Anatomy of a 6 Month IT Band Injury – Post-Injury Analysis and Lessons Learned

by Jason Fitzgerald

Yesterday afternoon I sent a 2,600+ word email to my newsletter readers detailing my past running history and a full analysis of last year. I talked about what worked, what didn’t, and what goals I have for this year.

[If you missed it because you're not a subscriber, just sign up here and you can read it in the Runner's Gear Bag.]

Now I want to talk about the most defining moment of my running career: the New York Marathon in 2008.

It wasn’t because I ran 2:44:38, which I thought was pretty fast. It was because the marathon reduced me from a somewhat fast, competitive runner to a cripple. After New York I couldn’t run again for six months because of an IT band injury.

I’ve told my story before: I devoted those six months to getting healthy, seeing physical therapists, doing a ton of research on strength exercises and training strategies, and seeing expensive massage therapists. When I started running again my training was different – and I haven’t had a major injury since.

Now I want to talk about what exactly I screwed up – and how I turned my running around for the better.

Diagnosing an IT Band Injury

My IT band injury didn’t happen during the marathon itself. But the race beat me up pretty bad – I had trouble walking for close to a week. In hindsight, I didn’t take enough recovery time and went for my first run only 9 days after the race.

I was able to do about four 20-30 minute runs every other day until a sharp pain started on the outside of my left knee – classic IT band pain. Most ITB injuries hurt at the knee insertion and I showed the traditional injury symptoms.  At the same time, my left glute and hip were extremely tight.

Why did it happen in the first place? My training leading up to the marathon wasn’t perfect. Looking back, there were a lot of things that I did poorly to prepare for my first marathon that led to my IT band injury.

  • I didn’t do any hill workouts and even avoided them during most distance runs.
  • The only core workout I did was my standard core routine (and I skipped it a LOT).
  • I didn’t do any flexibility exercises before or after my runs.
  • My overall volume wasn’t consistent and too low for marathon prep: 65-75 miles per week.
  • I did zero hill sprints
  • I didn’t lift at the gym

You’ll notice a pattern there: almost everything I skipped was strength-related. Not enough core exercises, no hill sprints, no weights, not enough miles, and no hills.

My initial treatment for my IT band injury was simple (and ineffective): take more time off. I rested for a few days and then went for a run, only to be struck down by the same crippling pain within a few minutes.

I kept testing my IT band every few days for 6 weeks, with the same result every time. Isn’t the definition of insanity trying the same thing and expecting different results? I spent hundreds of dollars and saw numerous massage therapists, who couldn’t rub the pain away.

My fiancée convinced me to do a one-month boot camp in January. Despite a lot of strength exercises, my knee still hurt if I tried to run. I was starting to give up. In February I sat around on my couch, watching episodes of House and eating ice cream.

March rolled around and I got more proactive. I made an appointment with a physical therapist. He sucked and had no idea what was wrong with me. I tried a different PT. And another one. It wasn’t until my fourth physical therapist that I finally found someone who knew about running injuries and knew how to treat me.

What worked for me was a combination of targeted massage and specific strength work. Since my injury was severe there was significant scar tissue along my IT band and a lot of tightness in my hip and glute. I needed massage to target these areas, break up the scar tissue, and increase my hip mobility. My trusty foam roller helped a lot.

The specific strength exercises I did while in physical therapy formed the basis for the ITB Rehab Routine I developed. It included exercises that targeted my hips, glutes, quads, and hamstrings. Here’s the routine for your use:

  1. Lateral Leg Raises: lie on your right side with a theraband around your ankles.  Lift your left leg to about 45 degrees in a controlled manner, then lower.  I do 30 reps per side.
  2. Clam Shells: lie on your right side with your knees together and a theraband around your lower thighs.  Your thighs should be about 45 degrees from your body and your knees bent at 90 degrees.  Open your legs like a clam shell but don’t move your pelvis – the motion should not rock your torso or pelvic girdle.  Keep it slow and controlled.  I do 30 reps on each leg.
  3. Hip Thrusts: lie on your back with your weight on your upper back your feet.  Your legs will be bent at the knee.  Lift one leg so your weight is all on one leg and your back.  Lower your butt almost to the ground and thrust upward by activating your glutes.  This exercise is great for glute strength and hip stability.  I do 25 reps on each leg.  50k American record holder Josh Cox demonstrates this exercise in this video (right after pushups).
  4. Side-Steps: with a theraband around your ankles and knees slightly bent, take ten steps laterally.  The band should be tight enough so it provides constant resistance during all steps.  Still facing the same direction, take another 10 steps back to your starting point.  That is one set.  I like to do 5 sets.  This exercise will look like a slow-motion version of a basketball “defense” drill.
  5. Pistol Squats: These are simply one-legged squats.  The key to a successful pistol squat is to not lean forward, keep the motion slow and controlled, and make sure your knee does not collapse inward.
  6. Hip Hikes: Stand on your right foot.  With your pelvis in a neutral position, drop the left side of your pelvis so it is several inches below the right side of your pelvic bone.  Activate your right hip muscle and lift your left side back to its neutral position.  I do 20-25 reps per side.
  7. Iron Cross: this exercise is in the Cannonball video and helps you increase mobility in your hip, glute, and hamstring.

After going to physical therapy twice a week and doing this routine almost every day for a month, I was ready to start running again. My first run after my six month forced-sabbatical was 20 minutes and I felt like death. Not running for half a year will wreak havoc on your fitness level.

While going to physical therapy, I was also researching the most successful training programs of elite runners. What did the best coaches prescribe? How did faster runners train so hard? Why couldn’t I?

For the next six months, I diligently did my core and strength exercises and gradually ran a little more. I started executing my new training strategies and slowly got in better shape. It was a long road, but by October I was running over 50 miles per week and feeling good.

So what specific changes did I make to my training to prevent my IT band injury from coming back?

Injury Free Training

My new training program addressed the weaknesses of my previous program and built on what I was doing right. Here’s what I added to my running:

  • hill sprints
  • roller coaster runs
  • lower body weights (specifically squats, lunges, and dead lifts)
  • consistent mobility work
  • patience to cut a run or slow down

I also became a lot more consistent with my core workouts and my sprint sessions. Before the marathon, I did core 1-2 times every week and strides about once every week. That’s just not enough. Now I do hill sprints, strides, and surges. I do some type of core or strength routine every day. And I’m a helluva lot stronger.

Now, if I go more than a week without hills, hill sprints, or a gym workout I feel weak and uncoordinated. It’s a recipe for an injury.

If you follow my training on Daily Mile, you’ll notice that I often talk about trail running. I do 95% of my running in Rock Creek Park in Washington, DC. The terrain is hilly, uneven, and in some parts even dangerous (I’m telling you – one of these days I’ll have to write about falling into Rock Creek). I see this as a huge benefit: the varied terrain makes me use slightly different muscles to run, increases my agility, and helps build even more strength.

Implementing variety in my own program is something I’ve talked about before but it’s worth repeating. Aside from trail running, I now rotate at least two pairs of shoes (often 3) with them usually being somewhere on the minimalist spectrum. Right now I’m running in the ASICS Sky Speeds and the Saucony Kinvara’s. Rotating different shoes stress your feet and legs in slightly different ways, which will help prevent overuse injuries.

Even more step-by-step instructions on how to stay healthy (and an exact treatment protocol for ITBS) is inside Injury Prevention for Runners.

