Have you ever suffered knee pain on the outside of your knee? It’s estimated that up to 50% of women and 81% of men have suffered this pain. The cause of this issue… IT band syndrome.

As is usually the case with this series of episodes, IT band syndrome is a fairly common overuse injury in runners. Resulting from weaknesses in the body and working the tissues further than their capability over a period of time which results in breakdown and inflammation in the area.

The good news is that this injury is easily prevented. So, let’s have a look at how you can prevent IT band syndrome before it puts you out of action. In this episode I will offer you some coaching on how to avoid this common running injury…

IT BAND SYNDROME

The IT band is a thick, strong band of tendinous connective tissue that runs the length of the outside of the thigh down to the knee. The IT band helps to stabilise the knee.

Iliotibial band syndrome or ITB friction syndrome as it is also known by is categorised as a non-traumatic, overuse injury commonly seen in runners due to a lack of strength in the hip abductor muscles (Glute medius, glute minimus and tensor fasciae latae). There has been a pattern throughout these common running injury episodes. A lot of issues are coming from having weak muscles in that bum/hip area. Or sleepy glutes as I like to courteously call them.

To simplify the injury science. The IT band is being compressed or rubbing against the thigh bone at the point near the knee by surrounding muscles. Repetitive movement from running and sports aggravates the tissues and they become inflamed and painful.

IT band syndrome is the most common cause of sharp pain or an ache on the outside of the knee for runners. The sensation can sometimes feel as if it is moving up or down the leg. It can leave the area around the outside of the knee feeling tender to touch, possibly with some swelling.

The more you do the more you aggravate this issue. You may not even notice it when you are day-to-day living, it may only come on when you start running.

Before you know it, you are out of action having to rest and ice as well as modifying your daily activities for up to 6 weeks!! Imagine not running for 6 weeks!!

If you’re like me then this will cause lots of stress and frustration at having to stop running and nurse an injury that could have been prevented with some simple additions to your weekly schedule.

I hope this series of episodes encourages you to take a different approach to your running, strength training and mobility work. I hope it illustrates how vital strength and mobility work is. I know sometimes it can feel like a chore to fit it into our weekly schedule when all we really want to do is get out and run, but it’s this proactive work that stops you having to be reactive when a preventable issue crops up.

Just a quick note: If you are currently suffering from this issue. Don’t use this podcast as a diagnostic tool. Go see your local GP or physiotherapist and have the issue confirmed. They will be able to offer you a treatment plan that will get you on the road to recovery.

To avoid IT band syndrome ever becoming an issue, let’s explore together what you can do to dramatically reduce your risk of getting this niggly, annoying injury.

HOW TO AVOID IT BAND SYNDROME

What are the risk factors that put you at greater risk of getting IT band syndrome?

• You regularly run a lot.

• You’re new to running.

• You’re planning on increasing your weekly running mileage.

• Weak glute muscles stabilising the hips.

• Weak muscles around the knee.

• Environmental such as surface that you are running on, especially in different weather conditions.

• Running on a bank that puts one leg higher than the other.

• Running on varied terrains.

• Mobility issues, tighten in IT band.

• Lack of foot strength causing over-pronation.

• Poor running form that causes uneven wear on shoes, this changes bio-mechanical angles over time.

That list is not exclusive, there are many more variables to this injury. That list gives you a good insight into some of the main risk factors that you can directly influence.

These are some of the main things you can do to reduce your risk factor.

The first thing you can start doing regularly is… Myofascial release, by booking yourself a regular deep tissue sports massage so the therapist can work into tight tissues and get more fluid into these tissues. Basically, we want the tissues of the muscles of the thighs and bum (quads and glutes) to glide over each other smoothly. So treat yourself to a nice massage. Failing that, you could also use a foam roller to massage the thigh and bum muscles and the IT band itself. Regular recovery work on the tissues is going to help keep them healthy and supple.

The next thing we can work on to reduce your risk of this injury is… STRENGTH TRAINING of the weak muscles commonly associated with this issue. It is so important to strength train to keep our muscles strong! It really is that simple. The following exercises will target the glute muscles:

Bridge pose - This yoga pose has so much power for its simplicity. Laying on your back with bent knees and feet on the floor. Drive your hips into the air, squeezing your bum and back muscles. I always encourage people to tap their glute muscles to make sure that they are active and working evenly. Holding this pose for 30-90 seconds and doing 3 sets of this is so simple its hard to not include it into your weekly strength plan. You can do it watching Netflix laid on the floor!

