Iliotibial Tibial Band Syndrome ITBS

Hi all,

I've self diagnosed ITBS due to pain on the outside of my left knee after running which mainly hurts when I'm bending my knee - up stairs etc.

I would class myself as a new to running person but had done running in the middle of last year which was pain free.

The ITBS started about a 2 months ago when I went out for a run which involved hills and since then I try and stick to the flat. The problem at that time was that the pain continued for nearly a week which at times was unbearable and I had about 2 weeks off from running until I started to slowly work up the distance.

Recently, I have been working on going up to around 10k with no pain after doing 9k for 3 times before doing my first 10k event yesterday. However, ITBS pain has returned and so I would like some top tips from people to try and overcome this.

I have read about stretches that you can do and have tried some, but some web-links on old threads don't seem to work so any up to date links for stretches would be appreciated.

Can I still run at all, or is it best to stop for a time? As I never seem to have pain whilst running and it flared up 2 hours after running. If pain was happening whilst running, at least I would know I should stop.

Another thing which seems to be mentioned a lot is about changing trainers, but given mine have only done 100k, should I look to get some advice from the local running shop to see if they're suitable for me?

I'm also thinking of going to see a physio if that would be suggested?

Any top tips would be appreciated, along with any other information you feel is relevant.

Thanks in advance.

May be worth seeing the physio. My own experience of ITBS was that it hurt whilst I was running and it's a little surprising if it doesn't hurt when running at all and only starts afterwards. Doesn't mean it isn't ITBS, but I know that after recovering from my first bout of ITBS I went back to the physio second time around and discovered that the pain, although similar in many ways, was actually caused by something entirely different !!! Hence, required completely different treatment to resolve.

Good Luck

Thanks, currently the pain only really lasts until the morning after my run.

I'll look to speak to both my GP and a physio and report back.

When I had ITBS it started hurting during the run, but could continue for up to 2 weeks afterwards (coming down stairs was agony!). I saw a physio about mine - you should do the same. It may take a while if you try and do it through your GP though.

Are you a member of a running club? Someone there might be able to recommend a physio.

This is a good stretch for the ITB 

http://www.runnersworld.co.uk/health/yoga-for-runners-position-12---padangustasana/7679.html

Approach with caution though - don't try and go fully into the stretch if it's uncomfortable, once I've bent at the waist I am stretching my ITB to it's limit!

Foam rollers are good too.

Good luck!

Unless you treat ITBS it will just continue to get worse. I suffered for months before visiting a phsyio and accepting I needed to stop running until I was pain free. A physio will be able to address the underlying causes of the ITBS (usually tightness in surrouding muscles) and loosen everything up. He/she will also be able to suggest targeted exercies to correct any issues. Foam rollers can be useful for stretching the IT band but they are painful. Don't bother visiting a doctor unless they are experts in sports injuries - go straight to a good physio.

Thanks for all the replies.

Unfortunately, I'm not a member of a local running club but had been looking into it - I might still send an email to them as I'm prob going to join them anyway.

The 'Walt Reynolds ITB Special' exercise seems to be working that area but will seek advice of a physio asap.

Luckily, my work has a number of treatment rooms next door to our gym and was able to get to see the physio today.

We went through the detail and he found a couple of issues...

The first one that he found a problem at the outside edge of the back of the left knee - which was something that I didn't feel painful previously. This was described as a 'biceps tendonitis' and having read up about this muscle is feels like in the right place.

I then mentioned that this pain wasn't where I was feeling it as described above and said that it seemed to conform with the ITB. He then went to poke around the ITB and found the pain that I had experienced previously. Whilst proding and poking the ITB above the knee there was some tenderness which I hadn't felt before.

He then continued to give me a massage and then ultrasound treatment before showing a couple of stretches and exercises such as the one I mentioned above.

He said that I should take a break from running until the pain has gone (a couple of weeks) but still to do some exercise such as exercise bike or swimming etc. He also said that I need to ice where the pain is and even once I start running again, that I ice even if I don't feel the pain.

