EDITOR'S NOTE: The following article is based heavily on one written for MileSplit in 2017 by contributor Nico Composto.
We've added a bit of additional guidance to it in the hopes that any
frustrated runner dealing with IT band pain will be able to continue to
train intelligently through it, while treating underlying causes of the
pain.
If you're reading this, you're presumably dealing with the dreaded condition known as IT band syndrome. You undoubtedly know all about the searing pain it results in around your knee, and its frustrating persistence even as you back off training.
IT band syndrome generally manifests as a sharp, sometimes stabbing pain on the outside (lateral side) of your knee, that can feel like it radiates up toward your hip. In milder cases, the discomfort can feel more like stiffness with a dull accompanying ache. Usually, the pain doesn't come on until a few miles of a run, and gradually worsens until you stop.
If you aren't actively ailing from ITBS, but are morbidly curious - or just want to better understand what's going on inside of your leg, mechanically - let's turn things over to Nico:
The iliotibial (IT) band is a piece of connective tissue running from the hip to the outside of the knee. The purpose of the IT band is to help stabilize the leg when it is in motion. When injured, the IT band typically causes pain at the insertion point on the outside of the knee.
Because this injury can worsen so quickly, it is imperative that you deal with it immediately. IT band syndrome is usually caused by weak hips or glutes. When these muscles are not strong enough to properly support the pelvis, the pelvis tugs on the IT band which is then pulled away from the knee, causing pain.
In other words, IT band syndrome is painful, can potentially disrupt a season, and needs to be addressed promptly! The good news is that the treatment is relatively straightforward, and doesn't necessarily preclude you from continuing to run.
When symptoms are especially bad, there's one stretch you'll want to incorporate, and a handful of strength exercises you should begin doing to address the root cause of the injury: weakness along your posterior chain. Again, here's what Nico researched and recommended in 2017, that's still true today.
To begin, there is a common IT band stretch that will
lightly loosen the muscles around the band. (You aren't stretching the IT band itself - that's a common misconception.) From a standing position cross the
uninjured leg over the front of the injured leg. Lightly reach towards the
inside of the foot of the injured leg (for example, if the IT band on your
right leg is injured, cross your left leg over your right and reach to the left
side of the foot of your right leg). You should feel a stretch on the outside
of the hip of the injured leg. This will help relieve tension on the knee. It should look something like this
Hip Exercises
Clamshells: This exercise is done by laying on
your side on the ground. Slide a resistance band around your legs so that it
sits just above your knees. Bend your legs at the knee and pull your legs up so
your thighs are perpendicular to your torso. Now you will open and close your
knees, keeping your feet together, in a motion that resembles a clam opening
and closing. Once again, make sure to go slow, maintaining control against the
resistance band. Do 2 sets of 15 repeats on each side.
Crab walk with resistance band: Put a resistance
band around your ankles, stand with your legs hip-length apart, bend your knees
so you are in a squatting position and walk sideways (while maintaining your
squat)... Make sure to keep your feet facing forward and move both your lead leg
and trail leg slowly (do not let your trail leg snap back into position). Do 2
sets of 15 steps in both directions.
Straight leg raises on side: Lie down on your
side and lift your leg up, being sure not to bend the knee. Go slowly rather
than shooting your leg towards the sky. Do 2 sets of 15-20 leg raises on each
side.
Glute Exercises
Bridge: Lie on your back and bring your feet
towards your butt so your legs form a 45-degree angle. Lift your butt off the
ground. Focus on engaging your glute muscles. Hold for 2-3 seconds then lower
yourself. Complete 2-3 sets of 15 repeats.
Squats: Just normal body weight squats. Focus on
engaging your glutes.
As you incorporate some version of this routine into your training plan, you'll also likely want to scale back actual running to the point where pain is minimal or non-existent, at least for a couple of weeks, until your body absorbs . That can mean reducing mileage about 50%, and totally skipping out on quicker running or running downhill. While annoying, you're likely better off avoiding re-aggravating the inflamed areas of your lower body as you strengthen them - pushing through can exacerbate the problem and make it into something longer-lasting. Only in the most severe cases is outright rest required - but be sure to work with your coach and/or doctor/physical therapist to devise an adaptable plan that works for you.
Don't view IT band syndrome as a season-ending injury - think of it more as a temporary setback. That said, take care of it now. Cutting back on training is no fun and can feel catastrophic, but it's better to address a potentially long-term training inhibitor now than let it become a chronic condition that disrupts training long term and frankly, can make even normal daily tasks painful and irritating.
Once you've got your IT band pain under control, be methodical as you ramp back up your training. Don't change too many variables at once - surface type, hills, speedwork, mileage - and be sure to keep up with some variation of the strength work that helped you get healthy again!
A fantastic, condensed hip- and glute-strengthening routine is this one. It takes about 10 minutes to complete. Do it a few times a week after running, and that may just be enough to keep IT band syndrome from rearing its ugly head again!
EDITOR'S NOTE: The following article is based heavily on one written for MileSplit in 2017 by contributor Nico Composto.
We've added a bit of additional guidance to it in the hopes that any
frustrated runner dealing with IT band pain will be able to continue to
train intelligently through it, while treating underlying causes of the
pain.
If you're reading this, you're presumably dealing with the dreaded condition known as IT band syndrome. You undoubtedly know all about the searing pain it results in around your knee, and its frustrating persistence even as you back off training.
IT band syndrome generally manifests as a sharp, sometimes stabbing pain on the outside (lateral side) of your knee, that can feel like it radiates up toward your hip. In milder cases, the discomfort can feel more like stiffness with a dull accompanying ache. Usually, the pain doesn't come on until a few miles of a run, and gradually worsens until you stop.
If you aren't actively ailing from ITBS, but are morbidly curious - or just want to better understand what's going on inside of your leg, mechanically - let's turn things over to Nico: