(Note: I’m not a health professional. I am merely a runner who suffered an injury related to my IT band and am sharing what I did to get back on the road.)
When I hurt my knee, I didn’t do the smart thing and go to a doctor – instead I went to the internet and self-diagnosed. I knew that ITBS and runners knee were two of the most common running knee injuries so that’s where I started and I found that ITBS symptoms exactly matched the pain I was having.
I quickly learned that a case of iliotibial band syndrome (ITBS) is a two part problem.
- There’s the acute injury (inflamation of the IT band near your knee that causes the knee pain)
- The underlying cause of the injury
They need to be treated separately. Step one was healing the damage done to my knee by the IT band. We addressed the inflammation in my last post when I changed my diet and though diet did solve the chronic achiness, it wasn’t enough to keep the pain from returning when I ran and diet alone didn’t treat the underlying problem – which I still was unsure of.
I was sure, however, that I needed a fundamental change in my training strategy.
Prior to the injury, I’d been running 4-5 times a week through our neighborhood, mileage was between 25-35 miles. Our neighborhood doesn’t have sidewalks so I run on the side of the road which is made of concrete and severely canted for drainage. Because safety is always my number one concern I always run on the left side of the road. (Surprise, my ITBS case was in my left leg.)
Also, I had switched the type of shoe I was training in. When I first began running I ran in the Mizuno Wave Creation. Later I switched to the Mizuno Wave Rider. The Wave Rider never suited me well. After a few weeks I developed pain the arches of my feet that never seemed to go away but for some reason I insisted that they were the right shoes for me and I continued running in them (that was stupid, don’t do that).
Finally, though I’d been consistent in my running I’d neglected everything else. I hadn’t been cross training, stretching, foam rolling or weight training. I knew I should be doing all these things but was just too lazy to do them.
The ITBS caused me to re-evalaute everything that I was doing and how it was working. I was still unsure of the exact cause of the injury but I knew that I’d been neglecting my body and I needed to change.
The first order of business was rest. I’d read online that it was safe to run until you felt pain, which for me surfaced around 1.5 miles, after that you needed to stop running. Knowing that I needed some kind of workout and knowing I couldn’t run further than 1.5 miles I started going to the YMCA. Since I didn’t want to quit exercising, I set a 30 minute cardio goal for each visit. I’d start on the treadmill and run until my knee began to hurt at which point I got off the treadmill and got on another piece of equipment for the remainder of my 30 minutes. I got to know the gym equipment well. The elliptical, the arc trainer, the rower, the spinner, they were all my friends. I even started swimming again.
During this time I realized that I could run further without pain on the treadmill then I could outside. The softer, flat surface of the treadmill combined with the lack of turns (turns place torque on your knees) meant I could run 50% further pain free. Soon I was running almost exclusively on the treadmill.
It’s almost impossible to read about an IT band injury that doesn’t talk about weak hip and glute muscles. Somewhere I read that if you couldn’t do a single leg squat then your hip muscles were too weak. I attempted doing one single leg squat, immediately my knee collapsed and I fell to the floor. Clearly the hip muscles needed some work. I bought mini bands and started doing hip exercises once a day.
One day, when researching ITBS online, I came across a blog post written by Peter Larson on RunBlogger. Peter was in a similar situation as me. He found that switching back to his old shoes made a difference in how far he could run without pain. That’s all the motivation I needed to dig an old, retired pair of Wave Creations out of my closet and take them on a test run. That day I ran 3 miles pain free – double the length of my last pain free run two days earlier. I immediately bought a new pair of Wave Creations online.
I gave my knee a few days rest and then started running in the Wave Creations and on the treadmill exclusively. After 3 weeks I’d gone from a 1.5 mile pain free run to a 7 mile pain free run. I finally felt like I was making progress.
All that time spent cross training made me realize just how weak my body was. Though my running muscles were strong, the rest of my body that supported those muscles weren’t. I could run a sub 1:50 half marathon but I couldn’t do 5 (knee) pushups.
I started lifting weights to build all my supporting muscles. I did the stronglifts 5×5 program which I modified to fit my abilities and my schedule.
During one of my rare outdoor runs, I was a half mile from home when that familiar tightness in my knee returned. I started running faster hoping to get home before it got worse, oddly enough the faster I ran the less it hurt. I began running faster all the time.
By the beginning of March, two months after the initial injury, I was running pain free. My total mileage for January 2015 was 6.5 miles by March it was 70 miles. I declared myself healed.
I knew running the Houston Marathon and The Woodlands Marathon only 7 weeks apart was going to require some serious training, especially since I was coming off an injury so over the summer I focused on building my strength. I continued to cross train and I lift twice a week. By the end of the summer I could do 15 full body pushups and I was squatting 135 pounds – 15 pounds more than my body weight. I started getting random compliments about how good I looked. All the hard work was paying off.
I started training for the Houston Marathon the second week in September. My plan included 6 days of running, speedwork twice a week and strength training once a week. I’d never asked my body to do anything close to this but surprisingly it handled it fine – so fine, in fact that I signed up for the Cypress Half at the last minute, just two weeks before the race. I thought racing a half during marathon training would be a good gauge of my progress and give me a better idea how to execute the second half of training.
The week after I registered for the Cypress Half I ran my first ever 60 mile week, the following Monday when doing my normal workout I felt it – that familiar pain in my left knee returned, six days before I was scheduled to race.
I was confused. I had been doing my hip exercises. I was still running in the same shoes. I was still doing most of my running on the treadmill. But I learned my lesson the first time and spent the next 5 days cross training while my knee healed. I also started reading Scott Jurek’s Eat to Run. One of the things he mentioned in that book was his stretching routine and The Wharton’s Stretch Book. I bought a copy and started doing the stretches recommended in the book. That was the final piece of the puzzle – three days of following the stretching routine for runners outlined in the book was exactly what I needed.
I ran the Cypress Half that Sunday pain free in a massive 8 minute PR (1:39). The days that followed my knee still ached but after an additional week of stretching my IT problems were gone.
Occasionally I still feel tightness in my knee, almost always when I have gone through a period of not stretching regularly. When I do, I immediately get down on the floor with my piece of paracord and stretch out my legs. It works every time. It’s like my body’s way of reminding me that I’ve been neglecting it and it needs attention.
The pain did return during the Houston Marathon but this time I knew it was due to tight muscles and I spent the next three days stretching my legs out. Two weeks later, it’s my shin that’s sore – not my knee and hip.
IT band problems are a very common and frustrating injury. When trying to heal my injury I found that testimonials from others who had experienced a similar injury was my best resource. I hope that by sharing my experience I can help someone else with their own injury and get back to running faster.