Orthopedic Consult

  To say that it was desperation time would be a bit of an understatement.  I am about 19 days away from the Boston Marathon and I was barely able to run 9 miles on my last run.  Yeah, that's right ... 9 miles.  Let's try to put that out there a few different ways ... - 9 miles = 1/3 of a marathon ... 9 miles = 15 km while a marathon = 42 km  ... - 9 miles from Hopkinton put me in Natick, which is actually a 20 minute drive from Boston on the Mass Pike.   When you start to put it that way, it is definitely desperation time.
  Like I said in some of the earlier posts, I definitely went back to the drawing board earlier in the week.  While the ultimately answer for IT Band Syndrome is to rest, there are a few other things out there that can help.  Unfortunately, I have actually tried most of them.   Physical therapy, Foam Rollers, Stretching, Hip Strengthening, IT Band Brace, Kinesio Tape ... you name it and I have tried it!  Well, all except for one thing, and it was that one last thing that I was going to try today.
  Earlier in the week I finally bit the bullet and made an appointment at our Orthopedic Clinic at Tufts.  My appointment was with Dr. Matzkin, a nice orthopedic surgeon who specializes in sports medicine & sports injuries (I actually saw her a few years ago when I had my stress fracture).  I got there at 9:30 am, got some xrays of my knee and then got put in the exam room.
   As is the case in all doctors' offices, I ended up waiting in the room until about 10 am before she made it in.  Those 30 minutes were tough because my mind was racing.  What happens if this wasn't really IT Band Syndrome and was something else?  What happened if I had another stress fracture and I am officially done with no chance of running?  Ultimately, Dr. Matzkin made her way into the room.  Thankfully, she is a marathon runner herself and could totally empathize with the position I was in.  She was actually really surprised that I was even able to get an official number for Boston at all because it was so difficult this year.   After taking my history, doing a quick physical and reviewing the xrays, she ultimately confirmed the diagnosis I had made about 8 weeks ago - IT Band Syndrome.  The rest of the knee exam was totally normal.  She was actually really impressed that I had sough physical therapy so early on in the course.
  So now it was the official moment of truth.  My last shot at actually having a chance to run a majority of this race.  The therapy that I am speaking of is the only thing I hadn't tried yet for my IT symptoms.  It actually tends to be a last resort because it functions as a "band aid" that only treats symptoms and doesn't help with any of the mechanical issues that led to the problem in the first place.  Yep, it was a cortisone shot.  From all my reading, many runners have been in similar situations as myself where their IT Band flares up days before the race that they have been training for.  Since most of the inflammation is located in the bursa (fluid filled sac that helps tendons glide easily over bone) a well placed cortisone shot is normally effective at temporarily relieving the pain / inflammation and generally buys people enough time to get through the race.  Thankfully, Dr. Matzkin agreed that we should try it since it would give me my best chance of completing the race without serious inflammation or pain.  There isn't a guarantee, but normally its effective.   The mentality I had with this was is summed up by what one of my coworkers said this week "This is basically Game 7 of the World Series, do what you have to do and then you can rest in the off season".
   So after a little hurricane numbing spray on the outside of my leg, a tiny pinch and a little burn ... the steroids were in.  Honestly, it was kind of like a flu shot ... tiny pinch and burn and then in about an hour it feels like someone punched you there because it is pretty sore.
    So for now, as per doctor's orders, I need to lay low for 3-4 days.  She did advise me to continue the stretches as many times a day as I can fit them in since my IT Band was extremely tight when she examined it.  Now ... as they have been for the last several weeks ... my fingers are crossed that this will be buy me a few more miles on April 18th. 

XRAY (PA View) of my knees.  Thankfully, the xray is totally normal from this view.  There are good joint spaces in the knee which means that the cartilage cushion in both my knees is intact. 

XRAY (Sunrise View).  This is a dedicated xray that looks at the patella (aka kneecap).  It helps show that there aren't any fractures of the knee cap and that the cartilage under it (black space) is also intact.

XRAY (Lateral View).  This is an xray across my knee.  This one doesn't show any recent injuries but randomly enough shows a remote fracture of my tibia (about half an inch up from the bottom circle).  Guess I had an evulsion fracture a while back and never knew it.  Regardless, it was an insignificant finding.

The Workouts

   So it took me a little bit of time to recover from this weekends 9 miles.  The knee was definitely a little bit inflammed for the early portion of the week, but I was back to normal late on Tuesday.  I have decided that the last three weeks of working out is all going to be on the elliptical.  This should give me a solid 3 weeks to get down the inflammation in the knee and be as close to 100% as possible for the big day. 
   Thus, my workouts this week put me back in a familiar place ... a place where I have now spent hours upon hours over the past 3 months ... the elliptical at the Wang YMCA.  I have to admit that the two workouts I did this week were no where near my best.  My workout on Tuesday wasn't that great because I was still in an emotional hangover from my botched run on Sunday.  I was able to power through and do a 45 min (4.5 mile) workout on the elliptical.  It wasn't my best, but I was happen with the time and intensity of the workout.  
   Tuesday was a long day though because I had a moonlighting shift scheduled.  As always, this means I went into work around 7 am on Tuesday and didn't come home until around noon on Wednesday.  This essentially meant Wednesday was a wash.  Unfortunately, the fatigue that I felt on Wednesday seemed to carry over into Thursday morning ... which is when I had my next workout planned.  I got to the gym early, around 6:40 am.  For me, its tough to get the legs working that early in the morning when I am not pumped in anticipation (like is the case for those Sunday long runs).  I hopped on the same elliptical as always and started pedaling away.  For some reason, I couldn't get the legs to wake up and I ended out starting the elliptical at a pace of 132-136 ... which is way below my normal pace of 144 or so.  After about 5 minutes, the legs warmed up and I started getting into it.  By the end of the workout, I had completed about 30 minutes and just didn't have it in the legs to keep going.  Again, I think this Sunday's workout was still hanging heavy on my confidence because I didn't know what the deal was going to be with my knee (although I knew I would soon find out). 
   I finished the workout by doing all my physical therapy stretches and exercises.  Then, I showered and went to work!

Motivation - 2

   With the recent funk that I have been in, I thought it would be a good time to write another entry on a source of motivation that I use when I run.  My first "motivation" entry was about a dying man named Randy Pausch who presented an amazing presentation filled with hints on how to live life.   One of the other sources of motivation on these runs comes from one of the best books that I have ever read.  The name of the book is "Lone Survivor" by Marcus Luttrell, and it tells the story of four Navy SEALs who were serving in Afghanistan.  Lutrrell and three of his comrades were sent out on a mission to find a high priority Al Queda target in the mountains of Afghanistan. 
    Not only did these soldiers go through some of the most hellish training any person could imagine to even become a SEAL, but now they were traveling in a group of four, armed only with what they could carry, through mountainous terrain while being surrounded by people who wanted to kill them.  When you start to put things intro perspective running 26.2 miles doesn't seem all that bad.  The real motivation from this story comes from the heroism and determination of these four men when they become entrenched in combat.  Outnumbered 200 to 4, they valiantly engaged an Al Queda force while being out-positioned, outnumbered and on unfamiliar territory.  As to not give away the high points of the book, I will just say that the author endured days of pure hell.  The only way he was able to survive was through pure mental strength and determination. 
    I have tried to think of what I will use to motivate myself when I "hit the wall" on this run.  Its foolish to think that "it won't happen to me" because it happens to even the most experienced runners.  One of the thing that always comes to my mind during these times is the quote "Keith,  Never Quit.  Marcus Luttrell".  That's actually what the author wrote on the inside cover of the book that was given to me by my friend for Christmas (see below).   Again, it makes me think about what he had overcome by being outnumbered, injured, shot and alone ... and then makes me realize that when the worst thing I have to look forward is a couple of hills on a 26.2 mile course of pavement with people cheering you on ... I guess I don't have it all that bad. 

