The last major injury I had was a severe illiotibial band (IT Band) injury after the New York City Marathon in 2008. I took 9 days off from running after the race and then started to slowly run a little bit, only to have sharp pain on the outside of my left knee. I couldn’t run for six months.
After seeing several physical therapists and spending countless hours researching the best treatment programs, I developed the ITB Rehab Routine. This strength protocol strengthens the glutes, hips, and quadriceps and allowed me to finally resume training after six months of inactivity.
Even though my IT Band injury has fully healed, I still do this routine because I think hip strength is very important to runners. New research shows that weak hips are to blame for lower leg injuries. More aggressive rehabilitation for IT Band injuries can be done in the gym with dead lifts and squats to strengthen the glutes, which are often weak in distance runners and the reason the IT Band can get inflamed.
The ITB Rehab Routine consists of seven exercises done in a row with minimal rest. I do one set. Below is a demonstration of the exercises, using a Thera-Band
- 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.
- 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.
- 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.
- Side-Steps / Shuffle: 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 position. That is one set. I like to do 5 sets. This exercise will look like a slow-motion version of a basketball “defense” drill.
- 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.
- Hip Hikes: Stand on your right foot. With your pelvis in a neutral position, drop the left side 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 reps per side.
- Iron Cross: This dynamic stretch will help you feel loose after the previous strength exercises. Lie on your back with your arms out to your sides and swing your right leg over your torso and up to your left hand. Repeat with your left leg and do 20 reps in total.
After my experience paying $30 to go to a physical therapist twice every week, this video is easily worth hundreds of dollars to the runner who applies it to their injury. If you use a foam roller for myofascial release after the routine, you are getting almost all of the benefits of a PT without the cost.
The only thing you need is a good Thera-Band
Here are a few things to keep in mind when doing this strength routine:
- If you currently have ITB pain, you can do this routine as often as every other day.
- Always modify the number of reps or recovery period if you need to.
- Even if you don’t have ITBS, you can do this routine 1-2 times per week for prevention.
- Increase reps or add weight to any exercise to increase its difficulty.
Are there other video demonstrations that you’d like to see?
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{ 102 comments… read them below or add one }
Whew, good to know I’m doing ‘em right. Sometimes it’s hard to picture stuff in your head. I’m looking forward to the next one!
Exactly, that’s why I’m hoping some videos will be helpful. Stay tuned!
Hey Fitz. Appreciate the video. Good stuff. I have been using variations of this routine for some time now. I like to mix it up a bit for the simple sake of variation and multiple muscle activation (ie. use the bosa ball for hip thrusts, and curls, etc). Just a quick question for you. Notwithstanding using the routine above I have been hampered by what I suspect is a case of ITB for the last month or so. Started with mild pain at the insertion above my left knee with some swelling on the outside of the knee. It has improved but it is still seriously hampering my ability to run and seems to be very slow progress. Uphill is fine but after an hour of varying surface the pain kicks in pretty quickly above and below the knee. Just was hoping for your opinion given that you have dealt with this in the past. Does it sound ITB-like to you? If I set the grade on the hill at 7-10% and run easy I get little discomfort- but this is boring. But I wonder if I am just setting myself back each time I do this? I struggle to take days off. Your thoughts would be greatly appreciated. Got my first ulta-race of the season in late April so…. time is not on my side.
Thanks a bunch.
Hey Adam, that definitely sounds like ITBS. Pain on the outside of the knee is ITBS the vast majority of the time. I would continue to train on hilly surfaces if that provides relief, but remember that dull/achy pain isn’t doing any more damage but sharp/intense pain will. If you feel anything sharp, stop.
Glute weakness is a major contributor to ITB pain, and for myself I found that dead lifts were a great way to combat this problem. I’m not sure what your strength training is like, but you may want to look into this. Hill sprints also helped me. Good luck on your ultra this April!
This is really timely for me. I’ve spent the past two months battling what I and my physio think is ITBS (though I suspect it’s something deeper). Whatever it is, I’m sure these exercises will assist my recovery. Many thanks!
Glad I can help Simon, thanks for stopping by. Let me know if there’s anything else you’d like to see here on Strength Running.
Exactly the same as you have been, my friend; you have an awesome website. I’ve actually ordered some resistance bands based on seeing your videos here to boost some of the strengthening exercises I’ve started doing. I still don’t understand what my problem is – knee pain on the outside along with upper quad tightness, misc aches all over and general “dude, your left leg is not cooperating” feelings. Seeing the physio again tomorrow so hopefully she can prod her way to the truth a little.
