Today’s guest post is something of a rare thing, a physio reflecting on their own injury story. This is sports physical therapist Sean McBride’s 2 part story of how ITBS nearly forced him to give up running (part 1) and how he got back on track (part 2)…
You can follow Sean on Twitter via @RealSeanMcBride
My long battle with iliotibial band syndrome (ITBS) began during the winter of my senior year of high school while training for the upcoming track and field season. Even though it was 12 years ago, I still remember the run and where we were when I first felt the pain. We were nearly back to the school after a 6 mile or so jog when I noticed what felt like a tight ball on the upper outside of my left knee.
The exact timeline is difficult for me to remember, but I couldn’t shake the pain and ended up going to an orthopedic surgeon. I had just come off of an All-Ohio Cross Country season and was preparing for the 3200m for the track team. I had also already committed to a small local university to run Cross Country and Track and Field. The only thing I remember about my visit to the surgeon was that he put me in a position on my side and placed my left leg in an odd position and kind of let it hang. He asked me if I had the potential to place high at the state championships and truthfully I wouldn’t have. He told me to shut it down for the season.
I was referred to physical therapy, which was my first experience with the profession. I still remember what my therapy focused on: my tight hamstring musculature and iliotibial band stretching. No strengthening exercises. After my first round of therapy, the therapist wanted me to go out for a run. I still had a sharp pain on the outside of my knee, and when it came on it altered my gait substantially. As far as I recall the pain was at least 7/10. Back to therapy – except this time the surgeon recommended another therapist within the same facility. The new therapist had me continue hamstring and iliotibial band stretching and recommended that I go buy over-the-counter orthotics. He explained to me the concept of stabilizing the arch of the foot and also had me get stability running shoes. I started to do some aqua-jogging to maintain some level of fitness. Still no strengthening exercises.
Once summer rolled around, it was time to start training for my first collegiate cross country season. I started slowly with my stability shoes and orthotics and gradually built back up. I maintained my flexibility routine and also continued some old core exercises that I used to perform. I successfully returned to running and ran all four years at the university. I ran under 16 minutes for the 5K in track, which was a major goal of mine. I had a pretty nondescript yet enjoyable running career. However, during my very last college race ever (a 10k on the track) my lateral knee pain returned. It was the same pain, only 4 years later.
By that time, I kind of felt that running had done me wrong and my attitude towards running turned sour. I hadn’t lived up to my running potential and was disappointed in my last two years. I had a great relationship with my coach, who asked me to be the graduate assistant coach while attending physical therapy school at the university. My four years of eligibility were up, but I could still be part of the team and it would actually save me a decent amount of money towards school. I didn’t even try to run – I knew the pain would just keep coming back. I was also too junior in my physical therapy education to understand what was going on. I was more worried about getting through a brutal first year of anatomy and biomechanics. Again, my attitude towards running was not good – I just didn’t care anymore and was probably jealous of some of my teammates who were running pain free and having great careers. I was jealous of their discipline and success. What a great combination for a graduate assistant coach right?
Admittedly, I did try several times to return to running. I tried to go on a few jogs with some physical therapy classmates, but more than once had to end up walking back due to the pain. Each time that happened my confidence that I would ever just be able to go out and jog again waned. Even recreational joggers were besting me. Would I ever be able to go back out on a nice 6-8 mile easy jog? Unfortunately, with such a bad attitude and the thought that running “owed me something,” I never put my mind to rehabbing myself and taking a smart approach to the problem. In physical therapy school I had come to learn that I was more varus on the left knee and my anatomy professor told me, “Maybe running isn’t right for you anymore. Your IT band may be the last thing controlling your varum.” I had also picked up that my left foot had a high arch and didn’t pronate as much as my right foot did. If we had to classify it, it would have back then called it a more “supinated” foot. Did that contribute to my knee assuming a more varus position while running? Did I have a leg-length discrepancy?
Moving forward into becoming a young, inexperienced clinician, I continued to make a lazy comeback to running here and there and look for a magic bullet. I’m embarrassed about it now – especially looking back at how much I’ve grown as a clinician. I tried the barefoot running craze – buying an expensive pair of barefoot shoes. Didn’t work. Someone had dry-needled my left leg. Didn’t work. Somebody noted a plantarflexed first ray on my left foot. I tried an orthotic with a first ray cut out. Didn’t work. I tried a heel lift. Didn’t work. I had graduated from the university with my bachelor’s degree in 2007. We are now talking about 8 years since my last college race when my pain returned. Eight years of a lazy, embarrassing approach. Eight years of not committing to an evidence-based program. Eight years of sabotaging myself by randomly attempting a 4-5 mile run when I hadn’t run a mile in the previous 6 months. All of this while even I knew better…
Coming up in Part 2, The Solution; how Sean beat his ITBS…