Ask Coach Jenny
Q: I’m struggling with ITB pain on the side of my knee. Do you have any exercises that are helpful for this? Thanks, Emily
A: I’m sorry to hear about your ITB issue Emily, but there are several exercises that can help. Before I get to them, let’s talk about what the ITB is and does…
The ITB (Iliotibial Band) tightness is a common running injury among all levels of runners. The ITB is a band of tissue that runs from the gluteus down to the outside of the lower leg just beneath the knee. Its main role is to extend the leg and stabilize the leg while you run.
It is important to mention that the key to healing is to identify what may be causing the condition to begin with. For instance, bumping up your mileage or intensity too much too soon is one of the greatest reasons for developing ITB. Also, changing to new shoes, running on a cambered road (slanted) and having weak core muscles and muscle imbalances can cause this pain. Part of your ITB recovery plan should include an inventory of your training and other variables to allow your body to heal without aggravating it and prevent it from happening again in the future.
In many cases, making changes to your regimen, weaving in cross-training with low impact activities (elliptical), and focusing on strength and flexibility can resolve the ITB issue. If it lingers for more than a few weeks, it is time to get a proper diagnosis from your doctor.
Here are three exercises to improve strength and mobility.
ITB Foam Roll – [Excerpt from Running For Mortals]
This exercise is similar to rolling out cookie dough or pie crust. Lie on your side and position the foam roll under your hip. Put the top foot and hands on the floor for stability. Use your arms to slowly roll your body over the foam from just below the hip to just above the knee. It’s a little like a “Search and Rescue” mission. When you find a knot, stop, hold and breathe. Try to stay on the knot for 15-20 seconds until it releases. Walk your way in reverse and repeat 10 times.
It may feel very uncomfortable at first and maybe even painful. If it is so painful you can’t lie on the spot, try to get as close to the spot and work into that area. Little by little, the foam roller will help release the knot as well as the pain. Perform this exercise before or after your run or workout.
Bridge with Ball – [Excerpt from Running For Mortals]
Lie on your back with your hands by your sides on the floor and a playground ball or rolled up towel or foam roll between your knees.
Using your gluteal muscles (buttocks), squeeze and lift your hips off the floor until you make a diagonal line from your knees to your hips and shoulders. Only the shoulders and feet are on the floor. While lifting, press the knees in toward the ball and contract your buttocks muscles, squeezing in an up and in motion. This will activate the gluteal and adductor (inner thigh) muscle groups. Pause for a few seconds and lower your hips back to the floor continuing to press in to the ball and repeat. Draw your naval into your spine and focus on two motions, pressing into the ball or towel and squeezing up toward the ceiling.
When this gets easy, progress and make it more challenging by lowering to a few inches off the floor and repeat. Even harder – put your arms on your stomach while you perform the exercise, or try the exercise with one leg.
Single Leg Stance – Hip Huggers
The single leg balance activates and strengthens your stabilizing muscles from your feet and ankles all the way up to your hips and improves your balance, too! If you sit all day like most of us do, your gluteal muscles that stabilize as you run stride for stride are deactivated. When these muscles atrophy (decrease in strength and stability) they no longer engage and support your leg and hip as your foot lands on the ground and can cause friction inflammation in your knee and hip.
Stand up with your feet hip width apart. Keep your arms out to your sides for balance. Lift your left leg a few inches off the floor and hold for 30-60 seconds. Engage your hip muscles to create a long, neutral line up your body.
Let your hip on the planted leg side relax out to the side and then tighten and contract it to align it under your shoulders. Try this in front of a mirror and you’ll see your hip go out of alignment and as you contract the hip your body will realign as pictured above.
Repeat for 30-60 seconds on each side or until fatigued, approximately two to three sets. You will feel the muscles in your foot, ankle and hip fatiguing in seconds! This is a great exercise you can do anywhere – even in line at the grocery store!
When this is easy, progress to performing the exercise without wearing shoes.
When that gets easy, stand barefoot on a towel, pillow or pad to further challenge the muscles and balance.
By performing these three exercises daily, your ITB pain should diminish or disappear, as well as improve strength and mobility for future runs.