"Lone Survivor" by Marcus Luttrell.  I highly recommend everyone read it.  Its an amazing story about people who give up everything to help protect the freedoms that we enjoy every day. 

"Keith ... Never Quit ...  Marcus Luttrell"  This is what Luttrell wrote on the inside cover of my copy of the book.   My best friend Noonan got it signed after he gave a speech to a governmental agency.

Trying to Bounce Back

   There isn't any real way to sugar coat how tough the early part of this week has been on my confidence.  The bombed long run on Sunday really took the wind out of the sail and left me back at the drawing board again, trying to find some answers as to what I was going to do about this run.  IT Band Syndrome has been a proverbial "thorn in the side" of thousands of runners and now I am stuck dealing with it as well.
    I think the most frustrating part of the injury is that unlike most other medical conditions there is actually an extremely simple & highly affective cure for IT Band Syndrome ... rest.  Unfortunately, the cure is the one thing that will prevent me from achieving this goal that I first set for myself 5 months ago, back on a day in late November.  This nagging injury really had my spirits in the dumps for Mon & Tues. 
    After I let myself feel down for a little bit, I starting thinking about what the ultimate goal of all this training has always been ... "To Complete the Boston Marathon".   As this is my first marathon, when I set my goal I didn't include a time since I didn't know what to expect.  No matter what the clock says when I cross the finish line on Boylston, it will ultimately be my PR (running lingo for "Person Record" or best time).  Furthermore, from the beginning I have said that I was going to do this race no matter what ... if I have to run, jog, trot, walk, hobble, limp, crutch or crawl ... I am lining up on the starting line in Hopkinton and will make it to Boylston.   It probably won't be as smooth as I first pictured it in my mind back in November, but it will happen.    Time to get back at it. 

"Rescued"

   It was finally here, the longest of our long runs that we would be doing during training.  Like I had mentioned earlier, our running group had actually chartered a few buses that were going to bring us from Boston College out to Hopkinton so we could run the first 20 miles of the actual marathon course.  Since the buses left at 6:45 from Boston College, Renee and I had to wake up early and set our alarms for 5:20 am.  It kind of worked out well since this is likely the time that we will be getting up to catch the bus on the day of the Boston Marathon.  That being said, when the actual alarm went off I really didn't want to get out of bed.  Once I did, I hopped in the shower and started gearing up.  In preparation for an early morning, Renee and I had laid out all of our gear / accessories the night before.  The weather was supposed to be sunny with temps of 27-30 at 8 am with the forecast calling for it to warm up to 40 by noon.  This made it difficult to plan the outfit since our run was likely going to encompass about 4 hours during which time we were expecting a 15-20 degree weather change.  I decided to go with shorts instead of pants, under armor cold gear shirt & t shirt covered by a windbreaker and then a hat and gloves.  I figured my legs would be a little cold to begin with, but I am planning on wearing shorts on race day, so I wanted this to be as close to the actual thing as I could get.  In addition to the close, I had all my accessories laid out as well.  These consisted of three powerbar sugar packets, ipod, sunglasses, running pack and my phone.  The morning seemed to progress well as Renee and I were right on time, leaving our house at 6:10.  We picked up our friend Lauren and headed out to BC.
    When we got to BC, it was still pretty cold outside.  I hopped out of the car and for a split second regretted my decision to wear only shorts.  I figured it was only temporary though and that once I started running around I would be fine.  We entered the gym where we checked in and waited for the buses.  I have to say, the scene in the gym was pretty impressive.  There were upwards of 150-200 people from our running group waiting in the gym for these buses (see pic below).  Again, they are of all ages, 20's up to 70's, and everyone of them was geared up to take on this 20 mile run.  Since I tend to run at a slow pace for our running group, I was loaded onto the first bus.  This meant that we would get out to the course first, that way when the fast people got out there, they wouldn't catch up to us for about 4-5 miles and it would help keep everyone somewhat together on the course.    The bus ride was long, which was a little bit unsettling since it I knew that we had to run the whole way back.  Ultimately, it dropped us off near the start of the race and all of the runners took off.
     After stretching for a big, I started my run.  Once I got moving, the chill that I had felt from being in shorts on a 30 degree day went away.  I started my pace out slow since I knew that this run was definitely an endurance run and that it was going to go on for upwards of 4 hours.  The run started out great.  It was nice to run with such a great group of people.  Like I said before, running in this large group really helps give you the "race day" type feel and makes running a lot easier and more enjoyable.  The first mile or two went by without a problem.  The course at this point is pretty rural, mainly consisting of houses and woods lining the road.   On top of it, the knee actually was feeling good.  The run continued through Ashland and into Framingham, where we could start to see the train tracks of the commuter rail.  At this point in time, our group had thinned out a little big, but on the flat straight aways you could see everyone.  I felt good at this point.   I had dressed correctly for the weather and wasn't too hot or too cold.  Unfortunately, as I passed the four mile mark my worst fear started to become a reality.  That all to familiar burning on the outside of my left knee.  I had dealt with it before and on past runs as long as I kept moving it had never really progressed.  Today, however, was a little bit different.  I turned up the music in the ipod thinking that if I could distract myself from it that it might go away.  As mile 6 came and went, the discomfort in my knee started to get a little worse.  The progression of this pain generally goes something like this .... a slight burning / painful sensation on the outside of the knee (location of where the IT Band crosses the knee and likely where all the inflammation of the bursa is), then a little bit of pain below the knee (location where the IT band connects to the tibia) and then as it really progresses the discomfort starts to work its was over the patella and into the back of the knee.  This ultimately ended up occurring right around mile 7.  I decided that if I could go a distance at a fast walk, that maybe it would help to loosen it up and I could get back to a slow jog.  The next two miles I essentially did at a power walk with intermittent pieces of attempting to jog.  As only my luck would have it, I was fine when I was walking quickly but the second that I started to try and jog ... all the discomfort came back. 
   Ultimately, I power walked my way into the water stop in Natick that was right around the 8-9 mile mark.  While I knew that I likely wasn't going to be able to run anymore, I decided that it probably wasn't worth walking the last 11 miles of the course.  Also, L Street will ultimately scoop you up to make sure that they don't leave anyone out on the course.  It was at the Natick water stop that I found one of the course monitors for L Street who was nice enough to pick me up and bring me back to BC where I would spend the next couple of hours waiting for everyone to finish their run. 
    So, not much to say about this one.  This was the big one, the longest of the long runs, the run on the actual course that I supposed to be running in three short weeks ... and I made barely made it 9 miles.  Like I said before, this run was a double edged sword.  Do well on it and you were going to be flying high and full of confidence heading into the race.  Totally bomb it like I did ... and ... well ... you feel like crap.  Frustrated and down I guess are the only words to describe how I felt after this one.  Its tough to train for something for nearly 5 months and then to bomb 3 weeks before the race. 
    Don't really have much more to say at this point ... back to the drawing board.

