async="src="/ Taking the Long Way Home: How to Deal with ITB Pain

Tuesday, August 27, 2019

How to Deal with ITB Pain

Disclaimer: The information in this post is purely informational and is not intended as a substitute for seeing a medical provider. 

Now that's a pain I haven't felt in a long time...

For about the past month, I've felt a little nagging pain in my right hip. Even as I write this, I've got this aching running down my outer right thigh to my knee. No, it's not RA. It's not joint pain, even though the pain is originating in my hip. I know this pain. Even though it's been a long time since I've felt it, it's a pain you never forget. Because like plantar fasciitis, once you've had it, you never want it again.

Have you ever experienced iliotibial band tendonitis aka ITB pain? If you have, you know of what I speak. I need to get it on it stat! before it gets out of control. Here's how I'm dealing with the re-emergence of yet another sleeping beast.



What is ITB syndrome? 
By definition, iliotibial band syndrome is an inflammation of the thick stabilizing fascia that runs along the outside of your thigh from your hip to your knee. The ITB is responsible for flexion and extension of the knee as well as helping abduct the hips. Most often due to overuse, the band becomes inflamed and painful.


In runners, cyclists, and athletes who do a lot of squatting, pain develops due to overtraining, poor conditioning, body imbalances, and lack of flexibility in the muscles. For runners, cantered roads can lead to ITB pain. Running on an uneven surface is almost like running with a leg length discrepancy. Hips don't lie. Running hills in excess (up or down) can also aggravate the ITB.

How is ITB syndrome diagnosed?
ITB syndrome can be diagnosed 'clinically', that is based on symptoms and the exam without x-rays. An MRI can be used to rule out other causes of knee pain but it usually isn't necessary.


How is ITB syndrome treated?
Really, the question should be how isn't ITB syndrome treated? Like my other nemesis, PF, there are a lot of experts out there touting all kinds of treatments. Everyone has an opinion on how ITB syndrome should be treated. I'm going to go with the remedies that have a basis in science. It's all about going with what works. If you know of any miracle treatment out there, please feel free to contact me. I'm open to suggestions.


-Rest and/or Cutting Back on miles is always good advice. The literature recommends 2-6 weeks of no running or reduced mileage.

-Antiinflammatories such as ibuprofen (Advil, Motrin) 400-600 mg every 6-8 hours or naproxen (Aleve) 500 mg every 8-12 hours can be helpful to manage pain. Topical NSAIDs such as diclofenac (Voltaren) can also be helpful. Talk to your medical provider about this.

-Strengthening exercises such as banded leg lifts (to the side), side steps, and monster walks are all helpful for hip strengthening. Clamshells? Bring them back.

-Stretching exercises crossing the affected leg behind the unaffected leg and leaning in towards a wall 40-60x as well as bending forward with hands towards the toes or standing with arms overhead and bending away from the affected side will send a nice stretching sensation down the ITB that is angry. I do yoga as well which can help with the overall flexibility of the legs.

-Foam rolling and/or deep tissue massage is thought to help break up adhesions in the tissues surrounding the ITB, although. Do not roll or massage directly over the band.

The research shows that a combination of using these tried and true methods have a high return to running rate. No one wants to rest or cut back on their miles but like with PF, sometimes a runner's gotta do...and for those who don't or progress to the chronic phase of ITB, I recommend you follow up with a sports medicine specialist who can develop a treatment plan to help you recover.

Iliotibial band syndrome is the devil, am I right? /via @oldrunningmom #runchat #runner #runninginjuries

Have you ever dealt with ITB syndrome? How long did it last for? What worked for you? What didn't work? 

I'm linking up with Kim and Zenaida for Tuesday Topics.




36 comments :

  1. This was my first running injury and it happened while ramping up way too fast right after my first marathon in 2007. I'd ignored the twinges for weeks. Then one day it felt like someone shot me in the side of my knee. This is when I learned to embrace the foam roller, strengthen my hips/medial glutes and and be careful about increasing miles. Hope you caught yours in time!

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  2. Seriously if it is not one thing it's another! That's how I feel lately. I have not had ITB pain but my shins have been bothering me for the past few weeks and I am only doing short runs. Hope you are feeling better soon :)

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    1. You get me! When I felt the twinge, I was like, come on, man!

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  3. I never dealt with ITB pain, but from my hamstring experience, I can recommend massage as therapy. My ortho guy (an Ironman himself) told me that when he is training he gets a massage every week. I started out getting a massage once/week, but now have cut down to once/month. You have to find a therapist who knows what she is doing, but it really helped me.