I enjoy your site very much and follow your training on Dailymile. I am having some ITB issues as well. Pain outside left knee. I have a marathon in 4 weeks. I did my 18 miler last week. Step-down to 14 this weekend and 20 miler next weekend then the taper. I have been doing alot of crosstraining, spinning & eliptical and less running during the week. Have been doing alot of those exercises already. I’m not out to break any speed records but finish my 1st marathon. I’m hoping this plan will work. I can add deadlifts with my kettleball at home. Thanks again for sharin gthis great information. I hope to really use this after I complete my race.
Thanks for the comment Lou Ann and sorry to hear about your ITB pain! I’d be a little weary of the elliptical because it puts a strain on the hips, but otherwise try out the ITB Rehab Routine and dead lifts definitely help strengthen weak glutes/quads (which are often a contributor to the injury). Good luck in your marathon!
Thanks so much for the video demonstrating these exercises. I’ve been suffering from ITBS since around the start of this year (after completing my first marathon in December), and thanks in large part to these exercises (and my foam roller!), I seem to be well on my way to recovery.
Awesome, great to hear Brandon. Glad it’s helpful.
Thank you so much for a video to tell me exactly how and what to do to keep my ITB pain away!!!!! so great to see the exercises so I know I am doing it the correct way:)
You’re welcome! I have several other ITB articles, so I hope you check those out as well.
I will be checking out those articles- How many times a week do you suggest doing the 7 ITB exercises?:)
Hi Katie – if your IT Band is tight/painful, you could do the routine every other day. But if you’re healthy, I recommend 1-3 times per week for maintenance and general strength. Good luck!
The last few weeks I have had really bad IT band pain on my right knee. Even brisk walking hurts. Very depressing as I love to run. SO I really hope if I do these exersices it will help me get back into running soon.
Hey Angie, I hope the routine helps. I also found that consistent use of a foam roller and lifting exercises like squats and dead lifts were helpful. You need to strengthen your glutes and hips! Good luck. – Jason.
Thanks Jason. Is it better to do these exersices everyday or should I do it every other day? I just want to get stronger faster.
Angie and Carlos – if you’re currently injured, I would do this routine every other day. But if you’re not currently injured, I would do it 2-3 times per week for prevention. The other days you can do a different core/strength/mobility routine. This routine can be done after a run. Once you’re comfortable with it and it doesn’t leave you sore, you can do it as a warm-up. Enjoy!
Hey
Just wondering if this would be a workout or a post-run type of thing… it sounds like this gives somewhat of a burn and might leave some soreness.
When / how often should you do this?
Awesome!! Thank you so much. I have been sidelined with an ITB injury and the PTs, I have been too have not addressed any of these exercises. Hence the ITBS keeps recurring. I am very grateful for these exercises and the video highlighting the right form!!
Hey Roshni, glad you like the routine. Some PT’s focus on the symptoms but the ITB RR addresses the most common causes of the injury, which is why it’s so effective. Good luck with it!
Thanks a lot for this routine!
I’ve had ITBS and knee pain for around 18 months now…it’s horrible!
I’ve started to do this routine and it seems to be subsiding!
How long do you think on it would take on average before I could start jogging again? Also, have you never experienced any kind of ITBS knee pain since performing these exercises? Thanks.
Hey Luke, no problem! Glad I can help. It’s almost impossible to say when you can start running again – but go slow and gradually work your mileage up. Don’t run through any sharp pain. I get occasional ITB tightness when I’m running 80+ miles per week and doing hard workouts even when doing the routine. It helps a LOT but won’t make you Superman
Just train smart – this will be a great addition to your strength program.
I see. It’s quite a tricky injury. It seems that no one has ever been completely 100% healed from it…at least I haven’t found any record of it. But I strongly believe mine is down to weak glutes/hamstrings as I sit at the computer all day. I continue to work on his routine and let you know how it goes! Thanks.
Fitz,
Thanks for the IT rehab routine.
I believe I have a moderate case of a damaged IT band that flares up only when I run (about 2 miles into the run). I’m a new runner and I was building miles too quickly which I believe led me to this nasty injury. It’s strange how quickly the pain dissappears after I stop running.
I finally got my thera-bands and completed my first rehab routine yesterday. I can report that I am sore this morning but I’m on the mindset that I am on way to recovery. I’m taking off 1-2 weeks from running and focusing on doing the IT routine every other day, foam rolling, and doing easy cycling on the days when I’m not rehabbing.
Looking forward to building strength and running in the near future.
Thanks for the comment Cenk – and you’re welcome. It worked for me and it sounds like you have a pretty good rehab schedule planned out. Good luck!
Update: When I first injured my IT Band and started the IT Band routine I was in low spirits and had doubts that I would be able to run like I had in the past. But I committed to the routine every other day and then after 2.5 weeks of no running outdoors (I did do spinning and other core exercises) I ventured outside and started running very slowly. To my surprise I really had little pain and felt much stronger in my legs, quads, and glutes.
