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Posts Tagged ‘Knee Pain’

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Leading into Sunday morning, I had run 42 miles for the week.  For me, that’s a lot.  During the peak of my training for both Smuttynose and Boston I hit 55 miles per week, but I don’t normally live in the 55 – 70 mile per week range.  In fact, I don’t think I’ve ever hit more than 55 miles in a Monday to Sunday stretch.  By Saturday afternoon my right knee was feeling a little wonky (yes, non-runners, that is a technical term).  When I woke up Sunday it was downright aching.

I stared at my schedule:

17 miles.

I had been here before.  Achy knee, long mileage, determination.  I had powered through it and then proceeded to have to take a week off from running.  I knew that I shouldn’t run but I still reached for my shorts.  Fortunately for my knee (but unfortunately for my little one) Brooke had been up sick that night.  The double-whammy of my restless sleep and my achy knee finally got the better of me and I went back to bed.

When I woke up at a more decent hour the knee hadn’t improved.  In fact, in addition to the achiness, it now had a clickiness (yes, that’s the technical term for that).  I sighed.  Maybe jumping up to the 12/70 plan* wasn’t such a good idea.  Maybe training for another marathon so soon after Boston wasn’t such a good idea.  Maybe I was going to need to take a little time off.

The fact that I felt a little under the weather didn’t help my mood.  Nor did the fact that Brooke had been the target of teasing on Friday help either.  I was mentally, physically and emotionally down shot.

I looked at my knee – pissed and pissy.

***

As I looked at my knee though, I realized that my stretching routine had gone by the wayside.  Yes, I stretched my quads and my hammies; my calves and my lower back – but I had essentially stopped doing —>>>THESE<<<— two stretches on a regular basis.  They were the two stretches that got me out of my endless cycle of running long miles and knee pain.

I immediately did the ITB stretch, held it for 40 seconds and …presto!… almost like magic the achy knee went away.  Had it not been already mid-morning, I would have slipped on the running shoes and been off for my 17.

The achiness stayed away for most of the day, finally returning in the evening.  40 seconds later and relief was once again mine.

After putting the family to bed, I decided to make up at least some of the miles I missed in the morning.  Due to time I only got in 9 miles, but I’ll take it.  Afterward I made sure to stretch.

It is obvious to me that the ITB tightens when the mileage gets high, but as long as I do —>>>THOSE<<<— two stretches, hopefully I will be fine.  The question becomes, “what is the mileage limit that those two stretches can counteract?”  When I was training for Smutty and Boston I peaked at 55 miles per week in both training cycles.  My current plan has me peaking at 70 miles.

70.

Wow!  That seems like a lot of miles.

You tell me if I’m wrong, but for now, I think I’m going to stay the course and continue to up the mileage (in conjunction with the stretches).  If the knee does not improve with the stretches, I will dial it back.

What would you do?

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*The 12/70 plan is the 12 week marathon program I am following that starts at 55 miles per week and peaks at 70 miles per week.

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Stretch

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Those that have been following this blog know that I have been struggling as of late with some “on again, off again” knee pain (located on the inner part of my right knee).  A while back I went to a doctor who advised me to take up rowing instead.  Yeah, right. How does that help me qualify for Boston? After months of trying to ignore the pain, I finally went to see a PT and was told that I had some chronic hamstring inflammation. He gave me a simple stretch to do three times a day and recommended that I ride a stationary bike on shorter recovery days instead of run.

Lo and behold, the pain went away. After two weeks of this (and probably cycling just a little too hard) however, a new knee pain presented itself on the outside of my knee. I did a little research, found a stretch for ITBS, and within a couple of days everything was back to normal.

After certain types of runs, the knee becomes more aggravated than others. Striders tend to not agree with me, and VO2Max runs can cause a little tenderness, however, these two stretches have changed my running life. No longer am I running in fear of hurting my knee.  No longer am I worried that my knee won’t hold up under the pressure of training for Smuttynose. These two simple stretches, have changed the ballgame for me.  Just earlier this week, I went out for a 20 miler.  I ended up running nearly a minute faster per mile than I had planned (and a mere 26 seconds per mile slower than my planned marathon pace), a sure recipe for knee pain.  Guess what? Nothing.  No pain.  No tenderness.  Nothing.

