Iliotibial band or IT Band Syndrome

A few runners with the Norfolk County Pacers have been complaining of iliotibial band or IT Band Syndrome. I had heard of it but fortunately had not experienced it recently so was not able to discuss it intelligently. I did commit to doing some research and I will summarize the results of that research here.

Caveat: Now, I am not medically trained but having run for 30 plus years I do know something about how my body works. Having read the research, I realize that I did have IT Band syndrome some time ago. How I treated it then turns out to have been proper.

Of course, if the pain persists, it may be best to get real medical advice.

What is IT Band Syndrome?
Pain and inflammation on the outside of the knee, where the iliotibial band (a muscle on the outside of the thigh) becomes tendinous, and results in a friction syndrome by rubbing against the femur (thigh bone) as it runs alongside the knee joint. (1)

What causes IT Band?
IT Band syndrome can result from any activity that causes the leg to turn inward repeatedly. This can include wearing worn-out shoes, running downhill or on banked surfaces, running too many track workouts in the same direction, or simply running too many miles. Unlike many overuse injuries, however, IT Band pain afflicts seasoned runners almost as much as beginners. (2)

Self-treatment:
First and foremost rest. Not what a runner wants to hear, but this is true and rest is required.

Second, ice. Need to reduce the swelling. Get comfortable. Put the ice pack on and catch up on some back issues of your favorite running magazine or that novel you have been meaning to get to, or maybe that other book someone mentioned at work.

Third, "oral nonsteroidal anti-inflammatory medication" or in our normal English this would be translated as ibuprofen or another generic equivalent.

After a period of rest you can resume running. The length of the rest period depends upon your injury and how quickly you stopped. If you stopped running right away, then the rest period can be shorter than if you continued running, trying to gut it out.

You need to be careful when resuming your running routine. Start by walking. Gradually build up your walking mileage. If you experience no pain, then you can progress to light running. Run lightly on soft surfaces. Grass or asphalt but not concrete. Avoid running on one side of the road all the time. The camber of the road itself may contribute to the injury.

Stretch before and after walking (at first) and then your running. The intent is to strengthen the muscles in the legs and hips to reduce the strain on the IT Band itself.

Stretching exercises:
The best I found with simple instructions and photos of the stretches is from Running Times

On-going Treatment:

1. Most importantly, always decrease your mileage or take a few days off if you feel pain on the outside of your knee.
2. Walk a quarter- to half-mile before you start your runs.
3. Make sure your shoes aren't worn along the outside of the sole. If they are, replace them.
4. Run in the middle of the road where it's flat. (To do this safely, you'll need to find roads with little or no traffic and excellent visibility.) (Or run on one side part way, then switch to run on the other side to balance the time and effort on your legs.)
5. Don't run on concrete surfaces.
6. When running on a track, change directions repeatedly.
7. Avoid doing any type of squats.
8. Schedule an evaluation by a podiatrist to see if you need orthotics.

Additional sources of information on IT Band:

• A good web site put together by a runner who suffered with IT Band.
• Another good site, more professionally done.
• Physician and Sports Medicine site.
• One simple page, good photos of the anatomy involved.
• Another good sports medicine site.
• The Sports Injury Clinic site.

Release therapy

Rich posts on iPod Therapy at "Hello_World"

This sounds good.
I wish I had an iPod.

Which got me thinking (always a dangerous thing)

You do find this release in other ways.

The release concept itself is what is important.

So, fill in the blanks!

1 - Wait until dark
2 - Get your ........
3 - Head somewhere quiet (take a quick peek for neighbours)
4 - Select your ...........
5 - Turn it up
6 - Close your eyes
7 - Breathe deeply
8 - Go crazy!

How would you fill in the blanks?

