Wednesday, May 23, 2012

Injuries Schminjuries: An IT Band Story

First of all - thank you all SO much for all of your encouraging words on my pity party post yesterday.  I promise I am already in higher spirits and am working on a "movin' on" plan.  I'm also working on that Girls On the Run post I promised you today... I PROMISE PROMISE it will be up tomorrow. 

But in the meantime, I've been working on this post for a long long time, but since I just finished talking about my 2010 Portland Marathon race AND I just read poor Robyn's struggles with the evil ITB (illotibial band, for those of you lucky enough not to know), I realized it was time to FINALLY finish it.

After Portland I was ridiculously sore, but not anything out of the ordinary for having just finished a marathon.  I must also preface this by saying that I did not have ANY ITB pain during the race itself, or during much of my training.  I did a short run on Thursday after Sunday's Marathon, and on Saturday, while I was just walking down a steep hill (one of the ones by Pike Place Market actually, that's how vividly I still remember this, I even know that I was wearing my fake-Ugg boots), I felt this crazy painful pop in the side of my knee.  After that it hurt to take every single step.

That crazy pain faded, however, and it left me with the common ITB problems I'm sure most of you have faced before - you know, that crazy stabbing pain that comes on only after you've run a bit.  For me it was about 1.5 miles.  I would feel great for the first 15 minutes, and then, like clock work, STAB STAB STAB IN THE SIDE OF THE KNEE.  It. Was. Horrible. 

I tried EVERYTHING.  And because I tried everything, and because this awfulness continued on and on for 3 freaking months, it's difficult to know exactly what worked for me.  But I'm going to tell you everything I did, in the hopes that it too, will help you.  Obviously I don't think I need to say that I'm no doctor and therefore interpret my results cautiously.  This is pretty much the order in which I did things. 

1.  Foam Rolling Like a Boss.  Seriously, foam-roll like its your job.  I did it twice a day. 

Spoiler alert: It will HURT.  If it hurts, that means you're in desperate need of it.  source

2.  Stretching Like a Boss.  Seriously, stretch at any and all opportunities.  You're in the shower?  Stretch that ITB.  Waiting for the elevator?  Stretch it out baby.  Brushing your teeth?  Stttreeeetttchhhhh. 

This is my #1 go-to ITB stretch.  There are others, but I like this one best.  source

3.  ART / Graston from the Chiropractor.  The Active Release Technique, or ART, is a soft-tissue massage technique not too different from what you do with the foam roller.  Basically the chiro presses into "pressure points" and then moves your leg around accordingly, trying to get the muscles to release and loosen up.  The Graston Technique, on the other hand, is similar to using The Stick on your muscles, except imagine The Stick is made of metal that is used to "scrape" your muscles and it hurts like no other.  Graston is seriously TORTURE.  It wasn't that horrible on my IT Band but I've had it done on my shin before and it pretty much reduced me to tears. 
They should call it the Torture Technique instead.  source

I do think that both of these things helped a bit but I think it would have helped so much more had I been resting and ibuprofen-ing at the same time (see #6 and #8).   The worst thing about this was the chiro was adamant that I could keep running through this as long as it didn't hurt.  So I kept running to that point of pain (15 minutes on the dot...) for WAY TOO LONG.  This was a huge mistake. 

4.  Physical Therapy.  I learned all about funny exercises to work your glutes and side glutes, like crab walks, clamshells, and the like.  I also went crazy on that machine at the gym where you open and close your legs (twss).
Clamshells: except to work harder put a resistance band around your thighs.  source 

Go to town on this machine.  Hint: make sure your shorts aren't too short!  source

5.  MRI.  After all of this, I was feeling hopeless and like it would never get better and the chiro agreed and thought maybe something was torn.  Nothing was torn.  He was just dumb for telling me to keep running through it.  This was a waste of money except for peace of mind. 

6.  Rest.  I finally decided I was going to rest for 2 full weeks.  I cross-trained on the elliptical and swam during (biking aggravated it as well so I stayed away from that).  I think if I had only done this sooner I would have been better way sooner.

