It happens too often to many runners—you feel great and set out for an easy run, only to feel the twinge of Illiotibial Band Syndrome (ITBS) on the outside of your knee.
You do what any good runner does in this situation: take a few days off, pop some ibuprofen, and then test your leg on a run a few days later. And no surprise—your IT band still hurts.
The same tired injury prevention advice isn't always going to cure an IT band injury. Instead, proactive and intense injury treatment is needed to get healthy and help cure your ITBS for good.
Below are the action steps you can take to get back on track (no apologies for the running pun).
1. Stop Running
Running exacerbates ITBS pain, typically at the knee insertion point, during the acute injury phase. It's simple—if it hurts to run, don't run.
2. Cross-Train with Cycling or Pool Running
These forms of exercise have no impact forces and shouldn't aggravate your IT band. They help you maintain fitness, circulate healing blood flow, and ensure you recover as quickly as possible. Start conservatively and make sure that either exercise doesn't bring any pain to your IT band. You can transfer long runs, fast workouts and recovery run to the pool or bike, and you won't lose much fitness at all.
3. Massage the Injured Area
This may or may not be appropriate for your specific situation, but in most cases, it will help. Use a foam roller and a tennis ball to work out tightness and any trigger points in the quad, IT band, glute, hamstring, and hip. Static stretching of these same areas after a massage can also help you feel loose, though it's still unknown if it offers any practical benefits.
How to Use a Foam Roller to Massage the IT Band
Lie down on one side, propping yourself up with one elbow, and position the foam roller just under your hip. Now, move your body forward so that the roller works itself down on the outside of your thigh; stop when you get to your knee.
Roll in a gradual, slow motion, and when you reach your knee, reverse directions back up to your hip. Adjust the amount of tension by applying more or less of your body weight on the roller. If you're new at this, your IT band will probably be tender, and you might not even need to apply much weight before you feel it.
When you come to a particularly sore spot, pause and hold it on the roller—this is called applying direct pressure. As you hold the roller on that spot, the pressure will help break up the knot. Only hold it there for about a minute, then do short rolls back and forth over the area to help further release the knot.
You may come across quite a few knots, and you won't be able to break all of them up in a single self-massage session. Think about foam rolling as maintenance, kind of like you would do for your car. You only want to target a particular muscle or tendon for up to 15 minutes at a time. The best way to go about this is to sneak in short sessions after your run, or while you're watching TV. Foam roll on a continual basis instead of ignoring it for a while then going crazy on the roller for an hour once a month.
Only roll to the point of discomfort—yes, it will be tender and sore, but you don't want to go to the point of unbearable pain because you'll just end up doing more damage than good.
After a few days and weeks of consistent rolling, you'll see results, and foam rolling across that IT band will become less of a torturous thought.
4. Increase Strength
Most IT band problems stem from a weakness in the glutes and hip area. It's vital to strengthen these areas. A series of strength exercises like the ITB Rehab Routine targets the weak areas so you can get back to running sooner. It's also wise to do core workouts even though they do not directly impact your IT band. With some time off from running, you'll have time to focus on your core strength. Staying on top of the little things is important.
5. Get More Sleep
Most recovery and soft-tissue healing happen when you're asleep, so make sure to get a lot of it. During any period of increased training or injury, more sleep can help you recover adequately. That's because your body enters REM and slow-wave Delta sleep after you've been asleep for at least 90 minutes. These are the most restorative sleep cycles for both your body and brain.
How to Stretch the IT Band
Another way to keep your IT band in check is to stretch. Here are two of the best IT band stretches:
1. Sit on the floor with your palms flat on the floor, spaced a few inches behind your butt. Bend your knees up and place the soles of your feet flat on the floor in front of you. Take your left foot and place your left ankle across your right knee. Drop your knee toward the floor, rotating at the hip in a sort of half-butterfly position. Hold the stretch for at least 25 seconds, and gradually try to get your knee closer to the ground. Repeat with the other leg.
2. Take your left leg, bent at the knee, and place it in front of you. Take your right leg and straighten it as best as you can behind you. You'll be in a semi-split position, except your front leg is bent. You might need to drop your knee, bend your torso forward and use your arms for support. You want to feel the stretch in the outside of your hip area, so lean forward and slightly to the left as you hold this stretch. Hold for at least 25 seconds. Repeat with the right leg in front.
The IT band, once irritated, can be a chronic and annoying bugger to deal with, so if it's not causing you problems yet, remember that the best way to avoid an injury is to be proactive.