Making 2011 Healthy and Injury-Free

These strategies will absolutely work to help you become a better runner. If you were paying me for this information, I’d offer a money-back guarantee.

As you start to sign up for races, plan your training, and set goals for 2011 I hope you don’t make the same mistakes I did. Learn from where I failed and run some of these workouts to help you get stronger and faster. Sign up for exclusive updates to learn more about beating your injuries.

Recommended resource for those with ITBS or who suffer from chronic injuries:

Join 10,000+ Runners and Get Faster!

Get the Strength Running PR Guide ebook and tips to run faster (without the injuries).

Share
Jeff

I would disagree that your mileage or lack of hill training would have contributed to your IT band injury. I think many marathoners (granted, slower than 2:44) would think 65-75 miles per week would be way too much for them (myself included) – and ITBS is an overuse injury, usually coming from doing too much rather than too little. (And I doubt your PT prescribed more running to help heal it.)

I think it may have more likely come from muscle imbalances as a result of not enough core work (which you mentioned) – especially in the hips and glutes.

Fitz

Hey Jeff – thanks for the comment. I think that for me (and that’s a huge qualifier – it will vary by individual), my mileage base was too low for my goal of ~2:38. However, I still ran about that pace for the first 20 miles (2:02 through 20) and paid dearly for it: crashing and burning hard the last 6 miles. For the last ~6 miles I ran out of fuel and every foot step felt like I was smashing my legs with a hammer. With more miles, that wouldn’t have been as big of an issue.

As for hills, that’s a similar story. Hills build strength. It’s like lifting for your legs. My legs weren’t as strong as they needed to be and I did way too much damage over the last 10k of the marathon. I think my ITB injury resulted (in large part) because of weakness in my glutes. Hills would have helped that a lot.

But you’re right – it was also probably an imbalance issue, coupled with not enough core.

Thanks! – Fitz.

Wendy

You made me feel so much better. I ran my first full in October and the last 6 felt the exact same way. I had stopped doing as much strength training as I should have. Your article is giving me hope that I can run well again. Thank you!

Wes

I have never been injured *knockonwood*, but I will use the information you provided to delay and/or make sure that never happens!

Jacob

Hi Fitz,

Great post. I find it very informative and will be doing the strengthening exercises you outlined.

I hope you don’t mind I’ll repost this on DailyMile and my blog…

Thanks!

Fitz

No problem Jacob. As long as you give attribution and a link :)

Jacob

Thanks Fitz, I will just be posting the link to your website. I’m pretty sure this will help a lot of people.

Cheers!

Barefoot Tyler

Hey, great post. I wrote about this blog in my most recent post.

keep up the good work.
-Barefoot Tyler

Fitz

Thanks Tyler!

Cyndi

Well, I do not run near the distance you do every week. I am new to running marathons. I have completed 4, but on my 5th marathon I injured my ITB. Well, maybe I didn’t injure it then, but that is when it decided to let me know it was inflamed. As a result I only completed the half marathon that day. That is so disappointing. I felt like I failed myself. I am not ready to let that stop me from running, though. I really enjoyed your article and information provided about ITB rehab. I plan on incorporating the execises into my daily/weekly regimen. It has been a week since the race and I haven’t ran, yet. I am gonna try on my legs tomorrow for an easy run. Wish me luck:)

Fitz

Good luck Cyndi! The exercises really do help.

The Other "Fitz"

Hey Fitz,

This post really resonates with me. Just re-read it for the 3rd time after experiencing some tightness yesterday in my IT band.

I ran the 2009 NYC Marathon without proper preparation (low mileage and not a lick of strength training) and paid for it big time, not only during the race (“running” the last 10k in 63 minutes), but for 6 months following. Like you, I didn’t experience any pain during the race, but I only took a few days rest before running again and was sidelined only a few weeks after. I wasn’t able to run a mile until May 2010, after visiting 2 doctors and spending 2-3 months in PT.

Since then, I’ve experienced ITB flare-ups/tightness here and there.. typically when I’m pushing the mileage and getting a little too confident/impatient. But, I’ve been able to curb them with a few days rest mixed with extra strength training (including your ITB rehab routine). Like most runners, my motivation and determination tend to get ahead of my body’s ability to recover, but your blog helps keep me in check. Thanks for the great post!

Fitz

Other Fitz! We seemed to have traveled similar paths; I’m glad you’re finding relief and that the ITB rehab routine is helping you out. It’s a bastard of an injury, isn’t it?

Chris Parker

Hello, Great website, spent the last hour or so having a good dig around it. Spent the last fortnight exploring the web for ITB issues. I had to pull out of London two weeks ago due to it. It was my first marathon and was on for a sub-3 so was devastated when i was struck down, ironically only 100 yards from where the marathon actually started. I gave my leg a rest for a week as I was not to sure what to do and went out for a run about 4 miles all ok, today was a bit different about two miles in my knee had a dull ache all around it, any ideas to what that was? Anyway i’ve started your routine today and I am rolling the hell out of it. I’m thinking of keeping off it now for two weeks just to make sure alongside your workouts inc core. I have another marathon in Oct so I want to tackle this efficiently now and bite the bullet instead of it reoccurring over and over. Sorry essay, friends do not understand the plight of the ITB.

Chris

Fitz

If you’ve never had an ITB injury, you just won’t understand it. I was out for SIX months because of ITBS – it’s a nasty injury. Your plan sounds good: plenty of foam rolling, lots of strength work. Also try doing some dynamic and static stretching of your quad, glute, and hips to really loosen that area up. I’ve that to be very helpful. If the foam roller isn’t enough to dig into your ITB (also try digging into where it attaches near the glute/hip), use a tennis ball or lacrosse ball if you’re brave. Good luck Chris!

Chris Parker

Hi Fitz,

I’ve kept up to date with this post all year since this. I too had exactly the same issue re: time. I injured my IT in March and It still flared up In October. I thought it would never go. Gym membership later, Lots of squats, Glutes, every leg strengthening, lower back and core i’m back on track and attempting to go sub 2hr 50 at this years London Marathon.

Many thanks you got me pointing in the right direction with your workouts.

Chris

Perry

Hi Fitz,
I am so glad I stumbled on your website. I recently got bit by the running bug after training for and running in my first race, a 10k. All I could think about after I crossed the line was running another and how I could shave some time off. Unfortunately a few hours after that I realized the slight knee pain that bothered me in shorter training runs was flaring up again. Sure enough, the next day I could barley walk, and I have suffered with a classic case of ITBS since then. This was a shock to me because I have always been active, and never felt so crippled before.
After reading all I could find on the injury, I began using your rehab routine today at the gym. I have to say that trying to perform the hip hikes and pistol squats portions was humbling. I plan to incorporate the routine and foam rolling into my gym visits, and I am just praying this gets me back on the road soon. I am truly desperate to keep easing into the world of running.

Fitz

Hey Perry – thanks so much! Sorry to hear about your ITBS – it is one of my least “favorite” injuries because of its long healing time. As you progress through the ITB Rehab Routine, add tighter therabands to make it more difficult, do more pistol squats, and more overall reps to keep your body adapting. During an injury phase, I’d do this routine every other day with my standard core routine on the other days. I’d also do a ton of mobility exercises to keep my muscles loose. Good luck! Also, if you’re interested, I’m giving away a coaching package next Monday (details here: http://strengthrunning.com/2011/04/happy-birthday-strength-running-lets-party/) that could help. If you’d like to enter just sign up for the newsletter and then shoot me a quick email. Cheers – Jason.

