The Dreaded ITB Syndrome

ITB (Iliotibial Band) tightness is a common running injury among all levels of runners. The ITB is a band of tissue that runs from the gluteus down to the outside of the lower leg just beneath the knee. It's main role is to extend the leg and stabilize the leg while you run. It can be caused from overuse or drastic changes in training, inflexibility, worn out shoes or shoes that don't support your feet, cambered roads, and muscle imbalances. Signs and symptoms include pain on the outside of the knee or hip.

How to get back to running after ITB Syndrome:

* If pain exists, decrease your running mileage, cross-train or rest to reduce the risk of further irritation. Ice the area and review your running program for drastic increases in intensity, mileage or terrain changes. Try to identify what caused the pain to avoid it from happening again.

* ITB can be due to having weak gluteal and knee stabilizing muscles and muscle tightness. Incorporate total body strength and flexibility exercises - emphasizing your core, upper and lower body at least three times per week. Building balanced strength and flexibility will not only prevent ITB it will also improve your running form and efficiency. You will be more successful in your journey back to running if you properly address specific weaknesses and muscle imbalances.

* Gradually get back to running by testing the waters first. Doing too much too soon can increase the time of recovery. After a 5-minute walking warm-up, run a few 30-40 second easy paced sprints on even terrain and walk back to recover between each one. If you have pain, continue to rehab and rest. If not, continue with the next step.

* Warm up walking briskly for 5 minutes. Run at an easy pace for 20-25 minutes and finish with a 5-minute walking cool down and flexibility exercises. Repeat this running workout on alternate days [i.e. M-W-F] 4-5 times. Cross-train on the days in between to maintain your cardiovascular fitness. If there is no pain present before, during or after the run add 10 minutes to the run next time.

* Gradually add minutes to your runs as your body allows. Every time you increase minutes hold what you have for 3-5 more running sessions until you reach your normal running regimen. This will avoid risk for re-injury and doing too much too soon. Alternate your run days with either rest or cross-training for the first four weeks back to running.

* Avoid adding speed or hill workouts until you are symptom free for at least 6 weeks and have rebuilt an adequate base of mileage.

* If pain returns, take 3-4 days off, continue to focus on cross-training, strengthening and flexibility and try, try again. Your body will recover and be stronger and less likely to develop ITB again.

* Be cautious about running on tracks, down hills and on crowned and uneven surfaces as it can contribute to ITB. All of these can contribute to developing ITB. Running on softer surfaces is more fore giving on the body and may be an easier for the transition back to running.

* Perform self massage/release techniques with a foam roll or The Stick to help release the tight tissue and decrease tension on the band. If possible, schedule a deep tissue/friction massage biweekly or monthly.

* Practice patience and go perform each workout with a goal in mind. If you're wise, every run will be one step closer to a complete and successful return. You may be surprised...and turn a negative into a positive and come back much stronger!