5 & Out

   To all my devoted blog followers, of which I think there are only 1 or 2, I apologize to my lack of posts over the last week or so.  The internet connection hasn't been working at our apartment so I haven't had access to the blog since Friday. 
   So we had another minor setback in my training this past week.  After my week or two of rest, stretching and strengthening I decided to go for a test run this past Friday to make sure that I would be physically capable of completing the weekly long run with L Street on Sunday.  I decided to head out and planned to do a 5 mile test run to see how the knee would hold up.  The run started out great as my pace was good ( ~ 9:15 min / mile), felt strong, the knee wasn't bothering me and the New England weather finally gave us a day without snow.  I ran down my normal 5 mile route of East to West Broadway, wrapping around towards the convention center, down to south station and back through the seaport.  About 2-3 miles into the run I could feel my knee acting up again.  This time, the pain was much more localized to the outside aspect of my knee than before.  I would occasionally stop and walk for about 15-30 seconds to given the knee a break and then was able to get back into stride.  After about a quarter mile though the knee started to hurt again.  It wasn't a bad pain at first and I decided to try to run through it ... as if it were a cramp and it would get better if I could just work it out (even though I knew better).  I kept on course although the knee slowly grew more painful as the distance increased.  In the end, I finished 5 miles in about 49 minutes (pretty good considering I had to walk due to my knee). 
   Overall, my cardiovascular conditioning felt great.  I easily could have had this run be a 9 or 10 miler since I felt great at the end of the 5 miles.  Unfortunately, my knee thought otherwise.  Like I said above, this was the first time that the pain seemed to localized to a specific part of the knee.  I could actually press on the part that was tender / inflammed and it was on the lateral aspect of my knee just just at the distal part of my femur.  It was then that I knew exactly what I was dealing with.  Its not patellofemoral syndrome like I first suspected.  Instead, its an inflamed IT Band ... which has been the thorn in the side of many distance runners.  It commonly becomes inflamed in the area that it traverses the lateral femoral condyle and can cause inflammation of the tissue and bursa (see picture I attached).  Occasionally it can cause pain up the leg towards the hip, but thankfully I don't have those symptoms yet. 
    So this was a major setback in my training since I knew I would be missing another long run this week, and likely would be out from running for another 1 ... 2 ... or even 3 weeks if I am going to get this better.  I have to say I was pretty depressed over the weekend thinking about being away from running and missing out on another couple weeks of training (never thought I would say that, but I guess I am slowly developing a runner's mindset).  I gave myself a day or two of being down and then finally decided that I can either pack it in and be upset that I cant run, or I can do something about it, continue my training even though its under less ideal circumstances and accomplish my goal of completing this marathon no matter what. 
    It reminded me of something one of my friends said to me back in my early days of med school.  I was having a down week in medical school and during one of my rants my friend said "If it were easy, then everyone would do it".  This quote once again rang true about my current situation.  I guess in a way I was naive to think that my training would go 100% according to plan with me able to rack up 20 ... 30 ... 40 miles per week without any injury or speedbump along the way.  Instead, I am at a point now where I need to deviate somewhat from my original training schedule and find a way to get it done.  In order to do it, this is what I have come up with ...
     1 - I already made a physical therapy appointment to help with figuring out what is causing my IT band to flare up.  Although I need to get the inflammation down which thankfully is easy to do with icing at this point, the more important issue is to figure out what is causing it.  Injuries like this don't happen unless something is out of balance ... muscles not being strong enough, not being flexible enough, etc.  Hopefully a couple weeks of intensive PT will help get me back on track.
     2 - Get rid of the inflammation thats already there.  This is going to involve avoiding running on the road for a little bit.  I have been icing the knee for 3-4 times per day for as long as I can bear it.  Having real ice on the area is tough to handle for more than 20-30 minutes at a time.
  3 - Continue my cardiovascular conditioning.  This is going to suck, but I am going to end up doing the next few weeks on the elliptical.  While its not ideal by any means, I am going to plan to substitute all my runs with these workouts from the time being.  Each mile that I would have run will likely turn out to be 10 minutes on the elliptical.  Thus, a 5 mile run is going to be a 50 minute ellipitcal workout.     4 - Keep my head up.  Like I said, it was depressing to have this type of set back in my training.  In the end, I need to keep the eye on the prize and that's getting to Boylston on April 18th 2011 no matter what.   From this point on, this one won't be an issue.