Overall, he said that it wasn't anything to worry about but should just take things steady when I get back into it.

I'm pleased that I went to a physio quickly and for £17, it's put my mind at ease for what I need to do next.

I'll let you know how I get on...

Excellent news! Thanks for postig an update, always good to hear that situations are progressing well 

 Type Tom Goom, into the search above... foloow it and message him.  Experienced physio, nice guy, will help if he can... you can rely on his advice.

Thanks again for the replies.

An update a week on...

The day after seeing the physio, a muscle in the quadriceps area just above the knee and to the outside (looking on the Internet, it might be the Vastus lateralis) was really tender. So I have been icing this as much as possible and it got worse for a few days before getting better. Now there is no pain in this area when I poke it. This is the same outcome for the pain in the back of my knee, so that's positive.

In the last few days, my knee has been getting more aching on the outside edge as before. When I'm doing the Walt Reynolds ITB Special' exercise, it aches more so think it's working the right bit. The problem is I've not been keeping up with doing the exercises regularly so need to get back into the routine.

So still not running and am really missing it. There's a number of events that I want to be doing in the coming weeks but am trying to keep strong and not ruin my rehab!

So three weeks on since picking up the injury and I'm pain free. 

The advice from King Kong above served me well as I contacted Tom Goom (http://runningphysio.wordpress.com/) to get some more information. He seemed to suggest that me doing the stretches was good but needed to work on what was causing the problem to flare up in the first place. Therefore, I went through a load of different exercises that he lists on his blog and found that single leg lifts were very poor on my left leg compared to my right. Thefore, I've been concentrating on strengthening my gluts and medial quads.

I found that whilst doing single leg knee dips, the ITB special and using a foam roller have really helped turn me pain free. Even when I'm driving now it's cleared up. I actually think that the foam roller made the difference as after the first session it made a vast improvement the next morning.

So, I'm going to wait for another week or so before getting my running shoes dusted down and going back out on the road.

It's great that you seem to have got the ITBS under control and that the runningphysio link was a big help. Great that you seem to have located the route of the problem as a weakness in one leg.

Most people have a dominant side when running or doing sport of any kind... therefor when you go back to running make sure that you pay attention to your running stride to see if there are any differences between sides. If it doesn't say it on the runningphysio site, it would be a good idea to continue to do the strengthening exercise for a least 3 - 6 weeks once back to running + stretch the ITB and gluteal region. Most runners are tight in this region and it can help with running stride King Pigon is a good stretch along with the adapted elephant pose. Its good to try and work up to 90 sec + in the stretches and do both sides 2 - 3 times (but work up to it ).

Good news that you're pain free! Good luck with the return to running

Thats good news, interesting thread - I found moving to a more midfoot strike helped me alot, though I run a tad slower as a result.

So nearly after 5 weeks after picking up the injury, I've been pain free for over 2 weeks and have started back running.

I started with a steady 1.2k on Tuesday and then 2.3k on Thursday and I'm feeling fine. Altough, its very hard work and am doing interval training.

I've found a fairly flat 1.2k loop and will keep slowly step up the running to 5k and then start getting faster!

I've also been reading up about form and also trying to sort out my running technique as it seemed as if I was doing everything wrong!

If anyone has any tips to set sights on a sub 22min 5k, I would appreciate it. 

Nice work! Good to hear the improvement. 

Ref the 5k, no specific tips for 22min, but interval training (200m-400m repeats) is a good starting place. The Warning is, with any interval training, start with low numbers of reps (Just 3-5) and build in one extra rep a week, find something other than concrete to run on, don't go completely flat out, and only do the intervals once a week. The problem with any other approach is the injury risk, especially if returning from an injury.

Good Luck! 

Quick message to say that I've now back up to 5k from last week without much of a problem.

I'm now working towards going quicker and achieved my first sub-25 minute 5k on Wednesday.

I've mainly been doing a couple of sessions with 1k intervals and then doing a 5k later that week, these seem to be working.

Onwards to low 20's....