 Cooper is a professional rester. 

7.  Doctor.  He was extremely unhelpful.  It took forever to get the appointment and I had already mandated rest for myself (FINALLY) by the time I went to see him.  He did tell me to do #8 though, which I do think helped.  I mostly just went to him to get my MRI read. 

8.  3 Advil 3 Times a Day for 10 Days.  I was seriously concerned about my kidneys and liver but the doctor said it was totally fine.  He acted like I was crazy for even being concerned.  Apparently I should eat Advil in the same fashion I eat candy.  This overlapped with #6 (resting) and I really do think that this combination helped. 


9.  New shoes.  Here is when I went minimalist and my husband got me a pair of Vibrams for Christmas.  I've since transitioned out of these because of shin problems and because they don't stop my heel strike.  But that's a story for a different post.  If your shoes are old, I'd get new ones.  If they're not, not sure this will help you. 

10.  Come back SLOWLY.  I came back very slowly, starting with 1 mile and adding half a mile at a time.  I could have come back more slowly (like I did 1 mile on Tuesday, 1.5 miles on Thursday, 2 miles on Saturday, etc.) but this worked for me.  I also incorporated stretch breaks every 5 minutes, lengthening these out to every mile, every 2 miles, etc.  I took longer at eliminating the stretch breaks.  I still remember how happy iI was the day I ran 6 miles again.  Make sure you're not running on a cambered road or running on a track because this can aggravate the ITB. 

So?  What's the verdict?  Obviously all injuries and bodies are different and there's no guarantees that what worked for me will work for you.  I read 100's of pages of forums about ITB problems on Runner's World and they all confused me.  But not one of them said what I really really REALLY wish someone had told me: that I needed to FULLY rest for 2 weeks.  I hope this helps you in some way!

Have you ever struggled with ITB issues?  Do you have any recommendations or ideas to add to this? 

Comments (18)

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I have never had IT band problems (knock on wood). I am currently going through everything imaginable to get my piriformis better, so not fun. I am actually seeing physician #3 this afternoon. So tired of making all these appointments and stretching like it is my 2nd job. I just wanna be better!!!! Totally have ZERO patience.
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5 replies · active 672 weeks ago
In the midst of my 2 week rest, I find this post reassuring (which is weird since I'm resting for an entirely different issue). I also had the most frustrating doctor's visit yesterday, (so frustrating that I had trouble sleeping because I was so pissed at her) and you addressed several of my problems with the doc...like the unhelpfulness of the doctor. Is it weird that I find it encouraging that your doctor helped you as little as my doctor helped me? I don't want to talk too much about what an idiot this doctor is, but trust me, she's awful. I like your IT band foam roller guy! That's so cool!
I have NEVER seen a doctor who I thought was actually helpful or who cared about my situation. Which is why I've seen like 5 different docs and 3 different PTs over the years!!! �What did your doc say?
I know! Why are doctors so not helpful?

Um..well she said I "Probably hurt the muscle," regarding my shin probs...no estimate of how long it would take to get better, nothing. The most ridiculous part was that I've been taking Ibuprofen per the Urgent Care doctor's orders (3 weeks of taking it 2-3 times per day), so she asked me how my kidneys were. I said, "Um, I think they're fine, but how would I know if there was a problem?" Then she said, "Okay." So I don't think I could be horribly harming my kidneys taking that small amount for 3 weeks, but she didn't even tell me what symptoms to watch for! She also wouldn't treat a very common skin problem I have and told me to go to a dermatologist. AND I've never seen her before and she didn't get any labs on me or ask me when I last had a blood draw. Oh, and her English was also terrible. So....I'm not going back to her!
That SUCKS. And she was a sports doc??
No, internal medicine...which explains why she was not informed about sports injuries, but doesn't explain why she wouldn't prescribe me anything for my skin...or why she didn't get any labs on me. AND she didn't even offer me a referral to sports medicine. :(

Oh well! Not going back to her! Now I'll wait another month till I can get an appointment with a different doctor. Joy!
I'm wondering if I might be developing some ITB problems. I'm foam rolling like a boss, not stretching enough (I'll add that in).

