Treating The Dreaded IT Band Syndrome

Today's Workout: stretching, lower body strengthening, yoga video, elliptical 30 minutes

The past few days have been absolutely gorgeous in NYC and its been killing me that I can't run. I've been watching all the happy frolicking runners with the smiles on their faces and secretly saying not-so-nice things under my breath. No, I am not cursing at the runners themselves but they are a reminder that I am sidelined. I am just jealous! Its as simple as that. I really, really want to rewind to a time when I was a happy runner... like 3 weeks ago...

NYC Half 2012. A happier time.

You may be asking yourself... "Megan, what happened to you?" For those of you who are new to my blog, unfortunately a week or so ago I was "officially" diagnosed by my doctor with IT Band Syndrome (even though I self-diagnosed myself at least 2 weeks ago). Since that time I've become slightly obsessive in learning everything I can about this injury and reading blogs, medical websites, and forums to see what the best treatment techniques are. I need to get healthy and back to running ASAP! You understand, right?!

I hate you IT Band. We are not friends.

Since this is a common injury, I know many people probably are wondering what they can do for it. I already described the causes and symptoms of IT Band Syndrome in a previous post, so I'm assuming this information is mainly for those of you who already know you have it.  I've decided to compile some of the information I know about this condition and tell everyone exactly what I've been doing for treatment.

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 Treatment strategies

Disclosure: these are things I have found that helped me, but everyone is different. Also, I am not a doctor (the schooling takes too long) and these recommendations are only from personal experience. I recommend that you visit your doctor for additional information about your own injury.

Anyone with this injury will tell you that the first step in recovery is stretching, and lots of it! I found a lot of good stretches around on the internet, and this video below summarizes pretty much all of the major ones I use. I also do the pigeon pose (yoga pose), but be careful with that one at the beginning. Also, this stretch is great but its another one that I don't recommend doing while your injury is still really acute.

These stretches I do daily at least 2x each. You can do them while watching TV, but its crucial that you stretch for this condition. Its the only real way to recover and prevent it from coming back again. 

The other major thing I do is foam rolling. I use The Grid foam roller, but you can pick up a cheaper one at most stores like Target. Usually, I foam roll for 5 minutes then take a break and do 5 minutes more. I do that 2-3x a day. Usually while I'm watching an inspirational show or something.. like Millionaire Matchmaker (hm, not inspirational you say? I beg to differ). Honestly though, with foam rolling the more often you do this, the better. It WILL hurt like hell at the beginning but after a week or so the pain won't be as bad.
***This might be one of if not THE most important thing you can do for this injury.***

Ice baths and ice packs are also recommended since this is an inflammatory condition. The main goal here is to reduce the inflammation and ice is the way to do that. You can put ice packs on the side of your knee where the pain is a few times a day for no more than 15 minutes at a time. I usually take 15 minute ice baths instead since it covers the whole length of the IT Band. Once you are in there for a minute or so, your legs get numb and you'll barely notice the cold. It's not as bad as it sounds. Plus, feel like it's helped me so it might be worth a try.

No idea who this is but ice baths aren't this horrifying!

Also, there's no need to put ice up to your neck. Ever.

It is also possible that muscle weakness in the core and lower extremities played a role in your IT Band syndrome. The condition will only return if you don't focus on strengthening the weak muscles. Specifically, the most important areas to strengthen are your glutes and thigh and leg muscles. I have been following a really great routine that was posted by a runner. It provides 6 different exercises to use in order to properly rehab the IT Band (below). Do these exercises only when your acute pain has diminished or you may continue to irritate the band. I do these every other day 2x each.

Also, even though its a small muscle the gluteus medius is crucial to running, but is weak in most runners. It's job is to abduct the hip and stabilizes the pelvis. When it is weak, it can cause tension in the IT Band which can lead to inflammation (see the photo below).  I have been working on strengthening this muscle and have been using these awesome exercises. I typically do these every other day (to allow the muscles to repair themselves) along with the other strengthening exercises.

Imagine your IT Band stretching over your hip and knee joints in photo B. Not good.

Core strengthening is also recommended during rehab, since a weak core can have negative effects throughout your body and lead to injury. Since I definitely have a weak core (watch me do a plank... I'm pathetic), I have been doing yoga for this and also for general stretching. In a previous post I provided two yoga for runners videos that I do every few days as possible.

Once the acute phase is over and your pain diminishes, you may want to try some light crosstraining (e.g. elliptical, bike, swimming). I highly recommend swimming since it put the least amount of stress on your IT Band. But if you do the others, take it easy with minimal resistance. And ease back into these exercises slowly. DO NOT do any of these if they cause you any pain, you will only make your condition worse!