As a runner, I would (and frequently have to)

1 - Wait until dark

2 - Put my yellow tights on (and other highly luminous running clothes)

3 - Pick a good route

4 - Head out the door

5 - After a good warm-up (at least a mile or so)

6 - Turn up the pace

7 - Imagine a good race

8 - Have a great finish with the crowd roaring in delight

Warm down, return home, update the milage log

Relax, enjoy the post run feeling, prepare for the next day

What do you do for your release?

Planning to succeed at running

So you are running now and may be thinking about doing a race.

1 - Planning is the first step in that direction. "Plan to succeed, or, you have planned to fail!" (Donnie Hall) The plan can be simple or elaborate. As simple as setting out how many days (or miles, or time) you will run per week before the race. Or elaborate: detailing the workout, the course, or time of day. Several books and magazines have published standard plans you can use for the typical distances: 5K, 10K, Marathon. The plans are available to cover a variety of runners from beginner to elite.

For me, the best two sources on the web can be found at:
Cool Running
or
Runner's World

If you need advice on putting the plan together, there are also sources for this. From runner training forums to personal coaches, to local running clubs, help is available. You do not need to do it alone.

2 - Now that you have your plan, you need to execute your plan and keep track of your progress. You should keep a log. There are plenty of formats for this log. I keep a simple written copy in a small notebook. It records the date, the course, the time, the weather and overall how I felt on that run. Sometimes I add more. Sometimes I am short and brief. I also keep an Excel spreadsheet with the daily mileage. Excel allows me to do some easy totals by week/month/year, and then build some charts on the data. Good positive reinforcement for the miles or time put in and progress made.

By creating this permanent record of your running, the log is a good place to look back and see what worked, and just as importantly, to see what does not. As I got older, the desire to run 5-6 days a week like I did in my twenty’s and thirty’s was still there. The log told me the body could not handle it. Now I have been much more successful running 4 days per week. My hard/easy pattern is maintained. I run a good 4-6 miles on the hard days, and 0 on the easy days.

3 – Tune the engine in your body. Abraham Maslow’s Hierarchy of Needs comes into play here. You need to take care of the basics especially as you start executing to the plan. The basics like sufficient sleep and nourishment. Your body will be starting to work harder than before. It is an engine and while you are tuning on the road or track for your race, you also need to take care of it in the shop. If you normally got 7 hours of sleep, you may need 8, or get by with a brief cat nap now and then. As your workouts increase, so will your appetite. Do not overeat. But be sure to include all the food groups and sufficient calories to continue to maintain your health. For guidance in this area one good person to turn to is Liz Applegate Ph. D, the nutritionist for Runner’s World. She has a regular column in the magazine and also has this article on the Runner’s World site.

4 – Positive feedback and encouragement will help you keep to the plan and be successful. Some of the feedback you can obtain from the log and the charts (assuming you go that route). If not, then the friends, family, and co-workers aware of your plan can be sources of this encouragement. (If they are not aware, let them know.) If you a member of Team-In-Training or a local running club, they can be great sources of positive reinforcement.

This is also the role for your coach to play. S/He should be able to coax you to a new level of effort at the same time as providing the right word at the right time to keep the positive energy flowing. It is important to have a good relationship with your coach. While one word at the right time is a great help, one word at the wrong time can be a problem. If the coach is not providing the proper constructive and positive reinforcement, then it is time to consider a new one.

By following these 4 steps (plan, execute, tune, positive feedback or PETS) your plan should get to you race day prepared to be successful.

If you have something else that you would add to this approach, I would be interested in hearing from you.

I will talk about the race day preparations at another time.

In the meantime, enjoy the run!

This was originally posted on December 6, 2004.

Cold Morning Run - Advice to make it a good one

The Norfolk County Pacers is the running group I have joined. Founded earlier this year (2004) by Scott and Kim Knous, it currently counts about 60 members from the area in and around Franklin. The hardy among us came out to do our thing on the roads this morning for the Sunday Fun Run. The outside temperature was 18 degrees Fahrenheit when I left for the middle school parking lot where we gather. I had volunteered for the coffee and refreshments for the post run social period, so I stopped at the local Dunkin Donuts on the way.

