My Iliotibial Band Problem (4)

It has been a while since I last posted about my ongoing iliotibial band problems. If you need some background you can read my previous posts at the links below.

• IT band problem (1)
• IT band problem (2)
• IT band problem (3)

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Generally they (IT bands) have been fine, but there has been one flare up that I didn't write about back in June and a new one that I need to figure out.

The one that I didn't write about occurred during my hill running sessions down at Beachy Head. I think that was caused by way too much downhill running, it sorted itself out very quickly once I cut out the extreme (down)hill running.

The latest flare up is on the left side. It has been very mildly saying 'hello, remember me?' on and off for about two weeks. In order to get on top of it I need to look at the things that have changed recently that could be causing it, ready?

This is what I've come up with so far..

• Not enough foam-rolling and pigeon pose stretching
• Downhill running (going up the hill is fine)
  
• Racing too often
  
• Increase in mileage
• Running whilst wearing my backpack

What now?

One thing that I know from experience is that NOT running does not work. It might help to ease the initial soreness, but the cause of the problem is still unknown and it is likely that the pain will return on the next run. With that in mind I will keep running, if it gets worse I may run shorter distances and increase the number of running sessions - this helped me to keep the mileage/running time up but each run was short enough to avoid bringing on the pain.

The first step is to foam roll and get into the pigeon pose as often as time allows - at least twice per day. I have to admit that over the last few months I have been doing these less than I should. When I am not at home and need to roll a good alternative is to use an unopened 2 litre fizzy drink bottle. Both IT bands seem to be knot free at the moment so it could be that my glutes are tight again ( please don't laugh - :-p ).

I'm also going to stick to running on the flat, or at least just walk any steep downhill sections I come across. Not a problem on my London route because it is as flat as a pancake!

I hope the mileage is not the problem. It hasn't risen drastically, I make sure I keep any increases to a couple of kilometres per week. I won't cut it significantly to start with (Although I could trim the long run). To be on the safe side I won't raise it either. Also, not sure if wearing a backpack (only during the runs to work) could contribute to this or not but I hate it anyway so this is a good time to stop.

Please don't let it be the racing (I love it so much). :-(


Steve. (7t)

My Iliotibial Band Problem (3)

I don't want to speak too soon but I may have had a breakthrough. The last two days I have been free of ITBS pain, the runs were relatively short at 5.5km and 4.5km but it feels like a huge step in the right direction.

On daily basis I am generally doing the following:

The routine for a run is

• Warm up approx 10-15 minutes (Leg Swings etc / pigeon pose)
• Run
• Cool Down approx 10-15 minutes (Stretches / Foam Rolling / pigeon pose)

At various points throughout the day I am doing

• Leg Abduction Exercises (just bodyweight, usually standing)
  
• Hip Hikes (not every day)
• Occasional pigeon pose
  

Then in the evening I am doing

• Foam Rolling (10-15 minutes)
• Pigeon Pose (Hold it for longer than at other times in the day)

Photo of me getting into the pigeon pose, when I feel ready I bring my torso all the way down to the floor for a really good stretch.

I'm sure everything is playing its part in helping, but since I started the pigeon pose I feel like my progress has stepped up a gear. In the pose I really feel a nice stretch in the glutes, it makes me wonder if my ITBS problem is simply caused by tight glute muscles. Probably too early to say for sure. Hopefully update 4 is full of more good news and progress.


7t.

My Iliotibial Band Problem (2)

I thought it was about time that I posted an update on my ITBS issue. So these are the things I have been doing...

Break: I had a 1 week break from running. - The pain went away completely (as expected) but obviously NOT running isn't a long term solution to the problem. By the end of the break my body was aching (literally) to run again.

Strengthening Exercises: I was doing some hip hikes and other hip strengthening exercises but I must admit that the last week I have been slacking on these exercises, mostly because I've been at home and had no access to my gym (which is at work).

Stretching: I have been doing all the usual leg stretches plus I've added in the yoga pigeon pose position for opening up the hips (I get a really nice stretch in the glutes!). I really like this position and it helped give me some relief after a few of my runs. I'm going to continue with this one.

Foam Roller: I have been using my foam roller on my legs. - It does provide quite a good amount of relief after I have run and I am enjoying the process, so far it hasn't made any difference to the onset of the pain but I will continue.



It's a very depressing problem/injury which seems to have no one single method for resloving it. I'm running again but find it difficult to do much over 4km at any one time, and I may have to re-evaluate my plans to race 10k's and upwards this year. I defintely think running the Tonbridge half marathon in September - which I really want to do - is looking unlikely.

I found some information online that suggested that the way I position my legs while sitting in my chair at work could also be a factor, I find that I put my legs back under my chair - Apparently not good. I am making an effort to sit properly with my feet in front of me.

