ITB Issues - Should I train through it.

I similarly ran through ITB pain 2 years ago and ended up with acute ITBS to the point of not being able to walk down stairs, let alone run. I didn't know what the pain was in the early stages, otherwise I would have stopped. ITB issues can be tricky and it seems that rest is the best way to fully get past it. I ended up taking 6 weeks off of running entirely, but was able to bike during this time and was in PT twice weekly. After the 6 weeks, I did a 3 mile run, then a 5 mile run, then a half-mary (note: I was right in the middle of marathon training when the injury occurred, otherwise would never have increased distance that way).

I recommend not running for awhile if your schedule will allow it. What worked for me was a program of strength training on the hip adductors/abductors as most runners are weak here leading to ITB issues. I did the ITB stretches several times/day and always before and after any workouts. I iced a few times a day and used massage as well. I did the marathon that year, took a month break after, and went on to run the entire winter trouble-free.

Good luck getting past this. 

Not a doctor.  A sports therapist yes.  He is not just any massage therapist but has worked for the Yankees for many years.  Not that the Yankees is any big deal but I think he has a long track record of dealing with sports related issues....

Good point on the cause.  The cause could be shoes.  I was at the limit on my shoes and actually had my new shoes on hand but was lazy and had not switch over my yankz laces yet and decided to use my shoes that were bout 6 months old.  I have read that shoes that are worn can cause the issue. 

I agree, I don't want to take weeks off and then it crop right back up.  I did that with my foot pain and it did not help at all until I found the cause which was not what I thought. 

Being a competitive runner for more than 15 years, I have run into this issue on more than one occassion, and it always comes at the most inopportune time. Everyone has brought up good points here. The shoes may be part of the problem. If you over pronate during your stride it can set off a chain reaction through your lower extremity. If this is the case, when your ankle rolls inward it forces you to bear more weight on the lateral side of the knee. This does not allow proper mechanics for the knee and can lead to inflammation. This is why it happens later on in the run. Orthotics will help this

 You may also have weakness in your hips. When running, if you have a weakness you automatically recruit additional muscles to help with the problem. This also leads to bad mechanics and can stress the joint. Strengthening your hip adductors and your piriformis muscles will help you balance out and control your motion much better.

 I rarely see that the problem is actually the IT band, but these other things that I have mentioned.

Next time you run and it flares up, when you get home , take your thumb and press firmly all around the knee joint on the outside to determine the exact location of pain (this may take a little bit). Once found, mark it with a pen. then when you go to the sports physician he can determine if it is the IT band or not. Also have him test your strength.

Back when I had some issues with ITBS, I was told (By Runners that I trusted) that this is the sort of running injury not to try and train through. Rest and whatever else you (or the profressionals are advising you to do) deem necessary but allow it to heal before heading back out on the road.

For me anyway, my ITB issues were caused by poor running form. I would get tired and start turning my knee in as my hips tightened up and this would quickly irritate my ITB where it crosses over the bumpy part of my knee. The trick for me was to stop running when my running form fell apart and not wait for the pain to tell me to stop.

It has been quite a while now since my last bout of ITB and my running form no longer breaks down when I get tired like it once did.

I hope you find a simple and easy solution to your problem before it becomes a bigger issue for you. Good Luck

Do you think a gate analysis by a foot store could be helpful or are these just marketing gimicks?

There is a local store that does "video-taped gait analysis", but not the same store I bought my shoes from. 

When I purchased my shoes, the guys at the store (a locally owned running shoe store), did a quick look and determined that I overpronate.  With my weight at the time (about 220) and my overpronation, they recommended Brooks Beast.  I am now on my 3rd pair of the Beast and am at about 198lbs. 

I was fitted for my running shoes a the LRS who did watch me run and have been quite happy with the results. I am an under-pronator so I guess it was pretty much a no brainer for them anyway.

I have also had a gait analysis done where they video taped me at the track at the beginning and again at the end of a workout and I found this to be very informative and interesting. (They did observe changes in my form as I got tired)

I personally think it was worth it but I know others may argue otherwise.

I have no experience with ITB issues but you mention that your muscles are tight, that you are in pain when using a foam roller, and that you have hamstring issues. Others have said you should try to strengthen the hip abductors...

You can work on all these issues doing yoga! In addition to getting a stride analysis and working on your running form that would be a good way to make use of the down time you'll need for the ITB injury.

Thanks.  I have started some exersizes for the hip abductors. 

oh no - not you too!

I am dealing with this too - my suggestion is to NOT run....I was trying to run every few days when mine started up about 5 weeks ago or so....initially I could run about 15 mins or so....things progressed to my last run (just over a week ago) to only being able to go 8 minutes!

Initially the pain would stop when I would stop running....lately the pain doesn't go away and lingers (quite badly) for several days....stairs hurt....walking hurt....

I am going to chiro, physio, and taking a break from running (least until next week) to give my body a chance to 'improve' with the ART, and stretching/strengthening excercises I have been doing.

My advice is to give your body a chance to heal first...I was too impatient because I wanted to do two races on July 27 and AUgust 10....and I kept testing my knees to see if progress was being made hoping I would still be able to race....not only was progress not made but it got worse!

hope you heal soon though Matt - I know how badly this sucks!

Thanks everyone.  I will stop.  At least until 8/30 at my next tri and maybe a few short bricks to prepare for that.  On that day, I guess it will be alot of advil and one of those bands to help with the pain. 

I have done alot of research and there are several things that are a common thread:

1. The issue is likely not the ITB but rather the buttocks or lack there of.  Strengthen the buttocks and do other strengthing exersizes related to the ITB

2. Shoes may be an issue.  Either worn out or the wrong kind.   This could be part of my issue.  My shoes were worn out but I also should have my gait checked and make sure the Brooks Beast are still right for me.  I have lost about 40lbs since I started using those.  I have read many stories of people switching to a nuetral shoe and relieaving the isssue.

3.  At least a few weeks of rest is mandatory and a regimen of Advil & ice to help get the inflamation down.

4.  Be consistent in stretching every part of the legs.  I am not good enough at this, have been getting better but this will likely make me get better.  Also, use a foam roller or TB products to help work out tightness.  Use a tennis ball on the buttocks to work out any knots.

5.  See a ART therapist.  I have seen one twice.  He did ART the last time.  He confirmed the ITB issue.  I have read that most people that used this to help required 4-6 treatments.

That is what I can think of for now. 

Your last post is reassuring trimore. Sounds like a plan!

As an ex marathoner with more running years under my shoes than I care to admit, I would suggest you should never train through ITB issues - I have trained through many injuries of various sorts over the (many) years - some more successfully than others - but with ITB issues, they just don't go away until you STOP running, allow time for the irritated tissue to heal and meanwhile figure out and correct what caused the problem in the first place.

Mine were usually lack of stretching, lack of glute strength, worn shoes - oh and a real bad flare up after running a race on a heavily cambered road - the itb on the downhill side didn't like it!

Good Luck

Triassic

I am just training for a sprint now but have a Olympic in view for later this year if possible or at beginning of season next year. 

Both times, I have run, it was right about 20 minutes.  I have heard others say that they could do some track workouts without pain.  I am just concerned that the issue is still there but the imflamation does not get to be enough until about the 20 minute mark.  I am definately going to stop until doing maybe a 10 min brick a few times before my tri on the 30th. 

Fortunately, I don't think biking is causing it any pain.