Tuesday, April 30, 2013

ITB - Training and Injury Update

It was bound to happen, I DNF'd my first race last weekend as a result of my now two-month-battle with ITB Syndrome. The looming question is where do I go from here? Unfortunately, I have two constraints pulling at me from both ends -- this injury seems to really need time and I have a race to prepare for in eleven weeks.

A quick little recap: I realized I was injured during the Old Pueblo 50 mile run in March. At the time, it was more of a dull ache/tingle in my upper hip/thigh area (sort of the tensor fasciae latae and upper portion of the ITB). I wouldn't describe it as pain, but I knew it wasn't "right". A few days after OP50, I tried to run again and that is when the knee kicked in -- extremely painful, particularly on downhills and stairs, classic ITB. My initial response was to approach it with relative rest (see below) and I did well for awhile. Along with rest, I did some active release and started doing even more cross training. I had not had any knee discomfort in several weeks, but the hip discomfort remained. My patience went out the door and I pushed things a little the week of April 15th, running three days in a row for the first time and running five days total for the first time. I had a flare up the following week, then my DNF, both severe knee pain. The odd thing is that my knee typically goes back to normal within 12-24 hours and I am unlimited until it flares up again.

I have researched ITB tirelessly for the past two days and have come to only two solid conclusions: 1) for all the great medical research and advances out there, there isn't much conclusively known about it and 2) the only thing that appears to be a sure fire cure is time. If you Google ITB, you will get answers all over the map -- stretch it, strengthen your hips, ice, etc... But the truth is that there is very little that supports any of those things as "cures". Many of those cures are found after relentlessly trying to rid of the injury, but time is likely the greatest cause to healing.

Time is the enemy of the training runner. How much time? All indications are that mild cases could be a few weeks and more complicated cases could be several months. Chronic cases may take surgery. My inclination is to believe (hope maybe a better word) that I have a pretty mild case. After all, I've run for 2.5 - 3 hours four times in the past month with only one flare up. The other difficult question is whether I need to give it full rest or "relative rest". Full rest being no running at all and avoiding any activities that irritate either my hip or my knee (nothing seems to bother it other than running). Relative rest is what I was doing most of the month of April -- running every other day, about 50% of my normal weekly miles, and shutting down at any sign of pain. Of course, the risk with relative rest is that it prolongs the injury even if you can train through it.

There are lots of turns that this post could take, like discussions about the potential "root" cause or whether I am "meant to be a runner", but I'll just leave you with some details of my plan for now. Here is my plan:


I aim to have full rest for at least one week and maybe as much as three weeks. With eleven weeks to go before my race, I think I can recover from a two week layoff and still train enough to run at high level.

Cross Training

As long as it doesn't bother either my knee or my hip, I will cross train 4-6 days per week during my rest period, and then 3-4 days per week once I resume training. While there is relatively little evidence to suggest that it cures ITB, it is still good work for me to be doing. Plus, I enjoy lifting weights. I have consolidated the overwhelming amount of cross training stuff that I've discovered into three things:

The exercises in my favorite book, Anatomy for Runners. I discovered a convenient and structured workout designed using the exercises from this book. This stuff is great because it distills things down to relatively few exercises to cover a broad spectrum of total body health: posture, stabilization, power and strength.

Another group of exercises that I plan to mix in are from the book Run With No Pain. The exercises in here are very similar in nature, but add a circuit component and just a little more flavor to mix things up.

Finally, I will continue to incoporate some of the work done by Jay Johnson. In addition to the general strength stuff, I really like using his Myrtl routine for dynamic stretching before both running and weight training.

That is pretty much it. During this next few weeks, I will continue to re-evaluate and see if I can find reasons to change my strategy. And I will likely continue to formulate other plans in case my body doesn't respond to several weeks of rest. But, I sure hope it does because the will to fight through more injuries is really starting to wane. My absolute nightmare scenario is either showing up with more half-assed training or with a worry that I might DNF again. I need to get by this thing for good.

Cheyenne Mtn Race Report

Last Saturday was the Cheyenne Mountain 50K run. Since I have been struggling with an ITB injury for nearly 2 months now, I didn't really do much training or thought-preparation work for this race. Nonetheless, I managed to put in 2-3 weeks of half-assed training and figured I would have a shot at finishing the race and maybe even a top-20 finish. But, the possibility of a DNF was a very real concern before the race.

On Saturday morning, I met up with some friends and we drove down together. Unfortunately, only one of us had been training consistently. Nonetheless, we had some good talk about possibilities, strategy, etc.... All the usual pre-race stuff. Once we arrived in Colorado Springs, we picked up our bibs, put on our gear and then waited. One thing that was obvious was that it was going to be hot. Now seventy degrees isn't that hot under most circumstances, but April has been an abysmal month and I would say most of us were acclimated to about fifty degrees as the high temperatures. In fact, I think there it is a pretty safe bet that Saturday was the hottest day of the year so far. Somehow I wind up with above average temperature races more often than not, so I am pretty used to it. And while I am sure it slows me, I haven't had any catastrophic outcomes.

