0 You're the doctor

Julie, of the fabulous blog Races Like a Girl, was dealing with an injury last fall and in this post offered a prize to anyone who could accurately diagnose her problem.  She was, of course, receiving the appropriate medical diagnostic tests for the issue as well.  I ended up being the grand prize winner having guessed stress fracture of the femur or pelvis before anyone else did, but I was shocked at how many people guessed correctly!  My prize was a Barnes and Noble gift card, which, ironically, I used to buy ebooks for my iPad to read while I was rehabilitating my own injuries after the Athens Marathon.

So, I am enlisting your help, dear readers, to figure out what causes my left leg to tighten up about 30-40 minutes into each and every run.  I have been treating my IT band (stretching, rolling, icing, time off from running, strength training, acupuncture, active release therapy) for the last month and am now quite sure that, while the pain I feel is coming in part from an irritated IT band, this is a symptom and not the cause.  I am looking for the root cause here, so I can treat it and get back to running longer than 40 minutes at a time.

During my run, a typical progression goes something like this:

• the first 3 miles feel awesome;  
• some tension just above and to the outside of my kneecap appears or the lower part of the outside of my leg tightens up; 
• that tension goes away, and I might feel some pulling or tightness below my kneecap;
• the outside of my upper leg eventually starts to feel a little weak or achy and;
• finally, I get a fairly persistent ache in the outside of my kneecap where the IT band rubs over the end of the femur.  Sometimes this is felt behind my knee and even into my calf.  This comes and goes later in the run and does not become worse the longer I run beyond 45 minutes, though I haven't done too many runs over 45 minutes.  Oddly enough, when I put direct pressure on the point where I feel this tightness, it does not hurt at all.  During the latter parts of many runs, I have felt as though my lower left leg is a peg leg, with no ability to push off at all.    

I have been doing everything right according to Dr. Lau: stretching every day after my run, rolling out my legs each night, regular strength exercises for my core and glutes.  The problem has not gotten any better or any worse over the last month despite all of this treatment.  I had a fantastic run last Thursday night, running 6 miles with 30 minutes at 6:30 pace.  I felt awesome the entire run, with no tightness at all in my leg.  The next morning, I tried to jog just a few miles and felt the tightness within the first 15 minutes.  So, Coach T decided it was time to try some cross training over the weekend.  I biked and pool ran for three days and did not run a step on land.  I ran today to see if anything had changed, and I still felt that insidious tightness off and on during my 8 mile run.   It came on, you guessed it, after 30 minutes of running.  It's not a run-stopping tightness at this point--so, no sharp pain.  It's just there, and I am afraid to push it.

I was traveling for work last week and had to run on the treadmill in the hotel gym.  I had my iPhone with me and decided to see if I could get some video footage of myself running.  It actually turned out pretty well.  I have been carefully analyzing these videos, and I see lots of things wrong with my form, of course.  But what I really want to know is if any of you see clues that may indicate what is causing this leg tightness.  I'm hoping something will jump out at one of you and that you will add your diagnosis in the comment section below.  The quality needed to be lowered so that it wouldn't take forever for you to download, but I think you can still make out the important things.  I left the sound unedited so you can hear my feet thudding on the treadmill in a Godzilla versus Mothra sort of way.

If you have trouble viewing the embedded video here, I've also loaded it on YouTube.  I will say that I was treated after my morning run today (I won't disclose what part of me was treated since that might give something away) and am hopeful that the adjustment will help.  Fire away!