I'd recommend seeing a physical therapist - also, massages, acupuncture, dry needling, floss bands.

Maybe try to get on an alter-g treadmill to see if you're able to run a bit with lessened impact.

Get your hips and ankles checked out by a good sports professional who understands running mechanics. And increase your cadence 2.5-5%.

Good luck

Get proper treatment and you will be fine. 7 weeks is a long time.

Step 1 -- Don't panic. 7 weeks is a long time.
Step 2 -- Get in to see a sports PT ASAP, not just any old PT, but one that works with elite athletes, even if it's a huge PITA and a long drive. The variance in PT quality is huge. You might also consider seeing a sports medicine doc and getting a cortisone injection to bring down the immediate inflamation.
Step 3 -- Stop doing what aggravates your knee. It will just get worse. You still have enough time to dial things back and ramp them back up. If you just let this get worse for a couple more weeks, you will no longer have that luxury. I'd start by swapping in AlterG running or aquajogging for 80% of your run volume for next couple weeks, assuming that doesn't aggravate your knee (sometimes it's the motion, not the impact that is bothersome)

Go see someone about it, but once I started rolling a lot mine cleared up.

Rolling twice daily seems to keep most things in check, with extra time spent on any areas that are flaring up. (nb. don't roll on the knee...)

If I'm really trying to get rid of something I'll up it to 3 times a day, but that's pretty rare.

Also worth looking at your shoe millage.

http://www.breakingmuscle.com/...r-endurance-athletes

Fixed mine right up!

---

Human Person

Don't defer. I typically would have the patient hold off running for a week..you won't lose since you'll be riding and swimming,

Main culprits of lateral knee pain with runners.

1) excessive stride length

2) excessive femoral internal rotation during stance phase due to poor gluteal activation

3) too much medial posting in running shoe.

No idea if you present with these

don't foam roll it, don't try to stretch it, quit icing and use some heat to promote blood flow. Get your running gait assessed if able.

---

CB
Physical Therapist/Endurance Coach
http://www.cadencept.net

Thanks for the info.

So my last run was 8/5 which was when this flared up so bad. I took a week off cycling and running immediately after. Have added cycling back last week and this week. I tried to run on the treadmill today and lasted 5 minutes before the knee flared up. No pain while cycling, swimming or any other activity for that matter. Should I stop cycling even though it doesn’t hurt at all? I’ve seen an ortho sports med guy who agreed it’s ITBS. I’m rolling, heating, applying anti-inflammatory gel, etc. how long would you expect this to linger? Now 6 weeks out from IM Lou.

I've had a few ITB issues over the years - some real bad and some pretty minor. Four years ago when I was training for Boston I developed ITB pain during a long run, but kind of ran through it - bad idea. That was in February, and things really didn't clear up until September. I was doing a variety of ITB exercises (Strength Running website has a good ITB stretch routine), icing, rolling, getting a variety of treatment including Graston and it took a real long time to get through.

Earlier this year I felt a bit of ITB pain, and stopped running immediately. I took ten days off from running, did exercises every day, then very slowly eased back into things - 3, 4, 5 mile runs, and was back up to around 40 mpw in two or so weeks. I think the important thing about this second 'bout' was that I stopped immediately when I felt the pain.

In your position, I'd probably defer or transfer to a different race if possible, but that's just me.

---

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

Did you try Alter G running? It’s specifically the body weight pounding that’s hurting me cuz cycling doesn’t hurt at all. I’m hoping maybe offloading the body weight may be a way I can get back in to it.

Stop rolling.

Do side planks.

What worked for me:

- get the strongest hips and glutes possible. period. Every exercise i could find - band walking, side leg lifts, attaching cable to leg and pulling in all directions, etc. Meanwhile, deep rolling of the glutes using a small ball to get deep, not a large flat foam roller ( and not on IT band itself)

good luck.

Yep. This is what I’m doing currently. Made the decision to stop cycling for a week or so and just swim. Even though riding doesn’t hurt I think the motion is keeping me from fully recovering. Will hopefully get myself a solid 6 weeks of training before Louisville.

I use mobilitywod, upright health and this site for help



Good luck.

This is ultimately what worked for me as well. My terrible IT band syndrome in lead up to IM Louisville 2009 ultimately resulted in two knee surgeries (neither really made a difference). I took a few years away from the sport. Randomly decided to get back into it but did months of hip/glute strengthening first. I've never felt stronger and knees have never felt better! PT works, but you have to REALLY commit to it.

I do a 20 min hip/glute routine 2x week. And if I have to skip either PT or a workout due to time constraints, I skip the workout.

Just to update this Incase someone else deals with it. 5 weeks from my injury on 8/5 and unfortunately I’m still dealing with IT and syndrome. Haven’t run at full body weight since 8/5 and have only tried riding a few times for 60 minutes. Tried Alter G running and it still flares up after 10-12 minutes even running at 70% body weight. Been doing PT twice per week including dry needling, rolling, stretching, glute/hip strength, icing, etc. At this rate I’ll just be eating the entry fee. Didn’t want to defer Incase it cleared up. Looks like it’s gonna be a long haul injury unfortunately.

This one is tough and needs to be assessed correctly for treatment approach. I don't blame anybody for shotgunning symptom management with a race coming up and sometimes if you can catch it early...

Your presentation is a classic case; came on like a knife in a later part of a longer run. Bombing it with modalities sometimes gets it done in the context of a bad training decision or overuse, but dollars to doughnuts you are dealing with a biomechanical issue in your running that will need changing. Some have been mentioned here and some IMO are incorrect/incomplete.

For example: Yes, too much medial posting could increase frontal plane load on knee towards adduction (bowlegged) and cause lateral strain across the joint and the IT band as it crosses the knee. However that doesn't mean medial posting is bad for everyone. Increased pronation is associated with increased tibial rotation and this could lead to pulling the insertion of the IT band on the tibia in the transverse plane which places it in more proximity to the lateral epicondyle of the knee....so a medial post or stability shoe may be in order for some.

This can be applied to much of what you read when thinking in all 3 planes.

Tons of post on here about it, but vet out a knowledgeable professional with a track record for successfully treating runners. A comprehensive running eval should do the trick for cause(s) and then it just putting the the work; likely a nice block of specific strength and extensibility exercises translated into running form. IMO, modalities should be used judicially e.g. post session/recovery as they could mask effectiveness of mechanical changes.

FWIW and I am not suggesting you do this, but in desperation while treating it is often possible to run on a treadmill with a few degrees of incline and/or some pickups on a track (with walking for cooldown) without aggravating symptoms. It is just a matter of more knee flexion when loading keeping the IT band posterior to the epicondyle..same reason symptoms don't appear when biking unless of course your seat is too high;)

Good luck! Bummer about Louisville, been there!

So I’ve been fit for the correct running shoes and I’m under the care of a good sports PT so I don’t feel like I’m doing a “shotgun” approach. I’ve been doing what has been prescribed to me. It’s getting better but just not fast enough for Louisville unfortunately. First IM looks like it’s gonna have to wait.

Was referencing as much the post on the thread, good luck.