Book excerpt from Healthy Running, Step by Step

The IT band is a thick band of fascia that extends from the pelvis down along the outside of the thigh to below the knee, attaching on the outside of the lower leg bone (the tibia). The IT band functions to stabilize the thigh bone and knee during the weight-bearing "stance" phase of the running gait and helps guide the lower leg as it swings forward through the air in the "swing" phase.

Just before foot strike, the IT band slides over a bony prominence on the outside of the knee called the lateral epicondyle. An internal structure called a bursa (a fluid-filled sac that looks like a blister) prevents friction between the bony prominence and the IT band.

How You Feel The Pain

Iliotibial band problems can occur at one end or the other: at the top, where it originates on the lateral side of the pelvis, or more commonly at the lower end, at the site of the bursa on the outside of the knee.

This lower IT band pain tends to appear suddenly on a run, and it often becomes so severe, you have to limp or stop the workout and walk home. Although it does not represent a high degree of damage to the bursa or the IT band itself, it can be one of the most painful conditions runners suffer. If you ignore the pain and continue to run, the pain will progress to daily activities such as stair climbing, squatting, and pivoting.

At the top of the IT band, where it attaches to the outside of the pelvis bone (the ilium) and the surrounding muscles, the pain can come on more gradually. Although less intense up there, it can be equally persistent. Pain in either the top or the bottom of the IT band should not be ignored. The problem can be very stubborn and difficult to resolve if you run through the pain for weeks or months.

The Art and Science of Tapering Workouts for Peak Performance

by Robert Forster, P.T.

The final stage of training for peak fitness and performance is where most athletes lose the competitive edge. Like the final reduction process to maximize the flavor of your favorite food recipe, the taper is where all your preparation comes together to peak your fitness. All scientific training programs are based on the principle of progressive overload. The body is stressed in training cycles where 2-3 weeks of progressively harder workouts are followed by a lighter recovery week. It's only during the recovery week where fitness actually evolves. No one gets fitter during workouts it's only when the stress is removed that the body has a chance to adapt to the stress of the workouts and get stronger. In this way, the strength gains of one training block is built on in the next.

After months of alternating weeks of hard work and recovery weeks, one's fitness will have progressed, but the most profound fitness gains are still to come for those who understand the art and science of "the taper". After the final training block is completed and recovery is provided the highest fitness level thus far in the training program is brought into the taper period where shorter, but harder workouts build on that fitness to peak performance.

If left to their own devices, both elite and recreational athletes, based on basic human insecurity and a superior work ethic, would typically continue training and deepening their state of fatigue when they should be focused on full recovery and peaking fitness. Instead of a decrease in training volume and increased intensity they try to squeeze in a few more weeks of the heavier training that they are accustomed to.

In the taper period, less is more. The higher fitness levels achieved during the previous training periods and the reduced frequency of workouts in the taper period allows for fresh legs to produce maximum efforts in the final workouts to truly peak performance.