L Street Running Club.  Everyone getting ready to board the buses for the big run.

Getting ready for the big run.  I was hopeful I was going to be able to do it, but ultimately ended up getting having to get picked up and driven back to Boston College after 8-9 miles.

Renee getting ready for the big run.  Thankfully, she absolutely killed it.  She ran at a great pace and took out her personal vendetta on Heart Break Hill when she kicked on the afterburners.  In total, the 20 miles only took her 3 hrs and 36 minutes, which is nearly 40 minutes ahead of her marathon pace from last year.

Nerves

     So as you could guess from the last couple of entries of the blog, I have been pretty nervous about this weeks long run.  I guess there are a few reasons for that.  #1, a 20 mile run will officially be the longest run I have ever done in my life.  Granted, I was able to do a 15 miler 2 weeks ago but 20 miles just seems pretty intimidating.  #2, this run is basically a walk through for the actual marathon.  Thanks to our running club, we are lucky enough to have an organized run that takes place over the first 20 miles of the actual course.  This means we get to become familiar with the lay of the land, the hills and get to know how it feels to run them when you are actually fatigued.   Now some people may think that this is a huge advantage ... being able to run the actual course.  Deep down inside though I feel as though it serves as a double edged sword.  On one hand, if you have a great run and absolutely kill the course it increases your confidence and morale going into the actual race.  On the other hand, however, if you totally bomb the run for some reason it is going to be a little bit unsettling with the big race only being 3 weeks away.  #3, I don't know how this IT Band / Bursitis is going to hold up.  At the current moment my knee feels great.  I don't have any pain or discomfort with walking or doing stairs.  I have to hope that I am as close to 100% as I can be for this run. 

   The good part about treating this run as a "walk through" means that I got to do everything as though it was the actual race weekend.  Yep, that means I even got to practice my carb loading!  Not sure what the night before meal is actually going to be at this point, but it will probably be chicken parm with spaghetti.  For this walk through though, I went with my favorite pasta dish (Chicken Bona Boca) from our local South Boston Italian place (Portobello's).   I am sure you can tell from the picture below why this is my favorite pasta dish. 
   Anyway, fingers crossed for this weekend.

Chicken Bona Boca from Portobello's in South Boston.  The meal that served as my carb loading the day before my 20 mile "walk through" of the Boston Marathon. 

 

Kinesio Tape

    Wednesday morning started out with an early morning physical therapy appointment.  In an effort to be in tip top shape for this Sunday, I actually booked 3 physical therapy appointments for this week.  Unlike all my other appointments which normally take place in the early evening, this one was actually booked for 7 am.  I have to say, I was half asleep when I walked in for the appointment.  I always find it really hard to wake up for anything besides work.  That's why I always prefer to work out at night since I know I won't be able to actually get myself out of bed for an early morning workout when it can be done later in the day.
    The physical therapy appointment went just like all the other ones have .... ultrasound, deep tissue massage, stretching.  At the end of this appointment though, we decided to try something new ... Kinesio Tape.  Kinesio tape is a type of tape that gets put on the skin and is may help with overuse injuries.  The data behind using this type of taping is mixed, but some people claim that it works.  The idea is that it helps stretch the skin / muscle, improves blood flow, promotes healing and may prevent inflammation.  I know it sounds like a huge crock of **** but I am desperate and willing to try anything.  Furthermore, both Lance Armstrong and Kerry Walsh (olympic beach volleyball gold medalist, see below) have used it and felt that it helped ... if its good enough for them ... its good enough for me.  The taping actually took about 5 minutes.  It consists of a large "Y" shaped band of tape that starts on the outside of the knee and runs up the outside of my leg towards the hip.  About halfway up the quad, it splits into the "Y" shape.
     I tested out the tape later that day and it seemed to work.  I was able to run about 3 miles before I even felt a twinge in my knee.  In total I did about 4 miles worth of running before I made it back to the house.  Hopefully it will continue to help.  Even if it just delays the IT band from acting up for 20-30 minutes, thats a huge gain!  I am actually heading back to physical therapy on Friday to get "re-taped" in preparation for Sunday's long run.

   You Tube Video Showing Kinesio Tape for IT Band Syndrome
http://www.youtube.com/watch?v=sCReh8GCUjc

Back to "My Machine"

    The goal of this week has always been to be as close to 100% as I can be for Sunday's long run.  In order to do it, I decided that most of my training this week would be done on the elliptical to help save the joints some wear and tear.  As always, I headed right over to the YMCA when I got out from work.  Thankfully, I got over there a little bit before rush hour and was able to get on my normal elliptical without any issues or waiting.  The elliptical workout started out a little bit slower than I wanted.  For some reason it was a little bit difficult to get the legs working during the first 2-3 minutes, but after that I got into a good groove. 
    The workout actually went great, much better than the last time I had hopped on the elliptical and had to hop off after 7 minutes due to pure boredom.  For some reason, I was totally tuned into the workout today.  Without even a sense of boredom, 30 minutes had rolled by.  My pace was good as I was doing ~ 10 min / mile in elliptical distance (which equates to an average of 144 rpm).  I through in a few "hills", which always consists of increasing the resistance by 1 each minute for 5 minutes.  The legs, particularly the hamstrings / gluts, definitely get a work out when the resistance gets cranked up to 13. 
    The next thing I new, I had ripped out 60 minutes (~6 miles) worth of elliptical.  Honestly, out of all the elliptical workouts I have done, this one seemed to go by the fastest.  As always, I ran into a couple of points where my toes kind of go numb from putting most of weight leaning forward but that feeling always comes and goes.   Although it wasn't a run, it was a good hour workout. 

Physical Therapy

   Monday was a day of rest and physical therapy.  The knee was actually more sore than expected today.  I decided to do a lot of icing and stretching.  I got to my PT appointment late in the day and told Declan how frustrated I was that this problem was lingering despite nearly 4-5 weeks of physical therapy.  Basically, that just caused this physical therapy session to be extra intense.  As always, we started out with the ultrasound therapy and proceeded to the deep tissue IT band massage.  The kneading and crushing of the inflamed IT band is definitely not the most pleasant thing in the world.  Since a lot of the mechanics are dependent on the gluteus medias, that muscle got extra attention during this session as well.  When I say extra attention, I basically mean I had Declan's elbow crushing the outside of my hip / butt for about 10 minutes.  I am not going to lie, out of all the maneuvers / therapies I have gone through at physical therapy ... this was the second worse (only behind the rolling pin down the leg).  I was literally white knuckling the exam table because it hurt that bad.   After the 30 minutes of torture, the last 30 minutes were spent doing more stretching and hip strengthening.
    I am not sure what we did differently during this physical therapy session, but when I woke up on Tuesday ... I felt like a million bucks. 

