The Vine: Runner Fest II
Hey Sars,
I am in a bit of jam and while I know you prefer to work out in your apartment, I was hoping that there are some avid runners out there in your readership.
I hurt my iliotibial band (a piece of connective tissue that, if injured, can just about destroy a runner’s career) while going for a routine run.The pain is like have a strip of muscle torn off the side of your knee, it sucks.But being young, stupid and naive I kept exercising on it.Of course it did not magically go away and another runner suggested that I had Iliotibial Band Syndrome (ITBS).Fortunately, I was in Australia at the time and they have a superior mentality than we do in the U.S. about preventive medicine.So I was able to get some uber-cheap physical therapy.They gave me a bunch of strength training exercises and stretches that I have been doing regularly since I hurt myself.I even bought a compression band (Patt-strap) to wear around my leg while I run.
Now, the problem.It has been almost a year since I injured myself and I am back in the States.I took a few months off of running, switching to lower-impact training like cycling for that time; then I started slowly getting back into running activities like ultimate Frisbee (you sprint a lot when you play Frisbee, so it does not aggravate the band as much as repetitive jogging).Alas, despite all this work, I still cannot go for a normal run for more than 20 minutes before my ITBS flares up, even with the compression band strapped on really tight.
I would return to physical therapy, but I can’t afford it because it’s sooooooo expensive in the States.As such if there are any suggestions your readers have to help me work back up to 30-40 minute runs, I would deeply appreciate them.
Missing My Morning Run
With the obvious disclaimer that I am not a doctor and my idea of “healthy living” is to put tomato on a cheese sandwich…
One short-term solution might be to turn your morning run into more of an interval train, if playing ultimate isn’t bothering you.Or maybe you could try incorporating more terrain into your runs, to use different muscle combinations and drive less weight through your heel; I don’t know if this is part of the issue for you, but it is for me — the “bad ankles” thing I mentioned above is actually just the one ankle, which I broke 20 years ago in a semi-complicated way that doesn’t “heal” so much as “stop hurting/impeding function….Usually.”So, I can’t sustain a flat-land workout for 40 minutes, but I could run stairs all day, and from what I hear anecdotally, this isn’t uncommon.
But again, that’s anecdotal, and my bone chips and high arches may translate to your situation, but they may not.I don’t know what you’ve tried, or whether ITBS ever goes away with a therapeutic course, or what.If it’s a chronic condition, you may have to revise your definition of “a morning run” to something more like “a morning stadium set” or “a morning uphill,” but for all I know, that’s even worse for you, so let’s see if the readers have any experience to share.
Tags: Ask The Readers health and beauty
I’m a runner, and I would back up what Sars says. I had knee surgery about 5 years ago, and I can’t sustain a long run anymore on flat ground, but I can incorporate intervals and more terrain and still feel like I got a good run in.
Moving the Gulf Coast didn’t help though–their idea of “hills” is a sand dune.
Good luck.
I’ve never had problems with this particular injury, but here’s something you might want to try.
If you can run normally for 15-20 minutes, but want to up your milage/time a bit, try splitting your longer goal into one morning and one evening session. There’s a lot of great research that I’ve read in Runner’s World magazine about how two shorter runs in a day are actually just as good for you, if not better than, one longer session.
I’d also alternate running days with the other lower impact activities like biking or swimming. (My cross training activities of choice are yoga and pilates) Cross training is great for you, anyway, even if you don’t have an injury! You may also want to add in some strength training just to bring up the overall strength of your legs.
Hope it helps! I’m looking forward to what the other runners have to say!
With the same ‘not-a-doctor’ disclaimer:
I’m an avid hiker and backpacker, and I keep myself in shape for long hikes by trail running. I went through about 6 months of the same pain flaring up whenever hiking on very steep trail and a good doctor friend had the same informal diagnosis for me: ITBS (I keep mistakenly referring to it as IBS, which: no). I haven’t gotten around to getting an appointment for an official diagnosis and referral to PT.
What I have been using is home equipment from Fitter First (http://www.fitter1.com/). I am a big, big fan of the wobble boards – I’ll stand on one for half an hour or so while watching TV in the evening. My knees and ankles have strengthened considerably – even to the point that I even wear lightweight trail running shoes while backpacking. No more heavy boots for me! I’ve also had less ITBS flare ups when hiking, but that could also be due to the addition of trekking poles to my necessary gear list.
Oh, finally. Something I can speak to.
I’m a runner, cyclist, ultramarathoner, triathlete, etc, but the catch is: I’m super SLOW, so when I run a 50k, I’m on my feet FOREVER. Which means my ITbands are almost always in distress.
