IT band and marathon training

[sloutre]

Here is the deal: I registered for Philadelphia marathon (Nov 20th) but I cannot run more than a few miles without pain in my knees and hips, probably cause by ITBS. Running barefoot seems to help, whatr else can I do?



The long version:

In the Spring (May, June) I could run a half marathon distance barefoot at any time

I didn't run barefoot enough during the Summer because of travels so I decided to order a pair of Lunas so I could increase my mileage a little faster than what my soles could take. (Stupid error #1)

First 13 miles in Lunas was awesome. I was full of energy, fast by my standards, confortable, happy. Nothing could stop me.

2nd week in Lunas: Pose workshop followed by a long run that didn't go well for a variety of reasons and I ended up walking 6 miles with a little blister on the side of my foot caused by the laces but no knee/hip pain.

3rd week: Everything was perfect for the first 10 miles and suddendly I had that pain on the outside of my right knee. Since I forgot my cellphone I walked 2 miles home while the pain increased. The next day a visit to the chiro made the knee pain dissapear. A few days later I ran 8 miles, barefoot and in leather thin sandals, with no problem.

4th week: 10 great miles and then the pain again. I called for a ride home. The chiroprator couldn't fix me this time, she said everyhthing was aligned properly.

5th week in Lunas: After an entire week of rest I felt the pain after 6 miles. I rested, rolled a little (should do more), did strengthening exercises for the hip flexors and abductors (I think) and waited for the next run.

6th week: 5 miles in Lunas and the pain came back. I was not far from home but I thought walking would be painful. For some reason I took off the Lunas and started running toward the house and the pain disspeared. I passed my house and ran for another 2 miles barefoot before the pain returned.

The following day I ran 5+ miles barefoot and the pain returned in both knees and hips but it may be because I didn't recover from the day before.



Questions:

Even if I focus on lift, short and quick when I wear the Luna sandals I think I may be overstriding, or my form degrades in some other way. I don't run properly in them yet. So I should run barefoot only. But I don't think my soles can take more than 10-13 miles barefoot at this point.

How much should I roll? And is it enough to recover and start the next run in "like new" condition?

Should I do the hip strengthening exercises up to the day before the run or are they tiring the muscles that I'm supposed to rest?

Is there anything I can do during a run (massage, strech) to be able to go a little further on race day? Shaking my leg seems to provide relief for a brief while but I didn't find stretches that worked.

I think if I can run 16 miles whithout pain in training it's worth trying the marathon. I feel so strong and full of energy after each run it would be a waste to not try. Is it crazy?

 

[sloutre]

Come on guys, I know the IT

Come on guys, I know the IT band issues have been discused over and over but can anyone help me?

I did some more rolling yesterday and it seems to hurt more today. Did anyone experience something similar?

 

[saypay45]

The only way to get rid of IT

The only way to get rid of IT band issues is to rest. STOP RUNNING!

So the reason that you're able to run progressively less doesn't have anything to do with all that rolling, stretching, hip strengthening stuff. IT band syndrome is essentially an inflammation of the tissues around your IT band. If you don't let the inflammation go down, you're only contributing to it with each subsequent run.

You can begin all that other stuff once you can run pain free.

Seriously. It's only going to get worse. Take my advice and I promise you'll be back running in a few months. Don't take my advice, and I promise you'll have lingering pain for the better part of 2012. I've done it both ways.

 

[sloutre]

Thanks Saypay. It's not what

Thanks Saypay. It's not what I wanted to hear but that's what I need.

I got confused by all these coping strategies I read about online (and didn't seem to work for me), that make it look like you can run with IT band problems. I was expecting a miracle trick, but like for everything else there is no shortcut.

I guess it's time to start a new form of workout until I can run pain free again.

 

[Barefoot TJ]

I don't know anything about

I don't know anything about IT problems, so I keep my trap shut. Have you thought about posting this in the Ask the Docs forum? Get well, Sloutre!

 

[NickW]

I don't know anything about

I don't know anything about them either. I injured my IT band years ago while I was in the military, but I don't remember anything about it or what we did to heal it. I think I just had to lay off it, but I don't remember exactly.

