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IT Band Friction Syndrome – When Knee Pain Comes From the Hip

 

What is the IT Band?

The iliotibial band (IT band) is a very thick, fibrous band of tissue that runs from the outside of your hip down the outside of your leg and connects on the outside of your knee.  Your glutes, hip abductor and tensor fasciae latae (TFL) muscles all connect into this band.

 

leg image

What is IT Band Friction Syndrome (ITBFS)?

A sudden increase in mileage (over a 5% increase in one week) or excessive downhill running can cause the IT band to rub and create friction on the outside of the knee creating pain.  Since the IT band has fibers that also connects into the outside portion of the kneecap this can also be a source of pain at the front of the knee.

What Causes ITBFS?

Remember Newton’s 3rd Law of motion that “every action has an equal & opposite reaction?”  During running, every time our foot hits the ground with a certain amount of force the same amount of force is also exerted from the ground back up through our foot and into our leg.  If the musculature involved (usually the muscles on the outside of the hip) cannot contend with these increased impact and force requirements, then the body can start to break down and often times this occurs at the knee.  A rapid increase in running distance, downhill running, or running on slanted or graded surfaces (the same side of the road every run) forces the legs to undergo a significant increase in impact and force.

How Do I Fix It?

Decreasing your mileage temporarily until your symptoms subside then increasing more gradually sometimes can help initially.  Increasing your cadence (steps per minute) can help because it decreases the time your foot is on the ground, limiting the returning force the ground can exert back.  There is research data to indicate runners with ITBFS may have weaker hip muscle strength on the affected side.  So strengthening those muscles on the outside of your hip is KEY and is very simple with performing either, or both of the following exercises (to be performed every other day at 3 sets of 10 or 15 reps):

exercises

The following stretches after your run will also be helpful to loosen those tissues & muscles on the outside of your hip holding each stretch for 30-45 seconds, 3 times daily:

stretches

HAPPY RUNNING!

bret-maiers-sm

BRET MAIERS, PT, DPT, OCS

Bret Maiers received his Doctorate degree in physical therapy from Eastern Washington University in 2010.  He is a board certified orthopaedic clinical specialist through the American Physical Therapy Association and is currently the clinic director for Mountain Land Physical Therapy at their Stansbury Park location. In his spare time Bret enjoys running and both watching and playing sports.

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What to eat before a race?

One of my favorite episodes of the TV show “The Office” is when Michael Scott decides to put on a 5k.  A charity 5k to raise money to find a cure for rabies, which already has a cure.  Just before the race begins Michael “carbo-loads” on a huge serving of fettuccini alfredo.  As you can imagine, he feels the weight of the alfredo like a rock in his stomach as soon as he starts running.  I’m sure all of us at one time or another can relate to that feeling and as a result we do everything we possibly can to avoid it!  We stress about what to eat, how much to eat, and when to eat it.  Unfortunately there’s not one specific solution that works for everyone every time.  The key is finding what works for you.  The foods that work for you before hard workouts or long runs will be what works for you before a race, so keep the same routine.  That doesn’t mean you have to eat the same thing before every race, you can have options and still feel confident that you’ll be fine for the race.

Pasta is probably one of the most popular choices for people before a race, and it is a good choice, but there are plenty of other foods that you can be safe eating before a race as well.  Plus, some pasta dishes leave you feeling heavy and that’s the last feeling you want to have going into a race.  If I have pasta I choose some kind of pesto with vegetables instead of alfredo or meat sauce.  Some other options could be grilled chicken, salmon, halibut, rice (I prefer brown rice but do what works for you, especially if you’re not used to eating brown rice), steamed vegetables (easy on the butter if you use any at all), baked potato with cottage cheese and salsa, fajitas (easy on the sour cream, cheese, etc.), etc.

Some things to keep in mind when deciding what to eat before a race:

-Avoid fatty foods.

-Avoid food that takes a long time to digest.

-Eat foods that you’ve eaten before harder runs or workouts.

-Don’t try new foods, now is not the time to experiment.

-Drink plenty of water, ALWAYS a good idea whether you’re a runner or not!

-Eat healthy foods.  Again, always a good idea whether you’re a runner or not.

The best thing you can do for yourself as a runner and as a person in general is to create healthy habits so that when the hard part of the race comes your body has the fuel it needs to perform and do what you want it to do.

