Iliotibial Band (ITB) Syndrome...that nagging and sharp pain on the outside of your knee that can lead to a Did Not Finish (DNF). Or worst, wreck your entire running season! Runners (and other endurance athletes) are probably familiar with this injury as ITB Syndrome is one of the most common injuries from running.
According to Cleveland Clinic, ITB Syndrome is when a tendon called iliotibial band gets irritated from persistent rubbing against a bone. The link above has a real good description, symptoms, causes and common treatment options so I won't recreate the wheel here and direct you to the site.
My battle with ITB Syndrome began in the summer of 2022 during Val d'Aran by UTMB in Spain. I started to feel pain outside of right knee at around 25 miles and the pain got worst with each passing mile, finally forcing me to withdraw at 75 miles. The pain continued for months after Spain, especially on long distance trail runs like the Northern Trail Loop around Mount Rainier.
I was distraught and worried that this injury would seriously curtail my trail running. A buddy urged me to try an IT Band strap and I thought "what do I have to lose" so reluctantly paid $20 for Pro-Tec Iliotibial Band Compression Wrap. I strapped it on my knee for a 32 mile run on Northern Loop Trail and to my surprise the damn thing worked! Prior to using this band, I couldn't run more than 10 miles on a trail without sharp knee pain but I completed 2022 Puerto Vallarta by UTMB, 110 mile ultramarathon with close to 25K of vertical climb and 30K of vertical decline, without any ITB pain!
The Pro-Tec Iliotibial Band Compression Wrap is made by a local Seattle company (actually Redmond to be precise) Pro-Tec Athletics that specializes in various sports support and recovery products.
The use is pretty simple: you strap it tightly around your knee with soft, square foam pad placed couple inches above the pain point. The magic is in the soft foam pad that acts as a compression point to gently press the ITB away from the bone, preventing the band and bone from rubbing against each other. The compression wrap is made up of stretchy velcro so it grips around your leg firmly; I used it for 43 hours straight running Puerto Vallarta by UTMB and never once had to worry about it slipping off.
One negative comment would be that leg movements from running will cause the leg muscles to expand and contract, shifting the band ever-so-slightly with each movement, which over an ultramarathon (or several hours of continues use) can lead to nasty blisters and skin irritation around the band from constant friction. See the picture below taken after Puerto Vallarta ultra. Few days of Neosporin ointment took care of this so it was a small sacrifice for being able to complete a 100 miler!
Lastly, support gears and equipment can only aid in your endeavor and never replace your natural body and ability. Therefore, the best long-term cure for ITB Syndrome is to make your legs stronger so you don't need to run with any artificial support.
Based on my research, ITB do not operate in a vacuum, similar to other muscles and organs in the body, but work in concert with other muscles, tissues and ligaments in the legs. So, to strengthen the ITB, the entire leg must become stronger, from quads to adductors to hips. Below is a video from Precision Movement for few simple exercises to strengthen your legs and fix ITB Syndrome for good. I incorporated these exercises into my weekly routine so hopefully you can too!
Good luck and let me know if you have other remedies for ITB Syndrome and I can share that with others here!
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