Slowtwitch approved IT Band rehab? Is swimming safe?

Triathlon Forum
1

I’ll just start by saying this: I’m an idiot who ramped up his running too quickly. I haven’t ran since my IT bands started aching, and I’ve been resting for two weeks with minimal riding as well-was doing 150-300 miles a week, now down to 50-75. I’ve been foam rolling for the past week twice a day, and I think it might be helping? But the ITB’s are still bothersome. So, slowtwitch: I implore you: share your ITB miracle solutions. Also, is swimming okay? What about weight lifting? I’m boredand going crazy with this sedentary bullshit, and there’s a gold’s gym 2 blocks away. What about yoga? This seems like a good time to try that, I’ve been meaning to for years.

Backstory: I haven’t ran in a decade. I’d dropped from ~300 to ~190 by cycling+some swimming, felt great. Dropped swimming to start running again. It was wonderful; I loved it. My plan was to start running 10 minutes at a time, two days a week. First run was ~11:30 mile pace. Every week, add another day to that until I was at 6 days. Then add two minutes to every run per week, until at 30 minutes. Then do hill sprints twice a day for 30 minutes(hard up; easy down). And slowly work my way up to the BarryP 3:2:1 proportions. Instead, I felt great, loved running again. Absolutely loved it. and was doing 45 minute runs 3 days in a row on week 2. Then I went for 60 minutes because what the hell, I felt great. At a 9:15 mile pace(2:15 faster than day one less than two weeks before). And my ITB’s said, ‘sit down and stfu’ so here I am. :frowning:

The worst part of it was I felt pretty good after that 60 minute run. I can’t explain how happy I was to have finally thrown off the yoke I was carrying when fat. I was finally approaching trim, and felt really confident and fit about my body. That run was GLORIOUS. I think it made me happier than settings PRs did in HS XC/Track. I was jubilant. And then my body betrayed me.

Or I was dumb and mistreated my body. Y’know, whatever. I like the other narrative better though.

2

I just got over IT Band issues myself. For me, stretching my IT band for 25 minutes both before and after my run helped tremendously. I also did ice baths. Initially I had to completely stop running for 3 days but was fortunate enough to be able to resume running at a much slower pace than usual for about 2 weeks after that. When I started running again I’d walk the first quarter mile to “warm up” prior to my slower run. The key is when you feel any pain or nagging at all STOP running. You don’t want it to flare up and prolong the healing. Rest is the real answer but I couldn’t NOT run…it drove me crazy. I also cut back on my mileage and cross trained with spinning classes and riding outside. Do you do any strength training for your hips? If not, I’d try adding a few exercises for that as well.

Side leg raise
Clam Shell
Hip thrust
Side hip bridge
Side shuffle
Pistol Squat
Hip hike

Do these both before and after running/spinning/biking. I noticed a significant change once I started doing these EVERYDAY!

I hope this helps!

3

I’d say a lot of this will depend on how big a hole you’ve dug yourself into. I tried to push on through my IT band issues earlier in the year with an ad-hoc mixture of rolling, stretching & painkillers and to put it lightly, that was **not **a clever idea. The amount I could run before the pain kicked in got progressively shorter and shorter and once it got to the point where I couldn’t even run a mile, I admitted defeat and took a break.

It sounds as though you’ve not got yourself into too much trouble yet, so be sensible, take a few days rest and take some time to learn about what causes the IT band issues. I found the blog linked below a really good resource for understanding the physiology of it, but didn’t find that particular stretch to help too much. Have a look on YouTube and find something that works for you, I’ve linked the one below that I use regularly. The exercises mentioned above are all good advice, but I’d say pick one or two of them and do them properly. It’s all too easy to do them with rubbish form and not target the muscles you’re supposed to be targeting, again look them up on YouTube and follow their advice on proper form (link for clamshells included below).

If you can bike and swim without it flaring up or giving you issues afterwards then go for it. This will depend heavily on (1) how bad it is at the moment (2) your kicking/pedalling style and (3) how hard you push it, so there’s not really a set yes or *no answer. *Listen to your body.