Are things better now at least?
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I had ITB issues last year. I was only running like 1x per week for like 3 weeks bc it hurt so badly. I went to a SPORTS doctor (NOT chiro or any other stuff) and was told rest for 4 weeks and advil and he gave me topical anti-inflammatory kind of like bio-freeze. the most important thing is to REST. It is a tendon that is inflamed and you can't get the inflammation down without rest. The foam rolling,etc helps but the KEY is rest. Then starting back super slowly and building up conservatively. While I was on my rest, i did Bikram yoga for those 4 weeks. It was pretty good.
I have had ITB issues. Mostly when I trained for my marathon in 2004. It was so bad, I couldn't bend my knee for half of the race. I still stretch like a maniac after every run so it doesn't come back. Foam rolling is awesome and very painful for me, which tells me I need to do it more. I should probably buy one:) Didn't know about the clam shells. I should try that.
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Wonderful advice, thanks for the condolences :) Foam rolling and I are in a very intense love/hate relationship right now. I have found two very distinct knots in my IT band (the culprits—I believe) and although I'm glad I found them, working them out is a biitttcchhh. I have been trying to lay off the anti-inflammatory meds because I was downing them when my knee was bad, but I suppose this could be upped. The one thing I would add to your list is ice! Icing down the length of my band, as well as my bad pressure points, is pretty soothing, and it seems to have a pretty lasting effect. Ultimately, I agree 100% that rest is key. Painful running isn't fun running, and it only makes it worse. And running should be fun! An ounce of prevention—a pound of cure.
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I had problems with ITB (from running on the same side of a crowned road all the time) and I can't say enough that truly that only thing that helps you get over it is rest. The other stuff will help it feel better, but if you keep aggravating it, it's not going to fully heal. And ice, ice, ice.

And on the topic of ibuprofen I thought this article was interesting...I don't know what to think now. http://news.runnersworld.com/2012/04/26/anti-infl...
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I (knock on wood) have never had any ITB issues but the horror stories from my friends about the shooting pain is enough to make me stretch and foam roll my ITB on a regular preventative basis. The crow pose in yoga is pretty much the best stretch ever for hip/ITB stuff and I do it almost every night.
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I had IT band problems last year and ended up in physical therapy. it really all stems from (or so the doc and PT told me) is weak hips-and most women have weak hips. I did tons and tons of exercises and stretches to help it and it went away. but, i still feel issues every now and then and know i should do more of the stuff i learned but it’s kinda like “out of site out of mind” since its not really, really hurting. just a side note-i was still able to train for my marathon while in PT. they just gave me different cardio to do for 2 weeks or so until i started to show improvement but i never had to stop running for longer than that.
I had IT band problems after my first marathon. I was off running for 6 weekish. I foam rolled and cross-trained and slowly started adding miles after 6 weeks. I rediscovered strength training and spinning. Rest, time, cross training, and foam rolling. That was my equation. Lots of icing too.
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I seriously had the ITB from hell injury. Mine got progressively worse, even after months of running. I was down to doing just about nothing and still it was an issue. I was finally fixed by a kinesiologist who got a tired glute medius back to firing. I found that foam rolling and stretching were the worse things for it, actually. I still believe you cannot stretch it--it is fascia, not muscle. Stretching will actually aggravate it by pulling it apart more (counterintuitive, I know). But like you, I'm a minimalist runner now, and I think that makes a huge difference.
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That's months OFF running, not OF!
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I kind of eat Advil like candy. I love it. So I have a lot of pain in my hips after running. Do you think that is related to ITB? I honestly dont find a stuff on hip pain/soreness when I research and foam rolling and some of the same stretches you show above seem to help so I wonder if they are related?
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I got the IT bands after I hit 15 miles on the long run for my marathon training. I had to take 2 MONTHS off and I came back slow without any problems. I'm back up to 13 miles.
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