I still remember the first time I got iliotibial band syndrome. I was maybe a mile into my first triathlon when I got this dull, aching, stabbing pain in the side of my knee — pure agony. But I’d just completely destroyed the bike course, so I wasn’t about to DNF midway through the run. So instead I gutted my way through two of the most awful miles of my life.
I remember telling my aunt about it and having her respond, “So why don’t you just hit the weights and rehab your knee?” I thought, “Good point — I come from a strength training background, so I can figure this out.” I hit the weights, and it seemed to go away. Of course, I went to another triathlon and had the lousy run of my illustrious endurance career. But small victories count for something, right?
Later, I realized that if I just run uphill — up a steep hill that left my glutes miserably sore the next day — it would stave off that miserable injury. At first, I didn’t really understand the mechanisms at work. I just knew that it did the job.
Turns out that it’s all about what’s called your “posterior chain” — or the muscles that run up your backside. Yes, your bum. And also your lower back, hamstrings, even gastrocs, etc. etc. When you spend all day sat down in a chair like I do, those muscles get awfully weak. Your tensor fascia latae and your psoas, meanwhile, get really short and tight.
When you pick up running or cycling hoping to counteract the effects of all of that sitting, people with shorter strides often strengthen their quads without doing much about their buns. It just makes sense that your body’s going to reach for its strengths and avoid its weaknesses when you put it in a physically demanding situation. Trouble is, stronger quads don’t really fix your problem — they exacerbate it. And all of that movement in your knee and your hip tends to bring out the pain from your iliotibial band.
So what do you do if you find yourself with a nasty case of ITBS? For one, start including a regular uphill run at least once a week. And don’t just run a moderate slope — go find something steep and challenging and then do hill repeats on it. You’ll know you succeeded if the outsides of your bum are really sore the next day.
You might also try adding a couple of strength moves to your regular routine. Everyone recommends clamshells, etc., but I’m a fan of stuff that’s actually running-applicable, like these two: (I figure Running Times is out of print now, so I’m probably safe to post this.) Personally, I’ve had more success with the second one, the runner touch, than with the first. But maybe you’ll be different from me.