Picking up where we left off in Part 1, we continue this article by physical therapist Chris Nentarz on “Iliotibial Band Syndrome” (ITBS) and ways you can prevent this common running injury.

Under Recover
Having a balance between work and rest will breed success. Recovery, or regeneration, should be an active process. It should be a lifestyle philosophy, incorporated into all areas of our lives.

Recovery steps should be done daily, best implemented after training in the form of foam rolling, stretching, and cold baths. In addition, we should schedule regeneration days into our programs that may include yoga sessions, body work or other measures you find add balance to your life. The better you recover, the quicker the body will adapt.

Foam rolling is a must for any runner. It is important to focus your time and energy on the most important regions. Most people spend time rolling the ITB. While this may seem effective, superior results can be obtained by performing self-tissue work on your Tensor Fascia Latae (TFL), not your ITB. The TFL is the contractile element of the ITB and is popularly left out of self-massage routines. This can be done at the gym, on the trail or when watching TV.

Poor Biomechanics

Would you start golf without some type of instruction? Probably not. Yet, the majority of us have never educated ourselves prior to starting the sport we enjoy most.

I recommend enjoying one of the numerous running methods taught these days, including Chi, Pose or my favorite, Natural Running. They all have merits, so do some research to find out which one fits you most.

Lastly, spend time with a running coach, as they will be able to give you subtle form tips and drills that will help you become a more efficient and powerful runner.

Listen to Danny Abshire, world famous running coach, discuss running form here:

Movement Pattern Dysfunctions

Movement pattern dysfunctions (MPDs) are imbalances in how our bodies move. They can be small or large. When someone limps, they are adapting MPDs to avoid further injury of damaged tissues, while simultaneously allowing the body to move. MPDs are subconscious and allow us to fight or flight when injured.

MPDs are caused by a combination of muscle imbalances, joint restrictions, poor stability or previous injury. In Iliotibial band syndrome there may be multiple biomechanical imbalances at play. The most common involve the ankle and hip joints.

Below the knee at the foot, excessive internal rotation forces can overload the ITB. These abnormal loads are usually created due to excessive heel striking, tightness in the gastrosoleous complex, and stiffness in the ankle mortise. Above the knee, weakness or early fatigue of our glutes can again cause the ITB to work overtime to decelerate and accelerate the forces that act on our bodies during running.

Performing a well designed and executed corrective exercises will restore and maintain the movement quality of your joints. This ultimately will reduce MPD’s and allow the body’s natural healing processes to function optimally.

Initial Treatment

The ultimate goal in your rehab should be to resolve the underlying cause of the problem; however, it is important to address acute symptoms immediately. Your initial treatment should focus on:

• Relative Rest - Take a break from activities that cause your knee pain. Continue to train using the activities that do not increase your symptoms, such as biking, swimming and functional training.
   
• Kinesiology Tape - The application of kinesiology tape will decrease pain and allow the key muscles surround the knee to function properly. A knee spider and TFL taping can be particularly useful in ITBS.
   
• Ice - Apply ice packs three to four times a day for 10 to 15 minutes.
   
• See a sports medicine physician if symptoms don’t subside within two weeks.
   

Final Thoughts

We have all fallen victim to isolating painful body parts. Pain is a fantastic warning signal telling us that all is not well in the system. To effectively treat ITBS, we must address multiple factors. When considering sustained high performance, don’t fall victim to reductionism. To permanently put an end to these nasty symptoms, we must look above and below the pain site and consider the system as a whole.

If you're a runner interested in using the TRX Suspension Trainer to enhance your run performance, check out the online training programs we created in partnership with renowned run coach Matt Dixon. Click here for more info.

Chris Nentarz is Physical Therapy Manager at Athletes’ Performance (www.athletesperformance.com). He is a Physical Therapist, Certified Strength Training Specialist and Performance Enhancement Specialist with over eight years of experience working with athletes of all levels, including providing consultation services to numerous professional and elite organizations in the United States and Canada.