UKH

So I seem to have flared up my IT band about 6weeks ago and have Continued to run anyway because I was in the mountains on holiday and I love running in the mountains. 
 

Ive looked at protocols for rehab and it all seems somewhat conflicting. From peoples experience what works well? 

I’m going to rest up for a couple of weeks to let it settle but any advice further than that is gratefully received?

In reply to Herdwickmatt:

Stretch - Stand up straight.  Put your right foot to the outside of you left foot.  Raise your left arm above your head and bend yourself to the right with your weight on your left foot  predominantly.  Arch your back.  Hold for 20 seconds.  Repeat, vice versa

In reply to Herdwickmatt:

My experience is nothing works except enough rest and a gentle reintroduction. And you need to work out why it flared up. You can spend your rest period sorting that

If you've already run through it, you could be in for a month of rest or so. 

In reply to Herdwickmatt:

I suffered from IT band problems for a while. After physio sessions the only thing that really made a difference was strengthening the surrounding muscles (think assisted pistol squats, one legged lunges etc). But that process should obviously take place once you are able to (i.e. don't forcibly do it and make it even worse). If in doubt see a specialist. 

In reply to XXXX:

Yeah it was pretty dumb to run on it but at the same time it was good to be out on the hill. I’m back on the flat now so I’ll rest up, tape it up and begin to rehab. 
 

In reply to Herdwickmatt:

Treatment advice is conflicting because there can be many causes. Most likely, something higher up in the chain is tight. I used to have IT band issues, just a bit, never enough to stop me from running. 

I finally found a good physiotherapist who detected some tightness near the hip (small muscles, don't remember the name), which he dry-needled. Solved the issue with one session. 

In reply to Herdwickmatt:

Go to a physio.

I've found the IT band is often an issue caused by another area - for me it's weak glute medius or hip flexors or other imbalances.

In reply to Herdwickmatt:

For me resolution came in squats, then squats on a foam cushion, then single leg squats, then single let squats on the foam cushion to improve strength and balance.

But as others have said, seeing a physio is a good first move. If I have a sudden flare up, it can be eased through application of really quite forceful pressure (physio friend's elbow leaving clear bruses!), but the longer-term treatment was the squats.

In reply to Herdwickmatt:

Personally I found foam rollering as a temporary working solution. I didn't rest it and just cracked on, it troubled me for a fair while, generally until I was thoroughly warmed up. Went away when I started yoga.

In reply to Herdwickmatt:

You’ll just get a load of mixed advice here too. Like some have alluded to, IT band issues can be caused by many things, and there are many “experts” that will offer you a “solution”. This may have worked for them, it may have been pure placebo *cough* foam rolling *cough* but you’ll need to luck out to find the one for you. Unless..

GO AND SEE A PHYSIO.

If you are ever injured in anyway from sport, an actual professional you see in person is the solution, not a bunch of poorly educated people on the internet who haven’t seen you, regardless of the fact that they are trying their best to help. 

In reply to ianstevens:

I’ve already booked a physio... however as with the internet you get a range of opinions from physios some who stick needles in you, some who tape and some who are just a bit crap. It was more out interest in what people have found to help, call it intrigue and curiousity

In reply to Herdwickmatt: Rest, not overdoing and avoiding high impact forces via adequate cushioning and/or running on soft ground.

A physio is a good answer is a good idea but if you get one who's not used to dealing with running, you might get a fix but not  a more permanent understanding of why it's happening

In reply to Herdwickmatt:

I would ask why it happened? This could be a warning/opportunity to fix yourself.

Think whole body strength and alignment.  I had IT Band pain that came on one run and stopped me. Had to get a lift back to work. The Physio saw me that day, found a knot in my teardrop muscle, got her thumbs in there and fixed it temporarily then permanently with a repeat massage a few days later. This was a warning I didn’t notice. 

Don’t know your background so apologies if you know this but for peeps researching injury, I’d take really good care of yourself when running.  Haven’t run for 18 months - back pain. I’ve done rehab almost daily since. I’d recommend:

1. A few physios - they all have different focus points, approaches and tips. Find out why it happened - ask them about shoulder alignment and pelvic tilt. I’ve seen 5. Costs but what value do you put on your mobility?

2. Theraband mobility work for your hips and shoulders to improve alignment - work against rounded shoulders and pelvic tilt. 

3. Pilates to strengthen the Core - keeps the upper body upright. 20 min of Jessica Valant beginner Pilates x2 a week - YouTube.

4. Climbing! Static stretches and core work as standard!

I miss running a lot.

Best of luck with the recovery. 

