The importance of flexibility is once again making itself clear to me. You’d think that after a year in Mammoth Lakes, California, running with Andrew Kastor’s weekly training club, I would believe in the benefits of his flexibility drills—the same ones his wife, Deena, uses every single day. You’d think that if nothing else, as an orthopedic sports medicine surgeon, I would understand about stretching. But of course all my scientific training leads me to question everything, and I’ve never found any evidence in the sports medicine literature to indicate that stretching decreases the injury rate in athletes.

So I don’t stretch. I do some yoga positions in the mornings, and after long days in surgery, but I’m not that guy who starts and ends every run leaning over each leg as it’s propped on a park bench. I’m the guy running past him. Well, I was the guy running past him; except now I can’t run. I’ve got ITB syndrome, so now I stretch.

Last week was a busy week of surgery, and on top of that, it was my final week in fellowship in Mammoth. I had some boxes to check on my to-do list for the year. Mt. Whitney was the first, so on July 20 th, Whitney (my wife) and I day-hiked to the 14,497 ft. summit. We took the mountaineer’s route, a more direct approach that involves some class 3 climbing, but descending that steep trail is brutal on the knees. That’s when the iliotibial band (ITB) on my right knee started to get angry: pain on the outer part of the knee, much worse going downhill than up. I spent the weekend on my mountain bike, 12 and 18 mile hilly rides, trying to keep the gears low. I ran again with the club on Tuesday: a 2-mile time trial, followed by four ¼ mile repeats. Then Tuesday night was my last race of the local mountain biking series, and I pushed it too hard. Great time and my highest place finish of the season, and the knee wasn’t even hurting.

Next on the list was Mt. Morrison, dubbed the “Eiger of the Sierra” for its imposing North face. July 27 th, we clambered up a scree-filled couloir to some blocky boulders and celebrated atop its airy summit. I wrote in the register that I was “topping out at 12,268 to top off a great year in Mammoth.” But again, I paid the price on the descent, with the same lateral knee pain as before. And I thought these long, high-altitude hikes would have been good for me.

Like so many injuries in runners, ITB syndrome is an overuse condition, and the only cure is to avoid the offending activity. But when you can’t stop exercising, you have to get creative. With patients in the past, I’ve found massage to be effective, especially combined with methods that physical therapists use with heat or medicated creams. But the root of the problem is in hip flexibility, something to which very few runners pay attention. The hip flexors tend to tighten up in distance runners, and a hip stretching program will typically prevent ITB problems. And that concept of flexibility applies in other ways, too, because you need to be able to cross-train with swimming, light cycling, or even speed-walking to maintain fitness during your training.

The last few days have brought some unintended rest with the move to Portland. Whitney & I are getting settled into our new townhouse, and I’ll be doing pool workouts and some road riding for several days to let the knee cool down. Then I’ll find some flat roads to get my running legs back under me, and hopefully progress back into some hills, speed work, and longer distances. And this time, I won’t forget to stretch.