This is what I posted on dailymile just a few days ago explaining the stretches:

So the two stretches are a hamstring stretch and an ITB stretch. The hamstring stretch is done in a chair where your feet can touch the ground. To stretch your right hammy, bend left leg to 90°, foot flat, and extend right leg out, heel on the ground, toes pointed at 45° angle away. Bend at the hips (NOT the waist or back) and hold for 30 – 45 seconds. For the ITB, take the right leg and rest ankle on left knee. Place your left hand under the right ankle, right hand under the right knee. Now lift up and to the left. You should feel a stretch in the ITB up to your butt. Hold for 30 – 45 second. Now you may be asking, what the heck do my hammy and my itb have to do with my knee pain. Well, for me the chronic hamstring inflammation and the mild ITBS were/are causing inflammation at the ends of the tendons which attach themselves, you guessed it, at and below the knee…my pain was in the back left of the right knee and on the right side of my right knee.

So that’s it.  Two stretches that have changed my running life, at least for now.  Short term, they have been nothing short of a miracle.  The verdict is still out on the long term, only because I really only started these stretches a few weeks ago.  Still, if the way my knee felt after a pretty fast-paced (for me) 20 miler is any indication, I’m keeping these stretches in the arsenal.

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This past Sunday I ran the Providence Marathon. This was the marathon I had been training for all winter in hopes of qualifying for Boston 2011. Instead, plans changed, I ran Boston 2010 two weeks ago and was forced to change my approach to this marathon. Running 2 marathons in 2 weeks, especially when you haven’t specifically trained for it, is just a tad nuts. Many of you let me know that two weeks ago when I announced that I would indeed run Providence. I did manage to give Sunday’s run some purpose with my $22 for your favorite charity post (and the 22 of you that participated truly helped me through the last few miles), but in retrospect, I don’t think it made it any less crazy.

As crazy as it was though, I came into Providence with a plan – start slooooooowly.

Which I did.

Kinda.

The thought of running Providence as a Boston qualifier did in fact cross my mind in the past week, but if I was going to be honest with myself, I knew that my body was still not fully recovered from my run at Boston. It didn’t help that I was still in the midst of fighting a nagging chest cold.

So the plan on Sunday was to run a steady, strong race. Start slow, pick up speed if I felt like I could, but not push myself to the point of serious injury. I figured a 3:35 – 3:40 was not out of the question.

As I drove down to Providence I heard a weather report on the radio state that the temperature for the marathon was going to start around 60° (Yes!) and climb to over 85° (NO!!!).

85°? Really? 85 frakkin’ degrees?

Any and all thoughts of a possible BQ vanished completely.

Sunday was going to be a test of survival.

I played with some numbers in my head as I pulled into the hotel to park the car and check my bag. 3:32 in Boston, under almost perfect weather conditions meant, what? a 3:40 in Providence? Maybe a 3:50 with the soaring temperatures? I shut the brain down as I went in.

I started looking for people I knew through my online running community and almost immediately ran into twitter friend @IronmanLongRunr. I had actually met him at the Manchester Marathon back in November and I was pleased to see that he was attempting to run his first marathon in Vibrams. We chatted on our way to the start, getting funny looks from people looking at our funny shoes. It was great to have a fellow Vibrams runner along for the ride.

What a different perspective from Boston. I wish I had the foresight to take a picture, but suffice it to say I started near the front on Sunday as opposed to the absolute rear. While waiting for the starting gun, two more dailymile friends tapped me on the shoulder to introduce themselves (Melissa C. and Martin A., both of whom were running the half – I also met Ryan D. after the race). It is such a neat moment to be able to put voices and body language with the faces and names of the people you have been following online.

Although I had placed myself in the 7-8 minute/mile pace area, I was determined to start slow. As the gun went off I could hear myself say out loud, “Go slow”.

IronmanLongRunr laughed. His approach was actually going to be similar. Despite having run nearly 1000 races and several marathons, this was his first in Vibrams.