As for when to eat . . . this is kind of a personal preference, and it takes some trial and error.  So try different things before workouts to find what works for you.  Personally, I like to eat my last “meal” about 2.5 to 3 hours before my race.  I’ll continue to hydrate leading up to the race and possibly have a small snack (mostly comprised of carbohydrates) an hour or so before the race.  If I’m racing in the morning (which is when most road races are) I usually wake up a few hours early to get some food in my body and depending on what time the race is I may even go back to sleep for a while before I get up to start getting ready for the race.  When I race in the morning I’m definitely more picky about what I eat for breakfast because my stomach tends to be more sensitive in the morning.  Some ideas are oatmeal, toast, a little bit of fruit, yogurt, etc.  Sometimes if it’s a shorter race I’ll just have some kind of a powerbar and a banana or something similar.  Again, the key is to find what works for you.  Some people can eat an hour before they race, some people have to eat four hours before.  Try a few ways and then once you’ve found what works, make it a routine so your body knows what to do and what to expect on race day.

The nice thing about having a set routine is that it’s one less thing you have to worry about on race day.  You’re naturally going to be nervous and if you have a set routine you can have confidence in the fact that your body will be ready to perform.  You just have to go out and do it!  Which brings out another point, don’t stress if things don’t go perfectly leading up to a race.  They rarely do!  Have confidence in the things you can control, your training, the foods you eat, the amount of sleep you get, etc.  And know that you’re ready, you’ve prepared yourself and now you get to go show off all the hard work you put in!  Enjoy the race and as Coach Pilkington always says . . . “Look forward to the hard part of the race.”  That’s what we train for, to prepare ourselves for the hard part of the race so that when it comes, as it inevitably will, you’re ready and you can still run fast when it hurts.

by Lindsey Anderson – Olympian | Professional Athlete

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STOP THE OFF-SEASON EATING INSANITY

Doesn’t it make sense that if you change your training, then you should change your eating? The normal winter habit of “taking a break from training” by dropping volume, reducing intensity AND eating the same or MORE carbohydrate is killing your race season performance. STOP THE INSANITY! The pursuit of optimal health and human performance is a year round endeavor!

Never fear, for a typical age group endurance athlete training less than 10 hours a week in the warmer months, this isn’t as drastic as it sounds. The key is realizing that your carbohydrate needs drop when your workout volume drops. Also, as long as you’re doing strength work twice a week and some speed in the winter (you are doing both of these right?) then your protein and fats stay the same or even increase a bit.  Another way to understand this idea is that you have to keep your training and nutritional focus on anabolic, muscle and health building, overdrive. That means training for strength, speed and power and eating meals that keep your insulin stable and kick your hormone system into that anabolic state of rebuilding lost muscle tissue, burning fat and boosting your immune system.

Here are some simple nutritional guidelines to help you achieve this optimal off-season flux:

Guidelines

  • Protein: Consume high quality non-denatured (not destroyed) lean protein 5-6 times a day.  Eat enough to equal 1 gram protein/lb of lean mass a day. Protein should be the first macronutrient you are concerned with.  This quantity is for those of you actually lifting and/or doing speed. Eat less if you are not doing these activities.
  • Fat: Eat fat to lose fat, boost anabolic hormones and stabilize insulin. Eat omega 3 based fats with most meals. Put flax seed or mixed plant oil into at least 1 or 2 protein shakes a day. 1 TBS /50 lbs of bodyweight/day is the maintenance dose.  Double if you have joint or inflammation problems
  • Carbs: refuel muscle tissue properly right after workout so you don’t starve later! Recovery drink or shake within 30 minutes of workout. Within the next 60-90 minutes eat a solid meal with an extra serving or two of dense carbs like fruit, yams, squash, red potatoes.  All other meals only require one serving of carbohydrate, if any! Daily intake of at least 90% produce based carbs with no more than 10% whole grain!  Eat a big dark green salad everyday.
  • Fluids and fiber: drink half your bodyweight in ounces of water a day. That does not include during and post workout fluid. Take a fiber supplement once or twice a day with meals (although not before a run!)
  • Meals: Focus on protein and produce and some fats like olive oil, nuts, sharp cheese to feel fully satisfied. Eat until you are full. Eat extra carbs only after workouts.

