Injury Help PLEASE!

Triathlon Forum
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Went on a run 6 weeks ago and had pain on foot strike. The pain is about 45 degrees from the front(outside)of knee.At first a PT said it was probably quad latteral attachment. Now told possible IT band. I beleive I injured after changing my seat position on the bike. Pulled seat forward and up,and was doing lots of hills. Well I stopped running.That was 6 weeks ago. I had kept up biking(no pain while biking)Up to century rides. I have had massages and a PT said my hips were to tight. Been stretching and icing constantly. Today I tried to run. I can stride fine but after 30 yrds,spot by my knee felt tight so I stopped. Had a deep ache for about 20 minutes. I have IM CDA in 10 weeks and am becoming very concerned. (I was deep water running and doing eliptical to replace running). I live in rural Montana. Doctor says it shopuld be fine if I stop doing everything for 3-4 weeks. He thinks ? IT? How long can I stop all but swimming and still be able to do CDA? If not running,I feel fine.

Any ideas? Do I still have a chance at CDA? I accept the disclaimers that no one is giving me a diagnosis. Any advice on what to do to replace the running. Anyone experiance this? Again ,pain on top left of left leg. After massage,tender to touch on side.On running though at the top 45 degree . Thanks all!

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I have no idea where on your knee you’re trying to describe. If it’s an IT band problem, It’ll feel like someone’s stabbing a pencil into the side of your knee. Generally, walking down stairs will really bring out the pain - you’ll feel it in your left knee as you step down with your right leg.

A couple things:

  1. Have you tried moving your bike saddle back to the pre-injury position? Sounds like you may have made a big change then went and hammered. Big no-no. Have you been professionally fit to your bike?
  2. Are your running shoes worn out? Are you doing most of your running on hard or crowned surfaces? Have you made a sudden increase in your training mileage? Any of these things could cause an over-use injury like ITBS.
  3. Have your stride analyzed, but you may need to take the prognosis with a grain of salt. I dealt with IT band problems for years. Had my stride analyzed by running stores, podiatrists, coaches, et cetera. Everyone said I had a neutral gait and that I needed neutral, cushioned shoes. IT band problems never improved despite chiropractors, massage therapists, sports med docs, stretching, strength training, icing, and rest. Finally, I bought a pair of shoes with a little bit of medial posting/stability and BAM, no more IT band problems (medial posting helps prevent over-pronation, the most common cause of ITBS in runners).
  4. Water running will keep you in decent shape until you can get back out on the road.
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Thanks for the reply,as far as

  1. Have you tried moving your bike saddle back to the pre-injury position? Sounds like you may have made a big change then went and hammered. Big no-no. Have you been professionally fit to your bike?
    Yep,thats what I did. Went on a couple of 50 milers the same week I changed my position. Have put my position back to were I was origanally fit. (Fit on my road bike and this year tried to go more of a tri position) Did not hurt riding,just the next day when I went to run. Was a little sore,ran through it. Since cannot run.

Does not hurt except running. Can do a stair master anything except run.As far as the point of pain. If you put your finger in the middle and at top(not on top) of left knee and move to left to top corner. Originally,after running it hurt about a 1/2 inch long spot. Now more like a knot that is sore. …Do I still have time to take two weeks of just swimming? Shoes are fine. Never had any kind of problem like this. I know complete rest will probably heal with in a month,but that would bag the IM. That is the last option of course. Thanks for the reply though.

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I am not a doctor, have never played one on TV, and have no interest in playing one on TV…but…I have had what seems to be a similar problem, and am still fighting it occasionally when I overtrain. I got it on my right knee just above the joint at about 45 degrees outwards, extending maybe 4 inches upwards…diagnosis was ITBS. It showed up suddenly at about mile 4.5 out of a 10 mile loop, while I was running on a fairly short section of tilted sidewalk. Apparently domed roads are a big problem for the ITB.
For me the 90% solution was strengthening the IT band so that it didn’t tighten up while running, which seems to be the cause of most ITB problems…at least from what I have read.
http://www.sportsinjurybulletin.com/archive/0168-knee-injuries.htm
That page has a fairly good explanation for it. I also did sideways leg lifts (like what you see in old excersize-class tapes) where you lay on your side and lift your top leg straight up. I was shocked at how weak that muscle…since I could run sub-4 hour marathons at the end of an IM. Beware that most of the excersizes listed will irritate the ITB even more, so you might need to take a week or more off of any training just to fix the ITB. I found that the most effective method of stretching the ITB was during a quad stretch. Instead of using your right hand to hold your foot up, use your left hand and pull slightly across your body. You should feel tightness in that area.
It took a couple of weeks for me to get back to full speed. The worst possible thing you can do is run on it when it hurts. If it is ITBS it is an “overuse injury” and will NOT get better if you are training hard. Biking will also irritate the ITB, as will crossing your legs while seated. NEVER cross your legs while seated, as it puts a lot of pressure on that area.
Anyway, I hope this helps a bit! ITBS is very common in runners, but fortunately is becoming much better understood in recent years.

