WHAT SHOULD PHIT DO?
So this is what's going on with me this month? I am currently training for a running race at the end of September. I've been a runner for about 3 years (ever since I started to get a little thick around the middle) and I've never had an injury before. Unfortunately, the last race I ran was all downhill and now my IT (iliotibial band) hurts when I run. I tried rest and ice and my IT band feels better but the pain comes back after a few miles of running. Because I really want to run the race (I already paid the money and planned the trip) and I don't want to end up with a chronic injury, I decided to talk with Gail Molloy* to see if she could help me.
Phit: Why does my IT band hurt?
Gail the PT: The iliotibial (IT) band is a group of muscle fibers that runs along the outside of the thigh, from the hip to the knee. The IT band functions as a stabilizer during running. When there is a problem, the pain presents itself on the outside of the knee or leg. The 6 reasons for IT band pain are: joint stiffness (hip, spine, foot/ankle), overuse (usually increasing the distances), tight tissue, weak hip muscles, poor running form, and/or shoe/orthotic issues.
Phit: I've been resting and icing my outer knee but I have still have pain. What should I do next?
Gail the PT: Ice and rest are a good start. But, since you want to run in your race, I suggest physical therapy to address any biomechanical (joint and soft tissue) faults or restrictions that are creating the "rubbing" of the IT band, because the inflammation won't decrease unless the source or cause is determined. I'd start with evaluation to determine the underlying cause of the problem and look at the joint interaction between the legs/feet and pelvis/spine, the muscle strength and flexibility, balance and loading ability on the legs, and walking/running. Almost every runner in pain has some biomechanical faults that can be treated with Manual Therapy (joint and soft tissue mobilization/manipulation, neural glides) that are the underlying cause of breakdown at the soft tissue or joints. For treatment, I would likely focus on motor control exercises specific for you, stretching and soft tissue work, possibly trigger point dry needling and manual therapy. Ultrasound and iontophoresis may also be used if there is a localized inflammation. Occasionally, shoe orthotics may be useful.
Phit: Do you think I am crazy for wanting to run this race so soon?
Gail the PT: I understand your desire to finish the goal you set for yourself. I even admire it. It is extremely difficult to permanently damage your IT band but you may be doing damage to other parts of your body as you compensate for your IT band pain. An evaluation is the best place to start. If we know the problem, we can determine if we can get you back on track quickly and get you ready for your race.