I’ve done the search of the forum and google exhaustively. I guess whatever is produced hear will just be to temper my frustration with this ever irritating “injury”.
Here’s the story. Not too long so please listen and then provide any helpful stretches, advice, experience, whatever.
I kicked up my running mileage quite considerably over the winter which in turn caused some foot pain that eventually made its way up my knee and then disappeared with a little time off and a change in running shoes (I have moderately flat feet and moderately over pronate, but nothing major). I was running in the Mizuno Inspire 5s but jumped on board the barefoot is better bandwagon and started running in the Nike Free 5.0s (clearly not all the way on board). My pain in both my knee and ankle subsided and I’ve been running in the Frees ever since, although I feel like I’ve had a sort of constant nagging in my knee. No real pain or anything but just never felt quite 100%…more like 97%. It seems to “pop” a bit more than my left and just generally didnt feel 100% as mentioned.
Fast forward to last Thursday. I had a day of hill work on the bike and really kicked my ass during the workout. I also decided to wear a new pair of shoes during the workout and hadnt got my cleat position dialed in 100% and was making tweaks throughout the workout (not ideal…definitely not ideal looking back on it…or just flat out stupid). Immediately following the bike workout I threw in a short run as I’ve been trying to incorporate bricks as much as possible and about half way through I got some splitting pain on the outside of my right knee. At first I was like “well I’ll just run through it until it goes away”. That didnt work out so well. I had to stop and walk. Friday was a swim and a run. Both the swim and the run felt great. No pain at all. My run was only 45 minutes but even so, I didnt experience any pain. Saturday was my long bike which consisted of 60 miles of rollers. Again, no pain. Sunday was my long run and I felt great for the first 45 minutes but then my knee almost just gave out. The pain was so intense. I had to walk home, which felt fine, but as soon as I started to run, bam, back came the pain.
Anyway, I’m freaking out. I’ve got my first race of the season at the end of may, an olympic and my A race being RI 70.3. I cant stand the thought of taking time off. It feels weird even when I’m healthy to take my scheduled day of rest each week. So what do I do? I’ve already scheduled an appt with a ortho/physiatrist and also scheduled a deep tissue sports massage. I’m buying a foam roller tonight and have been googling IT band stretches/strengthening exercises like a fiend today. Can anyone else provide more help/suggestions?
It may be your new bike cleats/bike position. Seems like the pain appears after a hard bike session. If you haven’t already, I would get a professional bike fit, which includes a full cleat set up. Also, see a doctor to make sure you are not dealing with something more serious. If it is indeed the ITt band, get a roller, get some good stretches and maybe even look into active release.
X2- but I recommend the tp quad baller. It will make you sweat and cry at the same time.
X3, but start with a regular foam roller if you’ve never used a foam roller before, as even that will be painful for the first week more than likely. Once you feel OK on the foam roller, switch to the quad baller and get ready for some real pain
I’ve had ITBS twice. The first time was from increasing mileage too quickly. I was out for 6 weeks, and the recovery was slow until I started foam rolling. After that I foam rolled regularly even when I didn’t have ITB issues. The second time I got ITBS was from switching shoes without taking the time to allow my body to adjust to the new shoes (ie. didn’t reduce volume or switch-up with old shoes). I got over this completely in about 3 weeks, because I knew when to stop running and how to treat it. Ice religiously. Foam roll religiously.
It seems to me if you could run 45 minutes before the onset of the pain, you’re not too far into the injury yet. I’ve had ITBS once in each leg, and I remember going for a wonderfully successful run like you described (already aware of the risk, trying to moderate it) and then WHAM it locked up.
Don’t freak out too much. The cleat issue is something to look into. However, since I have not any problems that a few degrees of float couldn’t solve, I think its more related to your run. It sounds like you don’t feel too awkward on your bike.
I would do three things from here.
Scale back your run volume as if you’re tapering. If you can survive some shorter runs at recovery pace, maybe you can beat this without taking time off. Do not run to the point of the pain. If the pain starts creeping up sooner proportional to the shortened distance, don’t try to run through it. (It won’t let you. Obviously.) Consider a few days off the run to improve your bike
Stop with the bricks. Unless you’re doing them to accommodate time constraints, I see no reason in doing them beyond the psychological preparation of running off the bike. In a long-term training plan, I would much rather have some rest between the bike and run. I can give you no factual evidence that your brick contributed to the ITBS, but for the sake of conservatism, just take a break from them if you can. Maybe you will run better, maybe not. It won’t hurt to try.
Do not worry about too much about stretching, or compensatory “strength” exercises. During my second encounter with ITBS I experimented with an ankle weight, doing single leg-lifts on each side, working the outside of my upper leg. BAD IDEA. Contracting it more only aggravated the problem. Also, with stretching… touchy topic. I used to be obsessed with stretching post-run. However, as I began to do multiple sessions per day, I found this problematic. I quickly became lazy and stopped stretching altogether. No performance detriment whatsoever.
