IT Band Syndrome

Pale Rider

Pale Rider

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I've had a terrible time with my IT Band and related hip bursitis. I used to be able to run 5 miles, and now pain might start even if I'm sitting. It's not terrible, but I can't run. Any advice??

I've tried stretching and am now wearing a support for my hip and am doing exercises for my butt muscles. These seem to be helping and I'm hoping to start running again soon.
 
Check on some of the Pigeon stretches or yoga positions and their variations. They are mostly geared for for posterior but I'll tell you it can work the hip flexors too. It will take you a while to get into any of them, so be patient. I've been doing variations of them for almost 6 months and can just now attempt a real pigeon pose, but no where near completing it. And I may never get there. I do the upside down version (thread the needle) and working up to the classic. There is a variation that uses a chair to do standing that I use sometimes.

Supine and seated are shown here.

https://www.peanutbutterrunner.com/four-pigeon-variations-to-stretch-tight-hips/

https://www.healthline.com/health/back-pain/sciatic-stretches#be-safe


If you can't do them on the floor try this. This shows using something to put the leg on.

https://www.menshealth.com/fitness/pigeon-game

Before I got to the classic pigeon I would get on the matt. Put one foot flat in front with knee bent, then push the other leg back with toes back and heel up. Then I would move forward to stretch the quads and in that process I would move side to side some looking for the tight spots. Trying to push the hips down to the floor. The problem with the front leg muscles group is your body is not designed to stretch them. So you really have to work hard to get a good stretch to lengthen those muscles. Mostly by pushing the hips down as much as you can to lengthen those muscles. The cliche runner hamstring/quad stretches are not nearly enough.

Look up kneeling quad stretch. One keeps the leg on the floor. One you can pull the leg up behind you and lean into it. I use my couch to lean on. If you have someone willing to do it to you, look up the Thomas stretch.

I'm no expert on running, but a quick look into it says that the way you are training/running might be causing this. Too many up or down hills, IIRC.

I injured my lower back a couple years ago. The opposite side took most of the work to support the injury and never gave it back. So the good side was over working and the injured side stayed weak. The pigeon stretches have been a game changer for me. I also have a friend that did a couple session of Nero Muscular Reprogramming massage that helped me pinpoint which muscles were turned on (working) and which ones were turned off (not working). That changed some of my focus in stretching.
 
Pale Rider said:
I've had a terrible time with my IT Band and related hip bursitis. I used to be able to run 5 miles, and now pain might start even if I'm sitting. It's not terrible, but I can't run. Any advice??

I've tried stretching and am now wearing a support for my hip and am doing exercises for my butt muscles. These seem to be helping and I'm hoping to start running again soon.
Click to expand...

It can be painful. Saw a friend for it a couple of months ago. Received a Kenalog shot and a print out of some exercises to do to help. She said if that didn't help then a referral to PT was next. The Kenalog helped for about 2 days. Most of the exercises she printed off are already covered in my exercise program anyway. Mine bothers me more if I miss a couple of days of exercise. I assume it's because I didn't get the stretching exercises in.
 
ITB syndrome in the Navy is called "I Tried BUDS." It's one of the biggest reasons for medical drops at BUDS, and in BRC/dive school for the Marines.

The ITB, hip flexors, psoas, piriformis, it's all connected, so you should be stretching the entire chain. There are gobs of Youtube vids on how to stretch an ITB; also, buy some stretching bands (they are stupid-cheap: https://www.sunshineyoga.com/power-...MIlO7hoKPk2AIVkoqzCh29pgnwEAQYAyABEgJ-QPD_BwE).
 
