It’s official. I have my first sports-related injury. Before I go any further, I want to preface this post with the following: While I am a physician who is licensed to practice in the state of New York, please do not use my comments in this post to make an attempt to diagnose or treat any knee pain you may be experiencing. Nothing can replace the value of a good clinical history and physical examination so please see your family physician, physiatrist, or physical therapist in order to be accurately evaluated.

Now that a disclaimer has been placed, back to me. Last week I wrote about the knee pain I experienced at the most recent race I ran, the UAE Healthy Kidney 10k. This was the fourth race I ran since taking a year off from running, and also corresponded with my fourth episode of sharp left-sided knee pain. In the previous three races, my pain started vaguely, around mile 2, and progressively became worse, especially when downhill segments of the race course were encountered. The pain resolved over the next 24 hours as I limited physical activity, iced my knee and intermittently wore a knee brace. Rapid flexion or extension of the knee, as occurs upon getting up to stand from a seated position, or vice versa, caused excruciating pain. It was all very debilitating, as you can imagine.

At the UAE Healthy Kidney 10k, pushing through, “I will complete this race. I will complete this race!”

At my last race, the pain started much sooner, within the first few minutes, in the early part of mile 1. Alarm bells started to ring, but the competitor in me wanted to complete the race. Although I did run/walk/limp the 6.2 miles to completion I decided that I could not keep doing this anymore, especially if I wanted to run the 9 New York road runner races to guarantee NYC Marathon eligibility for 2012, and so I made an appointment to see a physiatrist.

When you decide to go to a teaching hospital, as I did, you should be prepared to repeat your clinical history twice, and sometimes even three times, before you will be seen by your actual doctor. I was first seen by a nurse, then a resident (physician-in-training) with a medical student in tow, and finally by the physiatrist.

While some may find this system this annoying, I don’t mind it. I have been on the other end, as both a medical student and a resident; nervous that the patient will see through my cool physician facade and realize that I am, in fact, merely, in-training; anxious about blanking out when quizzed about the diagnosis by the attending, and just overall apprehensive of making a fool of myself. The system serves a purpose, and that is to teach the residents and medical students the ability to autonomously and confidently make a diagnosis, and thus pass the threshold into becoming a real doctor.

The resident asked me many questions, which I answered as thoughtfully and accurately as I could. She then examined me. This did not yield much as my painful episode had subsided by this point. She just had to go by my description of where the pain was located, how bad it was on a scale of 1/10, and so on and so forth. Afterwards, she rubbed the side of her forehead and said “I really don’t know what it could be…”

I knew she had to go and report her clinical impression to the physiatrist so I decided to cut her some slack and say, “I think its iliotibial band syndrome.” (I had researched my symptoms beforehand and had a pretty good idea of what was going on with my knee). Her face lit up and she nodded, “Yes, that’s probably what it is,” and left the room, promising to return with the physiatrist.

When they returned, I repeated my story to the physiatrist. After he finished examining my knee, he turned to the resident, beaming, and said, “I completely agree with your diagnosis of iliotibial band syndrome.”

I tried to catch the resident’s eye to give her a conspiratorial wink but she did not look me. Well, at least she will always know how to diagnose an iliotibial band syndrome!

Source: www.sportsmd.com

Iliotibial band syndrome is a common cause of knee pain in runners. In this condtion, the iliotibial band, a thick band of fibrous tissue connecting the hip and knee joints (see above), for a variety of reasons, becomes inflamed, causing pain on the outside of the knee. The cause, in my case, was increasing my mileage too quickly. After taking a year off, I resumed running in the beginning of March, running short distances, never taking it beyond one or two miles. Since I ran regularly before the hiatus, I felt invincible enough to tackle a 10k in April, with no proper training. Bad idea apparently. So the take-home lesson is: Always train for your races! It is not worth getting injured.

Crossing the finish line (far, right, in the green t-shirt)

I start my 4-week treatment plan with a physical therapist this week. It is a bit disheartening not to be able to run especially now that the weather is getting nice. But hopefully I should be back, hitting the Central Park concrete, in July. Until then I shall live vicariously through the race recaps of all my favorite bloggers!

Have you ever had a running-related injury? Or dealt with iliotibial band syndrome?

