Runner's Knee & ITBS

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Hi All,

I've been having such a hard time with my knees. I started getting knee pain as I was training for my marathon back in June. I have been diagnosed with Runner's Knee as well as symptoms of ITBS. I've seen my doctor and been going to PT and maybe I'm just impatient, but I'm not improving and it's been 3 months.

In the past few months, I've taken running breaks ranging from 1-2 weeks off, and each time I run again, the knee pain comes back.

I do an array of hip/glute exercises (clams, leg lifts, wall sits, etc.), stretching and recently added in foam rolling. I'm taking the next 3 weeks off from running and signed up for cycling and barre classes in the mean time.

I guess I'm wondering if anyone has had success with treating these conditions, and if there is anything else I could be doing to help? Just feeling a little frustrated today.

Thanks!

Replies

  • MeanderingMammal
    MeanderingMammal Posts: 7,866 Member
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    I had a bout of ITBS at one stage. Took about a month off running for the symptoms to go away.

    In terms of cross training, I do a fair amount of cycling which seems to help a lot.
  • jasonsunlee
    jasonsunlee Posts: 48 Member
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    Unfortunately runner's knee is something that will always come back if you're training that hard. You should definitely try stretching for longer periods of time to help prevent these types of injuries. It will continue to worsen if you don't lay off it and allow your body time to heal. Ice down the sore areas and stay off of treadmills or trails for a while

    If you're concerned about losing your cardio endurance, I highly suggest you run on an elliptical machine. The alternative is a rowing machine if your local gym has one. The elliptical will keep your knee in place and prevent heal or toe strikes against harsh pavements / trails. The rowing will keep your cardio endurance up while preventing any further aggravation of your knee pains.

    You may also want to consider getting some knee compression gear to help lock your knee in place and prevent some of the wobbling and cronating that may be causing your knee pain.

    Lastly, I also had some acupuncture done (find a really good acupuncturist) to help with the healing process.

    Hope you feel better soon. Let us know how you're recovering!
  • BeeerRunner
    BeeerRunner Posts: 728 Member
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    Are you taking glucosamine supplements? It sounds like you are doing everything right. I had knee issues in the past, but glucosamine and focusing on my form did the trick for me. If I get occasional knee pain or swelling, I ice my knee. I also use one of those thin knee braces that just goes under the knee whenever I do long runs.
  • Somebody_Loved
    Somebody_Loved Posts: 498 Member
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    @MeanderingMammal - I'm hoping the cycling classes will keep me from going crazy while I'm taking the next few weeks off - glad to hear it's helped you! I wonder if I just didn't take enough time off previously.

    @jasonsunlee - Thanks for the feedback! I'll be doing cycling to help keep my fitness up - I tried the elliptical but it was causing my feet to go numb each time. I just got compression sleeves and am wearing them for the first time today. Not sure if it's psychological or not, but my knees don't seem to be as sore as they were a few days ago.

    @BeeerRunner - I haven't heard of those but I'll look into it. Thanks!
  • WickedPineapple
    WickedPineapple Posts: 701 Member
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    I would think your PT would know best. It sounds like you're already doing most of what you should. I had trouble with ITBS (note - not diagnosed by a doctor, but doctor google). I had pain with not just running, but walking too. This is what I did, which mostly overlaps with what you're doing.

    (1) No running. I had to take about a month off from running, step, hiking, and kept walking to a minimum. I did the elliptical for cardio during that time. Anytime I tried to run, it would be fine for a mile or so and then the pain would return. Usually it would set my recovery back (like I didn't have pain while walking for a day or two, then I'd run and would have pain the next few days from walking).

    (2) Strength training. Once I identified it was ITBS, I researched and found a variety of strength training exercises. I did ITBS specific strength training every other day (clam, side leg lift, pistol squat, single leg hip thrust, side shuffle, side hip bridge, and hip hike). I increased the reps and/or sets each week to keep it difficult.

    (3) ITBS stretching everyday. I still do this.

    (4) Foam rolling. I'm not convinced it really did anything.