 

[zapmamak]

Sloutre - oh I am totally

Sloutre - oh I am totally with you on this!! I know exactly how you feel. I agree with SayPay that its an inflammation and to rest. I think you are aware of my strategy (from DM) which is the no LSD runs and instead replacing it with HIIT training. At least it seemed to pay off for me with my recent marathon. If you need to run it wouldn't hurt to follow up with some ice baths as well. I know there's a lot of hemming and hawwwing on this, but I was doing this after all my workovers before race day and it may have helped me get through my marathon. I would do an ice bath and follow with a warm epsom salt bath.

Also, one of the things that I started doing about 4 weeks prior to my race was getting up early in the morning (before the crack of dawn) and spending a good 40 minutes rolling my achilles, calves, quads, outside of knees, hips and glutes. I can't be sure, but I noticed some major tension in my glutes and deep in my hip sockets which could have been contributing to my IT band issues this whole year... I would lie on a baseball until the muscles finally released and would work these trigger points every day. I had no idea my butt was so tight!!! It was very painful, but I finally worked it out so I could lay flat with a baseball deep in one ass cheek without any pain at all. Ha! Yeah. That was a serious accomplishment.

On race day I also focused on my form as I tend to overstride, which I am almost certain doesn't help and aggravates any issues I already have. I focused on keeping my feet directly under me by increasing my cadence. I also walked a bit more than I am used to (although the trail was pretty gnarly and there were a LOT of people walking parts of it.)

Also, I notice even when I'm not running I hold my body in tension for some reason. I've been focusing more on relaxing my body and doing a "body check" to see where I'm tightening up and then making an effort to release and relax those muscles. I did this during my marathon as well when I stopped to walk especially uphill.

Not sure if any of this will help you, but I know you and I have similar issues. Oh and when you roll, get something like pipe or a badass wooden rolling pin to roll yourself with. The foam just doesn't get into the deep stuff as well. Just my two cents. ;-)

 

[sloutre]

Thanks everybody for the

Thanks everybody for the support. I'm convincing myself to stop running. We will see for how long it will last.



Krista, I've been thinking a lot about your training considering the success you had with you trail marathon despite previous issues. I don't think I will get a personal coach but I will try to do some type of high intensity training by myself to burn the energy while my running is on hold. I hope it put me in a better mood. I was thinking of starting with the things described in Jason's book.

I'm already an adept of the ice bath + Epsom salt bath and when I start running again I will definatly do it again.

Regarding the rolling, I'm glad I'm not the ony one: the baseball in my butt chick hurts like crazy. I was not sure if I had to keep doing it every day or wait until it heal and relax a little by itself from rest.

 

[saypay45]

I do agree with Krista.  As

I do agree with Krista. As long as you don't have pain in your IT band, doing strength training is a must. The root cause of IT band pain is generally glute weakness and/or hip weakess (or stiffness).

Runners generally have really crappy glute and hip strength and even worse mobility. Workouts like Krista and I do that are really squat, deadlift, and lunge heavy are great for all of those issues.

My recommendation for workout plans for all runners is K-Crosstrain for Runners. Very good program by my friend Pete Kemme.

 

[sloutre]

Pete Kemme plan is second on

Pete Kemme plan is second on my list. My problem with that plan is that is uses a variety of exercices that I've never heard about. I appreciate the links to a video for each exercice and I know they are pretty simple but I cannot watch and learn 10 different exercices at a time.

For the first few of sessions I will follow one of the formats mentioned in Jason's book, with repeats of only 5 different exercices per session. Once I feel confident with the whole repertoire I may switch to Pete's plan.



Before, I stayed away from strength training by fear of doing more damage than good. I was afraid of creating imbalance by working some muscles and forgeting others. I though that running with good form would develop the muscles I need to run with good form, a kind of minimalist training approach. But since I don't have perfect form and my mileage was getting serious it didn't work.

 

[buzzie]

Thanks for the K-Crosstrain

Thanks for the K-Crosstrain link, saypay!

I've looked at CrossFit stuff before and found it all a bit overwhelming... lots of insider jargon, a zillion exercises, all kinds of homemade equipment (which is all great, once you're in the know). This document makes it seem approachable and seems to give a pretty clear idea of how to get started.

And, for me, the timing is great - coinciding with a few other lifestyle changes I have in the works.

 

[NickW]

That link is awsome saypay!

That link is awsome saypay! Thanks!