We hit the first mile marker at about 8:00. Perfect. My goal was to hit 10 miles at about 80 minutes and see how I felt. Unfortunately, not much past the first mile marker I hit my first speed bump. The course took a right turn down a hill and the moment I hit it, my right knee buckled, I mean seriously buckled.

Sharp pain! Sharp pain! Sharp pain!

Frak! No Frakking Way!!!

I didn’t change my pace. Two strides and I was upright. I tried to ignore it. I looked over at IronmanLongRunr and forced a smile. We were pretty much maintaining the same pace so I decided to distract myself with a little conversation. We made small talk while we waited for the course to split and send the half-marathoners in another direction (on a complete side note, I loved that the organizers of this marathon split the course in two different directions early. This way I knew that anyone who was running with or around me was running the entire race and not peeling off at 13.1 – see my Manchester experience to see why this mattered).

The pain was not going away. It wasn’t getting worse, but it definitely was NOT going away. I gritted my teeth as we approached the first real hill at mile 5. Going up was fine. In fact, I incorporated a little of my falling uphill move with very nice results. But every step coming down sent a sharp pain through my knee. I tried to adjust my stride, but didn’t want to do anything too dramatic and cause something else to give. Fortunately, the marathon course overall was the flattest I’ve run so far. About two miles later we hit another hill with the same results. Going uphill I gained some ground on some runners, going down I whimpered with every other step.

As we approached a turn around at about mile 9, I got a peek at some of the leaders. I saw my buddy Brad (the runner who patted me on the back at Eastern States). He would tell me after the race he crashed and burned and had to walk the last few miles…he finished with a 3:27…right, a 3:27 walking the last few miles. Anyway, after I made the turn around I spotted one of the runners who had encouraged me to run Providence, my dailymile/Twitter friend, and fellow blogger, Robyn. At that point, IronmanLongRunr dropped back, I shortened my stride and picked up my pace.

At that point I latched on to two runners who I would find out are both Ironman competitors as well. John was pacing Steve for a 3:30 race. I followed them for several miles, chatting about my shoes and their training. They tried to convince me that doing triathlons actually hurt less than doing marathons – that the recovery time was much shorter for triathlons.

Yeah, right.

Turns out that I wasn’t the only crazy one in the group. John had run Boston just two weeks before as well. At around 16 or 17 I picked up my pace for no good reason and left them behind. I was happy to see that my fear of the 16th mile seemed to now be completely obliterated.

I picked up a young woman named Steph. Steph was running her 4th or 5th marathon in hopes of running a sub 3:30. At this point we were on pace for about that so we chatted for a while. Turns out she had qualified for Boston this year, but had been unable to run it. She was hoping to run a qualifying time again. I told her I’d hang with her as long as I could to push her along, but I knew that there was really no way I was going to keep up. About 2 miles later she dropped back. I probably should have followed her lead.

The pain in my right knee continued to bother me. There was just no way around it. IronmanLongRunr had said to me early on around mile 3 or 4 when I mentioned it, that the body and the marathon were strange things and that pain that was bothering me at mile 3 or 4 could suddenly disappear by mile 10 or 15. I had kept that thought in mind the entire time but to no avail. Although the pain wasn’t getting worse, it was still not getting any better.

Although the pain never caused me to think about quitting (aside from that first mile or two), it was definitely starting to get to me at this point. The mental fatigue of fighting the pain was wearing me down. I looked at my arms and shoulders and saw all those who were riding with me and picked up my pace.

As we hit the 20 mile marker, I said to myself, “Just a 10K at this point. You can do a 10 K.” And despite the constant knee pain, the rest of me felt pretty good. The next two miles went along quite pleasantly for having just run 20 miles.

But then the sun and heat came out in full force.

At 22 it was almost like someone had decided to turn the thermostat WAY up. I was convinced that my pace was slowing.