ITB tenderness and dysfunction are not uncommon in running sports. As a matter of fact, most of what I have treated is sports related. The muscle that is the driver for the track (or band) is at the front of the hip and the tendon(or band) is long and attaches below the knee. Stretching this muscle is next to impossible by yourself especially if it sore but you are welcome to try. There are few bad techniques only failed results. I will try to address your pain and "What can I do" and then some other suggestions. A PM and a chat will add more benefit but here we go.
Get a tennis ball, preferably used, as they are softer but either will work. Lay sidelying, painful side to the carpet. You may want to support your head but keep your hands free. Bring lower leg to 90* and place the ball just above knee line and GRADUALLY let the weight of you leg sink onto the ball. Is it tender? Relax and wait 10-15 seconds for pain to ease. Move ball upward 1" and repeat, repeat, repeat until you get to hip and can go no farther. If 10 was awful awful pain you want to not exceed 7 or 8. As you touch these points and relax, the pain should lessen some and the tissues will be less sore on the next pass from knee to hip. Even if one has no pain there will be tender points for ALL people I have found.
Next, same sidelying position and same ball, Leg at 90*. Place ball, NOW we want to move knee upward/downward rolling the ball from front of the leg to rear. Basically you are pinning the ball to the carpet and then rolling the ball from front of the leg the back of the leg to treat the side(ITB). The band runs up/down and you are working across the ITB fibers....also called crossfiber work. Move ball upward 1" and repeat, repeat, repeat until you get to the hip and can go no farther. Is it tender? Remember the areas that "lit up" and, if they just hurt where you pressed or "triggered" sensations elsewhere like the foot, hip or even the low back.
You can do a couple sets of these in a day but only treat with the ball every other day. There is hip stuff that works well with the ball but you should see some results with just treating the ITB. Exercising at this point could only worsen the condition; You need to get the tisues where they are not sore so you can rehab them correctly. One last note....no insult intended......have you consulted a running coach to evaluate your program and evaluate your gait? Running places unusually high stresses on the anatomy especially running on hard surfaces. Shoe choice also plays a large role. A running coach will know all these things and probably be a runner also....if you havent talked to one please do.

Rooster
 
cjcullom said:
ITB tenderness and dysfunction are not uncommon in running sports. As a matter of fact, most of what I have treated is sports related. The muscle that is the driver for the track (or band) is at the front of the hip and the tendon(or band) is long and attaches below the knee. Stretching this muscle is next to impossible by yourself especially if it sore but you are welcome to try. There are few bad techniques only failed results. I will try to address your pain and "What can I do" and then some other suggestions. A PM and a chat will add more benefit but here we go.
Get a tennis ball, preferably used, as they are softer but either will work. Lay sidelying, painful side to the carpet. You may want to support your head but keep your hands free. Bring lower leg to 90* and place the ball just above knee line and GRADUALLY let the weight of you leg sink onto the ball. Is it tender? Relax and wait 10-15 seconds for pain to ease. Move ball upward 1" and repeat, repeat, repeat until you get to hip and can go no farther. If 10 was awful awful pain you want to not exceed 7 or 8. As you touch these points and relax, the pain should lessen some and the tissues will be less sore on the next pass from knee to hip. Even if one has no pain there will be tender points for ALL people I have found.
Next, same sidelying position and same ball, Leg at 90*. Place ball, NOW we want to move knee upward/downward rolling the ball from front of the leg to rear. Basically you are pinning the ball to the carpet and then rolling the ball from front of the leg the back of the leg to treat the side(ITB). The band runs up/down and you are working across the ITB fibers....also called crossfiber work. Move ball upward 1" and repeat, repeat, repeat until you get to the hip and can go no farther. Is it tender? Remember the areas that "lit up" and, if they just hurt where you pressed or "triggered" sensations elsewhere like the foot, hip or even the low back.
You can do a couple sets of these in a day but only treat with the ball every other day. There is hip stuff that works well with the ball but you should see some results with just treating the ITB. Exercising at this point could only worsen the condition; You need to get the tisues where they are not sore so you can rehab them correctly. One last note....no insult intended......have you consulted a running coach to evaluate your program and evaluate your gait? Running places unusually high stresses on the anatomy especially running on hard surfaces. Shoe choice also plays a large role. A running coach will know all these things and probably be a runner also....if you havent talked to one please do.

Rooster
Click to expand...