Here’s the deal (as best as I understand):
When your IT bands hurt, it’s because they are irritated. Once they hurt, there’s nothing to do but advil, ice and REST to un-irritate. Running more on irritated ITbands will only make the problem worse. Rest rest rest. And then rest some more. (By rest I mean: stop running. Just stop. Swim. Bike. Whatever. But stop running) While you’re resting …
go buy a foam roller. In addition to the strength training stuff you were already told to do (keep doing it! Balancing out inequalities in muscle strength will go a long way towards solving this problem), the foam roller is the most effective way to loosen up tight IT Bands. Take the roller (can be found at any chiropractor or running store — it’s basically a round 6 -12 long tube thingy of stiff foam) place it on the floor, lay down with the side of you hip on it, your leg outstretched. Slowly roll your body over the foam roller along the side of your leg, right over the IT Band. This hurts like a bitch, but it’s productive pain: it’s loosening up that band. Do that for 5-10 minutes, then flip and do the same thing to your quad to loosen up your quad muscles.
Other suggestions: do you need new running shoes? do you stretch? Streching, new shoes and the foam roller did more for me than the compression strap ever did.
Good luck! It’s a sucky problem :(
Hey! I hurt my right IT band training for a half marathon this summer! It completely wrecked my race for me- I couldn’t get past the 10 mile mark without that pain- I described it as ‘the outside of my leg from hip to knee being ON FIRE’ but the way the letter-writer describes it is really good too. Everything I’ve read and heard from doctors ( I’m a Userican, for what it’s worth, and have had nothing but excellent care for this injury) and trainers is that it CAN be overcome. It just takes a huge amount of stretching, and STOPPING when you feel the pain. Not that you have much choice, but don’t try to run, swim or Frisbee through the pain. Just stop whatever it is you’re doing. Google ‘IT band stretches’ and do those twice daily. (It will seem like you’re concentrating on your hips, and that’s actually right- because the band begins at your hip.)
My band is getting looser, very slowly. This injury is, from all accounts, one of the very, very few knee injuries which you yourself can actually recover. Good luck.
I don’t know how well this would work for physical therapy, but for working your way up to running again I know of a great program. It’s called Cool Running: Couch to 5K. Just google it and you can find the site. It’s a 2 month program that works you up from no running to running 30 minutes at a time. Take it from me; I was a total couch potato and now I’m running 30 minutes 3-4 times a week. You can take longer to do the program if you want to. I repeated a couple weeks because I didn’t feel capable of moving up yet. But it is a nice program for a gentle set-up to more activity.
It probably wouldn’t hurt to try it and see if it bothers your injury.
I am a repeat marathoner who has struggled with IT band injuries in the past. First of all, ITB injuries suck. I am sorry for you.
Second, have you changed the kind of shoes you’re wearing? I had chronic ITB pain until I changed to a more supportive shoe (I am a super overpronator with the flattest feet you’ve ever seen.) Getting into a good running store (ideally, one with a treadmill where they can analyze your stride) and changing up your footwear or even adding orthotics can make a WORLD of difference.
Most importantly as you’re trying out different solutions, don’t try to run through ITB pain. Stop. and. Walk. You’ll only aggravate it.
Good luck!
Oh man, I know exactly how you feel. I ran the Rock & Roll Marathon in San Diego back in June, and around mile 14 I tripped in the road and strained my IT Band really, really badly. I ended up walking the last twelve miles in some of the most excruciating pain in my life.
While mine wasn’t an overuse injury, the one thing I can definitely suggest is NO HILLS. During my group training runs I ran for a bit with an orthopedic surgeon, who told me that hills (both up and down) put extra stress on the IT Band, and that I should walk those hills AT ALL TIMES. I did that, and lo and behold I was running 6+ miles virtually pain free. Granted, this was after two solid months of complete rest (no bike, no swim, no nothing).
So my humble suggestion is to run on soft flat surfaces, avoiding hills.
Happy Running!
I second everything that Elizabeth said. I hurt my IT band when I was training for the Chicago marathon (also a very slow runner) and the trainers I was working with told me all the same things Elizabeth mentioned. Then my doctor also told me that I needed to focus on strengthening my abs and hip muscles (especially lower abs), because that would help the IT band from getting irritated in the first place. As I understand it, if your abs are not strong enough to sustain the distances you are running, it causes your IT band to move to a place it’s not supposed to be to try and pick up the slack, and then it gets inflamed.
My husband is a marathoner w/ ITBS. He has to do a lot of his cardio training on an elliptical machine in order to minimize irritation close to the marathon. His suggestions: new shoes, a visit to your GP for good anti-inflammatories as a prevention prior to a long run, and the “Core Performance” series of books for the excersise and stretching program.
Good luck and my sympathies- that kind of injury HURTS!
I totally agree with the foam roller. And stretching. Both together will help prevent the injuries (at least that’s what my marathon coaches told me).
ITBS is pretty common among runners, and it’s often because we can’t stretch it so well (…can’t and don’t). So in addition to the IT band stretches, the foam roller will help knead out some of the other muscles and help you to stretch them. It is been invaluable in my training (and, I’ll probably be seeing it again before/after my half this weekend).