Other suggestions to help heal your IT Band include: taking anti-inflammatories (daily from a doc or Aleve), checking your shoes to see if they could be causing misalignment of your lower body, and eating right. A friend suggested to eat more protein during the healing phase so I am trying that (not sure if it works, but hey I'll try anything). I am also making sure to take my multivitamin, my random assortment of vitamins, and also Vitamin C. Vitamin C has been said to aid in healing, so why not give it a try.

Don't we all just love our vitamins?!

If you really NEED to run or are just returning to running after this injury, you can check out the IT Band strap. It helps distribute pressure to minimize friction of the IT Band over bone. This should not be used as a permanent solution by any means but is an option for some situations.

I really hope this information helps some of you. I will keep you posted on my recovery and how all these strategies are working for me. Heal well everyone!

Summary of treatment strategies:

stretching, foam rolling, ice baths/ice packs, lower/core body strengthening, yoga, light crosstraining (especially swimming), taking anti-inflammatories, IT Band strap, eating right, checking your shoes.. and just hoping your body cooperates!

Any other suggestions for IT Band Syndrome recovery?

What injuries are you dealing with at the moment?

What types of vitamins do you take?

The Runner's Rule Book

Today's Workout: stretching, 25 minute elliptical, 12 minute bike

The foam roller was my best friend today. We have a really nice relationship with one another, even though it put me through hell at the beginning. Just like any normal relationship, right? Not.

 "The Grid" foam roller. That's not me on it, obviously. I look far less graceful that this girl.

I decided to take advantage of this beautiful Sunday by spending lots of time taking care of my IT Band Syndrome by stretching, strengthening, rolling, and working out. I even took a nice 15 minute ice bath tonight to decrease any inflammation after I spent some time at the gym (Thanks Claire@ Let's Go on a Living Spree for the suggestion!). I feel like the bath ices the entire IT Band, which a typical ice pack can't do. Plus you stay cold for a while.... I'm still defrosting from my ice bath.

So since I am still not running I decided to share some running wisdom from The Runner's Rule Book by Mark Remy. Its a great little book that has little tid-bits of information for runners. Plus its super funny and always gives me a good laugh. I would definitely recommend reading it and adding it to your running book collection, especially since its pretty cheap on Amazon (~$12).

Here's some funny and true excerpts from the book:

Rule 1.2. Expand your definition of fun

As a runner, your definition of fun--which previously might have included such activities as visiting water parks, watching screwball comedies on DVD, and scrapbooking--must be... well, let's call it broadened. For runners, fun might include:

-Waking up at 5:30am to run 10 miles

-Running in blistering heat

-Running in the rain

-Running in 400 meter circles

-Feeling as if your lungs are about to explode

-Paying a race director good money for the privilege of turning your own toes black and blue

-Any combination of the above

Rule 1.11 Signing up for a race is instant motivation

A race--weeks or months away--is the proverbial carrot, dangled out there for you to pursue. Even if you don't plan to really race your race (in the "run till you feel like puking" sense), registering for an event that is 6 or 10 or 26 weeks down the road remains the single most foolproof way to motivate yourself to get out there and run day after day.

Rule 1.26 Running plans must go on the fridge

...Nothing can replace the printed-out training plan stuck to the refrigerator... So put the plan on the fridge. Remove a child's artwork to make room, if need be. We won't judge.

Rule 2.32 Do whatever it takes to finish ahead of a costumed runner

Because being outkicked by Elmo is too much to bear.

Rule 3.5 Save the race shirt for post race

Wearing the official race shirt during the race is like wearing a U2 t shirt to a U2 concert. Not cool. Don't do it.

The Runner's Rule of Thumb (excerpts)

1. If you see a porta potty with no line, use it. Even if you don't need to.

3. If you have to ask yourself, Are these shorts too short? The answer is yes.

17. Whenever possible, begin and out-and-back run into the wind.

31. A long-sleeve shirt and shorts will always look better than a short-sleeved shirt with tights.
37. No one sleeps well the night before the race; the night before the night before your race is the important one.
51. If you even care a little bit about being called a jogger versus a runner... you're a runner.

Those are just a few examples of what's in the book. I definitely recommend getting this one, its a fun and light read! Plus, if you are a new runner there's some good running tips in there. Anyway, spring break is over for me and its back to the grind tomorrow!

Also, good luck to all the Boston Marathon runners this marathon weekend! Supposed to be a hot one, but just keep an eye out for this...

Have you read any good running books lately?

