Fellowship of the ITBS

BTW, I don't believe you should be stretching an injury. When you stretch an injury, you are tearing apart the fibers that are trying to heal. Try not stretching for a couple of weeks and see what happens. Also, see Dr. Gangemi's article on the home page called Do Not Stretch (you'll have to run a search).
thanks for the welcome! i will check out the do not stretch article.
 
ITBS annoying the heck out of me also.

added running into my weekly exercise routine in april of 2011...worked up to running nonstop for an hour (covering 7 miles).
exeperienced my first ITB injury while running the Tough Mudder ~ mile 11 in October 2011.
Ever since then I cannot run more than a couple miles outdoors without irratating my ITB. Strange enough it seems running on the treadmill doesn't bother me.

went to an orthopedic sports doc recently....he gave me some anti-inflamitory medicine and a worksheet of stretches.
I have been using a dense foam roller and daily stretching; but no luck.

Need to add a few years ago I blew my achilles tendon in half (in the same leg). So that calf muscle is still not 100%...which i am suspicious of maybe what is contributing to my ITB problem.

Now, i am turing to strenthening the muscles in my legs and trying barefoot running. i am hoping that barefoot running will help strengthen my weaker calf muscle and correct any running posture/stride issues i may have.

Just picked up some five finger trail shoes this past week. will follow up with my progress!
Really spend some time focusing on your upper legs and hips up into your core. Weakness in those areas can cause you problems.
 
Hips and core +1.
 

I've started doing this exercise in the last week. Only about 20 at a time, and they have really decreased the aggravation in my left IT band. I suspect it's a bit of the core/adductor/abductor AND arch being worked out. Very interesting...
 
I don’t mean to get everyone depressed, but ITBS can be a hellish, enduring experience. Many people get over it quickly (like, three weeks). Some never do from what I’ve heard. Hopefully my cautionary tale will help people take it a bit more seriously than “I just can’t stop running.” Which may work for you, or some, but if it doesn’t, you’re really hosing yourself.

My experience: Hilly muddy remote trail race in the UK. Seemingly unrelated, at mile 8 I slipped and impaled my right hand on a gate latch, about 1/5” deep (and an inch wide…), almost all the way through my hand at an angle. Bled like crazy, I checked and surprisingly I didn’t do any tendon, severe muscle, nerve, or ligament damage. So I run 2 miles to the next aid station, washed it out, bandaged it up like a boxing glove, and, what the heck, kept going. Figured an extra few hours until the hospital wasn’t going to kill me.

Then, at mile 30, within literally about 10 feet of running, my knee went from totally fine to absolutely not being able to support my own weight on it when bent (as in: so painful my leg collapsed and I hit the ground). While that may sound more like acute trauma than an overuse injury, I’m not alone in it coming up that fast and hard. The problem now was I was in the middle of nowhere, with 5 miles to go, but I couldn’t pull out and wait for help: I had to get to the hospital for my hand (doh!). So I locked out my leg, and hobble-ran 5 hilly muddy miles on a locked out leg. Am sure that did my back no favors. Or my knee.

That brings us to Lesson 1: Pushing on with that injury probably REALLY screwed me.

That was 13 months ago. Here’s what I’ve done since then:
  1. Been through three different physical therapists
  2. Been to one chiropractor
  3. Been to my regular doc (who’s pretty good and knows ITBS)
  4. Done 10+ sessions of deep tissue myofascial release technique (many ITBS recoverees swear by it)
  5. Done 8+ sessions of Active Release Technique (many ITBS recoverees swear by it)
  6. Ice 3-5 times/day + ibuprofen
  7. Had an MRI
  8. Seen Dr. Michael Frederikson, _THE_ ITBS doctor at Stanford University health clinic. He sees the Stanford track team, and is the lead researcher on the initial scientific papers linking weak hips with ITBS. Also referenced here (reasonably good article): http://runningtimes.com/Article.aspx?ArticleID=3528
  9. After visit #3, Dr. Frederikson did an ultrasound guided cortisone shot.
  10. Did the exercises and stretched in the referenced Running Times article for, I dunno, a year now?
  11. Did multiple multi-month layoffs of running completely, followed by trying to run slowly. As in: start with TWO MINUTES of running, and add a minute every week.
  12. Tried those IT Band Straps (three different brands) and taping. No help at all (for me)
For the first 10 months or so, none of that worked. Then I finally found a decent physical therapist (probably part of it) and stopped running again (probably part of it). This PT, unlike most of them for whom I now hold little respect, actually did a gait analysis, decent measurements of all sorts of things I don’t understand, and came up with a bunch of issues that everyone else glossed over. Everyone else is like “Oh, you have a bad case of ITBS, you need to do X, Y, and Z.”

