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1817 Views 6 Replies Latest reply: Jul 8, 2012 11:34 PM by JamesJohnsonLMT RSS
Christieloop Rookie 2 posts since
Apr 27, 2012
Currently Being Moderated

Jun 27, 2012 8:55 AM

IT Band injury / Runner's knee

I recently decided to begin training for a marathon, after running only once a week for 5-7 miles for the past year or so. I started my own "training method" since I couldn't find one suited to my current level of fitness. I cross train Mon - Friday with a boot camp program. I began slowly 1-2 miles 3 days a week, and my longer run on Saturday, even scaling back to just 4-5 miles on Saturdays. I noticed pain in my left groin on my long runs, but nothing that was a deal killer. I went to a masseuse and she worked on that left leg for me, but later that night when I attempted a small run I felt a burning pain on the outside of that left leg. When I woke the next morning it not only hurt to walk, but I have a popping on the outside of my left leg with every step I take. I went to the Dr. and they said it was Runner's knee, AKA IT band tightness / injury. So the Doc I went to wanted to charge me lots and lots of money, and honestly after several visits he just wasn't doing anything. So I did my own research and found that a foam roller and stretching seemed to help a lot of runner's. I'm just worried because this is my second week of no running, and I'm itching to get back to it. Anyone else have any experience with this? Any suggestions on how to get this better, or how to get back into my running routine?

Thanks guys,

Christie

  • Angie682 Rookie 3 posts since
    Mar 10, 2010
    Currently Being Moderated
    1. Jun 27, 2012 11:44 AM (in response to Christieloop)
    IT Band injury / Runner's knee

    Christie,

    I am going through the same injury right now. Unfortunately, this is a repeat injury for me. The key here is to take it SLOW. I was advised by my doctor "no running for two weeks" and after only one, I am itching to get back out there! I am currently taking walks, going just a couple of miles, and slowly increasing mileage depending on how the knee feels. Last time I had this injury, I tried to recover quickly by not giving it enough time to heal..BAD IDEA! I wasn't able to run for about 6 months. Slow and steady really is the key here.

     

    Foam roller, stretching, and the correct shoes/ support (insoles) really do wonders. When you do start running again, don't push yourself too hard. Good luck and here's to a quick recovery for both of us!

    Ange





    Ange

  • Damien Howell Legend 312 posts since
    Feb 27, 2008
    Currently Being Moderated
    2. Jun 27, 2012 5:16 PM (in response to Christieloop)
    IT Band injury / Runner's knee

    Christie, stretching IT band is controversial and tricky, take a look the short article IT band: Controversey Regarding Stretching.  I am NOT a big fan of the foam roller, the logic escapes me.  The fact that the problem is on one side of the body (left) is an important clue.  Take a look at short article Symmetry - Asymmetry: Problem Solving Repetitive Ue Inury.  In my experience hip knee problems which occur on one side of the body often have a lot to do with habitual asymmetrical sitting habits.  Take a look at Buttock Hip Pain: Stretching Exercises particulary the photos. 

    Damien Howell PT, DPT, OCS

  • Damien Howell Legend 312 posts since
    Feb 27, 2008
    Currently Being Moderated
    4. Jun 30, 2012 8:59 AM (in response to Christieloop)
    IT Band injury / Runner's knee

    Christieloop, in my experience if the manner of running (running form) is a factor in the development of IT band syndrome it is running with too long a stride or too long a step length.  When you walk and run consciously strive to shorten your step length.  Recognize for a given speed (velocity) step length is directly related to cadence.  Shorten step length increase cadence.  Do a browser search for "running cadence" for additional information, and strive to increase your cadence walking/running while keeping your speed the same.  Again, your knee pain is one side of the body (left), so if you are running with too long of a stride you are running with too long of a stride on both the right and left side.  Therefore you still need to identify why the left leg is experiencing more stress than the right - see above articles.  In terms of increasing your running safely the quick answer is the "10% rule", however this rule has recently been questioned. Evidence does suggest that avoiding consecutive days running can help prevent injury, take a look at short article Consecutive Days.

    Damien Howell PT, DPT, OCS

  • SaraJo1212 Rookie 3 posts since
    May 30, 2012
    Currently Being Moderated
    5. Jul 5, 2012 3:12 PM (in response to Damien Howell)
    IT Band injury / Runner's knee

    Damien - Thank you for that information!  I'm a relatively new runner, and only run 3 miles every other day.  I've been trying out a longer stride this week, and my knees are really hurting.  I was guessing that was the problem, but it's good to have confirmation.  The bummer is that I'm going to restrict myself to walking workouts for another week, but after that I'll be back to running--with shorter, faster strides.  Thank you so much!

