Thursday, 25 April 2013

IT Bands - The Plague of Runners

I never considered myself much of a runner, mostly because as you can see from my turtle like paces while training for a half marathon, I'm not. However, whenever the urge takes me to increase my milage, I always start to develop the same set of problems. The most common to all runners of these is difficulty with my IT bands.

What Are IT Bands?

Well, it stands for illiotibial band. Pretty much it's like a leather belt of fibers that runs from the outside of your hip to the outside of your knee. And it's pretty important particularly in stabilizing your knee, which is not a joint you want to be moving in the wrong direction.

Through over use/incorrect use it becomes tight, rubs against the bump at the bottom of your upper leg bone (aka  the lateral femoral epicondyle, 'b' in the diagram) and becomes inflamed. 

borrowed from

What Does ITB Syndrome Feel Like?

Wondering if you have it now? Well, the most common symptom is pain on the outside of your knee, though the pain can extend all the way up the band. It can be while running, or increase even after you've stopped the activity (that's inflammation for you). This can also be followed by swelling if you ignore it.  Still not sure if this is the cause of your pain? Well, it is usually worsened by going up or down stairs, where the IT band is relied upon more. Feel free to test that one out.

What Can Cause ITB Syndrome?

So, overall it is inflammation from overuse and friction. However, 'overuse' doesn't just mean too much running, it means exercise where either the other stabilizers are not doing their share, so the ITB is doing too much, or where the particular motion requires more stabilization than the normal.

Other Stabilizers Not Doing Their Share:
Your ITB is meant to work in conjunction with lots of different muscles around your leg such as your glutes (yup, your butt, it's big for a reason!) and the guys around your hip (inside, outside, upside down... you get the idea) as well as core muscles further up. If these other muscles are weak or not firing properly, your poor ITB picks up the slack, he's just that kinda guy.

Need For Increased Stabilization:
There are a range of body abnormalities that can increase the strain on your ITBs, such as high or low arches, uneven leg lengths, or a tendency to turn the foot in or out too much. These you need to identify, and try to correct as much as possible. A good sports doctor is what you want here.
However, there are also a range of external factors. The most common for runners is always running on the same side of the road. As the road tilts just slightly to drain away, it means you are constantly running unevenly.
Similarly, various types of exercises can increase the strain. For example, exercises that require a squatting motion - climbing up and down stairs or rowing - puts your knee in a position where it is less stable, and if your other stabilizers aren't helping, will overwork your IT band more than normal.

Treatment and Prevention:

First of all, deal with the symptoms. If you have gotten to the inflammation stage: RICE - Rest, Ice, Compress and Elevate. You can then start stretching the ITBs out by using a foam roller and doing particular stretches such as this one:

Stretching has always been recommended for ITB syndrome, but a lot of people find it only helps slightly. That's because it's helping with the symptoms, but you haven't addressed the underlying problems. So, don't forget the next two steps for a lifetime of (this particularly type of) pain-free running.

Second, try to minimise external factors. Swap the sides of the road you run on. See if you can get correction for arch problems, etc.

Third, strengthen up the other stablisers to they do their part. Try these exercises on a regular basis to keep everything pulling their own weight.

Using the combination of all three there is no reason not to look forward to running, jumping and hiking pain free.

Now it's just a matter of fitting it into my training schedule! These can be done before or after your work out. I like to do them without the band while brushing my teeth, as it makes sure I at least do something.

Anyone got any other good exercises for treating ITB syndrome?

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