Thanks for all of the advice. I've had balky IT Band and hip bursitis issues now going on years. That said, I have found some ways to address the issues, and I think things are getting better overall. I'm now doing exercises focusing on the muscle groups around my legs and butt, along with stretches. I've been pain free on runs for about a month now. Hoping that things continue!
 
chiefjason said:
Check on some of the Pigeon stretches or yoga positions and their variations. They are mostly geared for for posterior but I'll tell you it can work the hip flexors too. It will take you a while to get into any of them, so be patient. I've been doing variations of them for almost 6 months and can just now attempt a real pigeon pose, but no where near completing it. And I may never get there. I do the upside down version (thread the needle) and working up to the classic. There is a variation that uses a chair to do standing that I use sometimes.

Supine and seated are shown here.

https://www.peanutbutterrunner.com/four-pigeon-variations-to-stretch-tight-hips/

https://www.healthline.com/health/back-pain/sciatic-stretches#be-safe


If you can't do them on the floor try this. This shows using something to put the leg on.

https://www.menshealth.com/fitness/pigeon-game

Before I got to the classic pigeon I would get on the matt. Put one foot flat in front with knee bent, then push the other leg back with toes back and heel up. Then I would move forward to stretch the quads and in that process I would move side to side some looking for the tight spots. Trying to push the hips down to the floor. The problem with the front leg muscles group is your body is not designed to stretch them. So you really have to work hard to get a good stretch to lengthen those muscles. Mostly by pushing the hips down as much as you can to lengthen those muscles. The cliche runner hamstring/quad stretches are not nearly enough.

Look up kneeling quad stretch. One keeps the leg on the floor. One you can pull the leg up behind you and lean into it. I use my couch to lean on. If you have someone willing to do it to you, look up the Thomas stretch.

I'm no expert on running, but a quick look into it says that the way you are training/running might be causing this. Too many up or down hills, IIRC.

I injured my lower back a couple years ago. The opposite side took most of the work to support the injury and never gave it back. So the good side was over working and the injured side stayed weak. The pigeon stretches have been a game changer for me. I also have a friend that did a couple session of Nero Muscular Reprogramming massage that helped me pinpoint which muscles were turned on (working) and which ones were turned off (not working). That changed some of my focus in stretching.
Click to expand...

Thanks for sharing all of the above. I really appreciate it. I competed and did other athletic things with pretty much zero injuries for 30 years, so to be grounded by hip and IT Band issues had been very discouraging. But lately with the advice like the things you wrote above, I have been able to run lately pain free. I'm continuing work outs in hopes of strengthening muscles that stabilize my leg and hip. Thanks again!
 
Pale Rider pain free and running is what its all about. Glad to hear you are back in the saddle!!

Rooster
 
Pale Rider said:
Thanks for sharing all of the above. I really appreciate it. I competed and did other athletic things with pretty much zero injuries for 30 years, so to be grounded by hip and IT Band issues had been very discouraging. But lately with the advice like the things you wrote above, I have been able to run lately pain free. I'm continuing work outs in hopes of strengthening muscles that stabilize my leg and hip. Thanks again!
Click to expand...

Not a problem. Glad it helped. It took me a year or better of seriously chasing my nagging back issue and a couple trips to a friend that does therapeutic message to get on that track. Hopefully I helped speed up your search a bit. That's what it's all about.

For the record, I'm almost into a full pigeon stretch, leg 90 degrees flat on floor and other leg straight back. I can lean forward into it a bit. Holy cow does that stretch some crazy places.
 
chiefjason said:
Not a problem. Glad it helped. It took me a year or better of seriously chasing my nagging back issue and a couple trips to a friend that does therapeutic message to get on that track. Hopefully I helped speed up your search a bit. That's what it's all about.

For the record, I'm almost into a full pigeon stretch, leg 90 degrees flat on floor and other leg straight back. I can lean forward into it a bit. Holy cow does that stretch some crazy places.
Click to expand...

I'm impressed! I've been back running for three weeks now. Still seem to be doing OK, although I've had a few aches. But nothing as I'm running.
 
