Thread: IT band problems = 5 months of training down the drain?

I am in the same boat. I did a long endurance race last year, blew-up (irrated) my IT Band on the marathon portion of the race, which was run on the beach. I didn't realize it was bad until the next day when I got out of bed. I went to my trainer, he said foam roll and don't run, so I didn't...for 7 months.

I am doing an IM this summer, so I started light running in January. Flats and uphill were golden, down hill though, my IT Band got pissed, to the point to where I could barely walk home.

I went to a PT, they found out I have ZERO flexibility in my hips, glutes and quads. So, the first month was painful deep tissue "rubs" and odd body contorsions to increase flexibility. Now that I am loose, I am doing stability exercises. Single leg squats, single leg balance exercises...basically single leg everything.

I was told to run easy pace (8/M) for no longer than 30 minutes. So, I am in your same boat...it sucks and is mildly depressing. If you want I can scan and email you exactly what I am doing, to compare it against your routine.

Originally Posted by neufox47

Interested as to the kind of strength and mobility training you did leading up to this.

Strength - Squatting 2x/week, deadlift 1x/week, power clean 1x/week, press 1x/week. Set/rep schemes varied. Also some bodyweight work and circuits.

Mobility - I typically did an hour of yoga on sundays as a recovery workout but not much else. Mobility has never really been a problem for me (I can touch my toes and squat full depth easily) so I've kinda neglected it. Other than the quad tightness the PT didn't identify any other real mobility problems.

Originally Posted by neufox47

This guys is probably spending $1,000 a month between the coaching, massage and PT though

Holy mother of god.

Originally Posted by supermodel159

I am in the same boat. I did a long endurance race last year, blew-up (irrated) my IT Band on the marathon portion of the race, which was run on the beach. I didn't realize it was bad until the next day when I got out of bed. I went to my trainer, he said foam roll and don't run, so I didn't...for 7 months.

I am doing an IM this summer, so I started light running in January. Flats and uphill were golden, down hill though, my IT Band got pissed, to the point to where I could barely walk home.

I went to a PT, they found out I have ZERO flexibility in my hips, glutes and quads. So, the first month was painful deep tissue "rubs" and odd body contorsions to increase flexibility. Now that I am loose, I am doing stability exercises. Single leg squats, single leg balance exercises...basically single leg everything.

I was told to run easy pace (8/M) for no longer than 30 minutes. So, I am in your same boat...it sucks and is mildly depressing. If you want I can scan and email you exactly what I am doing, to compare it against your routine.

That's interesting that the real pain didn't appear until the next day. That was not my experience. My worst pain was during/immediately after the 50, and it rapidly improved over the next 24-48 hours.

My PT seems to be a big fan of single-leg work. He didn't prescribe much this visit but I think there will be more coming next time I see him. He was also pretty meh on foam rolling, said IT band-specific research on it is pretty inconclusive right now. The easy pace thing is interesting. One thing he mentioned was that running slower tends to cause more IT band issues. He recommended speed work like hill sprints, 800m repeats, etc.

That would be great if you could scan stuff. It would be interesting to compare. dean dot daniel at gmail

^Initially, the pain showed up the next day. Now, when I run it happens right away (generally after about an hour 8/M pace).

Dan, I'm wondering if what you have is even iliotibial band pain. I remember one of your posts saying the pain was where it inserts into the tibia and I have never heard of it manifesting itself that way. I though it was always around the lateral condyle of the femur area.

I got an mri, it showed a "small radial meniscus tear" that the doctor didn't seem too concerned about. It didn't show anything around the IT band or anything bad in the patello femoral joint, but that doesn't surprise me with what I have read.

I really don't think the tear on the mri is where my pain is coming from tough. It's classic IT band pain, right at the lateral condyle, worst is when I'm bent between 30 and 60 degrees. Meniscus tests done by p.t. don't trigger the pain at all. I am guessing this small meniscus tear is causing the clunk or some of the grating in my knee, but I am afraid another surgery right now will just screw my IT band problem up even more. Tried some single leg balance stuff, barely bent at all, maybe 25 degrees and sure enough I am paying for it now, 48 hours later. Still can't find anything that makes it progress beyond miserable.