Greg

Speaking of IT band injuries, I’ve got a doozy: my IT band is split from the tibial end to about 3 inches above the tibia. Pretty gnarly. Not really sure how it happened, any thoughts?

Right now, my orthopedic specialist’s course of action has involved PT, but that may not be enough. Secondary option is surgery.

Fitz

You’re right Greg – that’s a doozy. Unfortunately, I don’t think I’m qualified for that severe an injury. I might casually recommend an MRI if the ITB is split, but just know I’m not a medical professional.

Jeff Dirks

Hi Fitz,

This is a great posting. I’ve been suffering through a very similiar set of issues with respect to fighting ITB issues that flared up after running a recent Marathon (May 1 Vancouver BC); however, I aggressively cross-trained with a specific routine to fight my ITB being a post-race problem here in the Spring of 2011 but still managed to inflame and irritate it again where it joins in with my left Tibia.

As a back-drop, I’ve had a couple of good years getting back into serious running (at the age of 45) including some halfs and a smattering of 8K’s in the low 34’s and 5k’s around 20:00. I suffered through and rehab’d a right ITB in Sept 2009 after running a 1:44 half (first half in 20 years) and swore to never again go from running 40 – 50 miles a week to zero. After about 12 weeks of complete rest and a lot of ITB foam rolling and core/glue/hip work, I was back on my feet running in December 2009 and running a full program for racing in 2010 that got me down to a 1:34 half in Sept 2010.

After tearing and rehab’ing a left hamstring in October 2010, I got onto a marathon training mode that was based off of Jeff Fink’s marathon training program while also including a full complement of core/glute/ab/flexibility work that I thought would stave off any further ITB issues with my 2011 racing program.

I trained on a 14-week program that had me running 40 – 55 miles a week (depending on timing of my long runs) and suffered through a bit of a right ITB issue in the weeks leading to my first Marathon that I was able to manage through via laying off with a couple of days of rest, foam rolling, core/glue/stretching work, etc. For the Vancouver BC Marathon on May 1, I ran a 1:35 opening half and finished in 3:20 with a lot of gas in the tank; however I had to lay off the last 12 miles or so due to left ITB tenderness flaring up.

As I mentioned, I anticipated the issue in racing the marathon and did a lot of preemptive training to avoid the nastiness of going from 40 – 55 miles a week to 0 as you mentioned in your posting. However, It’s now been 8 weeks since the Marathon and I’m still layed up. What caught my interest in your posting is that I think I made the same mistake you did which was trying to run too soon after the Marathon. I made a very foolish decision and decided to race an 8K just two weeks after the Marathon and completely aggravated my left ITB. I felt fresh at the start of the race and went out running 6:40’s before left ITB just said “enough is enough” at the 3 mile mark and the pain was too great to continue. Since then, I have done little running and been working my a similiar rehab routine to what you’ve described in this posting — but it’s slow.

My specific question is based on research I’ve done with respect to really aggravating an ITB issue with follow-on stress once it’s already irritated (aka running a fast race 2 weeks after irritating it in a marathon) What I’ve read is that this tends to make it even hard to rehab as it tends to set the swelling in at a deeper level. My take is that I can cross-train as much as I like; however, I’m stuck not running (or doing any exercise that might slow the reduction in swelling down) until the irritation has abated. I’ve been rolling 2x/day and see a trainer 1x/week and am still not able as of this this week to run more than 2.5 miles w/o tenderness. I’ve decided to do NOTHING the next 10 days except roll, do strength work and stretches to see if it helps. What are your experiences with rehab once the ITB issues sets in deeply? It sounded like from your posting you had the same issue exactly.

The challenge I have is that I’m trying to both get healed up as well as gear back up for the Berlin Marathon in September 2011. The other challenge is I qualifed for Boston in 2012 and don’t want to blow myself completely out of the water for next Spring by not managing the next 6 – 8 weeks of rehab just right.

I’m a cross-training convert, but my question of you is whether at some point the only thing one can do with a deep ITB issue is stay off it and completley stay away from running while doing lots of rolling and glut/ab/core/stretch work.

Thoughts?

Fitz

Hi Jeff – that’s quite the journey. Your ITB troubles seem to be far worse than mine after the NY ’08. Once the ITB is severely inflamed/irritated, you just need to stay off it. Stretching it is incredibly difficult as it’s a band of connective tissue, not a muscle, so that didn’t help me whatsoever. What did help though was stretching the surrounding areas – quad, hamstring, hip, and glute. But most of all, it was strengthening the area with the ITB Rehab Routine. When I was doing more intensive rehab I was doing more pistol squats which really helped my glute strength. Additionally, I was going to PT twice a week and receiving targeted massage on the hip and along the ITB to break up scar tissue.

Now that I’m healthy, I’d say my left ITB is a trouble area – meaning it’s one of the areas that is most likely to be re-injured, but it’s fine as long as I keep up with prehab. What helps now is ITB Rehab, hill sprints, and dead lifts (may vary for you – only do HS once you’re healthy).

During the ~6 weeks of this rehab I did no running and started back up extremely slowly, running 10-20 miles/week for about two months before increasing. With this type of injury, it’s best to be conservative with coming back to running, race frequency, etc. Good luck with the rehab!

Dallas

I lost 5 months after running the Marine Corps Marathon. I did do hill work but generally no strength training and I had run a marathon 3 weeks prior. Also I was dumb and ran just 2 days after the marathon. About two miles into my run it got bad quick and it was down hill from there. Each subsequent run my distance shortened and the amount of rest I needed to feel whole again lengthened to the point where running even a mile after long rest wasnt happening.

I also found I got no relief until I did both the strength work and the massage therapy as I also had a pretty severe case. It took a lot of sessions and rolling(foam roller and rolling pin) to get rid of the knots/scar tissue I had in there. I read everything I could online though I didnt come across your post. Though the thing that struck me was finding that in several instances people would rest month and have it instantly reoccur. The big take away being rest for ITBS is not the answer. You may not be able to run but you better be working those glutes and hips and do some other cross training if you want to get back at it. I think in the long run my 5 month hiatus will make me a better runner because I concentrated on other things to keep me sane such as strength training and expanded my fitness.

One last thing that helped me but I generally didnt do religiously to start was stretching. Specifically the hamstrings and quads as the whole region was tight and required work. I have read and been told (by my PT) that stretching of the ITBand itself is somewhat pointless but stretching the surrounding area did have benefits. For example my massage therapist noticed a marked difference in her therapy when she stretched my hamstring first in terms of loosening the ITBand when she worked on me.