Played It Safe

   This was the first Sunday in a while that I didn't have a long run / workout planned.  I figured it was the important to try to give my knee as much time to recover as possible before my big 20 mile run next week.  As I mentioned in my last post though, Renee and I decided to sign up last minute for a 5k St. Pattys Day Roadrace in South Boston.  In order to get a decent workout in, Renee and I decided that we would do a 4-5 mile run before the race.
   The weather was perfect when we set out on our run.  It was sunny, barely any wind and the temperature was in the low 40's.  We headed out and followed our favorite 4 mile run down around Castle Island.  The run started out great and for some reason when Renee and I run together we tend to run at a pretty fast pace (probably because neither one of us wants to feel like we are holding the other one back).  We took off and started running at a 8:40-9 min / mile pace.  Before you knew it, we were down by Castle Island.  It was down here that my IT band started to flare up again.  I decided to continue with the run hoping that it wouldn't get worse. 
   As the run went on the weather warmed up and before I knew it my hat, gloves and jacket were all off because I thought I was going to sweat to death.  As we rounded Castle Island and started heading down Columbia my knee started aching again.  It was at about the 4.5-5 mile mark that I decided to stop. 
    It was less than ideal since I was planning on running 8 or 9 miles today, but I really wanted to make sure I went into the 20 mile run as close to 100% as I can.  Unfortunately, this meant that I missed out on the 5K race, but I didn't miss the St. Patty's day party afterward!  Looking ahead, next weekend is going to be a huge weekend for me.  The 20 mile run that we are participating in is actually the first 20 miles of the course.  This is good because it will familiarize me with the course and could serve as a huge morale booster if the run goes well.  Fingers are crossed that everything will go great!

Renee & I on Emmet St at the beginning of our run.  Unfortunately, stopped after 5 miles and never made it to the race.  Renee, however, ran the 5k in in 28 minutes!

  

Epic Fail

   Over the last four months that I have been training I have had some good days and some bad.  I have to say that with regards to my training this Friday was the worst day I have had yet.  As I mentioned before, this week has been pretty chaotic at work and the overnight shift this week really seemed to take its toll on me.  Just to add to it, I had to through together a last minute case presentation on Thursday night that I was going to be presenting in front of a visiting Chairman of Medicine.  Essentially, I woke up Friday absolutely exhausted from a long work week.
       Since I want to do my best to get as close to 100% as I can for my big run on March 27th, I decided that I would hit the elliptical after work.  As the workday on Friday went on, I could feel the long week just catching up to me.  I really just had no gas in the tank.  I had been in similar positions over the last few months at which point I was able to push through it and manage to have some decent workouts and I had hoped I would be able to do something similar today.  Unfortunately, it just didn't work out that way.
      I got out of work around 5pm and headed over to the Y.  Again, it was nice out with temperatures in the low 60's.  From the second I got to the Y things just weren't going my way.  I got changed and went to head up to the elliptical when I realized I forgot my headphones to my iPhone.  This was a crushing blow because the elliptical is boring enough by itself, but add in listening to awful YMCA sponsored music (essentially a playlist consistent of Justin Beiber, Nelly Furtado, and Britney Spears) and it becomes essentially unbearable.  Nonetheless, I was determined to get this workout in so I proceed up to the elliptical sans music.  My day took another turn south when I actually got up to the elliptical and found that out that the workout area of the Y isn't air conditioned.  Instead, their only mode of ventilation are two small 17" fans mounted on the way.   That was essentially strike three for me ... #1 Pure exhaustion from a long work week, #2 Forgetting my head phones and trying to do an elliptical workout without music, #3 The fact that it was at least 80 degrees with 95% humidity in the gym.   I tried one last time to push through all of these miserable circumstances and fit in a workout as I figured even 20 minutes is better than nothing.  In the end, I did a total of 7 minutes and 47 seconds before I called it quits.  Honestly, it felt longer than the 2 and 3 hour workouts I have done on the elliptical.
      Looking back this is the first time in my whole training that I wasn't able to complete a workout.  In the past, I was at least able to knock out a quick 30 or 40 minutes, but on this day.  I figured it would be better to skip the workout, go home and catch up on some rest and come back stronger with a solid workout this weekend.  To help motivate me to have a good workout this weekend, Renee and I both signed up for the South Boston St. Patty's Day 5K Roadrace.  We figured we would go for a run and fit in 5-6 miles before hand, and then use the race as a fun way to get in some extra mileage.  In total, I am hoping to do about 8-9 miles this on Sunday.  For the upcoming week, my work schedule is pretty light so I am hoping I get can get in 4-5 good workouts during the week in preparation for next Sunday ... the 20 mile L Street run that encompasses the first 20 miles of the actual marathon course.   Here's to looking ahead to this week!

Quick Run & PT

    This week actually went by pretty quickly and unfortunately didn't give me a good chance to get in very many workouts.  Monday was essentially a recovery day that was filled with lots of ice and rest.  Tuesday also turned out to be a recovery day since the IT band was still a little bit irritated.  Unfortunately for my training, this week at work has been pretty hectic.  As there are three chief residents at Tufts, normally there are at least 2 of us around to get all of our daily duties done.  For the most part, these consist of doling out admissions to the medical services, dealing with any issues that arise with the residents and setting up for conferences.  What made this week so crazy was that both of the other chiefs were away this week as Kevin was on vacation and Eugene was the attending on the Gen Med Service.  This meant that my days were crazy and hectic.  In addition to an already crazy schedule at Tufts, I was also moonlighting on Tuesday night at Shattuck Hospital.  Basically, this meant I was getting to Tufts at 6:45 am on Tuesday, working until 5 pm at which point I took the T to Shattuck Hospital, working at Shattuck Hospital from 6pm until 7:30 am on Wednesday and then taking the T back to Tufts to work 8 am  4pm.  Needless to say once I got done with that shift ... I was beat!!! 
     I woke up on Thursday and was feeling totally exhausted.  I knew I had a physical therapy appointment scheduled at 5:30pm and was concerned that I wouldn't be able to fit in a workout at all since I was already going to be cutting it close as I was getting out of work at 4pm.  Thankfully, I was able to time the bus perfectly and got home at 4:30 pm.  As this was one of the nicest days of the year, with the temps in the low 60's and the sun shining, I couldn't pass up the opportunity to get a Castle Island run in.  I changed into the running gear, through on the sun glasses and took off.  I had exactly 40 minutes before my physical therapy appointment started and was going to try to fit in 4 miles. 
     To switch things up, I decided to do some intervals.  I ran my first 1.25 miles at a 7:40 min/mile pace and then walked for a bit.  In total, I did a bunch of intervals with my final tally being 3.95 miles in about 36 minutes.  While the time seemed good for me, it wasn't the best run I have had.  I think that the first 1.25 miles at a sub 8 min mile pace really gassed me out.  Regardless, it was a beautiful day, I got to run around Castle Island which is my favorite and I made it to physical therapy on time.
      On this day, however, I think PT stood for "punishment therapy" instead of "physical therapy".  I told Declan that when I was doing the foam roller at home I found a spot higher up, near my hip that seemed to be pretty tender.  His response was "that just means its another area of inflammation, we will get it out".  What I didn't realize is that by "get it out", he meant I was in for about 15-12 minutes of the most painful therapy I have had yet.  In order to "get it out" Declan started with a deep massage, moved towards using the point of his elbows to help do pressure therapy and then moved to the rolling pin (see below).  Honestly, I think the rolling pin could be a substitute for water boarding because it was basically torture.  For about 10 minutes I laid on the table laughing because I was having the outside of my leg crushed with a rolling pin in an attempt to loosen this damn IT band.  Ultimately, Declan asked me why I was laughing and I basically told him because if I wasn't laughing I would be crying.  
     I do have to say though that since that physical therapy appointment, while my leg has been sore (in a bruised type of way) the knee issues do seem to be much much better!  Guess it comes down to the old saying ... no pain, no gain. 

