General Discussion Triathlon Talk » ITB Issues Rss Feed  
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2008-11-16 7:42 PM

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Subject: ITB Issues
So I am trying to train for a marathon that is in early Feb. I ended up with a vicious head cold that has put my training behind, and now I suddenly find myself with a very painfull IT band issue. I have read both that part of treatment should be reduced milage, and that you don't really need to cut down on mileage, so I put it to the BT brain trust. Is it ok to run through the pretty severe pain to log the miles, or should I back off a bit. I did 9 miles today, and minor pain came in at mile 2, was moderate at the turn around, and mile 7 was a stream of exlpetives as I made myself keep running. Oddly, the final mile or so the pain receded a bit, and I would have to label it as moderate. Since then I have done several rounds of stretching, ice for 10 min out of every hour and can almost walk up the stairs pain free. Thanks for any thoughts on if its ok to HTFU or if I need to listen to my body for a change.


2008-11-16 8:00 PM
in reply to: #1811487

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New Haven, CT
Subject: RE: ITB Issues
have you tried rolling them with the stick or a foam roller? 
2008-11-16 8:29 PM
in reply to: #1811487

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Subject: RE: ITB Issues

I have had/ do have ITB issues.  I have seen a sports MD for this.  Prior to seeing him, I had already began a vigorous stretching routine of the ITB (4-5 times per day), ice, and tennis ball massage.  His only further recommendations were to cut back mileage in half or even stop completely for a while, run on flat surfaces, and do not run through anything worse than mild pain.  If this doesn't work, there is always surgery.                                                                                         I took approximately 6 weeks off with no running.  I do not want surgery.  I ran 5 miles today with a little discomfort.  I am not sure if it was psychosomatic or real.

 

2008-11-16 9:03 PM
in reply to: #1811529

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Subject: RE: ITB Issues
jsklarz - 2008-11-16 9:00 PM have you tried rolling them with the stick or a foam roller? 
x2 on the foam roller...get the heavy duty kind, not the wimpy soft one. IMHO you should not be running through the pain. I had ITB issues that were fixed quickly with a combo of Graston ,ART and lots of foam rolling. Good Luck!
2008-11-16 9:42 PM
in reply to: #1811487


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Subject: RE: ITB Issues
X2 on the foam roller.  Like everyone says, it hurts like heck when you roll it, but it works. Rolling my legs...calves, shins, thighs, hams, ...and more streching (duration and frequency) got me back to normel in about a week.
2008-11-16 10:00 PM
in reply to: #1811487

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Subject: RE: ITB Issues

rollers, yes! i went thru this in cross country this year and it went away for me with some stretching and ice. i used a roller when i could but i didn't have one often. anywho, i do some yoga and i learned some good stretches for this. go into push up position, pull your hurt leg up underneath you with your knee bent and lay down on it so that your chest and stomach are on youe thigh. you can roll to the side for a better stretch. that's the only one that i can really put into words. the three or four other ones that i know are hard to describe without a picture of some kind. PM me if you want them with pictures, and i'll see what i can do.



2008-11-16 11:34 PM
in reply to: #1811487

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Subject: RE: ITB Issues
Use the roller and stop running.  You shouldn't be running through severe pain.  If it's mild or maybe even moderate you can get by on reduced mileage and stretching/icing. 
2008-11-16 11:59 PM
in reply to: #1811487

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Subject: RE: ITB Issues
First you need to face the fact that you will have to take a week or two off from running... sorry, but it's absolutely necessary.

Second, go get your self a foam roller and roll out the ITB every morning and evening. And when you get this problem under control, continue to roll the ITB before and after each run. Combine this with a good stretching routine and you will be problem free.

And to prevent this from happening in the future, start a strength training program where you focus on balance (i.e. forget hitting the weight room, you can do this right at home since you don't need anything except a stability ball).
2008-11-17 10:03 AM
in reply to: #1811487

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Subject: RE: ITB Issues

I am currently dealing with this.  I am now in my 2nd week of zero running after a few months of reduced running.  Running through it does not seem to help.  I am walking doing the elliptical machine some.  No more than 12 min on each though several times a week.

I have spent hours reading, talking to people, watching videos and doing exersizes.

I believe I am ready to get back at running but am forcing myself to wait until after Thanksgiving. 

