9 miles!! You can make it 9 miles!!! Wow, you're my hero! I just made it up to 3 miles with no pain.

Find a good massage therapist and have them go to work on your IT Band. It will hurt, and pretty much make you cry, but it's worth it.

I had a similar problem and corrrected it very easily. First, I took a month off. Good chance to build some base in the pool and on the bike. Second, I worked my way back into running by doing 15 minutes on the Elliptical Trainer and then 15 minutes on the treadmill. Built that up until I could easily do one hour on the ET and one hour on the treadmill. Then abandoned the ET and headed onto the road. All during this I was buidling strength in the hip aducters and abducters by using those machines that women are always using. The ones where you sit down, spread your legs as if you are going to the gyno and either bringing your legs together or pushing them apart. Also, added yoga to the mix.

Since doing this for only 6 months I have had no pain. Believe me before it was unreal! Now I have no problems. Runs up to 19 so far and biking up to 112. No pain.

I also read/ heard that this problem occurs often when triahtletes move into marathon mode and abandon the bike training for the off season. I would suggest keeping the bike in the mix at least twice a week.

I am no strength coach but this sure worked for me. Also could try something called Active Release Therapy. Or just roll your ITB on a tennis ball on a hardwood floor.

Jeremey

I have heard great wonders about Active Release therapy for IT band issues. So much so, that a good friend of mine considers herself "cured" of the problem.

thanks for letting us know the shoes you are using so we can avoid 'em!

-Trisha

What would Marshall Ulrich do?

My cousin is a pretty good licensed physical therapist, and, this is interesting, he calls this "runners knee," also he calls chrondopalia something runners knee, which look like two separate things. How many runners knee's are there?

So I was bitching and whining to him about it, and he shot back something like: "Here's the exercise, take your left leg and put it here, and then lean to this side, lift your left hip up here, and then cross your left knee under your right leg, now lift up your right foot, etc., and then lean down in the opposite direction...do you feel it, do you feel it. Email me back if you can feel it. Ha ha ha...."

I called him back: "Well hell yes. I can feel it. I didn't need a diagnostic tool. It's confirmed. You win. That's it. And why would I want to stretch it TO CREATE THAT SAME HELL I FEEL WHEN I RUN? Why don't I just go outside and run over my left leg instead of doing that? What does stretching really do? It pulls it. What do I get out of stretching to pull that tendon?"

I'm waiting on his answer. I think, what I'm going to do is just cut off circulation in the whole knee cap with this pat band, and then just run like Captain Hook for 16 miles, with a dead leg. Stump running and then run a bunch of hot water to revive the leg after the run is over.

The Nautilus "Quad or Glute machine" from thread above and yours.

And I'm not knocking that New Balance shoe, because it's one of the best if not the best running shoe out there, it has a "roll bar" running through it. But I had as an underpronator just as much problem with it as i did the Mizuno Wave Rider. It just didn't work for me. We would want a shoe which was a cushioned shoe which almost forces the foot strike, strangely enough on the inside, cushioned on the outside of the foot, I think . Thanks for the tip.

Start with the obvious - get a podiatrist or similar (who is an endurance runner themself) to analyze your gate and recommend shoes with the relevant orthotics. Then find an ART Chrio (he / She will make you cry - of that I guarantee). Do the abductor excerciese mentioned above DAILY - alternatively lie on your side and lift your top leg up so your legs from a V. Build up to be able to do 3 x20. STRETCH - more than once a day. ICE more than once a day - under no circumstances try to run through the pain!!! If the above doesn't work you have the following options - a courtazone shot (i know the spelling is not even close!!), ESW Treatment or ITB release surgery. I went the whole 9 yards and then some - yes including the surgery!! Believe it or not after having around 10 odd years of problems I believe I finally have it licked. The surgery helped and got me back on the road but - (and no doubt Frank will crow about this for years to come!!) Powercranks seem to have been the final healing tool - no I don't know why - no I don't care why and no I am not going to get into any long rambling debate over it. Surfice to say I have been on them for around 3 months now and can run up to 32km pain free for the first time in 10 years without doing anything else different!