Got any good tips for fellow runners?

What were your workouts this weekend? 
Anyone running or watching Boston?!

What to Wear While Running

Let's talk about clothes. Specifically, running clothes. I am bringing this up because I recently purchased two cute running skirts/skorts: this one and this one. Its definitely perfect weather for these babies and I can't wait to properly test them out. Aren't they just adorable?! Because I just made these purchases, athletic clothes just happen to be on my mind. I also know that most people don't really know whats weather appropriate or what items are more necessary than others... that's where I'm coming in!!

If you're anything like me, you love getting running gear (or just buying things in general.. I wish I had more money or an unlimited Amazon.com gift card or a rich anonymous donor who just wants to treat me to things). In addition to the thrill of getting gifts for yourself (like my skirts that were a gift to me... just because it was a Wednesday :) ), buying quality items that keep your body temperature regulated, dry, and comfortable is super essential. The first step in figuring out what to buy in the never-ending supply of athletic clothes is to decide what items you need to get based on weather. This book is great for that....

Half Marathon, By: Jeff Galloway

 A book with most of the information you will ever need to know.

Jeff Galloway's book gives a great little chart about clothing and temperatures. Here it is:

Temperature                                              What to wear

              60 degrees+                                     tank top or singlet, and shorts

  50-59 degrees                                          T shirt and shorts

          40-49 degrees                                long sleeve lightweight shirt,

                                                                    shorts/tights, mittens and gloves

               30-39 degrees                              long-sleeve medium weight shirt,

                                                                    and another T shirt, tights and shorts,

                                                                        mittens or gloves and a hat over both ears

                  20-29 degrees                                  long-sleeve medium weight shirt,

                                                                           and another T shirt, tights and shorts,

                                                                          mittens or gloves and a hat over both ears

                 10-19 degrees                                long-sleeve medium weight shirt,

                                                                         medium/heavy weight shirt,tights & shorts,

                                                                         wind breaker suit, thick mittens and a hat

                         0-9 degrees                         2 medium or heavy weight long-sleeve shirts,

                                                                  thick tights, thick underwear,

                                                                      heavy warm up suit, gloves & thick mittens,

                                                                    ski mask, vaseline over exposed skin,

                                                                  and a hat over both ears

Key take-away from this... don't dress like this guy..

 I don't even know what I would do if I really saw this guy in real life.

Also, I'm not sure I would ever run in 0-9 degree weather, but someone is or else Jeff Galloway wouldn't have included it in his chart. But anyway, that's the basic run-down and will help you get a good idea of whether or not you are dressing correctly. Tip: You should always be a little cool when you first leave your house, not totally warm or you will overheat when you start to run. If you go through the list above, you can pick which items you don't have depending on the type of weather you typically run in or to help you prepare for next season. 

I think its important that if you buy nothing else, you have the basics: shoes, moisture-wicking socks, a good pair of shorts (and capri tights if you prefer to run in those), a singlet or tank top for warm weather, a long-sleeve top, a thicker zip-up jacket (one that covers your neck in cold weather is best), long tights for cold weather, and perhaps a light windbreaker for windy or rainy days.
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Also, if you run in cold weather you may want to get a nice pair of running gloves and a hat or ear warmer. I got mine from Lululemon (and the ear warmer really stays on my head!) and they worked great this winter. See my gear review page for the specific items that I wear, but definitely shop around online and in running stores for good deals. You can always find them if you look hard enough! And keep an eye out for this magical four-letter word:


 

Some other basic tips:

• Stick to dry-fit or any moisture-wicking fabrics. Cotton is usually not a good choice since the sweat just stays there and weighs you down.
• Make sure you test things out on short runs before you go on a long run in it, just in case it doesn't agree with your body for some reason.
•  Be careful washing your clothes in the dryer! Some of the fabrics shrink easily.
• As is my rule for everything: if you find something you really like, you might want to get several of that item in a few colors (e.g. I have 3 of the Hana Run Short because it's so awesome)

Good websites to check out for deals: 

runningwarehouse.com

roadrunnersports.com 

brooksrunning.com 

REI 

paragonsports.com 

Nike Store 

Athleta 

Campmor.com

What are some items you can't live without?

Useful Tips for New Runners

Today's Workout: 30 minute swim session

You will all be happy to know that I kept my promise and haven't run all weekend to give my poor knee a rest. I made an appointment with my family orthopedist (yes, my family is injured so often we have one of those) and will be seeing him next week. Unfortunately, I admittedly took resting my knee to heart and I didn't do much of anything at all for the past few days except devour Easter candy (Cadbury mini eggs and Cadbury caramel cream eggs are the loves of my life. YUM!). But the break is over and today its back to work. To ease up on my joints and ligaments, I did some swimming this afternoon followed by serious stretching. My body agrees with me best when I swim (hm.. is it trying to tell me something?).

best. candy. ever.... period.

