ITB issues only when running

In Jan 2018 I started running gently but suffered ITB irritation after a 4 miler. Bloody things been persistent and I didn’t start running properly again until September. I’ve slowly built the mileage up and done 3 10k runs with varying success until todays 10k race when my leg blew up after 6k and I hobbled over the line. Admittedly my pace was too high and it kicked it off again but after over 12 months of the same injury I’m losing patience. I have no issues on the bike which is also frustrating and been using TR 3 times a week!
For reference I’ve seen a private physio a couple of times who diagnosed the issue and helped with a massage and I’ve been stretching before every run and often through the week. I’ve reduced running to once a week.
At this point I don’t know what else to do. I’ve even considered CBD oil, tried codeine, ibuprofen etc, body weight squats and physio recommendations, foam rolling, but don’t seem to be making progress
I have an Olympic Tri in 8 weeks and another 3 weeks later and feel I might struggle…
Any suggestions? Probably doing nothing this week now

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I’ve been struggling with something like this for almost 2 years now. I can barely run at all, and at this point I’ve almost given up on ever doing another tri. I can swim, I can bike with zero issues. I run and my left knee is shot and it SEEMS like an IT band issue. I’ve been to physio, massage, etc. I finally have an appointment for an MRI but I’m skepitcal that it’ll provide useful guidance and/or I’ll be willing to have surgery.

What has helped to some degree is genuine strength training – not just body weight squats but honest to goodness strength training – squats, deadlifts, clean and press, bulgarian split squats, etc. It’s genuinely helped, though its not 100%.

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If you are wearing the same shoes you always have been before this happened, then you may want to consider stop running for a few weeks and do this exercise https://www.youtube.com/watch?v=7Jpm3r6hvh4&ab_channel=AnnaNeroznak or similar on a weight machine. DO NOT FOAM ROLL. I tried that and it made things worse for me. The hip abductor exercise is very effective, but you have to stop running for at least a week so the inflammation has subsided before attempting to run again.

Also, try shortening your stride–that can help as well…

Thanks guys.

Yeah I think I’ll take this week off completely, then go back to basics with my weights.
My physio gave me a similar abductor exercise. Guess I’ll just have to stick with it.
If it didn’t take 2 weeks for a docs app (for him to tell me to stop running most probably) and then god know how long for a referral then I’d be up for an MRI but in all likelihood I’d just be told what I already know.

Hi Adam, I’ve found that the root cause of a lot of ITB issues arise from hip instability causing the leg to collapse medially so I would suggest getting your physio to assess you whilst running to assess stability.
Also I’m not sure if you have or not but unfortunately if the injury is in an acute phase it may just need 7-10 days rest from running. You should also make sure your running shoes are up to date (usually change over every 4-6 months for high mileage)
Static Stretching prior to running is of no benefit for injury prevention so I’d say look into a more dynamic stretching routine(as advocated on the latest TR podcast). Contrary to the previous post I find using a foam roller really effective as long as you don’t roll on the inflamed area in acute cases. It is also important to use a massage ball to release the gluts as these attach into the ITB.

ITB issues often cause pain because the tendon itself actually inflamed the patella fat pad and if this is the case then taping can also help reduce symptoms.

I would also advocate consulting your physio on any of the management recommendations on here so that he/she can advise on whether it is appropriate to your situation.

Long winded but hope this helps.

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Considered stop running?
I also wanted to do triatlon but had too many injuries. Sometimes it is not meant to be…

Two cents…

The physio I spoke to when I had knee trouble said that the root cause of ITB pain often higher up in the TFL (tendon between hip and thigh). Stretching that, or releasing it with a hockey or lacrosse ball might do some good.

Also, making sure your glutes and hamstrings are well stretched out might help.

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@markbrouns never say die!

I’ll look into the massage ball type things, I’ve noticed my hamstring/glutes are pretty tight so will work on that

If you have the ability to see a sports medicine doctor, do it. Not a physical therapist – an honest to goodness sports medicince M.D.

I’m not sure where you are located, but most sports medicine doctors are affiliated with major universities in the States, for obvious reasons.

I did this. I am 44 now, but when I was 26 I almost had to stop running altogether because the pain in my knees was so bad. I went to see an orthopedic surgeon and, naturally, he wanted to perform a surgery. I’m sooooo glad I didn’t do this. At the time, I didn’t know I had an IT band issue, I just knew my knees were incredibly painful.

Then I read an article in Runner’s World about how sports medicine will look at you holistically, and not just at the symptom – to find out what is causing your issue.

Here is what I found – and some of it is contrary to the advice above:

— He told me the problem wasn’t my knees, it was my feet. And he recommended what I needed to look for in a shoe to accommodate the way my footfall was torquing my knee, and thus causing my IT band to flex…and then causing the IT band to subsequently tighten after I cooled down, which was the origin of the pain.
— He told me to take his diagnosis to a physical therapist – not to get diagnosed by a physical therapist. And I did, and I worked on rehab there. Twice a week.
— He told me to get a foam roller, and to roll my knees out before I ran – and twice after I ran…immediately after, and then again 1-2 hours after running.

