Running with IT Band Syndrome: A Step by Step Approach to Treatment

IT Band Syndrome (ITBS) is one of the most common injuries in runners, especially in those new to the sport. The Iliotibial Band is a thick tendon that runs from the outside of the outer hip bone all the way down to the outer knee. Repetitive motions, such as in running, can overuse this area and cause inflammation. Read on to learn what steps to take whether you are just experiencing new symptoms or have been dealing with them for a long time.

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Running 101 for Beginners and Race-Seekers

Looking to start running? Maybe you’re interested in getting into a more structured plan to set yourself up with new PRs? Either way, this article has you covered! Read on to learn about my top tips to start your running journey, which are also useful for those of you getting back into the sport after a break.

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My Journey to Fast Running

Fast race times are not just for the pros. Anybody can train to improve their speed as long as they put their heart and soul into running and find the right plan for themselves. Some runners do better running every day or with high mileage plans, while others do best with minimal miles and more rest days. For me, it took some trial and error and lots of research to get faster. I am questioned almost every day on how I cut my race times in such a short period of time. It did not happen overnight. I put in a good amount of work and a part of my passion is to share my story in hopes that my tips help so many of you!

Once Upon a Time, I Ran ONLY for Fun

First of all, my initial BIG improvements had much to do with the fact that I was not focused on getting faster AT ALL during the years I was racing before I decided to make this my goal. I’d been a runner since 4th grade, participating in cross country and track and field on and off until I graduated from high school. I kept running in college only because I hated the cardio machines at the gym, and running was just something I knew how to do that was outdoors. A friend of mine suggested signing up for a half marathon, which I thought was crazy at the time, but she promised me that one day running 13 miles was going to feel like what 3 miles felt like back then. She was right. I signed up for the 2009 Miami Half Marathon and was hooked, but not how I am hooked now. I did not pay attention to finish times or pacing or anything that has to do with improving at the sport. All I cared about was staying in shape and the excitement of the races once a year.

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This is how I treated running up until 2016, when I randomly put on the Olympic Marathon Trials after reading about it in a Runner’s World Magazine. This was about 2 weeks after finishing my first Miami Marathon in 3:53. All of a sudden I got the urge to get faster—I figured, I actually like to run, I’m not bad at it, and the training plans I read in the magazines all seemed doable to me. A few weeks later I raced the Miami Beach Half Marathon and got my best time, 1:44, which I attribute to the motivation and adrenaline from my new found passion. That same week I bought a Garmin watch, new shoes, and signed up for the Ft. Lauderdale Half Marathon in November. Within those 8 months I spent hours researching training plans, advice and every amount of information I could to implement into my new venture.

More Miles Works

I went from running at comfortable paces 3 days a week to running 5 days, which included my long run and a speed workout that I would switch up every week. I believe it was the gradual increase in mileage and added speed work that got me a 9 minute PR in the half in only 7 months time! I was nervous to run more than every other day thinking I would get injured, but from everything I researched (and my research only comes from scholarly written studies, as I was taught in school—haha), I learned that as long as you SLOWLY add in the miles, keep it easy for the majority, and continue strengthening exercises, it can most definitely improve race times. This 100% worked for me. I ran the rest of 2016 getting up to an average of 75 miles per week.

I had already been a physical therapist at this point for 5 years, so I was super strict about injury prevention, recovery, and paying attention to my body. I raced the Miami Marathon in January 2017 and finish in 3:22—a whopping 31-minute PR! Of course, like the rest of us, I wanted more. After more research I decided to attempt the daunting 100-mile week before my next full marathon, but I knew this was going to come with some sacrifice. More miles = more sleep/downtime, more eating, and more recovery sessions. My baseline training over the summer that year was around 60-65 miles per week and I gradually added in more once the fall came around to hit 100+ miles for 3 weeks before I tapered for the race in January 2018. I cut another 16 minutes off of my PR that race. My half marathon PR came 3 weeks after that one where I cut 8 minutes from 2017.