Here is what I have done.  Alot of rolling.  Find the spots that hurt like no other pain you have experienced before and stay on that spot as long as you can take it... up to a minute.  Use your other leg as a guide to compare the pain.  Don't concentrate on just the exact IT band area but all around.  I found the worst pain right on the edge of the IT/hamstring.  Don't neglect your but either.  You could have tightness in your glutes that is pulling on the IT. 

Here is a laundry list of stuff I researched.  I have been focusing on strengthening the hip adductors and glutes.  I have also seen a ART specialist 2 times and a kinesiologist/chiropractor.  He adjusted my knee and found a number of weaknesses related to the IT bands.  I also do some ART of my own while on the roller.  I roll up and down and curl my leg.  This is similar to ART in that it moves the muscles while putting pressure on them and this helps to break down any joining of the tissues that should not be there. 

------------------------------------------------ 

 

Walt Reynolds exersize
To stretch. Place one foot on a chair and tough your toes, then start to point the foot your standing on as far in as you can. You should really feel it in your hip.
 I'm amazed by how often the above is overlooked when talking about ITBS. My issue a few years back was twofold:
1) Weakness of the TFL. Corrected by doing hip hikes standing on a step. I'd do 3 sets of 20-25 reps per leg, and after that it was damn tough to walk across the room! I now do them every once in a while when I am taking a week off from running/biking.
2) Tennis ball, tennis ball, tennis ball. It cannot be said enough. Just get a worn out one and sit on it, literally. Roll around throughout the butt, lower back, and especially laying on your side with the ball directly on the upper end on the TFL. Mine hurt like hell when I did that, and I also found two more minor muscles in my butt that were excruciatingly painful to put my whole weight on. After a week of doing this regularly all my problems were gone and have stayed gone.
4. Knowing #3, check your running shoes and your gait. ITB is often brought on by running in overly supportive shoes. You may be running in a support shoe, when you should be in a neutral cushioned shoe. Don't worry, this is a common problem - many runners are running in shoes that are too supportive for them.
Basically the exercise involves attaching a bungee to a fixed object and using it as resistance for standing hip adductor/abductor exercises. Don't hold onto anything for stability while doing the exercises. I do 45 adductors (15 toes pointed left/15 toes straight/15 toes right), 45 abductors, and 45 in a forward motion. Do them in a slow controlled motion. By the time I get to the end of the first set, both legs are burning, especially the leg being used for stability.
Yes strengthen TFL and gluteus medius.
Well the advice you have recieved in regards to strengthening you Gluteus medius is correct except few have told you how to do this. Sidelying hip abduction is the simple exercise that requires no equiptment. The ITB is a tough piece of fascia or connective tissue that runs off you Glute med. and goes down the lateral aspect of the thigh and inserts where you are having the pain. Most men have pretty weak hip abductors and this is the source of the problem from my experience treating patients with this problem. We simply are not recruiting the necessary fibers of the Glute. med muscle when your running. As you train that muscle to contract and it starts to strengthen the pain will start to go away. I don't care what anyone says. You can not stretch the actual ITB, it's impossible. You can stretch the glute med. though. They have strung cadaver ITB's up with weigths hanging off of it for hours and measured before and after. Absolutely no change in length. It's completely an issue of strength. Your lateral knee is taking the abuse because the muscle is not doing the job it's suppose to do to stabilize while running because as men we do nothing to strengthen our little outer muscle. Unless of course you have played hockey or was a speed skater etc.. This doesn't happen as often to females. They get inner knee problems instead. Start doing your sidelying hip abduction and make sure you are doing them properly (ears over sh, over hips over ankles and strictly raise up to the side and lower slowly. 2x15-20 reps and you will see how weak you are. Do them every day. 2x15-20 reps and keep doing them especially before you run. It will take some time but will get better with consistent strengthening. If pain while running does not start right away which is usually the case. It usually starts about 10-15 minutes into the run and then pain gets very sharp very quickly. If this is the case do your exercises and then run on a treadmill. As soon as you even feel the slightest twinge shut it down. If you run on the treadmill you will not be stuck 2 miles from home and have to make the painful walk home. 10-15 minute of running is better than nothing, plus you can gauge progress if your able to run a little longer each time you know it's improving. Ice the outside knee as well after even if it doesn't hurt. (It shouldn't hurt because you stopped running before the pain started, remember)
Things I have seen help:

strengthen gluteal medius

hip hikes

stretch the hell out of your IT band

run in the right shoe

also iontophoresis right on the bursa has helped

--

 

2008-11-17 3:18 PM
in reply to: #1811487

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Subject: RE: ITB Issues

Lots of good information here.  I just had to pull out of the Philly Marathon cause of ITBS. 