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  4. Oh no Wendy! I hope your ITB pain clears up soon. I've never had an injury that didn't get better after a few days of rest (once I was ready to admit that I had the injury and start taking the rest) but my husband has PF and it's exactly like you say, there are very few ways that it isn't treated.

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    1. I'm doing my stretching and hoping that I can head this thing off. If it's not one thing, it's another!

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  5. Ugh the dreaded ITB injury - been there done that! I had to do a few weeks of PT. Even now I implement those PT exercises a few times a week so that it doesn't come back - that and foam rolling!

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    1. Yep, time to pull out the resistance bands! I thought I had this all covered with my strength training!

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  6. ITB is the devil! One of the worst injuries and just as bad as plantar fasciitis. I've had it for a few years but it isn't so bad that I've had to stop running. Usually I stop running because I've lost interest or burnt out. I do foam roll but sometimes that is painful so I don't do it as often as I should. I went to a doctor last month and he told me to foam roll on the days that I run but yeah that hasn't happened. Sigh, sometimes I wished for a pill to make it go away. :-)

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    1. I'm not as good about foam rolling as I used to be. Looks like I need to get back on the wagon...

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  7. That's great that you're dealing with it early before it gets too bad! When I went to the PT last year she had said my hips needed strengthening so I've been keeping clam shells and side leg lefts in my strength training routine since then.

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    1. I thought I was ahead of the game with all my strength training! Clearly not.

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  8. Bah - back to the dreaded clamshells. I got joy out of rolling it, too, and I haven't had mine come back for years. But it lurks, doesn't it, in your mind if not in your leg!!

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  9. Knock wood, ITB is one thing I've never had to deal with, and I have wonky hips and asymmetrical knees. Now, piriformis issues and angry hammies? I could write an extensive log on the frustrations with them....

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  10. I have definitely dealt with it. At one point to the point of almost never running another half (but I did, obviously).

    It's been a really long time since I've truly had problems with it -- the occasional twinge -- I can't really tell you what I did because yes, I did a lot of things.

    For me it was discovering KT Tape (and subsequently Rocktape) that got me back to running long distances pain free. I ran 15 miles & 17 miles untaped, but you better believe I taped for my 18 mile race last year. And could easily walk the next day . . .

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    1. I'm glad to hear taping has helped you. Me, I'm not so sure about it's effectiveness.

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  11. I had it in my left knee 2 years ago and it kept me from running for about 5 months (!!!). Every time I'd try to start up again, it would hurt increasingly within the first 1/2 mile that it was too painful to continue. Finally 2 cortisone shots (about 6 weeks apart) fixed it. I still feel occasional twinges, and although they terrify me they haven't developed into full-blown ITB again (yet).

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    1. What I've found with ITB pain is that it simmers down after you warm up. But I'm not going to leave it to chance. Getting back on the rehab.

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  12. Great post! I had some IT band pain linger for a while after my last marathon - never severe, but just enough to notice. I swear by banded walks to keep it at bay, especially when pregnancy weight stressed my joints a bit more.

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    1. I was pretty surprised to have ITB pain after all these years of running! I have upped my mileage again--nothing crazy. I swear, it's always something, isn't it?

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  13. Ugh, if it’s not one thing it’s another. I’m glad you mentioned not rolling directly on the ITB, which just tends to crush everything together instead of breaking up adhesions. I’ve also been using my massage gun to keep things moving there too.

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  14. Not to many people know about ITB and the pain that can come with it, so I appreciate you talking about this. I am now researching new lifestyles for my husband to follow as he has been told he has arthritis worse than a 90 year old... Ugh!

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    1. Whaaat? Does he have RA? Who would tell someone that? Poor guy!

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  15. I caught it really early and a sports doctor was able to help me get back on the road quickly. We worked on massage/foam roll and strengthening exercises. I try to stay on top of those regularly so I don't have that issue anymore. Once was enough!

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    1. Seriously! That's why I'm all over it. Like PF, once it settles in, it's hanging around.

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  16. I had a severe bout with ITB pain a few years ago, so I do the foam rolling pretty religiously. It literally makes me want to cry (or puke) sometimes. But it works! I haven't had much problem lately as long as I stay on top of it.

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    1. I hate the foam roller which is why I've neglected it! What doesn't kill me makes me stronger...

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  17. Luckily I never dealt with ITB. I hope you get well soon.

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  18. Funny, I was just thinking about this common running injury when I somehow found your blog. Keep up the great work (you really are stronger than you think ... RA ain't no joke).

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    1. Yep you are right on all counts! Not going to let RA beat me.

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