Now that I have a couple of physical therapy sessions under my belt, I thought I’d give a quick update about where I am in my IT band recovery process.
(I know, I know. Y’all have been just dying to hear.)
I decided to go to the same physical therapist that did my running analysis. I had a very positive experience and learned a lot through that analysis, so I was confident that he knew his stuff and would be able to help me. So, during lunch on Monday, I drove to his office for my appointment. One of the first things he asked me as he was beginning to run me through basic strength tests was whether or not I did any cross-training. I was a bit taken aback by this question because I found him through my tri club which I knew he remembered because he had already mentioned it. So I assumed I was missing something and replied rather tentatively, “Well, I mean, I swim and bike…” Apparently, he gets that answer a lot from triathletes. It turns out that one thing swimming, biking, and running all have in common is that all their momentum is focused on going forward. That can lead to a loss of lateral coordination. This will come back in a moment.
I was a bit surprised and quite pleased with the results of the strength tests. Unlike most IT band problems, it appears that mine don’t stem directly from weak hips and weak glutes. Regarding strength, I had almost full marks across the board (I had one 4+ instead of a 5… so close!). However, despite my good performance on the strength tests, when he had me do single leg squats, he saw some instability in my knee position (basically, it was collapsing inward somewhat). So, even though my muscles were strong enough, I lack some of the muscular coordination to actually put that strength to good use. The one other test I failed was flexibility. My hips are actually fine, but my calves, hamstrings, and IT bands are all very tight. I knew I was not flexible. But I had never connected it to my IT band issues before, probably because it never showed up on my good friend Google. It makes sense, though, that if those muscles that surround or attached to my knee and my IT band are tight, they could contribute to IT band pain.
So I was given three bits of homework. First, I should continue with my strengthening routine and make sure that some of the exercises include lateral movement. He gave me a couple of elements to add to the routine, but mostly, he approved of what I was already doing. Second, I should stretch four times a day (hamstrings, calves, glutes, and the TFL—the muscle attached to the IT band) and roll out my IT band daily. Third, I should keep exercising as normally as I can and try to continue improving my running form, specifically keeping a high cadence so that I stop heel-striking.
He also did something called ASTYM® on my whole leg. Basically, he beat it up. Using these hard plastic tools, he scraped and prodded my leg until it hurt. It was actually bruised for a few days. The reasoning behind this has to do with your body’s natural healing response. If you sprain your ankle, it gets swollen and bruised. That’s because your body was doing things like increasing blood flow to the area to facilitate healing. With chronic injuries, sometimes that process stops. The idea behind ASTYM® is that doing minor tissue damage, you can stimulate the body’s healing response and fix the issue that’s actually giving you trouble. To be honest, if I had read about this on the Internet, I would have been giving it the skeptical side-eye. But considering there’s a good chance that a physical therapist knows more about physical therapy than I do, I was more than happy to accept the validity of ASTYM®.
That evening after I got home from work, I prepared for my run. I stretched well and did some dynamic drills as well as the one of the stretching sessions I was assigned as homework. And I left for my run. Not long into my run, I started to feel cautiously optimistic. I felt like this might be a good run. But I tried to hold off those thoughts until I hit 15 minutes (typically, I start to feel little twinges of pain around 10 minutes). Fifteen minutes in, I was still pain-free. At thirty minutes, I still hadn’t felt any pain and decided to finish up five miles (which would be my longest run in weeks). During the last few minutes, as I was getting a little more fatigued, I could just start to feel the IT band—not pain, but I could feel that it existed.
Five miles without pain! That’s a pretty big milestone. I am finally feeling confident that I’m getting better. I’m looking forward to testing out longer runs and building my running endurance back up to where it should be right now.