IT Band Pain - My injury experience

Colico (IT), 2^nd September 2023.

It has been 2 weeks since the RunFire 40km race. As every Saturday, I am getting ready for my long run. This weekend I am in Italy in the small town of Colico located in the north of the Como Lake and I am thinking where to run my 24km of the day.

I have beautiful childhood memories of this place. When I was a kid, I used to bike with my parents to this typical Italian “agriturismo” named “La Fiorida”. Around 15 years ago this place was a small family run farm open to the public, selling their own fresh products such as milk, cheese, and ice cream. After a long bike ride, I loved running after chickens and looking at the milking cows. It has been such a long time since the last time I have been here and I now want to go back again. I checked the route on Google Maps and it said 11km one way (~22km the full loop) … that was just perfect for my long run!

10:30 am – the temperature is around 27 degrees; hence I decide to take the running vest with 1L water, 1 gel, and 1 Cliff strawberry chews. I start running. For the first 5km I’m in good company as my dad decided to join me for the first part of the course. The run starts smooth, overall, I feel good although my Garmin says my HR is high. I decide to ignore my watch as I often do, and I keep going. Around the 8^th Km I put on my phone the UTMB live streaming and I chat a bit with Yunus commenting the outstanding race.

Km 12^th I arrive at “La Fiorida”, I am so impressed by how much this place has changes since the last time I was here. What used to be a local family-run farm is now a fairly big Agriturismo with hotel rooms, spa, restaurant with a local but curated cuisine, and with still the animals and the local shop. There were too many people around, hence I didn’t stop and I turned back with direction Colico.

Km 14^th I quickly stop to a small fountain to refill my water flasks while eating some Cliff candy chews (the gel under the heat got a terrible taste and I could not drink it). Km 15^th is approaching, I’m relaxing while listening to the UTMB live stream, Jim Walmsley is leading the race, he is 20’ far from the finish line, and I am getting so excited just by the thought of what is happening for the first time in the past 20 years of UTMB history. All of the sudden, I start feeling an unexpected and sharp pain the outer side of my left knee for the first time in my life. At the beginning I ignore the symptom thinking that it’ll go away soon, but I was wrong. I am 9 km away from home and I have to deal with this new friend in my knee. At some point I remembered Yunus telling me that he had a very similar pain in my exact same spot during Eiger ultra trail. After that memory I thought “well, Yunus run 90km with that pain, hence this is nothing to worry about”, however the pain was still there without getting better. I don’t have many alternatives; hence I keep on running motivating myself with this thought and Courtney Dauwalter talking about the pain cave. I reached Km 20, at some point I even have the impression that the pain is getting better and it’s almost going away (in retrospective, I think it was pure illusion). 

Km 24, after ~2h 30’ run I am back in “La Breva” beach in Colico and I can stop my run. I decide to walk home to cool down (wise choice), the pain is still there but with the walking movement I feel like it’s not getting any worse. I am 100m away from home and I have to climb up and down a few stairs. Going up is painful, but not too much. Going down, literally killed me. Finally, I arrive home and I think it’s a good idea to do some stretching. I start with the pigeon pose first, and then I changed to some basic quads stretch until my mom called me saying that the lunch was ready and I better shower quickly. Well, that signed the end of my stretching for the day. I have some good lunch and I relax for a couple hours watching F1 qualification for the Monza GP (good news, Ferrari will start in pole position tomorrow).

Albigna Bregaglia (CH), 3^rd September 2023.

It’s 7 in the morning, I turn off my alarm, wake up, eat some breakfast and get ready for a full day of hiking and trekking with my family. My knee is feeling not at its best, I have some pain going up and down the stairs, but walking is not bothering me that much (I can feel that there is something not right, but the pain is very light). The plan for the day is to go to Albigna, a small village right after the Swiss border, take the cable car to reach 2.000m altitude and start the hike from there. We started walking, the knee is responding okay, I feel it, but I can keep going. After 50’ we reach the cabin. My brother, dad and myself decide to keep hiking up to the “Pass da Casnil Sud” (2.941m) for a couple more hours.

The way up is not the easiest, there is a lot of elevation, climb, and 70% of the trail was on granite stones. At some point I feel the pain in my knee coming back in full, but climbing up is bearable and the views are stunning enough to get me very distracted. I reach the Pass, take a short water and photo break and I am ready to go back. The way down already starts painful, but I can keep going. Walking on the rocks was both helping and scaring me at the same time. From one side, the rocks are allowing me to do both short steps and sit down where the passages were too steep. On the other hand, one wrong step or my knee not bearing the pain could make me fall with no happy ending.

