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How to Treat Injuries Like an Elite: Healing ITBS in Five Days

Two weeks ago, I set out to run 11 miles with a few 30 second sprints near the end in my old Nike XC spikes. It was supposed to be a standard distance run with some turnover work, but it ended badly with tightness in my IT band at the knee insertion.

Luckily, I took some very proactive steps to aggressively treat the problem and I want to explain how to treat injuries so you can limit their impact on your training.

How to Treat Injuries - IT Band

After I ran 67 minutes, I changed into my old spikes (which didn’t have any spikes screwed in) and ran 4×30 seconds hard with a 45 second walking recovery. I noticed a few things as I was doing this workout:

  1. The spikes were very stiff and I had a hard time running comfortably in them.
  2. Being stiff, running very fast on asphalt was a bad idea. It felt like I was stomping my feet against the pavement.
  3. I was doing these surges in a parking lot near my apartment which isn’t completely flat. Half of the surges were slightly downhill and I was pushing it too fast. My form was suffering and in hindsight, I should have went slower on a level surface.

As I was finishing my ten minute warm-down, I could feel the outside of my left knee start to get tight where the IT band inserts. I finished the ten minutes, did some core, and hoped a good night’s sleep would take care of the tightness. It didn’t – the next day I barely finished my morning run and I knew my IT band was in trouble. This is the same issue I dealt with after the NY Marathon in 2008.

Aggressive Injury Treatment

Elite athletes are known for aggressively treating injuries so they can maintain their fitness and resume training as quickly as possible. I’m not claiming to be elite, but I modeled my treatment plan on a professional who needs to be back running as soon as possible. Here are the action steps I took to be able to run again:

Stop Running. Running was causing pain on the outside of my knee, so I took Wednesday – Sunday off with no running. It’s simple – if it hurts to run, don’t run.

Increase Strength. Knowing that my IT issues stem from a weakness in my left glute and hip area, I took extra time to strengthen that area. I expanded my ITB Rehab Routine to include more pistol squats and more repetitions.

(you can get an illustrated guide to the routine here)

I also did a lot of core workouts even though they do not directly impact my IT band. With five days of no running, I had time to focus on core strength. Staying on top of the little things is important.

Massage the Injured Area. This may or may not be appropriate for your specific situation, but in my case it helped a lot. I used a foam roller and a tennis ball to work out tightness in my quad, IT band, glute, hamstring, and hip. I also stretched after using the foam roller and tennis ball. I don’t think it does a lot, but it did make me feel better. I own “The Stick” but I find the foam roller to do a better job for self-massage purposes.

Sleep More. Most recovery and healing happens when you’re asleep, so I made sure to get a lot of sleep. I usually sleep for 7-8 hours, but during periods of heavy training or if something is especially sore, I try to increase that to 8-9 hours.

A more detailed version of this treatment protocol is included in the Injury Prevention for Runners program.

Lessons Learned from Being “Almost Injured”

I don’t really consider this a major injury since I took only five days off and am now back running strong. But there are very important lessons I learned from this experience that I hope will help you too.

First, realize when your body is fatigued. It’s important to run when you’re tired sometimes so you can get better, but I was doing too much: running in unfamiliar shoes while I was tired, downhill on pavement, at nearly 100% of my maximum speed. In hindsight, that’s a recipe for disaster. I was not being smart.

Try to have foresight instead of hindsight. Looking back, I know that I was making a poor decision. But at the time I thought I was Wolverine and couldn’t get hurt. We’re all human, so recognize when to back off and run easier.

Keep up with your strength exercises. Admittedly, I wasn’t doing as much strength work as I should have been and this probably put me at a higher risk for tweaking my IT band. My left IT band is always problematic, so I realize that I have to be diligent in taking care of it.

It’s helpful for me to have “routines” that are 10-15 minutes long and consist of 15-20 different exercises. When I say I’m going to do my “standard core routine,” I know that I won’t do just a few exercises and quit.

Strength exercises are the cornerstone of injury prevention along with smart training decisions. I had been slacking off in both regards and I lost 5 days of training and had a week of lower volume. Running is cumulative, so the best thing you can do for your long-term progress is stay consistent.

The one thing I wish I had done during my time off was cross-training. In addition to helping maintain fitness, it probably would have made my recovery easier. By circulating blood without hurting it, the injured area of my leg can heal faster. Next time, I will try to bike or pool run. Luckily I own a road bike, but finding a pool that has AquaJoggers is difficult.

After my five day “holiday” I ran a 50 mile week, which is about 30% less volume than I was doing before my ITB problems. I’m happy to report that with consistent strength exercises, use of my foam roller and tennis ball, and running slow when I need it, that I’m healthy and back running.

For a step-by-step treatment protocol for ITBS (including the top myths about treating the injury), check out Injury Prevention for Runners.

If you always forget the exercises to the ITB Rehab Routine, get an illustrated guide (free) to the routine here.

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