When you think you’re ready to run again, keep it **short **and slow. I can’t stress this enough, just completely forget what distances and paces you were doing before, start fresh. If you can only do a mile or two, then start with that and build it up from there. I was told by someone else that a good motto whilst rehabbing yourself from injury was to “quit whilst you’re ahead”. I didn’t like it because it sounds very negative and defeatist, but in my experience, it’s good advice. Going out and trying to run 10 or 15k isn’t going to help your fitness if it’s not sustainable; getting in a 5k and calling it a day before your knee flares up is going to be more beneficial in the long run.

Good luck and have a look at these:

http://forum.slowtwitch.com/gforum.cgi?post=5670639
http://forum.slowtwitch.com/gforum.cgi?post=5698841
http://b-reddy.org/...t-band-stretch-ever/
https://www.youtube.com/watch?v=M0e8FPL787E
https://www.youtube.com/watch?v=7iXpLxKs1sY

4

I went through some IT band issues a few years ago, and similar to the poster above physio had me doing all the same exercises to strengthen the glutes.

I found I was able to still do some light cycling and swimming was ok as long as I didn’t push off the walls to hard.

When I came back to running it was a really slow process for about 3 weeks starting with 30s run/30s walk and building on that each run until I was up to 15 min of continuous running. During that build I would also avoid doing any downhill running, and if I came to a small downhill I would walk it because I found that extra impact and force on the quads using to run downhill aggravated the it band more than flat running. I would recommend when you start running doing it on a treadmill if you can that way you can just hop off it it starts to bother you and not have to walk home.

5

I found I was able to still do some light cycling and swimming was ok as long as I didn’t push off the walls to hard.

I only read the title and my immediate thought was the same as this. When I’ve had ITB issues swimming has been fine as you’re not bending your knee/hip joint in the same way that cycling and running causes the ITB to rub on the hip/knee.

If you’re swimming I suggest you do light push offs from the wall so you’re not bending your hip/knee too much which causes the ITB to inflame.

6

+1

After 4 years of IT band hell, I finally cracked it last year.

The answer was there all alon I just had to take it to new levels.

  1. strengthen
    Not just doodle with a couple exercises. Last year I was determined to have the strongest hips/quads/glutes/hamstrings at my entire gym. I worked my ass off with cable leg raises (side, front, back), squats, deadlifts, single leg squats. I would leave the gym a wobbly mess and once I had to take the elevator instead of the stairs I was so weak (note: gradually worked up to that)

  2. tightness is your enemy
    Not a casual stretch here or there. Get a lacross ball or a small massager ball of some sort and grind away deep into your glutes, hips and entire quad. I have a desk job and kept a ball at my desk to grind on daily

I would strengthen twice a week at the gym and roll daily

Started my mileage back at 0 and started running. My first long run was 5k. Increased by 1.5km a week. Worked up to 30km

Last year after a winter protocol of this I did my first 70.3 without any IT pain. I was so happy I could cry since it was so bad before.

I followed it up with my first full ironman also IT pain free

I maintain this work to this day, once a week in the gym and haven’t missed a single session

Good luck!

7

My first post on Slowtwitch. :slight_smile:

I have had IT Band Syndrome in my right leg since I was a teen, I trained for my first half-marathon and marathon last year and got ITBS on the left leg too. I went to every type of doc (and got the same diagnosis everywhere), read everything on the net I could find and nothing really helped.

My advice would be: take longer steps, for most ITBS comes out on hills up and down and that is because (at least I think so) steps become shorter. If I run like the pros (really long strides, pulling my knees high and my verse high, use more of my thigh and glute muscles instead of my calf muscles) my ITBS doesn’t come out.
If you train in the gym you should be able to run longer with proper form and use more muscle groups for longer.

If you run too long and you start to become tired, your steps/strides become shorter, so stick to short distances (for me that’s 9km with 2km uphill running right now, on flats I can run a halfmarathon without any problems), keep an attention on your running form, if you feel weak take a couple of seconds to recover. I run twice a day, which gives my body enough time to rest and recuperate.

