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 http://doctoratehousewife.com

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:

From http://www.rice.edu/~jenky/sports/itband.v2.html

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?

Foam Rollers and Myofascial Release... What On Earth?

In the last few years, you might have noticed these cylindrical foam thingies gathering in the corners of the stretching areas at gyms. Occasionally a personal trainer will even make someone roll on top of them. Have you ever wondered what they are for and whether they are just a passing fad?

Well, here’s the low down.

It is all to do with myofascial release. 

Myofacial release, you ask?

It’s a type of soft tissue therapy, which relaxes contracted muscles, increases circulation and lymphatic drainage and stimulating the stretch reflect muscle.

Basically:

It’s the same sort of benefit you will get from a sports massage, but a lot cheaper and you are in control (so might not make you scream as much.) The roller stretches out the muscles and tendons, while also breaking up trigger points.

It is also seen as more beneficial for flexibility than just stretching, which only lengthens out the muscles without dealing with any tension points.

Now, for the more jargon-y explanation:

The myofascia system is the combination of the muscles and the superficial fascia (ie. soft connective tissue that wraps and connects the muscles, bones, nerves and blood vessels of the body). (There are a couple of different types of fascia, but we are talking about superficial fascia here.). For various reasons, the fascia and underlying muscle tissue can become stuck together (soft tissue adhesion), with the result of restricted muscle movement and soreness.

By sustained pressure on the soft tissue with traction to the fascia, the fascia can be softened and lengthened, breaking down the adhesions. Like when a massage therapist puts pressure into an area and then rubs it along. 

So, how do you use the foam roller?

Slow and pressure are the two concepts you want to keep in mind.

Basically, you position yourself on the foam roller and roll along the muscle at a slow pace with some of your body weight adding pressure. Then you stop and increase the weight at the most tender spots. Once the pain starts to reduce, roll on. The eventual goal is to have no sore or painful spots.

It is recommended that you start at the point closest to your centre, and roll outwards. For example, with your hamstrings, start rolling out just the top area nearest your butt and slowly work down towards the knees.

Each muscle should get about 1-2 minutes of rolling. So, a good session can take between 30-40 minutes, and is perfect for doing in front of the TV if you want to invest some money in buying your own roller. Or it is also a great time to catch up and chat with friends before or after a work out. As there is less risk of injury compared to stretching, it is great to do any time.

Below is a great video for showing you all the different muscles you can work with. Though I recommend doing it just slightly slower, and pausing where you personally feel a tension spot.

It's only 5 minutes, so take the time to watch and the go and practice!

Benefits?

Great for IT band issues and shin splits, as well as improving flexibility. It can get rid of tension spots and soreness, and prevents these from developing. Great for people that suffer backpain, or problems with tightness in their muscles.

However, like stretching, it doesn’t happen overnight. We are in it for the long term improvement.

Conclusion:

It seems to be a very cheap piece of equipment, that has little risk of injury, and can have great benefits if you use it regularly. So, not much to lose.

So, no need to be afraid of those rollers ganging up on you. But always ask a trainer for help if you think you might be doing it wrong. Also, it does take some practice balancing on top of the roller without falling off, so maybe practice when not cute guys are watching.