I just wanted to put this in here since it is essentially the same "rolling pin" that was used to absolutely crush my IT band during my physical therapy appointment this week.

A Few Days to Recover

   So the early part of this week was spent recovering from the aftermath of my most recent long run (a run which also happens to be the longest I have done up to this point).  Monday and Tuesday were tough days because the IT band was pretty sore after the 3 hours of running it endured on Sunday.   I spent most of Monday & Tuesday icing the outside of my knee to help cut down some of the inflammation that was going on.  It helps working in the hospital since I have access to an ice machine, plastic bags and ace bandages.  Literally, over the course of Monday & Tuesday I think I iced my knee at least ten times.  Like before, when my IT band is really flared up I have some problems walking down stairs just because that is a motion that is notorious for irritating the inflamed tendon.   I used the elevator a little bit more than normal at work but I was able to get by.
   Thankfully, I had two physical therapy appointments scheduled for this week since I knew that I would likely need it after a 15 mile run.  Monday's appointment was pretty uneventful and went like most of the other appointments had gone.   It started out with some ultrasound therapy (still haven't looked it up to see if it really works, but I am will go with anything at this point if someone tells me that it will work), deep tissue massage on the IT band to try to loosen it up, stretches aimed at the hips & legs and then it ended with quad / hip strengthening exercises.  Overall, it took me a little bit longer to recover from this run but I am assuming it was just because of the shear distance of the long run.

Do or Die

  That was pretty much the feeling I had heading into this weeks long run.  Its definitely crunch time and with my longest run up until this point being a 13 miler, I needed to get back on the road for some serious mileage.  As I mentioned in my last post, this weeks L Street long run was scheduled for a 15 mile stroll through Boston.  As Sunday starting to get closer, I could definitely feel some anxiety building up.  I didn't know if my elliptical training was enough to get me ready for this type of distance or how my knee was going to feel during it.  Regardless, there is literally 4 months of training riding on the fact that I can do these last few runs and complete the big run on April 18th.
   As I wrote about in my last entry, our Saturday night was spent at the DMSE Gala with Tom and Lyn.  Unforunately, this weekend happened to be daylight savings time ... which meant that we turned the clocks ahead and lost a precious hour of sleep.  Regardless, Renee and I ended up getting to sleep around 12:30 am (after pushing the clocks ahead).  Before I knew it, my alarm was going off ... 6:30 am!  Despite the fact that we were meeting our friend Lauren at 7:30, I woke up a little bit early so I could shower to make sure I was wide awake and to get some serious stretching in. 
   The weather this Sunday had finally started to warm up.  In the morning, it was in the 40's with overcast clouds and barely any wind.  I decided to wear shorts, a T Shirt and a wind breaker.  As we stepped outside, I knew this was crunch time ... and I was pretty focused on having a good run.  Renee, Lauren and I started out an slow - average pace.  From what I had noticed based on my last few runs, my IT band pain seems to be better if I am running at a faster pace (apparently, after doing some reading online this is pretty common).  After we hit the first water stop at about 4 miles, I decided to try to run at a little faster pace and ended up breaking away from the girls. 
   The first four miles had gone by like nothing.  For the next leg, I increased my pace a little bit and was lucky enough to find a group of 4 runners that happened to be running at the same speed I was.  I ducked in behind them much like a race car will draft one in front of it, and I used them to help me maintain my pace.  The next few miles seemed to fly by.  While I didn't have our watch on, I am guessing that my pace was probably around the 9:30 mark.  I passed another two water stops and before I knew it I heard someone say that our mileage was up to 8.5!  Yep, thats right, I had just run 8.5 miles and barely even felt tired.  While my knee was starting to get a little bit sore, I felt great. 
   After our water stop at the 9 mile mark, I hit my first group run screw up.  The guys that I was following seemed to split ways and before I knew it I was running behind 3 other people.  As we were coming up to an intersection at Beacon St they turned around to me and said "Any clue where we are supposed to go?".  So this brings to light another fact of my running career ... since I am no where near the fastest person on these runs ... I really only look at the route for the first 3-4 miles of a run since I know that after that there will be a ton of people in front of me that I can just follow.  Well, needless to say, I followed the wrong people and got myself lost.  Thankfully, there was a speedy lady in her 40's who ran up and said she knew where to go. 
    I basically spent the next two miles running along the Charles river trying to keep up with her so I didn't lose sight of her and get totally lost.  And when I say "trying to keep up with her", I basically mean trying to keep her in sight.  It wasn't until this portion of the run that I started to hit a few problems with the IT band.  At around mile 10 or so it started acting up a little bit but as long as I was running, I was fine.  
    The real trouble hit when I stopped at the water stop at mile 11 and started to stretch out a cramp I had in my right quad.  I learned a hard lesson on this one ... my IT band tightens up really quickly when I am not moving.  It only took about 1-2 minutes worth of standing still and them my IT band totally locked up.  I spent the next 2-3 minutes massaging it and stretching it out.  After walking for a short distance, I finally got it loose enough to get back to running.  I knew in my head that for the next few miles ... there wasn't going to be any stopping!
    The last portion of this run took us from downtown Boston under I-93 and back into Southie.  I guess to make the run harder, they build in a huge 0.75 mile hill (West Broadway) into the end of the run.  This is when I really started to feel fatigued and realized I probably hadn't drank enough water to replace what I had been sweating out for the last 2 hours and 45 mins.  I ended up digging it out up the hill on West Broadway, and had to go right past the water stop because I was afraid that if I stopped moving the IT band would lock up yet again.  In the end, I was able to push up the hill on West Broadway and run down the hill on East Broadway to complete a 15 mile run!
    Like I said at the start of this entry ... this run was a do or die for me.  Deep down I felt like if I wasn't able to complete this run i was going to be in some real trouble for the marathon.  That being said, I am not out of the woods yet since I am still nursing this knee issue, but this run definitely gave me the confidence that I needed looking ahead at my last two big runs .... #1   March 27th - 20 mile long run ... #2  April 18th - Boston!
    Its hard to believe that when I first started this blog I mentioned how the Boston Marathon was ~148 days away.  Well, now its only 34! 