If it hurts too much take a week or two off.

I think that drugs that reduce inflammation are making it worse on the long term, but that is just a feeling.
For some reason cartilage drugs help me with my recovery, but I have no idea why.

8

My first post on Slowtwitch. :slight_smile:

I have had IT Band Syndrome in my right leg since I was a teen, I trained for my first half-marathon and marathon last year and got ITBS on the left leg too. I went to every type of doc (and got the same diagnosis everywhere), read everything on the net I could find and nothing really helped.

My advice would be: take longer steps, for most ITBS comes out on hills up and down and that is because (at least I think so) steps become shorter. If I run like the pros (really long strides, pulling my knees high and my verse high, use more of my thigh and glute muscles instead of my calf muscles) my ITBS doesn’t come out.
If you train in the gym you should be able to run longer with proper form and use more muscle groups for longer.

If you run too long and you start to become tired, your steps/strides become shorter, so stick to short distances (for me that’s 9km with 2km uphill running right now, on flats I can run a halfmarathon without any problems), keep an attention on your running form, if you feel weak take a couple of seconds to recover. I run twice a day, which gives my body enough time to rest and recuperate.

If it hurts too much take a week or two off.

I think that drugs that reduce inflammation are making it worse on the long term, but that is just a feeling.
For some reason cartilage drugs help me with my recovery, but I have no idea why.

Pros have long strides because they are moving faster. Their turnover is high at all speeds. If you watch them running slow, they will have very short strides. Having a slower runner use a long stride would result in very poor run mechanics.

For myself at least, my ITBS was a direct results of tight hips and calves. I’m not sure mechanically how I was compensating specifically, but ultimately not using my glutes and calves efficiently caused the issues.

When it flared, stretching, stretching and more, and more stretching resolved it. I’m talking about taking a solid 30 minutes doing 6-8 different stretches, holding them for 20 seconds or more and repeating that 3 times each stretch. Do the math, it adds up. When it was its’ worst, I did that 2x a day. Chiro, massage, rolling did nothing. Almost a complete waste of time and money for me. Well, rolling might have helped just a little at least, but not on it’s own.

FWIM - when you get tired, your turnover often drops and you stop driving your leg and using a less effective leg recovery. The results is lower run economy, more vertical motion, using your hamstrings and hips more. I think you have stride length a bit misunderstood. You need to consider ground contact time vs stride length as well. Look at walking, maximum ground contact vs. fast running, minimum ground contact. As a sliding scale, as you running get less efficient, strides get longer, cadence drops, ground contact increases and it’s more like walking. Running involve jumping from leg to leg at a high rate and the key is recovering the energy using you Achilles and arch when landing and releasing that stored energy when you extend your leg at the end of the stride.

I do agree with using frequency and reducing the length of long runs in training. Running 6 or 7 days a week to complete the same total training load/mileage, is a great strategy.

9

I’ve been struggling with this issue since my marathon in mid October. I was doing fine, have never had any issues or symptoms until the race switched to a road with a lot of camber and I knew I was in trouble within a mile. My pace dropped by almost 3 minutes per mile, though I did finish (longest 10 miles of my life). I took a month off to rest and did some strengthening exercises, but not enough. I jumped back into running with a 5k to set my threshold pace (stupid idea) and re-injured it. I went for a massage and the lady noticed that my sacrum was out of whack and recommended I see a chiropractor who specializes in endurance athletes. I went to visit him and have learned a lot. My issue seems to be the entire kinetic chain of my right leg and it’s been fascinating watching him work through the chain to find the underlying problem… it’s almost like performing a root cause analysis at work. It turns out that my hips were rotating internally which allowed my sacrum to get out of position. Everything was pretty misaligned and my right leg was substantially shorter than my left, which explained why the camber in the road (sloped down and to the right) caused such a big problem. I’ve been doing many of the exercises mentioned in this thread with the side leg lifts tiring my glutes out the most. I went back a couple of weeks ago and my glutes are firing and much stronger, but I’m still having issues so he followed the chain down to my knee. There is a muscle that comes up underneath the calf and attaches right below/underneath the knee that made me scream when he touched it. He worked on that for a couple of weeks and has now moved onto my feet. I land on the outside of my foot and pronate in with the right side being much worse than my left. He taped my feet to reduce that side to side roll and the results have been promising as it’s a noticeable improvement just walking around. Unfortunately I went for a swim last night and the water proof tape is not kick set proof! I guess the point of this long drawn out response is to find someone who knows what they are doing and get help… don’t let it linger! I even get to try running tonight… 10 minutes of 1 minute walk and 1 minute run. I guess starting over with a hard 5k is not the recommended course of treatment!