With that PT’s help (in my case a combination of realignments, additional hip exercises, a LOT of glute exercises, and VERY slowly returning to running… I’m now up to 2.5 hours for my long run and about 40 miles/week (to put that in context, we’re talking half my volume from before).

So my input to this is follows: Many may get over it quickly as they simply have a weak glute medius, or tight TFL, or something that is actually solved by the exercises/stretches as provided in that actually very good Running Times article. That’s a good place to start. Many may get over it simply by laying off running for a bit and starting back up. Many may get over it by some simple gait changes. But some of us have some little tweaks, weird weaknesses, stuck fibular head (me), misaligned hip (me), ridiculously off combination of super strong and super weak muscles (me), and the cookbook recipes do not work.

If you are having a REALLY hard time getting over it, you need to step back and probably do several things at a minimum.

  1. STOP running for a month. Lord, at least a month.
  2. Ice several times/day. I’d stay away from the ibuprofen though.
  3. Do ALL the strengthening and stretching work in the article above, PLUS
  4. Do glute work. Lots of glute work. One legged pistol squats. Romanian deadlifts. Lunges… lots of lunges of all different types.
  5. Find yourself a GOOD Physical Therapist who specializes in runners. They’ll all tell you they’ve worked with/solved ITBS. Because they all have. But they all haven’t had complicated cases and frankly if they don’t do walking and running gait analysis, they aren’t qualified to be telling you what to do for your particular difficult to solve case.
  6. Then, start running slowly. Here’s my example: running 1 min and walking 5 for 18 min (that’s three minutes total of running). Next week, run 2 /walk 5 for 21 min total. Next week run 3 / walk 10 for 26 min total. Next week run 4/walk 10 for 28 min total. Next week run 5/walk 5 for 30 min. Repeat that week for 3 more weeks. Then run 7 / walk 5 until 30 min. Do that for two weeks. Now run 8 /walk 5 for ~ 35 min. Do that for 2-3 weeks. You get the idea. Do that until you hit whatever your goal runs are; once I hit an hour of running, I was generally good to go. NEVER, EVER run if it even remotely starts to hurt, and if it does, go back to step 1.
Note: Items C & D may not be your issue, but they can’t hurt. Arch work? I dunno. Other stuff? Don’t know. I think it all depends on what YOUR biomechanical issues are that are leading to the injury. Thus, the good PT is kinda key or you’re shooting in the dark like I did for a year.
 
I've started doing this exercise in the last week. Only about 20 at a time, and they have really decreased the aggravation in my left IT band. I suspect it's a bit of the core/adductor/abductor AND arch being worked out. Very interesting...

Your video is not so dissimilar from the following CrossFit exercise that I think really helped me. The two are different, yet address the same issues and muscle groups. I think you're probably right in your assessment.

 
Ken, thanks for posting that. After reading through a lot of the other threads and articles, I think my case it pretty mild. I've had a few good weeks, but didn't want to post a success story too soon. I know I have a long road ahead of me. For now, I will just have to be happy running shorter distances. I would also like to note that I do the "stretches", but not to the point of hurting, so I don't think I am actually "stretching" and I am rolling, but not to the point of pain. I figure if something is painful, it is probably not good for you.

Others, thanks for posting the videos and other links, I will be researching those.
 
Your video is not so dissimilar from the following CrossFit exercise that I think really helped me. The two are different, yet address the same issues and muscle groups. I think you're probably right in your assessment.


Interesting, as I had no looked at the Crossfit program yet, I would have never known! Now that I have been doing these jumps, I realize that the exercises I had been doing for my hips, etc. have been inadequate because, they just aren't intense enough. That being said, had I not been runing for the last 12 months, reasonably regularly, I doubt I would have even been able to do one of these exercises, at all. So I guess it's good timing. I have been looking for something that I think will really ramp up my strength in preparation for the Dirty Dash and Warrior Dash and I these types of exercises are it for me, for sure. On days when I run out of time to do my lower intensity muscle building routine, doing these basically creates the same benefits and then some. I laughed in pity when I watched that poor person whack themselves on that box. I spent 5 minutes today just staring at a concrete block in a park today, trying to decide if I could clear it with a single jump from a standing position. I decided against it. Because I like my shins. And my face. Lol. I found an instructional diagram/video online that shows how to make those boxes. Which is a very good thing since they cost and arm and a leg.
 