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http://www.endurancesports.ca
Coaching and Training Camps

Joining the choir.

Do:

-Podiatrist (just be careful, they tend to be less holistic than a runner needs) and perhaps Orthotics
-Physical Therapy (you maybe can go to a doctor to get a PT script and skip the podiatrist if orthotics are overkill)
-Specific stretches for the rest of your life.

Also, there is a myth that certain shoes fix all problems. While simple o/u pronation can be helped, shoes are VERY personal... when I run out of my 3-4 pairs of identical shoes I usually have to go through 10 pairs to find a new one (which caused me recently to go from an Adidas Motion Control to a Reebok Stablity). Join the Road Runner Sports, and use their 60 return policy liberally until you find the one that works. Then buy 5 pairs.

-zee

The reason you can feel your ITB hurting when you push on your hip is because your ITB attaches to your pelvis via a muscle called the Tensor Fascia Latae. This muscle is relatively easy to stretch. Lay on your back with your knees bent 90*. Put your right ankle on your left knee like you are crossing your legs. Reach through and pull your left knee towards you. Repeat on both sides. You can also stretch this by sitting with good posture in a chair. Right ankle on left knee. Lean forward with your CHEST, keeping your back flat and feel your hips and but stretch.

One of the likely reasons for this pain is a lack of core/torso strength. Your body is having to compensate and keep things straight. It may also have to do with a leg length discrepancy. Your opposite leg is shorter and your hips tilt, straining that muscle on the other side.'

Hope this helps. -Craig

Yeah, you can also work this area with a tennis ball, though my massage therapist used his elbow.

My massage therapist - who was a pro Iron-distance triathlete and now competes in 50K runs and is a CTS coach as well - believes that massage is an important part of training, and done well, can work out biomechanical problems and stop ITBS before it starts. Hal Higdon also recommended massage as part of his marathon training plan. I am going back once a month to get tortured - hopefully this will get me sorted out before next season.

Hello there,

I had this problem pop up a few years back and didn't know what to do. Normally I would just take a week off, but that never helped me. One day a friend of mine asked me to describe the knee pain and diagnosed me with an ITB problem. He had it the previous year and had managed to recover by stretching it relentlessly.

Time off never helped him and it certainly did not help me either. The reason your friend had you do that stretch is to understand where you feel the strain. The pain comes in your knee because it is rubbing back and forth on the , but the stretch is felt in your hip. The only way for the pain to go away is too stretch out the band. In the beginning you have to do this all the time, but after it improves then you don't need to do it anymore than the other basic leg stretches.

I think the suggestion of a massage therapist is a great one. I agree that it will make you cry.

I have had a problem with my ITB for the last month and a half, I have cut running out and have just been swimming and biking. I am seeing a therapist, getting orthotics, stretching, trying to strenthen the area, icing, ect, without much progress. I will continue to do these things and hope I can start running again soon, the posts help.

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"You're guaranteed to miss 100% of the shots you never take" - Wayne Gretzky

ITBS is caused by the inflammation of the bursa sacs at the insertion point of the ITB in the knee. It originates at the tensor fascia latae, which is under your glutes. To fix ITBS, you have to fix the underlying problem, which is usually three things:

1)The bursitis has to go away. Try icing, anti-inflammatories (prescription or over the counter) or oral cortisone if you can find someone who will prescribe it. If you have had the ITBS for a while, go for the cortisone. You may have to take 2 dose paks to get rid of the inflammation. Do not run while taking the dose paks-let the inflammation heal.

2) Biomechanical problems. Try to see someone to make orthotics to fix the motion problem you are having.

3) Tightness in the tensor fascia latae and/or calf. The strain on the ITB that causes the inflammation originates from one of these two places or both. The TP massage ball and roller are wonderful tools to use to release the trigger points that are causing the problems. You can find these at Road Runner Sports-they sell them as a kit.

They also sell bands that you place around your quad directly above the knee that help release some of the pressure on the bursa. You cannot really stretch the IT band per se as it is a band of connective tissue, but you can stretch the muscles at the origin and insertion

Good luck!