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Thanks…I have not run for weeks but have been biking. In your experiance with your injury,since I have taken weeks off running,is it possible(just possible)with 7 days complete rest I will be able to start slow runs. I have missed a sprint I was signed up for tomorrow. Have a local race that a few hundred is already invested in in 10 days. Will drop that if necessary though.

A mistake I made was trying to run through a 10k 6 weeks ago.

Thanks again Kenney

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Go to this site. Get the whole thing, but most importantly get the Quad Baller. Massage the shit out of your IT band. 10 times a day if you can. Look up a few stretches as well. They will help, but the message is the key. Make sure you read the whole site and soak up ALL the info you can.

http://www.tpmassageball.com/index.php

The shoes may be the problem as well. Go to a good store and have them watch you run in the parking lot, none of that tredmil BS. Get the proper shoe. The less shoe you can get the better. So, If you look OK in the Asics 2090, try the DS Trainer. Still OK? Try the DS racer. Play around with different shoes and go with what “feels” the best annd the most natural.

But trust me on the message.

Good luck.

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I am a doctor, even though I have not played one on television, and I don’t have a clue as to your diagnosis. Anyhow, this is not an attempt to turn this into a flame fest (but I am sure my efforts will fail) but, it would appear that if you were to put PowerCranks on your bicycle you could get away with almost zero running mileage for the next couple of months and then very low mileage in the month or so before CDA and still be ready to rock and roll if you are structurally sound.

Frank

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It is possible that you may be able to start up with a run, but I wouldn’t guarantee it. I made the horrible mistake of trying to run through the pain for the 5 miles home, and I could hardly walk the next day. Rest time, stretching, massage (as LaWoof mentioned) and strengthening the IT Band was the only thing that cured me. Unfortunately I can’t recall how long it took for the pain to go away. I do know that I have to be very careful how I run to make sure I keep my knees even and straight, as part of my problem was my gait. If you do go running to try it out, make sure you don’t go too far from home…in case it suddenly starts hurting again. You don’t want to run through it…

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http://www.physsportsmed.com/issues/2000/02_00/fredericson.htm

This is a very comprehensive web site with IT band solutions and discussions you will find helpful, I know I found a lot of releif after following the reccomendations for stretches here.

Good Luck

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What were the shoes that you got with the medial posting/stability? Over-pronating is rolling to the inside, right?

I am having ITB problems, but seem to be rolling to the outside (according to a therapist and my own observations). When I focus on making sure that the ball of my foot contacts the ground, and emphasize the push off with my big toe, it seems to lessen the tightness a bit.

Just curious about you shoes.

Thanks!

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I do not know what you are talking about. I have weight trained cdonsistantly for three years.

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Thank you very much for the link
.

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I have been wearing Saucany Hurricanes. Had 100 or so miles in these shoes with no problems. As stated above,I had adjusted mu bike position and did some long rides. I think that is how I hurt it. After the biking,went to run and hurt for the first time right at the start. I have stopped running for weeks and does not seem to be healing. So it seems that the biking is keeping it from healing? I have never had this problem before. I had done runs of up to 12 miles with these shoes before without any problem.

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Hi Kenney

Do you remember this post about knee problems a week or so back?http://forum.slowtwitch.com/gforum.cgi?post=93170;search_string=search_string;guest=1175639#93170

I listed a suggestion - an exercise who’s variation has also been noted in a couple other postings, the crab walk. Many times the IT band will get irritated and cause the friction at the knee, which it sounds like you have and have been diagnosed with. Unfortunately, that band is quite difficult to treat and stretch so the remedy is usually in treating the hip area, TFL & glute med. Not only will the exercise strengthen the area (obviously if the exercise is painful, do not do it) but as with any movement in the muscle it brings blood to the area, which is a healant, a nourisher. Massage does the same thing, in that respect, however it is more superficial, to the fascia, not deep to the muscle and other soft tissues where the damage usually is. I am not saying to not massage, I am saying try all of it, stretch (all areas connecting the hip, not just side), massage and strenghthen.

Remember that the side of the hip, primarily the glute med, helps in femur traction, straightening your gait. When that weakens, you tend to have problems in over-pronation, patellar tracking problems, hip area stress, etc.