DMSE Gala

   After a great night at our fundraiser on Friday, Renee and I were right back at it on Saturday.  Thanks to our good friends Tom & Lyn we were able to buy tickets to the Dave McGillivary Sports Enterprise (DMSE) Gala, which was an event aimed at celebrating the fact that Dave McGillivary (race director of the Boston Marathon who I mentioned in a post back from January) has been involved in organizing, directing and donating to charities for over 30 years.
    The event was very nice and had a raffle / auction similar to ours.  I guess the only difference is that instead of $25 gift cards and 50% of a massage, they were auctioning off autographed bike jerseys from Lance Armstrong, 7 night cruises, tons of Red Sox memorabilia and more!  I bid on one item which was an Oakley Backpack ... but in the end I ultimately got outbid. 
    The highlight of the night was definitely getting to spend some time with Tom, Lyn, Chrissy and Aaron.  We hadn't seen them in about a month or so and it was a great opportunity to catch up.  Unfortunately, we had to take off earlier than we had hoped since we had a big run planned for Sunday morning and we were losing an hour of sleep from the daylight savings time change!  Regardless, it was great to see them!!!

Renee and I at the DMSE Gala

DMSE Gala Flyer

Keith, Renee, Lyn, Tom

Charity Fundraiser

  Friday marked the day of our big charity fundraiser, which was aimed at raising money for Generation Excel.  Since Renee's official was through a charity, she was obligated to raise $3500 in order to uphold her end of the bargain.  While we have been getting tons of donations from our close family & friends, you realize very quickly that $3500 is a lot of money to come up with!!  At the time of the fundraiser, we were about 36% of the way to our goal with a total of $1250 raised.
   Our fundraiser took place at the Atlantic Beer Garden in the Seaport District and consistent of a raffle in which we raffled off tons of gift cards and services that were donated to us free of cost from local businesses.  Between charging $10 at the door and then selling raffle tickets we were able to raise nearly $1000.  The best part of the whole night was when we found out that one of our friend's companies is actually willing to match the donation ... which basically means that we were able to raise a total of $2000!!!  Between what we had already raised and the funds we got from the fundraiser we are essentially at our goal.
The success of our fundraiser is due totally to our amazing group of friends & coworkers as well as the multiple businesses that were willing to donate to us!  It couldn't have gone better! 

Renee and I working the raffle table.

All of the prizes being raffled off.

One arm's length of raffle tickets for $10

Picture of Patrick Malone, who was the winner of the most desired prize in the raffle ... a free twosome to Granite Links Golf Course.  He is also an avid reader of this blog. 

    

Best Run in 8 Weeks

  Today was a big day in my recovery and in my training overall.  As I mentioned before, I was planning on hitting the road for a short - mid distance run.  I guess before I should get into the run, I should talk a little bit more of the 'retail therapy' that took place earlier in the week.  I know I wrote about the shoes that I bought over the weekend since I was desperate for anything that might make a difference and help me out.  Well, Monday night I decided to order my own foam roller.  Not sure if I described what a foam roller is, but its a big round cylinder/tube of foam that you use to "roll" your IT band.  The goal of the roller is to try to stretch out / lengthen your IT band with the hope that loosening it up will help alleviate or improve the symptoms.  Since I was pretty desperate this past week after my miserable run last Thursday, I decided to order this as well hoping it would help.  While I was on the amazon page for the foam roller they had a section that said "Most of the people who viewed this product also bought this IT Band brace".   Up until this point I had never heard of an IT band brace, but I figured for $14 it was worth a try.  Remember ... its crunch time and I am starting to get pretty desperate!  Well, both of these items actually came in yesterday which was perfect timing since I was able to use the brace on my run. 
   I got home from work today around 3:30.  Despite being pretty tired (since we got last minute tickets to the Celtics game last night) I knew I had to man up and get this workout in.  The weather was kind of lousy today ... temperatures in the 40's, really cloudy / overcast and a moderate wind of 10-15 mph.  I actually decided to make the run today in shorts and an under armor shirt with a light windbreaker.  In addition to the usual stuff, I also strapped on the new IT band brace that I had recently bought.  Like I said above, I had never heard of an IT band brace and wasn't sure if it would have any benefit at all ... but I was desperate and figured it couldn't hurt to try.
    Once I was geared up, I headed out to the road ... unsure of how the run was going to go.  I started running and actually felt good.  I headed down East 1st towards Castle Island and before I knew it I was half a mile into my run ... and for the first time in a while didn't have any pain in the knee!  My pace was good, actually, it was faster than I expected at 9:20 min / mile.  I headed down East 1st and before I knew it I was at Castle Island.  With the lousy weather, there weren't many other people out there.  The distance kept piling up and I felt great.  After 2 miles, my cardio was in tune and my knee felt great.  I actually finished my first two miles in under 19 minutes which is a great pace for me.  When I made the turn to head back home my pace picked up even more.  I am not sure if I was just on an adrenaline rush from being on my first good run in a while or whether it was the fact that for once I actually had the wind at my back, but my pace picked up to 8:40 min / mile. 
     It wasn't until about 3.25 miles that I felt the first twinge in my knee.  The pain in my knee was different this time.  I think the brace may have actually worked because the discomfort was much more mild and much more localized than previously.  I kept pushing through ran straight to my physical therapy office.  The final stats when the run was completed were ... 4.25 miles in 38 minutes!  The most important part of the run was that the knee barely hurt at all!!!! Again, I am not sure what made the difference but I didn't care.   Was it the physical therapy finally kicking in?   Did the new shoes I bought actually make a difference because they had a firmer sole that prevented pronation of my foot?  Could a $14 dollar cloth IT Band brace really make a difference and have this type of effect?   Like I said, I really have no clue what it was and I really don't care.  I am just hoping that my next few runs are as good as this one.
    The plan for now is going to be some pretty heavy icing / stretching for the next 12 hours.  I am going to try to get to the gym in the morning for a little elliptical work since I won't have time afterward with our big fundraiser tomorrow night.  Then, the sights are set on this long run on Sunday.  That will be the real test ... fingers crossed.

Back on the Elliptical

  After tons of ice and a little bit of time my knee got back to normal.  I figured I wanted to work my way back into running slowly so that I didn't over do it.  As such, I decided to hit the elliptical pretty hard on Wednesday.  I did have a slight curve ball thrown my way since when I showed up to the gym there was actually someone on "my elliptical".  Yep, that's right, it was literally the first time in the last three months that there was actually someone on the elliptical that I always use.  Since I didn't feel like waiting, I decided to hop on the machine next to it.   What I didn't realize, is that there is apparently some differences in the resistance between machines because a 9 resistance on the new machine was way harder than it was on "my machine". 
    While the workout didn't start out great, I pushed through the early low and was able to rock out a solid 70 minutes (~7 miles) on the elliptical.  I was pretty spent after this workout but was glad that I was able to get in over an hours worth of cardio.
     Once the workout was done, it was time to complete my PT exercises.  I started to realize that over the last couple of weeks I have literally been spending upwards of 40 minutes a day doing my physical therapy stretches and exercises.  It really made me think about how much time gets invested into doing these races.  Literally, its been hours and hours and hours worth of stretching, exercising and running.  Thankfully, I am finally starting to see some results as I am getting better at all the strengthening exercises and starting to see a really significant increase in my flexibility. 
     Looking ahead to the rest of the week, I am planning on doing a short run tomorrow (4-5 miles) followed by a physical therapy appointment in the evening.  Friday, I am going to try to hit the elliptical again for a 30-40 minute workout.  The big test is going to be Sunday ... the long run.  This week I am going to do my long workout on the road with L Street.  The planned run is scheduled for 14.7 miles ... which will officially be the longest run that I have ever completed. Keep your fingers crossed that the knee holds strong during this run since we are down to crunch time and there really isn't any room for error at this point. 