The high school parking lot was a sheet of reflections broken here and there with crusted snow. I gingerly made my way across. Running on ice is okay if you keep your strides short and ensure that your center of gravity stays level over your feet. Arms should be loose anyway, but especially at this time, so they can be extended quickly, if necessary to help keep your balance. I did a loop around the high school and made my way back to the middle school to see if the 3 mile group was going to be more than just me.

There was a light breeze and lots of sun, no clouds in the sky this cold morning. I had layered properly and was nice and warm. Of course, the body provides plenty of heat when moving so the key to the layering is to keep the sweat off you and keep the heat within.

For the upper body:
The bottom layer should be something along the new material line that wicks the sweat away. I like this layer in a long sleeve with an extended cuff that also provides a thumb hole. This gives a complete seal to the layer. A short sleeve cotton t-shirt goes over this and all this is topped with a good wind breaker. I currently have a luminous yellow top that was on sale at the local Saucony outlet store. The only draw back is that it has no pockets. I get around that by either tying my key into my shoe laces, or recently have been pinning it into the inside of my jacket zipper binding. For this short run, I don't carry any ID or money. For a longer run, I have a small running wallet with some changes, a couple of dollar bills, and some ID. For safety sake, and my wife's peace of mind mostly.

For the lower half:
I wear some close fitting leggings, dark blue today to run in the daylight. For the dark, I have a couple of pairs of yellow tights. I admit, I must look like a character but in the dark it is better to be seen than look good. Over the leggings a pair of exercise shorts. For the under 30 degree days, a regular pair of jockey briefs goes underneath. As it gets warmer, this layer is less required. Over 40, I usually only need a pair of lined nylon running briefs. If the temp dropped below 10, and or the wind chill was more of a factor, I could also add another bottom layer. Beyond that, you try to schedule your run for a better day. Discretion is the better part of value.

For the feet:
A good pair of socks is a must. I am currently rotating amongst a trio of "Run Across America" socks (item RRS-894) from Road Runner Sports. They are CoolMAX with a nice cushion and advertised to last for 3000 miles. While I have not gone that many miles in them, they indeed have stood up better to the running better than any other socks I have worn. They come in the full crew (mine) or the shorter ankle form. I do have some woolen liner socks that I wear as my bottom layer when I am wearing hiking boots. The wool ones are good if I know it is one of those days that I won't be able to avoid getting my feet wet. The wool handles water better than cotton.

For the hands:
I feel in love with some glittens several years ago and they have been very serviceable. It is only now getting to the point that I am considering upgrading the ones I have. The polypropylene material is good for most temperatures. They can be used as a glove, roll the mitten cover over the fingers and obtain the additional warmth. On the days when your hands are cold to start with, but then you warm up enough so you don't need them, you can take them off, roll them up and carry them in your hands. If you don't like things in your hands, they can tuck nicely into a pocket or into your waist band. (Updated: I had found a link to purchase some glittens but it is no longer available. The only ones I find are knitted.)

For the head:
The head is actually the most important part of the body to protect in the cold. Numerous studies have shown how much heat is given off through the head. In the 50 - 30 degree range, I'll use a nylon stretch head band from Saucony that my daughters gave me for Christmas. Below 30, I go with a good knit cap.

Post run:
Get out of your wet stuff as soon as possible. Yes, when it is cold, this can be a challenge. You will attract some attention with your steaming upper body exposed. I focus on the upper body layer as that tends to generate the most sweat. Getting some dry clothes on and letting the body cool down gradually is a good thing. Keep moving, gently shifting the weight from leg to leg, especially when socializing in the cold over coffee and bagels, will leave you feeling better as the day goes along.

Well, no others arrived for the 3 mile so I headed out. About a half mile away, I found a threesome coming back in from their six mile run. I turned around and headed back with them. I opened the car to make the coffee and refreshments available, then took off to do another loop to complete my own run.