Enjoy your massage! I hope my wall-o-text is worth something. Keep us posted…
First, thanks for all the suggestions. The massage last night was intense. Not what you would expect from a typical massage and quite painful at times. At one point I heard the woman say something like “ohhh boy” and I was like “what? is it bad…like the tightness” and she goes “well I dont want to alarm you”. Clearly I needed a massage. I do feel more loose and will probably go back for another next week. She said I could probably benefit from 3 or 4 more within a months time and then getting one just once a month thereafter would be sufficient. I’m not sure I’ll go that route unless I really see it pay off.
To answer some of the questions, yesterday was my scheduled day off so I didnt do anything. Today I have a bike and then tomorrow a swim and a run. I’m still debating on taking tonight off as well because my appt with the ortho/physiatrist is tomorrow afternoon. I’m thinking of holding off until then just to hear what he has to say.
I would agree that the cleat issue is probably not the problem although I feel like because I had a really tough day on the bike doing hill work with a mal adjusted cleat that it could have contributed to the pain I’m now feeling. Like, maybe its not even ITBS but just possibly some intense soreness from riding so hard in shoes without a proper cleat adjustment. I would like to hope thats what it is. Although, that doesnt explain my knee essentially just giving away 45 minutes into my run on sunday I guess.
This is also a recovery week so if I do decide to do anything, I’ll be sure to make it extra light. I figure I can still go hard in the water but maybe just take it extremely easy on the bike/run.
I just seriously hate this. I’m a 26 year old former college athlete and have never had any issues such as this and I’m just immensely frustrated. I feel like I’m too young to have this sort of thing manifest itself. AHHHH!
I saw a thread some time ago about a series of strengthening exercises on Youtube called “Myrtl” or something like that. In any event, I have always had strengthening exercises because I want instant gratification, but after doing these for only a few days it really helped. the exercises focus on the muscles of the hip, which seemed to really help me.
I have a freind I train with that has been battling this same IT band issue for two years. 45 yrs old, 185 6’1" (1/2 IM). We both looked at everything and spoke with everyone to find a solution without luck…until a few weeks ago.
He tried rollers, ortho look, massage, streatching, orthotics, new running shoes etc…
He decided to buy a new bike and get a retul fit about a month ago. I had not seen this retul bike fit system before and asked if I could watch. Everything was going much like other proff bike fits until we looked at the hip, knee, ankle alignment numbers. His ankles were 20mm inside his hips on the pedal stroke. (picture that streach in the IT band for 56 miles at a 90 cadance) We moved the cleets out and picked up about 4mm on each side and the bend began to straighten on the graph and we saw the 4mm in the numbers. They then moved the cleets back out and added 20mm spacers to the spindals and it was perfect - the graph that looked like and eyebrow was now straight up and down.
The conclusion was that the IT band was getting streached and irriitated during the bike and contracted during the run wich caused the pain. I’m no doctor or fit specialist but so far the problem has gone away. It worked for him.
When I got my fit done I was 8mm in at the ankle on the left and 0mm on the right. We just adjusted my left cleat out a bit. Maybe its nothing maybe it will help. The only thing I know is - without the numbers we would have never seen it.
My run-in with ITB started after I did a trail marathon a few years ago - had never had any problems with it before, then couldn’t run a step for a couple of months after. Finally got it resolved with a lot of time off and a fair bit of yoga, but it’s still a slight management issue if I don’t stay on top of it.
FWIW, ITB seems kind of like plantar fasciitis to me - what works for one won’t necessarily work for another. But here’s what works for me these days:
regular runs - not necessarily long, but regular. Too much time off of running (like more than 2 or 3 days in a row), and it starts to tighten up.
Swimming with the masters group. This seems strange, but I think all of the kicking we do, and particularly the breast stroke kick, seems to keep the ITB happy. Of course I have no way to be sure of this - but there certainly seems to be a correlation.
Foam rolling has also definitely helped in the past - but don’t go crazy with it. And ice is always a good idea.
A few weeks ago I started having sharp ITB pain on the 5th day of 7 straight days of riding from LA to San Fran. I’ve never had ITB problems previously. I assumed that I must have been riding with some pronation, so I adjusted my cleat for maximum supination without my heels hitting the chainstays. By the next day the ITB pain began to subside and I was feeling fine again on day 7. I temporarily over-compensated my cleat position to take stress off my ITB as I needed to put in miles on days 6 and 7. I assume I would develop pain in my patella tendon if I kept a supinated cleat position. Obviously the key is to find that sweet spot in between.
