IT Band trouble - another DNF

I had trouble with my IT band about two years ago when I was training for my first 70.3 in Galway which led to a very painful shuffle during half marathon on race day. Not knowing much about the injury I saw my friend Jamie Isherwood at Fortis Clinic a specialist sports injury oesteopath who has dealt with all manner of my injuries in the last few years including shin splints from running and a dislocated shoulder playing rugby.  Back then he gave me a number of stretches to perform and also suggested doing deep tissue massage over a six week period which seem to sort the issue and it didn't reoccur.

That was until the Royal Parks Half Marathon back in October when while on course for a new PB I started getting a shooting pain down my right leg at about mile 7 and then a searing pain under my knee cap at about 9 miles.  Realising that it was a reoccurrence of my IT issues I pulled up immediately so to not aggravate it any further. Since then I took a week off running and ensured I stretched and rolled at least four times per week.  This seemed to have sorted the problem until a track session two weeks ago when I woke up on the Wednesday morning and my hip and knee were in agony.  Taking another week off I then attempted to run my final race of the year which is the Wildman trail run but decided I needed to pull out after only 2 miles as even with Ibuprofen could feel my hip. I have now done my first ever pilates class and had physio with Jamie today who diagnosed weak outer glutes (Gluteus Medius) which may be the cause of my IT Band issues.  I now have a number of new exercises to try and also some resistance band exercise loops to add to my ever expanding training room which I am adding to the new flat we are currently in the process of buying.

The Symptoms Hip or knee pain, or both. Specifically, pain on the outer side of the knee where the bone bumps out above the joint, or on the outer side of the hip. The pain usually starts after 10 minutes of running. Walking usually causes no pain.

What’s Going On In There? The iliotibial band (ITB) is a thick tendon that runs the length of and connects the tensor fascia lata muscle—which starts on the outer side of the hip—to the outer side of the tibia, the major bone in the lower leg.

Here’s how the pain happens: A small, fluid-filled sac called a bursa sits between the tendon and the outside of the femur near the knee. You also have a bursa at the hip joint. When the ITB is tight, it increases the tension on the outer sides of the hip and knee. The ITB then pinches these two sites and the bursa (one or both) swells. Over time, the bursa becomes enlarged—big enough to cause pain every time you begin to run (which is why pain usually starts within 10 minutes of activity).

Fix it • Roll it: A 6-by-36-inch foam roller is the best tool for stretching the ITB. Lie on your side with the roller under your leg and roll it from your hip to your knee (see right), using your body weight to knead the area. The pressure will help loosen the tendon and the fascia, almost like a self-massage. Do this at least once a day for several minutes, and make it a permanent part of your exercise activity.

• Beef up your glutes and hips. Weak butt and hip muscles contribute to ITB impingement syndrome. Make sure your lower-body work includes squats, especially single-leg squats, as well as multidirectional lunges (for more ideas, see exercises and stretches below).

• Having a properly fitted bike can help triathletes who suffer from ITB impingement while riding.

Prevent It Build up your glutes to reinforce the body’s largest and potentially most powerful muscle group. The stretches and exercises here all help build up your glutes and hip flexors, and can be added to any workout.

Lying Glute Stretch Lie face-up on the floor with your knees and hips bent. Cross your right leg over your left so that your right ankle sits across your left thigh. Grab your right knee with both hands and pull it toward the middle of your chest until you feel a comfortable stretch in your glutes. Hold for 30 seconds, then repeat on the opposite side. Repeat twice for a total of three sets, several times a day if you’re really tight.

Lateral Band Walks Place both legs between a mini-band and position the band just above your knees. Take small steps to your right for 20 feet. Then sidestep back to your left for 20 feet. That’s one set.

Hip Raise Lie face-up on the floor with your knees bent and your feet flat on the floor. Place your arms out to your sides at 45-degree angles, your palms facing up. Raise your hips so your body forms a straight line from your shoulders to your knees. Squeeze your glutes as you raise your hips. Make sure you’re pushing with your heels. To make it easier, you can position your feet so that your toes rise off the floor. Pause for five seconds in the up position, then lower your body back to the starting position.