Beating ITB Syndome – For Runners

Since dropping out of the London marathon last spring I have struggling with horrible ITB friction. For those of you who have experienced it, you’ll know just how debilitating this deep, grazing knee pain is, for those of you who have never had it, I’ll give you my best tips to make sure it doesn’t ever happen!

I have spent many hours reading about it and trying to treat it. Ideally, you want to see a physio or good sports massage therapist weekly for the dreaded massage but if you don’t have the money for this kind of luxury, you’ll need to take your time over rehabilitation. ITB recovery very much depends on how bad it was in the first place, your body type, running gait and how committed you are to rehabilitation.

My first bout of ITB pain started about 3km into a 10km run in July 2012. I thought I would go with the pain and run through it but it felt like someone was manually drilling through the side of my (left) knee with no let up. I had a session with an excellent physio who put me through immense pain massaging the ITB, watched me run and gave me a program to follow. I did enter the Nike 10km at the end of July and managed it in a plodding 54 minutes; dosed up on diclofenac, ibuprofen and paracetamol, felt like I was at a music festival, rock ‘n’ roll. Good job it was more of a fun run, lots of fairies holding hands and nobody paying attention to the ‘keep to the right’ rule! I ran half of it semi-skipping on the ball of my left foot to hold back the ITB.

I was ordered off running for 8 weeks, I couldn’t have gone out anyway, the ITB chafing was too bad. I took up a gym membership and completely forgot about running for about 3 months. Letting go of my habitual runs was the hardest part, having constructed a  fitness and mental regime around running, entering half marathons and 10km runs on a regular basis to keep me motivated. I had a very blinkered view of training in the gym, always believing ‘outdoors’ is best and shunning any strength program.

In hindsight, I was very short-sighted and for the part of it, a little intimidated by the thought of the gym; everyone crammed into one indoors space, all that sweat and parading! 6 months on and I’m a gym convert, wouldn’t miss my circuit sessions for the world and I look a million times better than when I was just running.

Now, I’m ready to start running again and have set myself realistic targets of competing in 10km and 5km races with the focus on overall fitness and conditioning, not just being run-fit.

Here is an overview of the sort of exercises I have been doing to get fit for running after a nasty few months of ITB syndrome. I get bored quickly so I have a good arsenal of variations, mix them up however you feel. Look up any of these on youtube to get good technique instruction.

Squats – building up over 6 months to 4/5 sets of 25 with 5kg in each hand or using an 8kg kettlebell. At first I was just doing 3 or 4 sets of 15 with 3kg in each hand, on and off a BOSU board. Now I’m doing single leg squats with 5kg on a BOSU board and my balance when running is feeling good! Powerplate squats are excellent too, hold a low squat for 45 seconds, then recover for 10-15 seconds. Repeat 10 times. You will feel this the next day! If you can’t do 45 seconds, do 25 or 30, build up to it. Your legs and backside will feel and look incredible too.

Lunges – static lunges, forwards, backwards, clock, curtsey, on the TRX, off a swiss ball, jumping/scissor lunges, slow ones, fast ones, they all work a treat! Again, lunges on the powerplate are good too, I like to do them really slowly and feel a deep resistance down the back of the leg.

Core –  so important to get strong hips, abs and lower back. Plank, up and down plank, press-ups with good form, press-ups on a BOSU board, tricep press-ups, side planks, straight crunches, weighted sit-up, the list goes one! One of the main factors in my ITB pain was poor gait, my arms were stiff, my knees bowed in a little and I had one leg markedly stronger than the other. I’m still balancing out after having had my right foot in a Wayne Rooney boot after breaking it in May 2011! Seriously, I’m still weaker on the right food after all this time.

Foam Roller – AAAAAAAGGGGH! It bloody hurts, yes it does but you need to use it. I didn’t for a while because I just hated the feel of it but Mr Physio said I will never get over the ITB if I don’t go on the roller. I’ve found a compromise, I use a hard orange one on the powerplate at the gym. It feels deep and massaging but not sickly painful. I roll over the side of my thighs, both sides for 60 seconds at a time and really go deep into the painful spot.

I never quite found good form with clamshells and the rubber band, and always maintain that weight bearing glute strength exercise, (if possible) trumps non-weight bearing.

I can now run 6km without a twinge but have to be very aware of my form, monitoring how the ‘good’ leg feels and trying to match the ITB one to it. Not exactly conventional medical guidance but it does help. I use my arms well now, feeling a fluid motion in the shoulder and some swing in my waist with good stability in the hips.

I also take nutrition and supplementation seriously these days, I’ll write another post on that later! In short, I’m never without a high quality vegan protein shake post-workout and I am on a restricted diet when it comes to sugar, feeling incredible.

Mine has been a slow journey, I didn’t listen to Mr Physio when it came to the foam roller, I also read a fair bit of information that dismissed the use of the roller, that just made it easier for me to ignore its importance. Now I’m using it and continuing with a hardcore strength program, mostly based around the TRX and circuit training sessions I can run again and I will probably run faster than ever because I am so strong right now. I’m going to have a go at one of the Park Runs soon and enter a few races over the summer. I became very despondent when I couldn’t run any more and gave up the ghost for a bit but fitter and healthier than ever I can reignite my passion for pavement pounding!

I’d love to hear your stories about running injuries, you’re more than welcome to post on this blog!