 

[zapmamak]

Cool link, SP! Nice to have

Cool link, SP! Nice to have some other resources. I end up having to look few things up online when doing my workovers because even though I have a coach writing the programs for me he is not able to be there for me 100% right now. He will be opening his own gym sometime next year (I'm working on his logo/identity). Eventually, I will be able to work directly with him a lot more.

Sloutre - you might find you really enjoy the HIIT training. It can be a lot of fun. It also kept my fiyah for trail running. I was chomping at the bit to go long on the trails at my marathon. That was a really good thing.

 

[buzzie]

Dr. G - Wow that was an

Dr. G - Wow that was an interesting story!



I've had my own battles with the IT band - mine at the point of insertion. (I'm better now after much glute/hip strengthening/activation, soft-tissue work, rest, etc.. But, more than a year later, it still lets me know it's there in day-to-day life - usually just small chirps, and it doesn't tend to flare when running.)

Nevertheless, I have a bunch of other niggling things going on and just feel like I'm bound up in some way and totally out of whack, unable to move freely, fluidly.

Just last night I was having dinner with my ART/chiro friend... she suggested an acquaintance certified through the CHEK Institute. I looked into it a bit...not overly encouraged that anyone local would have any idea what to do with me.

But, after that story; well, I'm curious to spend more time checking out your site...learning about applied kinesiology and the other magic you do.

 

[Dr. Gangemi_SockDoc]

I've never had to have a

I've never had to have a patient stop running to resolve their ITB problem, other than maybe 1-2 days. It's a nasty injury and whether someone stops to rest or not, they're still going to have it for months, regardless. Sure it may go on longer if you keep running, but it's not like your pain is going to be gone quickly if you don't run. Conventional therapies fail this ailment big time.

Here's the SockDoc video and post on ITB http://sock-doc.com/2011/03/itb-frictional-syndrome/

And here's a post from a well known runner/blogger who had ITB for 6 months (and rested), didn't get better in that entire time and I was able to resolve in

 

[saypay45]

Not everybody has access to

Not everybody has access to someone like you Dr. G. My point is that in those cases, the old "let's keep running and hope that it gets better by rolling on a piece of foam afterwards" is a strategy that just cases further worsening of symptoms.

 

[sloutre]

Dr. G, that's an amazing

Dr. G, that's an amazing story. But like SayPay points out, it's hard to find people like you. And the source of the problem could be so different form person to person that one cannot apply the miracle cure that worked for another runner and expect it to be successful. I may try a local chiro, ART guy who has a lot of experience with athletes but I'm not expecting any kind of evernight cure.



I started working on exercices from Jason's book, in Tabata format and it's quite satisfying. I usually lay on the floor unable to move or think for several minutes after the workout and then I feel sore but great for the rest of the day.

When I was unable to register for my first half marathon I decided to just run 13.1 miles by myself to check it off my list. And a month later I ran a great trail half and had much more fun than I would have on a road race. I think I'll do the same for the marathon: I'll skip Philadelphia (and go camping with my son that week end instead) and I'll train for a trail run when I feel ready. I had registered before discovering the joys of trail running.

 

[Dr. Gangemi_SockDoc]

Yes SayPay and yes Sloutre,

Yes SayPay and yes Sloutre, agree. I think the take-home message here is that injuries, especially ITB is one of those injuries (as many are) that tend to be from many things gone awry for some time - overtraining, poor footwear, too much of life's demands, poor diet, etc....next ya' know - ITB is killin' you. I've had it twice in college. And I'd say I fit that model.

 

[zapmamak]

Dr. Gangemi -Curious what

Dr. Gangemi -

Curious what your general take on Kelly Starret's Mobility WOD is. His mobility work advocates the "smashing" and realligning of the muscle fibers using the trigger point stuff, but he also has some stretching (like the couch stretch) that he even uses bands for. He's also kinda hyper and can be very technical.

 

[Dr. Gangemi_SockDoc]

Zapmamak - that's insane. I'd

Zapmamak - that's insane. I'd never do those stretches. Way too much torque on the knee. And I never recommend trigger points down that low on the ITB - only on the TFL and Glut Max. I clearly stress staying off the distal (end) part of the band and especially where the pain is felt. The pain is a result of the other areas being out of balance. Mashing on the pain in the fascia only pissess it off more.