    (5) New shoes. My running shoes were 1.5 years old at the time the ITBS started. This probably contributed to the problem.

    It took about a month of no running and three weeks of consistent strength training for the pain to go away.
  • LazSommer
    LazSommer Posts: 1,851 Member
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    Have you ever explored your hamstrings?
  • DoubleG2
    DoubleG2 Posts: 121 Member
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    ITBS is rough. I needed a solid three months off before I was able to run without pain. After some research into the causes, it appeared that I was over-striding - especially during tempo runs. What worked for me was completely changing my stride and foot mechanics. I changed to a much shorter stride (almost a shuffle) which gives me faster foot turnover. I also concentrate on making sure I am striking mid-foot. Both of these things have kept me relatively injury free for well over 5 years with the added benefit of increasing my speed relative to my effort. Without seeing your mechanics, it's impossible to determine the root cause of your ITBS, but you may want to take a hard look at your stride. Good luck and feel better soon.
  • Somebody_Loved
    Somebody_Loved Posts: 498 Member
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    @WickedPineapple - That's exactly what I'm going through. I take two weeks off, my knees feel great and then the pain comes back after a mile or two of running again. Sounds like maybe I haven't taken enough time off - I'll make it a full month before running again.

    @LazSommer - I haven't. Do you mean in terms of strength training or stretching (or both)?
  • Somebody_Loved
    Somebody_Loved Posts: 498 Member
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    @DoubleG2 - Thanks for the feedback. I have a PT appointment tomorrow morning and he wants to analyze my stride at that point. It'll be interesting to see what he has to say.
  • LazSommer
    LazSommer Posts: 1,851 Member
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    @WickedPineapple - That's exactly what I'm going through. I take two weeks off, my knees feel great and then the pain comes back after a mile or two of running again. Sounds like maybe I haven't taken enough time off - I'll make it a full month before running again.

    @LazSommer - I haven't. Do you mean in terms of strength training or stretching (or both)?

    Both - I started getting knee issues myself not long ago. I've always squatted and like to run but have struggled with deadlifts, so my quads are strong but my hamstrings need work. I noticed as soon as I incorporated Romanian deadlifts in to target my hamstrings I was feeling relief. If your quads are much stronger than your hamstrings the imbalance can mess with your knees.
  • Somebody_Loved
    Somebody_Loved Posts: 498 Member
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    @LazSommer - That makes sense - I'll look into adding some hamstring exercises. Thanks!
  • esjones12
    esjones12 Posts: 1,363 Member
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    Hi All,

    I've been having such a hard time with my knees. I started getting knee pain as I was training for my marathon back in June. I have been diagnosed with Runner's Knee as well as symptoms of ITBS. I've seen my doctor and been going to PT and maybe I'm just impatient, but I'm not improving and it's been 3 months.

    In the past few months, I've taken running breaks ranging from 1-2 weeks off, and each time I run again, the knee pain comes back.

    I do an array of hip/glute exercises (clams, leg lifts, wall sits, etc.), stretching and recently added in foam rolling. I'm taking the next 3 weeks off from running and signed up for cycling and barre classes in the mean time.

    I guess I'm wondering if anyone has had success with treating these conditions, and if there is anything else I could be doing to help? Just feeling a little frustrated today.

    Thanks!

    Both of these are very treatable, but I am guessing these are only the symptom of your problem. Which is why they keep coming back. Those exercises and the foam rolling will be very beneficial and required for recovery - but you have to fix the problem. Most likely your body is out of alignment and/or you have bad running form. I would highly suggest seeing a chiropractor for an evaluation (most will do this for free or a small charge and they should be able to tell you what is wrong before adjusting you). If you are still hesitant about a Chrio, see a DO. Someone who will look at the structure of your entire body. I would also recommend having a real running coach watch your running form.

