Iliotibial Band Syndrome (ITBS)

liotibial Band Syndrome (ITBS) is one of the most common overuse injuries among runners — and it is an injury that I have been suffering from ever since running my last half marathon.

ITBS happens when the ilotibial band — the ligament that runs down the outside of your thigh from your hip to your shin — is tight and/or inflamed.  The IT band attaches to the knee and it helps stabilize and move the join.  When your IT band stops working properly, moving the knee becomes painful — and you have a lot of knee movement while running, which usually means you begin to have a painful running experience! Trust me, it is not fun!  If not treated properly, IT band pain can be bad enough to completely sideline a runner for days, weeks, or even longer.  (Talk about bad timing as I am currently training for a full marathon on December 1st.)

ITB

How do you identify the symptoms of ITBS?

The most noticeable symptom of ITBS is typically the swelling and sharp pain on the outside of the knee, which as a result many runners will mistakenly think they have knee injury.  The best way to test if you have ITBS is to bend your knee at a 45-degree angle and if you have an IT band problem you will feel the pain on the outside portion of your knee.

What type of injury is ITBS?

Technically, IT band syndrome is an overuse injury; however, this is kind of a misleading classification since there are usually other factors that contribute towards the injury — but approaching IT band syndrome as an overuse injury is an important step towards recover.

After icing the side of your knee and resting (yes, that means not running!) for a few days, you may need to change up your training regime.  Sometimes this can be as easy as avoiding repetition — try changing your running route or getting away from the treadmill or track for a jog outside. If you normally run outside try going indoors and running on the treadmill for a while.  If getting in shape or building up your endurance is your goal, try some cross-training while you slowly ramp up your mileage.

What are the common causes or ITBS?

IT band syndrome can result from any activity that causes the leg to turn inward repeatedly.  This can include wearing worn-out shoes (or the wrong type of shoes), running downhill or on banked surfaces, running to many track workouts in the same direction, or simply running too many miles.  Unlike other runners injuries — the IT band pain that runners experience will affect seasoned runners almost as much as it affects beginning runners.  IT band syndrome is also more common in women than it is in men — possibly because some women’s hips tilt in a way that causes their knees to turn inwards.

How do I treat ITBS?

Even though we runners try hard to avoid injury — they happen.  It is a fact of life as a runner! (Bummer, I know!)  Once you notice you are experiencing IT band pain the best way to get rid of the pain for good is to rest immediately — something that runners (both seasoned and beginners) rarely like to hear.  That means you need to run fewer miles or if the pain is bad enough — no running at all.  (I took almost three weeks off from running after my last half marathon, and when I began running earlier this week I am still experiencing IT band pain after going over 3 miles.)  I know how hard it can be to take it easy when trying to train for an upcoming race!  I have a 10k in two weeks and I am debating whether or not I should race or pull myself.  If you do not give yourself a break from running and let your IT band repair — ITBS can become chronic.

I am sure hearing that you need to rest or back off your mileage is causing you to worry.  I know it worries me!  But that does not mean that you have to be inactive.  While you are backing off your running mileage you can cross-train.  Try swimming, pool running, cycling and rowing.  Stay away from the stair-climbers at the gym because those are too much like running. (Repeated knee movement!)

Stretches focused on working the IT band will also help — as will treating the side of the knee with ice and/or a heating pad.

If your IT band problem does not getting better after several weeks you should seek help from a sports medicine professional.

Prevention is always the best medicine!! 

I am a firm believer that prevention is always the best medicine.  As a runner we are constantly trying to do everything we can to prevent as many injuries as possible.
Here are some steps you can take to try and prevent IT band syndrome:
  • The most important thing you can do – If you begin to feel any pain on the outside portion of your knee(s) is immediately decrease your mileage or take a few days off.
  • Walk at least a 1/4 of a mile to ensure you have a good warm-up in before you start your runs.
  • Make sure you are wearing the proper shoes and ensure that your shoes are not worn out along the outside of the sole.  If either of these of happening, replace your shoes immediately!
  • Try to run in the middle of the road where it is flat.  To do this safely you will need to find roads with little to no traffic on them and roads that have excellent visibility.  Sidewalks are often tilted or uneven so try to avoid sidewalks unless necessary.
  • Avoid running on concrete or hard surfaces.
  • If you are running on a track — make sure you are changing directions constantly!!
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Had a Bad Race Experience: Now What?