When I now run I pay much more attention to my gait, making sure that I’m not overstriding and keeping my cadence at the 180 level. I have even stopped running with my ipod shuffle so I can focus more on my mechanics and environment. I’m continuing the IT Band routine and I have even incorporated other exercises such as using the abductor machine, leg presses, and lunges.
Thanks Fitz for your routine. It’s made a huge difference in my running.
Wow, that’s a great recovery story! Congrats on getting back to running again Cenk. Let me know if there’s anything else I can do to help.
Hey thanks so much for the routine. I pulled my it band 7 months at an ultimate frisbee tournament I wasn’t in shape for. Since then I can usually run without much pain but it starts to hurt later that day. I know every situation is different but what’s the minimum amount of weeks that you’d do this routine before trying to run again. And how often would you use the foam roller and how many minutes per session? Thanks for the help!
Hi Heather – it really depends. I would do the routine once every 2-3 days with other types of core/strength work for at least 1-2 weeks. When you don’t feel any pain walking around or unusual tightness, you could try to run very easy for a few minutes. As long as you’re not really beating yourself up, you can use the foam roller every day. Keep it relatively brief or you could get sore. Good luck!
Hi and thanks so much for this routine! I’m a runner who has been battling with this injury for almost 7 months now. I did both Graston and ART therapy for almost 4 months, but at this point my PT/chiropractor believes that there is nothing left for him to do – my ITB is loose, but it still hurts in my knee (and more recently, also in my hip and glute). My PT wants me to take the rest of the summer off from attempting to run, swim, bike, or dance, then slowly begin interval running rehabilitation in September. In the meantime, he mostly wants me to concentrate on strengthening my glutes, and prescribed most of the exercises you show here (although I’m definitely going to add some new ones after watching your video).
A couple of questions for you:
1. How important did you find stretching as opposed to strengthening? I have been doing both, but after 7 months of dealing with this, it’s starting to get really burdensome (I mostly work on stretching my hips). Did you stretch much to recover? If so, which stretches and how often did you do them?
2. Is there anything else you did to help recover? Icing, etc?
I have only attempted to run 3 times since injuring myself in early January, and each time I made it less than a mile before my ITB became inflamed. Each inflammation lasts a month or so, and then I recover and feel OK to run again, but it still hasn’t worked out. There was a period of time when I was able to do some interval sprint training, but then I hurt my shins and decided to stop (there are only so many injuries I can deal with at once!) When I attempt to run again in September, I’ll be starting very slowly with a program of 8 seconds of sprinting, then walking. Every few days I’ll increase the sprint time a bit more (and with more repetitions of sprinting and walking), until I gradually slow down to a normal running pace (this is what my PT advises). How did you begin to run again?
I have orthotics and correct shoes now (a pair of pronated shoes caused this injury), but it hasn’t solved everything. I now think glute strengthening is going to be what finally cures me. Thanks again!
Hey Meghan – I’ll try to make this brief:
1) Strength over flexibility (fix the problem, which is 9/10 times a weakness NOT an inflexibility)
2) Flexibility work is helpful once you start running again to prevent stiffness, sore spots, trigger points, but for recovery focus on strength
3) I am not a fan of orthotics. 99.9% of people don’t need them.
4) This sprint/walk program sounds terrible. NOT recommended.
5) Glute strength helps a lot – dead lifts, squats, pistol squats are all immensely helpful.
Good luck! If you have more questions email me at support@strengthrunning.com
Been suffering from left hip and ITB problems for a while now, going to give this a go. Just tried the routine and could not do the thrust and the squat was a big struggle which highlights the weakness. For the thrust, is it OK to do a bridge without the leg raise to build up strength.
Good luck Brian. Definitely do as much as you can, but adapt the routine to fit any weaknesses. Doing that will ensure you won’t get hurt. Cheers – Jason.
I am suffering from ITBS for quite sometime. I think with the exercises demonstrated by you, I ll be fit to run long distance again. Could you send me the link for Thera Band from Amazon, medium to high strength/resistance ? I found lot of options for it and did not understand the color coding etc. Please help.
I just emailed you Kaushal
Fitz, thank you so much for the video! I’ve had ITB on and off since I started running almost 4 years ago and I’ve had quite a few trips to the PT… however I finally got a foam roller a few months ago and that’s been helping quite a lot, now I’m going to start doing these exercises so ITB will be gone for good
Good luck Claudia! It’s a hard injury to beat since the ITB is connective tissue and not a muscle, but you’ll get there. Let me know how I can help.
