ITB recovery

Earlier this year, ITB syndrome - one of the most common injuries for marathon runners - meant I had to pull out of the London Marathon only 12 days before the race.

After hundreds of miles of training, over several months, this was, to put it mildly, a bit of a disappointment.

Thankfully, I was able to get physio on the NHS and was enlisted onto special 'knee classes' at my local hospital, so am now slowly - ever so slowly - on the way back.

Following requests from a few people (notably @PatrickAvis) I've eventually got round to putting together a post on my ITB recovery routine.

For those that don't know, ITB (illitobial band) syndrome is a problem that affects a fair few high-mileage runners.

The illitobial band is a bit of tissue running down your thigh that apparently has the tensile strength of steel! How cool is that?!

Unfortunately, long distance runners have a habit of doing it a mischief.

When the knee bends the band is pulled back over the bony bit of your thigh bone that's next to the knee. There's a fluid filled sac (*cough* *cough*) that's meant to prevent friction, but repeated flexing can cause it, the band or sometimes even the bone to get damaged.

Annoyingly, you can't tell you're doing it at first as the band isn't like a muscle and doesn't have nerves to let you know it aint happy.

So, by the time you start to notice a pain on the outside of the knee when running, you've already done the damage. At first the pain will subside soon after the run, but rears it's head again the next time you're out. If, like me, you ignore it, the pain comes on sooner, and doesn't go away when you're doing 'normal' things like walking, or going up some stairs.

The outside of the knee can also feel quite sore too when you prod it. Some might say 'don't prod it then', but that's like telling me not to press the big red button under the sign saying 'do not press'.

It would be against nature.

It sounds nice and straightforward as injuries go, but if, like me, you ignore it and hope it goes away, you're gonna really screw yourself over.

Only once the pain has been reduced to less than excruciating (lots of rest and ice!), can you start trying to fix it.

For me, that meant six weeks of physio on the knee to strengthen it overall, combined with daily ITB specific stretches.

I've put instructions for the basic ones below as best I can, but it's a bit weird to describe really. Unlike say, a hamstring stretch, you can't really tell you're doing anything as there aren't any nerves in it, so I found myself actually feeling with my hand to check the band was tight ie stretching.

The main one involves lying on your good side, with that knee slightly bent, on the edge of a bed/sofa/table, with your back facing out over the edge. You then slowly lower the bad leg down behind the other, using gravity to stretch the ITB. Hold for 12 seconds and slowly bring the leg back up.

I started by doing this five times, then built up to 12.

As cycling to and from work doesn't always necessarily give you access to a bed to do this one on (and it turns out my desk it more slippery than it looks) I got my physio to give me a few others that could be done standing up.

With both knees straight, bring the bad leg behind the good one and as close to the unaffected side as possible,. Then bend down (ooh err missus!) as far as possible towards your good side.

Slight variation on this one is bringing the bad leg in front of the other, then bending down gently to touch the toes (or ankle if you're an unsupple as me!) of the bad leg.

Another one involves standing with the good leg slightly bent, and stretching the bad leg behind this one, as far out to the side as you can.

I built up to doing these standing ones twice a day, 8 times each and so far, it seems to be doing the trick.

Saying that, my ITB was caused by my running form putting too much pressure on the wrong parts of my knee (turns out I've been running/walking wrong for years!) so I've also been doing a lot of general knee strengthening too. Added to that, at least 22 miles of cycling a day and the strength is getting there.

But, I've still got to be very very careful about running. Building up mileages slowly (irritatingly slowly!) is the best way to avoid repetition of the injury, so I'm still yet to get above five miles!

Hopefully the cautious preparation will mean I'll make it to the start line this time around, but in the meantime it's trying to hold myself back and hoping the miles on the bike are helping with the overall endurance.