How to Recover from IT Band Syndrome
Iliotibial Band Syndrome (ITB Syndrome, IT Band Syndrome or ITBS) affects hundreds of thousands of runners each year. However, despite being one of the most common injuries in runners, it is still often misunderstood and poorly treated.
In this article, I’m going to briefly explain what IT Band Syndrome is and what you need to do to recover quickly and get back to running pain-free.
But first, what is the IT Band?
The IT Band is a thick connective tissue, similar to a tendon or ligament, that runs along the side of the leg. It starts at the hip and goes all the way down to the knee. Its job is to provide structural support during leg movements, particularly stopping your knee from buckling in or rotating out when you walk or run. It also acts as an anchor for several major muscles like the glutes and quads which attach to the IT Band at different spots.
What is IT Band Syndrome?
IT Band Syndrome is an injury that results from overuse and causes pain on the outside of the knee. This pain comes from irritated tissues underneath the IT Band – not the IT Band itself. It is important to be aware that the IT Band itself is not damaged. In fact, the IT Band might have little to do with the injury, despite the name.
The actual irritated structures are cysts and fatty tissues that lie directly under the IT Band, next to the knee. These structures get inflamed and painful when there is too much repetitive strain over the knee.
IT Band Syndrome usually only affects one leg – the weaker leg – because joint stress is always greater where there is less muscle support. So the most important part of recovering from IT Band Syndrome is strengthening the supporting muscles around the IT Band (particularly the glutes, hamstrings, and quads), and improving single leg balance and control.
What your IT Band Recovery Plan Should Look Like
Phase 1: Rest and Pain Management
I don’t normally prescribe rest to runners. In fact, injured runners usually do better when they continue with (some) running. However, with IT Band Syndrome, runners who take some time off and completely stop irritating the injury, recover much quicker.
How much rest do you need? It depends. I know that’s not the answer you’re looking for, but it really is different for every person. Some people can rest for as little as a week, others need several months before they can get back to running.
The most important thing is, you need to be pain-free before you start running again.
During this rest time, your priority is reducing pain. Find remedies and treatments that work for you, whether it’s massage, Physio, ice baths, acupuncture or medication, the end goal is the same – pain relief.
However, while resting from running, you’re not resting from all activity. The more strength and conditioning you can do during this time, the better your return to running will be.
Cross training, walking and strength training are critical during this time. To help you plan your ‘rest’ weeks, here’s a sample training week I give my athletes. Use this as a guide and modify it based on your routine, as well as pain levels.
Phase 2: Getting Back To Running
Once you’re pain-free during normal daily activities, you’re ready to start re-introducing running. To make sure you don’t flare up your injury, you’ll need to be careful and conservative with how much you’re running. To be honest, initially, you’ll be running much less than you were before the injury. The hardest part for most people is dealing with the frustration of this. However, if you push it too much, you’ll find you just set yourself back.
To work out how much you can run, you’ll need to find your baseline distance – this is the distance you can run (at a slow, comfortable pace) pain-free. You’ll need to stop once the pain goes over 2/10 and then you’ll need to monitor your symptoms for 24 hours. There should be no extra pain later that day, or the next morning.
Your current pain-free running distance is your baseline. For the time being, you should not run further than this.
In Phase 2, while you’re getting back into running, you’ll still need to continue strength training as well.
Here is a sample training week for Phase 2:
You’ll notice that there is only one run in the week that gets you to the full baseline distance. That’s because the other two runs will be at a faster pace. This variety reduces repetitiveness stress overload and injury risk.
Phase 3: Increasing Running Volume
For the first 2-3 weeks, keep your training volume the same and monitor symptoms. At this early stage, it is better to focus on strength training and slowly get your body used to running again.
If after 2-3 weeks you have had no increase in pain and your knee is handling the current training volume, you can begin slowly increasing your weekly mileage by ~10%.
Your schedule should remain similar to previous weeks with a mix of strength training, running at various speeds, and rest days. You can begin increasing your baseline distance slowly. However, continue to monitor symptoms.
ABOUT ALINA KENNEDY
Alina is an Australian Physiotherapist, Strength & Conditioning Specialist and avid runner. She works exclusively with runners in injury rehabilitation, prevention and performance improvement. Learn More Here