Under normal circumstances, this would have been a race report for the 2018 Black Canyon 100K. However, these are not normal circumstances. Instead, due to some pain around my knee, I wound up on the sidelines for most of both January and February. So instead of a race report, this post is mostly about the things listed in the title, my investigation into them, and links/documentation I found on the topic, so that if I ever want to locate them again, I know where to look. (And maybe someone out there will find this to be a shortcut to finding information.)
So first, a bit of the backstory about my injury, followed by a few links…
Valgus knee: If you’re reading this, you probably already know what valgus knee is, but if you don’t, it is when your knee moves medially (aka, “knee cave”) when running or walking. It’s potentially a bad thing, because it can wear down cartilage in the knee joint, cause chronic issues, etc.
When I first started having issues, I was running around 70 miles/week, and this wasn’t new territory for me. (In fact, in comparison to prior training cycles, it’s pretty low, as I’ve peaked at over 95 miles/week more than once.) I thought I’d just take a week off from running – shifting to the elliptical and some uphill walking on the treadmill – and then resume training. After a week, the knee was no better, so I tried another week of rest, continuing elliptical work. Still no improvement. One more week, and it wasn’t any better.
OK, so let’s try a week off of everything…just rest.
Nope…
Around the same time, I wound up having a conversation with my physical therapist (without an appointment), and he didn’t think anything was structurally wrong, so I made a few appointments. At the first appointment, he watched me run, and immediately noticed that my left knee was caving in, and it only made sense to him that this was the reason for my pain. Although he started with the IT band, over time, we both came to the conclusion that a lot of the muscles in my left leg and hip area were tight, and perhaps more importantly, that my Gluteus medius was significantly underdeveloped.
Since the first appointment in early February, I’ve been doing strengthening/stretching exercises, and a month later, am just getting back into running. There’s a link below to a video about Cross-over gait, and how that relates to all of this. It is how I have been running for several years, due to a weak gluteus medius. After spending three weeks just on strengthening and stretching, I am working my way back, focusing on a new gait, in the hopes of getting rid of the valgus knee. It seems to be working, at least for now. One week into it, my longest run without a rest break is 400 meters, and after about 2 miles, my gluteus medius begins to tire to the point where I can no longer maintain an appropriate gait. But…it is a start.
With all of that said, here are some links, with brief descriptions of their contents…
Neil Asher has some interesting info on IT-Band syndrome, and this article discusses how the IT-Band usually isn’t the source of the problem, even though a lot of physical therapists will focus on it. I’ll let him explain why.
N.A., part II: If you prefer a Powerpoint presentation, this link offers that format to much of the same information.
N.A. Gluteus medius: This link discusses how a weak Gluteus medius can be responsible for valgus knee (or lateral knee drift), and eventually, knee pain.
TFL stretching: If your IT Band is “tight,” as mentioned above, it’s usually something else that is triggering the issue. Often, it is the TFL that needs stretching. This video shows how, but as mentioned in the comments for the video, some of the language may not be appropriate for small children or pets.
Sports Injury Doctor: The link begins with the following premise: “The gluteus medius should be considered in every running injury. So many athletes with running overuse injuries of the lower limb present with poor gluteus medius function that I have come to the view that the strength and function of this muscle is probably the most important active component in the achievement of a biomechanically efficient running technique.”
Valgus Knee Strength/Conditioning: This link offers some strength/conditioning exercises, many of which were recommended to me by my physical therapist.
Yuriel Kaim: More gluteus medius strengthening exercises…21 of them, in fact.
Gait Guys: If you run and are not familiar with The Gait Guys, you might find them worth checking out. This link is to a video (part 1 of 3) about Cross-over Gait, which is often due to a weak gluteus medius, and often results in valgus knee.
GMB Hip mobility: This link offers a series of exercises for increasing hip mobility.
Biceps femoris tendinopathy: Although I didn’t get a definitive diagnosis, this link resonates with many of my symptoms, so I thought it worth including.
If/as I find more information, I will try to remember to update this link. In the meantime…I need to do some stretching!
Mak Running... 