IT band syndrome recovery

20 messages
03/11/2013 at 20:02

Hi all, I got back into running about 4 months ago to train for a 10k race I completed in early October. Following that, I started running with a club and have been going on some pretty long runs with them twice a week, as well as the 5k Parkrun on Saturdays. 

Last Tuesday I went on a long run with the club and pushed myself too hard, especially running downhill too fast. We were doing efforts and probably ran around 13k in total. Towards the end of the session I noticed a pain coming from the side of my right knee. I continued to the end (about another 2/3k) and stretched out afterward but the following day the pain was back with avengence!! 

I took 3 days off, icing and resting the knee and it felt better by Saturday. I decided to go to my local Parkrun but unfortunately had to drop out after about 3k as the pain in the side of the knee returned. After lots of research online I'm pretty sure it ticks all the boxes for IT band syndrome. The pain always comes from the side of the knee, and is especially prominent when going down stairs or bending the knee. 

I've designed some stretching and strengthening exercises (i.e. squats) to try and help and bought a foam roller to help relieve strain in the IT band. I also think it's time I purchased some new shoes as the Nike Airmax I am using at the moment are so old I can't even remember getting them... I use gel insoles in my shoes too, but these are just something cheap I found on eBay and probably don't compensate for how bad the shoes are. 

I suppose I am looking for advice from other members here based on my experience. 

  • Has anyone here had IT band syndrome? 
  • How did you deal with it? 
  • What stretches/strengthening exercises work best?
  • How long does it take to heal before you can begin running again? 

Fortunately I work for the NHS so I believe I get access to a free staff physio, so I will attempt to organise an appointment with them soon. Any help would be much appreciated, I'm so disappointed I have had to stop running just as I was getting back into the sport and improving my fitness. 

03/11/2013 at 20:34

Yep. Had it, hurt like a mother!

New shoes, foam roller and stretching. I ended up probably having 3-4 weeks off. The worst thing with ITB (I found) is that all the synptoms would clear when you were walking (no more pain going down stairs or when leg came up in normal stridint) but then as soon as you would run for 5-10 mins it was back and back to square one.

Worst thing in the world is to be patient.. but you have to do it!!

best stretch I have found for ITB is to lay on your side knees together and slightly bent. flex top leg so foot is up to bum (hold with hand) then put the lower leg on the top knee and pull down. 

good luck! 

03/11/2013 at 20:55

Hi Dibs, thanks for the advice. I will add that stretch to my routine and try it out. I'm aiming to do my stretching routine twice a day - does that sound about right? 

You're right - the pain had almost completely faded after my initial 3 day rest period between Tues evening - Sat morning; but when I started running again it kicked in after about 5-10mins! I suppose the annoying thing is not being able to know if it has truly healed before setting out again! 

As soon as the roller arrives I will start using that twice a day during my stretching routine too. It's a frustrating prospect having to do much shorter runs of less than 5k to get back into it when you know you are able to consistently run more than 10k! 

03/11/2013 at 21:03

Hey Steven,

 

I only stretch when I am warm (dynamic stretches or maybe cycling if you can manage). Foam rolling I would take it easy to... I nearly cried when I used it on my ITB/glutes for the first time. 5 mins max and I was off!!

take is slow and steady and also drink plenty of water post foam rolling. I get a headache if I don't.

Defo look at getting new shoes or look at your run form. I used to be a heal striker and that didn't help! took me a month and a bit to convert and have never looked back! (times went from 1:05 10k to now 48 mins

04/11/2013 at 12:58

Can't be bothered to re-post, so check out this thread (only a short one) on ITBS.

http://www.runnersworld.co.uk/forum/health--injury/itbs-it-band-problem/267862.html

10/11/2013 at 22:41

Hi Roger, thanks for the post.

12 days since I started feeling the knee pain now and it is still very painful. I bought an 'all day' knee support from Boots the other day which I have been wearing for long periods - not sure if it is really helping at all yet. I feel like applying more pressure to the knee area may actually be causing me more pain... 

I also purchased some deep heat which I have been using infrequently - not sure if this is a good idea if I do truly have ITB problems? 

