Hello, IT band!

I’ve had some not-all-that-worrisome knee pain during this marathon training cycle.  I had a little bit of pain after a run here and there, but it always got better within a day or so.  Most runs, I didn’t feel it at all.  I was being careful and trying to give it the care it needed.

And then it was like something pushed it over the edge.  It wasn’t either of my twenty mile runs.  It wasn’t fast intervals or long tempos.  I think it was doing the dolphin kick.  I noticed after swimming one day that my knee hurt, which was surprising because, well, I was swimming.  Then the next day (my first week of taper), it hurt so badly on my 15 mile run that I cut the run down to 8 miles.  Suddenly, I went from mildly concerned to panicked.

A panicked Katie is a Googling Katie, so this weekend, I finally searched online for what the problem was.  The two main knee issues that runners face are runner’s knee and IT band issues.  I suspected it was the latter, and when I read that if you have IT band issues, fast intervals are typically less painful than longer slower runs, I was certain that it was my IT band.  Chronic, soft-tissue pain is a new experience to me.  I’ve had two running injuries.  When I was a freshman in high school, I broke my hip running cross-country.  It was a pelvic avulsion fracture, which basically means that the muscle pulled the bone apart.  It was a hairline fracture, so my treatment was crutches and pain meds.  Once it stopped hurting, it was better.  When I was a freshman in college, I got a stress fracture in my fibula.  Again, once it was properly diagnosed, the treatment was simple.  No impact until it stopped hurting.  After spending a few weeks pool running and getting to know the elliptical, I was better.  And I never had an issue with it again.

Soft tissue problems are a scarier beast to me.  Especially when I’m supposed to be running a marathon this weekend.  I kept Googling.  The words on the screen were basically, “Be careful while you run and add in some hip and glute strengthening activities, and you should be able to get past it.”  The words that my brain read said, “You’ll never get better.  You will be in pain until you die.”  Here’s the thing.  The more stress that piles up in my life, the harder time I have maintaining perspective.  I tend to catastrophize (it’s an anxiety thing).  I’ve become better at not doing that as I’ve become better at managing my anxiety.  But when the stressors pile up, that’s right where I go.  And, well, the stressors have been piling up lately.

All this to say that this IT band issue quickly became something terrifying to me.  I had to come up with a plan for dealing with it.  After doing some reading online, I discovered that most experts think the underlying issue behind IT band pain is weakness in the hips and glutes.  That means to put the issue completely to rest, I’ll need to build up some hit and glute strength.  But since I was doing all this research literally one week before a scheduled marathon, I knew that strengthening would have to be part of the post­-marathon process.  I was not going to gain hip and glute strength in a week.  So my post-marathon plan was going to have to be different than my pre-marathon plan.

Pre-marathon/marathon plan:
Skip the final long run (10 miles) and do a long pool-running session instead
Take the week before the marathon off running and focus on non-impact exercise instead
Continue icing and taking ibuprofen regularly
Buy some kinesiology tape for the marathon
Double up on ibuprofen and acetaminophen on “race” day

Elliptical
I guess it’s time to get re-acquainted with this old friend.

Post-marathon plan:
Continue with ice and ibuprofen regimen
Take at least one week completely off running (more, if my knee continues to hurt)
Immediately start a strength routine to build hip and glute strength
Continue using kinesiology tape while running for several weeks
Kick this problem in the butt before I start Ironman training on April 4

IceIbu
Ice and ibuprofen—the poor man’s physical therapy. Frozen peas and ibuprofen—a bitter reminder of your sad financial state.

So, how does this stupid knee thing affect my marathon on Saturday?  Well, I’m not setting any time goals because of it.  I know where my fitness is.  I know what pace I can run if I’m feeling 100%.  Based on my training times, if I’m feeling good, I will probably run between a 3:35 and 3:40.  And really, training, not racing, was the main point of this whole marathon training cycle.  If I feel like my knee slowed me down, I’ll be disappointed… regardless of my time.  I’ll be disappointed if I run a 3:50 because my knee was hurting.  I’d be disappointed if I ran a 3:20 (YEAH RIGHT) but felt I could have run faster if my knee were feeling better.  If I take care of my knee until Saturday, though, and take some over-the-counter pain medication before running, I think I’ll be able to make it through just fine.  I’m typically pretty tough.  I finished a cross-country race on a broken pelvis.  I completed half a heptathlon on what was at that point a pretty serious (undiagnosed) stress fracture.  I’ll make it through the 26.2 miles.

And then, I’ll rest up, start a strength routine, and hope for the best.  I’ve got five weeks between my marathon and the start of my Ironman training plan, so that should give me enough time to get 100% healthy.  This whole potential injury thing has reminded me both how lucky I am to be able to train and that training for an Ironman is a great opportunity, not an obligation.  Lately (probably because I’ve been running more than anything else), each workout has felt like something I have to do.  That’s normal, I think, and slumps like that are where dedication is important.  But the past week, I’ve felt fortunate for the workouts I’ve been able to do and antsy (almost excited, in fact!) to run again.