I've made a page that I can use for quick reference listing the different things I am doing to help get over this problem. You will see the tab for it at the top of the page. If not it's here.

Update 3 will follow very soon.

7t.

My Iliotibial Band Problem (1)

As you may have spotted from previous posts, I have recently developed Iliotibial Band Syndrome in my right leg. In the past it has always been my left leg that has suffered. Somehow I have managed to get over the pain in the left leg but I'm not completely sure what I did that helped.

I am feeling very frustrated as the weather has been great and all I want to do is get out and run. However I am being sensible and forcing myself to take a break from running.



From what I have read the pain comes from the fact that the IT band is 'pulled too tightly causing it to rub over the femoral condyle (bone) and\or the bursa.' - Taken from this helpful post, it also contains links to exercises.

The following 'could' be reasons for the pain. I have highlighted which ones I think are most likely. But this is just what I think is most likely, in reality I really don't know what has caused it.

From Wikipedia:

Training habits:

• Running on a banked surface
  
• Inadequate warm-up or cool-down
• Excessive up-hill and down-hill running
• In cycling, having the feet "toed-in" to an excessive angle
• Running up and down stairs
• Hiking long distances
• Rowing
• (added by me) Increasing distance too quickly
  

Abnormalities in leg/feet anatomy:

• High or low arches
• Supination of the foot
• Excessive lower leg rotation due to over-pronation
• The force at the knee when the foot strikes
• Uneven leg length
• Bowlegs or tightness about the iliotibial band.

Muscle imbalance:

• Weak hip abductor muscles
• Weak/non-firing multifidus muscle
  

Points to Note:

• I have a new pair of trail running shoes. (Although, I haven't had pain while wearing them)
• I recently took part in a 10km race on a very hilly course.
  
• There were a few runs where I may not have stretched quite as thoroughly as usual.
• I haven't raised my mileage in the last few weeks, but have started the year with more miles per week than at the end of last year. (Could this be it? Maybe taken a while to catch up with me?)
• The pavements I run on are not the flatest, but I have been attempting to run on the roads with the least amount of uneven surfaces. I have been trying to make sure it's not always the same leg that encounters the banked/cambered surface.
• Over the last few months I have been trying to run slower, maybe this has had an effect on my running form.
  

What Now?

• Initial Rest Period (No running and Daily Stretching)
• Start Running but keep them short (under 4km to start with)
• Stretch Well
• Use a Foam Roller (awaiting delivery) for Myofascial Release
• Exercises that attempt to strengthen the leg muscles (focusing on - but not limited to - hips, glutes and hamstrings)

As I type this post it has been 4 days since my last run, I plan to start the strengthening exercises from Thursday (just body weight) and to attempt a 3km run on Saturday, that'll be a full week without running. Of course, when my foam roller arrives I'll start rolling too.

7t.

Workouts - Week Commencing 28 March 2011

• Monday: Legs bodyweight (focus on hips)
  
• Tuesday: 5km treadmill run (Right IT Band sore after 3.5km) ( summary )
  
• Wednesday: Chest and Triceps
• Thursday: Legs bodyweight (morning / lunch / evening)
  
• Friday: Back and Biceps / Bodyweight legs (lunch) / Legs with ankle weights (evening)
  
• Saturday: 3.9km run (IT band ok) ( summary / map )
  
• Sunday: 8km country walk (knee/it band felt strange, with a slight wave of pain every now and then) ( summary / map )
  

Due to the IT band issue I reduced my mileage this week. At the end of the week it didn't really feel any better so I'm taking a complete break from running until at least next weekend.

7t

Workouts - w/c 21 March, plus new IT band Issue.

I was sick for the first half of the week, and although I still managed to run 22km in total I didn't get to the gym at all.

• Mon - Sick
• Tue - Sick
• Wed - Sick
• Thurs - 10.5k (right knee/IT band really sore)
• Fri - Rest (right knee still in pain)
  
• Sat - 5.5k (mild knee/IT band pain)
• Sun - 6.5k (mild knee/IT band pain)

The worst thing is that my right knee/IT band has flared up. I'm having trouble with anything over 4km. This is really frustrating especially as the trouble I've always had with the IT band has previously been in my left leg/knee. I don't know if this is caused by the surfaces I run on, shoes, weak/imbalanced muscles, or something else.

So for the next few weeks I'm going to cut back the length of my runs (after an initial rest I'll start with a 3km limit and build slowly from there) and focus on a combination of resting, strength training (especially the hips) and stretching.

I'm working towards a 10km race in May, so it would be brilliant to have this under control by then. The thing is I have no idea exactly what I did to 'fix' the left leg - It just stopped hurting towards the end of last year and has been fine ever since.

7t.