After a month on working on my overall flexibility (I’m naturally VERY tight), working with a physio and foam rolling, I was cured. Period.

I’m now 44 years old, and I still run without pain. I can’t stress this enough – as a 26 year old man, I could barely run at all.

Good luck – it’s super frustrating, and foam rolling is super painful when you get started. There is no quick fix here. Even if it’s working you might feel worse before you feel better. Run a mile at a time, and test it out.

Again, good luck. Hope you fix it – but I’d start with your feet.

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I’d second running mechanics as well. Like a bike fit, having a gait analysis will help prevent this. I’ve been dealing with this for over 10 yrs now. Flexibility and hip strength are priorities and cyclists typically have neither.

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Hey I’d like to add my experience with this ITB. Back in the early 1980’s when I was doing my infantry platoon commander course this issue arose in my early 20’s. Nobody could tell me what it was, the sargents and warrant officers concluded I was out of shape and needed to have more additional running at the end of each day. wrong.

Next in the the middle 1990’s I started to run again and and it surfaced again. I ran my 10K and quit again.

Next in the late 2000’s took up triathlons. It started up again except this time I knew what it was.

I did two things: I never ran further than 10K in a training run (we have a 10K lake trail loop near my home) at a very easy pace. After 65 minutes I could feel it so I never pushed the pace. When I did push it I found that 35 minutes faster pace it acted up. So I found my two limiters. distance and intensity. For about a year I did not worry about pushing my limits. I heeded this limits… this was important.

You will do various PT therapies, but in my case that IT realign itself over time and went away. Like all running related issues do not push yourself and take time. I have gone through the range of running related issues while getting my boston qualifier at age 50. I have gone through shin splint, ITB, ACHILLES TENDON, Heel insertion for 3 years (god that hurt) - shock wave treatments- and now a bit of planter’s fascitias.

So take it easy on running don’t violate the golden rules like I did: raising intensity too soon, too much tempo running, not giving the body time to adapt (ITB and shin splints), etc. I love running … well it takes a few years to get to that stage…

Now I lot of posters here were inferring they are triathletes. Hey everybody there is a thing called Aquabike… I’m off to spain for May 4th 2019 ITU worlds: 3KM swim and 120 KM bike.

While dealing with running related issues, learn patience deal with the issues (they take years to resolve…) and still train hard in swimming and biking with your fellow triathletes and compete. I’m 58 this summer, and there is a lot of us old guys doing Aquabike, which the USA started in 2008… God bless the USA triathlon organization for this. Because when running becomes to frustrating there is always this event to keep you motivated.

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Here’s my 2 cents - I’ve had ITB issues and I’ve treated ITB issues…a lot. The above info is correct, ITB issues usually come from hip weakness, esp glute med. The tissue gets inflammed and tends to bind to the lateral quad. You can’t stretch the ITB itself. I’ve read studies where they took a cadaver graft of the ITB, hung a 50# weight on it for a week and there was no change in length. But, a skilled therapist (ART, Airrosti, myofascial release specialist or PT) can dig into the quad/ITB junction and release the two. Foam rolling is ok, but tends to just squish the tissue. For strengthening, hip hikes, abduction exercises, single leg bridge (these https://www.youtube.com/watch?v=GwPe0JwYbrA ) will help control what happens down the chain when your foot hits the ground. You can also check from the ground up (foot biomechanics), and get an over the counter orthotic if indicated

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I don’t work for them but one thing that has really helped me is aggressive massage with a Hypervolt.

Runner’s World

I use to use a foam roller religiously and honestly it never generated any lasting benefit. The Hypervolt allows me to work on areas on or around the IT band and it appears to last well beyond the treatment.

YMMV but I’ve been super please with the results and definitely feel like I can run at any time without worrying about my IT band flaring up.

Hah, I’ve been dealing with ITB issues in my right leg consistently since ~2008. Fortunately, I don’t like running, so I considered this an excellent excuse to just stop running

I have been there too! ITB and some tight bands very close to the ITB and sore knees. I have seen a fantastic physio, he has treated with dry needling to hip flexors and to the ITB, always mad a massive difference. if its is very persistent then its more likely a compound issue, multiple muscuels/tendons/fibres involved. if you can, regular massage with a focus on the ITB, hammy, hip flexor, quad, glute has kept me running (I go twice a month) the dry needling sorted issues that were too ‘deep’ for the massage and foam roller. Good luck! its a horrid pain to have!

Sounds like you need to switch Physios. I go to a chiropractor who specializes in sports related issues. People are giving good advice for specific issues, but you need someone to let you know which one you have. My issues were fixed relatively quickly, but it required to do the prescribed work. If your dr. doesn’t give you any, find a better one.

My ITB issues were because my leg was drifting over midline especially when I got tired. I didn’t know this until I went to a PT and got filmed on the trainer. Corrected the midline problem with glute work and stride work and now I’m fine.