I'm a 41-year-old male running for approximately three years. In May I ran my first marathon with no issues. I rested from running for about a month and then began training for the NYC Marathon. About three weeks into my training I started to feel a discomfort/stiffness on the outside lower part of my right knee only after I cooled down, but not while I was running. The pain was especially noticeable while going down stairs or after sitting for a while and getting up. But the discomfort would be gone after a day or so.
After a month of training I was running on a treadmill and the same knee buckled. I rested a week and tried to go for a much slower run (normally run a 8:30 mile this time a 12-minute mile) but after half a mile my knee buckled again. Went to see an orthopedic sports doctor, who told me that I had tendonitis and ITBS, but that nothing was structurally wrong and that I could continue to train as long as I rested after the marathon. He also recommended a PT, who told me that I should rest a month.
I'm eager to start running and continue to train for NYC, but not sure of the best or right training regimen to follow, or even if I still should be trying to run NYC? I want to, but I am concerned about risking further injury.—Frank
The NY Marathon is just around the corner, so you cannot be away from training much longer, and it may be tough for you to get back on track for this year’s race given the time you have taken off due to your injury. When I see a patient with ITBS (iliotibial band syndrome), I am immediately suspicious of another culprit causing the pain. A deficiency in the kinetic chain can cause pain, especially in the knee, which links the foot to the trunk and transfers forces up stream. If the foot and ankle are not moving properly or the pelvis in not aligned properly, the ITB can become functionally tight and cause pain. Other issues include cant of the road if you are training on the streets, too much volume or intensity too fast, or too much or too little foot support for your running style.
Finding the root of your problem is the key to your injury-free return. If your training seems reasonable and your training surfaces are varied (not always on the same side of the road), then looking at your body mechanics is a must. I would look for a provider who can assess your kinetic chain mechanics from foot to low back to see if simple corrections will take the pressure off your ITB. You should also have your core and butt muscles evaluated and begin a strengthening program if you are not in balance, as a strong pelvic platform keeps your pelvis level to the ground and supports your running.
If you do not have the running base and strength to complete the NY Marathon, you should consider putting it off for a year. Running without adequate preparation is a set up for further, and possibly more serious, injury. I hope this helps.
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