Last weekend I ran the Duo at the Ledges Half Marathon — and it was literally the worst race I have ever ran.  For three years now I have been talking to other runners, along with reading lots of online blogs, forums, articles, etc and everyone who has been running for a while will tell you that eventually you will have that a bad race.

For three years I never believed then. “What do you mean have a bad race?” I thought.  I love race day!  Waking up early, getting to the starting line and  the rush and thrill of running with hundreds of other runners — is just amazing.  I have always been able to run a 10 mile race better than I could do a 6 mile training run.

Although I had experienced bad training runs — which I have talked about before (Having a Bad Run) — I have never had a bad race…. Until this past weekend!  The evening before the race I ate a great pre-race meal, I slept well, woke up excited and ready to run, and felt great when the race started.  So what exactly happened?  What exactly went wrong?

Looking back throughout the race I am not exactly sure what happened or where things went wrong.  The only thing I did differently this race was at the 2 mile marker I drank the water at the water station a little faster than I normally do.  All I know is from mile 2.5 through mile 8 I felt like I was dying.  My stomach felt like someone was in there playing twisties with it while a professional boxer punched away. I was miserable! 

Why Do You Have a Bad Race?

There are hundreds of reasons to answer this question!  Maybe the weather was bad, you were injured or sick, you did not train enough for the race, you did not eat properly to fuel your body, you mentally are exhausted — I could continue to list ideas forever.  If you would like to try and pinpoint why you had a bad race ask yourself some of these questions:

  • Did I really train myself properly?
  • Did I do anything different during the race than I normally do?
  • Did I wear clothes, socks or shoes that I have never wore before while training?
  • Did I supplement with something during the race that I have never tried while training before?
  • Did I eat enough food/fuel for breakfast on race morning and/or for dinner the night before?
  • Did I eat the right type of food/fuel for breakfast on race morning and/or for dinner the night before?
  • Was the weather drastically different than you were used to running in?
  • Were you mentally prepared for the race?
  • Are you injured or does your body feel tired at all?
  • Did you start the race too fast and burn yourself out to soon?

What Should You Do When You Have a Bad Race?

If you have not yet experienced a bad race, count yourself luck — but prepare yourself because if you continue to run one day it will happen to you!  If the race is more mentally challenging than it is physically challenging that you should push yourself through the race to the finish line.  If there is something that happens to you physically throughout the race and continuing on would cause yourself major injury — do the right thing and pull yourself from the race taking a DNF (did not finish).  I can tell you from experience that causing yourself injury to finish is race is just not worth it!  

What Happens Once You DNF or Finish a Bad Race?

Running is a mental sport as much, if not a little bit more, than it is a physical sport! Getting past the self-doubt that a bad race or a DNF can leave you with is difficult.  The first thing you need to do is ask yourself the questions above and try to figure out the reason you had a bad race/DNF.  If the reason is something beyond your control — such as weather or sickness — you cannot let yourself dwell on the bad race.  If the answer is that you did something different or turns out to be something you can control that’s easy — just adjust your preparation and plans for future races and make sure you avoid making the same mistakes in the future! 

Here are 5 tips for helping you get past a bad race experience or having a DNF:

1. IMMEDIATELY AFTER: WALLOW (A LITTLE) — More than likely have spent weeks and months training for your race and not getting the results you expected — and have been training for — can be very disappointing and upsetting.  Expressing your frustrations is natural and should be part of your recovery process.  Cry, mope, blog, vent — do what you need to do for the next or two to help you emotionally get back on track. 

2. THE NEXT MORNING: FIND YOURSELF A POSITIVE — Were you able to push yourself through to the finish regardless of how horrible the race was?  Did you save yourself from having an injury which would have sidelined you for days, weeks or possibly even months?  Although my race this past Saturday was the worst race I have ever ran — I realized that the saying I love so dearly “Pain Is Temporary, Quitting Lasts Forever” is something I can live through!  Now, when I am having a bad race I can think back to that race and I know I will be able to push myself through to the end.

3. A WEEK LATER: ANALYZE WHAT HAPPENED — A week later your emotions will have settled down and you can begin to look at your training plan, diet, race day strategy and the race to see if there is anything you can improve and do better for next time.  Just remember — each and every race is different.  Even if you are running the same race each year, each year your experience will be different!  A race is like a puzzle and to know what went wrong you have to look for clues to help you solve the puzzle.  The questions listed above (and others) should help you solve the puzzle. 

