ITBS: Hello Hip Pain
Your hip aches when you lie on your side at night.
There's a tender spot when you touch on the outside of your leg bone.
Or maybe it's the outside of your knee? You know, just above that little bony knob that sticks out on the side of the knee?
Whatever it is, this lateral pain can be sharp - like someone stabbed you with an ice pick. It can be mild and intermittent, dull and aching at night, or sharp and painful every time you take a step. ITBS can be a minor irritation, or it can become so severe, the pain prevents you from running at all.
Lateral leg pain is often a sign of a troubled iliotibial band associated with trochanteric bursitis, which is a syndrome that plagues many runners – both newbies and veterans. It is affectionately known in running circles as iliotibial band syndrome, or ITBS for short.
So what exactly is this, and why does it hurt so bad?
The iliotibial band is a long strip of connective tissue on the lateral side of the leg which attaches at your hip and distally at your knee. You remember the song, right? Hip bone connected to the knee bone... Conveniently located under this tight band of soft tissue are little cushions called bursa sacs. When a too-tight IT band (ITB) moves back and forth against these little bursa cushions while running, the bursa sacs become irritated, which leads to trochanteric bursitis of the hip.
Women are more prone to ITBS at the hip, while men are more prone to develop ITBS near the knee. I have experienced this on several occasions throughout my running career. A few years ago, while training for the Boston Marathon, I had a bout that flared up when my long runs were extending past 15 miles. I tried a few of the short term fixes discussed in this article, however with the training cycle nearing the end, I was unable to achieve the long term fix needed to run pain free and ended up missing out on racing the Boston that year. Once I was able to lengthen the IT band, long runs were no longer painful. The happy ending to this story was that after learning how to correct the ITBS, I was able to train for and complete the Boston marathon the following year with my second best ever marathon time.
The fix
To relieve pain from ITBS or bursitis, a two step process is helpful. First, runners can get temporary relief and reduced inflammation from use of ice massage, anti-inflammatory medications, or joint injections into the bursa. But more importantly, the long term fix requires some concentrated effort on your part. This means stretches and exercises to lengthen the illiotibial band which takes the pressure OFF the bursa sac and prevents pain and inflammation all together. Shown below are some basic stretches that can eliminate ITBS pain. I also recommend a search on you-tube of "illiotibial stretches" or "ITBS pain" or "trochanteric bursitis" which should produce some physical therapy vidoes demonstrating stretches to loosen and lengthen the IT band.
Here is a youtube video clip of 2 physical therapists performing the top 3 stretches to lengthen the IT band. Two of these stretches require no equipment, however the third requires a 6" foam roller which you can purchase at a running store, or sporting equipment store.
https://www.youtube.com/watch?v=MO2ZNz03YEI
Top 3 Stretches for the IT Band (Iliotibial Band) Physical ... Famous Physical Therapists Bob Schrupp and Brad Heineck describe 3 top ways to stretch your IT Band- your Iliotibial Band. Make sure to like us on FaceBook https ... |
For icing, a recent study found that using a point focused ice massage for just 5 minutes is as effective as generalized icing an area for 15-20 minutes. To perform a point ice massage, simply use an ice cube directly on the most tender point and gently massage for 5 minutes. Ice massage is a natural anti inflammatory that is safe, effective and has no side effects that medications can cause.
Original blog post published Dec 2016 for
High Intensity Training Institute. Reprinted with permission.