10

I had same issues back in February. Took me about 7 weeks to recover and not a problem since. The bottom line is you need to strengthen your butt. I used a Jason Fitzgerald plan (not paid by him, it was just one that I followed) http://strengthrunning.com/. He has a lot of free information on ITBS recovery. I would recommend once you are back to running, keep doing the exercises. I also went to a PT. She worked on flexibility more then strength. Foam rolling is great but your IT band is very hard, so rolling it in my experience does not to do much. Using a lacrosse ball on your hip will help more. As was previously posted swimming is fine, just be careful pushing off the wall. In my recovery I swam and biked my normal routine with no issue. After a three weeks, I ran once a week just to see if there was still pain. If I felt pain I walked home. Once you are back, I would recommend staying close to home, just in case it flares up. GOOD LUCK!

11

You seem to have had all the advice you need, although I have only skimmed posts above.

I had a major IT band problem after doing too much running (and long distance travel) a few years ago. Had all the classic symptoms, including feeling like someone was jabbing a screwdriver into the side of my knee after a couple of miles of running. I tried to fix it while still running gently, but it only prolonged the problem. I ended up stopping running for 3 months.

You cannot run through this! If you do the following you will fix it:

  1. You have to stop running.
  2. Foam rolling/massage is imperative.
  3. Do this strength routine: http://strengthrunning.com/2011/02/the-itb-rehab-routine-video-demonstration/

Do this for 2 months and then you might be ok to start running again, depending on how bad it is currently. Be disciplined!
If you feel any pain in your knee when you try back running again, stop running immediately and rest more.

Good luck!

12

My advice would be: take longer steps, for most ITBS comes out on hills up and down and that is because (at least I think so) steps become shorter. If I run like the pros (really long strides, pulling my knees high and my verse high, use more of my thigh and glute muscles instead of my calf muscles) my ITBS doesn’t come out.

This is actually really bad advice in general (and it’s interesting it works for you). For most people, taking longer strides will cause them to heelstrike, which puts MORE pressure on the IT band. See what someone else said about professional runners’ high turnover.

13

Swimming is fine. Try some breaststroke kick on your back — the abductive movement is good for your glutes.

STRETCH your hips and glutes. Strengthen glues, especially glute medius - look up “clamshell” exercises, and do good old fashioned leg lifts.

14

Swimming has never bothered my ITB. For me long slow runs were never the problem. Prolonged efforts at any sort of tempo would cause a flare up. Foam rolling didn’t really work for me; and the studies I found did not seem to support continuing rolling. Hitting the gym and doing squats and hip thrusts in particular have seemed to resolve my issues.

Good luck!

15

Hi, I too have been trying to get over ITBS for 1 yr now and have like everyone else seen everyone and tried everything, played with Therabands, stretching etc… but like I have read from others its a case of really hard work in the Gym to fix this. I am now 2 weeks into solid Gym work strengthening the Posterior chain and getting the Hips, Glutes, Hamstrings properly strong.

Can I ask how long others had to work in the Gym before they were finally over this annoying injury?

Thanks

16

Hi, I too have been trying to get over ITBS for 1 yr now and have like everyone else seen everyone and tried everything, played with Therabands, stretching etc… but like I have read from others its a case of really hard work in the Gym to fix this. I am now 2 weeks into solid Gym work strengthening the Posterior chain and getting the Hips, Glutes, Hamstrings properly strong.

