a couple of thoughts. Let me know if this seems on track or if I'm way off. You said that you have pain on your long runs. If I were hazard a guess, I would say that you're probably breaking down after a certain mileage which is causing a change in your running form. To me this seems to imply a muscular strength issue. Try incorporating lunges into your routine. The trick is to make sure you knee is tracking directly inline with your ankle. I would even suggest having someone watch you as you do it.
You also mentioned that you have been having pain especially on hilly-long runs. Hills can definitely cause problems if you have tightnesses somewhere. Because my calves were so tight, I found that I over-compensated by running even more on the outside of my foot. This caused me so many issues from knee pain, to pain in my achilles, to plantar fascistic. After about 2 weeks of persistent stretching my calves my foot plant returned to normal (well, closer to normal anyway) and many of the issues got better.
You may try backing off for a time and finding out what distance you can go with no pain. If you're doing 9 mile long runs now, try 7 and see how you do. If 7 is still to much, try 5 next week. This isn't forever - you just need to give yourself a little break while you figure out what's wrong. I'm guessing you might be trying to push it a little too much for what you can handle at this point in time.
As far as the knee brace goes. I've never used one myself. It's your call, but I I'm a believer that if you can strengthen the legs, you can probably do without the brace.
As a little encouragement, after fixing a lot of things I was doing wrong, I went from thinking I would never be able to run again to almost breaking my Half Marathon PR a couple of months ago. It's definitely worth fighting!
bjoiner, thank you for your encouragement.
To answer your questions
I have been running 30-35 miles a week for a little over a year now, before then I slowly built up to that. My long runs are usually 8 miles or so, since I don't "need" longer than that. I am currently doing my first ever training schedule, which has me at 10 next week, 11, then 12, then 5, then the half marathon. So, I'm 5 weeks out.
I typically by shoes with guidance. I almost exclusively run in Saucony shoes because I like big toe boxes. If you know the brand, I've been using the Pro Grid Guides for years, but the 6s were the new ones that killed my feet, so I'm now trying a Cortana. I did have a neutral shoe for a while, but that was when I upset my ankle.
I actually do have lunges in my typical workout routine. I do circuit training 4 or 5 times a week (a Jillian Michaels version and she LOVES lunges). But I could try to incorporate more?
I could definitely be breaking down during my runs and losing form. I have my "quirks", like I raise my chin as I run (to stop my nose from running!). I also just started running with a new partner who is a bit slower and (though I love her dearly) has TERRIBLE form. I wonder if I mimic her, as I know when I run with my best friend (who is an amazing runner) I hit faster paces and feel better after runs. Maybe I need to not look at my running partner .
You are right that I might be trying to push it, I just don't know what pushing it is. Like I said, I ran Friday, Saturday and Monday with absolutely no pain up to 6 miles. The week before I did a 7 mile with no pain. But when I was supposed to do one long run a couple of weeks ago I was only 2 miles in before I had to limp to my husbands work for a ride home.
This is so hard to explain in text! Sorry. Thank you so much for taking the time to give suggestions. I agree with you on the knee brace thing, I'm just feeling a bit desperate I guess!
This morning I ran two miles on the treadmill, felt pain and stopped. I got on a stationary bike for a bit. Then I walked to work and back. My legs started getting that itchy "you aren't doing enough" feeling, so I took another 4 mile walk around town at a quick walking pace and it felt great. I haven't had any pain other than on the run this AM. I just hope this is resolved soon. I'm going to do a lot more stretching, some more icing and hopefully get that roller this weekend and give it a shot. Thanks again and I'll keep you posted. Not that you really care, but it's nice to have a place to vent my frustrations when the pain comes back. Hopefully (fingers crossed) I'll wake up tomorrow and it'll be gone for good. Wouldn't that be great?
I haven't had any pain since Thursday and that was minimal. It was like this last week, though, so I'm very leery of tomorrow. I'm scheduled to run 10, which in any other circumstances would be just a "good distance run", but I'm really nervous that I'll hurt again and then hurt for the next few days afterwards.
I feel different this weekend, I had absolutely no weakness or pain in my knee and felt like normal. But, I don't want to get my hopes up...