That's the response of my left it-band after my last trail run. I believe I jumped back into training too fast after my 50 mile race by doing a 40-mile long run on the Pacific Crest Trail just a week afterward (hey, it was the weekend with free parking and wilderness permits!) My brain was itching for another adventure and a hefty dose of endorphins, so I wasn't quite thinking straight.
Things took a bad turn several days later as I went to Cougar Mountain for the 14-mile "grand tour" loop. On the way up to Wilderness Peak, I felt some odd twinges in my left glute. Within a minute, I was unable to lift my left leg. Literally, I couldn't do it. My sciatic nerve was getting pinched and was letting me know it. I turned back and gingerly made my way back down the mountain. I took the next week off running and spent a couple of hours per day stretching, rolling my hip on a foam roller and my butt over a tennis ball, and doing some self-massage. On my first day back I was happy to be rid of that pinched nerve, but a new and much more insidious issue started to crop up after a few runs - the dreaded it-band syndrome.
My hip joint was sore to the touch. Okay, I thought, this is an upper it-band issue. I just need to work on stretching the psoas, glutes, and tensor fascia, strengthening my hip adductors, and icing my hip, and this will resolve. I set up a sports massage with my go-to massage clinic, as well. Fast forward another week or so, and as I expected, the hip problems are on their way out (and completely gone right now). That's good news, so let's go back to Cougar!
I had no problems going uphill, in fact all of the extra stretching really loosened me up and it felt like the climb took less effort. Midway through my descent on the steep switchbacks down to Wilderness Creek, I started to feel a tightness in an odd spot: the outside of my left knee. By the bottom that tightness had evolved into a dull pain. Within a few hours after the run, the pain disappeared, but I know it's going to be there the next time I go down a big hill.
I have two weeks to get this issue wrapped up as well as I can. I am grateful that the hip and upper it-band issues have been resolved. They caused me pain during the day that flared up during runs and made it impossible to maintain good form. This outside knee pain, which is clearly at the insertion point of the it-band, is much more mild and more of a dull ache than anything, but it's still worrisome. Because in two weeks I'm running the Pine to Palm 100 which has 20,000+ ft of gain. That's a lot of downhill to cover, and as anyone who runs ultras knows, small issues can blow up in a hurry after a few hours on the trails.
So what's my plan? Go to war with this thing. Redouble my self-guided therapy, which now consists of five different it-band stretches, three strengthening exercises to target both hip adductors and abductors, icing, massage, and myofascial release with my tennis ball and roller. I have a deep history with chronic injuries, and if I've learned anything, it's that persistance and attention from the onset of pain is critical to avoid as much degeneration as possible and return to full mileage.
If I still have the pain, will I slug it through the 100? Probably. I'm young and can get away with a lot right now.