Fitz

Thanks for sharing your story Dallas, sounds all too familiar to me. I also found that stretching the surrounding areas (also the glutes and hips in my case) worked really well to loosen the ITB. Since it’s connective tissue, it’s very difficult to stretch (and heal…)

chris austin

hello fitz,before i start to tell you my story this is the best article ive came across on ITBS and has gave me a little hope that i needed.
ok so im not a marathon runner like yourself but i am a soldier in the british army and physical training especially running is what makes me tick and has always been a big part of my life,and job.unfortunately in dec 2010 my body decided to give up on me and ITBS kicked in.having had this injury before in the other leg i was aware immediately what it was.the previous time i had this it went after approx 2months of low impact exercise and stretching.this time however it has been extremely severe and i just cant seem to get it shifted.i have been seeing a physio therapist at work for the last 8months,been doing rehab,and even had 3 steroid injections but still cannot run or even use the cross trainer.walkin can sometimes hurt.i perhaps had not been doing the strenghting exercises for my glutes etc enough but have changed that around last week and been given a much more intense package almost identical to your method.i just have some questions to ask as nobody seems to be able to answer this for me.did you find that icing helped your condition,because for some reason it actually makes me worse.possibly because the it band is contracting?did you also feel the friciton when you put pressed on the side of the knee and flexed it?i find if i do so and flex it or squat i can feel it rub against the bone.i have been referred to see a surgeon to get the it band released but im a little bit wary of this as its not a very common operation in the united kingdom and im told if i did go for this method i would be one a very small percentage and it may not work.they only seem to have the experience in the states.will i ever get over this,and can you give me any other help?many thanks chris

Fitz

Thanks Chris! To answer your questions, I found icing did not help me at all. That could be my own personal case, but my thinking is that it’s too difficult to ice a connecting tissue. After all, not much blood gets to it anyway. I can actually still feel my ITB rub over the outside of my knee, but it’s not painful. There’s a slight snapping sound as I flex my knee. It’s not painful so I don’t worry too much about it. You may also look into finding a form analysis service that can help you determine if your running form is causing/exacerbating your ITBS. Good luck!

Valerie

Hello Jason,
Thanks so much chronicling your IT injury and recovery and sharing it. This post, more than anything I’ve heard or read in the few weeks since my own ITBS kicked in, has left me feeling hopeful that I can run again. I’m by no means a high-performance runner, but I was running what seemed like a lot for a short, round, 40-ish woman. I’m not fast, but running made me feel tall and invincible. And I was able to increase minutes over four years despite my poor choices and bad habits (no strength training, minimal stretching)before it caught up to me. Even though I’d only been averaging 6 1/2 hours a week, when I realized that I won’t be running for who knows how long (just had 1st PT session four days ago), I think I’m as devastated as any marathoner! Running has been a source of joy and the physical activity that balances out the mental activity of writing a doctoral dissertation. I can’t wait to get back to it. Your post is really inspiring. I’ll be sure to check out more of your site.
Thanks,
V.

Fitz

Thanks so much Valerie! That means a lot to me. I hope the PT sessions go well – be sure to check out the ITB Rehab Routine (video: http://strengthrunning.com/2011/02/the-itb-rehab-routine-video-demonstration/).

Mark E

Very nice post Jason.
Have you had any achilles issues? Other than the eccentric heel drops I am looking for some relieft.

Fitz

Hey Mark – yes, I had achilles tendinitis several times throughout my college career. I HIGHLY recommend eccentric heel drops, but otherwise traditional therapy like massage (foam roller/stick), rest, ice during the acute phase is best. Once you’re healthy, preventative measures like barefoot strides help a lot as well. Using some barefoot or minimalist work in your program can help prevent a lot of lower leg injuries. Good luck!

Ralfrede

I used to have serious ITB problems (still have sometimes). For many years I couldn’t run more than a few kilometers. Last year I changed to a much more stable running shoe (I pronate moderately) and suddenly I could start running several kilometers. I slowly increased the distance and last month, I was able to run a 15k trail race. Then last week, I tried running in a new neutral running shoe with just moderate pronation support and after 7k, my IT band was hurting so much that I had to stop running altogether. I waited three days, and then tried my old very stable running shoes again and was able to run 17k before I started to feel pain in my ITB (which was less severe than after 7k in the other shoes). This makes me believe that the type of shoe one uses also plays a role.

Valerie

Good to have the right shoes, but the fact that the pain came back at all isn’t good.
Have you tried the hip, glute, core strengthening? Sorry if I sound preachy; it has worked for me and I can’t help but want to proselytize :)

Ralfrede

I am doing some core strengthening and stretching now; hopefully this will help eventually.

Jason

With consistency, they sure will! Thanks for commenting Ralfrede.

Alex Segovia

I have suffered from ITBS for the third time now the second time being the worse where I was out for about a year. My third time is now when I started feeling that old feeling again, but it was all my fault. Boosting up the miles quickly, no core or hip strengthening exercises, poor warm ups and cool downs, changing from 45 miles a week to 70+. The moment I felt it I immediately stopped what I was doing and was pretty much cripple for a week with barely being able to walk. I came upon this site last week and immediately slapped myself in the face and called myself stupid. I’ve been doing the core exercises, ITBS rehab exercises, warming up going into stretching/rehab to the foam roller which I have around, but like an idiot have always gathered dust in my closet, to icing with rest. It’s been 2 weeks and I barely feel pain. I know now that I am going to have to keep these exercises continuously if I want to keep running smart.

Jason

Sounds like a familiar story, thanks for sharing Alex. I think runners like me and you are prone to ITBS, so it’s vital that we keep up with the prevention exercises. Good luck getting back to normal, let us know how it goes!

Valerie

Glad you’re healing, Alex and so glad to have this forum where those with ITBS can, um, band together!
After 8 weeks of no running and PT exercises, I’m back to it. I want to think I’ve learned my lesson as well and will try to realize, gracefully, that I’m going to have to be doing a different kind of running. That means doing the exercises and stretches and being sufficiently warmed up, certainly. But it also might mean running slower (kinda hard, since I was pretty darn slow to begin with) and (heartbreakingly) for fewer minutes. The physical changes are so much easier than the mental/emotional changes!

Jason

Good lessons there Valerie, thanks for your comment.

“Band together” – couldn’t resist, could you? :)

chris austin

well guys im still out with this horrible injury and am penciled in for surgery on dec 8th.its been 1 year now and i still cannot even run for more than 5 minutes without pain.even walking about i can feel it rub.ive completely exhaust rehabilition and my core stability,hip,glutes and general leg strength is through the roof.doubled infact with a single leg press of 120 kg (seated machine) and i only weigh 78 kg.i even do pistol squats with 20kg in a rucksack lol.this is my only option left or its good bye to my prefession.if anyone has had or knows anybody that has had the release surgery advice on recovery would be greatly appreciated.i hope you all do not have to go down this road.

Louie

Hi Jason, I was really inspired by your article. I’ve had ITBS for five months now. I’m currently seeing a physical therapist, and she is great! Some of the exercises you mentioned in your article are the same ones that my therapist gave me. I planned on running a half-marathon this last September, but IT band problems kept me from doing so. Hopefully I can run before this year is over. Your article has made me feel optimistic about running again and hopefully I will be able to fulfill my promise to run a half marathon.

Jason

Thanks Louie. Good luck with the ITB! I developed the routine after seeing numerous PTs so there’ll be some exercise overlap for sure.

Jen R.

Hi Jason-

Great article. I’m a “friend” of yours on DM as well. I’m currently going on week #8 of no running and ITB troubles. This is my second bout, with my first being 4 yrs ago. I seem to have had a similar path as you the first time, looking for help with various professionals and a lot of time and $$ spent. I found a great PT who helped me back then, but it was a total of 7.5 months of no running! This time, I’m trying to address things on my own, since I feel like I understand the issue better and have the exercises and knowledge (thank you for posting exercises).

