Questions on various running ailments - a mix

Question
Hello John,

Let me up front apologize for the length of the following e-mail.  I did not want to include quite so much but felt it necessary to explain the entire picture.  Your time is much appreciated.

Background:

I am a relatively young runner (24) with only eight years of real training.  I began with cross country but quickly transitioned to the marathon and then ultras as I found the distance most enjoyable.  Due to work though my training has been interrupted on several occasions and resulted in ramps up in mileage probably a bit too fast (usually peaking at 70-90mi weeks).  In the last year though my training went quite well with the addition of quality recovery weeks (amazing what they can do!) but certain issues have continued to come up.  After a summer of failed ultras (drops at 66mi and 44mi) I decided it was time to give my legs a rest (no direct injuries but a general fatigue and overuse concerns).   I have not run for almost five weeks and was planning to continue this one more week before picking up the running again.

Description of the problems:

One: Constant tightness in both legs (nothing new but something I believe is affecting stride and thus possibly overall performance), especially my right leg.  For example, if I lay on my back in an attempt to stretch my hamstring I feel exceptionally tight along the anterior of the shin and foot rather than feeling anything in the hamstring.  As a second example if I kayak or take part in a sport which requires much sitting with both legs straight my legs tend to tighten or become a little numb along the line running through the ITB 杝hin-foot.  Any general suggestions, concerns?

Two: Right ITB band.  Again both legs seem tight but the right especially so.  I have used 搕he stick?in the past and am now working with a foam roller and tennis ball at the moment.  These forms of massage do seem to bring relief but more pains seems to creep in later in the day as a result?does this indicate bruising from the loosening of the band and as such is a good thing?  Additionally sitting seems to cause it to tighten (I am presently a student ?it seems sitting is my profession).

Three: My knees (but again the right one in particular) make odd popping sounds and creaking sounds after sleeping or sitting in the same position for a long time.  This never hurts and seems related to when my legs are cold (when warmed up they tend not do this).  Again flexibility seems to be lacking or proper range of motion.  Are there any concerns here with development of arthritis, etc?  

Four: The upper anterior of the shin (next to the bone) I have had a tender area develop during my training.  Once developed it never worsened but did appear and disappear from time to time based on foot wear while running or everyday life (ie: sandals are not acceptable).  I have looked in to Jumper抯 knee but it is not at the proper location and a stress fracture seems even less likely as the pain seems to be next to the bone and never increasing (I ran with it at times during both ultras over the summer).  Certain forms of pounding (squats) seem to bring out the symptom of tenderness.

None of the above symptoms would cause me to stop running but my concern is not really the present symptoms but the possible issues they may lead to if not properly handled.  Perhaps all of these problems are somehow related (beyond overuse)?  Do you feel I can run now and still properly recover/improve in these areas?  Rest with out sport is horrible for a 24 year old!

I understand this is a lot to consider but I think without a complete explanation of all the issues it would be difficult to offer a recommendation.  One last factor for my scenario in particular; I live in China (and will be for two years) and do not have access to an exercise bike (additionally my ITB has always become tighter when riding a bike ?spinning, road, or mountain) as suggested in answer you offered concerning 揷racking knees?  I am concerned that certain equipment is not quite as accessible here and thus my road to recovery may need to be a bit different although any suggestions would be excellent.

I would greatly appreciate your reply to the above.  I enjoy running immensely and would like to start up again but want to avoid an endless cycle of injuries in the coming years.  I intend to focus on shorter distances for a while if only to avoid severe mileage.   If the above is too much it would still be a huge help if only to offer suggestion on parts.

Thank you again,

Robert


Answer
Hi Robert
Thanks for the very detailed description of your situation.Never a need to apologize.Without good detailed info i can't provide the kind of information someone needs to take care of there quest to resolve there situation.Your not going to like this answer,but yes everything is very much interrelated.Quite frankly if you don't take a long break of the kind of training you have been doing you will be in serious trouble,and at your age you have a good solid 50 years plus in front of you to enjoy  some great running and great health.With that in mind i think taking some time to resolve all these issues would be the smart move before you really break down with some real serious career ending problems.Everything you mentioned here is your body screaming at you to give me a break and fix me.It is our job as athletes and coaches to listen closely and pay attention and not keep training threw.There is nothing here that at the moment that is real serious,but your totally right on the edge of the cliff.If i was your coach you would have never got your self in this situation.Your breaking down fast and if you don't take this seriously  you will regret it.This is just the down side of our sport for not paying attention to symptoms that surface from time to time and we blow them off and keep pushing.Don't feel bad we have all been where you are.I was out 8 months and at the time i was in the best shape in my career setting pr's from 5k to the marathon one after another knocking down 100 plus weeks.The next step for you is let me know what kind of rehabbing equipment and cardio machines you have available to you if any.You just have to rebalance and rebuild your body and correct the tracking alignment.If you take what ever time it takes to resolve all these issues and heal you will be as good as new.Let me know your thoughts Robert and any questions you might have.You can always call me if you want.

All the best

John