My IT Band started to bother me the last few miles of a 1/2 marathon two years ago. I’ve struggled with it since then. I am thrilled to find your video of seemly very effective exercises for ITB sufferers which I will start — working into some of them slowly, I’m certain, as I’m 67 — but otherwise in good shape. I’m also going to get a foam roller.
Good to hear Beau! It’s a good idea to progress slowly with some of the exercises if they’re difficult for you. Be smart and I’m sure you’ll see progress. Good luck!
I have been fighting ITBS for 2 years now, I just can’t seem to beat it. At times it is all I can do just to get through the day walking. Because it is now chronic it effects everything I do, swimming, biking, anything that bends my leg. I am going to give this a shot, it couldn’t hurt right?
It probably won’t hurt – as long as it doesn’t hurt. If it’s painful to do any of the exercises then I would stop. Of course, I’m not a medical professional, and your case sounds severe so I would recommend seeing a physical therapist or your doctor. But you should also research the other ITBS articles here on Strength Running if you’re interested: http://strengthrunning.com/2011/01/it-band-injury/ and http://strengthrunning.com/2010/10/how-to-treat-injuries-healing-itbs-in-five-days/ come to mind. Good luck!
Fitz,
Im 2 weeks into the regiment with additional weight lifting exercises (squats/deadlift) incorporated in as well. My question is when can i test running again? Do i continue to hold off or can i try and work in a couple runs up until the pain starts each week?
Hey Brad – I’d make sure that you’re not experiencing any pain doing the exercises, walking, or bending your leg. Once your glute, hip, ITB, and quad area feel somewhat loose, then I’d attempt a run. But stop immediately if you feel pain because at that point, you’re doing additional damage. You may also want to look into a good massage. Good luck!
I’m really excited to try these exercises! I noticed that there are different resistance options available for the Theraband. The link you posted is for the extra light resistance ones. I found that there are medium and heavy resistance ones too. Do you specifically recommend the extra light ones? I am not an elite runner by no means. I picked up running about a year ago. I went from running intervals (to keep shin splints at bay) to running a 5K but between 2-3 miles my left knee would start hurting really bad. I only got to run 3.2 miles a couple of times before it hurt so bad. I haven’t gone for a run in a month. I just tried today by walking briskly for 3 miles then ran for .5 miles and felt my knee hurting again. I’m pretty sad that it’s hurting sooner into my run after all that rest time!
I have an appointment with a sports medicine doc next week and I’m hoping she can help me resolve this so I can get back to running and increasing my mileage.
Hi Kimberly, sorry to hear about your knee. I think you should start with the light resistance bands when you first start with these exercise. When you’re ready (i.e., when they get really easy), you can progress to a higher resistance band. This pack on Amazon has 3 different types of resistance: http://amzn.to/piKAkI. I hope this routine helps your knee, good luck!
Great video and workout routine. I, too, suffered from ITBS at one point and I rehabbed it using a strengthening routine similar to this. (Hip hikes, side lifts, and lunges) It frustrates me that the common wisdom for rehabbing ITB injuries seems to be various forms of “stretching” the ITB when this is almost entirely ineffectual, running doesn’t test the limits of the ITB, ITB length is not correlated with increased incidence of injury. What *is* correlated with ITB injury is a decreasing angle between the femur and the pelvis during the landing phase, i.e., hip droop, and that is fixed by stabilizing the pelvis which involves strengthening the muscles that attach to it, the hip abductors in particular. I like how that is what you focus on and you didn’t mention stretching the ITB once. (I’m not counting the Iron Cross since that’s a dynamic and not a static stretch.)
Two quick points of emphasis I’d add:
1) When doing the clamshells and side lifts is it is important to keep the torso on the ground so the torso forms a line with the active leg when it is in the rest position. You do this correctly in the video, but don’t point out its importance. It seems everyone’s first inclination when doing this exercise is to prop their torso up on their elbow, so the torso forms an angle with the ground. This puts the hip at an angle it doesn’t see when running and risks involving the abdominal obliques in the lift rather than the gluteals.
2) Virtually all of these exercises are nonspecific to running. They involve angles and motions that don’t occur during running. So the runner really only benefits from the eccentric part of the movement. This just means it is important that the runner do the eccentric movement in a controlled fashion and not simply relax and let the leg return to the starting position on its own. Again, you do it correctly in the video, but you didn’t emphasize it so I thought I would.
Agreed – and thanks for the pointers. I should have made that more clear!
I injured my knee several years ago running in a 5K on the banked side of a road. I didn’t know what to do about it and since I don’t run much, it eventually went away. I recently decided to try a 10 miler, trained for 5 weeks (on a treadmill) and reached the point where I could run 4m and walk 1m (twice) without too much difficulty. However after 2.5 miles on the course I felt it again – a pain on the outside of my right knee. By mile 4.5 it had spread to my hip and below the knee, and I had to walk/hobble the rest of the way.