So, the problem I feel I’m having now is that I jumped into the strength exercises way too soon and have in fact further exacerbated the problem. I’m having tightness and aches along the side of my thighs daily. I’ve been rolling and stretching, and have stopped with glute work and lunges, I think those are harming more than helping at the moment. I’m also noticing my glutes and hips are extremely tender and tight when I foam roll or roll on a ball. I’m going to seek a massage therapist to address these issues…did you find massage a big part of your recovery, to have some of those trigger points and knots released? Also, do you find that letting the inflammation totally settle down before doing the strength exercises would be beneficial? I guess my theory is, if glutes are tight, then doing clamshells (for example) will be ineffective?

Thanks for listening!
Jen

Jason

Hey Jen – it sounds like we have very similar ITB issues… I think initially a person should rest and increase flexibility with a foam roller. If the IT band or surrounding area is painful, address the pain before you start doing the strength exercises. Once the knots are out (yes, massage from my PT helped), you should start on the strength work.

Kelly

Hi Jen –
Until recently, I was in the same boat as you, with the frustrating aches and pains while trying to do the exercises listed above. I wasted so much money on massage and therapists over about 4 years but I got lucky and through a random yoga instructor I found a corrective exercise specialist (kinesiologist) who has taught me how to properly do rehab exercises. I stubbornly thought that I could get stronger by myself and I foam rolled and strength trained for months on end on the advice of my PT – I got stronger but still couldn’t run and was achy all the time.
From the kinesio I’ve learned that over time I’d created tiny imbalances in the way my muscles responded to strength training – so I although I thought I was doing the exercises properly I wasn’t… they were actually making the tension worse and creating more knots – especially with the clamshells. I now see the kinesio only every couple of weeks now as I work through each exercise on my own and now I know exactly how my muscles are supposed to fire and I can tell when they aren’t. With the support of my trainer, whenever I feel like something isn’t working right she shows me the little tweak I need to make to do it properly. Now I’m finding the tension is letting go and I’m getting stronger in areas that I hadn’t realized I had weaknesses in and my knee pain is going away. I’m about to start water running and hope to be trail running again by June. If you happen to live in Vancouver let me know and I’ll give you her name. If not consider a corrective exercise specialist like this http://essentialkinetics.com/
I’m happy to help with any other info you need.
Kelly

Jen R.

Thanks for the response, Jason. When I had the initial knee pain, I actually felt great in the following weeks. No daily pain while walking, going up/down stairs, etc. I think that lack of pain tricked me into thinking I was ready to start the exercises at full steam. The aches and pains I’m having now almost feel like a delayed reaction, if that makes sense. Anyway, I’ve scheduled a sports massage this week with someone who specializes in athletes with injuries. Hopefully that helps with mobility in the hips and glutes so that I can get back on track with rehab. Thanks again, it helps to know that people can rebound from this debilitating injury!

Jack

Hey, I too am suffering from a crippling IT band injury. However I am not a runner, at the time of my injury (almost 3 months ago) I was playing 3 sports at once at rather high levels, I don’t mean to come across like I’m pumping my own tires sorry if I do. There wasn’t one particular thing that spread it but I was playing rugby on a sunday (I had played football and soccer on days before that) and started to feel some knee pain. We were winning by a lot and I subbed myself off, the next day I was still in pain so I booked a sports physio session. They said to give it a weeks rest and see how it feels. Well….here I am 3 months later. I have followed up on the physio on a weekly basis and he has given me the same tips as your 4th Physio. Things just don’t seem to be getting better, I’m rather frustrated as I am a junior in high school and have missed some opportunities already and if I don’t get healthy in 8 weeks I will miss the Senior Rugby tour to Argentina. Any tips?

Jason

Hey Jack, typically an IT Band injury is caused by weakness in the glutes and hip tightness. Here are some real basic first steps: use a foam roller on your quads, glutes, and hamstrings, try to work your hip with a golf ball or lacrosse ball, strengthen your hips and glutes with the ITB Rehab Routine and if you can, some gym work like dead lifts and lunges. You’ll also want to work on flexibility using a routine like the Myrtl Routine. Here are a few resources for you: http://strengthrunning.com/2011/02/the-itb-rehab-routine-video-demonstration/, http://strengthrunning.com/2010/10/how-to-treat-injuries-healing-itbs-in-five-days/, and http://strengthrunning.com/2010/05/elite-core-and-dynamic-warm-ups-a-comprehensive-guide/. Good luck Jack!

Andrea

Almost the same exact thing happened to me, and is continuing to happen. It is so frustrating.
I am in high school and run everything long distance(track, cross country, and cross country skiing) and I have been very successful. I was the mile champ and took second in the two mile. This summer I trained extra hard because I wanted to be the best I could possibly be. I bumped up my mileage quite a bit and after three months of training, the day before cross country practice started my IT band started to flare up. I had no idea what it was and continued trying to run for about a week. After that it was unbearable. I went to a few PTs and massage but none of i was helping so I gave up. I ran my sectionals and state race because my coach wanted me too and I got 3rd, with no practice at all. Everyone just said rest, so I did for 2 MONTHS! It was the hardest thing I have ever done. After it continuing to not get better I went to another PT in a bigger town. She is amazing and is helping a lot, she perscribed a lot of the excersises you have posted. But, my knee still flares up all the time and now it has been 5 months and i still can not run, and track is on the way. I just wanted to say thank you for this wonderful information and I am going to start adding some of your workout to my routine and hopefully my stubborn knee will finally heal. Thanks for giving me hope because right now I feel like it will never get better and was about ready to give up completely.

Allyson

Thanks a lot for this info, best I’ve found so far. I haven’t been officially diagnosed by a pro yet, but by fellow runners and websites I’m almost positive. I’m fairly new to running, been at it just under 2 years. But I’ve run everything from 5K to half marathons. I belong to a running club and we have a race series in 2012 and I planned on running them all, including a full marathon. Its all I’ve talked and thought about for months now. I do a series of 5K’s called the fudgicles (I live in new england) in the winter. Just a 5K on saturday mornings. This past week it snowed so I ran REAL slow to avoid injury. It was also my long run day so a friend and I did a real slow 7 miles after the 5K. Around the 4th mile I felt like someone stabbed me in the side of my knee. After that the pain was dull, then subsided. Well when I got home I could barely walk. Talked with a friend that has ITBS and when I said outside of my knee he merely said “oh no.” I rested sunday. Tried a real slow 3 miles on monday, could not walk after. Felt like I had a resistance band stuck inside my leg. And now it also hurts below my hip. I’m massaging it with a tennis ball which is painful, going to try the foam roller. Ice is useless. Seeing a sports injury PT this friday. The marathon I plan on running isn’t until October which gives me 9 full months. Is there ANY chance I’ll be able to pull it off????

Jason

Definitely! 9 months is a very long time and in my case (which was a severe one) I cleared it up in 6 months, though it should have been more like two. I’m coming out with something very detailed on this in a little while, so make sure you’re signed up for my private list to get notified. Don’t forget the ITB Rehab Routine too!

Allyson

Just signed up! Thanks for the quick response!