The Aftermath

   After my first quasi-long run I knew I was in for it, especially since the knee was pretty sore towards the end of the workout.  Thankfully, I started icing my knee right after the workout and did it pretty religiously for the rest of the day.  For the rest of the day the knee was really sore.  As always, the pain is located right on the outside of the knee and it gets a lot worse when walking down the stairs.  Overall, it wasn't all that bad but I did have some problems sleeping that night since the discomfort woke me up every time I rolled over.
   Monday started as I would have expected ... with the knee being sore as shit.  Again, I knew I had to do everything that I could to cut the circle of inflammation so that I could get back on the road.  My go to regimen is basically Aleve and ice.  Over the course of the day I was able to ice another 5 or 6 times for 20 minutes per session.  I really think that the ice helps out a lot and makes a huge difference in how quickly my knee recovers.
   Thankfully, by Tuesday morning the knee was back to normal and I was good to go.

Motivation - Part 1

   After all of the ups and downs of my training lately, I figured it would be worth including a few entries on what serves as my motivation for taking on such a big goal and continuing to try to fight through the adversity that has seemed to plague my recent training.  I guess its hard to really describe what motivates a person.  I think we all have different things that push us forward to achieve certain tasks.  I know that over the past few years, I have spent a lot of time reading stories about people who seem to accomplish amazing things despite having the odds stacked against them.   Most of these stories revolve around soldiers in a time of war (Flags of Our Fathers, Lone Survivor, etc) but others were just inspirational stories like the one about Team Hoyt (Devoted). 
    In my last few entries, I have referred to this ITB / knee pain as a "speed bump" in my training.  It really reminded me of a YouTube video that I became very fond of a few months back.  It was something that I had seen on a TV special and had always wanted to get around to watching.   Finally, on a slow call night I had the opportunity to watch the video, and I think I have watched it at least 30 times since.  The name of the video is called "The Last Lecture - Randy Pausch"(just clinic on the link to be taken to the actual YouTube video).   Its something that I would recommend everyone watch at some point ... just make sure you have the tissues handy.  The reason that I referenced this video clip is because there is a quote in it that I have continued to think about lately.  It comes about 3-4 minutes into his speech when he describes his multiple rejection letters from a job he had always desired.  He calls these hurdles "brick walls" and insightfully says that:

   "The brick walls that are in our way are there for a reason.  They are not there to keep us out, they are there to show how much we want it."

   I don't know why but this quote seemed to strike a cord with me recently, since I seemed to be up against my own "brick wall" with this nagging injury.  Fighting through and overcoming my "brick wall" should serve to show how bad I want to achieve this goal. 

Sunday ...

   As I have mentioned many, many times before in this blog ... Sundays mean only one thing during training - The Long Run.  While our running group had a solid 20 mile run planned today which encompassed the last few miles of the actual marathon course ... I had spent most of the end of the week trying to figure out exactly what my Sunday workout was going to consist of.  At the recommendation of Renee, we decided that it would be best to incorporate some "on the road" running into the workout since the actual marathon is rolling up really, really quickly.  After some discussion, we decided the best thing would be to run to the Y (~ 2 miles), workout on the elliptical for 1-2 hours and then run back home.  This would give me the workout time I needed for a long run while also working in ~ 4 miles of actual running. 
    I woke up around 8 today, well after Renee had taken off to catch her bus that would take her 20 miles west of Boston where her run would be starting.  After I woke up, I had a peanut butter sandwich and did some pretty intense stretching.  I wanted to make sure that I stretched a lot since I was going to be running more than I had in a while.  After my stretching, I took out the new Asics and put them on.  Regardless of if they would help the problem, they looked and felt pretty good.  As the temperature was pretty mild today ( low 50's), I actually headed out for my run with shorts, a t shirt and a wind breaker. 
    The run started off pretty well and was definitely much better than the 1.5 miler I completed three days earlier.  I ran down west 1st street and was doing pretty well.  I bet I got at least 1-1.25 miles into the run before I felt even a twinge in the knee (for that 10 minutes I thought that maybe the shoes had worked a miracle).  I was able to complete the two miles to the gym without any real problems although my knee did start to have a twinge or two towards the end.  Once at the gym, I spent about 5 minutes stretching some more and then hopped on my designated elliptical.  On a side note, I have literally not seen any other person use this machine in the past 4 weeks ... I am starting to think the Y should just donate it to me because nobody else uses it.  Once on the elliptical I punched in my normal settings ... Time = 60 minutes, Weight = 203 lbs, Resistance = 9 ... and started pedaling away. 
   The elliptical workout didn't start out well because my head just wasn't in it.  It was really the first mild day in a while and deep down inside I really wanted to be outside running.  I kept pedaling, but I really just couldn't get invested in the elliptical today.  After about 10-15 minutes, I decided that it was enough and that the rest of my workout for the day would come on the road.   I did a couple more minutes of stretching and then headed out back towards home.  The run home went pretty well, the knee had a twinge but no where near how it felt just three days earlier.  Next thing I knew, I was back at 13 Emmet and had tallied up 4 total miles for the day.  I decided to switch out my phone, which I use for music at the gym, for my smaller ipod and head out to continue my run.  I figured that since I had already clocked 4 miles for the day, if I was able to run down and around Castle Island I would be happy ending with a total of 8. 
    The run down towards Castle Island went well.  Since it was windy throughout my run, I knew that Castle Island would be interested since the winds are easily 15-20 mph faster than they are in Southie or the city.  What I have learned from my many runs around the island is that the key is to look at the flag when you get there and plan your run so that you have the wind at your back when you are on the far part of the loop (I learned this the hard way over the summer when I tried running against a 30 mph, lets just say mother nature won that battle).  Since the winds were blowing towards Logan Airport, I decided to go counter clockwise around the loop.  I was probably about 6 miles into the run when my knee really began to ache.  I completed the remaining two miles alternated between running for ~ 0.5 miles and then walking for 10-20 seconds to let the knee loosen up a little.  Regardless of how it went, I completed 8 miles today. 
     Overall, I was happy that I got a relatively good run in.  I am not going to lie, my ITB was extremely sore after the run, but I have come to the conclusion that this is just something I am going to have to deal with for the next 45 days or so.   The rest of the day was spent with a pretty hefty bag of ice on my knee.  I included a picture which shows how both Renee and I felt after our Sunday workouts. 
     Looking ahead, I think my plan for the remaining weeks of training is as follows ...
1) Continue my weekly workouts on the elliptical with maybe a few 3-5 mile runs sprinkled in there over the upcoming weeks.
2) Complete the L Street long run on Sunday 3/13 which is scheduled to be a 14.7 miler.
3) Aim to do as much of the L Street long run on Sunday 3/27, which is a 20 mile run that mimics the first 20 miles of the actual marathon course.
4) Taper after that run, which will give the ITB about 18 days or so to recover before the big race
5) PT, PT, PT, PT ....
     Again, this isn't anywhere close to how I picture my training would go back when I started this endeavor in November.  Honestly, I had dreams of running every L Street long run and showing up completely healthy and injury free on April 18th.  Unfortunately, a wrench got thrown in that plan, so I am kind of making things up as I go at this point.  I figure as long as I can get these two long runs in over the next few weeks I should be alright to go from a training standpoint ... I hope.

