The Doctor's Orders

Today I had my appointment with Dr. Cooley at the orthopedic clinic.  I was really impressed with his friendliness and his confidence.  I had some x-rays taken of my knees and then the doc pushed and prodded on parts around my knee to see where there was any tenderness.  Fortunately, the x-rays showed healthy knees and no issues.  The other good news was that my current injury and running will not cause any permanent damage, however, I do need to cut back on my running to allow time for healing (boo hoo).  I saw this coming from a mile away (no pun intended) which is precisely why I waited until after the half-marathon to see the doc.

The diagnosis is Iliotibial Band Friction Syndrome (IBFS).  Lucky for me, I have been doing all the right things leading up to the half-marathon: icing, glucosamine, rolling, and stretching.  I will now have to attend a physical therapy session to learn proper stretching for my knee and also build muscle in my quads.

I will have to time my marathon carefully.  The doc says it will take about 3 months of cross-training and a little less running to be fully healed.  That leaves me 3 months to train for the marathon after I'm healed.  Ideally, I would want 4 months to train.  I will have to choose a marathon carefully that will allow me enough time to be prepared.  I'm really dreading lessening my running mileage, but I guess I'll just have to get over it, move on and be disciplined.

Here's the info on IBFS:

Click image to enlarge

Diagnosis

Your diagnosis is iliotibial band friction syndrome.

Injury or Condition

This condition is persistent inflammation and pain which occurs at the outer prominence (lateral epicondyle) of the femur near the knee joint.

Cause

The most common cause is “friction” from a taut tendon iliotibial band) during unaccustomed use or “overuse” while running or hiking downhill. Attempts to “run through the pain” result in greater inflammation.

Symptoms

Typical symptoms are pain which classically occurs during running or downhill hiking, and which radiates from the outside (lateral) aspect of the knee according to severity. Visible swelling is almost never present.

Treatment

Standard treatment includes:

1. Rest from jogging, running or hiking until you can perform these activities without pain.
2. Modify your activities. Biking is tolerated better than running.
3. Make sure your running shoe maximizes shock absorption at heel strike.
4. Anti-inflammatory medication for 1-3 weeks.
5. Apply ice to the painful area.
6. Stretch your iliotibial band regularly after symptoms have been relieved.
7. Physical therapy will be helpful for instruction on stretching on strengthening exercises.

Precautions

Important precautions:

1. Do not attempt to “run through pain”.
2. Avoid surfaces which slope slightly downward on your affected side.
3. Surgery is a last resort and may or may not yield significant improvement.
4. Avoid Cortisone injections, which may mask pain and lead to greater risk of “overuse.”
5. Unnecessary or over-corrective orthotics may contribute to this condition. Consult your doctor prior to obtaining orthotics.

Recovery

The expected recovery often lasts about twice as long as the duration of your symptoms.