And if you want to take the advice from Mr. Winkie, here is his response from a thread he posted the other day regarding a study I posted on this very exercise helping people with ITB problems - thanks for the props, Mr. Winkie :slight_smile:

References #3 and #5 pertain to use of resistance training for rehabilitation of already-injured athletes, not to the prevention of injury by weight training in healthy athletes.
http://forum.slowtwitch.com/gforum.cgi?do=post_view_flat;post=102449;page=3;sb=post_latest_reply;so=ASC;mh=25;guest=1175637

What Mr. Winkie does not realize is usually the best exercise to prevent an injury is the same one it takes to heal it. As you get stronger you just up the resistance or progress it in another fashion.

Good luck Kenney. I have plenty of clients that have used this technique if you want their emails to ask for recommendations One is on her way to Boston right now :slight_smile:

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Thank you so much Maylene. Actually I have always had problems with my hips(I walk like a duck,especially on the right leg(left is hurt)A massage therapist this past week was able to loosen my hip for the first time in weeks. A question for you. How long do you normally have to lay off everything? It seems biking has kept it from healing though I felt no discomfort. CDA is 10 weeks,with the signing up a year in advance,adjusting work schedule,ect I would hate to bag it unless I absolutely have to. Is eliptical OK? There is no swelling or pain. Sometimes,if I feel anything(except trying to run of course)it just feels weak. No pain going down stairs ect…

I love living in Montana,surronded by mountains and trails,though the drawback is finding knowledgeable people around. Thanks Again Kenney

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I am off to buy some tubing now Thanks again. Any encouragement is/was needed ansd appreciated! Thanks

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Kenney I am in the same predicament as yours. I too am doing CDA. I have been nursing my IT and now another injury on the inside of my knee.

My IT flared up after a much to long run of over three hours. I was feeling great and I thought the extra miles would be ok. It wasn’t and my hips got tight and IT got injured. So took some time off running and biked more, it didn’t hurt to bike. Well Baam! Injury to the inside of my knee from riding to much to soon.

Here it is 9-10 weeks away from my race. Well I decided to bite the bullet and take a week off to get the healing started. I ice like crazy, started doing roller ball, foam roller and stretching… Also started to do strength work along with the crab walk thing with the bands… It does hit that area well.

Well I am back to building up training again and plan to stay within my pain.

Bottom like I think if you bite the bullet and rest the area… Do some work on it you may be ok for your race. I figure you have a big base already so you should be able to get back most of any loss fitness up to the race. Just don’t try and push anything to hard with in the last 4 weeks or at coming into the race. Also no pushing though any type of pain. The main thing I feel is to get the healing started and then do all you can to maintain the healing while training. There seems to be know way to cheat the healing and recovery process.

Get the healing going and do what you can afterwards to stay away from the injury…

Good luck to you!

Dan

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Just a few things to add:

  • If you “walk like a duck” you may have a muscle imbalance that is throwing off your gait when you run. It may not affect you on the bike, since your legs are clipped into the pedals. A Physical Therapist can evaluate just how out of balance you are and give you some exercises to correct that particular issue.

  • How much rest you need is not something anyone on this forum can tell you – only your body can tell you. The goal is to be as fast as possible on race day. In your case, the controlling factor is probably going to be not having a searing pain in your leg on the run. If that means resting up until the race, that’s what it means. If it means taking a week off then slowing adding back the run & bike miles, that’s what it means. Your body will tell you.

  • If a little rest does the trick and you can start running again, RESIST the temptation to do intense workouts, as you normally would in the build period leading up to the race. You stand a high likelihood of re-injuring yourself, and you’ll have even less time to heal because it’ll be closer to the race.

  • If you overpronate moderately or more, you might consider arch supports for your cycling shoes. It’s possible that your arch collapses when you push down on the pedals, which causes your IT band to rub. Again, it might not bother you on the bike, but only affect you on the run. Mine bothers me on the bike but not the run – go figure.

  • I’m going to disagree with LaWoof about shoes – if you have ITB issues you probably should not go with as little shoe as possible. It’s quite likely that you need the extra stability that a shoe like the Hurricaine offers. Best thing is to have someone watch you run, and it’s far easier to watch someone run on a treadmill than it is for you to run in the parking lot.

  • You can finish the race. You can walk, right? So worst possible case, you walk some or all of the marathon. Disappointing? Maybe, but not as disappointing as bailing out completely.

Lee Silverman
JackRabbit Sports
Brooklyn, NY

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Thanks for the info. Will keep you all informed.

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Thanks. See you at CDA. We are staying about 1/2 mile from the start. We have a full kitchenette and outside our door a picnic table. We will be having a BBQ friday probably. Before I leave for the race I will post the details,so you can stop and join the dinner. Thanks Again Kenney