Thankyou for the information, I appreciate it....

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"You're guaranteed to miss 100% of the shots you never take" - Wayne Gretzky

I feel your pain...literally! A month after IM-WI I just started feeling recovered and my IT band flared up! I was lucky enough to stumble across some good articles and I'll pass on the best I found. I tried the "strap" too and it did nothing for me, though I've heard it helped some people.

From my own experience and what I've read, just stretching will do virtually NOTHING to prevent ITBS from re-occurring. You must STRENGTHEN and STRETCH the IT-Band to cure it for good. Of course, this assumes you have no major biomechanical issues.

Read this article and do the "Walt Reynolds ITB Special" everyday. After 2-3 weeks, I'm up to 24 minutes of running and seem to be adding about 5 minutes per week.

-Scott

http://www.sportsinjurybulletin.com/...68-knee-injuries.htm

First change your running gait. www.posetech.com or www.chirunning.com Second implement self massage. www.julstro.com in addition to the stretching.

It will take a lot of work (and a lot of new aches and pains) to change your running form. It took me about 3 months to start feeling normal with the new running form. But once I "got-it", my 3 year long itbs problem went away. I am running faster without any itbs pains.

Good luck.

Booth,

Runners Knee or ITBS is the most common complaint for runners. Many feel your pain, including me. The other posters in this thread have hit on most of the remedies, but I'll share some thoughts. The first is to go to www.julstro.com and read what Julie Donnelly has to say about the subject, because her methods worked for me and most of what I'm about to say is more or less cribbed from her "pain free triathlete" book.

* Your legs are not strong enough for the work you're asking them to do. What's happening is that because your muscles are working too hard, some of your muscle fibers are going into a mode where they contract and stay that way -- it's an injury prevention mechanism. Of course, that only makes the remaining fibers work harder, so they start to go into the same mode. It gets exponentially worse the longer you push it, because fewer and fewer fibers are actually doing any work. And you're not training the other ones to be any stronger, either -- they're just hunkered down waiting for the torture to stop.

* The result of your muscle fibers contracting is that your muscles get shorter. Since almost all of the muscles in your upper leg attach to your kneecap, that shortening puts a great deal of tension on your kneecap. The problem with the human leg is that there are more muscles attached to the inside of the kneecap than the outside, and those muscles are stronger than the muscles that attach to the outside. There are also more muscles attached to the top of the kneecap than the bottom. The result is that your kneecap is pulled up and to the inside, and the muscle(s) on the outside of your leg are put into even greater tension. Important point: even though the *problem* is in your muscles, the *pain* is in or near your knee because that's where the muscles attach. Sometimes you also get pain in your hip because that's where the muscle(s) attach on the other side. Your "slewfooted" running is just adding to the tension in your knee, because a lot of that rotation is within your knee joint.

* The muscle that's most affected by this chain of events is the Tensor Fascia Latae (TFL), which is on the outside of your leg. It starts near your hip and runs a little bit down the outside of your leg to about your groin level before it becomes tendon. The tendon is called the Illiotibotal Band (ITB). But even though the pain is in your TFL and ITB, I would bet big bucks that after you've done a half marathon you've got huge knots in your quads, in your hip flexors, and probably very tight hamstrings. All of those muscles are overworked and are pulling on your knee, and hence on your ITB and TFL. Chondramalacia Patella is a condition that comes from having your kneecap pulled way too far to one side or the other, so that it starts to rub the cartlidge inside your knee joint. The cartlidge gets inflammed, which makes the rubbing worse, etc etc. You get CP by trying to "run through the pain" of ITBS, and it takes MONTHS to recover. Another related problem is patellar tendonitis. That's the tendon that runs from the bottom of your kneecap to the muscles in the front of your shins. The upward tension on your kneecap stretches your patellar tendon and causes inflamation, microtears, and other problems. Again, the cause is trying to "run through the pain" and again it takes MONTHS to recover. All of these conditions fall under the general heading "runners knee".

