Long Distance Running Pain Management


ITBS (Iliotibial Band Syndrome) is one injury that is primary experienced by long-distance runners. It presents itself as sharp or burning pain on the outside of the knee. The pain usually stops when you stop running and resumes when you begin running again.

The iliotibial band is a long, flat band of fibrous tissue that originates on the ilium (upper portion of the lateral pelvis) and extends to the tibia, just below the knee joint. It serves as a tendon for two hip muscles, the tensor fasciae lata at the front of the upper thigh and the gluteus maximus of the buttock. It helps stabilize the knee joint when the foot lands on the ground. During this landing motion, the ITB rubs over the lower portion of the femur. If the rubbing is excessive or too forceful the soft tissues become inflamed. This is known as iliotibial band syndrome.

There can be a number of causes of ITBS: running on a sloped or banked surface, not warming up or cooling down properly, increasing miles too quickly, excessive running downhill, high or low arches of the foot, or overpronation.

This tendon needs no extra strengthening as it is used in every step we take. Stretching the muscular attachments is helpful.

Lie on your back with hands at your sides and your legs out straight. Rotate your right leg outward so that your toes are pointed to the right. Lift your right leg off the floor a few inches, and keeping the knee straight, cross it over the left leg, making sure to keep your toes pointed right. You should feel your groin muscles work to hold your right leg crossed over to the left, and a tightening on the outside of your right thigh. Hold and repeat 8-12 times for each leg. Be careful not to roll over onto your hip as your right leg crosses over the left. Lying on the floor will keep your pelvis stabilized while you use opposing muscles to apply the stretching force.

If you do develop ITBS, get medical advice that goes beyond rest and anti-inflammatory medications. Symptoms will continual to return if the cause is not addressed. If you know that you overpronate, get good motion control running shoes. Try to run on flat roads and do your hill runs during low mileage weeks when your legs are strong.