Anyway, after about forty-five minutes of standing around and chatting with friends like Wyatt, they sent us off. My buddies and I had planned to hang together for the first of two loops and go easy. The trouble is that the trail is mostly single track-like and there are several parts of the course that are two-way traffic. We were sort of running alone, but in view of one another. Things went really well for me the first loop. We ran a conservative pace, and I felt pretty good. I had cobbled together a last minute nutrition plan with more carbs than normal figuring that my effort and the heat wouldn't allow me to eat much solid food. That plan worked out pretty well -- basically 1 serving of GU Roctane Brew per hour and 1 Vi Gel, totaling almost 350 Kcals an hour. At aid stations, I would take plain water to help stay hydrated.

Toward the end of the second loop things still felt pretty good. We kept the pace reasonable on the big climbs from mile 8 - 11. While it was certainly getting hot, I felt like I was still in control of my race. Once we started heading downhill it became apparent that one of my buddies (Jon) was not doing so well.  (Really, I could tell earlier as he was pretty discouraged when he compared his heart rate to our pace). Jon had planned to run 8:00 - 8:30 downhill and he was leading us at more like 9:30 to 10:00. It must have been about mile 13 when our other buddy, Mike, took off and started running his own race. I stopped briefly to urinate and then resumed. Jon told me to "just go" and he was having a bad day. At the halfway mark, I refilled my water bottles in my race vest with Roctane and took off, hoping to catch Mike. I knew Jon had to go about a tenth of a mile off course to get his drop bag and he would be lagging for a while.

Unfortunately, a little less than a mile into the second loop (mile 16.5 or so), my knee began acting up. The dreaded ITB flare. The trouble is that once it sets in, it isn't something you can easily undo in the middle of a race. And the build up to the pain happens pretty quickly. There is no doubt that the downhill running in miles 11-15 and the relatively slow pace (slow leg turnover) combined to aid in my knee flare up. I knew then my day was done. Before heading in, I found an intersection in the Blackmer trail and stopped to wait for Jon and Mike. After 10 minutes, neither of them came through. I was pretty certain Mike was ahead of me (he was) and Jon had probably dropped (he had). I proceeded on the slow return to the start, took off my bib so the course announcer wouldn't read it, and went around the finish line. That was it, my first DNF.

Jon and I hung out for a few minutes to see Mike pass by the start line on his way to his last loop and wish him luck. Then we headed back to Castle Rock. I am humbled and frankly not entirely sure where things are headed from here.

Sunday, April 21, 2013

Weekly Training Wrap - 4/15 - 4/21

Well, I didn't intend to run five days this week, but I just let my body be my guide. I am not willing to declare things 100%, but I feel like I am turning a corner very slowly.  With some more patience, I think I'll be able to start pushing things pretty hard in a few weeks.  I plan to start working close to five days a week with two days a week of weight training and one day a week focused on weak areas. That should allow me to get fit, get stronger, and rest more all at the same time. I've also let me diet go (mostly in terms of portion control) a little bit and plan to resume using MyPlate for a few weeks to get that back on track. My racing weight is about 185 pounds and I am a little over 190 right now.

This upcoming week I have the Cheyenne Mtn 50K. Between injury and lack of training, I don't think I'll be "racing" it. But, if things line up, I'd like to think I am capable of about 5.5 hours on that course in an under-trained state.

Day Miles Notes
Monday Off PT and Strength Training
Tuesday 9 MAF
Wednesday6 MAF
Thursday7MAF and PT
FridayOff PT and Running Strength
Saturday 19Hilly Road Long
Sunday 5 Recovery
Total 46 About 3200 vertical feet

Sunday, April 14, 2013

Weekly Training Wrap - 4/8 - 4/14

Another successful week as I rebuild.  Things are starting to feel almost normal.  I have the Cheyenne Mtn 50 coming up in 2 weeks. The plan at this point is to run all 50K and treat it like a long training run. Hopefully there are no setbacks between now and then.

Day Miles Notes
Monday Off PT and Strength Training
Tuesday 7 Mile Repeats @ LT Pace
WednesdayOff PT and Running Strength
Thursday8Easy/MAF Miles
FridayOff PT and Running Strength
Saturday 5Easy
Sunday 13 Mt Falcon Trails
Total 34 About 3930 vertical feet

Sunday, April 7, 2013

Weekly Training Wrap - 4/1 - 4/7

Wow, pretty good week on lots of fronts. I ran 4 times without any pain, though I wouldn't quite call things 100% yet. I got in a long trail run (2+ hours). I achieved my goal of 30 miles for the week. And,  I saw some progress in my HR -- a drop of 10 bpm on one particular run.

In addition to my active release technique massages, I am staying on top of icing. I am continuing to run only every other day (every 36 hours at most). And I started a strength training regimen from http://runwithnopain.com/. Consistency is the key right now.

Cheyenne Mtn 50K is in three weeks, and while it is clear I cannot "race", I am hoping that I can stay patient until then and use that race as my jumping off point to kick start a push toward Leadville Silver Rush.  I honestly think that even 35-40 miles per week until then is enough to keep me in a good place.

Day Miles Notes
Monday Off PT and Running Strength
Tuesday 6 Mile Repeats @ LT Pace
WednesdayOff PT and Strength Training
Thursday7Easy/MAF Miles
Friday13 Night Trail Run
Saturday OffPT and Running Strength
Sunday 6 Easy
Total 32 About 3600 vertical feet