4. A FEW WEEKS LATER: SET YOURSELF A NEW GOAL OR TWO —  Every runner has — or eventually will have — a bad race. (Trust me!) Even professional runners have bad races! Use your disappointment to to fuel you towards your next success.  When setting your next race goal, make sure you make it a manageable goal!  If you struggled to get your training miles in for your last half marathon (or other race), you might want to set a goal to do better training — or set a goal to do better at a shorter distance first. Remember — small victories will help you rebuild your confidence after a disappointing experience! 

5. BEFORE YOU NEXT RACE: MANAGE YOUR EXPECTATIONS — You should start every race knowing full well that when running, there is a chance that something can (and eventually) will not go right — or as according to your plan!  Before the race starts make sure you remind yourself that your performance — good or bad — will not nor does not define who you are!  Running is part of a healthy lifestyle — it can make you feel stronger, happier and is a huge stress reliever.  You are out there doing something that a majority of people couldn’t! Those benefits should outshine any poor race performance you may experience.

Just remember — having a bad race happens to everyone — and how you can push yourself past this experience is what will make you a better and stronger runner! 

Duo at the Ledges

Race Name: Duo at the Ledges
Distance/Type: Half Marathon
Race Location: Grand Ledge, MI
Race Date: July 6, 2013

Finish Time: 2:28:52
Finish Place (Age Division & Overall): 16/16 & 182/206

Mark’s Finish Time: 2:20:30
Mark’s Finish Place (Age Division & Overall): 12/13 & 165/206

This was our first time running in the Duo of the Ledges Half Marathon.  Unlike most races we enter now-a-days, which have to have an awesome tech shirt and medals — we picked this race based solely on it’s location.  As you fellow runners know, racing is not a cheap sport by any means.  Sure it is free to head out each day on the sidewalks and open roads for your practice runs; however, once you start figuring in the cost of running shoes, clothes, race entry fees and travel expenses it can add up quickly.  Specially when both you and your better half run, which means most of the expenses are doubled. 

Since we needed a half marathon to fit into our training and this was the closest half marathon — this is the one we picked. 

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Our race bibs and the tech shirt we got with our race entries.

Mark and I headed over to Playmakers in Okemos on Friday to pick-up everyone’s packets.  (As always, Playmakers does an amazing job with their packet pick-up process.)  That evening Mark and I tried to spend the relaxing and headed to bed around 9:45 pm, knowing that we were going to have a super early morning.  

On Saturday we woke up to our alarm going off at 4:15 am — UGH, yes, that’s right — 4:15 am!!!  We got ready, had some breakfast and headed out the door towards Grand Ledge, which is about 30 minutes away from Mason.  When we arrived at Grand Ledge High School it was still pretty dark and none of the parking lot lights were on (bummer).  It was a little bit of a cluster trying to get my running shoes on, our bibs pinned, and our race belt all ready to go in the dark but we managed.  Mom and Dad met us right there at the high school and also finished getting ready. 

After we were all set we took off towards the starting line to find the restrooms and gear check our one bag we were all sharing. (Yes, a race with 200 people had a gear check and it was awesome!) The line for the bathrooms wasn’t very long so I decided to wait and make sure I was going to start the race with an empty bladder.  After all four of us hit the bathrooms and checked our bag we began to stretch and get ready for the start. 

Mark and I before the race.

Mark and I before the race.

Mark, myself, Mom and Dad before the start of the race.

Mark, myself, Mom and Dad before the start of the race.

The race started out on one of the side street in downtown Grand Ledge and was just a “gun” start.  For being a half marathon this is one of the smallest races I have ever ran in — including all the 5k’s I have done.  With only 206 runners it was a pretty small field and even with a gun start everyone was able to make it across the “starting line” within 10-15 seconds of the “ready, set go!” we got! 

The pack took off from the starting line and 200 yards in I had to remind Mark that we needed to set our own pace and not run with the pack.  I could feel that we were running a tad faster than our goal pace and knowing we had 13 miles left ahead of us I knew we needed to slow down or we would be in trouble towards the end of the race. 