I recently stepped up my running to train for a 25k and experienced an IT band problem also. The pain I had was located on the outside of my left knee on the impact of every step. Couldn’t run more than three paces. This is what cured mine, take this with a grain of salt as I am by no means an expert:
Ceased running completely for 2 weeks, I bike everyday 8-10 miles to commute for class, fortunately I was able to continue to do so as I experienced no pain while cycling
Purchased a foam roller and rolled with my entire body weight up and down from my hip to my knee, did his in conjunction with the strectching
After two weeks off I would do speed training on a soft surface such as a turf field every other day, I set up cones and did “shuttle run” type drills, once I felt any twinge of pain I immediately stopped for the day. I felt like this helped to strengthen both of my legs lateral strength.
At the end of the third week I was back to no pain at all! Now before and after I run I stretch and roll extensively. Good luck!
Abduction (moving the leg laterally away from the body) - stand with a foot on a stair, or a pillow (to make yourself less stable), or this can be done in the pool standing against the wall. Lift leg to the side. Also can be done laying down.
Extension: like your hips go into when you flutter kick - leg goes behind body. Get on all fours, tighten glute to “kick” (controlled motion) the leg upward, knee bent at 90*.
Combining the two: on all fours, abduct knee (like a dog would lift a leg to pee on a fire hydrant), then extend back, then bring knee back to ground. I HATE these. But they’re good.
“Monster walks”: Get a resistance band and tie it around your feet so you have some room to move but you also have to work to abduct your hips. Squat down - stay low - walk BACKWARD and walk laterally, so you step diagonally behind you. You should feel it in your glutes after awhile. Another “hurt so good” one.
Hip hikes: stand on a stair with one leg. The other foot hangs over the edge (you should be facing the railing). Drop the “hanging” foot and hip – use other glute/ hip to lift the dropped one up, rotate it upward past normal. Will start to burn in the glute you’re standing on.
Leg lifts: laying down on your side, but rotate your foot outward a bit.
Bent leg lifts: as above, but bend knees and keep ankles together. Use a resistance band between your knees. It helps to lay with your back to a foam roller (which you’ll need someone else to hold) for this one - hard to do on your own.
Final one: do this for 60-80 seconds; when you get good, close your eyes. Stand on one foot, the other foot just off the ground. Squat down a bit. Shift weight to heel. Hold it.
My hip exercises:
Hip hikes: stand on a stair with one leg. The other foot hangs over the edge (you should be facing the railing). Drop the “hanging” foot and hip – use other glute/ hip to lift the dropped one up, rotate it upward past normal. Will start to burn in the glute you’re standing on.
Bingo!
OP: can you do 100 of these? If you can’t, you should.
I had ITBS, tried stretching, drugs, hot&cold, short runs, no running, warmup on the bike before running - nothing worked.
Tried hip hikes: could only do ~30 first time, now I can do 100+. No more ITBS!
I think the theory is that if your gluteus medius (?) is to weak, your pelvis will drop/rotate at each impact, pulling on the IT band. Makes sense to me.
While running, I also try to put my foot/leg/pelvis DOWN to touch the ground as opposed to letting my torso LAND on my hip bone. Can you picture it?
Focus on active foot contact instead of passive impact in order to counteract pelvic rotation.
I’ve had ITBS twice. The first went away with basically not doing anything and ice. The second time took a bit more rehab. I would contribute both to ramping up the volume too quickly.
Foam rollers are said to work, however, they did not work for my IT band. I’d be curious to hear how you felt today on your ride after your deep tissue massage. Deep tissue massage works great for temporarily relieving the pain. All you need is 30 minutes with the massage therapist and you’ll be pain free for about 1-3 weeks. However, like I said that is only temporary, and likely you will have to find the source of the problem. Generally, ITBS is not caused by the IT band, it is something else that is weak, imbalanced, etc. Many times it comes from the hips(like in my case). For instance, when they video taped me running, I would drop one of my hips during swing phase causing extra strain to be put on my IT band. The PT will likely give you exercises to strengthen your weak muscles, which should clear your symptoms in the long run.
As I said before, get the deep tissue until you get through your races short term, but also go to the PT and do the exercises they give you, that is ultimately what will relive your pain.
Oh, and yes deep tissue hurts like hell, but well worth it.
Most of these exercises center around thigh abduction. With that in mind, you can play pretty much any team sport and get great abductor workouts. Basketball, soccer, football, and especially hockey will work your abductors well. Still gotta stretch though. IT band friction sucks.
Here are my coach’s thoughts on IT band syndrome, and some possible fixes. He really focuses on the glut med as the culprit and thing to target. Note, not a doc or PT!
I started having bad problems with my ITB last September. Started doing the stretches-with a wine bottle instead of the foam roller (helped some). Did the core work (helped some). But it didn’t go away, until I stopped running on the road and ran on a treadmill. The road around here are cambered enough that I think the constant stretch was a problem. No problem in over 3 months now. I know I will probably go to hell for running on a treadmill so much in this nice weather, but at least I can run pain free.