  • JamesJohnsonLMT Legend 1,150 posts since
    Aug 23, 2009
    Currently Being Moderated
    6. Jul 8, 2012 11:34 PM (in response to Christieloop)
    Re: IT Band injury / Runner's knee

    There is a load of information we could cover here, but I'll just mention a few things for further discussion later, if you so desire.

     

    Most important, is the program you are looking for may not exist. Your story presents a unique set of circumstances that require a customized approach. You sensed this when you found no programs matching your individual needs. When Angie emphasizes the need to take time during recovery, she has the right idea. As they say, listen to your body. Pain will always trump programs, any day. Controlling your ambition is much tougher.

     

    It is true that physicians have difficulty treating injuries that result from adult athletes training for marathons. Their education is directed towards issues requiring an uncommon knowledge base and a high degree of diagnostic skill. This is more a matter of common sense. In cases like these they tend to say, "stop running," because they know your body will eventually recover from the abuse of overtraining, as long as it stops. The concept of someone willingly beating themselves up is beneath their level of interest. They are not necessarily trained to deal tactfully with your athletic ambitions, and therein lies the problem, in my opinion.

     

    Transitioning from being a weekly runner to a marathoner isn't easy for most people, but for you it should be harder. Your height to weight ratio suggests a stocky build that may need great patience to change, without a rare amount of durability to spare you from injury. Every now and then, you will run into someone who melted many pounds off, seemingly through exercise alone. It does not follow that anyone can do this. Their story is likely to have had a very different explanation.

     

    The requirements for balanced endocrine, immune, digestive and other systems is more important than the musculoskeletal issues that exercise physiologists specialize in. For most people, weight loss has much less to do with exercise than with how their body generally functions. Exercise is beneficial, but not a panacea for all things morphological (it is rather the other way around for most of us). In some cases appetite increases and there is no weight loss. In others, the subject simply falls prey to one injury after another. The point here is not to lose hope, but to invest your energy where it will result in less disappointment, fewer injuries, and maximum results.

     

    Damien mentioned the asymmetry of your injury or pain. If you've checked out the usual culprits, a slanted road surface or running tight turns in the same direction, and there is still no clue, seriously consider an anatomical asymmetry. It is quite common to have one leg shorter than the other, or a particular hip or foot structure that forces other structures to compensate during movement to achieve balance and efficiency. "Compensation" often leads to overuse injuries within training programs that otherwise have a high survival rate.

     

    On the remedial side, I agree with Damien that stretching the ITB specifically is a waste of time, even though the movements involved in stretching often have tonic effects. The ITB is tensioned by hip and gluteal muscles in order to stabilize the knee. While this soft tissue group can become quite tight, it really can't be stretched much without pulling your leg apart. The purpose behind stretching in general, is to relax soft tissue, not to stress the joints. This is where foam-rolling or other massage techniques come into play.

     

    The logic is to mobilize the tissue and the lymphatic fluids that maintain it, without stressing it with further exercise. In this way, some of the benefits of exercise and stretching are obtained without the risks associated with either. Where people go wrong with foam-rolling on the limbs, is to force lymphatic flow against the valves that prevent pooling of fluids in the extremities. Centrifugal force is checked by these valves, so it only makes sense to roll towards the heart, instead of rolling against the valves. Most foam-rolling videos ignore this, for the simple fact that it is a hassle to remove weight from the roller during the return stroke. Too bad, it needs to be done, even if it makes foam-rolling look awkward instead of easy. If the idea of humping a roller seems ridiculous, then learn another self-massage technique. Rollers are too general for many remedial tasks anyway.

     

    Back to the weight issue, you may find that tweaking the timing and composition of your meals, and hydration, to be the fastest way to make changes. Most people grasp the concepts of eating healthy, but fail to address the timing in a meaningful way. When to eat and drink is often more important than what to eat. A glass of water 30 minutes before a meal gets better results than drinking "when you are thirsty," which is the latest trendy advice after the "8 glasses" myth was retired. Carbs late in the day not only convert to fat more easily, they interfere with weight-busting hormone production at night.

     

    Forget any claims that sports drinks make. They are sometimes valid for hours of competition involving bursts of activity, but have no importance to the average endurance runner. Focus on whole foods and avoid smoothies and other liquid nutrition or concentrated "sport foods." Grain products are less healthy than the USDA food pyramid would suggest. Study glycemic loads of different foods. Your weight is reflecting how your body is handling what goes in. Exercise is more of a celebration of good health, which should be able to exist without it.

     

    Any doctor should be able to tell you that weight is the leading contributor to knee pain, whether exercising or not. If you want your money's worth from a physician, get them to look for skeletal asymmetry and hormone levels, check you for blood-sugar spiking, look for gluten sensitivity, etc., which are things that affect injuries and weight. Musculoskeletal pain and exercise physiology are usually not their areas of expertise.

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