Side plank - There are two variations to this based on difficulty. The first one you would lay on your side and stack your knees on top of each other then press into your elbow and knees lifting your hip off the floor for supported side plank. The harder version would be to stack your feet on top of each other so your legs are straight, then dig your elbow and forearm into the floor sending your hips up into the air. You can hold this position for 30-90 seconds or you can do 15-20 repetitions of letting the hip slowly lower towards the floor and then sending it back upwards. Make sure to do this exercise on both sides obviously!

Side lying straight leg raise - This is one of the best exercises for targeting the Glute Medius, providing you get the muscle activation correct and you don’t use your thighs to do the lifting. Tapping the bum muscles near the hip to make sure they are activating is going to ensure that you are correctly training your central nervous system to fire off the correct muscles. Strengthening this area will create the stability and strength in the hips. To perform this exercise, lay on your side in a supported position, cushion if you need it. The leg that is on top is going to kick the heel up to the sky. Ensure you keep your leg straight like a plank of wood from the heel to the hip. Let the work come from that hip/bum area. Do 3 sets of 15-30 reps depending on when you feel the burn, make sure you do equal work on each side.

Hip drop - This is going to work into the same area around the glute/hip region that we want to strengthen so we get more stability. This will increase the strength of the tissues in that area. When we create strength, they can function with greater loads going through the muscle and tendon tissues. The hip drop is very self explanatory. Standing on a step facing along the length of the step. Allow one leg to hang freely off the step and lower this leg towards the floor so the pelvis drops and the leg on the step has a hip that is higher. Squeeze the hip/bum area to bring the lowering leg back up so the pelvis becomes balanced again. You can do 3 sets of 10-20 reps on each leg as part of your strength sessions.

Single leg wall sit - Single leg exercises are going to be great at targeting the area we want to strengthen to improve your strength and reduce your risk of IT band syndrome. The single leg exercise I’ve chosen for this injury can be done anywhere, providing you have a wall. Like the normal wall sit, you push your back into the wall and sit your hips as low as your knees into a squat position. The difference with this one is that you lift one leg off the floor at a time. This strengthens the hovering leg too in the hip flexors but we’re focusing on pushing the big toe into the floor on the standing leg and really driving the back into the wall to get strong activation of the glute muscles. Do 3 sets of 15-60 seconds on each leg.

Strengthen the big toe connection with the glutes with some toe-ga. Toe-ga or toe yoga is rarely done yet hugely important for the function of your body. A really simple strengthening toe-ga exercise is to press the big toe into the floor whilst lifting the other four toes, then switch and press the four toes down and lift the big toe up. Swithc between the two for 60-120 seconds on each foot. This will strengthen big toe/glute connection, the arch of the foot and will ensure you are getting good activation of the stabilising muscles in the leg, reducing your risk of injury.

If you need strength training coaching online through video call or in-person that contact me today and I can help you take your strength training to the next level.

Check your footwear. Notice the wear on the bottom. If there is an imbalanced wear, basically if one foot looks more worn than the other there may be some bio-mechanical issues going on. Either that or you are always running on a bank that is elevating one side higher than the other. If you do notice uneven wear on your trainers you will need your running form analysing to see whats happening. You can film yourself, I’ve done a recent episode on how to film yourself running and what to look for. Or if you would like a professional to look at it and review, make some tweaks and put these into action, contact me and we can arrange for you to send me the video or arrange an in-person video session.

Last thing to consider is the mileage. When you are increasing your running miles be cautious of doing too much too soon. I’ve covered this in a recent episode so I won’t go into too much detail but increasing too quickly will increase your risk of injury significantly. Progressive overload not aggressive overload.

If you are proactive with your strength training in these areas you are going to reduce your risk of IT band syndrome quite dramatically. It’s also really important to connect to your body and understand when your body is telling you you are doing too much. This injury can be avoided with these simple tweaks so why wouldn’t you want to start adding some of these into your week?

SUMMARY

• Book yourself a deep tissue massage to release tight tissues. Failing that regularly foam roll after a run, especially the IT band and glutes.

• Work on strengthening the glute/hip area with the exercises mentioned to create greater stability when running.

• Check your footwear for uneven wear. Any issues film yourself or contact me for a video analysis session.

• When upping your mileage, increase progressively not aggressively. Allow your body time to adapt to the extra work.

• If you need strength coaching, form coaching or mobility sessions contact me via the following details…

HOW TO CONTACT ME

ashfoster1983@gmail.com

Insta: @runbetterwithashfoster

Online: runbetterwithash.com

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I shall speak to you in the next episode my fellow runners!