The epicentre of pain is still very much located around the outside of the knee cap, however I have also started feeling pain around the front of the knee and other areas around the outside. The only way I can describe it is a 'twisted' feeling, and it does feel more painful when I am actually twisting or turning, and walking up and down inclines of any sort (even very small curbs etc.). 

I have a physio appointment on Friday and I am hoping they will be able to determine whether it is actually an ITB problem or something else. In the meantime I am going to lay off the stretching and foam rolling as I have been doing it for over a week and am seeing no results whatsoever. 

10/11/2013 at 23:28

If it is ITBS I'm afraid deep heat and knee support are unlikley to do any good, as it is friction between the bone and tendon on the outside of the knee that causes the pain and if not resolved may manifest as other types of pain in and around the knee. 

If it is ITBS your physio should be able to tell what is causing it as there can be several root causes. If I were you I would do some reading up before going on Friday so that you will have some base understanding of what the issue and treatment may involve. Forewarned is forearmed and all that.

A decent intro can be found here : http://www.athletico.com/2012/06/05/it-band-syndrome-the-top-5-causes-and-solutions/

I will ask this again though, where on your leg are you rolling? 

10/11/2013 at 23:54
Thanks for the comment. I have already done quite a lot of reading up on the issue but that page was very helpful too! After giving my it band close to the knee joint a long rub it seems to extremely temporarily relieve the pain. I'm also hearing a popping sound coming from my right knee every time I bend and contract it. There's also sometimes a grinding sound coming from within the knee cap when I bend it too.

I have been rolling the side of ny leg up and down just like most of the YouTube videos instruct. So I put the roller underneath me and lie sideways on top of it while going up and down the it band.
10/11/2013 at 23:56
Like I said in the original post, I absolutely nailed it down a hill during training and I'm almost certain that's what started the problem off. The strange thing is on the actual night I can't remember feeling much pain at all. It was only the following 2 days that it struck with vengeance!
11/11/2013 at 00:11

Like on the other thread, I'm afraid rolling the side of your leg for IT band issues will do sweet FA. The IT band is tough and relativley inflexible so rolling the band directly will not release ANY tension, it is the muscle groups connected to the band which need rolling if you are to get any relief, ie TFL, glute med and glute max. The most common culprit is the TFL located on the front of your leg/ hip above the quad, a tennis ball works better than a roller on this little sucker.

Roger the dodger wrote (see)

Thought that might be the case, most do. 

What you're doing there is foam rolling the ITB itself, unfortunatley as the ITB is made of fairly inelastic matreial, rolling it directly will not release any tension (tension that is probably causing your pain/ discomfort). 

What you need to concentrate on is the muscles connected to the ITB. If you are getting pain on the outside of your knee then chances are you have a bit of muscular imbalance between your gluteus medius and tensor fascia latae (TFL). 

Short term fix would be massage the TFL in order to release the tension in your ITB, can use a foam roller but due to the location of the TFL a tennis ball might work better: 

http://www.rangeofmotionnyc.com/wordpress1/wp-content/uploads/2013/03/picture191340683655588.jpg


 

This will most likley get you through the race.

A longer term fix would be some strengthening exercises for your glute med to address any imbalance.

 

25/11/2013 at 22:49

I had IT band syndrome as well and foam-rolling worked really well for me. It was gone in 3 weeks, I was also given  some strengthening exercises for my gluts and medial hamstrings.

this blog explains how to do it, last post: http://victoriaparkfitness.com/blog/

06/12/2013 at 08:43

Hi Lucila, it has been over 5 weeks since i injured my knee now and i can still feel it. i am reluctant to start training again just yet in case it comes back. i have been seeing a physio at work who massaged my IT band this week which i think really helped - it felt a lot better afterwards.

the article on foam rolling in your link is good - especially the pictures of the different foam rolling techniques. it looks like the IT band and TFL rolling techniques are the same though?

i always find my arms start to ache after about 2 mins of rolling too as i'm using them to support some weight.