Originally Posted by Dantheman

My PT seems to be a big fan of single-leg work. He didn't prescribe much this visit but I think there will be more coming next time I see him. He was also pretty meh on foam rolling, said IT band-specific research on it is pretty inconclusive right now. The easy pace thing is interesting. One thing he mentioned was that running slower tends to cause more IT band issues. He recommended speed work like hill sprints, 800m repeats, etc.

That would be great if you could scan stuff. It would be interesting to compare. dean dot daniel at gmail

DTM - Once you begin your single leg stance progression, could you, if you don't mind, share not only what the exercise is, but what your PT has you trying to control and be aware of with regards to your pelvis and trunk. Its not so much what you do but how you do it that makes the difference.

tone- realize the dx of IT band syndrome/what have you will encompass anything related to the IT band, including, insertional pathology, where the band has to negotiate its way over the lateral condyle, mid tissue restriction, to it origin in the TFL. Its just part of the vaguity (new word?) of musculoskeletal diagnostics.

Your workout plan seems way to injury prone for my liking. When did you schedule rest recovery weeks? High milage runs burn into your muscle, then you max RM the next day= injury waiting to happen. I know milage is high with ultramarathon activities but I dont see much room for recovery in your workout plan. How do you vary your milage across the week? Over 20 miles and you start to burn stuff you really need. Whats your diet like?

Originally Posted by tone capone

Dan, I'm wondering if what you have is even iliotibial band pain. I remember one of your posts saying the pain was where it inserts into the tibia and I have never heard of it manifesting itself that way. I though it was always around the lateral condyle of the femur area.

The two are close enough together and the pain was radiating far enough that I may have just been misinterpreting the origin. I was also pretty dejected and pissed off at the time so I don't trust my memory that well.

Originally Posted by lookinback

Your workout plan seems way to injury prone for my liking.

Considering that I have posted almost no specific details about my training plan, I'm curious what exactly you are basing this statement on.

Hope you are doing better now Dan. Injuries are frustrating.

unless I missed it, was running surface talked about? if you're not running on an even surface everything can be aggravated. fascia manipulation and amt are fixes and can improve biomechanics, but with 50-60 miles/week any imperfections are magnified. Keep in mind some people will never be suited for long distance running regardless of how much work they put it.

So I have been walking and biking, started really easy and have built up my tolerance a bit. I can walk up and down mellow trails fairly well with no pain, but I can't take big steps (stairs) up or down without pain. I could barely bike in the beggining, but now I am able to pedal up some fairily decent hills and descend carefully (mountain bike). I don't have much funtional improvement otherwise and there is no way I could ski or run, but it feels damn good just to have those slight improvements. Going to keep on this program and do some glute mead strenghthening and hamstring curls on the ball and see how things go. Unfortunately I can't do anything to really strenghten my quads yet but hopefully that changes with my graudal return to moderate activity (NO post season backcountry skiing) program. Good luck to everyone else with IT band issues, keep us informed.

Hey tone, keep us informed if anything works for you. I'm really hoping I never have to go through this, but I'm curious about what can help or prevent that kind of agony.

For glut med strengthening, there are two exercises that I've found work really well. I'm not a PT. I had hip surgery and was still having compensation issues 2 years after surgery (because I skied/played soccer on it for 4 years). My PT and I tried a number of traditional glut med exercises, but I just kept using my TFL. These two work well for me, so maybe they'll work for someone here too.

#1: Find a couch/wall/etc that has a good a 90* angle. Lay on your side with your knees matching the 90* angle - hamstrings pressed against one side of the couch/wall corner and your caves touching the other. Now, tuck your tailbone under and round your back (really important to have a neutral back - think fetal position). Shift your upper leg slightly back to engage adductor and hamstring. Press your bottom leg down into the ground while lifting your top leg (which is what works glut med). Keeping the hamstring engaged and pressed against the wall will inhibit TFL. Once the lift becomes easy, add internal rotation by lifting the ankle upwards. This was the first exercise I ever did where glut med (rather than TFL) aided with internal rotation. I didn't even know glut med existed prior to this. (Keep in mind the last time my hip was functioning properly was in early high school - 7 years ago.) Add ankle weights for more difficulty.

#2 is kinda of difficult to explain (though an excellent workout). Happy to write it up if there's interest.

http://www.mobilitywod.com/

This guy has helped me a bunch. Start on the last page (episode one.)

Just took a quick look at this thread. Sorry to hear about I-T band issues. They suck.

