Injury Stopped Me in My Tracks

My 2017 - 2018 winter running season was built around a half marathon I intended to run at the beginning of April. I was ready, had done all my preparations, trained throughout the coldest winter I’ve ever faced (remember I’m from South Africa – we don’t get crazy winters there like in the US) and was all set to hit my target race pace for this half marathon. In an earlier post, I discussed how I selected and trained for my target race pace.

A week before the race I wanted to work in one last long run to build up my endurance for the race. I picked a course that was mostly downhill – in my mind the biggest mistake (see profile below). The training session covered a 16mile (~26km) distance to allow the body that extra test beyond the race distance. I figured with the downhill towards the back part of the session it would also add some speed into the mix and give me the ability to simulate a fast finish to the race. I was able to cover the distance well, but shortly after the efforts of the day I realized that something wasn’t right…I had picked up a knee injury!

Many runners will tell you that downhills are far worse on the knees than uphill running and it proved to be the case for me. You’ll also notice from the profile how the course covered lots of small and sharp rolling hills in that last stretch, all of which added to the stress on fatigued muscles. By the time I started to feel the pain in the knee from walking up and down stairs after the run, the damage had already been done. At that point I blew off the pain and figured it was just another ache that would go away after a few days of reduced training – something I wanted to do to taper for the race in any case. 

Screenshot taken from Strava activity.

Screenshot taken from Strava activity.

Leading up to the Sunday race I wanted to shake out the legs one last time on the Friday night and went for a light jog (the first since my bigger effort). That’s when I first realized that this wasn’t just another simple ache from a hard effort. The knee tightened up quickly during that short run and I was back to the same sharp pain as after the longer run. I iced, heat rubbed, stretched and taped the knee. Nothing helped! The sharp pain didn’t persist, but whenever real pressure was placed on the knee it definitely hurt. Walking down a flight of stairs really aggravated it.

Still not exactly sure from where the pain was originating, I got up on race morning very fearful of how the knee would react to a half marathon. Nonetheless I strapped the knee well and bravely lined up at the start to give it my best shot. From the first few steps I could feel I was not at full health and with each stride on my left leg I knew this was going to be a long day. I felt great, so strong, ready to race, but restricted to push hard. I ignored what was at that point just a mild discomfort and kept running. I managed to keep within the top 10 by mile 3. I even managed to break out a nice smile to Christin for a photo while grimacing through the discomfort. Then the real challenge on the day began. We hit what was to be the first of a few sharp downhill trail sections at around the 4-mile (~6km) mark. Immediately the pain was back and I was forced to hop down the hill on the strong leg. After walking a short bit, the trail flattened out and I was able to push on, still trying to hang on to a decent placement at that time. Ignoring the pain I got back to my originally planned pace and held on. As can be seen on the profile along with my pace analysis I was able to keep going until the next big downhill section. That’s when the knee had had enough. 8 Miles (~13km) was all it could take.

Screenshot taken from Garmin Connect.

Screenshot taken from Garmin Connect.

Restricted to walking, I could do nothing more than watch runner after runner pass me, some nice enough to ask if I’m okay or even giving me a pat on the back. Any attempt to start running again was just too painful. I was forced to walked to the next road crossing where I was able to find a support vehicle that took me back to the start. Just as painful as the knee, was knowing that my whole winter training program led up to this race, which ended with a humiliating walk and withdrawal. My biggest lesson on the day: sometimes being fit and ready just isn’t enough to cross the finish line.

Screenshot taken from iMuscle 2 App.

Screenshot taken from iMuscle 2 App.

On a positive note, the race doctors provided a very helpful assessment and pinpointed the source of the pain. It was in fact the reoccurrence of an injury that I had back in 2006… the dreaded ITB (iliotibial band) syndrome. As can be seen in the diagram, the IT band runs from the hip and wraps around the knee to connect just below the patella.  When this band becomes tight, it feels like a stretched elastic band, which in turn will rub over the side of the knee with each bend of the leg. It hurts! It becomes tighter with continued exercise, and creates more friction on the side of the knee. Now comes the hard part – recovery! The previous occurrence of this injury took months for me to shake off. This time I want to be smarter and more focussed about getting back sooner. Follow along here at Mountain Road, as I write about how I’m treating this common running injury.

- Wiehan