Gaby

I love your post! I have been working with a physical therapist for a tight IT band and knee pad herniation; five out of the 7 exercises you listed above are part of my new routine. I was able to successfully run a mile yesterday, at a much slower pace, but pain free! Do u have any recommendations for flair ups, or higher intensity versions of the exercises listed above?
Thanks for sharing

Jason

Hi Gaby, glad to hear you’re starting to run again. My recommendation is to do the routine consistently – higher intensity versions of the exercises likely won’t help much. But you can do other things like more pistol squats, dead lifts, and bridges (listed in my Standard Core routine). Good luck!

chris austin

just an update for you itbs sufferers who have had the injury a long time and not getting anywhere with conservative treatment.i had the surgical release 3 months after 14 months of solid rehabiltation daily.i was getting absolutely no relief whatsoever from this aggressive program and it was purely a last resort as my job is on the line.3 months post op i am back running again very pogressively.itb bad is noticalbly alot looser by eye,and no longer snaps over my knee.only problems im having at the min is that my patella is not tracking too well due to the release which gives me a little pain when not exercising at times however its early days and my surgeon tells me that it will take up to 1 year for my body to adjust and that i must concentrate on strengthening the surrounding muscles especial VMO.

i have just put this out there to give hope to anyone who feels that their running/exercising days are over.if anyone needs any information regarding the op im happy to help.

hopefully you will not require this as it is a very last resort

Jonathan Lindsey

Hey Chris what doctor did you use a d where is he located. My story is similar to yours….

Jonathan Lindsey

Kelly

Hi there – great info…reading your story is very familiar – almost as if I wrote it myself. My cycle of rest, re-injury and frustration went on a lot longer as I unfortunately stuck with the PT’s that sucked a lot longer than I should have. I was even coached to keep running through it and as a result have just been handed an MRI result of grade 4 chondromalcia in both knees (fancy words for bone on bone). While the specifics can vary between runners on exactly what is causing the pain/discomfort while running – finding the right therapist (in my case a kinesiologist) can be the only difference between a couple of months off or career ending injuries.

chris austin

its great to hear that your getting to the bottom of it finally.unfortunately medical professionals tend to give very different diagnosis.one things.its very frustrating at times

Jessica

I’ve been struggling with IT band pain for 3 months. When I take time off running, I still continue to cross-train with swimming, spin classes, core work, and yoga. At times I think that maybe the spin classes exacerbate it even though I don’t have pain while spinning. Anyone else experience something similar? Any other ideas of how to maintain fitness (and weight) while not running?

Thanks!

Jason Fitzgerald

Pool running, cycling, elliptical, and swimming (in that order, in my opinion) are the best options for runners to cross-train. But make sure there’s no pain – stop if there is! You can also lift weights to stay in shape (different kind of shape) while you’re rehabbing. Good luck Jessica!

Jessica

So I haven’t ran in 4 weeks and have been cross training with spin class 2-3 x wk, an interval class once weekly, swimming 2 x wk, and yoga. My left IT band flared up 1 wk ago (to the point where I do have some pain with just walking again), and I am now suspecting that spin class is too much. I must have overdone it on resistance. So my plan now is to stop spinning all together because I think it has been contributing to my IT pain bilaterally x 3 months. So I tried pool running today for the first time and my left IT band started paining me about 20 minutes into the session. Did you every have IT pain with pool running? Am I doing something wrong? And by the way, I have been glutes and hip strength training 5-6 days/wk for the last 4 months. Doing exercises given to me by my phsycial therapist and following your program too.

Jason Fitzgerald

ITB pain during pool running never happened to me. Check out this article for more: http://strengthrunning.com/2011/06/pool-running-why-you%E2%80%99re-doing-it-wrong-and-how-to-pool-run-to-get-faster/.

Megan

I love you!!!! After spending the big bucks at the physical therapist, and feeling hopeless I have been on the web searching for help with my annoying it band issues and you have saved the day. I am excited to try your rehab exercises and get this injury undercontrol. Thank you a million times over!

Jason Fitzgerald

You’re welcome! :)

Liz

Thanks for sharing. Are you able to email me the PT who knew how to address ITBS issues? I’m in the DC area and have been struggling w/ IT band issues for a while! thanks!!

Chris

I’m happy to hear about the exercises you did to get your core back into shape and strengthen your legs to help the IT band issue.
I’ve run (luckily) pain free for several years, but my participation in a recent Ragnar Relay put me on the DL in a hurry. I have the same classic IT pain on the outside of my left knee. I’ve used the foam roller a bit, but done more resting than anything else. But it’s frustrating me because I really want to keep my mileage up as I’m training for my first full marathon in October in the Twin Cities.
Am I off my rocker to think I can get the IT band issue worked out, stretch, strengthen my core, etc and still manage to prepare for the mileage I need in the next 3 months? I’m not anywhere near your speed, just hoping to finish right around 4 hours.
Any thoughts or rehab/training advice would be appreciated.

Jason Fitzgerald

Hi Chris, sorry to hear about your ITB injury – it’s not fun! It’s hard to say since I don’t know more about your running history/background, but it’s surely possible to get ready for the marathon since you have 3+ months. You just have to be very careful with your progression and make sure you’re doing enough strengthening/flexibility to kick that ITB issue. If you’re interested, I’ve written a lot of rehab plans for ITBS. Feel free to email me or pick one up at http://strengthrunning.com/pr-race-plan. Good luck!

Rachel

I’ve started physical therapy and the strength exercises to fix my IT band issue. I’ve been able to run for about 30min for 4 times a week, but anything more than that cripples me. Would you recommend that I stop running completely during my physical therapy or keep up my light jogs?

Thanks!

Jason Fitzgerald

Hi Rachel, you can keep running as much as you can as long as it doesn’t hurt. But don’t run through any sharp pain. Good luck!

Lara Schick

Hi Chris,

Any ideas about problems with opposite IT band pain once you healed the original IT band issue? It took me 4 months to heal my initial IT band problem. Ran a race this past weekend, and am now experiencing pain from the opposite IT band. I know it is recommended to roll out/stretch both sides, which I have been doing for the past 5 months. Not sure why this happened.

I really appreciate your advice.
Thanks,
Lara

Thanks
Lara

Lori

Thank you everyone for the article and comments. I was an off/on runner for a while then this past March started back fell in love with it- it just clicked. Apparently I overused- did too much too quickly and sitting here today coming off two weeks rest from IT injuries. I started running again this week and do ok for 3 miles then it all starts up again. I’m getting massages from a sports med person which helps and use the roller 3x/day. I practice yoga do core work etc. I feel like I’m grasping at straws in how to get back to running safely. My husband and I had planned on running a marathon nov. 3. I will begin these theraband exercises today. Any advice or thoughts is greatly appreciated.

Jason Fitzgerald

The ITB Rehab Routine has helped hundreds of runners – give that a try first, combined with some of the advice here. I’d also massage the areas around the IT band like glutes, quads, hips, hamstrings. If all else fails let me know – I’ve written a lot of ITBS rehab plans for folks that have helped. Good luck!

Corey

I’m a swimmer, not a runner, but I have had on-off tightness, discomfort, in my thighs (the tops) for about 5 months now. Swim coaches tell me it’s an I-T band issue, though my knees are fine. The foam roller helps and I felt much improved after 2 weeks of rest. But a yoga class and 5,000 yard swim workout reactivated it. Any ideas of specialized rehab exercises for a swimmer vs. a runner?

Jason Fitzgerald

Sorry Corey, I don’t know much about swimming. But the ITB Rehab Routine can’t hurt – I’d give it a try.

