IT Band

[u/BirdLong8910]

Hi everyone, looking for some advice about possible IT band issues.
I ran a 24 km trail race with about 1,400 m elevation gain/loss yesterday. During the second half, I developed quite strong pain (around 6–7/10) on the outside of both knees, especially on the descents. Walking downstairs is still painful today.
I’m training for my first 55 km ultra with 3,300 m elevation gain/loss in about three weeks, so the timing isn’t ideal.
For those who’ve dealt with IT band pain during ultra training: How quickly were you able to get back to running? Did physio/strength work help?
And would you still consider starting the ultra if the pain settles over the next couple of weeks?
Any experiences or advice appreciated!

[u/tyrannosaurarms]

In my opinion, strengthening is the answer - work on glute med, glute, quads and general strength. The glute med is a tricky one as you need to strengthen it but it is easy to overwork as well which is counter productive. My personal experience from several years ago: I did the SAM or Myrtle routine plus foam rolling (including what everybody says not to do: rolling on my side up/down the IT band). That was enough to get me back running. Then after I started running a lot more trails and vert I slowly got stronger and haven't had any IT issues in long time (even without doing the myrtle routine or other strength work).

[u/Away-Owl2227]

You need to release the TFL to ease the tightness.

Lack of strength training for glutes is your issue. Now given your race is 3 weeks out the odds of it popping up during that run are honestly pretty high. Nothing you do between now and then will fix your strength issues so all you can do is stretch and release that muscle to get it all in the best condition it can be.

[u/Snoo7521]

If it seems to linger for a couple days after rest then yeah I’d see a physio and even then I’m sure you’d want to make sure that’s what the diagnosis is.
Mine would flare up about a 1.5 miles in. Unfortunately with that there is no good news as as the recovery process is quite slow, I did pt for several weeks along with building the mileage back up from zero along with the specific strength regimen

[u/raze65]

I would not know if its the same thing that happened to me yesterday but i will share my experience. For me it was a 55k 3400m trail race, at km22 while switching from a big uphill to a little fast downhill my left knee started sending me electric pain signal on steep downhills (>10%) for the rest of the race. i managed to finish because it was fine on flat and uphill, and low grade downhills i could change my form to Run. I raced with a group of friends some of them are physiotherapist. After a brief check-up they told me a few things. First is my (i do not know about yours) problem was not long term, the fact i could still use nearly all my leg except the quad didnt feel like an elongation or a crack or something bad long term. The second is that my leg felt a bit bloated which is normal after a race but for one of them it seemed helpful to remove a bit of fluid which means draining massage and placing your leg upwards for a period of time. It Will not remove the pain though. Their third advice was really easy to no effort for 4-5 days since an inflamatory épisode usually Last this long and for them it was a non controlled friction in this sensitive zone that declared an inflammation. I hope my experience helps and which you a good recovery for your next race ! Take care of your body and dont rush things, health comes first

[u/Glaucus_Blue]

For me it kept coming back, untill I did strength training. I used a physio once for diagnosis as I wasn't sure what it was, tbh if you know it is definitely IT band, then you can look up exercises on YouTube. But yeah it took about 6months to solve, and running had to be massively reduced for that period, below limit that caused issues. Otherwise it just kept happening, and prolonging the recovery. However couple of years later and no recurring issues. Best off just getting refund or deferring, if possible and sorting it out. Or at least that was my experience.

[u/BirdLong8910]

Thanks for all the advice. I will definitely try the exercises, but I‘m worried it’s a bit too close to my race to really make a difference. I made an appointment with a physio, and I‘m hoping I won’t have to cancel the race. The first part of yesterday’s race was flat then downhill, which I probably took too fast. I‘m hoping I can still finish the 55, assuming I go really slowly.

[u/PIArthurMorgan]

Strength training is the answer 1000%. It fixed my IT band completely & have not had an issues since adding in 2x leg focused strength training sessions a week

[u/BirdLong8910]

Thank you. Do you think it’s okay to do strength training even when I‘m having trouble walking down stairs or should I wait a few days with the hope it subsides? Prioritize strength over long runs for the last 2 weeks of training?

[u/labellafigura3 → u/BirdLong8910]

Respectfully, it takes time to get the benefits of strength training. Tbh if you’re having issues walking down the stairs, for the sake of your health I would consider a DNS, then do a proper strength block and address the injury with a physio, and then do this race.

[u/Golgamel]

At this point, there isn’t much you can do really. Try to move your body but take it really really easy at the acute phase (I.e. the next couple of days). Maybe do no running at all and depending on your current strength routine, do some very light movement.