Although the pain is not always consistent, my knee basically hurts when I walk or bend it, and sometimes I have pain in my hip as well. If, in fact, I have an ITB injury, should I wait until I have no more pain before I start your strengthening exercises?
Sarah
Hi Sarah, sounds like ITBS to me. The best move here is to limit your running but start on the strength exercises as soon as possible. If a particular exercise hurts, then don’t do it – or limit the movement – but you should try everything to make sure. Good luck! Let us know how it goes and if you have any other questions.
Hi i am 15 and have been having sharp pains on and off for 3 months usually after i do sport an hour after the joint in the outer knee is also hot and hurting worst is it ITB? it also felt like it was swollen but the swelling has redused now but the pain is still there and mostly hurts when going up or down the stairs. what should i avoid? will it ever go away? and can i do any cardio in the gym to warm me up? please reply THANKS
Hi i have been having sharp pains in my outer knee for 3 months when it seems like it is getting better after a week or 2 of rest and i go rugby training or gym ( A LOT OF RUNNING) it gets bad again and about an hour after a long run the outer knee joint feels hot for a while is it ITB? these pains started when i was increasing my time on theadmil by 5 mins each time i went gym (often) i am young and can’t live my life without sport. i want to know is it ITB? what should i not do? can i do any cardio in the gym to warm up? PLEASE REPLY THANKS
Sounds like ITBS to me Emmanuel. I’d talk to your parents and see if you can get to a physical therapist.
Jason,
First, thanks for all the information, insights, and encouragement you provide here. Quickly: I ran for approximately 7 months last year (getting up to 3-5 miles a day, 4-5 days a week) mainly to lose weight and get in shape. I was doing great – until the strange pain on the outside of my knee started eating into my ability to run. Like an idiot, instead of getting it checked out, I basically just stopped running and exercising until finally getting it diagnosed and “treated” with PT in July & August.
I say “treated” because, though my IT band went from “extremely tight” to “loose” according to therapists as a result of my PT routine of mainly stretching but some of the strength drills you demonstrate in your video, I still haven’t been able to shake the vague, low-level pressure in my IT band that I feel at rest. It never really hurts – and I have yet to resume any real exercise on it – but the stretch-heavy routine I’ve been doing for four months now only seems to temporarily remove this pressure (it’s not really pain per se). A few hours after stretching it, I’ll begin to feel it again.
Given all that, I’m interested by your opinion above that strengthening rather than stretching is more strongly correlative with recovery from ITBS – and eager to finally kick this syndrome’s ass to the extent one can. If you’ll permit a few quick questions:
1) Do you think the fact that I left my ITBS untreated for almost a year explains my longer recovery period? (Again, I’m over 4 months into a routine of daily stretching and foam-rolling w/ some strengthening and full rest)
2) You’ve emphasized the importance of strengthening in general and mentioned deadlifts, squats,etc. I have access to a gym. Would I get more bang for my buck with weights and traditional leg lifting or by banging the Thera-Band on a mat in my house? (Just curious. I’m willing to do both of course, if that’s best, but, after tons of “light” therapy exercises geared for “beginners” in PT, I’m ready to get as rigorous as possible)
3) That chronic (albeit low-level) tightness/pressure I describe – I take that to mean I still have an issue. Stretching has not alleviated that. Any experience with that or similar cases? Any thoughts on whether more time on strengthening can alleviate that feeling?
Sorry for the very long post – I’m frustrated but still hopeful. Thanks in advance for any thoughts you can share!
Thanks for writing James – and sorry to hear that you’re still having problems after all these months! Some answers to your questions: 1) Perhaps, though who really knows? I’m sure you’d have been better off treating it sooner, but there’s no real way to tell. 2) I’d say do both. 2x/week in the gym (just be careful) and 2x/week with the ITB RR. 3) Yes, my left ITB is not the same since I injured it. It still gets tight and I have to take extra care of it. You may have a similar case or, unfortunately, the only thing to make it feel 100% might be to stop running.
Thanks a lot, Jason, for the feedback. I’ll plan to let you know how it goes!
James,
I’ll chime in just because this is a pet peeve of mine. Stretching doesn’t help. In fact there was never a reason to believe it would. (Running, even for ITBS sufferers, doesn’t test the limits of the ITB’s range of motion.) But doctors and therapists constantly try to treat ITB with stretching. The real issue is weakness, particularly of your hip abductors but of your core muscles in general. Off soapbox now, let’s get to your questions:
1) It’s possible your tendon thickened when it was unable to heal itself. This thickening isn’t like muscle hypertrophy, it doesn’t contribute anything to the strength of the tendon. Your PT should be able to check for thickening and treat it, either with ASTYM or Grafston,. You won’t thank me for this. It’s very painful.