Can I ask how long others had to work in the Gym before they were finally over this annoying injury?

Thanks

as a reminder for everybody here, we do archive the most useful threads on a range of topics, and the most important category is “illness an injury”. turn down the HOT FORUM TOPICS arrow to see everything archived there and to suggest adds to this archive.

forum_topics.jpg

17

Hi, I too have been trying to get over ITBS for 1 yr now and have like everyone else seen everyone and tried everything, played with Therabands, stretching etc… but like I have read from others its a case of really hard work in the Gym to fix this. I am now 2 weeks into solid Gym work strengthening the Posterior chain and getting the Hips, Glutes, Hamstrings properly strong.

Can I ask how long others had to work in the Gym before they were finally over this annoying injury?

Thanks

For me what really worked was changing to a more stable shoe.

If you are pain free at rest you can gradually build up your time running until you start to feel pain. Usually running too slow can make the pain worse. Doing this with gym work it usually takes 3 weeks to 3 months for the pain to go away.

18

A few years ago, when I was coaching my son before college, he had some ITB issues and did not respond to the things that had worked for me. I did some research and came across a website from a doctor that had collected years and years of information and data on treating IT band issues. It was a pay site (like $20) but he told people beforehand that if they were expecting a perfect solution that will get them running and moving again, then it did not exist. He also offered a 100 percent rebate if you felt like you did not get what you wanted.
All that is to say, IT band issues are complex, vary from person to person and there is no surefire treatment for every person. The doctor’s website outlined half a dozen things that had worked for some people, but the only surefire way to treat IT band issues was rest.
That is not what most people with the problem want to hear. For me, I have been able to do some aggressive stretching (I normally don’t stretch at all) of the muscles in the glute and hamstrings and relieve the issue. That did not work for my son. He had to stop running as much as three months. One time he returned after a few weeks and it came back quickly.

So, feel free to see all the different advice people give, but if someone says, “This is what you absolutely have to do,” then take it with a grain of salt. It worked for them, but it may not work for you.
The doctor who published the site said that IT issues are not really a popular subject and really hard to fix so doctors don’t like to address them. Patients don’t want to hear a doctor say, “you need to take three months off from running.”
Good luck

19

A few years ago, when I was coaching my son before college, he had some ITB issues and did not respond to the things that had worked for me. I did some research and came across a website from a doctor that had collected years and years of information and data on treating IT band issues. It was a pay site (like $20) but he told people beforehand that if they were expecting a perfect solution that will get them running and moving again, then it did not exist. He also offered a 100 percent rebate if you felt like you did not get what you wanted.
All that is to say, IT band issues are complex, vary from person to person and there is no surefire treatment for every person. The doctor’s website outlined half a dozen things that had worked for some people, but the only surefire way to treat IT band issues was rest.
That is not what most people with the problem want to hear. For me, I have been able to do some aggressive stretching (I normally don’t stretch at all) of the muscles in the glute and hamstrings and relieve the issue. That did not work for my son. He had to stop running as much as three months. One time he returned after a few weeks and it came back quickly.

So, feel free to see all the different advice people give, but if someone says, “This is what you absolutely have to do,” then take it with a grain of salt. It worked for them, but it may not work for you.
The doctor who published the site said that IT issues are not really a popular subject and really hard to fix so doctors don’t like to address them. Patients don’t want to hear a doctor say, “you need to take three months off from running.”
Good luck

I struggled from January to October of last year with nasty IT band issues. Rest was 100% the golden ticket. You can do all the exercises, stretching, and foam rolling in the world but it’ll keep coming back if you don’t wait until the inflammation goes away. Strengthening the glutes and hip stabilizers will help keep it away, though. Most likely they were the reason for the pain in the first place. Some people also have success using cortisone or PRP to speed up the healing. I’m finally able to train without IT band pain, but it took a long time of NOT running to get to this point. And I have continued doing my exercises 3-5x a week.