* What to do? First, stop running for a little while while you correct the problems. DO NOT try to run through the pain as your running buddies suggested. You need to get rid of the knots in the muscles in your upper legs to relieve the tension on your kneecap and TFL. Then, you need to strengthen those muscles so they can do more work so don't get cramped up when you run long and hard.

* To get rid of the knots, you need to press on them very hard. For your quads and hip flexors, try getting a piece of dowel (1" or 1.5" thick). Press it into the knots, don't roll it. For the TFL, you need some kind of ball. You lie on your side, put the ball underneath you just below your hip, and use your body to roll it down your leg until just past your groin. People have had success with baseballs & softballs. If you're doing it right, it's going to HURT like hell. Keep up the pressure for 60 seconds and you'll start to feel the knot release. If your legs are as bad as mine, it's going to take several sessions of 1/2 hour or more to really get all the knots out if you do it yourself -- or you can find a massage therapist who can do it for you. Yes, this does hurt, but you don't want it to hurt so much that your muscles tense back up. The phrase I've heard is "Hurts so good" -- that is, you should be able to tolerate the pain with a grimmace. Combine the massage with stretching to get those contracted fibers to relax and elongate. Massage, stretch; massage, stretch. Do yourself a favor and don't run for a few days, to give your muscles a chance to relax.

* To strengthen your legs, get some ankle weights. Sit on a chair with your feet dangling and lift both legs at the knee until they're straight out. (Works the quads). Lie on your back and lift both legs 6 inches into the air (works hip flexors and abs and believe me, it's hard enough without the ankle weights!). Lie on your side and lift your upper leg 6 inches into the air (works the TFL). Lie on your stomach and bring your ankles to your butt. Three times a week until it gets easy -- then add reps or weights. Hill repeats combine all of those movements into one fluid motion.

Hope that helps!

Lee

I lift weights, probably too much, doing squats with about 160 pounds, 4 sets of 12 reps. I use a block on the heel. And hacksquats for the bike with about 200 or more, 4 x 12 reps. The ITBS doesn't flare up after a day with free weights, at all. My legs are huge. I lift weights I think, too much, because they are an impediment, I think, to running. I won't lift before a half marathon or 10 k something like that, a week before the race, to avoid tightness. Maybe I need to venture over on to some of the nautilus machines, for knee extensions and quad curls.

Lots of good advice in this thread. I'm going to scare you into taking care the problem. My ITB was so badly inflammed that I could not walk pain free for a month, run for 3 months or run more than 15min 2-3 times a week for a year. It cost me a year of running. Thats with cortisone injections, stretching, massage work and PT.
Let it heal, stretch, and learn to bike race like I did. It's not worth taking a year to completely recover when 2 months might do the trick.

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Brian Stover USAT LII
Accelerate3 Coaching
Insta

I am a lifelong runner, triathlete of 2 years, PR OD 2:30 (2nd race), hoping to go 2:15 next year.

I had this problem for 6 months, now completely healed. Took a few weeks off x 2, and two months off once (including one month off the bike, too -- be sure your saddle position is not too high, it can exacerbate ITBS even if you don't feel pain while on the bike).

What didn't work for me:

1. Massage and yuppie toys - feel great, did no good.

2. Ice/heat (except for ice immediately after initial injury).

3. Orthotics.

What did work:

1. Patience. Adding just 5 minutes per week to each run session, and then only if no pain.

2. Hip abductor and lower inner quad strengthening (google search for exercises).

3. Limited, gentle ITBS stretching AFTER running (never before).

4. Switching to softer running shoes with limited motion control.

The best source on how to cure this problem is The Lore of Running. If you follow the writer's guidelines (he's a respected runner and doctor in South Africa, Comrades dude) there is a 98% heal rate. If you have just come down with the problem, an interesting treatment is 3 days total immobilization of the knee -- apparently the U.S. marine corp. uses this treatment with great results.

Good luck. I s'pose pushing thru the pain is possible (not like you will snap the IT band, never heard of that!), but unless you are a Pro, why??? If you are patient and heal yourself, you will be faster in the long run (speaking 1 year, 2 years later).