2) It depends on you. I’m of the opinion that compound motions are better than isolation exercises for dealing with isolated weaknesses. If you have a weak muscle in a chain there is something wrong with the entire chain that brought that weakness on in the first place. Squats, when correctly done, are an excellent exercise and will build a stronger core than you’ll ever get on a swiss ball. They take a lot of work, however, and if you’re not willing to learn how to do them correctly or shy away from heavy, hard workouts, isolation exercises are a good alternative. They are easier to do, don’t require a big investment in equipment or memberships, and I know lots of people who have overcome ITB problems using just isolation exercises. Jason’s program is excellent and I’m sure you would be successful if you follow it.
3) You can be healed. Don’t let anyone tell you otherwise. Build up your strength until your pelvis is rock stable when you run, make sure the tendon has healed properly, and you’ll lick this thing. My experience is you can get about 80% of the benefit in very short order and be back to a basically normal running routine in just a few weeks. Fixing that last 20% might drag on for the better part of a year, but it should improve constantly. If it is not making progress find out why. Your body wasn’t meant to hurt.
I’d temper Jason’s advice about stopping running by adding the words “in pain.” Stop running in pain, but run as much as you can pain free. If that’s 2 minutes on a treadmill then that’s how far you should run. If you can run longer then run longer but longer runs will fatigue your stabilizing muscles that protect your ITB. You should never run past their ability to protect your ITB, but if you stop running altogether your body will heal for the condition it finds itself in, i.e., sedentary. This can lead to randomly formed scar tissue, adhesions, and softer tendons. True, all of these problems can be fixed, but basically by undoing the incorrect healing and then doing it again right when you want to start running again.
Many thanks, Rick, for your very thorough response to my questions. I’ve been lifting a lot for my legs and am hoping this will pay off. Thanks again!
Hi Jason,
I recovered from a bout of ITBS a couple of years ago after increasing my mileage too fast and unfortunately, am suffering from it again. I’ve got some lateral and mid-calf pain going on, too, as well as the typical ITBS symptoms. I’m wondering if this sounds like two different issues going on, to you? At this time, I’m not running, just ordered a Theraband and will restart strength training as well as using The Stick for massage. This time, I won’t drop the strength exercises when I feel recovered. Thanks for the video and instructions!
Hi Carol – there could be a relationship between the two pains, but it’s too difficult to tell without setting you up on a high-tech treadmill for a gate analysis and physical therapist evaluation. My recommendation is to keep up with the strength exercises, work on your mobility with some flexibility exercises, and learn to love your foam roller (the Stick works too). Good luck!
Thanks for the speedy reply, Jason!
Hello! I am a new runner and over the last few months, as I approached my first running goal of 5km, I aggravated my left IT band. Eventually it started hurting on its own, so I went to see a physiotherapist a few times. She rotated my hips (the source of the problem) and gave me some exercises to do. My leg still doesn’t feel normal yet, but my hips are in place now and I’m working on strengthening the muscles that are weak because of the hip issue. The physiotherapist said that I could try running a little bit for a short distance. I’ve stayed away from running for a month and am anxious to start up again, but is that a good idea if my IT band doesn’t feel completely healed?
Sometimes the best thing you can do is to run a little bit. If I only ran when I felt absolutely 100%, I wouldn’t be running nearly as much as I am! You may still feel some soreness or tightness, but as long as you keep doing your PT you’re in a good spot. Try the ITB Rehab Routine and use your foam roller on your glutes, hips, hamstrings, and quads to loosen the entire area. Good luck getting healthy!
Hi Jason,
My name is Lisa and Ive just come across your utube video for the ITB routine and keen to try it!! I have spent so much money on Physio’s and podiatrists that I have run out of my private health cover and apart from now not being able to afford a session, I also dont see the value as I am still where I was 10 months ago..
I have always been a runner, love it! But noticed some horrible knee pain a year ago whilst doing a 14km fun run. I didn’t do any prep for it so no wonder really. Since then and up until now, I began getting awful heel pain and now my knees are both bad too. I also have some crazy pain in my right hip/hip flexor sort of area. I have stopped running as of two weeks ago and am only doing dead lifts and glute body weight exercises. I stretch/roll all the time to try and relieve the hip/glute pain but its pretty bad. Unfortunately I didn’t stop running when it started and pushed through,hoping it would just pass and Im thinking due to this it could take a lot longer to now get it better..?
I guess Im asking if you think all of this is relating to the ITB? Unlike other comments, my knee pain is right at the front of the patella and all around and never leaves me, is often worse when Im sitting down. Sorry for the lengthy email, its just good to know theres other runners out there with the same issue and gives me hope that I’ll be able to run again..
