Friday, January 18, 2013

Way to Make Race Weight 357: Cut A Piece Out Of Your Knee

In about twelve hours, I'll be heading into knee surgery for the lamest of all reasons: to fix an illiotibial ("IT") band injury.  Last May, June, and early July, I basically buried myself with ultracycling.  Every other weekend for two months, I had a ride that was at least twelve hours long, with the longest approaching 18 hours.  During the week I'd ride my trainer twice, run intervals, lift, do yoga, and swim.   To exactly no one's surprised, this eventually caught up with me, although it happened in a surprising way.  During a 5-mile brick run (that's a run immediately after a bike ride), I felt a bolt of pain on the outside of my right knee, like I'd tweaked something.  I hopped a bit and tried walking it off, but I found I basically couldn't put weight on my leg.  It was bad enough that I hopped to a cab in the area and hitched a ride home.

I'd heard people complain about IT band injuries before -- they're quite common among runners and cyclists.  Essentially, the IT band runs from the outside of the hip, along the outside of the femur, around the outside of the knee, and connects to the tibia just below the knee.  IT band friction syndrome arises -- at least according to most physicians -- when the IT band rubs along a bony point on the outside of the knee, becoming inflamed.  Because it's an overuse injury, I assumed it would come on slowly and be somewhat easy to remedy with rest, icing, and foam rolling, but neither was true.  When it came on, it felt like I may as well have sprained my knee: running was not remotely an option.  I did everything humanly possible to treat it, from getting massages 4x/week, to icing, stretching, and using a foam roller until I couldn't stand it any more, and then some more beyond that.  I was lucky enough to be able to finish Ironman Mont Tremblant four weeks after the injury, but I could only run for about the first three miles.  After that, my fall was a series of false starts; I just haven't been able to shake the injury, as much as I've tried.

From what I've learned, if this injury doesn't go away quickly, it can turn into a life partner.  There are many stories out there about runners who give up the sport entirely for years, only to have the injury flare up again a couple of miles into their first easy jog.  I could have kept up with the anti-inflammatories, icing, rolling, and stretching, but the fact is that it's utterly demoralizing: it's hard to motivate oneself to put in hard work when you're pretty certain that you won't be able to run more than a mile or two, and when, after a hard bike workout, it hurts to walk for several days.  Enough is enough.

So, tomorrow morning I'm having what's known as an IT band release.  In my case, this means that a nickel-sized piece will be cut out of the inside of my IT band, i.e., the part that rubs over my knee will no longer exist.  I know several people who've had this surgery, and their main thought is regret that they didn't have it done sooner.  Because nothing has to grow back together afterward, recovery is somewhat quicker than with, for example, an ACL repair.  My understanding is that I'll be on crutches and unable to do much at all for a week or so, but that I ought to be back up to spinning on a bike without resistance after a couple of weeks, and that things should progress from there.  Jogging can resume, slowly, after 5-6 weeks.

This is quite the opposite of how I'd like to be spending my January and February.  But, taking the long view, it's not really optional -- I just need to get it done.  And I've found that I tend to bounce back relatively quickly after layoffs like this one; indeed, some of my best seasons have come after my deepest fitness troughs.  It's never fun to rebuild running fitness, but I've done it before, and I'll do it again.  I just need to know that, when I head out the door, I won't pull up limping after a mile or two.

My positive spin on the whole thing is that this will give me all the motivation I need to become good friends with the neighborhood pool.  In the longer term, it's just a bump in the road.