06/12/2013 at 09:18

Steven - I'm sorry to be the bearer of bad news but ITB injuries can hang around a long time. I have been suffering with it for 9 months and I have heard of people with it for 18 months to 2 years. I haven't suffered with it too badly for the last couple of months but it has been slow progress. I started with about 5/6 weeks of doing no running but did go to the physio a few times who gave me plenty of exercises and stretches to do. When I started running again I did 1 mile on grass each day and after a couple of weeks of that I increases the run by 10%. After about 4 months of thinking I was OK I increased the mileage but much too quickly so it came back again. This time, however, I have taken it very slowly and didn't run over 5 miles in one go, I also kept away from speed work and hills. For the last 2 months or so things have been going OK and I'm  now up to nearly 40 miles a week with a long run of 16 miles. My advice to you would be to do as much stretching, exercises, plyometrics, rolling etc as you can, take your running very slowly indeed and increase very gradually. While things are going OK for me at the moment I know it isn't back to normal yet and it does feel as though it can go at any minute. Good luck

Edited: 06/12/2013 at 09:19
06/12/2013 at 09:37

I was going to comment on this but Roger has provided a very comprehensive answer!
Steven problems with you IT band should be considered indicative of a problem elsewhere. It cant really be stretched, it isnt a muscle, although i have found that rollering does help with adhesions.
the problem will be with the muscles attached to the IT band which will have gone tight, and are now pulling on it. causing your IT band to pull on your knee.

06/12/2013 at 10:33

Hi carterusm, thanks for the reply. dont worry, i have read elsewhere that IT band problems are recurring and it is actually what stopped my dad from running when he was my age. i think the major point for everyone is that increasing mileage too quickly inevitably leads to injury, if it's not the IT band it will be something else in either the knee or leg.

i am going to leave it for another 2 weeks or so and then start with a 1k run around the block. i will also make sure i have my gait analysed and purchase some new running shoes. to be honest if you are now able to run 16 miles it is very reassuring for anyone with IT band problems to read this.

how long do you spend stretching before running? and do you do IT band stretches before and after running? i don't think i was giving myself enough time to stretch before i injured myself, and i would never warm up before stretcing either!! the problem i'm having now is figuring out how to warm up before stretching at home when i'm injured... i usually just do star jumps but that can actually cause pain in the knee!!

Edited: 06/12/2013 at 10:35
06/12/2013 at 10:43

Steven - I had to admit that I have never done stretches before a run. After visiting the physio I kept up with the stretches for a couple of months but I have to admit that I haven't done any stretches in the last 3 months or so. I know I'm not doing myself any favors and really should start up with them again. Here are a couple of links to some stretches and exercises that might help you - http://www.knee-pain-explained.com/iliotibial-band-syndrome.html - http://strengthrunning.com/2011/02/the-itb-rehab-routine-video-demonstration/ - http://www.runningwritings.com/2012/02/injury-series-biomechanical-solutions.html

10/12/2013 at 15:36

Noticed a slight pain and quiet grinding/popping sound coming from my knee every time i bent and contracted it last night. The strange part was it was only coming from my right knee (the injured one) and not the left. It wasn't too painful at first but when i continued doing it the actual popping began to hurt and bring back the original feeling of pain from the injury.

it basically feels like there is trapped air there, and if i bend it enough an air bubble will pop in the knee - this isn't too painful though. it definitely feels as though the IT band is rubbing over the knee cap and that is what's causing the pain, i could feel it so clearly last night that i could almost picture exactly what was happening in my head.

i will be buying some proper running shoes very soon and hoping to try and do a short 1k run either next week or the week after. until then i will continue doing some light stretching at home - i say light because i found that if i stretch too much it actually brings back the pain!! will let you all know how the run goes - definitely going to keep it to a flat surface too!!

11/12/2013 at 16:05

Hi Steven,

It sounds like you've done some really good research into what could be going on and diagnosed the condition you have.

The one thing I would say is you need to go one step further and ask 'Why did I get this condition in the first place?' 'Why is my IT band rubbing abnormally against my knee and why is it tight.'

Muscles and bands and other tissues get tight for a reason. Often it's because they are having to stabalise another part of the body which is not doing it's job properly. Or because those structures are out of position which causes a tightening of surrounding tissues.

Only if you go after the root cause will you find a permanent solution.

Putting on straps, or changing sports, or altering your running pattern might help temporarily, but often, the pain returns even with your reduced activity either in the same location or somewhere else, as you haven't addressed the root cause.

So what could be going on with you? Well the IT band essentially runs from your pelvis and hip to your knee. So if either of these structures is out of alignment they will not function properly, and therefore the IT band will not function correctly either.