Hope to hear from you soon..
Lisa ; )
ITBS usually hits on the side of the knee, not in the front. You could have patella tendonitis or another type of knee injury. I don’t know for sure, but it’s very possible (and maybe likely) that all the pain is related to a particular weakness or running inefficiency. Yours definitely sounds like a very advanced case – I don’t have all the answers, but I’d stop running for awhile and get this figured out!
OK thanks ; )
I have had ITBS in the past. It went away and came back with a vengence durring the JFK 50 in November. I finished knowing that I would have to take some time off. I took 6 weeks off and started short runs. The IT band starts to get tight at around 5 miles. My question is can I continue to do short runs as I rehab this issue? Thanks
My philosophy is that as long as there’s no sharp or stabbing pain, you’re fine and not doing any additional damage. Never run through pain, but if it’s just a mild soreness or tightness you can run. Good luck!
Is this helpful for hip bursitis? It only really hurts when lying on it at night so far, but I can feel a very slight bit of discomfort at times since starting a biking/walking/running program 4 months ago.
That’s a tough question Heidi. I’m not very familiar with that injury – it’s probably best to talk with a physical therapist.
Jason,
Thanks for this – I’ve bookmarked it. This was the exact injury that kept me out of running for about 5 months in 2010/2011, and many of the physicians I spoke with couldn’t recommend a solution other than “stretching.” I’ll integrate this into my routine as I train for the next race!
Great, I hope it helps Christian – probably a lot more than just stretching
Thanks for this – I need something to build up my hips and these worked well so far – only tried once but like the variety and the challenge.
Jason,
I decided to take up running last October 2011 and went to a 5 mile “Mud Run” with some friends. After that I felt great and even ran occasionally a mile or so at times when I felt like it. I eventually did a 5 miles run with a friend and decided I wanted to make it a normal routine to run. About 3 days after running the 5 mile run the outside of my left knee began hurting. After looking into it and talking with a couple other runners, ITBS seemed to be my condition. Since then I have been strength training at the gym, using ITB stretch routines, foam roller, and running small amounts occasionally to see if the pain is gone. I have noticed that I’m good for about 1.5 miles everytime I run. I have signed up for a 10K that is coming up at the end of this month but I’m not sure if I should try to endure the pain for last 4.5 miles or just not risk it at all. I’m curious to know what you think…. would I do permanent damage to my knee if I continue and try to run the 10K? Another Q would be when is it safe to try to run again after solely strength training? Thanks.
Hey David, congrats on starting to run! I doubt you’ll do permanent damage if you gut it out for the remaining 4.5 miles, but you could definitely make the injury worse and lengthen the recovery time you need. I’m not sure it’s worth it. I’d keep running as much as you can without pain and gradually that amount of time will get longer. Good luck!
Thanks for the advice. It’s encouraging to know that this pain can go away with the correct training. I just have a problem with staying off of it b/c I usually can’t sit still and then I get anxious to see if I’m progressing. I guess I just have to understand that it is going to be very gradual.
Jason,
Last weekend was the 10K I was training for and it was a success because I was able to run the entire race (51:11). I was able to make it through w/o the knee pain while running. I’ve found that through my training it pays off to start at a very slow pace and then gradually increase pace. I’ve been training with a friend doing negative splits. Warming up before the race also seemed to help. I can say that I’m on the road to recovery and I believe soon I will be able to quicken my pace and still be pain free.
Maybe it is in here someplace and I missed it, but can someone please give me an idea of which size and color of TheraBand to use? I have never used one but see there are various different ones available. Thanks.
Start with a low resistance band and you can move up eventually. I believe Amazon sells a 3-pack of different resistance bands.
Thanks Jason. However, besides the resistance there are various sized loops as well – 8-inch, 12-inch, 5 feet. Am I guessing correctly that 12 inch bands would be appropriate?
I’d buy the 5 feet bands and cut it so you can make different sized loops. In the video I have a rubber tube that’s tied. Try these: http://amzn.to/zdf4Ww
If your band breaks you can just super glue it.
I just wanted to say thank you for making and sharing this video. I’m currently on break for training for my first half marathon due to ITBS and I’ve been using this routine to hopefully get back on track. So far so good!
So you’re saying that I can replace this routine with dead lifts and squats??
Honestly that sounds a lot more up my alley. As long as it will give the same benefit….
Thanks for the tips!
I wouldn’t replace the routine, but adding dead lifts can be very helpful.
So you’re saying there’s no way to get out of doing these stretchy band exercises??
Also, what type of resistance am I looking for, as far as the thera-band goes.
I know it probably varies, but if it helps, I’m a 6′ male, 180, decent shape.
