Hello
I am sorry to hear about your ITB syndrome, it can be incredibly frustrating. I am not a medical precessional at all and it is always recommendable you should visit a physio who specialises in biomchanical issues. Hopefully I may be able to provide some bits of information which might help because I had to do quite a lot of digging to get rid of the issue
Unfortunately It band syndrome was present with my running from February 2016 till about a month ago ( I was however able to train fully during this period ). I became really frustrate during because I tried lots of things and nothing seemed to work for me. What may work for someone may really be useless for someone else, so if you haven't already please have an individual assessment from a physio who can look for potential intrinsic causitjve factors for it band syndrome (just out of interest, do you exeperinece symptoms in both legs or just one? ) it is also really important to confirm your diagnosis with a professional, because what may be symptomatic as it band pain may in fact be something else, like entrapment of the peroneal nerve.
I think the key point regarding this issue is that the causative factor may be different from person to person, and therefore treatment and recovery is different. This can be confusing and a little disheartening because this multifactorial condition can be very perplexing. From what I gather the issues which have been known to precipitate the onset of it band syndrome are varied, and include-
--
Extrinsic contributory factors-
Running on crowned or cambered road surface
Inappropriate footware for the individual
Issues with trajning volume increases (e.g. Exceeding intensity and volume too rapidly beyond body's capability)
-- intrinsic factors
Leg length discrepancy
Lack of internal leg rotation owing to tightness in TFL muscle
Overpronation or oversupination
Weakenss in hip abductors and hip abductors
A lack of effective arm swing, or unbalanced arm swing causing rotation for the trunk during running
Compensating for lack of flexibility or pain inhibition from prior injury (like a previously sprained ankle)
Limited big toe flexibility
Shortened hamstrings
Tight or weak posterior compartment muscles
The actual shape of the leg bones and the hips themselves
Unfortunately this is all horribly complicated and I found with no specific anatomical expertise the whole process of working out the causative factor was a nightmare. I kept reading these online physio articles about having to find the cause and then the problem would go away but the body is so complicated and it is often to complicated to trace exactly what muscle is not doing its job. The itobial band performs many functions and so there are a lot of things to consider when treating it band syndrome, I foind the whole picture becomes clouded and overwhelming with lots of advice on the internet often confusing me further.
As far as i understand The it band controls rotation of the leg and stabilises the knee when the foot is placed on the ground on the stance phase of the gait. It also works as a long lever arm to the TFL muscle (effectively a hip flexor) as you lift your knee towards your body. Therefore, any issue with hip flex ion or excessive rotation could cause this issue.
From what I gather from your post, you have been strengthening the legs but the issue still persists. A lot of the advice online (which seems to benefit a lot of it band sufferers) focussed on working on hip strength and balance and coordination of the lower limbs, the idea being that this reduces the amount of stabilising work the it band has to do if the supporting muscles are stronger.
I felt rather downcast when months of strengthening made me a lot stronger but did not reduce my symptoms. This demonstrated to me that alhough strengthening helps some people it is not the answer for some.
I also attempted massaging the TFL muscle with a foam roller and hockey ball in the hope that this would reduce the tension in the attatched it band. This seemed to help some people but I just got some strange tingling sesnastions at the it band insertion point.
Foam rolling the it band seems controversial and although it shouldn't cause much harm it probably won't stretch the it band like some Internet articles claim (the it band needs to be tight to keep the knee locked in place and stabilised when you straighten your leg - as a consequence, the collagen fibres of the band combine to make a largely inelastic structure with a. Tensile strength higher than steel - it is therefore unlikely to stretch even if you wanted to)
However, even if foam rolling other muscle (like hamstrings or calves) s or strengthening the legs doesn't solve the issue for you, I still found they are still beneficial for general fitness so I kept them both up regardless.
What I found helpful
What I found solved the issue for me may be completely useless for you but it may be worth trying
I tried insoles, changing shoes, strengthening, foam rolling and modifying running form (the last of which is hard because lots of advice I found from online running g websites talks about 'runnking tall' or 'light', whatever that is because at the end of the day I found trying to deliberately modify y technique made my whole running pattern even clumsier. I even tried forcing myself to run at 160bpm cadence which was awkward and silly of me when I was nowhere near that cadence).
It really helped me to keep things really simple and to stop over analysing everything.
If possible, keep running even if you still have it band pain. It band pain is horrible, but there is no permanent damage from the soreness (the fascia of the it band just compresses nerve rich fatty adipose tissue on the lateral knee) and it is not like an acl tear or menisval tear where you have to wait for it to heal. You can keep running but remove the pressure and just keep everything relaxed. I did 5 6 km runs a week when I had it band syndrome and it really made me feel better when I was still getting a run in, even if the pain was still there.
I found hill spirits really helped me improve running technique because you have to engage your glutes and drive your arms hard.
I improved my hip internal rotation with foam roller, which increased the amount of rotation at my hip and meant that during running my foot wasn't rotating on the floor due to s tight hip, and causing me pain in the it band. I also worked on my arm drive and made sure each arm was driving forward and not across the body (excessive arm movement across the body rotates the trunk and consequently then the it band, causing pain)
With these simple changes I feel much better now and i am back training. I got frustrated with all the info online so I just waked in front of a mirror and found my arm swing was wrong . Maybe you could try walking in front of a mirror, just to see if you spot any differences between your arms in legs on either side if your body. I found in my affected side I wasn't swinging my arm much.
I am sorry about the length of that of that but please don't feel disheartened if you are not finding eh magical cure advertised so much on those ghastly American running forums ( which I swear all the online physio websites take all their info from). Please try some hill sprints, keep up the strengthening, see a physio and keep feeling positive because this will pass and you will be back stronger than ever.
Thanks
