I've been fighting it for years with less luck than you unfortunately. It sounds like you know what to do and are on the right track. The only other thing I could suggest is looking at a good insert. A teammate of mine (don't know him well, but thought I'd mention it in the interest of full disclosure) came up with a line of custom inserts. I don't want to put words in his mouth, but would say he's an expert in biomechanics and was pretty disillusioned with the custom insert market. He came up with a system of essentially 4 parts that he combines to make an insert that gives you support where you need it. Take me for example, I need more help on my right foot so that "prescription" is different from my left, but there is some support in my left foot to help balance things out. If you're interested, check out https://gravitusinsoles.com/...gravitus-plus-system. I don't get any commission or anything like that, but I have sent about a half dozen people to see him and he's been able to help every single person.

I'm just starting to get over ITBS and what has helped me was seeing a PT that specializes in posture. My left hip sticks out further than my right, she gave me 3 exercises to correct the imbalance and get the glutes to fire. A few days after I started I no longer had to run with a pat strap anymore. Before that I saw two other PTs who were also runners and they gave me the standard glute exercises and I never saw any improvements.

not much help here. I got it Jan 2 and am just now getting to running 3-4 miles at a time. i'm pretty sure mine was caused by dysfunctional muscles that needed to be released, but I also did the glute strengthening and mobility stuff. seems it just takes time.

Thanks for replies so far. The Gravitus insoles look like something I may look into.

The perplexing thing for me is that I averaged around 55 mpw from October - February, and have been running around 40 mpw since then. Why does this flare up now with few miles???

I really hope some complete running rest and working on some strength exercises may help.

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Blog: http://262toboylstonstreet.blogspot.com/
https://twitter.com/NateThomasTri
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What specialists are you seeing??

I have had 2 bouts so far, one on each side.

Glute strength was not the primary issue for me.
It was tight quads.

Mine got so bad all at once the second time around that it felt like I was walking around with a marble in my kneecap for 2 weeks, and for a month walking downhill hurt ( mechanism of destroying my quads was hard downhills at an ultra )

My quads were soooo damaged from the constant hard eccentric loading they healed tighter and tighter as they inevitably did heal, but I neglected some self care being the end of the season.

I doubted my PT at first but he is brillyant and confirmed it for me a couple times.

1 month off running, 2 months to slowlybuild up to 50k a week and now 2 months to get into marathon shape.

It might not be the glutes!!!! :p

First bout years ago I did so much glute work to no avail before seeing my PT who said that was quads too, loading it too much compensating for my weaker side. ( post surgery, has since been remedied )

I wish I knew... I'm finding that ITBS is a weird thing and seemingly unique to each individual (to some extent). Mine seems to be at it's worst when I try to run after a long ride, but I had a 70 mile ride and a 10 mile run in training last year without any problems. 70-80 miles into MT I could feel it coming on and I ended up walking every step of the marathon. In my case I'm still going with the idea of muscular fatigue and am doing lots of strength training exercises and taking the year off running. Unfortunately that doesn't really help you... wish there was more I could say!

I had very consistent ITB problems for years. Unfortunately (for diagnostic purposes), I made two big changes at the same time. I worked super hard on my form towards mid/forefoot strike, then simultaneously started foam rolling my ITBs directly. I haven't had problems with them since.

The foam rolling hurt almost to the point of tears initially, but now it's merely breathtaking :)

damen

Hi. First off....this is my first post. Many are skeptical of first timers, but I have been lurking for about a year now. I'm not a doctor and I'm not affiliated with any product I might recommend. I've seen several threads about ITB over the past year. I did not read through all of them, but I don't remember anyone recommending a leg strap for help with ITB.

I have had four of the big five common running injuries. (I just need Patellar Tendonitis to complete the slam). Several years ago I was running and had a sharp pain on the outside of my knee. Had never felt anything like this before and I was able to walk home, but each time I tried to run the pain was just unbearable. Stayed off it for a bit and tried again. Same result. I really thought I tore something, but after researching on the net I narrowed it down to IT band - which I had not heard of until that point. I found a site that talked about using a strap right above the knee. Eventually, I ordered a 'pattstrap'. The relief while running was almost instant if I recall. I ended up wearing one on the right and left leg for probably a couple of years. I tried a couple products from the store - one neoprene and one a little more substantial but they would not stay on my leg while running. There may be better products now or maybe you could even rig one, but I still have this pattstrap. While I feel that I have solved the issue long term by running only on trails (off road helps my plantar fasciitis too), I still had this strap in my pocket last year when I did my first Ironman (Lou) just in case the road got to me.