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18 Responses to Not The Bee’s Knees: My Running-related Injury

  1. Lauren says:

    Thanks for stopping by Foodtrainers; your blog has the best name. I am sorry you are injured as a runner (and mom) I know how frustrating that can be. I swear by a supplement that combines all natural anti inflammatory agents (ginger turmeric etc). Good luck.

  2. Dori says:

    I've had a few injuries while running… it is the worst, but you did the right thing by getting it checked out now. I am sure you will be fine! Invest in a good foam roller if it really is ITBS — it will help!

  3. Amber says:

    I'm so sorry you are injured but I am glad you got it taken care of and are on your way to recovery! I feel really fortunate I've not had to deal with any serious injuries yet, but I have deliberately not signed up for any races after my half marathon just in case. I don't know how long my luck will hold out for!

  4. Oh no! Sorry to hear you have an injury. I had some knee issues during marathon training (likely a combination of increasing my mileage too fast/too soon, too little recovery time between fast running, and moving to a new area with significantly many more hills) Injuries suck, but you will work through them…and be faster and stronger than ever!

  5. Jess says:

    Oh man. I had the EXACT same thing two years ago and it TOTALLY bummed me out. Took about the same amt of time (maybe more) to get through PT to recover. BUT it was worth it in the end, my knee and hips are stronger for it and it taught me a lot about how to be extra aware of any sort of knee pain vs. trying to ignore it and "wish" it away. Hang in there. :(

  6. Lauren: Thanks! Turmeric has great healing properties. I'm glad you reminded me about it. I have used it in the past for various ailments with great success.Dori: I have been thinking of getting a foam roller. I know its very helpful in ITB syndrome. See you tonight in class!Amber: I hope you don't have to deal with any injuries. Good luck with the half-marathon! I hope you managed to find a good playlist.

  7. Rach: It's amazing how many of us get injured while running and yet we persist! Can't beat that runner's high. Thanks for your comment.Jess: My physical therapy sessions are for 4 weeks but I will continue them longer if necessary. I'd rather take care of this issue now,even if it takes longer, rather than deal with it next year, when I am hopefully training for the marathon..

  8. Ameena says:

    Oh how I can relate to knee injuries! I ran way too much and now my knee is permanently in bad shape – my running days are pretty much over. After many, many appointments I learned that I have arthritis in my knee and it's not going away anytime soon.I hope physical therapy works for you and you are back on the trail soon!

  9. Ameena: So sorry about the arthritis. Thankfully there are many other ways to stay fit but I know it must still be rough. Thanks for sharing your experience.

  10. ellen says:

    Oh no! So sorry to hear about your injury. I second Dori's comment about the foam roller – I LOVE it. I had some running-related knee issues a few years ago – the good news is with some diligence and extra care, you can certainly come back to running and run injury free. Wishing you a smooth and speedy recovery :)

  11. Ellen: Thanks for the reassurance! A foam roller it is!

  12. Oh no! Sorry you have to deal with this. :( You're knowledgeable enough to get it taken care of sooner rather than later though. That's awesome. I bet you'll be back on the run in no time. I haven't had a sports injury yet, so I really try to keep them from coming by playing it safe with training and keeping up with cross training, strength training, and stretching/foam rolling.

  13. Tina: It's smart of you to cross-train. Definitely a good way to prevent an injury from taking place. And the comments on the post reaffirm the fact that I must invest in a foam roller ASAP!

  14. Jill says:

    Yikes. Yeah, sometimes pushing through the pain isn't a good idea. Especially for just training races. Feel better and take it easy.I have been relatively lucky. In 25 years of competitive running, I've only had bursitis but it was pretty debilitating. I was training for a marathon for which I raised money so I felt I couldn't bail. I took the summer off then ran it with less than 2 months training. But, I did it!

  15. Jill: I'm going to take 4-6 weeks off running while I get my PT. Good for you for being able to run a marathon with only 2 months of training. I agree, bailing is not an option when you've raised money. Still, I'm super-impressed!

  16. Ugh… I'm sorry to hear about your injury! Hopefully, you'll nip this and be back at it before you know it!

  17. Jess: I hope so too!

  18. [...] I felt a slight pang on the outside of my right knee. The last time this happened was during the UAE Healthy Kidney 10k last May, which was ultimately diagnosed as Ilitibial band syndrome and required weeks of physical [...]

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