Lori

Jason- I’m seemingly stuck on the 3-3.5 mile wall since the IT band injury escalated. I wa running up to 14 miles several days a week before it happened. Any suggestions?

Jason Fitzgerald

Tough to say without knowing your past training, injury history, and all that extra info. If you’re interested, I do write custom rehab plans for ITBS. Feel free to shoot me an email.

Rachael

Really interesting article and something that I am unfortunately dealing with at the moment.

Started training for an October marathon in March and from week one I noticed a sharp pain up the right side of my leg. I ignored it and carried on training, increasing my mileage and resting when it came unbearable. 3 weeks prior to the race I was out on what was to be one of my last big runs before the big day. 18.5 miles I was set out to do but unfortunately for me I couldnt get passed 9. Took me 50 mins to limp 1/2 mile back home. Luckily there was a short cut!
Now I am seeing my physio every week and I had to pull out of the marathon. I was devastated. 6 weeks on and while the pain isnt as bad, the physio has uncovered issues that I never thought were an issue and the reason I have had IT Band injuries.
Basically, the bottom of my spine is overarched which has meant my pelvis is tilted backwards, which has given little support to my legs as my hips are too far back. This has meant that my IT Band has been doing a lot of the work during my long distance runs and pretty much given up after a certain point; 9 miles always seeming to be my pain threshold.
Because of this, one of the areas we are working on is my posture and ensuring that I am pushing my hips forward when I walk, stand or sit down. This is taking a lot of time and using muscles that have been switched off for a while.
On top of this the IT Band keeps becoming aggravated if I walk on it for a long period of time. Depressing considering I was running 6 days a week.

I am hoping that in time I will be up and running again, but it is disheartening as there is little I can do other than my posture and ITBand exercises in the hope that this will all get better for me to run again.

My top advice would be to never leave an injury until the dying death as it will only turn out much worse than what it actually is. If its a problem and preventing you from running, go and see a sports physio as soon as.

Jackie

I’m so glad I came across this article! I injured my IT band 2 weeks ago and it’s been a frustrating road to recovery already. I can’t imagine what 6 months must feel like. I stubbornly went for a (painful) hike the day afterwards, took a couple of days off, then went for just a mile test run and ended it quickly when the pain came right back. That was a terrible idea.

Since then, I’ve tried to smarten up by increasing my strength training considerably. I have tried to get my cardio workouts done mostly on the spin bike so I don’t totally lose my fitness level. The bike doesn’t seem to irritate my IT band. I’m itching to go run though… what’s a good sign that a runner is ready to take a little test run after an IT band injury?

Jason Fitzgerald

Hey Jackie, I’d say first see if you have normal range of motion, no pain during normal activity, and can walk fast/hike without any pain. If that’s true, then go for a short run (avoid any hills) to test it out. Good luck!

Jackie

Thanks Jason! It feels like this is taking forever, but I’m impatient. Argh!

Renee

Hey Fitz, thanks so much for this article and the ITB rehab routine! I’ve had ITBS in my left left for over 2 frigging years, ever since running my 2nd half marathon. Have had copious amounts of physio (acupuncture, rehab excercises, Pilates routine for ITB!) yet the injury lingers. My physio gave up 6 months ago and referred me to chiro, which despite weekly manipulations ain’t helping either – apart from now having referred pain from my hip up through my back. I haven’t actually run now for around a year… Would love to hear your view on why trusty REST isn’t at least making the pain and tightness dissipate? So frustrating! The chi running book suggests ITBS comes from crossing your legs/feet over your centreline when running or walking; creating torque on the band. Does that fly with you? If so, maybe general walking is what’s aggravating it now…?. Anyways, will absolutely dedicate myself to your rehab routine and have my fingers crossed! Cheers Fitz from Renee from New Zealand :)

Jason Fitzgerald

Rest doesn’t fix the underlying issue, which is most likely a weakness/imbalance in the surrounding musculature. Crossing your legs over the centerline can contribute but I highly doubt it’s the #1 reason why you have ITBS. If you’re interested, I’ve helped a lot of runners with rehab plans for ITBS. Shoot me an email and we’ll chat…

Justin Darrow

Hi Jason,

I’m a competitive runner and facing my second bout of ITBS. I’m running in the Boston Marathon 18 weeks from now and am just coming off of achilles issues that kept me out for 3 months. My IT band feels tight but not painful while walking around. However if I try to go for a run or pick up my knees while walking I can feel a tendon popping/.sliding over my knee cap. Its not really painful but feels really awkward and Im afraid to run through that. I’m going to start doing the exercises you posted. Any advice?

Jason Fitzgerald

Hey Justin,

I actually have the same tendon sliding over the side of the knee thing too. It doesn’t hurt and it’s never presented any problems, so I don’t worry about it. Just a battle scar :) If it doesn’t hurt I’d say you can keep training. Good luck at Boston! Are you trying for a particular time?

Justin Darrow

When the tendon slides over the bone does it ever feel uncomfortable? I’m just worried about making the situation worse. I originally planned on aiming for 2:40 but since I missed 3 months of running due to achilles injury I’m probably going to shoot for 3 hours.

Justin

Do you do the exercises every day or every other day?

Jason Fitzgerald

Try about 3 times per week, combined with other rehab work of course!

Carol

Thank you for sharing your exercises. It is very hard to find a doctor/PT that knows about running injuries. I was told to take a break and do alternative exercises like recumbent bike or elliptical while I healed but my ITB actually got worse. After hours of google-ing I saw some improvement with a mix of foam rolling, clam shells, and side-steps but my legs still felt very weak. I’ll try your routine (those pistol squats look brutal! LOL) plus Pilates and Yoga to help my core and I’ll hope for the best. I really want to run again but right now I don’t have the money to join programs like RunOn! or try more PTs.

Kelly

Thank you so much Jason, for sharing your inspiratioaln recovery story, as well as your comprehensive ITB recovery plan.

I am a dedicated runner with a recent ITB injury. I have a good physiotherapist, foam roller and am doing hip exercises, but it is taking time and in getting impatient I have had similar flare ups when I have attempted to return.

I’m not training for any race but had been running quite a bit as I find I to be the best stress relief and overall mood enhancer there could possibly be. Finding a continuous 12km route in Venice Italy and doing it at sunrise on vacation, sneaking in a run along Miami beach at a work conference, and unexpectedly doing a half marathon in sub zero temperatures have each been personal thrills.

Needless to say, I’ve been a bit bummed out for the past few weeks as I do my exercises and hope it gets better.

Anyhow, while I have been waiting and researching on-line I came across your amazing website. Thanks so much for putting together and maintaining this fabulous resource. Your story has given me hope and your recovery plan complete with video has given me much needed additional advice. Better yet, for the uncoordinated such as myself, it comes complete with needed how to video instruction for each exercise and so much more.

I’ve been thinking of this injury as an opportunity to become a better and stronger runner and I now feel fortunate that I’ve come across your website as a tool that will help me achieve that. Many thanks!

Wendy

Fitz,
I ran my first marathon in 2011 and was okay until the last 6 miles. My injury is exactly what you described and I started running again way to quickly. I had not done a lot of strength training either. I started using your IT Band routine last week and was able to run almost 4 miles today until the flare up started.

While I know you are not a doctor, do you think that my injury is less severe than what you experienced? I don’t want to overdo it but your training plan you use now makes so much sense.