After falling for the comments on how I wouldn’t be able to keep this up on my own, I decided to try out a coach, who initially kept me at decent mileage (although still 75% of what I was doing when I was at my best), and then dropped the milage down to 40 miles per week by the end of 2018. This actually got me out of shape and my streak was over. Since starting back up on my own this year I have gone back to my previous training plan, with much more updates, and finally feel back to my old self with even BIGGER goals!

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2015: 35 miles per week —> 3:53 full / 1:44 half

2016: 75 miles per week —> 3:22 full/ 1:33 half

2017: 100 miles per week —> 3:06 full/ 1:25 half

2018: 70/40 miles per week —> 3:14 full / 1:33 half

2020: 90 miles per week —> 3:03 full / 1:24 half

Varied Speed Work

I spent the summers incorporating short speed sessions—200-800 meter repeats and Fartlek runs. During my actual marathon training, my speed sessions varied every week. I alternated between mile repeats, continuous 200m on/off 10ks, Yasso 800s, and progressive ladder workouts at the track. I rotated between these workouts every 4 weeks and was able to see improvements in each once a month when it was time to repeat them. Since 2018 I’ve learned all about the benefits of longer intervals for distance running (which intimidate me!), so that’s what I’ve been incorporating these days with amazing results. My best seasons are those where I’ve managed to stick to one track session of shorter intervals and one tempo run each week. The rest of my running is all EASY paced. Click here to see a few examples of my go-to speed sessions.

LOTS of Eating

It’s a good thing I love to eat, because marathon training allows me to eat twice as much as I used to! When I was training early on, I believed I could eat whatever I wanted. That is the most untrue statement for runners. First of all, we don’t burn as much as we think—in an hour-long run I burn around 350-400 calories. That’s probably just about a slice of pizza! Second of all—if you want to improve your performance, you must think of food as fuel, rather than pleasure…at least 90% of the time. Following a high-quality diet of the right amount of macros and calories will keep your body at a healthy weight, help you last longer during any run, and help prevent injury. In my opinion nutrition plays a bigger role in performance improvement than anything else. Once I started increasing my calories, especially carbs, I saw a massive spike in energy, better sleep, and more strength during speed sessions. Mid-run fueling switched from an intake of 200 calories (a pack of PowerBar chews) during an entire marathon, to over 1200 calories! This was a game changer for long runs and races—I am never exhausted afterwards like I used to be.

Quality Recovery

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Recovery has many different sides. It includes sleep, elevating the legs, use of compression, icing, stretching, massage, physical therapy, foam rolling, and full rest days. It sounds like it requires so much time, and it does, but without these components, you risk being able to run more, hit paces, and recover from workouts quickly. This is probably my weakest area. If I skip something one day, it’s usually not my runs, strength training, or eating. I used to skip stretching, go to sleep late, and sometimes walk around too much on my complete rest day. Now, I am slowly learning to prioritize recovery—going to bed earlier, using my Normatec compression boots, getting a massage every few weeks, and stretching after every run. Since being more strict about this, I rarely get sore or feel fatigued legs on my runs—and I’m running around 90 miles per week right now!

Make Time for Cross Training

During the off season I was going to the gym 4-5 times per week for at least 45 minutes. Of course as I start to run more, I shorten my gym sessions, but make sure they stay high-quality and that I hit every muscle group. My workouts are mostly full body sessions, with a big emphasis on all core muscles, at least 3x per week. I NEVER skip the strength training—I remind myself of the time I was injured and how horrible it felt, and that is enough to get me to do the work. I also make time to go for walks and use the stationary bike—this will only be a couple times per week for 20-30 minutes.

This is MY Plan, Not YOURS!

As I mentioned in the beginning, adding in all of these components is totally doable for anyone. The only obstacle most people have is lack of time, but with a little sacrifice, and shifting of your schedule you can find time for each and every one of these components. The one thing you don’t want to sacrifice in order to add more miles is sleep—it is VITAL if you want to run well. You don’t need to run every day, and it’s actually okay to not have a full rest day. You just have to make sure at least 75-80% of your runs are easy. If you are stuck and unsure about how to structure your training to get results, a coach may be the answer—even if it’s just for one season. Don’t hesitate to reach out to me with any questions or if you’d like to join my team and have me be your coach!