Post Sunday Workout Icing.  Renee icing her feet / ankles after completing an 18 miler, which consistent of a small ankle tweak after stepping in a pot hole.  And me icing my knee after an 8 miler, which was my first run of any real distance in a few weeks.

Retail Therapy

  Saturday rolled around and I was still feeling pretty down about how my last workout went.  Its just frustrating that there doesn't seem to be much, if any, improvement in my knee over the past 3 weeks.  As I was feeling pretty miserable about where I was in my training, I decided that maybe a new pair of sneakers would help me out.  I figured ... even if they helped a little bit ... it may get me closer to achieving my goal.  Thus, Saturday afternoon led Renee and I down to City Sports on Boylston.  We took a peak at the shoes and talked with some of the guys who worked there.  In the past, I have always been partial to Asics since they seemed to work well for me before.  Since I didn't want to switch too many things up, I decided that I would stick with that brand and see if a newer shoe may help give me a little bit of support.  According to my physical therapist, really the only two abnormalities that he saw in his initial PT evaluation were  - 1) My left foot pronates (turns in) more than my right  2) My hips weren't that flexible.  I figured that getting a more supportive / newer shoe may help work on problem 1. 
    In the end, I decided on a new pair of Asics aimed at stability (pic).  Also, they had colors similar to the official BAA colors so how could I turn them down.  The sole of the shoe is pretty rigid and really helps prevent the foot from pronating during the running motion.  Like before, there was a small glimmer of hope that a new pair of shoes would be a silver bullet for this ITB ... even though deep down inside it was probably just retail therapy at its best.  Whatever happens, I figured that it couldn't hurt trying a new pair of shoes and that maybe, just maybe they could help the problem.
    Hopefully they will have some positive impact ...

My New Asics

 

Test Run

   So I have been doing relatively well with my elliptical workouts since I am definitely getting stronger and the intensity of the workouts has no doubt picked up in the last couple of weeks.  Unfortunately, the Boston Marathon isn't run on an elliptical machine because if it was I might be considered one of the elites (actually, I probably still wouldn't be anywhere close to the front of the pack).  Since the big race is only about 6-7 weeks away now, it was time that I got back on the road and tried pounding the pavement again to see how the knee had improved. 
    Since I just wanted to take it in baby steps, I decided to go to the gym and get a good 30 minute cardio workout in on the elliptical so that my days workout didn't consistent of just a 2 mile run.  The elliptical workout, like I said above, was definitely a lot more intense than they were when I first started working out on the machine 4-5 weeks ago.  I was able to rock out 3.4 miles in 30 mins on a course with "hills" at an avg rpm of ~160.   After my elliptical workout, I spent about 20-30 minutes doing my stretches and exercises in the gym.  I have found that using the stretching cage (see picture) has helped me out a lot. 
    With that little piece of training behind me, I got on the bus to head back to South Boston to go for my first run on the road in almost three weeks.  The excitement that I felt towards actually going outside for a run was almost like a kid on Christmas.  I was hopefully that the physical therapy, the stretching and the exercises I had been doing would finally pay off.  Deep down inside, there was a part of me that was hoping for a miracle and was thinking that maybe I would be magically cured and that I would finally be able to run pain free.
    Once I got home, I through on the winter running gear and heading outside.  Armed with the Garmin watch, I had high hopes that this two mile test run was going to be awesome.  Those high hopes, however, quickly faded about 1 min & 30 seconds into my run when I felt that familiar feeling of a burning / sharp sensation on the outside of my left knee.  I thought for a split second that maybe it was something different ... a cramp, an itch, anything ... and that it would go away if I just keep running ... but it didn't.  In total, I ran 1.5 miles in about 13 minutes and returned back to 13 Emmet Street ... down, dejected, frustrated and miserable. 
     It was hard to imagine that after 3 weeks of not running that the knee had appeared to get worse.  Back when this started in mid-late January, the symptoms didn't pick up until at least mile 4 or 5.  Now ... only 0.16 miles into the run ... they were there.  Really, I don't have any words to describe how I felt that afternoon.  When everything else seemed to be going so well ... my elliptical workouts had been getting better / more intense, I was gaining flexibility with all of my stretching, my cardiovascular conditioning is the best its ever been ... Every other part of my body felt good, except a 4 x 4 inch section on the outside of my knee. 
     For the rest of the day, I packed it in and continued to ice the knee.  Thankfully, I really didn't run enough for it to be sore after I had iced it ... really what hurt was just the frustration of dealing with the nagging injury. 

Stretching cage at the YMCA

Physical Therapy

  I have to say, that after my nearly 3 hour long elliptical session yesterday the muscles in my legs were pretty dead today.  Thankfully, I had planned on taking the day off from any type of cardio what so ever.  Instead, I had a follow up appointment with my physical therapist, Declan, to continue trying to get me over these ITB issues.  The appointment started out like all of the others with some simple stretching aimed at the hamstrings and hips.  After the stretching, we moved to ~ 5 minutes worth of ultrasound therapy.  Like I said in an earlier entry, the ultrasound therapy is aimed at increasing blood flow to the injured / inflamed area to help promote healing.  Honestly, I am not sure if I buy that it works ... but I am willing to try anything.  When I have a free second I am going to have to look into the medical literature to see if there is any evidence for it.  After the ultrasound therapy, came the deep tissue massage.  Honestly, this part hurts like hell.  Its basically when the physical therapist mashes the hell out of the inflamed ITB to try and stretch it out ... it was about 5 minutes of pure pain.  The next step was some slightly more intense stretching aimed more at the hip flexors / thighs.  I think that my flexibility over the past few weeks has definitely increased from doing all of the stretching exercises that I was instructed to do. 
     As this is where my last couple of PT appointments had ended, I thought I was done.  Instead, Declan had a few more exercises that he had me do wit a PT intern.  The next battery of exercises revolved around resistance training / weight training aimed at the hip flexors / extensors.  I have to say that doing these was harder than I thought, mostly because my legs are so out of shape.  My homework was the same as before ... hamstring stretches, hip flexor stretches, ITB stretches and some gluteus medius strengthening.
    Unfortunately, since I am overnight on Tuesday night I won't have time to do cardio.  I am going to try to aim to run 2-3 miles on Wednesday before my PT appointment to give the ITB a little test drive.  Hopefully all goes well.



In all the times I have been to the gym, I never thought I would ever use this machine!  But, apparently my hip adductors & abductors needed some strengthening so it is now part of my routine!

Clamshell exercise aimed at strengthening the gluteus medius.