Wednesday, January 23, 2008

Iliotibial Band Syndrome

While on a training run a few months prior to GTR 100 last year, I was stopped dead in a run by tremendous pain on the outside of my left knee. It was brutal. I could walk with a limp, but any attempt at running was met with excruciating pain. A day off or two later, I found that I was able to run again, but the pain would come and go. I was also at the point where it seemed as if my AM run was causing the pain to last through the day, to the point where my morning commute in NY City was a chore.

After some research and discussions with Coach Lisa Smith-Batchen, I came to the conclusion that I was suffering from one of the leading causes of lateral knee pain in runners - Iliotibial Band Syndrome (ITBS). I also learned that : The iliotibial band is a superficial thickening of tissue on the outside of the thigh, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee, and is crucial to stabilizing the knee during running, moving from behind the femur to the front during the gait cycle.... and The continual rubbing of the band over the lateral femoral epicondyle, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed, or the band itself may suffer irritation.

Symptoms of ITBS can take the form of :

  • A stinging sensation just above the knee joint (on the outside of the knee or along the entire length of the iliotibial band).

  • Swelling or thickening of the tissue at the point where the band moves over the femur.

  • The pain may not occur immediately during activity, but may intensify over time, especially as the foot strikes the ground.

  • Pain might persist after activity. Pain may also be present below the knee, where the ITB actually attaches to the tibia.

As for causes, there are several possibilities. People who suddenly increase their level of activity, such as runners who increase their mileage, often develop ITBS. Others who are prone to ITBS include individuals with mechanical problems of their gait such as people who overpronate, have leg length discrepancies, or are bow-legged. I gravitated over to the "overuse" cause.

I tried a couple of remedies to deal with my ITBS in an effort to keep me on the trails and on track for GTR 100, including the Cho-Pat Iliotibial Band Strap, the Cho-Pat Dual Action Knee Strap, Advil, ice, and so on and so forth, avoiding the most logical remedy - rest.

The Dual Action Knee Strap seemed to work the best. The strap applies pressure upon the patellar tendon below the kneecap to stabilize and tighten up the kneecap mechanism, which improves patellar tracking and elevation and reduces patellar subluxation. It adds further strengthening to the kneecap mechanism by applying pressure on the tendon above the kneecap as well. This tends to reduce the forces of the quadriceps on the patella tendon and erosion of the undersurface of the kneecap due to a possible misalignment of the quadriceps. The device’s design and construction apply constant dynamic forces to the surrounding areas of the knee reducing the likelihood of overuse syndromes. At the same time, the strap allows for full mobility while providing maximum benefits.

Finally, I read about foam rollers and purchased the PB Elite Molded Foam Roller (3 inch long, 6 inch round)from Perform Better. The roller comes with a foam roller exercise sheet (which you can actually get on-line), providing instructions for various self myofacial release techniques, including the iliotibia tract. This did the trick - no more pain, and, I began to feel more flexible. As advertised, use of the foam roller seemed to enhance my training program and recovery, and I continue to use the foam roller twice a week.

Yesterday, Bob Gentile e-mailed me a great You Tube video - "Top 5 Foam Roller Exercises". The video is great (and posted below), and will show you the technique I used to deal with my ITBS. Here's to injury-free running !


  1. Bummer on the ITBS. But it looks like you've got things under control ;D ;D Sweet!

    Also what is with that "hairy" junk on the dudes buns?!? Is that supposed to be a signature? LOL

  2. Oh that is nasty...looks like a signature up close, but at first look...yikes ! :)

  3. Cute butt up there:)
    Hope you get injury-managed by RR. take it easy now.

  4. I've had ITBS in both legs, and it sucks!

    The foam roller is awesome, and it helps a lot.

  5. Ahhhh I can't wait to get my foam roller tomorrow ...that FIRST exercise in that video I SOOOO need to do, it feels so sore right now...need to ROLL it OUT Bigtime!! I dont need any IT issues, hard enough dealing with all my Mental issues -LOL

  6. I see you mentionthe Cho pat strap, but i wanted to let you know i have used both the chopat and one called a PattStrap by Fabrifoam and I found the a lot more confortable. Give it a try and let me know if you agree.

  7. Thanks Jonathan. I'll give it a try and let you know how it goes.