    Side note about foam rolling - please research self myofascial release techniques. Most people I see foam rolling roll around like idiots not helping their bodies. It should be a solid 30 minute process that is nice and slow and rather uncomfortable as you work out those knots in your feet, calves, quads, hammies and hip flexors. Don't ever roll your ITB directly!
  • BrianSharpe
    BrianSharpe Posts: 9,249 Member
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    I missed about 8 weeks of running a number of years ago due to ITBS. I did all the self-help stuff - foam rolling, stretching etc etc etc to no avail. I then went to a registered massage therapist for deep tissue massage, it hurt like crazy but after a few sessions I was running again (like a PT she also went through a list of stretches to do and really emphasized the value of cross training....) I now see my massage therapist on a regular basis for a good beating.....check it out.
  • Somebody_Loved
    Somebody_Loved Posts: 498 Member
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    @esjones12 - Thanks for the feedback. I have an awesome Chiro who is also a runner but for some reason didn't think to go to him - I just scheduled an appointment! Thanks for the tip on foam rolling - I've looked at YouTube videos but still don't feel like I'm being all that effective.

    @BrianSharpe - Seems like the 2 week breaks weren't long enough. Hopefully taking a full month off will help. The Chiropractor I am going to see does Active Release Technique which I *think* does the same as deep tissue massage? I'll ask him about it - thanks!
  • BeeerRunner
    BeeerRunner Posts: 728 Member
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    @MeanderingMammal - I'm hoping the cycling classes will keep me from going crazy while I'm taking the next few weeks off - glad to hear it's helped you! I wonder if I just didn't take enough time off previously.

    @jasonsunlee - Thanks for the feedback! I'll be doing cycling to help keep my fitness up - I tried the elliptical but it was causing my feet to go numb each time. I just got compression sleeves and am wearing them for the first time today. Not sure if it's psychological or not, but my knees don't seem to be as sore as they were a few days ago.

    @BeeerRunner - I haven't heard of those but I'll look into it. Thanks!

    I would definitely look into Glucosamine for the knee pain. Glucosamine helps rebuild cartilage in your knees. I was diagnosed with arthritis in my left knee in my 30s before I even started running. (Probably do to years of ballet and ice skating as a kid and then getting kicked in that knee by a horse in my 20s.) I'm honestly surprised I can even run outdoors. I swear by it. If you Google glucosamine and runners knee, you'll find tons of articles about it. My dr talked about the supplement like it was a bunch of hooey, but when ibuprofen wasn't cutting it, I decided to try it and it worked.

    It won't help the ITBS, but should definitely help the runner's knee in 2 weeks.
  • Somebody_Loved
    Somebody_Loved Posts: 498 Member
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    I missed about 8 weeks of running a number of years ago due to ITBS. I did all the self-help stuff - foam rolling, stretching etc etc etc to no avail. I then went to a registered massage therapist for deep tissue massage, it hurt like crazy but after a few sessions I was running again (like a PT she also went through a list of stretches to do and really emphasized the value of cross training....) I now see my massage therapist on a regular basis for a good beating.....check it out.

    Just got back from the chiropractor and he went to work on my IT bands. He said they were extremely tight and that's why my knees were hurting - not from runner's knee. It was super painful but I already feel better. He said a couple more sessions with him plus foam rolling at home should have me back to pain-free running in no time!

    Thanks to everyone for the feedback, and @esjones12 for the chiropractor recommendation!
  • efleetwood
    efleetwood Posts: 4 Member
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    I'd also looking in to getting new shoes. Old shoes can cause issues. Good luck!
  • trailrunner81
    trailrunner81 Posts: 227 Member
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    I have had issues with my ITB and the only thing that I think has helped me is leg workouts, squats, leg lifts, etc, strengthening the hamstrings, quads, and calves has really been a life saver. Shoes also make a big difference. Best of luck to you!
  • Azdak
    Azdak Posts: 8,281 Member
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    If you don't stop running, the recovery will take much longer (not saying you have to stop, just need to be realistic). I worked with a 67 yr old female who wouldn't stop (she ran only 3mi/day) and it took a solid year to build her up and alleviate the pain.

    You are working hands on with professionals, not sure what specifics we can add on an online forum. You could look up "eccentric exercises for runners knee". That might be something you haven't tried. Just remember that this is trench warfare and progress will be very slow.