 

 

Benefits

  • Each protein dose, when accompanied by a small amount of low glycemic carbs, releases growth hormone and glucagon (the opposite of insulin). This sets up the body to burn fat throughout the day.
  • Metabolic efficiency! The focus on protein, fats and produce teach the body to live off its own carbs stores and finally burn fat more easily because it has to.  This transfers over to being able to burn fat longer and in greater quantities in training during longer and slower workouts when you add them in later. SWEET!
  • Your insulin becomes more stable, sensitive and efficient so your body doesn’t need as much of it as it used to in order to process carbs.
  • Feel more satiated, recover better from workouts, improve sense of health and wellbeing dramatically, don’t get sick much, strongly curbs carb cravings and you sleep better.

 

The goal

The smartest athletes will use the off-season as a time to rebuild their bodies. After 4-8 weeks of resting, then eating and training in an anabolic pattern will get the body lean, mean and ready for a full season of specific endurance work. Cheers to a wise winter!

 

by Debbie Perry

Certified Sports Nutrition Advisor

USA Triathlon Certified Coach

Colgan Power Program Strength Trainer

Local Elite Runner/Triathlete

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Pre-Exercise Ventilation

I thought a short explanation of a typical ventilatory response to the onset of exercise might help answer this question. Carbon dioxide in our blood increases at the onset of exercise at a greater rate than it does later during our exercise bout (after we’ve warmed up for a while). Respiration is what gets rid of this carbon dioxide, and thus our breathing rate also increases more than normal at the beginning of exercise. As exercise progresses, the chemical conditions of our blood (i.e. increased heat & metabolism) allow more oxygen to distribute carbon dioxide out of the blood, creating less demand for our breathing rate to do that.

Read More….

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Foot Pain! What’s Wrong?

Expert Panel Questions???

“12 Days before Marathon, I have had pain on the bottom of my foot (arch area) for about 1 week. I am stressing mentally :) Any suggestions on what I should do would be appreciated.”

“I ran a half marathon the other day. About 12 hours after I finished, the outside of my foot started hurting. It’s the bottom of the foot on the opposite side of the arch. It has not stopped hurting since, especially when I walk. What is this?”

(ask your questions to the UtahRunning.com Experts here)

Answer!!!

The short answer to these two questions may be accumulated stress from training at increased intensity and volume of marathon preparation. Damage done to your tissues has exceeded your body’s ability to recover and heal itself. These issues are discussed in “Why does my heel hurt during the power phase of training?” Mechanics out of alignment or a worn-out or improper shoe may exacerbate stresses on the foot. Consider revisiting my article on how to select the correct running shoe.

Regarding why the lateral side of the foot is sore after a run–The short answer here is that you are running on the lateral side of your foot. You may have a cavus (high arch) foot and naturally run on the lateral side of your foot. Running in a stability shoe or using a rigid, high-arch orthotic will make you run more on the lateral side of your foot. Alternatively, you may have a planus (low arch) foot. In this case your shoe may not have enough stability and your posterior tibial tendon may be sore. Your body then tries to protect the posterior tibial tendon by activating the anterior tibial tendon, which inverts the foot and causes you to run on the lateral side of your foot.

Revisit the running shoe article and think hard about what type of foot you have. If pain is not improving, you may have a stress fracture, and you should seek treatment and have an xray.

By Jeffrey Rocco, M.D. Rocco Foot and Ankle Institute 801-644-8795

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Do I have a mild form of asthma?

Expert Panel Question???

“When I run my chest burns like crazy. After a while I start to get light headed and dizzy. Do I have a mild form of asthma?”

(ask your questions to the UtahRunning.com Experts here)

Answer!!!

In addressing chest symptoms whether related to activity or not it is helpful to think of the 4 body areas in the chest that these symptoms may be coming from: the heart, the lungs, the esophagus or the chest wall. Of these four, a problem with the heart raises the most concern and should be addressed first (for obvious reasons). This is followed by the lungs, the esophagus and then the chest wall.

Any chest symptom associated with activity and especially those that include light headedness and dizziness as the run continues necessitates at least a basic cardiac evaluation i.e. a thorough history including family history, a listen to the heart with a stethoscope and an office EKG (electrocardiogram). If there is any concern based on these tests, additional tests may be needed. Once you are reassured that your heart is ok we move on to evaluating the lungs.

Exercise induced asthma (formally known as exercise induced bronchospam or EIB) is not uncommon in runners – up to 30% in some studies – and could explain your symptoms. EIB is defined as a reduction of 15% in your normal lung function at rest compared to after you exercise. People with exercise induced asthma may or may not have underlying asthma but people with asthma almost always have exercise induced symptoms.

Read More….

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