In reply to Herdwickmatt:

In which case I stand corrected. Maybe I've looked at too many running forums/twitter threads, but it's not uncommon for people to request diagnosis by internet then follow the advice they get to the letter with no avail. Hope it clears up.

In reply to ianstevens:

It's also common to go to a physio and follow their advice to no avail. The internet is a great resource for injury recovery, better than professional advice in many cases. Lived experience can often be very informative.

If anyone wants to know how to get over patella tendonitis when the NHS has basically sent you to the glue factory, i can recommend some great online resources that I followed.

My first action is always to get a sports massage. A regular one, even when feeling well keeps most things away.

In reply to ianstevens:

Totally agree with what you are saying. As someone who has suffered from hamstring tendonosis for years, I'm wary of following anyones advice without thought and consideration. I've seen great physios and terrible physios, received great internet advice and some pretty shocking stuff as well. 

With the advice above I'll consider it, weigh it up, chat to a physio (who is a senior lecturer at a uni/former premier league physio/runner) and take it from there.

In reply to Herdwickmatt:

I had a case of ITBS which flared up in April. It came about on a shorter recovery run out of nowhere, no obvious signs beforehand. Took a few days off and then tried running again and wasn't able to run 2km even, it was that painful!!!

I ended up not running for 3 months... 

I had been running high-ish mileage for the past few years and never had any issues before this. I started stretching twice a day every day and that has alleviated the pain. I focused on stretching glute med, hip flexor TFL, quads. 

I have been told by a Physio my cause was that my glutes are not activating and I am now working on that. 

From my experience and what others have said this is not an issue solved by rest. 

In reply to Delbiz:

Funny that, it’s exactly what the physio said last night. Tight flexors aren’t allowing my glutes to activate, so it’s not a lack of strength in them, it’s that they are being hindered by my flexors. So stretch and stretch and stretch some more! I might add in some eccentric flexor exercises as well to see if that helps.

In reply to Herdwickmatt:

I'd agree with Delbiz on the TFL. I find getting a fairly solid ball (I use a dog toy I got from the co-op for about £1) and using that to get into the TFL really helps - when I hit the right spot I can feel it right where you feel the ITB pain.

In reply to Steve Jones:

6weeks later still not pain free but saw a different physio on Thursday who was brilliant. Gave me lots of time, gave me clear explanation of the probable cause and pointed out my left side is all sat 2cm higher than my right. Going to stick with him as I liked his style, although the dry needling was incredibly painful!

In reply to Herdwickmatt:

The word on here and also my experience is that you do need to find the right physio, and not necessarily fee-paying either. When they fix it, it's like a miracle has occurred!

+1 for the legs-crossed stretches, but ianstevens advice is the trump card (can you even say that anymore?)

Good luck with your treatment.

In reply to freeflyer:

Just clarify-cross legged stretch? For the glute medius?

In reply to Herdwickmatt:

If you want to stretch the gluteus medius the pigeon pose stretch is good if you are not too tight. 

In reply to SouthernSteve:

Painful if you are too tight !

In reply to Herdwickmatt:

Yes - create stretching tension in that area, the best time for me was immediately after a run (it was reasonably under control), and go reasonably gently.

I had a quick go with nnif's suggestion above and that seemed to work better than anything I could remember doing - it was a while ago, so that was the reference to the cross-legged stretches.

In reply to Ridge:

  Definitely need to warn up for this!

In reply to Herdwickmatt:

Hi Matty, I would advise going to the physio. I used to try stretching and foam-rolling and it didn't work. I then went to see a physio for a one off session, and they gave me a program of leg strengthening exercises including lunges, squats and leg raises and stretches. I do this 2-3 times a week and I've been following for 6 weeks now, I can now run for 1.5 hours without pain when I used to be able to only run for 0.5 hours before I'd start hurting. If you can't see a physio straight away because of the pandemic, there's no harm in simply googling for some exercises - you might not find the most effective ones for you, but you can see if they make a difference. I saw a difference within 2 weeks. 

In reply to paulinepavlova:

Hi Pauline,

Thanks for the response. If you scroll through the thread (it's long and tedious) I did see a physio and it's improving with lots of dry needling/trigger pointing and pilates/strenghthening exercises. I'm running again (maybe an hour or so with minimal/2 out of 10 pain) so getting there. Hopefully be ready for racing season next year!

Out of interest which exercises do you do?

In reply to Herdwickmatt:

That’s good news. I’ve just seen the thread and the first thing I was going to say was that it’s physically impossible to stretch the ITB. But then read the rest of the thread and saw it’s a long running thread. 
 

Good luck. Sounds like you’re making progress. 

In reply to JohnBson:

MrsD is a strong advocate of the roller, usually in the process of overdoing her triathlon training !it does seem to help.