Training for a Race? Here's What to Include

When it comes to searching for the best training plan it is important to note that not every plan is suitable for everyone. Many factors contribute to being able to tolerate one plan over another, such as how the body reacts to exercise and how much time one has for training. Personal goals also play a role in which training plan to choose as well. You will find that some training plans incorporate a multitude of components, while others are very basic. Beginners and those who have a goal of just finishing a race, no matter what pace can get away with a minimalist approach with few running days per week. Advanced runners and those wanting to set personal records should incorporate more miles at a variety of speeds. Whatever your goals are for race day, it is important to understand the necessary parts to include in your plan in order to achieve the best results and limit injury risk.

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Must Have Components

The Long run

All marathon and half marathon training programs should include a long run. This run is easiest done on a day with the most available time, such as the weekend. A gradual increase in miles, by no more than 10%, is the safest way to increase the miles without risking injury. A good strategy for beginners is to increase this run by a half-mile each week. Running long at even a slow pace naturally builds endurance by training the body to store more glucose for energy and increasing the growth of capillaries and mitochondria, which help transport oxygen to the working muscles.

Cross-training

Many runners skip this component when preparing for races, since they believe running is all they need. Unfortunately running only strengthens body systems and muscles solely for the task of running. Only incorporating running into your plan will eventually lead to overuse injuries. The key to limiting this injury risk and keeping the whole body strong is to include cross-training activities such as weight lifting, swimming, cycling, or other fitness classes.

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Flexibility Exercises

Keeping muscles as flexible as possible will not only help running feel easier, but it will reduce injury risk as well. Most tears in muscles and tendons occur from overusing tight muscles, which is common in the Achilles tendon and hamstrings. Flexibility exercises should be a daily component of every plan. Besides static stretches, using a foam roller and other massage tools are other good options to relieve tightness in muscles and tendons.

Rest Days

Surprisingly even beginners sometimes skimp on rest. Recovery days are extremely important in every training plan in order to avoid overtraining syndrome. Exercise produces tiny tears in muscles and rest days are when the body repairs these tears, which is what eventually increases strength. Therefore, if these vital days are skipped, the body can never really build proper strength.

Components for Improving Pace

Speed Intervals

If you are looking to improve your race finish time, it is best to fit in runs with a variety of paces. There are plenty of interval workouts to choose from using a track or road. If you are training for a short race such as a 5K or 10K, shorter intervals of 200m or 400m are ideal, while longer intervals of 800m and above are useful for half and full marathon training.

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Tempo Runs

A tempo workout is basically a set time or mileage within a run that is done at a comfortably hard pace, or threshold pace. Some will call this run a “lactate threshold” run due to the lactic acid that is released into the muscles during the run that eventually causes fatigue. These workouts help train the body to push through this hard pace for longer before fatiguing, leading to being able to hold your goal pace on race day.

Hill Repeats

Not only is it important to practice running uphill and downhill if that’s what your race calls for, but hill workouts help build muscle strength and power, improve posture and breathing, and running cadence. If you do not have hilly routes around to run on the road or trails, the treadmill works just as well with the incline setting as high as a 4-6% grade. Performing 4-10 sets of 45 seconds to 2 minutes of uphill and downhill running will leave you feeling stronger and a more efficient runner.

Not every athlete responds the same way to the same programs. As long as you are incorporating the necessary components—the long run, cross-training, flexibility, and rest days—you can be a successful marathoner. It is always possible to adjust your training plan to work with your current lifestyle. Listening to your body is a key factor, so if you are feeling overly tired or are having consistent pain, it is important to incorporate more recovery time.

Sources:

Eystein Enoksen, Asle Rønning Tjelta, Leif Inge Tjelta, Distribution of Training Volume and Intensity of Elite Male and Female Track and Marathon Runners, Journal, Feb 23, 2018

Leeja Carter, John Coumbe-Lilley, Ph.D., Brenton Anderson, Strategies for Working with First Time Marathon Runners, Journal, Feb 23, 2018