Some of you may recall that I injured my ITB last February and had quite a bit of trouble recovering. Sunday morning I ran my first race since then, 9 weeks after coming off the elliptical. The race, a 5K, was huge (3600 chip-timed runners and 19,000 total) which was interesting, but not something I plan on doing again. Anyway, I ran 20:19 which is 22 seconds faster than I ran before getting hurt. It was my fastest time since high school (over 7 years ago), and quite a bit faster than I had hoped for. While I could go on all day about what I could have done differently to run even faster, it's obvious that I should be very pleased with the result, and I am.
But the reason I am posting... I promised myself I'd detail how I came back from this injury once I fully recovered. To me, full recovery meant regaining not only the ability to run as much as I like, but to run as fast as I did too. This may be the most common running injury out there, and many runners have extreme difficulty getting over it. Hopefully this post will help out a runner or 2 who is dealing with ITB syndrome, but doesn't have the resources available to see a medical professional.
The article that really got me moving in the right direction is here...http://www.runningtimes.com/issues/04may/itbsyndrome.htm
The main point of the article is that ITB syndrome is a result of weak hip flexors, and while other factors may contribute to the problem, strengthening the hip flexors should be the primary focus. My hip flexors were pretty weak... I could barely do 10 of the leg lifts described in the article. This surprised me, since I have a weight lifting background, and consider myself to be at least a little bit stronger than average for a distance runner. Doing the stretches also seemed to help quite a bit, especially in relieving the pain. Icing the outside of my knee and doing ice massage on my leg were also key.
The stretches and strengthening exercises are here (also there's a link in the previous article)...http://www.runningtimes.com/issues/04may/itb.htm
Specifically what I did:
1) With the side leg lifts I built up to 2 sets of 20 each day (held 5 seconds each) over 3 weeks. I also built up to 3 minutes per leg of balancing. While balancing on one leg, I would move my arms and other leg in a running motion. Again, 3 weeks.
2) I did stretches 2 and 3, 3 times per leg, 30 seconds per stretch, 3 times per day. I found stretch #1 to be very painful on my knee, and replaced it with another classic ITB stretch. I lie on my back, and extend my straightened (well, fairly straightened at least) leg across the other so that it makes as close to a 90 degree angle with my unstretched leg as I comfortably can (though I don't actually get quite that far). I stretched to the point where I could feel it, but it didn't hurt... I was relaxed and could breathe normally. I did this for 3 weeks, and have continued to do these stretches as part of my routine before I run... but only one of each per leg.
3) I iced the outside of my knee (where the worst pain was... if you've had ITB syndrome, then you prolly know) for 15-20 minutes each day.
4) I did ice massage 2-3 times per week. To do this, I put a styrofoam cup in the freezer, filled with water. After letting it freeze, I cut away about half of the styrofoam and would massage along the length of my ITB... but without touching the especially sensitive areas around the knee or the hip. I read somewhere (sorry, can't find the link) that rubbing in these areas can actually irritate the injury... tried it once, and that was my experience. Massaged for 10-15 minutes at a time.
5) I found that I could work out on an elliptical fitness machine with some pain, but while still allowing the injury to heal. I feel like this was important in getting my running muscles ready for the real training. I have read more than once that this isn't a great idea, but it did work for me. Pool running, for example, might be a better way to go.
I hate cross-training, boring exercises, and lots of stretching, and recklessly returned to training after just 3 weeks (first week was about 50 miles, hehe). I had planned to wait 6, but just got too restless. Since then, I have only done what I need to do to keep my ITB feeling healthy. Before starting this "program", my ITB hurt all the time, even when I was lying in bed. Training was out of the question. Rest did nothing... in fact, the injury just got worse. And I rested it for as many as 2 months at a time. I am now convinced that it is crucial to get to the root of the problem, and aggressively work to correct any weakness, lack of flexibility, etc. that may be causing an injury. Rest alone prolly never would have worked for me. I have used a similar approach to get rid of some runner's knee in my left leg.
I am uninsured, and would definitely have gone to a doctor if it were practical. Fortunately, my injury was very easy to diagnose (every sign pointed to ITB syndrome) and I was eventually able to take care of it on my own. Just wanted to make it clear that I do believe in going to the doctor if possible, hehe. Also, I am 25, so perhaps I can get away with a bit more than some other runners.
In previous posts, I received some sound advice from Ryan, Rita, Steve, and Paul (sorry if I left others out, quite a bit of time has passed... you too of course) that really helped. A quote from Ryan in another post in response to an insightful comment from Rita... "If you don't find the root cause of an injury and solve that, you are bound to reinjure yourself."... a point that he brings up quite a bit, and with good reason. Thank you guys for taking the time to help me out with this injury... it's definitely made a big difference.