Ask the Coach: How do I manage IT Band pain?

Coach,

After running a couple miles, I start to have pain on the left side of my knee. I have been told stretching the IT Band and using a roller helps to prevent this type of knee pain. Can you tell what the best stretches are for the IT Band? Should I use a roller before and after I run?

Donna

Dear Donna,

What a delightful "Ask the Coach" question to receive. For those who have wondered if we generate our own questions in this forum, I am proud to say that Donna is very real, and I have had the pleasure of coaching her for a few years now. I even know her hair stylist, although obviously not on a professional level.  

Your IT band question is an astute one, and reminds me of the “Seinfeld” episode regarding car reservations, "You know how to take the reservation, you just don't know how to hold the reservation. And that's really the most important part of the reservation." *(Self-disclosure: everything reminds me of a “Seinfeld” episode).

And so it is with running and self-maintenance: we all have a general idea of what we should do, we just don't do it. And that is really the most important part if we want to prevent injuries. 

Let's first address some pain reduction for you: ITB syndrome does not respond well to added and ongoing stress. So you may first need to cut back on your running volume. While this is every runner's worst-case scenario, I happen to know that you can swim and bike really well, and you attend our FFXT sessions, so you already have excellent options. 

You can alleviate discomfort by icing the area. You could also use an ITB tendon strap when you run to take pressure off of the attachment point on the outside of your knee. You should walk for 10 to 15 minutes before even starting your run. Make sure your shoes are not worn out, try to run on flat roads, and avoid concrete. If you run on a track, change directions frequently.

Now let's get back to your question on what and when to do some stretching and rolling. First, think infrastructure. The Golden Gate Bridge was completed in 1937, and it is in very good shape, despite being exposed to the highly corrosive sea air. The reason it has lasted so long is that it is painted continuously, not when rust appears, or when it has rusted through and has to be replaced. 

Hence the beauty of your question: maintenance of our bodies has to be an ongoing practice, not just a response to injury. So, before, after and anytime you have a free moment to stretch and roll yourself out is the correct answer. 

Like anything else, you have to work on it to make it a habit. Commit to at least 10 minutes a day. Learn to use the time you have; I keep my Addaday Massage Roller in my car; If there is a red light, I'm rolling. 

As far as stretches and exercises there are so many you can do. For years I have strongly recommended Brian Fullem's work with ITB, which emphasizes massage and strengthening to prevent ongoing ITB problems. It may seem a little daunting to learn these routines at first, but keep in mind: ultimately this is what allows you to continue doing what you love to do, with no down time. 

Here is a good resource by Brian Fullem: www.runnersworld.com/injury-treatment/treating-itbs

I look forward to seeing you spinning, swimming, cross-training, massaging, rolling, strengthening and running at full strength again soon. 

Coach Brendan