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Monday, December 22, 2008

How to recover from ITBS

After much research and experimentation I'll now publish my thoughts on the most effective approach to coping with Iliotibial Band Syndrome. It should be noted that this is a nasty little injury and must be attacked in an aggressive manner as it will not go away on its own. It's also a deceptive injury that left me dejected many times after thinking that I was "cured". It seems the more you read writings of and talk to elite triathletes, the more you come to realize that this injury tends regress and resurge at various times and must be dealt with accordingly.

So here it is ...

Core / Stability and Strengthening.

If your IT Band flares do this everyday for two weeks, especially before your run, then 3 days a week after that. This first set of exercises was sent to me by my coach and pro triathlete Jonathan Caron.

Squat 2X15 and place a ball or block between knee and squeeze it!!! Very important!

As warm up, 3X2min on each legs….simply balance..nice posture…stand tall, work on keeping both hips stable and even…you can use different toys for balance..challenge yourself… it as to burn!

Start on the ground like this…hold for 5-10 sec…alternate legs and repeat 5-10 times… hips need to be level…butt in…nice and straight like a beam!

Next progression as you get better..use a ball and do the same kind of exercice…balance on one legs and lift the other one…my butt should but in more!!! Always keep strong and nice posture…!!

Same thing…but on the front! Lift one leg..keep for 5 sec…repeat alternating legs…5-10 times…challenge yourself until it burn well…

Progression now using a ball!!!

Hold this position from 5 sec…repeat 5-10 times…alternating legs on the floor… nice posture again…butt in…hips level!

I call them whales! Lift both legs and arms…repeat 2X12….

More exercice of balance to do when done…as a cool down… lifting the leg at the front, then on the side, then backyard…a few more pic of the same exercice

More Core Stability, Strengthening and Stretching

This next set of exercises came from Chris Olson ...

Stretch. I do 10-15 min of stretching. I make sure to get the quads and hammies really stretched out. I always do this before any strength work.

I don’t do all of the following every night, but as I have more troubles, I do more.

1. Ankle weights. Lying on my back with 10# ankle weights on, I raise each leg 6-10” off the floor keeping the leg straight. I do 10-12 reps and 3 sets for each leg. Next I lie on my side and raise the leg in the same manner for the same sets. Then I lie on the other side and do the same. I finish by lying on my stomach and do the same. You’re targeting the small muscles around the hip joint.

2. Resistance band. I lie on my side with a resistance band (big rubber band) around my knees with my knees bent at about a 30* angle. I lift my knee with my feet together…kind of like a clam opening if that makes sense. I do 3 sets of 10-12 reps on each side. Again targeting the muscles on the outside of the leg near the hip.

3. Ankle bands. I really can’t describe this one well…wearing ankle bands I take big sweeping steps across my living room. [EDIT: I took this to mean the monster walk]

More Stretching

The other thing I make sure I do everyday and before each run is the runner's stretch

Loosen Dense Muscle and Breakup Scar Tissue

For these I use both ART treatment from our local practitioner, Dr. Renick, on a regular basis and I do Trigger Point therapy. For the TP therapy you don't necessarily have to use their specific tools. You can substitute a tennis ball or ball of duck tape for the TP massage ball and you can use a hard foam roller, rolling pin, or PVC pipe in place of the quadballer and footballer. I'd recommend ordering the Hip Dysfunction Kit if you want the Cadillac version.

The main focus of these treatments should be on the hip and calf as the IT band pain in the knee is only a symptom of a problem somewhere else in the kinetic chain. Read this and click on all the links:

Quick Update (2-09-09)

It's been a few months and I'm happy to report that my running form has never been better ... even setting a few PRs. I wanted to add a few helpful items ...

Dynamic side plank (very important to lift the hip up and down 20 times each side x 3)

Crunches on ball (front and each side 30 each x 3)

Awesome article from Joe Friel on the importance of core strength for running and specifically how weak core muscles cause ITBS even in runners with a neutral gait:


mat steinmetz said...

Hey Nick,

Check out Daily Triathlon today.

Carolina John said...

Cool post, very thorough. I'm going to be sure and work in some of those.

you ever tried yoga? the runner's stretch is called Warrior 1 in yoga. it's one of my favorites. and yes, i'm just gay enough to do yoga. i'm ok with it.

merry christmas!

Kevin said...

Those are some great tips. I recently purchased the TP Therapy kit and saw results after a few days. After a 7 night cruise without it, I could really tell the difference

David said...

Some fast dudes to learn from, for sure.

Merry Christmas, Nick! To you and your family.

Mendy said...

Merry Christmas Nick!!!!

Palmetto Solo said...

Good post, I too have ITS. Too many 24 hour races. Thanks for the tips.

JB said...

Good post for sure.
Come ride w/ us dude!

JHMcKnight said...

I've been following your schedule for ITBS recovery. I've been affected for over a year now. Do you suggest doing this routine every single day, or rather have recovery days in between and do it every other day?

Kirsty said...

I've been battling chronic ITBS for over 5 years now (it kicked in 3 weeks prior to running the Boston marathon) - tried everything.. daily rolling, multiple physical therapists, exercises, different doctors, massage therapy, minimalist shoes, even ART. I've tried resting as well to no avail. I'm going to give this a go to see if it works. Thanks for posting!