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.