Tuesday 21 February 2012

Dealing with Iliotibial Band Syndrome (ITBS)

Barefoot running.

I’m not going to sell this to you, but if you’re interested in it you should begin with Daniel E. Lieberman’s research into the comparison of foot strikes in running. Although the research states that it does not advocate shod running over barefoot, it does state “most forefoot and some midfoot strikes (shod or barefoot) do not generate the sudden, large impact transients that occur when you heel strike (shod or barefoot)”. Considering that I suspected that the impact was the root cause of my ITBS, this was music to my ears.

However, going straight to running with no shoes in an urban environment is asking for trouble, so I’ve been starting slowly using a pair of Vibram five fingers. It is the closet thing you can get to running barefoot with shoes on. It is a completely different running experience. It is not as easy as changing your shoes and off you go – running barefoot requires the correct technique. Here’s one of the many videos I’ve been absorbing over the last month.

I’m not saying that simply running barefoot has solved my problem, but I do think that developing a proper technique that excluded heal striking has significantly contributed to being able to run again. Call me a convert, but it’s not all down to running barefoot …

Squat Cleans

I don’t just run, I also lift weights and although I’m not about to compete for my country any time soon, it’s something that aim to constantly excel at. I suspect that my hip flexors were contributing to my ITBS so as part of my recovery I’ve been really focusing on squat cleans for a 45 minute session once per week because they really hit the hip flexors when you go deep and they’re much more fun that a back squat (though you still have to do your squats).

Here’s a short video of me knocking out a 90kg clean –

My workout looks like this. I’m yet to hit 100kg in this lift, but it’s included because I aim for it every week.

  Load Reps
Squat Cleans
70kg 6
75kg 5
80kg 4
85kg 3
90kg 2
95kg 1
100kg 1
Front Squats (Cleaned)
95kg 1
90kg 2
85kg 3
80kg 4
75kg 5
70kg 6

If you don’t have access to a proper olympic weights set, then don’t fret - bodyweight squats done correctly and going as low ( “ass to grass - ATG as“ as some Americans would say) as possible may give you the same results. I just happen to love lifting weights.

Yoga, stretches & foam rolling.

As mentioned above my ITBS (I suspect) was coming from my hip flexors. I’ve never been particularly flexible. Round about the time I developed the ITBS I noticed that when I performed a deep body weight squat (aka the “third world squat”) I had a twisting sensation deep inside my hips. At first I thought this was unrelated, but then I began to unearth more and more anecdotal accounts of how a yoga based stretch routine combined with foam rolling with had helped many people overcome ITBS.

I’ve been doing a half hour routine combining yoga, stretching and rolling 6 days per week now for a month. The difference is outstanding and the weird twisting sensation in my hip flexors has vanished.

The routine I’ve developed is as follows. Each movement lasts for ten slow inhales and exhales, which is about one minute.

ITBS all gone?

Almost, if I push myself too far it does rear it’s head, but when it does, the pain is no where near as intense as it was. This is a remarkable achievement for me because I thought I was done with running. I’m taking it really slowly and only increasing my distances by 10% each week and at this rate I’ll be back up to half marathons well in time for tough mudder.

I’ve been performing the stretches and barefoot running for little over a month, but they have both done more for my recovery from ITBS that anything I’ve tried. If you’re looking to do the same then give it a try, however I’m not a medical professional and it’s up to you to do your research and listen to your body.

Bonus: Even when the ITBS all clears up, I’ll still be sticking with the yoga and stretches – I’ve been looking for an excuse to get into yoga.

Double bonus: I’ve also came out of this running barefoot and although I have to run the streets in my vibrams, I can run fully barefoot on the beach. I can tell you first hand that there is no sensation like it. You should definitely try it.

Update 3rd March 2012 : I’ve just ran my first 10K in six months - pain free