With maybe 3 to go, John and Steven passed me by like I wasn’t moving. I was still catching people myself, but they were in a groove. John paused and asked if I wanted to come along. I shook my head. The combination of heat and pain was too much for me to try and pour it on for the final 5K. Shortly thereafter Steph pulled up next to me. She had picked up another young woman and they were cruising along. She too paused momentarily to see if I wanted to latch on and again I shook my head. They were just going a little too fast for me at that point – 2 marathons in 2 weeks was finally, truly taking its toll. I felt like I had enough fuel to hold steady, but any sudden acceleration would have taken me down to empty.

It was around this time that my phone died on me again. It may have had something to do with trying to pour water on my head and missing completely and hitting my left arm instead. My phone was soaked and the automatic tracking stopped. I tried to guess my distance based in time and perceived pace, but everytime I thought 2 minutes must have gone by, I’d look at my watch to discover that only 60 seconds had passed.

Somehow I missed the marker for 24 and was convinced I had also missed the marker for 25. Imagine my dismay when 4 minutes later I came across mile marker 25.

The sun decided to turn it up even more for the final mile. There was no place to hide. I felt like I was dragging my feet for the final stretch. The air was thick, my body was tired, and at this point my knee had had just about enough thank you. Every small downward slope shot a sharp pain along the outside of the knee. I looked at my watch. 3:20 and change with just 1.2 to go. I knew I had a shot at a second PR in as many weeks and maybe even a sub-3:30. I dug deep and thought of all of you who had donated $22 to your charities to come along for the ride.

“COME ON!” I yelled to myself, scaring the crap out of a poor half-marathoner I was passing. I pushed along, hoping to run close to an 8 or 9 minute mile.

As I came around a bend, I looked for the finish.

Nothing. Just a few runners ahead of me. Around the next bend I went, looking for the finish.

Nothing.

I looked at my watch. Closing in fast on 3:29.

“How far?” I yelled.

“Around that bend,” someone yelled back. I looked. It was so far away, but this was it. I ran as hard as I thought my knee would let me. As I made the turn a kid in a green shirt started to pass me. I looked up – 50, maybe 75 yards to the finish. Green shirt passed me. The finish line was coming up fast now. I hadn’t seen this kid all race. He had been behind me the entire time. I wasn’t going to let this happen.

A sudden burst of adrenalin and the pain in my knee was gone. I broke into an all out sprint, the crowd cheering the two of us on in our mini-duel. I pulled away and finished a few yards ahead of him and proceeded to collapse into the arms of an awaiting volunteer.

I came to a dead stop. I couldn’t breath for a moment but caught my breath just in time to feel the pain return to my knee.

As I hobbled my way to food and drink area, I found John, Steven and Steph. They all had done well, Steph achieving her goal with a 3:28. She thanked me for pacing her along the way and I did the same.

As I sat there drinking my bottles of Mix1 and trying to eat a banana and some pizza, maybe a half dozen runners came over to thank me for pacing them along at certain points during the race. All of them had finished behind me, but each and everyone of them had kind words about silently following me at some point. I couldn’t help but think of “Ilsa”. I recognized some of them, but there were a few I hadn’t been aware of.

In the end I didn’t run a sub-3:30, but boy did I come close.

3:30:11. A PR by nearly 2 minutes. 114th overall out of nearly 1000 marathoners and 26th out 150 men in their 40’s. Not bad for a race that was the second in two weeks.

A couple of things I learned – never do 2 marathons in 2 weeks. I am mentally spent! I’m glad I did it though. I learned that my body can take the pounding of 26.2 miles better than a chest cold can. As of yesterday? No more chest cold. I also learned that maybe there’s more gas in the tank at the end of a race than we think. Looking back, I wonder if I should have latched on to either John and Steven or Steph. If I had, could I have held on to run the last 5K with them? My sprint at the end tells me just maybe I could have. Only one way to find out, right? Yeah, I think the next marathon isn’t for at least 5 months. Of course, that means if I’m going to follow a 16 week program, training starts in a month. I’m tired just thinking about it. Finally, I learned that, in the words of Dalton (RIP), Pain don’t hurt. As bad as my knee was killing me, I was able to run through it, using it almost as a tool to keep me from going out too fast.

I think a week off is going to be necessary, but then it’s right back to road. Next race – Boston Run to Remember at the end of the month…at least this one is just a half-marathon.

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