Julian,
If you are talking about *replacing* Jason’s rehab routine with heavy weight training, realize you are conducting your own experiment. Much of what Jason proposes is based on or similar to studies that have been done on ITB rehab and has a lot of anecdotal experience testifying to its effectiveness. I personally rehabilitated my ITB problem many years ago using movements very similar to what Jason recommends.
That said, there is good reason to believe heavy, full-range squats *could* rehabilitate an ITB injury. While I had already resolved my ITB issues long before I started barbell training and so can’t comment on how it affects that injury specifically, I feel it has cleared up a bunch of nagging injuries that I had constantly been fighting. Recently there has been quite a bit of research into heavy lifting to improve running performance, but to my knowledge none of this research has addressed injury rehabilitation or prevention. It boils down to how enthusiastic you are about experimenting on yourself.
The keys are in the phrases “heavy,” “full range,” and “squats.” Doing dozens of reps with plastic-coated dumbells is more likely to cause a repetitive motion injury than resolve one. No way those cute little dumbells are going to mimic the forces your muscles experience during landing when you run. As for full-range, the hip abductors in particular don’t get much use in partial squats. Finally, barbell squats, not smith-machine squats, and definitely not machine leg presses or seated knee extensions are critical to strengthening the entire chain of muscles involved. Avoiding injury means stabilizing the pelvis against abnormal and wasteful (no pun intended) motions. Your pelvis is constantly in a tug-of-war between your core and your leg muscles. Isolation exercises like knee extensions strengthen the legs without strengthening the core, thus contributing to the very imbalances that cause pelvic instability.
One final note: Many runners avoid heavy lifts because they are worried about putting on weight. Weight is an important concern for endurance runners, but lifting more doesn’t add to your weight, eating more does. Exercising can alter body composition, but only eating can add mass and therefore weight. Not eating more and continuing to run while you train will definitely impact your max lifts, but since your goal is running and not maximum lifting that shouldn’t bother you. You should still be able to make progress on your lifts and avoid injury while you run. Watch for overtraining, though. You probably should cut back on the weight training during heavy endurance training and vice-versa.
Is that it??
Just kidding, thank you very much for that response. I’m new to all this, and that gave me a lot to think about.
“Is that it??”
No. I forgot to mention for runners I really like power cleans.
Hi Jason, I have had what I am confident is ITBS for about 3 months now and have tried to run through it with a few breaks in hopes of fully healing it. I am on my third break right now and hope to return back to running asap as I’m currently in my last season of High-school Track. Each break hasn’t fully healed it and I felt I needed this break because it was getting really bad. Could you do these exercises everyday or do you think that is too much? Also, have you ever met someone who has run through ITBS and successfully gotten over it with strengthening exercises? I hate missing time from running but just wish this nagging injury would go away. Thanks so Much, Matt.
Hey Matt – First I’d consult your coach and trainer to see what they think you should do. The ITB Rehab Routine can be done regularly, but the most I’d advise is 3-4 times per week. You can do other types of beneficial strength work on other days. Running “through” ITBS is risky, but as long as you’re not feeling any pain you can run. Good luck!
Here’s my question. It seems like these stretch band exercises are going to also strengthen the outside of your legs, and if you are having also runner’s knee or patellofemoral problems (which I am starting to get minor symptoms of), I read that it is from an imbalance of the inner quads being weaker than the outer quads. They had you using the stretch band from the outside (tied to something) pulling your leg in to the midline. So are the IT band exercises going to further aggravate patellofemoral syndrome unless you really work on inner leg/quad exercises as well? Hope this makes sense.
Hopefully the ITB RR isn’t the only routine you’re doing. The pistol squats will help with any imbalances, plus any other core/strength work. But usually hips are weak in most runners because we spend most of our day sitting so it’s not generally an issue. I wouldn’t worry about this level of detail.
Julian, I have one more question. When you had ITBS and started to do these every other day, how long did it take before you could return back to running pain free?
***Jason***
I’d say about 4-6 weeks, but keep in mind it was part of a larger rehab strategy including other exercises and massage.
I don’t have ITB issues, though I have very weak glutes. Would this routine help with that. I’ve already started with Jay Johnson’s Myrtle Routine. Should I do the ITB Rehab Routine in addition to the Myrtle Routine to make sure I really strengthen my glutes?
The 1-legged bridge thrusts and pistol squats for sure. Enjoy!
Hi, I have myofascial pain syndrome in my left hip and my orthopedic dr said I could run through the pain. This routine sounds like it will help to strengthen my hips and surrounding muscles and may help with my pain. Is this also a good routine for hips or can you recommend one?
Hey Melissa – this routine will definitely strengthen the hips. That’s one of it’s main focuses as ITBS sufferers typically have weak hips. I can’t say whether or not it will help with the pain though. Good luck!
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