IT Band/Knee Pain

svgreengoddess--I've read

svgreengoddess--I've read that running FASTER can help with IT band issues, though I don't think of it as a foot strike issue. One day I was having a rough long run, with lots of IT band tightness. I had to keep stopping to walk, more than I wanted to. Then I came to a busy street and sprinted through the crosswalk...and seriously, that short sprint was like an awesome dynamic stretch for my IT band, and I was okay for the rest of the run! It was just a little further (maybe 1/4 or 1/3 mile) so my IT band might have tightened up a bit after that if I'd kept going. But I really do think that doing a bit of faster running (in between your longer, slower run intervals) can help.

I also have started doing run/walk intervals in the last 3 1/2 months. (I usually do 4 minutes running/1 minute walking.) I'm able to run faster during my running portions (and faster is probably good for my IT band), and then switching to walking uses different muscles, which many people (like Jeff Galloway) feel is a good way to avoid overuse injuries. Sometimes when my IT band is feeling tight, it seems to loosen up as I walk. And you know what? I'm a faster runner when I utilize walk breaks! My pace is better overall because I don't have to try so hard to conserve energy while running--I can push harder, knowing a walk break is coming up. I still feel somewhat weird using walk breaks--but they make me a better, faster, and probably even healthier runner. Walk breaks work...at least for me!

When you want to keep a midfoot/forefoot strike and run faster, you have to think about letting your foot trail BEHIND you longer before picking it up, while keeping the same cadence. (As opposed to a heel strike runner who might try to put their foot further in FRONT of them when they step down. I find that when I try to do this, it feels like a nice dynamic stretch. Remember that your legs mimic what your arms are doing, so think of pumping them further behind you to help lengthen your stride. When running with my (very slow) 5-year-old, I've even let myself slow my cadence so I could make my stride longer--just while my IT band felt tight. I wouldn't normally want a slow cadence, but I think it may have helped me get through that run without my IT band totally cramping up.

These three Chi Running arcticles were so helpful to me! Scan all of them--the last one was where a light really went on in my brain.

ITBS article, level pelvis article, pelvis rotation article.
 
Great post Beth.  You rock.

Great post Beth. You rock.
 
C. Beth Run.

C. Beth Run. said:
svgreengoddess--I've read that running FASTER can help with IT band issues, though I don't think of it as a foot strike issue. One day I was having a rough long run, with lots of IT band tightness. I had to keep stopping to walk, more than I wanted to. Then I came to a busy street and sprinted through the crosswalk...and seriously, that short sprint was like an awesome dynamic stretch for my IT band, and I was okay for the rest of the run! It was just a little further (maybe 1/4 or 1/3 mile) so my IT band might have tightened up a bit after that if I'd kept going. But I really do think that doing a bit of faster running (in between your longer, slower run intervals) can help.

I wonder is running fast intervals and sprinting might help since it is essentially strength work? Maybe even hills?
 
Abide wrote:I wonder is

Abide said:
I wonder is running fast intervals and sprinting might help since it is essentially strength work? Maybe even hills?

While I think it's the dynamic stretching aspect that leads to immediate relief when running faster, the muscle strengthening probably helps to resolve the issue in the long term.

However--be careful about hills when you have IT band stuff going on. Hill running can actually stress out the IT band more, so I've read you should stick to flat ground when you have IT band issues. When I was first dealing with this, I went to a (very boring) flat route until I was doing better. Honestly, lately even if I have issues I often still do hills. :) I have some confidence knowing how to deal with a flare-up when it happens now so I'm not perhaps as careful as I should be. But the advice I've read says not to, and it makes sense to me.
 
I'm signing up to be the hill

I'm signing up to be the hill test pilot. I live on one and since I start most runs from home there's always some hill in there somewhere. Just did somewhere around or over 6 miles (with Doug and Josh from our chapter) and my knee only hurt a little towards the end so the stretching and rolling is working. I'm amped to be getting my legs back. Feels so good to be able to really run in the woods again. :)

Beth you have given me confidence to keep running while working on it. Thanks!
 
Woot woot, Joshh, I'm SO glad

Woot woot, Joshh, I'm SO glad it's getting better!
 
This is a great thread.  Lots

This is a great thread. Lots of people getting help.
 
you guys are all an

you guys are all an inspiration for me! i saw my chiropractor yesterday and she reiterated the importance of strengthening my inner thigh muscles to help with the IT problem, and the importance of rolling. she also watched me walk and said my pelvis, hips and upper body look extremely stiff and my feet are too wide-no wonder running is painful!

she also said that despite the extra weight i'm carrying my muscles are really strong so somehow i just need to loosen up when i walk/run.
 
svgreengoddess--I'm glad you

svgreengoddess--I'm glad you got some help!