I've been doing A.R.T and Graston but it's by no means a "cure".  The Foam Roller is also a god-send.  Buy one asap and start rolling.  But all these things will help you rehabilitate slowly - time and rest are the only cures. 

The second you are running and you feel an ITB twitch, Stop Immed.  Running through the pain will only make the band flare up and prolong your recovery. 

Try to run on the treadmill.  The crowned roads tend to aggravate the condition. 

Good Luck.

2008-11-17 3:34 PM
in reply to: #1812922

Subject: RE: ITB Issues
Dream Chaser - 2008-11-17 4:18 PM

Try to run on the treadmill.  The crowned roads tend to aggravate the condition. 

Yup, good point. I was started to have IT Band issues this summer (rolling and stretching helped a ton, as others have said) and running on cambered trail sections that sloped down to the outside really did a number on the side that was hurting. So I tried to stick to the parts of the trail that were flat, since running towards the middle of the trail would get me yelled at by the cyclists.



2008-11-17 5:48 PM
in reply to: #1812964

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Subject: RE: ITB Issues
The OP statement on running through it works in a race if need be, but not training. The pain subdues after a while becuase your brain releases endorphins... May feel somewhat better, but as others mentioned, you are making the recovery longer. After a year+ of dealing with this on/off, I am just getting the point of realizing I have to stretch religiously and use the foam roller to avoid future flare-ups.

Also check your Bike fit. After months of tryign to figure out underlying cause, it was that my hip was mis-aligned in aero and causing the band to tighted at hip level. Now I ice the knee, but really work Band around my hip and it helps.

Good luck.
2008-11-17 6:15 PM
in reply to: #1811487

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Subject: RE: ITB Issues
Oh yes, the ITB issue.  I went through the Portland marathon with it, flared up at 6 mi and I was walk/limping the rest.  My doc and PT and coach all say to stop running IMMEDIATELY when it hurts.  They had me take 2 entire weeks off of running with lots of stretching and foam rolling.  As everyone has said the foam rolling hurts like crazy but really helps.  You may also want to have some kind of gait analysis done, a lot of the time, it's bad running mechanics that bring it on in the first place.
2008-11-17 11:41 PM
in reply to: #1811487

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Subject: RE: ITB Issues
Thanks all for the replies. Looks like I am off the street for a bit. Got a roller today, and other than feeling slightly foolish rolling around on the ground, and the fact that it hurts, it's not too bad. Also planning on a lot of stretch sessions. I work from home most of the time, so this shouldn't be too hard to do.

I do have one last question though. Someone mentioned that it is ok to run through the pain for a race, but not training. I take that to mean that not treating it will prolong the recovery, but you aren't doing any additional damage to yourself. This comes from a someone who has played rec league softball with a broken wrist and ankle, and as a result has limited range of motion in my left hand and pains in my ankle any time I sit still for more than 30 minutes or so.
2008-11-18 9:38 AM
in reply to: #1811487

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Subject: RE: ITB Issues
Lots of good advice here already. I'm a fellow ITBS sufferer and found that the straps worked really well for me, you may want to also give them a try.
2008-11-18 9:52 AM
in reply to: #1811487

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Subject: RE: ITB Issues
I'm a big fan of A.R.T. I had ITB issues and after 1 session it went away for about 3 weeks. A.R.T for president!!


2008-11-18 12:57 PM
in reply to: #1811487

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Subject: RE: ITB Issues
You actually can cause more damage by continued training through the pain.  Prolonged inflamation and pain can lead to thickening of the tendon.  Thickening of the tendon leads to increased friction at the knee.  Increased friction leads to increased inflamation, which leads to increased thickening.....  If left simmering for too long, it can require surgery.
2008-11-18 1:19 PM
in reply to: #1811487

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Subject: RE: ITB Issues
I just re-read all the posts, including mine and wanted to officially for the record say: I HATE IT BAND SYNDROME.  There I feel a teency bit better.  I was so pschyed and mentally ready to run Philly this Sunday.  That'll teach me to ramp my mileage up too quickly.   
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