Knee Pain / Training Advice Needed

[RnbwSktles]

A little background...

I am training for the WDW marathon. I have been using a modified version of Galloway's plan that has been working great. However, 2 weeks ago I started getting pain on the outside of my knee about 20 minutes into my run. This was on a treadmill while I was just doing one of my 30-45 minute maintenance runs. I never felt the pain on a long run and I had just done 15 miles 3 days before that.

The pain was still there on my next 2 runs, so I decided to take the next week off. I iced, stretched, foam rolled for the next 6 days to prepare for a 5K I had that weekend. The 5k went well and I didn't notice any pain during the run. I felt over-confident at this point and decided to get my regular training run of 7 miles in the next day. Big mistake - my knee bothered me the entire time. It doesn't hurt so bad that I can't maintain my intervals, but I went very easy on it anyway.

So here is where I need some advice. Over the next month and a half, I have 3 half-marathons that are screwing up my training schedule. They are on 10/13, 10/20 and 11/9. I plan to use the first one as my proof of time to submit for the marathon.

This weekend calls for a 17 mile run. I would then have 2 weeks to recover before the first half. Do I skip the 17 mile run and take it easy until 10/13 so I am hopefully injury-free for that race? Will that completely ruin any momentum I've gained for the full marathon? The other option I may try is biking for 3 hours instead. Not the same as running, but still using my legs for the same length of time.

If I skip it, my last long run (15 miles) will have been on 9/8. The next opportunity I will have to do a longer distance will be 11/23. I suppose if my knee feels ok, I can try to get additional miles in later in the same day of some of those races.

Sorry for the wordy explanation. Basically I want to know what should be more important at this point? Keeping up with my mileage so I can actually finish the marathon? Or being healthy for the half so I can get a good time to submit for corral placement? Is this all a moot point because I won't have enough down time to heal my knee??

 

[cewait]

Let me see…

Have you seen a doctor? Will you see one if this continues or gets worse? Between the lines I am hearing you may have a chronic overuse injury that may not get better without a little intervention. Jumping up and down on training miles has not helped the situation either. I do not have the detail on the plan you are following, but skipping eleven weeks under the Galloway plan is not optimal; especially the teen mile weeks.

If you want, PM me your schedule so I can look in a little more detail; from maybe 8 weeks ago through the marathon. I will try to sort out something that may help. A couple questions up front… What are your race priorities? From this post, I see the First half and the full are “A” races, where are the others? Would you be willing to dump a race to help make the full a success?

It is still very doable

 

[RnbwSktles]

Thanks, Coach. Just sent you a PM with the schedule.

To answer your other questions...

Yes, I will consider seeing a doctor if it doesn't get better. My friend has suffered the same issues and highly recommends her doc.

Yes, I can drop races if necessary, but I am hoping not to have to. I am running #2 & #3 with the same friend and she's already said she will be really upset with me if I don't do them. She's scary

To explain my stupidity behind signing up for 3 races..

I signed up for the 11/9 race first and then learned of the new proof of time requirements for Disney

I signed up for the 10/20 instead. Then part of the course burned down (it's in Seaside, NJ) and I was afraid it would be canceled last minute. Also, the course is not USATF certified and I can't help the nagging feeling it will end up not qualifying as a proof of time race.

That led me to the 10/13 race.

 

[RnbwSktles]

So the PT place I will probably use gave me a recommendation for an orthopedist who specializes in knee problems. The earliest I can see him is Oct 8 though I hate waiting that long.

Coach (or anyone really), what is your opinion on cortisone shots? I've seen on other running forums that some runners suffering from ITBS have needed to resort to a shot. I am wondering if that might be a short-term solution to get me through the next 3 months. After the marathon I can really take the time to recover and hopefully fix whatever is causing the problem in the first place. Obviously, the doc will make that decision.

Thoughts? Experiences?

 

[jmasgat]

I have suffered from ITBS on a few occasions in the past, and personally, I would not resort to cortisone shots. I have never had one, though, so I don't speak from that perspective. Rather, I just think that "covering up" --my words- a problem is not the answer. It seems the potential for one problem--ITBS--to lead to others is just too great, if that first problem is masked. I know when I had ITBS, if I tried to run through it, I started feeling things in other parts of my upper legs.

I totally understand your wanting your marathon training to be successful. I also understand--unfortunately from personal experience--that training for something when your body needs to heal just causes more problems. But every person's body is different, and my personal experience is just that--my experience.

Whatever you choose--good luck, and fast healing!

 

[cewait]

So the PT place I will probably use gave me a recommendation for an orthopedist who specializes in knee problems. The earliest I can see him is Oct 8 though I hate waiting that long.

Coach (or anyone really), what is your opinion on cortisone shots? I've seen on other running forums that some runners suffering from ITBS have needed to resort to a shot. I am wondering if that might be a short-term solution to get me through the next 3 months. After the marathon I can really take the time to recover and hopefully fix whatever is causing the problem in the first place. Obviously, the doc will make that decision.

Thoughts? Experiences?

I think cortisone has its place in the treatment of soft tissue injuries. I am a believer in it on a personal basis. However, folks need to understand the negatives as well. There are a few side effects as well as a slight risk of infection. Again, personally, I think these are minimal.

My old doc would be slow to recommend unless the patient asked. Once asked, he would order the injection. The good thing about trying today, versus waiting a couple months, is that if it works and you start to have the symptoms again just before the race, you have time for a second treatment. Generally, injections are limited to one every 3 months.

As a general rule, knees and hips usually require little to no downtime. Ankles and other non-meaty areas will require 7-10 days of no running.

I do think that PT is more important to relieve the cause of injury... the injection is there to offer relief and mobility.

Good luck

 

[RnbwSktles]

I do think that PT is more important to relieve the cause of injury... the injection is there to offer relief and mobility.

Good luck

If PT is recommended, I definitely plan to do that as often and as long as prescribed. I just want something to go along with it that might get me through my races and training!