Your video is not so dissimilar from the following CrossFit exercise that I think really helped me. The two are different, yet address the same issues and muscle groups. I think you're probably right in your assessment.

BTW, my hubby and I just saw Act of Valor -awesome!
 
Oh, and, those squat jumps are the ONLY thing I have found so far that actually warm my feet up for running!
 
Hey Jen,

You can also build up the leg/hip muscles by stepping up onto the box/brick wall/whatever. Know what I mean? Like this:


It's a good way to build strength/confidence while working your way to jumping. Oh, and it's hilarious when someone "faceplants" or catches a hoof on the box jump and end up twisted like a pretzel on the floor....as long as it's not me. I've done it and I had to extinguish the life from everyone in the gym who laughed. Unfortunate for everyone involved.
 
"You can also build up the leg/hip muscles by stepping up onto the box/brick wall/whatever."

I am guessing that stepping up and down on a box is not the exact same movement as doing it on a stair machine, because stair machines eventually kill me. Just like a treadmill also eventually kill me, but running on the ground doesn't. Looks a bit boring though, I am really getting into this jumping thing. :) I have discovered as of late that I just have not been challenging myself enough in my exercises. Being a kangaroo is definitely challenging. :D
 
...Looks a bit boring though, I am really getting into this jumping thing. :) I have discovered as of late that I just have not been challenging myself enough in my exercises. Being a kangaroo is definitely challenging. :D

Hellz yes! Once you move from just plane old box jumps to stuff like multiple box jump burpees you will be able to hear colors and conjure paisley decorated dragons....or at least if you push yourself far enough you'll think those things just happened.
 
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Hellz yes! Once you move from just plane old box jumps to stuff like multiple box jump burpees you will be able to hear colors and conjure paisley decorated dragons....or at least if you push yourself far enough you'll think those things just happened.

I just peed my pants laughing over this comment! Not really, but that IS hysterical! :) However, I can get the same effect by just skipping my morning medication. ;)
 
Ken! thanks for your write up! i am glad to hear you able to run for 2.5 hours now!

my brick wall right now is somewhere around 2 to 3 miles.
I have been working on glutes lately...and am going to try your progressive run/walk program.
 
Hey Everyone,

I'm new here, but I'm so happy I found this thread. I made the move to minimalist/barefoot running a little while back now and had great success, about 20-25 miles a week, loving every second of it. Worked my way up to my first half marathon and was able to maintain the pace i wanted without any problem. Then I got mono. About a month later started running again, started off slow on a few miles at a time. When I felt ready I bumped up two a 5 mile run and boom-throbbing pain down my left IT band, pain on the outer knee. Hard to walk the next day. Stairs were a joke.

Took about 3 weeks off and tried again, but within a mile the pain was back in my knee. Tried taking a few more weeks off, with the same result. Had to back out of my first planned marathon just this March and have been extremely discouraged for a while now. I haven't been running for about a month now and have focused on weight lifting, but I can always feel a little twinge on my outer knee the day after lifting legs. It's amazing how mentally afraid/aware i am of every little movement, i swear sometime i get phantom pain just because im so hyper about it. All my friend think I'm just babying it because i can walk around fine. All that to say, this is driving me crazy.

Two questions: 1) Am I doing the right thing by lifting (and rolling)? 2) What in the world else can I do?

Thanks so much,
John
 
Hi John,

You might want to re-post in the ask a doc forum.

I have had a lot of success in the last month. Most of my miles have been barefoot. It seems to help. I take a long time to warm up and then during running if I feel at all tight, I stop and do a few squats and loosen up a little. If I am nice and warm and the surface is good, I'll do a few sprints, it seems to loosen up things even more.

There was some good links to exercises posted in a knee pain thread and also, Maple Grove Barefoot Guy has a great article on his blog (nice pictures too).

Good luck to you.

Rick W.
 
John, I'm sorry to welcome you to the group. I certainly don't think that lifting and rolling do any harm. I also THINK that lifting (especially squats and other leg/hip strengthening exercises) has helped me keep ITBS at bay. With that said, the day after I run more than about 2-3 miles my knee almost always feels a little weird. Not quite like that weird feeling I would get before a full blown ITBS flare up...but just strange enough that I'm worried about it. I'm very careful now to take a day off between every run, since before my first flare up I had done some back to back run days. That's kind of how I help to psychologically deal with the fear of a recurrence. I don't usually get any strange feeling after a lifting day.

Good luck on your journey.