ITB Blues

I came down with ITB syndrome about 6 weeks ago, but I didn’t know it for a couple of weeks. I kept trying to run through the pain until the pain won and I was injured. I saw an orthopedist (surely the spelling nazis will cut me some slack on that one) three weeks ago, and he diagnosed the ITBS. His recommendation was 4 weeks of no running, daily stretching and anti-inflammatory meds.

3 weeks into my “recovery,” I went out and attempted to run a few laps on a padded track. I started to feel the pain after about a half mile, so I stopped.

I’m starting to approach my first “A” race (one of three, each spaced about 6 weeks apart). I’m already willing to concede all non-“A” races, should the ITBS problem continue, but I don’t want to stay on the bench for any more time when it seems that refraining from running doesn’t appear to have helped for squat so far.

Here’s my question: do those of you who suffer (or have suffered) from ITBS continue to run during your recovery? Can I heal and train at the same time? I’m still biking and runing, but I really want to get running again.

Any help would be appreciated. This is really getting me down…

The IT Band itself is rarely the cause of the problem. The culprit is most often the muscles that attatch to it up in your hip, generally the Tensor Fascia Latae.

The TFL is a small muscle that is located between your hipbone (pelvis) and the top of your thighbone (femur). This muscle merges into the ITB, which then goes down the lateral side of the thigh and inserts into the knee joint. But the fibers of the ITB are just strong, slightly stretchable, fibers. The real source of the pain is a spasm in the TFL. A second piece to the problem is because the ITB travels over the lateral borders of the quadriceps and the hamstrings. When the ITB is pulled tight by the TFL, it causes both the quads and the hamstrings to contract under its fibers.

Here is a good treatment: lie on the floor, on your side. Place a tennis ball directly under the TFL and roll your bodyweight onto the ball. You will feel the spasm, and it may really hurt so regulate the pressure you are using. It should always “hurt so good”, anything more is too much and is causing a problem.

Next, keep rotating your body around so you find all the spasms in the hip area. You’ll know exactly when you are on one. You’ll feel it. You need to stay on the spasm for 60 seconds or it will come back as soon as you stop pressing on it.

Finally, take an 18" length of dowel (closet pole) or a rolling pin (don’t let it roll, hold it steady) and from a sitting position, place the dowel at the very top of your leg. You need to put it where your leg meets your trunk. Then push it down toward your knee. Don’t go over your knee joint or kneecap. Cover your entire quad this way - lateral, middle and inner thigh.

While it will hurt, you should always feel like you are doing something good for your thigh/hip/knee. You’ll know if you are right.

This problem is easy to fix and works great. Do it frequently - you are working out for hours each week, you need to keep the lactic acid flushed out of the muscles on a regular basis.

With any luck you will be completely over it in a week or so.

For more information on this, there are several threads on this problem at the discussion forum at www.julstro.com/18.html

(Julstro Muscular Therapy)

I was able to run as my ITB problem was “going away.” It would be more accurate to say that as soon as I started to address the root of the problem, I was able to run without the really painful flare-ups that would come on at random times with different level of pain. I did the rolling pin thing (still do every day) and got massaged as much/regularly as I could afford. Once the TFL and the ITB started loosening up and stretching became a regular part of the day (including glute stretches) the problem went away pretty quickly. I had some lingering point-tenderness at the insertion point on the side of my knees (I had it in both legs), but this didn’t have any effect on running day to day. This tenderness diminished over the course of a few weeks.

Best of luck,

Berti

ITB does suck and what work like a magic pill for me (after months of stretching/strengthening which I’m sure helped too) was ART. 2 treatments and I was good to go. Now I only have it done when I feel it starting up again. www.activerelease.com

good luck.

For me it was six weeks of NOTHING. after that it was running only (bike was impossible) until the moment it start to tighten and hurt. Sometimes I got in a 20 min run. sometimes I got in a 5 min run. It’s very frustrating, but keep doing those stretches and it will be fine.

You also might think of kissing off that first “A” race.

Good luck.

Burns

deja vu! one year ago almost to the day i did a road race that i was not prepared for (60-70mi or so) and stupidly decided to finish it anyway after getting dropped 25 mi into…anyway the next day i ran and my ITB blew up, and i was all concerned because lake placid world qualifier was less then 2 months away. long story short i didn’t get a deep tissue massage until june 1, afterwards i was running w/ no problems (probably similar to ART, magic bullet indeed), but still not enough time to prep for the race, so get the treatment NOW and you still may be able to make your first A race… postscript…keep stretching relentlessly after you’re healed, you never want that pain again!