Miles 1 and 2 went great. We ran a 10:10 and a 9:45 mile (respectively) and then came the first water station a little bit past the 2 mile marker. For the first time ever that I remember I broke one of the cardinal rules of drinking water while running. Instead of slowing sipping, I downed the entire small dixie cup of water in one big gulp.  I am not sure if that was the cause of my issues for the next 5 miles or if it were something else, but the next 5 miles were the wort 5 miles of my life!

Mark and I at mile 2.

Mark and I at mile 2.

I literally felt like I was dying as I ran miles 2-8.  It felt like my stomach was being twisted over and over again, while a boxer was constantly slugging away it at the same time.  I was able to push through the pain for miles 2 through 5; however, around mile 6 it really started to take a toll on me.

Around 6.5 miles I asked Mark for my package of Chomps and forced myself to down at least 3/4 of them along with a few small sips of water. Within minutes I felt like that had been a horrible decision and my stomach pain got worse.  After we hit the 7 mile marker I could no longer physically run. It hurt — and I mean — it hurt!  I finally looked at Mark, asked him for the cell phone from the race belt in case I needed to call for help and told him to go ahead without me.  As much as I love running our races together — I felt horrible about holding him back that badly and knew I wanted him to finish better than I would. My loving husband gave me this look like I was crazy for wanting him to leave me in that condition, but I promised I would be okay and told him again to go.  He gave me a quick kiss, told me he would see me at the finish line and took off running.

I pushed myself through mile 7 which felt like death.  At this point I had been pasted by three younger runners, a very elderly gentlemen who was doing a run-walk, and a very elderly lady also doing a run-walk.  Finally I decided that the next time I saw a race worker I was going to ask if they could get me a ride back to the starting line and I was going to take my first DNF (Did Not Finish) ever. It was a relieving feeling knowing that I was making the right decision to pull myself from the race as I knew something was not right.  At this point I had been pasted by three younger runners, a very elderly gentlemen who was doing a run-walk, and a very elderly lady also doing a run-walk. 

Then came mile 8. As I passed the 8 mile marker my stomach pain suddenly started to subside quickly.  I decided to try my hand at running to see if the pain came back and took off in a slow jog.  Not only did the pain not come back it continued to quickly subside. The relief felt amazing and I was able to seriously pick-up my pace.  Over the next two miles I passed every single person who had passed me while I walked, plus a few more.  I ran miles 8 through 11 with an average pace of 10:05 miles! Heck yes!!!!!!  Miles 12 through 13 I ran a little slower because I began to have massive pain in my right knee.  At that point I was not going to let anything stand between me and the finish — anything!!!! 

I rounded the corner downtown Grand Ledge and saw the finish line in sight.  I could hear the theme song to “Rocky” booming from the announcers booth, which just happens to be one of my favorite running songs of all times and I took off as quickly as my legs would take me towards the finish line.  Hearing my name and hometown called as I ran down the finisher’s shoot was one of the greatest sounds I could hear!  I crossed the finished line and within 5 feet gave my Mom a high-five and a hug as her and my Dad were standing right there waiting for me to finish. 

Finish_Meghan

Meghan at the finish line!

A volunteer handed me my finisher’s medal along with two bottles of water and I began to look around for Mark.  Unfortunately, Mark did not get to see me finish.  He finished 8 minutes before me and had headed into the building for some food and water thinking he had about an hour before I would cross the finish line.  Little did he know just how tough his wife really was and how hard she could physically push herself! The instant I saw him, we gave each other a massive hug and he told me how proud he was of me!  I think I was more proud of him though, as that was his very first half marathon. 

Mark at the finish line!

Mark at the finish line!

Mark, myself, Dad and Mom after we all finished!

Mark, myself, Dad and Mom after we all finished!

This, by far, was the most physically and mentally challenging race I have ran to date.  I am incredibly proud of myself for pushing myself to the finish line.  I have heard plenty of runners talk about how one day you will have a bad race.  For me, it took 3 years to experience a bad race but it finally happened.  I am just happy that I had enough strengthen to push myself through it.  (Which brings up the fact that my next article I have decided to write about having a “bad race” and what you can do to help you push through to the end, along with when is the right time to call it quits!)

The race volunteers this morning were all amazing.  All 100+ of them!  The race organizers had more than enough water and food pre-race and post-race for all the runners.  For a half marathon the medals were lacking compared to most other races, but overall it was a good race and I am glad we ran it.  It is not a race that we will make sure is on next year’s list of “must run races”; however, in the future if we are ever looking for another close (and cheap) half marathon this is one we would do again!