Has anybody talked about shoes? I had an I-T band lock up in a 50 mile ultra (McKenzie River, back when it was 50M) about 15 years ago. I finished, stiff-legging it the last 10 miles. Awful. Couldn't walk for a week. Couldn't run for weeks.

I ran that race on board lasted (straight) overly corrective inflexible running shoes (Brooks Beast or equivalent). I took off a couple months from running and then, on the recommendation of a PT/famous ultrarunner bud, switched to more curvy shoes with more forefoot flex. Ran White River 50M a couple months later. No problems. >70 ultra finishes and thousands of miles since then. (Note that did have surgery for compartment syndrome in my tibialis anteriors about halfway through that stretch of ultra finishes.)

This is purely anecdotal. I have no scientific explanation to offer.

Best o' luck

Originally Posted by 5B

http://www.mobilitywod.com/

This guy has helped me a bunch. Start on the last page (episode one.)

Interesting stuff, thanks.

Originally Posted by GIJoePSA

unless I missed it, was running surface talked about?

Running surface definitely changed a bit from normal. I typically run 90+% trails spring through fall, then mostly stop running and just ski during the winter. Out of necessity this winter I ran a lot more road miles than I ever have.

Originally Posted by GIJoePSA

Keep in mind some people will never be suited for long distance running regardless of how much work they put it.

True, but this isn’t my first rodeo. I’ve been trail running for about 12 years now, and been doing the marathon/ultra thing since 2007.

Originally Posted by 5B

http://www.mobilitywod.com/

This guy has helped me a bunch. Start on the last page (episode one.)

I’m actually quite familiar with Mr. Starrett. After my PT consult I did some searches on the MWOD site and I’ve been doing his recommended mobs for IT band issues in addition to the stuff from my PT.

Originally Posted by Big Steve

Has anybody talked about shoes?

I highly doubt it’s a shoe issue. I’ve been running in more minimal type shoes for a couple years now (La Sportiva Crosslite, then NB MT101, now NB MT110 for trails; Merrell Trail glove for road) and I have never owned a true motion control shoe.

I just wanted to give a progress report.

Been carefully progressing with hiking and biking. Even easy biking and walking were not too good at first, but with time and incrementalism I have improved drastically. I still have knee pain, but it is mostly kneecap pain again, with only slight IT band pain during the most intense biking and walking activities. I can easily feel the IT band pain pretty good if I try and walk down steeper hills and stairs, so I have still been avoiding that. Still no squats and no skiing but I really made great strides on the bike. At first I couldn't stand and pedal at all, for like 3 weeks, but now I feel a little pain in the begging and it fades. What's weird is if I felt a little pain skiing, it would just get worse and worse even if I took it super easy.

I really think that walking on gentle inclines, as on your average trail, is helpful. I think downhill hiking can help as long as you progress the pitch and distance carefully. Slowly but surely I have regained composure downhilling on the bike as well, as long as I keep the bad leg FORWARD and slowly build up to using it as the back leg.

I have also tried my best to keep doing hamstring curls on the excercize ball, glute mead strengthening, and single leg balance stuff. I don't have anything tight, as confirmed by three physical therapists, so no extra ordinary stretching routines.

Besides, when I was getting crazy with the stretches and other conventional IT band and petalla femoral related excercizes it just made my condition worse. Quad setting, straight leg raises, and leg extensions all set me back more than once, so go figure. I'm just not going to fuck with those things any time soon, because being functional in real life is way sweeter than crippling myself again trying to do that stuff.

I know this is still a process and I have alot of work to do before I can ski again or do any mountaineering or backpacking, but finally I have some progress to be very happy about. I can ride my bike pretty much however I want and that is a far better condition than the broken shell off a human being I was this past winter.

I know everyone is different, but we're all meant to ambulate, so at least consider that.

Thanks for the update, tone. Glad you're able to ride again!

Man, it's been a long battle but I think I finally got that It. band shit beat. Sorry again for the thread hijacks, I was a miserable prick with that shit going on. Hopefully Dantheman is out killin it somewhere. Don't fuck with the It. band pain, it will take you down. Progress carefully, for a long time. That is the only way I found.

Originally Posted by tone capone

Hopefully Dantheman is out killin it somewhere.

I wish, foot is still fucked six ways from sunday. Haven't run, jumped or even walked a significant distance in 4 months. Been ecstatic that we've gotten a bike season encore here as that's about all I have right now.