HELP FOR RUNNERS - ILIOTIBIAL BAND SYNDROME

From time to time if you are a runner you will experience pain and/or some kind of injury. I have been most fortunate to never have a serious injury, but unfortunately I have an on going issue with my Iliotibial Band or as we refer to as an IT Band. This causes a lot of down time from running, pain and irritation and not running is not a happy place.

Iliotibial band syndrome is one of the leading causes of lateral knee pain in runners. The Iliotibial band is a superficial thickening of tissue on the outside of the thigh, extending from the outside of the pelvis, over the hip and knee. and inserting just below the knee. The band is crucial to stabilizing the knee during running, moving from behind the femur to the front of it during the gait cycle. The continual rubbing of the band over the bone, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed or the band itself may become irritated.

The iliotibial (IT) band is often the hidden cause of outer knee or hip pain. Iliotibial band friction syndrome can cause a nagging, dull ache, or flare into a sharp, acute pain felt at a specific spot on the outside of the knee and lower thigh. For some athletes, a tight it band may cause hip pain as well.

The symptoms of IT Band issues can cause you considerable pain and discomfort and cause havoc with your running.
The symptoms range from a stinging sensation just above the knee joint on the outside of the knee or along the entire length of the iliotibial band to swelling or thickening of the tissue at the point where the band moves over the femur. The pain may not occur immediately, but it will worsen during activity when the foot strikes the ground if you overstride or run downhill and it may persist afterward. A single workout of excessive distance or a rapid increase in weekly distance can aggravate the condition.

There are several causes of injury. Running on a banked surface, such as the shoulder of a road or an indoor track, causes the downhill leg to bend slightly inward and causes extreme stretching of the band against the femur. Poor training habits and anatomical abnormalities such as bowlegs or tightness about the IT band can cause issues. Running excessive distances or increasing mileage too quickly can aggravate or cause injury as can inadequate warm-ups or cooldowns.

There are some short term and long term treatments available.

Short Term Treatment

Decrease distance
Ice knee after activity
Alternate running direction if you are running on a pitched surface
Use a lateral sole wedge to lessen pressure on the knee
Stretch to tolerance.

Long Term Treatment

R.I.C.E.: Rest, ice, compression, and elevation is the best way to treat initial IT band pain.

Physical therapy: A therapist may use ultrasound and other modalities to help the injured tissues heal more quickly. A skilled PT can also help you correct any biomechanical or training errors, and teach you how to perform the right flexibility exercises.

Reduced activity: Runners with IT band pain should reduce running mileage and be alert for signs of overtraining syndrome.

Foam roller myofascial release. Using a foam roller to release the tissues may be painful, but many athletes have success with this technique.

Anti-inflammatory medications: These may also be used to reduce pain and inflammation.
Rest and recovery: Rest is an important part of your recovery and should be maintained as part of a balanced training program.

Preventing IT Band Syndrome

The following tips may help you prevent chronic IT band syndrome:

If you are a runner, review how to prevent running overuse injuries. This includes increasing your distance my no more than 10 percent per week, taking a rest day between running days, and building speed or incline intensity gradually.

IT band strengthening exercises include those that target the external hip rotators. One simple way to do this is with the one-leg squat exercise. Perform these in front of a mirror and make sure your pelvis does not drop on one side during the reps.

IT band stretching exercises may help prevent irritation from IT band tightness.

Use the right shoes. The amount of support or cushion in your shoes can either aggravate or alleviate IT band issues, so be sure to choose the right shoes for your sport.

Consider using orthotics or inserts. Some IT band trouble can be helped by using either custom or commercial orthotics, particularly if you have high arches.

Replace aging running shoes. Running in old, worn shoes can increase IT band pain, so switch out your shoes at regular intervals, at least every 400 miles.

Avoid overtraining. Training too much or too often can make any aches and pains worse, so rest and recover after hard workouts.

Cross train. Doing the same thing over and over makes recovery more difficult. Mix up your training to balance out your body.

Get adequate rest and recovery. Frequent high-intensity workouts can do more harm than good. Learn how rest can improve your training.

Try backward running to correct muscle imbalance and reduce pressure on the knees.

Run on a soft, level surface or alternate directions on the road to avoid stressing the IT band.

IT band friction syndrome doesn't have to be a chronic, debilitating problem. A little bit of prevention and careful diagnosis of the cause can lead to a full recovery.

The Good News

Almost all of the runners I’ve communicated with about I-T Band injuries have been able to run during the recovery period, once the healing had started. Many of these folks have continued their marathon training program, after making the adjustments for the injury. Once you’ve determined that the healing has begun, and your training stays below the threshold that could further irritate the injury, you’ll probably be able to continue your running. The first priority, however, is being conservative enough (with slower pacing, more walk breaks, and days off from running) to allow the healing to continue.

So if you are like me you will never stop running, you will just keep trying to figure out this IT Band issue thing and work at making it a happy band to create a happy run.

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