It has been tough though not to be running, which could be why I ate so much candy to compensate. I was wallowing in self-pity and chose chocolate as my own form of self-medication. I guess there are worse things in the world..

Having so much time to just sit there and eat, though, gave me some time to think about how far I've come in my running career over the past few months. I started seriously running last September/October after the 2011 Tunnel to Towers run. Since then, I've run a bunch of races including a half marathon. Talk about an addiction. Six months ago I hated running and my longest distance was 3 miles. Now, not only do I love, love, love this sport but I finished my first half marathon (13.1 miles in 2 hours and 6 minutes!). Sort of crazy when you stop and think about how far you can really push yourself. I bet its more than you thought was possible!

 

                                   Me before: probably watching Bravo                   Me after: still a couch potato at heart, but a healthier one

Because of this realization I decided that I owe it to beginner runners to give some tips to help get them going on their own running journey. It really is a great sport that anyone can do. All it takes is heart, determination, knowledge and and some body glide. I know when I first started out I found a lot of helpful information from blogs, Runners World, forums, and the mysterious and magical Google (its amazing, you type things in and find an answer to your totally random questions!). Some of it you will learn as you go along, but I figured I'd pay it forward a bit and list some of the most important information that helped me. DISCLAIMER: This is just my own advice and recommendations. I am NOT a professional running coach or doctor or licensed anything.

*Make sure your body can handle running. 

Several months into training I realized something was not right with my breathing. I went to the doctor and, sure enough, I discovered I have chronic asthma. Now that I have medication, I can breathe more normally but I probably would have just given up on running had I not seen a doctor. Which leads me to my next point...

*Don't be afraid to see a doctor.

When you are an athlete, you will get injured. It's as simple as that. We try to avoid it as much as possible, but it happens. Don't hesitate to get something looked at by a professional. It could save you from pain later on!

 *Invest in a foam roller or The Stick.

You can find cheap foam rollers online (I use this one) and videos on how to use them on YouTube. The Stick is a bit more expensive but its great too and you can get a travel size. Use these often before and/or after runs (as your body needs it). They will help with recovery and preventing injuries. 

*Don't wear cotton socks during running. Ever.

Wearing cotton socks from Costco was a major source of foot pain, discomfort, and many blisters early in my running career. Because of this, one of my favorite days as a runner was finding out about the wonders of synthetic materials. I use DryMax socks but use whatever works best for you. Just no cotton!

*Make sure your running shoes are 1/2 a size larger than your normal shoes.

I accidentally did not abide by this rule and my first pair of Asics was a half size too small. The result: major blisters and some uncomfortable runs. Also your feet swell as you run so you need room for them to expand. Which is why this is so important...

*If possible, get specially fitted for your running shoes by a specialist.
 Running stores such as Super Runners Shop and Jackrabbit Sports have running shoe specialists who can analyze you foot, gait, and everything in between. They help you pick out the best shoe for your specific foot, running goals, and running style (e.g. midfoot striker vs heel striker). Since it's incredibly important you find the right shoe for you, definitely try to go to a specialty store if there is one near you.
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*Buy Body Glide (or SportShield).

Once your runs increase in mileage, you'll know how important this is. Nothing ruins a run more than blisters or chafing (gross, I know. But it's a reality of running).

*Learn how to dress for the weather.

For an outdoor run, the rule is to dress as if it's 20 degrees warmer than it really is. This is because your body will warm up fast once you start getting into your run. Its crucial to layer up in cooler weather (so you can take off outer layers if needed) and don't wear too much in warmer weather. You should always be a little bit cool or chilly before you start running so that you are comfortable once you start. Again, though, listen to your body and its individual needs!

*Compression gear can really help.
 There's a ton of compression gear on the market now, from socks to shorts, to long sleeve shirts. You don't need to get all of it but it might be good to look into. A lot of these are great! I always wear compression socks to run and they decrease my recovery time and help the calves stay loose. Typically, you should wear compression clothing for a few hours after a long run for recovery.

*Be aware of the 30 minute post-run recovery window.

 The 30-60 minutes after you run are very important for re-fueling and recovery. The experts recommend food or drinks with a carb to protein ratio of 2:1 or 3:1. I usually drink a protein shake (Hammer Recoverite) with the right balance of carbs and protein, but a glass of chocolate milk with fat free milk works really well too. Also, ice and/or foam roll your sore muscles at this time to reduce any inflammation (especially all you shin splint sufferers out there). Don't leave ice on for more than 15 minutes at a time.

