In this article, I’m going to answer the question of whether or not you can continue to run with iliotibial band syndrome (IT band syndrome).
The simple answer is: Yes, most runners will be able to continue training with IT band syndrome.
However, if you do continue to run with iliotibial band syndrome, while you’re unlikely to do any long-term damage, you will most likely delay the time it takes your body to make a full recovery.
Running through IT band syndrome, while possible if you’re willing to endure some discomfort, will extend the time it takes before you can once again run without knee pain.
If you’re currently suffering from iliotibial band syndrome, you’ll be all too familiar with the pain around the outside of the knee.
You’re also maybe wondering if you can continue marathon training with iliotibial band syndrome.
Every year, lots of runners successfully train for, and complete marathons despite suffering from iliotibial band syndrome. However, you will most likely need to adjust your marathon training plan, and race goals to take the injury and its symptoms into account.
Later in this article, I’ll explain how you can adjust your training plan to enable you to continue marathon training with IT band syndrome.
First, let’s begin by getting a better understanding of the injury itself…
Fix Your Knee Pain >>
Free Rehab Guide [PDF]
What is Iliotibial Band Syndrome?
Iliotibial band syndrome is an inflammatory response of the fat pad between the insertion of the iliotibial band – a thick layer of connective tissue – and the bony prominence around the outside of the knee called the lateral femoral condyle.
As an overuse injury, IT band syndrome often strikes runners as they increase their training load in preparation for an upcoming event, such as a marathon or half marathon.
Historically, we thought of iliotibial band syndrome as an issue of friction (repetitive bending of the knee), but more modern evidence suggests it is more an issue of compression.
What Causes IT Band Syndrome? <- Learn more about the common causes of iliotibial band syndrome
Image via @afranklynmiller. Illustrated by Levent Efe
IT band syndrome is relatively common in endurance athletes, especially distance runners and cyclists due to the repetitive nature of both the running and cycling leg action.
Symptoms typically present on the outside of the knee, rather than around the kneecap, and once aggravated generally become more severe as a given workout progresses in duration.
Running a Marathon with Iliotibial Band Syndrome
Let’s get to the big question for those of us with training for a marathon, half marathon, or similar running event…
Will running through IT band syndrome cause you further damage?
The answer to this question is actually very simple:
As uncomfortable as it may be, running through the pain of IT band syndrome is unlikely to cause you any further damage.
Think of iliotibial band syndrome as an issue of irritated tissue, rather than one of damaged tissue.
Continuing to run with iliotibial band syndrome is unlikely to result in further tissue damage, but may make your symptoms worse in the short-term by continuing to irritate the already inflamed fat pad.
My typical analogy here is to think about scratching an insect bite:
Scratching an insect bite rarely makes things better. In fact, we often regret doing it, and would have been better leaving the insect bite alone to let the body’s natural healing processes occur!
So, what can you do to encourage the healing process, treat the pain, and reduce the irritability of your IT band syndrome?
Below I’ve detailed a simple approach you can take to treating IT band syndrome…
Four Steps to Healing Iliotibial Band Syndrome Quickly
As with all injuries, a treatment plan for IT band syndrome needs to be designed for the individual. That said, these simple steps will usually be involved:
1. Reduce Your Training Load to Give Your Knee Pain a Chance to Settle
Whether, we’re talking about iliotibial band syndrome, patellofemoral pain (runner’s knee), or many of the other common “overuse” running injuries, training load management is essential to get your pain under control.
A reduction of your training load will help reduce the aggravating factors for your symptoms, and put your body in a position to heal more effectively, and reduce the irritation.
Of course, this is difficult advice to hear if you’re training for an upcoming event…
If you’re keen to continue training for your upcoming marathon, for example, try shortening the length of your runs but increasing how often you run.
Be sure to remember the following:
- The pain of IT band syndrome is usually aggravated by longer runs.
Once severely irritated, your knee will take time to settle down before you can recommence your training. - Weekly mileage is arguably more important than your long run duration when it comes to marathon training.
However, You can keep your weekly mileage high with more frequent shorter runs, without aggravating your knee with longer sessions.
Training Load Management for Runner’s Knee <- Learn how to manage your injury without having to stop running completely
2. Get Pain Relief for Iliotibial Band Syndrome
Bearing in mind the inflammatory nature of the IT band syndrome, taking advantage of anti-inflammatory strategies are an important step to take in managing the injury.
Ice & Cryotherapy for Iliotibial Band Syndrome
Exactly how and why ice and cryotherapy works is very much still up for debate, but using an ice pack local to the irritated area can usually help with pain relief for IT band syndrome.
Anti-Inflammatory Medication for Iliotibial Band Syndrome
I usually advise that runners discuss a short course of non-steroidal anti-inflammatory medication (ibuprofen or equivalent) with their GP or pharmacist and if symptoms are severe or irritable enough, a guided corticosteroid injection may be warranted.
Cortisone Injections for Runner’s Knee? Here’s What You Need to Know… <- Learn more about steroid injections for knee pain here
3. Increase Your Muscular Strength & Endurance
Building strength and endurance in key muscle groups around your knees and hips is a vital part of the rehabilitation process for runners dealing with iliotibial band syndrome.
Here’s a simple IT band syndrome rehab routine you might find helpful:
Muscles such as the quadriceps and glutes, and hamstrings will often require strengthening by way of a exercise-based rehab programme. In addition to strength, stability exercises will help your body control stress and strain on the knee as you run.
Check out the following link for more details about rehab exercises for runners who suffer from knee pain…
Fix Your Knee Pain >>
Free Rehab Guide [PDF]
4. Improve Your Running Technique
You may want to also consider changing the way that you run, to help you recover from iliotibial band syndrome.
This process isn’t straightforward, but if your symptoms are related to flaws in your running form, this may be something you need to change.
Most runners with ITB syndrome will benefit from either increasing their running cadence (step rate) or step width to help reduce excess strain on their IT band.
Proper Running Form: 6 Ways to Run More Efficiently <- Check out this article on how to improve your running technique
How Long Should You Rest From Running with Iliotibial Band Syndrome?
This question is, again, always specific to the individual runner. My answer will usually vary depending on the point in their training at which the pain of their IT band syndrome begins to become uncomfortable.
Some runners may need to rest completely from running for a period of time; while others may only need to reduce their running volume.
It all depends on how severe (how much does it hurt) and irritable (how long does it hurt after aggravation) your symptoms are…
If your symptoms are both severe and very irritable, a period of 2-4 weeks is usually sufficient to reduce/rest and allow other treatments to take effect, before you can consider gradually returning to running again.
If you absolutely have to keep running, this can usually be achieved with the help of an injection, but be warned, symptoms will always return if a complete rehabilitation approach is not applied.
As I always say: Rest from running alone isn’t sufficient… You have to work on the underlying weak links that predisposed you to iliotibial band syndrome in the first place.
Dr. Brad,
This post is well laid out and really helpful.I had some questions regarding this syndrome.
I am training for a marathon for the first time. My marathon is next week and unfortunately after my 20 mile run last week, I started to have pain around my knee specially while going up and down the stairs. My Physiotherapist diagnosed it to be IT Band syndrome.I am not sure if I have the right physiotherapist here.I am planning to do some exercises, stretching on my own and try to recover as much as possible from it before the run.
My question is does these anti inflammatory medicines reduce the pain while running or just delays the inflammation and thus delays the pain.Or are there any other pain killers I should take before my final run to help reduce the pain?Also, should I take these medicines just before the race or should I take a course of it this week whenever I am running/cross training.