Everyone is different, for sure....and I've never had a problem with ITB related to biking, but a few dollars for a leg strap is worth a try.

Hope this helps someone.

J.

Ibuprofen 800mg three times a day for several days plus no running. That should kill the inflammation. I would also skip VO2 stuff on the bike until pain goes away.

Start doing flute strengthen stuff. Squats deadlifts lunges bridges. It takes about 4-8 wks to see results of the strengthening.

When the pain goes away, don’t run for several days. Ofthen times the inflammation is still somewhat there even though you can’t feel it.

If by the time the race comes, and the pain is still there, you can try a cortisone shot. Make sure to do it about a week before the race. It takes a few days to work.

probably this won't help but im going to throw it out there... My left knee wobbles side to side just a bit when i peddle and on my 5 and 6 hour trainer rides lately it started hurting my I.T.... i shimmed my cleat and it fixed it.

That sounds like a ton of ibuprofen! The pain has now gone completely away - there was a bit of pain walking on Sunday afternoon and on Monday. I'm planning to not run at all this week and reassess next week, maybe trying out some short runs. I'll actually be on vacation in Bermuda next week, where I love running.

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Blog: http://262toboylstonstreet.blogspot.com/
https://twitter.com/NateThomasTri
Coaching: https://bybtricoaching.com/ - accepting athletes for 2023

Awesome! It definitely helped that you stopped running when you felt it after your run. You have to kill them at the earliest onset.
As for the ibuprofen, 400 is good for a headache. But for tendinitis, you have to hit it hard. I prescribe it all the time and even do the same when I feel my Achilles flare up.

Actually, this helps a lot! Thank you for posting and reinforcing the need for better bike fit, from your head down to your toes.

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DFL > DNF > DNS

Can you guys ride with itbs?

When the Problem started I did some long bike rides as I couldn't run. But there was often tension in the knee and sometimes pain too. So I stopped riding. About 30-60 minutes into a ride pain flares up. Unlike running I could push through that pain as it is not as sharp. But I guess it's not a good idea.

So at the moment I am only doing tons of corework to stay in shape (60-90 minutes a day).
I am a duathlete who is a nonswimmer.

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10k - 30:48 / half - 1:06:40

I would not push through the pain. Stop when you feel it. I was able to ride but lowered FTP by 10-15W and no vo2 stuff. Once you feel pain, stop.

ITBS on the bike? Try lowering your seat. Could be a foot alignment issue, but most likely to much reach when pedaling.

Do not foam roll your IT band. I think it just irritates it. Roll the quad but not the IT band. Side planks work great for rehabbing. Obviously slow down your running pace. One legged squats are another good one. A final good tidbit is to widen (not lengthen) your stride. I understand that IT band issues can come about because your foot strike may be too narrow. A good drill is to run on a lane line in the road and try to have your feet land on either side.

I had ITBS and Patellar Tendinitis that took me out of the sport for years. It's a bitch. I feel for you.

Rather than resorting to advice of well-meaning forum-folk who have never seen you sit, walk, ride, or run -- I'd get my ass to a highly respected sports PT ASAP and get to the root cause of the issue.

Given your history, it sounds like glute strength might be the root cause (since the issue surfaced when you stopped doing your "prehab"), but I am not a PT nor have I examined you, so who knows. A good PT will give you a progressive routine. The exercises you used to do might need to be modified while you are in this acute phase. Adjust your mindset and view this as an opportunity: seize the additional free time recovery will give you to have your bike fit and running mechanics analyzed.

Unless you are a pro and your livelihood is at stake (or you are very close to your key A race and just need to plow through the next few days), I'd go easy on the NSAIDs. They will get you back in the game fastest, but potentially mask your pain/injuries leading to worse future problems and into the death spiral that could sideline you for months or even years rather than weeks. Moreover, there is emerging research that NSAIDs delay muscle, bone, and tendon healing processes so it's really a short term optimization.

Rest. Ice. Recovery.... until you get to a PT who can help you formulate a game plan. You might try swimming or aqua-jogging (which will improve lower extremity and hip mobility) to preserve cardiovascular fitness.

Don't despair man. Sometimes to take a leap forward you must first take a few steps back to get a running start.