I’m not going to talk about the pain I had for the remaining 1.5h hike down to reach the cabin where my mom was with the rest of the group. When I arrived, I could barely bend my knee - thankfully I had running poles with me that were a huge help. We have a break at the cabin, eat some pizza, a panino with my favourite bresaola, and drink a warm foamy cappuccino. While eating standing I am doing some basic stretching for the IT band that I remember from Yunus and some videos that my physio had suggested me (but I have never done). After an hour or so, the pain is much less, the short rest and stretching worked, so I hit the last 40’ of the trail to get to the cable car. The downhill is going much better than the previous one, the pain went down from 8/10 to a 4/10. On the drive, my muscles are cooling down and once home I start noticing that even walking has become painful. Before going to bed I apply some Kinesio tape hoping it will help somehow.

Muggiò (IT), 4^th September 2023.

7:00am, my alarm is off. Today is rest day. I think it’s a good idea to fully rest and focus on my recovery. All my muscles feel incredibly sore for some reason, from my arms to my ankles. My right leg yesterday had to work double and today it’s feeling it all. My left leg is a mix of pain and soreness. I am 100% convinced that I need to take it easy now. I start looking online at both videos and articles talking about IT band, what to do and how to get better asap. After some study I realize that what I have to do is very simple; stretch, foam roll, and strength train (basically everything that I haven’t done in the past month).

8:00am, I have almost 1h before I start working. I begin with some mobility stretching that my physio suggested – child pose, pigeon, hamstring extender, lumbar rotations etc. Once I am done, I convince myself to listen to this guy Jared who I found on YouTube. I follow step by step his video “How To Fix IT Band Knee Pain FAST - The RIGHT Exercises For BETTER Results”. I have to say, it worked. I had some relief and now my pain was down to 2/10 while walking. However, I still feel A LOT of soreness and tightness in my muscles from my glute to the knee. To reduce inflammation, I also take 1 ibuprofen after breakfast and 1 mid-afternoon and by the evening, the pain seems being under control. Before dinner time I do another stretching plus strengthening session. This time I follow the Garmin workout “Pilates for runners” and I repeat Jared exercises for at least a solid hour.

Muggiò, 5^th September 2023.

At 8:00am I wake up hoping the pain is out of my body, but it is not. Jared videos suggested foam rolling, so I go get one at Decathlon and once back home I follow step by step all the stretching exercises and foam rolling he suggests for a solid hour. Foam rolling my legs is very painful, now I can really feel all the tightness I have missed to stretch; however, I feel like it’s doing the job. After a few hours of work, I repeat another short stretching session around lunchtime. It’s 18:00, I am done with work, my knee feels GOOD, I have zero pain when walking, doing a few stairs, and normal movements. I decide to go for a 4k very easy jog/walk session on flat and road course. Before getting started I did some warm up exercises for the first time – butt kicks, high knees, dynamic hip stretch; then I’m ready to go. After 2.5km I start feeling the slightest discomfort and I walk for 500m – the last thing I want is to have the pain back. Around the 3^rd km I go back to jogging, it feels ok, no pain, no weird feelings, but no great feelings either – 100% I was overthinking everything while trying to be extra cautious. After the last km I do full stretching and strengthening session. I follow the “Pilates for runners” using resistance bands for the glute’s strength exercises, then I finish another round of foam rolling and Jared exercises. Overall, the run went well, I was so happy I could go back to some jogging and put me in a very good mood. 

Muggiò, 6^th September 2023.

5:30am my dad wakes me up to go for a swim workout together, my knee is not feeling fully healed, but I think that some swimming won’t hurt me anyway. It’s 6:10am, I jump in the pool ready to go. After a few strokes I notice that I have no pain regardless of the style – that’s good news! I end up doing 2.200m and I experienced some light discomfort only towards the end. Once back home I do some stretching and then I start working. It’s 20:30, yesterday my run went great, now I want to try again. My idea is to attempt another 4/5km run, my dad decides to join me. We start jogging slowly after some warm up exercises. We chat and run at an easy pace the entire time while I try to move my legs and keeping the muscles loose. At km 7 I start feeling some discomfort and light pain, I’d say it’s a 5/10. At this point I walk for 500m and try to lose up. I pick up the pace again when I start feeling better, but it doesn’t last more than 500m, the pain is now 7/10 and I don’t want to go back to the bad pain zone. At home I do my usual Pilates, foam rolling, and stretching for 40’ that made me feel so much better. Probably, the 9km run wasn’t the wisest decision, however I think 4/5km wouldn’t have done any harm.