Various factors combined to give me some discomfort today during my long run. I tried a new method of dealing with it, which I'll share with you. I will preface this by saying...I probably should have cut the run short. But I didn't want to. So at least I found a way to deal with it that didn't allow it to get super-inflamed, and it kept my pain pretty minimal.

I did a 14 miler today (longest ever!) and had rapidly-worsening tightness/cramping in my right leg about 6 miles in. It was my IT band, knee, calf, quads--I was just tight today! So I took an EXTENDED walk break--around 12 minutes. That was after already taking a walk break of 5 minutes or so and then trying to run and realizing I was still tight. The LONG walk break helped me to loosen up a lot--I had been on the verge of entering into real pain, and I got past that point.

Then I switched away from my normal run/walk ratio (normally 4 min run/1 min walk) and instead did 1 min run/1 min walk for several minutes. I pushed my speed during the running parts, to give the leg some dynamic stretching. That really helped. And by taking the frequent walk breaks, I was resting the muscles. For the rest of the run, it was still a little achy, and honestly I was just tired today, so I changed up my run/walk ratio repeatedly, from 1/1 to 3/1 to 2/1, etc. Just did what worked. By the last mile or two it was feeling better, though not 100%.

Again--probably not the wisest course of action to keep running, and I'll pay for it with soreness this week. I'll need to do lots of rolling and probably some extra resting this week. But at least I do have a strategy for getting through a long run if I'm having IT band issues. Normally I should probably save this strategy for a really important run, like a race. So--my "official advice" would be NOT to use this strategy at all, or at least to only use it when you are doing a truly important run. And even then--if your IT band gets truly, really PAINFUL, walk as long as you need to, or stop the run early. But I gotta say--it really did feel good to be able to find a way to work past the worst of the tightness in the middle of my run, so that it improved through the rest of the run.
 
Thought I'd update a day

Thought I'd update a day after my long run. I tried to do a short "recovery run" with my 5-year-old daughter this morning and it ended up being mostly a walk. My IT band is mad--I definitely pushed too hard yesterday.

My prescription for myself--RICE (rest/ice/compression/elevation) and rolling. I'm sure it'll be fine soon but for now it's definitely inflamed in there and I can't run on it.

My conclusion? This new strategy for getting through the discomfort is a good one to keep in my back pocket for race days ONLY. It'll probably be several days before I can do much if any running again. It's not worth it to miss out on a bunch of this week's running just because I got greedy for mileage yesterday! But honestly it would have been worth it if yesterday had been a race.

And I had good reason to know that yesterday might be rough--it had been a busy week and I think I was still recovering from pushing so hard at a hilly 10K last Sunday. My leg was sore in multiple places Friday night. I should have listened to my body then and put off the long run for a time when my body was in a more rested/relaxed/strong condition.

I've learned how to prevent ITBS from flaring up most of the time, and I've learned how to get past it when it does become an issue. What I need to learn now is how to respect my body enough to give it a break when it's telling me it needs it. I got overconfident, and I'll probably be paying for it for the next few days.
 
 It has been interesting to

It has been interesting to me (being new to the minimalist/barefoot running craze and being a PT) that in every website I have found, the advice has been to start slow and wean into running "barefoot". Good advice for many people taking on this endeavor.

I believe that one thing that should be addressed is a person's skeletal alignment and muscular balance. Starting slow is excellent advice but to HOPE that a person's body will adjust is a gamble. So many of the described injury issues I am reading can be attributed to misalignment of the hips or ,as your example shows, an upper body issue.

The most common issues linked to hip misalignment are: plantar fasciitis, achilles tendonitis, patellar tendonitis, IT band syndrome, hip flexor tendonitis. The issue starts with our society's general lack of activity and most of our time spent sitting (either work/school/video games). 40 hours or more of sitting versus 20 minutes x 3-4/week, which do you think wins? And consider that many people started running for health reasons after years of mostly being sitting/relatively inactive. Also consider how much the majority of people spend time working on flexibility countering the negative effects of "the chair".

The human body has an amazing ability to adapt to the demand placed in it. If "The Chair" is what our bodies are exposed to for years and years for hours upon hours then it will adapt to the chair position. The result is shortened or tight hip flexors, tight hamstrings, external rotation of the hips and ,depending on the type of work, rounded shoulders with a forward head. Unless the "char" is addressed and taken out of the body it (the body) will compensate for the issues I described. This leads to stress in structures in ways that are not natural. Like a car that is out of alignment, the signs are subltle and get worse with increased demand. Tendonitis , where ever is might be felt, is a sign that something is not aligned/functioning properly. The question is what is the cause not just treating the symptom.

