As the miles ramp up and the countdown to CIM continues, I’m starting to notice some niggling aches and pains. Tightness in my feet after a long run. Soreness in my abs after a particularly fast run (lots of twisting motion). Other aches and pains are more bothersome, and one in particular is causing me some worry; my right IT Band.
My right hip is notoriously weak; eighteen years ago, while hiking through the muck of a Costa Rican rainforest during Winter Break in college, my sacrum was pushed severely out of alignment from the constant pushing and pulling of my feet through the mud of the soft ground. I didn’t notice the injury until we were seated on the bus several hours later. When I sat with my butt firmly against the seat of the bus, the right leg was an inch and a half shorter than the left. It took 24 hours and a LOT of tears, twisting, pulling and stretching to pop the leg back to its normal position. Ever since then the sacrum and adjoining tissue are much weaker than their left side counterparts. The gluteus maximus on the right side is weaker, and the right hip joint doesn’t have as much flexibility.
Over the years my athletic tendencies have strengthened that side so that I don’t notice the deficiency unless I’m doing yoga. Then, every muscular deficiency comes out in blazing glory and I literally fall over when trying to hold certain poses that require strength and stability in the right hip. My body has compensated for the weakness over the years.
“Stemming from the fibers in the gluteus maximus, gluteus medius and tensor fascia latae muscles, the IT band wraps around the leg, becoming the thickest on the outside of the thigh as it travels down to the knee and attaches near the knee joint.” Runner Times
During the past two weeks the IT Band on my right leg is starting to whine. Nothing hurts until approximately nine miles into a run, then WHAM. Owie. I’ll stop and stretch the leg, then continue on my run. The stretching helps for about a minute, then the soreness is back again. It starts with tightness at the outer edge of my knee, and after a mile or so, the right glute will chime in with either fiery pain or complete numbness that feels like someone is pushing their fist into the large muscle right behind my hip. As soon as I stop running, the pain goes away. This is a classic case of ITBS, also knows as Iliotibial Band Syndrome.
I’ve asked several people in the athletic community for advice, and I’ve heard a resounding vote for “stretching” and “foam roller”. These are both things I’ve been doing on a daily basis, spending about sixty minutes in small increments throughout the day on both these activities. My intuition tells me that the issue probably started because I wasn’t cross-training or strengthening those muscles in a balanced way. So, I did some further research.
Running Times ran an article by Mackenzie Lobby on IT Band issues and prevention exercises. He interviewed a doctor and found that “research… shows that only 12 percent of runners have a tight IT band. Interestingly, he also discovered that 80-90 percent had weak hip stabilizing muscles.” Well, this is me in a nutshell. So the question remains; what do I do about it?
Dr. Ferber of the Running Injury Clinic has injured runners do the following exercises. There are more than can be done, but in Mackenzie Lobby’s article, he identified these as the most important:
“1. Hip Abductor Strengthening: Tie a theraband around an immovable object. Stand with your feet shoulder width apart next to the object. Wrap the band around the ankle of the leg furthest from that object, with the other leg behind the band. Move the leg with the theraband attached outward with the knee straight, like a side leg lift. Hold for two seconds and slowly bring leg down. Switch sides.
2. Hip Gluteus Medius Strengthening: With the band still tied, face the immovable object and pull your leg back to a 45-degree angle. Hold for two seconds, bring the leg down, and switch sides.
For injured runners, Ferber prescribes three sets of 10 reps, three times a week. He also suggests that healthy runners do these exercises once or twice a week….”
I did these exercises yesterday while standing in the kitchen waiting for my soup to finish cooking. I did not use a theraband, as I don’t have one, and I thought that initially, the weight of my own leg would be resistance enough. I was right about the resistance, and felt that familiar burning sensation deep in the Gluteus Medius when I hit the third set of exercises.
As impatient as I am to rehab the hip and gain strength for the last four weeks of HARD marathon training, I am listening to the advice from fellow runners and Dr. Ferber of the Running Injury Clinic; only do the exercises three times a week (well, I might do them four times a week, on an every-other-day basis). The muscle needs a chance to heal and rest, and pushing it too far will only lead to further injury.
As well, I have an appointment with a sports Physical Therapist next week, to evaluate my overall muscle condition. I’m hoping to walk away from the appointment with a list of strengthening exercises I can do at home or in the gym to get my muscles into peak condition for the race in six weeks. Did I just say SIX WEEKS? Now is NOT the time to be injured! I need to be completely pro-active in my strengthening, conditioning and rest. The good news is that I’m not “injured” yet (knock on wood). The IT Band aches after 9-10 miles, which means that this is an overuse issue, nothing some strengthening and cross-training can’t solve.
Great article Lara!
I hope you get to “fix” that ITBand injury before your race. It is a complicated issue. As a massage therapist, I can only advise you to go easy on the stretching on days that you run. Save long stretching session on days off. Muscles need recovery and we often over stress them after working out.
Mari-jo
PS I have a sacro-iliac issue so I can relate!
Definitely roll your IT bands, but also the rest of your leg, particularly your quads, hamstrings, glute, and TFL. They may all be contributors to the problem. Consider upgrading to a RumbleRoller (rumbleroller.com), which gets in deeper and does more to improve muscle quality. And have patience; this type of injury takes time to heal, especially if you continue trying to push your mileage.