Holy Crap dude -- you need a new running store. Sounds like they took advantage of your situation.

First of all, the suggested retail price of the 1122 is $118, not $140. Second, the inserts that most running stores will stock (Superfeet, Powerstep, even Spenco) cost $25-$30, not $40.

Third, the population of people who need both an insert *and* a heavy duty motion control shoe like the 1122 is miniscule, and is usually people with little running history or people who have had muscle damage of some kind. Maybe you're a part of that population, in which case you should see a podiatrist. But having read your posts for the past year, I suspect that you're not in that population at all; you just have a fairly common injury that the running store folks took advantage of.

Fourth, whoever told you that the Asics Gel Cumulus might be a "[better] shoe for this" than the 1122 needs a serious refresher course in reality. The 1122 is a premium grade, heavy duty motion control shoe designed for heavier runners with serious overpronation and a history of injuries or other problems. The Asics Gel Cumulus is a mid-grade, mid-price ($80) neutral trainer designed for an efficient runner with little history of injury and little need for extra cushioning (eg a smaller, lighter runner). It's the less expensive, less cushioned cousin to the Gel Nimbus. The Cumulus and the 1122 do not belong in the same conversation with any given runner -- if one of them is right for you, the other most certainly is not.

I *hate* it when running stores take advantage of someone in severe pain to sell them whatever they can at whatever price they can. There is already SO much misinformation out there about shoes and running injuries that it really hurts when the people you're supposed to trust, the "experts" at your local running shop, get it completely wrong and probably make the situation worse, not better.

Even worse, now that you've been screwed out of close to $200 for a "solution" that is no such thing, you're probably going to be reluctant to spend money for products (shoes etc) that actually will help, and you're probably going to be skeptical of any advice you get.

More in my next response.

Lee Silverman
JackRabbit Sports
Park Slope, Brooklyn

I posted this thread last year, in november of 2003. My question is how you found it.

I now run in Brooks Radius O4.

My god...

No disrespect to your PT cousin, but "Runner's Knee" is not a term that anyone with medical training should use. "Runner's Knee" is a term that us laymen use to lump together several completely different but related conditions. All of them result from overuse and all of them cause pain in the knee, and usually you have more than one of them at a time, but the treatment for each different cause is different.

For example, the stretch that your cousin gave you probably demonstrates that the muscle at the top of your leg near your hip -- your tensor fascia latae or TFL, is extremely tight. That's the primary cause of ITB pain. As a *result* of that tightness, the tendon that connects that muscle to your kneecap (your illiotibital band) puts more force on your kneecap than it should, which can pull your kneecap out of alignment. If you continue running through the pain like your running partners told you to do, you can inflame and abrade the cartlidge in your knee joint. Your kneecap can literally rub away the cartlidge and causing significant damage to your knee that takes a very long time to heal, if it heals at all. That condition is called Chondramalacia Patella, and is almost always a result of people with ITB syndrome "Running through the pain." Yes, your buddies did it. They're the ones that somehow avoided permanent injury to their knees. The other guys who used to run with them but don't anymore are the ones who permanently wrecked their knees and had to take up golf.

As for why you would want to stretch it -- well, if you're like 95% of the people who have ITBS, the tightness in that muscle is the cause of all your other knee problems. You get that muscle back to its normal length and strengthen it so it doesn't tighten up like that again, and your pain goes away.

More in my next post. This has gotten me incensed!!

Lee Silverman
JackRabbit Sports
Park Slope, Brooklyn

Yowza! I didn't even look at the dates. The thread showed up at the top of the list of threads this morning when I logged in. "Ice" whoever he is seems to have dug it up.

Still, I'm mortified at the advice you got and I'm sure that others get as well. I started writing a whole diatribe on the causes and remedies for ITBS and then realized that I already posted it -- IN THIS VERY THREAD! Over a year ago!

I hope your ITBS has been resolved? It better have if you're running in the Radius now!

Lee Silverman
JackRabbit Sports
Park Slope, Brooklyn