Pale Rider said:
I'm impressed! I've been back running for three weeks now. Still seem to be doing OK, although I've had a few aches. But nothing as I'm running.
Click to expand...

Have you tried the foam rollers? My back and knees went a bit nuts last week and tracked it down to probably my Vastus Lateralis (outer quad) which is the muscle under the IT band. Since I don't run I'm figuring it's the muscle. Maybe flared up from squats and dead lifts. Ordered a foam roller from Amazon and started rolling that leg and calf tonight. Holy cow! It's like a foam medieval torture device. Hard to believe how tender that muscle is because it's over working right now. My wife was trying to message it out Saturday and I thought I was going to pass out. But working on it has eased up the back and knee pain a lot. This vid shows the plain roller. I bought one with nibs for extra stimulation of the muscle. That might explain why it hurts so much. lol


 
Torture rollers are painful is some areas of dysfunction or tissues with no pain symptoms. The reason why is first, the tissue is painful and you are treating it and second, its hard to control the penetration when you are balancing your body weight on the dang thing. I dont like to prescribe rollers for mostly the second reason. The pressure area is broad and can sometimes trigger latent(sleeping) trigger points that may become active(painful) trigger points long term especially if irritated by aggressive therapy. The "grit your teeth and take it" approach may help temporarily but why add insult to an already nociceptive(painful, painful/referring) tissue. Notice that points on some areas of the leg, when invaded, make the leg almost goes numb or you feel it in the foot or shin area or even into the hip/low back complex....those are true "trigger points".
The foam roller is working ALONG the length of the muscle fibers; The "tennis ball approach" I mentioned above is working ACROSS the length of the muscle fibers and is usually much more painful, but not, due to control of the invasion. The difference though, is the entire body(roller) on the tender point VS just letting the outer leg down onto the tender point(ball) and moving the leg up/down on the pressure. Controlling the therapy at a level where you can control your breathing and relaxation makes the therapy more effective.
Do what works for you and try to keep pain in the 5-7 range on a scale of 1-10. BREATHE, as you will catch yourself not doing this!
Rooster
 
Yeah, the balance and movement part take some work. For me, the broader roller seems to be a bit easier to deal with pain wise. I couldn't imagine using a ball on my leg right now. And I have a smaller roller designed for rolling the leg that I used on the ground a few time that worked OK but was still pretty aggressive.

My problem is that I have on old injury that has caused secondary issues in other muscle groups that took up the slack for the injury. Now that I'm strengthening the injured back area and stretching it the other muscles are causing issues. So back issues have turned into quad and calf issues. It feels like my posterior chain on the right side is in revolt and my outer quad and solenius muscle in the calf are pretty much "on" all the time. Pretty sure it's all related but having to try a lot of things to figure out how to attack the problem. The most aggravating part is getting to a point where I feel great for a few days and then something nagging comes back up. Focusing on my back got me a long ways. But when it started hurting again, I had to focus on my quad to get it under control this time. Fun stuff.
 
Let me help you with a resource:
Anatomy Trains by Thomas Myers
I see by your wording that you are "on this" with the research so it might be for you. Its funny when an old injury comes back it is usually accompanied by a new one...lol.
Rooster
 
cjcullom said:
Let me help you with a resource:
Anatomy Trains by Thomas Myers
I see by your wording that you are "on this" with the research so it might be for you. Its funny when an old injury comes back it is usually accompanied by a new one...lol.
Rooster
Click to expand...

Thanks. Man that looks a bit academic but I might get one of the others. I have a friend that does Neuro muscular reprogramming message. From the couple sessions I have done with her I know that if one muscle group turns "on" then another group has turned "off". I'm figuring I might be turning some of them back on but not sure how to turn the others off and they are over working. I was a bit skeptical until I gave it a shot. It's pretty wild. And generally she would tell me the side I thought was the problem was not, and the actual problem was somewhere else. Which is part of why I'm working on my quads and calves for back pain.

Wife is on me to go back, and I need too. But just had so much going on lately.
 
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