Thank you for any advice you can offer,
Wendy

Jason Fitzgerald

Hi Wendy – it doesn’t sound really severe so I’d start with the ITB Rehab Routine a few times per week. You may also want to try the Standard Core Routine and alternate days. Email me if you want a more comprehensive, customized plan if your ITBS doesn’t resolve. But hopefully it will!

Wendy

Fitz,
Thank you! I will follow your advice and be in touch if I need a custom plan. Happy New Year to you.
Wendy

IT Band injured

I have been dealing with IT band and hamstring issue myself. I am going to ASTYM treatments with a PT. this has been a god send for me. the ASTYM treatment is kind of painful but the results has been 1000%, I am a bike racer& a runner. this has been a game changer for me. the treatment along with aggressive stretching has got me back running again with no pain.

Cynthia

Hi Jason!

2 years ago, I ran a half marathon. It was humbling to finish and a great accomplishment. I took a few months off and started running again, only I didn’t last more than a few weeks before I pinched a nerve in my foot. That was when my body started to change.

Over the next year, i developed a limp, then my torso started to rotate. I had no idea what was going on. I went to 20+ doctors, and 4 physical therapists. No imporvement in my muscles and my pinched nerve. I began to accept that this is the best I’ll ever be – never running again.

It wasn’t until I saw a massage/ergo specialist that he told me nearly everything in your body’s foundation is in your hips. My hips are crooked from improper marathon training and lack of strength in your hips. He put me on a program that involves constant foam rolling and roughly 90 hip raises 2x a day (different positions). I’m only 3 days into the program and I can feel my body is moving correctly! His words are similar to what your post is about. Stretch and strengthen!

Jocelyn Prevedel

Hi Jason
I read your article and found it quite inspiring. I have been running for years but I do it mostly on a treadmill, three miles in 30 minutes every other day. Recently I developed injury to my left IT band and it’s been quite painful. Instead of resting for awhile I ran again and now it’s worse. I purchased the foam roller and it seems to help for awhile but then the pain comes back. Every other day between running I do resistance training. I don’t understand why I suddenly got this injury because I haven’t changed anything in my routine. Could you please suggest what may help me to speed up my recovery and what may have gone wrong. I want to get back to running soon, I just don’t know how soon to start. Thanks

Jason Fitzgerald

See here: http://strengthrunning.com/2010/10/how-to-treat-injuries-healing-itbs-in-five-days/. If you’re not seeing much progress, email me and let’s chat.

Jocelyn Prevedel

Thanks for the article to help me speed up my recovery. I still can’t figure out what caused my injury but it could be my shoes, that was all that I changed. I will definitely take your advice and try some strengthening and stretching techniques that you mentioned. Thanks for your insight and advice.

katie

Jeff,

Boston 2013 was my fourth marathon, yet my slowest. I decided to take in all that Boston offered and truly enjoyed my 3:47 marathon(yet, of course we all know how this ended.)

Now, more than 6 weeks later, I still cannot run b/c of my IT band on my left knee. I ran this morning, 8 miles with much pain after 6. I don’t think that I can go any longer without runnig so I decided that I would just run through the pain.

I ice, use two types of rollers, I play tennis twice a week(0 pain) and do weights at the gym after the eliptical. I am BEYOND frustrated. HELP!

Cheryl

Ever since my last race this past April (10 miler which I PRed and ran really fast and hard-extremely hilly race) I made the mistake of running a short run too soon after the race and my left IT flared up and it’s been bugging me ever since. I do a strength/core routine 2-3x/week many of which are exercises recommended above. I just cannot get past about 3 miles before it flares. I’ve been foam rolling as well. The tightness starts right above the side of my knee and ends up wrapping around the side. No other tighntess anywhere else along the band. I’ve had issues with my hips being misaligned before and am trying to diagnose my biomechanics. I think that maybe my right hip is slightly forward thus pulling my left IT band. However, I’ve been consciously thinking about changing my form when I run and it’s still there. It’s very frustrating. I am running 3x/ week about 3-4 miles. It’s not gotten any worse but not any better either. Any other suggestions would be appreciated. As you know, this is a really frustrating stubborn injury and I would love to get back to running 15-20 miles a week.

Megan

Hi Jason!

I’ve been struggling with an IT band injury for 3.5 years — it sounds exactly the same as your case. I’ve tried everything. PTs, doctors, neurologists, rolfers, massage therapists, etc. I also live in the DC area. Would you please be willing to send the name of your PT my way? I’m getting desperate at this point. Unfortunately, I haven’t run for 3 years and cycling and hiking (my other two outlets) are painful, too. I do enjoy swimming and yoga but they’re not quite the same.

I really appreciate it!
Megan

Jason Fitzgerald

Sorry I don’t remember! They’re on Georgia Ave just north of 495

Tania

Thanks for the inspiring story and all the advice. I have been suffering from ITB pain for the last 6 weeks or so after running my first marathon at the start of June. Stupidly I thought that I could resume my usual training regime within a couple of days of the marathon (which I did!) and immediately tried to step up the mileage for my next marathon which I had planned for September. Within a couple of weeks, I developed crippling pain on the outside of my knee which I continued to ignore for another couple of weeks until it got so bad that I could ignore it no longer. I had pretty much given up hope running the mountain marathons I had planned for our Southern Hemisphere summer as running downhill is virtually impossible. I am going to start these exercises straight away and I can see that form is also very important. I’m all fired up to beat this now!! …So thank you :)

marie

Been sidelined for 6 months already after consistent long runs and hiking. Did a couple of marathons, trail running and sometimes, mountain climbing in the weekend. Did a lot of ITBS stretches and still no effect. Just had an ITBS flareup after 5 kms in the treadmill. I’m desperate to get back in to shape. Shoot me an email please. Desperately need to get back in shape. Thanks!

Jenny

Fitz,

I am running the NYC marathon on November 3rd (my first), and last Monday I went on a 14 mile run and injured my IT band. I have since then stayed off of it and gone to two aggressive training physical therapy sessions. I am also feeling some pain in my lower back, did you ever feel this? I am currently 2 months out from the marathon and wondering if you think I will be able to run it? I am very concerned and would love to hear you thoughts and advice.

My goal is to finish the 2013 NYC Marathon and then I will be fine waiting 6 months to run again. I have raised a lot of money and devoted a lot of time to this marathon and just want to cross the line!

Jason Fitzgerald

I never felt pain in my lower back. I can’t really say – depends on how effective your treatment strategy is!

Aishwarya

I am in the middle of recovering from IT band myself. It has been hell. First my right knee blew up. I did the whole drill of stretching, foam rolling and regular physiotherapy. But I made the big big mistake of suddenly increasing my mileage drastically once my right knee got better. So now I am recovering from ITBS in my left knee. It’s frustrating and demoralising. But am back to square one of lifting weights, foam rolling, physiotherapy and running one day at a time. I read your blog and it gives me strength to go on. Thank you for the information but thank you even more for sharing your story. Hopefully next year I am back in the marathon circuit sooner than later.

Andy

Some good advise there, learning strength training is so important when it comes to injury prevention, also can improve performance. I suffered an IT band injury after an ultra in December last year and have only just come back to running now, lots of swimming and cycling but it’s not the same. Won’t go mad with mileage this time no matter how much you want to nd htting the gym no matter if you are the skinny weak one in there .

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