On the recovery side after two months of no running I started running 1-2 miles but would stop, stretch, massage, if I started to get a twinge. After resuming running it showed up again I would pack it in for the day. I would slowly up the length of the run, anytime I got the faint twitch I would try and stretch/massage, if the symptoms returned I’d pack it in.

The tennis ball, baseball treatment and rolling pin did the trick for me – you’ll know very quickly when you hit the right spot with the tennis ball…yow!

I am not a Doctor but have had ITBS - the only training related injury in 20 years of triathlon that resulted in significant down time for me.

Some suggestions from my experience:

  1. You need to fully rest and recover BEFORE starting back. It took me 3 - 4 weeks of absolutly no running. When I did start back running I was on a walk/run program for 3 weeks.

  2. Be sure that it is only running that is agrevating it. Cycling may be silently contributing to the problem. If so, you need to stop cycling to.

  3. Ice, stretch and get deep muscle massge at the ITB point of insertion. If you are not jumping off the table in pain, it’s not deep enough.

  4. If it’s running related, make sure that you are running in the right shoes. A great deal of ITB problems are from people running in medially posted and overly supportive shoes. Pronation is not the evil everyone thinks it is. It’s the foots way of absorbing shock and transfering stress and power. OVER-pronation is a problem in some runners but not all. The problem is that many runners are running in overly supportive shoes because for some reason they and the people that sell them these shoes feel the posted and supportive shoes are “better”. Ditto for cycling, if cycling is contributing - you may be set up wrong on the bike. Make sure that your bike fit is right.

Fortunately for me cycling was not aggrevating my ITB probem. Thus I was able to ride moderatly and swim while I was off running for a month during a key training time. It was a slow trip back to top running form, but I did go on that season to place in my Age-Group at IMC.

Fleck,

How do I know if cycling is silently contributing to the ITBS? I"ve been wondering about this myself, since abstinence from running does not appear to have abated the problem at all. Here’s more info: I’ve had my current set up for 1000+ miles with no ITB issues. I have speedplay pedals with full float. I don’t feel any noteworthy sensation along the ITB when riding, even when climbing or hammering. In fact, it “feels” theraputic to my ITB to ride. I’ve done 2 duathlons since my initial injury (but before the diagnosis) and each time the bike leg really soothed the pain. If riding is contributing, then it truly is silent. But I’d like more opinions on this before I bring 2/3s of my training to a full stop. :frowning:

Thanks

Check out Dan’s article about ITBS on the main site. A month off and liberal use of the stretching he describes took care of mine. I still stretch it regularly and any time I feel any tightness in that area

In response to the question of biking and ITBS, while you may not be feeling discomfort while biking, it may very well be a major contributor to the problem. Here are the reasons.

The IT Band itself is NOT a stretchable type of tissue. If it were, your knee would not stay in place. The band runs from your hip, where it attached to your Tensor Fascia Latae muscle at the front (right at your lower hip area, and the Gluteus Maximus at its back, travels down the outside of your leg, splits, part of it crosses your quads a few inches above your knee, and attaches below the knee joint on either side. If it were “stretchy,” it wouldn’t be able to do its job. When one “stretches” the IT Band, the only tissue being successfully stretched is of the attached muscles, which, by the way, is vital to overcoming the problem.

The reason it doesn’t hurt when riding is that while in the saddle, the Tensor fascia is contracted, and the knee is never completely straightened out. The movements on the bike don’t engage much of the ITB. However, because the TF muscle is limited in its movements and never goes thru the entire range of stretch, it will become shortened (much like if one were to do dumbell curls and only start and end in the middle ten degrees of the motion. Done enough, the bicep will become “shortened”). When you change your range of motion to run, the shortened TF muscle pulls on the IT Band, causing pain everywhere from the knee all the way up to the hip. So unless you get out of the saddle often, long periods in the aero position will encourage your situation, not help it.

By addressing the muscles of your hip, butt and lower back, you won’t need four weeks to recover. The tennis ball/rolling pin treatment, and ART therapy both work because they focus on the areas causing the problem, instead of addressing the IT Band alone.

Hope this helps.