Carry out a few simple tests for yourself...

Stand in front of the mirror and see if your feet and also your knee caps point straight ahead or do they face in or outwards at an angle. 

They should point straight ahead. Them being at an angle means the legs will not operate as they were designed to.

Also, stand up and close your eyes. Do you feel the weight evenly balanced on both feet and evenly on each foot? Or is one side more dominant and is the weight more on the inside or outside of the foot? Again, if it's not evenly balanced it's a sign of dysfunction.

You also need to get your hip joint assessed.

Good luck with everything and feel free to ask me any questions.

Ameet Bhakta

Postural Alignment Specialist

www.healththroughposture.com

 

 

12/12/2013 at 22:03

I'm currently suffering with a very similar occurrence of ITBS.  Mine came on after a 10m trail race in October during which I was ascending & descending some fairly steep inclines, in fact I remember thinking "this can't be good for me" whilst my feet were literally "slapping" the hard stone paths on downhill sections.

Pain started about 30mins after the race, and if anything got worse in the subsequent days.  Walking was almost out of the question, never mind running.  After getting bored with the rate at which it seemed to be healing I contacted a local physio for help.  I've since been strengthening my glutes, stretching my hamstrings and generally trying to improve my balance.  My physio has also been performing a sports massage during each visit.  At first it was still a struggle to run anywhere, therefore I kept myself sane by getting out on my bike which didn't seem to aggravate the injury too much.

The best advice my physio has given me is to not tolerate ANY pain.  He likens ITBS to a smouldering fire, and until the dying embers are completely extinguished, it's very difficult to make progress, and very easy to (re)inflame the injury.

I'm happy to report that I've been out tonight for a quick run (no more than 2.5k) which included a couple of hill sprints, and also a little walking (although that was more to do with a stitch than anything!).  I'm running nowhere near full pelt (I run a sub 40min 10k), however I'm targeting my local Xmas Day Parkrun and feel as though I'm on track.

So, ultimately I'd get to a physio....it was music to my ears to hear that I had a "classic" case of ITBS.  Also crucially, don't overdo it.  I was climbing the walls at first when I wasn't able to get outside, but the more you push it, the longer it will take to recover.  Also forgot to mention that I was prescribed a course of anti-inflammatories by my GP which seemed to help, my physio also agreed with me taking them.

All the best in conquering your injury!

12/01/2014 at 17:26

Thanks Ameet & Bobby for your responses, ITBS isn't an easy one to get rid of but with enough work I believe anyone can improve!

its been about 3 months since I injured myself now and I have seen the staff physio at work several times who has confirmed the injury is likely ITBS. I have set up a stretching & strengthening routine that I can do in the home and I have been doing that consistently (almost every day) for about a month. this involves just stretching all the different muscle groups in both legs and then a number of strengthening exercises to try and rectify any muscle imbalances which may exist.

I have signed up for a 5k in early march and have risked going for a few short runs recently. today I successfully completed a 3k which is the furthest I have run since when I first injured myself - glad to say it went pretty well (although my time was a lot slower than I used to run) and there doesn't seem to be too much pain coming from my right knee, just a sight bit of tightness around the top of the calf/behind the knee area.

I feel as though the strengthening exercises really help, and that my leg muscles are slowly getting stronger. I also bought a gel ice pack which I use after each run at the moment - these are great as they conform to whatever shape you need even when frozen, I would highly recommend! (mine cost about £7 from Boots). the reason for this was that I felt there was some very minor swelling developing behind the right knee each time I have been going for a run recently, therefore I have been icing to try and prevent that!

just thought I would give you guys an update, and I hope this info is useful to anyone else who may be suffering from ITBS. my main advice would be:

  • let it rest until the pain has completely gone,
  • write down a stretching/strengthening routine that you can do at home to try and condition as many leg muscle categories as possible,
  • GET PROPER RUNNING SHOES WITH A GAIT ASSESSMENT FROM A SPECIALISED RUNNING SHOP,
  • when you feel comfortable begin some short runs of 1-3k on a FLAT SURFACE,
  • if you experience any pain during stretching, strengthening, or running stop immediately and let the knee rest and apply ice for 20mins at a time!

hope this helps, thanks guys!


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