Tight hip flexors prevent the hip from extending leading to stress in the low back. External rotaion of the hips can lead to landing too much on the outside of the heel/foot and loading onto the outer knee and loading onto the IT band. Inversely an internally rotated hip leads to loading onto the inside of the foot/ arch (plantar fasciitis), loading onto the inside of the knee.

These issues can be addressed through progressive and directed exercise routines. This along with a gradual weaning into minimal/barefoot running can decrease the amount of injury being seen "Due to barefoot running" as many nay sayers are quick to point out in their efforts to discredit the natural way we were meant to ambulate.

More later on the effects of modern footware and the upper body connection

Orlando Gomez PT

www.adapttraining.com
 
Am I having deja vu, or

Am I having deja vu, or didn't you post this a day or two ago somewhere else, Orlando? ;-)
 
I wanted to resurect this

I wanted to resurect this thread just to share my own woes.

I have never had ITBS before 5 July 2011. I developed it on a short training run (4 total miles). It started at mile 2 and I had no idea what it was and ran through it for the last 2 miles. After the run, I quickly figured out what it was via this site, RW-Barefoot Forum and a handy physical from my wife who luckily is a physician.

For interest's sake, I'm normally a barfoot runner, meaning skin to ground, but on the 4th of July (the day prior to the flare up), I did a very rough chip and seal race in VFFs. The course had a bunch of hills. I don't normally train on hills. So, I don't know if any of these things had any part in the injury, but I thought I would put it out there. I suspect the combination of unfamiliar hill running and VFFs may have contributed to the injury, but I can't prove it.

Anyway, I got some great advice (Thank you C. Beth, SayPay, Abide, Barefoot Gentile, and others I have not mentioned). I have been doing a lot of crosstraining, weight lifting, hip strengthening exercises, etc since the injury. I've used ice, the foam roller/torture device, Motrin, deep knee bends, etc. I incorporate some static stretching after crosstraining. I've been doing a ton of swimming in the hopes I can maintain my cardio if not improve it.

I was feeling pretty good after over a week of no running and doing the activities above. So, I decided to go ahead and attempt a 10k on 15 July that I had already registed for and planned for prior to the injury. I got a little over 2 miles before the ITBS started to flare up. I stopped the race and walked back in shame to DQ myself. That hurt my soul.

Alright, so now I'm not running endurance. I recently did a few sprints after playing a little soccer with my son. I felt the beginning tingling of the early pain I feel with ITBS and did a couple of 50 yard sprints. Pow! Pain gone. I did a few more for good measure. That night and the day after I have no pain. I'm still not going to try an endurance run however. Thanks to Abide for this advice about sprints.

Now, my questions. Have any of you long time ITBS warriors ever tried to incorporate sprints into the long runs/races to alleviate the pain? If so, how did it work out? I'm wondering if I were to attempt this on a long run if it would have good results or end in disaster. I'm talking about doing a couple of 50ish yard sprints in the middle of a race if I start feeling the pain flare up.

Also, as I continue to strengthen the hip and loosen the IT band I've been eyeing one of those IT band straps that go around your thigh (pro-tec IT band thing). Has anyone had any luck with these or are they equivalent to snake oil? I know it's not going to fix the underlying problem, but I wonder if it could be used as a tool during a run while I continue to work on correcting the weak muscles.

Thanks in advance.
 
So, ITB pain = run faster. 

So, ITB pain = run faster. Who wouldathunkit?

Do those bands cost a lot of money? If not, I'd say why not try it. Could it hurt?
 
Barefoot TJ wrote:So, ITB

Barefoot TJ said:
So, ITB pain = run faster. Who wouldathunkit?

Do those bands cost a lot of money? If not, I'd say why not try it. Could it hurt?



Hey, TJ. They're not expensive. I found it on Amazon for $15.

I hope someone who has tried it out pipes in. I'm not afraid to be an experiment, but if there are any hints for suggestions I can pick up beforehand, I'm open.

I'm also willing to test out sprinting on a race. Mainly since I signed up for the Hottest Half in August and I am willing to do just about anything to run it....including but not limited to wearing chicken bones, strangling kittens, etc.
 
Oh no!  Don't strangle

Oh no! Don't strangle kittens! Don't! They're furry, cute, and cuddly. Yes, I'm a girl for those still wondering!
 
Talonraid, for me massive

Talonraid, for me massive amounts of rolling was really the silver bullet. Once you do it enough, it doesn't hurt anymore and you'll no longer think of it as torture. Just my $.02. Good luck!
 

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