How To Avoid IT Band Syndrome During The Marathon

Audio Transcript

Danny: Today’s question comes from Elizabeth.

Elizabeth: Hi. I recently ran my first marathon last month and accomplished my goal of qualifying for the Boston, for 2018. However, I had terrible IT Band pains starting at mile six in the race. When I trained for the marathon, I ran mostly on flat trails, sidewalks, treadmills, and I was able to get out to my 20 mile run without having any IT Band pain.

However, in the Phoenix marathon that I ran last month, I started having IT Band pain around mile six. I’ve looked at some strengthening exercises to do and managed to get through my training without real bad IT Band pain.

But how will I avoid this pain during the Boston, which is run on the roads, when I think the curvature of the roads to allow the water to drain off is what sets off this much more quickly than any other training environment that I’ve had?

I’ve done other races before too, and the road races are what seem to really cause that IT Band pain, that curvature to start real quickly.

I tried running on the top of the road where it’s a little flatter, but the WLE line was raised so that my foot was landing crookedly. So, I’m just wondering if there was any advice that I could have on how to avoid this, when I run the Boston in 2018. Thank you.

Danny: This question is asking about IT Band Syndrome or ITBS, you know, the pain in the outside of the leg, around the knee.

Elizabeth believes it is due to the camber of the road. She is asking how she can avoid this, come spring when she is racing the Boston Marathon. So, assuming she has seen a physical therapist and she has been diagnosed with IT Band Syndrome, from the best of my knowledge, typically I would point to the hips as the main cause.

A lot of people have pain in the knee, so they associate something is wrong with their knee, which it could be.

But I would always, nine times out of ten, point to some kind of weakness in the hip.

So, a little bit of information on the IT Band. It is mostly effecial, which is like the shin that surrounds the muscle but it’s not actually a muscle.

The density of this thing is more in relation to something like the sole of your shoe or the rubber on the bottom of the sole of your shoe, or a car tire. More so than like a rubber band. Its job is to stabilize the knee on foot strike.

So, the camber of the road could cause this, and it’s not unheard of. It’s a very common injury, somewhere around 10% of runners have IT Band Syndrome.

But how do you address this?

We still have seven weeks until the Boston Marathon. Firstly, you’ll need to strengthen it and mobilize it, basically making it on sticky.

To make it more mobile, you want to do things. You can stretch it, and that will relieve pain in the short term, but ideally, you want to roll it.

You don’t want to foam roll right on the IT Band, and you don’t want to lay on your side and foam roll, back and forth.

If you do that, you’re just going to add more problems. You’re basically going to roll over the problem and continue to inflame that area.

What I’ve had success with, is rolling more at a 45 degree angle. It’s that gap between your IT Band and your quad, or your IT Band and your hamstring. Roll at it, roughly at a 45 degree angle, on your foam roller.

You can also go and use some active release exercises. Use a rope – do the crossover stretch. You’d have to get on YouTube or get on Runners Connect and find those.

But those are some things that you’d also want to incorporate, to relieve that pain, right after a run, or even in the middle of a run.

On the other side, you want to strength train it. Some general exercises that have relieved or cured IT Band Syndrome would be, in a general sense, a lot of squats, a lot of lunges, basically anything that’s going to strengthen the hips.

We have a great hip routine at Runners Connect, in our strength training routines. Things like clams, horseback riders, fire hydrants, hip drops, bridges, glue bridges, single leg squats, and lying hip abduction. You can also lay down and do leg raises.

Things of that nature are going to help increase the strength of that, and you want to start those immediately.

You need to take a handful of exercises, do those upwards of two or three times a day, for as many days as you can.

Just like with any injury or a nagging ache or pain, you want to incorporate these when you first have the pain, obviously.

But once the pain goes away and subsides, you want to continue to keep these small injury prevention, these preamp routines as part of your daily routine, before or after any run.

I’d rather you take five minutes off your 60 minute run, or if you have an eight mile run schedule, to really go seven and a half, and spend that extra five minutes if you’re crammed on time, doing these kind of routines and stretches.

Because I’d rather you run seven and a half miles today instead of eight, as opposed to running an eight and neglecting the strength training for your IT Band, and then needing a whole week off, down the road. That’s very important.

Some more aggressive approaches for the IT Band would be icing it. Ice it immediately after you run. That will restrict it and get the irritation out of it and stop some of the swelling if there is some.

Ice it and let the blood vessels dilate and get fresh blood flow in there.

So, repeating icing, I really [00:07:43 wouldn’t] do because you don’t want to restrict that blood flow that carries all those nutrients that help with repair and rejuvenation.

You can also try some art or some grasping techniques. A physical therapist would have a great idea of some kind of guidelines to follow up with this, and give you more in-depth knowledge about how to treat that.

I would definitely incorporate those kinds of things when I think about the Boston Marathon.

For those of you who are listening, that don’t have IT Band Syndrome, but maybe have had it in the past and are worried about that, Boston does have roads with some camber to it for that watershed.

So, I would definitely advise you to be proactive in addressing this issue. It takes a little time, just 30 seconds to a minute of your day. Incorporate these exercises for your IT Band, which a lot of us have dealt with.

Great question, loved it.

Thank you so much for asking. For those of you listening that want to have your question answered by one of the Runners Connect coaches, head over to runnersconnect.net/daily, and click the record button to send your question over.

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