This completed a good week of running, 17 miles over 4 days. It felt good to be "back" to this level of fitness. Now, I need to keep it here, no sliding back. I can build on this to continue the gradual increase in fitness and strength.

Originally posted on November 14, 2004.

Running in the dark, safety steps

Daylight savings has left us, we are heading towards the winter solstice. Only five weeks away from the shortest day of the year and then two-three minutes of light get added to our life per day, culminating in spring. Winter does not have to be dull and dreary. There is so much to hope for. We need to recognize that it comes and goes in those daily two-three minute increments.

So with this hope, and the energy to run, much of it will be in the dark over the next couple of months. Here are the rules I run by during this period.

1 - Never run a route in the dark that you have not run at least a couple of times in the daylight. You should be familiar with the route, and not just the turns, but the surface you are running. I have mostly run in a built up area whether city or town. The sidewalks can be a challenge. The road side gutter can be a challenge. Knowing where the sewer covers are, the pot holes, the low spots will help when you try to navigate the route in the dark.

2 - Avoid the blackest black. Darkness is really the absence of light. When running in the dark, there can be sources of light from houses, store signs, street lights, moving vehicles. But where there is no light, there is dark. And the less light, the darker it is. Where two shadows cross, it is darker. In that dark, you might find the black hole. This hole could easily cause a stumble or twisted ankle, etc.

3 - Avoid all puddles, especially in the rain. Water is a wonderful thing, the substance of life, but in the dark, it shows one of its other powers. It fills holes. When it fills the hole, the surface is smooth, shiny and reflective. But seriously deceptive because you can not tell how deep it is from the surface. It may be shallow. It may be deep. You won't be able to tell running along in the dark. Avoid it.

4 - Wear reflective clothing. It is important to be seen by any of the moving vehicles that will share the road with you during the run. Your senses will be sharper so you'll see their headlights, and hear their motor or tires as they approach. But is is equally important that they see you. Do not be afraid to be over visible. It is better to be a luminous object and run again.

5 - Run with the traffic, not against it. This may cause some discussion but I have found it so much safer to run with the traffic than against it. I don't get blinded by their headlights. Their lights are behind me and help show me the way. Just as important, the lights can allow me to pick out what my options would be the closer they come to me. Blinded, you have little choice but to stop, pull over until you can see again. The one serious fall I took was the last time I was running against the traffic. I had followed all my rules, I was familiar with the course having run it frequently during daylight hours. I was coming over a little crest and the approaching vehicle flipped on their high beams to get a better view of me. The high beams blinded me. I slowed and remembering the sidewalk was just over there stepped into the wheelchair curb cut to get out of the way. Unfortunately, right in the middle of the curb cut was the galvanized steel street sign. I hit it directly, nose first. Drawing some blood with a nice cut on the forehead and ending up in a heap at the foot of the pole wondering what had just happened. A lesson learned, never again have I run facing the traffic.

I hope this helps. If you have your own rules, I would be interested in hearing about them.


Originally posted on November 6, 2004.

Welcome

I have been blogging since September 2004 and some of the posts were my thoughts on running. To make it easier for runners to find these posts, I have created this blog to focus on running.

I have been running for over 30 years so I some experiences to share, some advice to offer. I'll post my running thoughts, advice on running, good information on running, favorite links, etc.

I coached at the high school level for 6 years and left high school coaching only because I switched jobs (from substitute teacher to call center operator). The "real" business world provides a better income for the family but does not have the same time allowances that the teaching schedule did. I have been unofficially coaching myself and others since then so I never really "left".

If you have any passion about the running you do, then we have something in common and you should like what you find here.

If you want to start running, this will be a place to get some good advice.

Effective blogging is a two-way conversation. I look forward to your feedback. Feel free to comment or send me an email.

May the roads be kind to you!