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Knee Me – Felix’s Tale of Injury Recovery

author : Team BT

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In their own words, triathletes give their take on the issue of the day. Today, Felix talks about how he recovered from the usually devastating ITBS injury.

BACKGROUND

After smoking for 4 years and not being much of an athlete in my teens, I decided to take up tennis. I soon realized that people over twice and even three times my age were whipping my butt on a regular basis. So I decided to quit smoking, obviously, and complement my tennis training with cycling. This was 12 years ago - I was 19.

Unfortunately, I didn't have anyone to ride with (mountain biking was fairly new, and I was in a little island in Venezuela, after all!). I wish I had known back then what I sort of know now, as training was not really as specific as it should have been. Anyways, 5 years later, I left that island for the big city to pursue studies and couldn't really afford playing tennis in Caracas. So, I started cycling more often.

By 2002, I was ready to graduate and about to turn thirty. I set a goal to start MTB racing as soon as I reached my third decade. My racing began nearly three weeks prior to my birthday while visiting family in the US. I managed to stay in Miami long enough to complete three races in that series and placed top 5 twice (beginner category). I then returned to Venezuela with better cycling shape than ever and some racing experience under my belt and was invited to try an adventure race for 2-person expert/newbie teams. The race was a life-changing experience and, best of all, we won! I was so excited to have gotten on a podium that I actually began to believe that my preparation and fitness level was higher than it really was. After all, this was a short Adventure Race (4hrs) favoring mostly mountain bikers.

I then left bike-specific training behind and began to kayak, hike, weight train and even rock climb. I was fascinated by all these "new" activities and so much cross-training. I was fortunate not to get injured right then and there as my training load rose immensely.

In subsequent races, I always felt some pain around the knee, but didn't pay much attention to it. I also started doing road races (10k and 5k). Then, in a City Challenge AR, I felt some excruciating, stabbing pain in my right knee. One of my teammates was dehydrated at the time, so the focus was to get him and the rest of the team to the finish line. I sucked up the pain for a few hours and made it to the finish line. We were dead last!

That was an indication of things to come. After a week's rest, I started training more on my hiking/running skills, balancing pain, recovery and improvement. I did a few more races and placed mid-pack in most. I guess cross-training helped my knee recover on its own as I had no idea at the time that I had overcome my first bout with ITBS.

INJURY

A year later, I was still training but work, changing teammates and personal situations affected my training volume. My appetite, however, paid no regard whatsoever to my decrease in exercise. Political situations in the country, among other things, led organizers to postpone or cancel most races at the beginning of the year.

So here I was nearly 20 pounds heavier than a year ago and not having raced for almost 9 months. The date of the biggest Adventure Race of the year was finally set, and it turns out that I had only three months to get my fat butt into shape again. So I start training my weakest areas first: hiking / trail running. All this with a backpack, since the race was for 3-days non-stop and we would have to carry all our food and gear. Just imagine: not only was I way over my "fit" weight, but I was training with approximately a 20-pound load in my backpack.

You do the math: 20 pounds on chubbier Venezuelan + 20 pounds in backpack + abrupt increase in training = a sure road to injury.

By the second month of training for this race, I had developed a mild case of shin splints, and three weeks prior to my race I had my first case of horrible pain on the outside of my knee (left one this time), a clear symptom of Illiotibial Band Friction Syndrome.

To many, adventure races are senseless. I once read about someone asking "Why would anyone want to do that to him or herself?" Still, the thrill of going beyond your limits, being in a natural environment and sharing with your teammates and friends is unsurpassable.

I raced in spite of the pain and lack of fitness. I paid my price dearly though.

The race began at 8am on Thursday with each 4-person team being assigned a single horse. I was chosen to ride because I was the only one with horseback-riding experience. My teammates walked and ran alongside. About five hours into the race, we decided that it would be best for the only woman on the team to get some rest and hop on the horse. So, it was my turn to walk and carry two backpacks. An hour into this, we began to distance ourselves from the other teams, we were actually fifth at the time in the most important and longest race ever in Venezuela! So we decided to do some fast-walking / running intervals. Immediately after the first interval, I felt that stabbing pain I had experienced in the previous weeks. We decided to stop after the third interval and just walked. My knee was in pain, but it was somewhat tolerable.

We managed to pass another team and, after leaving the horse behind, were fourth place overall--way beyond our wildest expectations! The day continued and, by 7pm, we managed to reach the control point for the transition to mountain biking. I figured my knee would recover since I would be off my feet; but, well, it didn't. Once you get ITBS, there is no immediate cure or no pain killer that will work on the spot. Even coasting downhill, hurt.

At 4am, I had to swallow my pride and ask the team to stop, since I felt I could not take one more step forward. My teammates set up camp, and we slept for 2 hours. When we woke up and realized we were in 7th place, so we got moving. The pain was still there, but I guess it became a little more tolerable. Another day of riding, walking, rappelling, etc. Lucky for us, we walked mostly uphill. If I could keep my leg as stiff as possible, I thought I could manage. Another night got a couple of hours rest. Then began walking at 2 am, this time we had actually passed another team. We started moving on foot and ended up walking for eight hours before the next control point. We went from cool mountain temperature to scorching hot beach weather. It took me ages to walk down that mountain. When the race doctors saw me, we were advised to quit the race - we were in 8th place at the time. My two other teammates carried on unranked and managed to catch three other teams within the next 12 hours. My girlfriend, who is the female member of the team, decided she had had enough and stayed with me at the control point. No other teams reached that control point, so we were listed in 8th place, even though 2 of us did not complete the race.

RECOVERY

I thought I would just take a week off and be back in training. After all, in spite of my injury, my team had been ranked top ten out of the 20 toughest teams in Venezuela.

I was in for a surprise. After four days, my condition did not get better. In fact, I could not sit for too long, but couldn't remain standing either. I decided to go get a diagnosis. I was told I had a patellar injury and that therapy and two weeks off would get me running again.

Obviously, they were wrong. After those two weeks of massage therapy and no training whatsoever, I showed very little signs of improvement. I was devastated. I went to another doctor, had an MRI and was told the same thing. Tried a third doctor, and in a matter of minutes was correctly diagnosed as having ITBS.

I was told to start swimming and cycling in low gears / high cadence and to stay away from running for about a month. Also, I was prescribed anti-inflammatories for two weeks. Around that time I found BT; I figured since I was swimming and cycling and would soon start running, I would end the year and celebrate my recovery by treating myself to a triathlon.

It's been a little over three months since I started therapy. I received massage therapy and worked on guided stretching and strengthening three times a week for exactly two months. I gradually moved from 5 minutes walking / 1 minute running intervals to running for about 1hour, three times a week. I listened to my knee the whole time and never ran in pain and continued specific stretching at least twice a day. Unfortunately, I did not pay attention to my eating habits and gained weight again.

I will be doing my first triathlon on October 24th (1K swim, 40k bike, 10k run) and might just do a 1/2 IM on November 21, depending on what my knee "tells" me and how it reacts to a gradual increase in training.

My advice is simple:

- Get diagnosed.
- Receive massage therapy.
- Do guided stretching and strengthening exercises.
- Once you begin walking, start by doing intervals of at least 5-to-1 walking-to-running ratio.
- Work your way up gradually.
- Listen to your body and never exercise under pain.
- Watch your diet during your recovery time.
- Prepare yourself mentally; there will be times when you feel like you are not making progress.
- Take advantage of this opportunity to improve your swimming and cycling.

Regardless of how I do in my race in late October, I already feel this story has a happy ending.

Félix