So let’s hope I retain the motivation for Saturday but get rid of the pain!

Has anyone else struggled with IT band issues?  What worked for you?

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16 thoughts on “Hello, IT band!

  1. Occasionally I’ve gotten IT band issues from either running on a banked road for too long or from shoes being too old. I normally rest and get a deep tissue massage focusing on quads and IT band (it’s one of the most painful things but it has always gone away after).

    Liked by 1 person

    1. Thanks! I’ve thought of foam rolling my quads, so maybe I should do that. I’ve read mixed advice about massaging/rolling the IT band itself. Some people swear by it, but others say you shouldn’t do it.

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  2. So sorry this happened so near your marathon! Hopefully the care you’re taking now will help you get through the event.

    A bonus to the strength workouts you’ll be doing to help your hips and glutes is that not only do they help with IT band issues, but they should help you get faster as well 🙂

    Liked by 1 person

  3. Jenny

    I know there are conflicting opinions about foam rolling, but it helped me. But instead of rolling up and down the leg, I rolled ACROSS the band instead. Start off with the roller just under your hip bone (the same way you would do if you were going to roll down the leg.) But instead, move your body back and forth so you can feel the band flip over the roller a few times. Then move the roller down a couple inches and do the same thing. Keep doing that all the way down until you get as close to the knee as possible without being on the bone. It will be tender, especially in the middle of the leg, but if you can do that I think it will help you. Good luck and keep us posted!

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      1. Jenny

        The roller would be perpendicular to your thigh. And when I do this, I use the smooth side of my roller. You could use the bumpy side but it would probably hurt more! I found this technique by googling IT band treatments but unfortunately can’t remember the source now. You might have luck finding it by googling IT band foam roller techniques, maybe?

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  4. Oooooohhhhh IT band issues. I had a major bout after my marathon training cycle. Blogged about it, too. I really think it is caused by 1) alignment issues, 2) weak hips and glutes, and 3) just generally overusing running muscles, particularly on longer, slower runs. Nothing is more frustrating!

    I really think a solid month of low mileage (ie. rest and time) is the way to go. Physical therapy helps, with things like ultrasound, anti inflammatory patches, TENS, etc. And definitely life heavy weights once you are healed. Squats and deadlifts are the way to IT band health! Also, Google “Best Damn IT Band Stretch” and read that page. You can’t “stretch” your IT band, because it is not a muscle. You need to strengthen and stretch accessory muscles that hook onto it.

    Good luck! I know how you feel at the end of this training, but I might even advise skipping the marathon. This type of inflammation is cumulative, and I’d hate to see you out for months.

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    1. Ooooh, alignment issues… I think I have a tilted pelvis (as in, I think I remember a chiro saying I did a few years ago). Perhaps stupidly, I really want to give the marathon a try. Just a few weeks ago, I did a 20 miler with literally no knee pain, so I’m hoping a week off heals it up to the point is was then…

      Fortunately, as much as I’d like to start running soon, I can pretty easily take off 4-5 weeks from running after the marathon. Thanks for the links! I will definitely check those out!

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  5. Oh and my blog posts:
    http://hardlyawesome.blogspot.com/2015/04/how-to-injureyourself-in-10-easy-steps.html
    http://hardlyawesome.blogspot.com/2015/05/how-to-rehab-si-joint-problems-pelvic.html

    The second one has a list of the exercises they had me doing in physical therapy.

    Here’s the page I mentioned: http://b-reddy.org/2012/03/04/the-best-damn-it-band-stretch-ever/

    It explains soooooo much, and I found it really helpful.

    Liked by 1 person

  6. If there’s one thing I’ve learned with soft tissue injuries, it seems that for runners (or triathletes who do a bit more running), it’s always weak hips and glutes. I’ve never had IT band issues, but I dealt with a really awful bout of postibialis tendinitis… weak hip and glutes were my demise. Good luck with the marathon; I’m sure you can find plenty of glute/hip strengtheners online for after, but if you need help I have a boat load from physical therapy 🙂 I’ve since learned to “wake up” my glutes/hips before every run and it’s helped immensely. Therabands became my best friend!

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      1. I actually did a three part one one my pre-hab and post-hab routines, plus the in between stuff. And even though it was over a year ago, it still holds true today and it’s stuff we do in my running/triathlon endurance class.

        This is part 3/3 but it has links to the first two: http://runfastorfaster.com/2014/07/25/pre-hab-post-hab-and-the-in-between-part-3-of-3/

        I hope it helps you, I reference it a lot actually when I forget or need to change up my routine.

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  7. Pingback: My IT band success story – Something Something Triathlon

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