*Decide what you want to eat on long runs. 

 For runs an hour and a half+, you should be refueling every 45 minutes. Some people bring candy (e.g. gummie bears, Swedish fish) and others bring gels or chomps (e.g. GU Chomps/gels, Clif Shot blocks, etc). You will have to find what works for you based on taste, consistency, ease of eating, etc. Test out a few things then stick with what you like. I'm still working to find out what I like best, too, so I'll let you know when I decide!

*Don't change anything on race day.

Don't try out new shorts, don't try out a new type of food, and don't drink Gatorade if you never drank it during a run before. Bad things happen when you try something new for the first time on race day, so just continue the routine you used throughout training.

*If you find something that works for you, stick with it.

Even if someone tells you otherwise, if it works for you then don't change what you are doing. Every person is physically different so some advice isn't always universal. As long as you are injury and pain free, listen to your own body.

What other advice have you learned as a runner?

Why IT Band? Why?!!

Disclaimer: I am not a doctor. I never claimed to be a doctor. If you want one, my sister will be one in a few years. But I never will. In that case, the information I am presenting comes from my own experiences and from reading books and the internet. If you have a similar problem, its recommended that you do not self-diagnose like me but go see an actual doctor for a real diagnosis and treatments.

Ask anyone who knows me really well, or actually anyone who knows me even just a little bit, and they will tell you that I am incredibly accident and injury-prone. Its just in my family genes. Thanks mom and dad. I've had more injuries than I can count and since I have always been an athlete, the number and severity of injuries was probably doubled because of that. Since I started running last year, I've had problems with shin splints and blisters. So I got compression socks for shin splints and sport shield for blisters. Problems solved.

Now a new issue has arisen. And while I'm not surprised I have another ailment, it is disappointing when all you want to do is run pain-free. During the end of my 5 miler yesterday, I started to get a little throbbing pain on the outside (lateral part) of my knee. It stuck around after I stopped running and was still there in the morning. So in my crazy mode I googled everything under the sun until I realized, "Hey I spent money and bought a book for times like these". I opened up the Running Doc's Guide to Healthy Running (by Lewis Maharam) and turned to knee injuries. Pretty soon, I self-diagnosed (not recommended!!) myself with Iliotibial (IT) Band Syndrome.

So what the heck is the IT Band? Well, it looks something like this....

 

Look at those sexy muscles. The IT Band is that big ugly white band running from your iliac crest (hip) to your tibia.

 A few of the major symptoms of this common running injury include: pain on the lateral side of the knee a mile or two into a run (check!), but no pain on the first step (check!), pain going up and down steps (check!), and tender points over lateral femoral condyle (check!). The pain is caused by the IT Band rubbing on bone over and over during running. This causes inflammation and... you guessed it: pain. 

There are so many reasons someone can have IT Band Syndrome including types of arches, body structure, over-pronation, uneven leg lengths, and weak muscles. Also, it could just be that the IT band is tight (I'm hoping this is it for me). That's sort of where the doctor (the actual expert) comes in because they can actually pinpoint the cause of the problem. Gotta love doctors and them being so smart!

You might be asking: I might have IT Band Syndrome... what now?

Well, as you can see by the amount of symptoms I have, I am pretty sure I have this condition. Luckily I just started feeling this pain/irritation recently so recovery should be quick. Running Doc and the internet suggest foam rolling the IT band or using the Stick (love this thing), doing stretches, taking anti-inflammatories, cold therapy (aka ice packs), and massages. When the pain is gone, then strengthening begins to prevent this injury from coming back.

 The Stick. Looks so simple, but its a miracle worker. Really wish I invented this.

Well since I'm crazy I'll probably be trying each and every of these things. Often. I'm sure my boyfriend Karl will appreciate me rolling around on the floor on my foam roller all night during American Idol. So attractive. As if watching AI wasn't torture enough for him.

Unfortunately this means I'm going to have to stop running for a few days, probably until Monday to be safe :( To normal people, that doesn't seem like such a big deal.. but for anyone who loves running as much as I do, you know how much that sucks! Its like someone telling you you can't breathe anymore. Except you don't die when you don't run. At least not right away. But I have been trained to understand that health comes first, so I shouldn't cheat and run anyway (as a student in a healthcare field I should probably learn to take the advice I would give to patients and not be such a hypocrite. Blah.). Cross-training it is.

What kinds of running injuries have you had?