Good luck!
I have to recommend looking into trigger point massage. I had horrible tendinitis in my right knee (pain along outside and bottom of kneecap), or so I thought. Turns out I had developed trigger points–basically knots of muscle–in my IT band/tensor fascia latae that were pulling everything out of alignment and causing the pain. Really diligent massage to the IT band following the trigger point massage principles, meaning about a two minute session three to five times a day, finally cured the pain, and it has never come back, despite all the running and hiking and weights I do. I keep up the massage, but not like I did the first two weeks. Check out “The Trigger Point Massage Workbook” by Clair and Amber Davies. It has been a lifesaver for me, and the best thing is that you can do it yourself. If you’d like some coaching to get started, find a massage therapist who is familiar with the techniques, and have them show you, but the book is meant to be used by the reader. Good luck!
Speaking as a PT, I agree that if you pay out of pocket, therapy is stupidly expensive. If your MD writes you a script for it your insurance should pick it up though, and you would only have the copay to contend with. Even if your copays are high you could always just get an eval to make sure nothing else is going on, and then a couple of sessions to develop the appropriate home exercise program for you. I suggest that simply because I’ve seen a lot of patients come in with ITB issues only to discover the problem is actually originating from their hip alignment or foot biomechanics, so all the stretching in the world won’t help them long-term until they fix the base issue. That having been said, I agree with the other comments left about proper footwear and the importance of stretching, and wish you the best of luck!
I second Elizabeth, mpb, and all the other ITBS sufferers. I had my bout with it while I was training for my first half-marathon. I stupidly popped 6 Advil and ran the half without pain…until about an hour after I finished. More sensibly, I did nothing for the next 2 months — no running at all — and it healed fine. I’ve had a few other overuse injuries, (strains and stress fractures) where I didn’t stop right away and I paid the price in time spent waiting to heal and PT visits. The moral? Stop running. I also recently had a knee injury from a fall on a trail run, and I tried swimming instead of running for a few weeks, and it actually helped speed healing quite a bit, so you may want to give that a try. And, like everyone else says, stretch and cross-train. It sometimes sucks to work into your schedule, but it’s the only way.
I’ve had the same problem for a few years now, it does suck. It started for me about 4 years ago, and I, like you, attempted to train through it, only to further the injury. The only thing I could do, other than the recommended pt exercises, was rest and ice! To this day it acts up occasionally. Getting new running shoes helped, as did changing the terrain. Good luck, it seems like there’s some good advice here!
Not a doctor either…
There’s lots of good advice here.
Like one poster said, STOP RUNNING. I would even advise against Frisbee. I completely stayed off any and all running activity for 6 months. I weight trained and did yoga. On that note, you really should look into Bikram Yoga. It’s not for everyone – it’s more like “boot camp” yoga, you do a bunch of poses in a room that’s heated up to 105 degrees. The awesome thing about it is, you get a kick ass workout, it’s extremely cleansing, and you only perform to your ability. It helped me tremendously not only with injuries but also from not gaining 800 pounds. Find a studio and talk to the professionals and do some research to find if it would be right for you. But stay away from running. Walking is a good alternative if you have good shoes and you have good form.
On that note – make sure you have good shoes. Go to a running shoe store that offers gait analysis. They’ll shoot video of your feet while running on a treadmill and then help you get shoes so that you can run more efficiently with always helps prevent injury. And change your shoes when you’re supposed to. A decent rule of thumb is every 6 months if you’re a consistent runner (around 30 miles a week).
You can find an awesome amount of info at http://www.runnersworld.com. They have a massive amount of injury advice and recommendations. Good luck!
I have also had IT band problems. It is a very common running injury, especially for women. Most of my advice would be to reiterate what others have already said.
STOP RUNNING! Sorry to yell but seriously, the only thing to do is to let it rest. I could not run at all for at least a year and then it was probably at least another year before I could go for more than 15-20 minutes and it still flares up from time to time. Respect your body’s limits. Stop at the first hint of stiffness or pain. Ice, stretch, etc is all good too but rest is the biggest thing.
Correcting any muscle imbalances is also critical. Probably an assessment from a sports physio or sports kin or athletic coach would be a good idea. One piece of advice I had gotten was to do one legged exercises so one legged squats, dead lifts, cable extensions, etc. and you are looking for exercises to activate the gluteus medius.
Check your shoes. If you pronate, you may need a more supportive/corrective shoe.
The other thing that has really helped me is Active Release Therapy from a sports massage therapist. It hurts alot alot alot alot but it does work.
Hey all, thanks for the great suggestions! Actually since this letter is a bit on the old side I have tried a few different things since then. I’ve actually found that massaging the band with a lacrosse ball (it was what I had lying around and it was cheaper then a roller) worked out fairly well. I massaged it a few times a day and alternated my running days with cycling and/or swimming. These are all really great tips though and I look forward to giving them a try!
Thanks!!!