London (UK), 8^th September 2023.

4:30am, my alarm is ringing, and I have to get ready to go to the airport to fly back to London. The flight goes well, and in a few hours, I am already at home. I start to unpack and to get ready to work when I realize that I have a massage gun here (of course out of battery), but I think this can turn out very useful now. H13:00 it’s time to do some exercises. Yesterday, I took the full day to rest, stretch, and recover. I start with massaging my legs with the gun, then I move to the foam roll, and some stretching to begin. The feeling is good, I am pain free now. The only exception is the first stretching position suggested by Jared, however, compared to the past days, the pain is much lower. 

I finish all the stretches and I feel strong to do some strength training with resistance bands. I follow first all the strength exercises in Jared video – single glutes bridge, side-lying hip abduction, hip hikes, lateral band walks. Once done, I keep going with other strength training exercises for my hips and abductors. The feeling is good and pain free, I add 3 sets of 15 reps of squats, lounges, and squat jumps. Last, I finish with 4x1’ planks (1x on arms, hands, side, other side) and a final stretch. I am happy that I’m not in pain and in the evening, I complete another strength training session. 

It's 22:10 and I am ready to jump on my bike to meet some friends for a beer and a good post-vacation catch up at my favourite spot in Hackney Wick. I start biking, it is not pain free, but it’s very bearable, probably a 3/10. I start noticing that if I focus on activating my glutes while moving my legs and I turn my knee outwards the pain goes away. Well, after 25’ bike I arrive and enjoy the night out.

I start thinking that the whole reason of this pain is my running form that probably makes me run with my knees turning slightly inwards each step (I should look myself in the mirror next time!). I get even more convinced of this theory when I start thinking of Zach Miller photo at UTMB finish line (you can clearly see his knees turning outwards!!!).

London, 10^th September 2023.

After 3 days of active recovery with stretching and strengthening, I want to attempt a short run today. I start the day easy with some stretching in the morning and around lunchtime I am ready to hit the road. The first steps are not painful, I keep going until km 2.5 when I start feeling some dizziness. This feeling makes my thoughts spin even faster; hence I stop and do some squats, lounges, and light stretch...weird that nothing hurts now (maybe it was only my brain overthinking it). At this point I make my way home and during those 2.5km my dizziness did not get worse, but not even better. Anyway, it was not my intention to go back to painful km otherwise I would only slow down my recovery, so I think that run was a good test. This time I do plenty of stretching and foam rolling after and so far, the pain hasn't come back. I start thinking that I have to give more time to myself to recover a bit more before going back to running. Last thing I want now is to worsen my injury and not being able to run in Cappadocia. For the next 3 days I will not run, I will go to the pool in the mornings and focus on strength training in the evenings. 

London, 11^th September 2023.

H6:00 my alarm is off; I am weirdly excited that I will finally do some sport with (hopefully) no pain. I have some breakfast and then jump on my bike with destination swimming pool. Biking still has a weird feeling, but I guess it's only the "morning effect". After a solid 2.5k swim 100% pain free am I'm ready to start my workday. During the day I apply ice on the knee twice and after some reading, I also start taking some multivitamin and joint specific supplements that I could easily find at Holland and Barrett (I got a multipack with a mix of creatinine, omega 3, vitamin C, D, and other good stuff). Once home I do a good 45' strength training following Jared videos and adding some exercises like squats, jumps, plank, and core strength followed by extra stretching, foam rolling, massage gun, ice, and good night sleep. I repeat the same routine for 3 consecutive days adding some variety in the strength training but keeping high focus on doing all these exercises in the "no pain" zone.

London, 14^th September 2023.

After 3 days of no running, I want to attempt running. It has been 11 days since the pain started and I have done ~25km in 3 runs since then (much lower compared to my usual ~70km weekly). My quads and glutes are a bit sore from the strength train but overall, my legs feel strong and ready. In the middle of the day, I go for a 30' fast walk to keep my blood flowing and test how my knee feels with fast walking. Test is positive, there is no pain, and I am even more convinced that I am ready to try a short run. h19:00 I start getting ready. This time I do plenty of warm up exercises (foam rolling, active stretching, butt kicks, high knees, jumps, and a good 5' walk before I start running). Now I feel ready, and I start running with my dad on a call who will keep me company for the entire time while forcing me to go at slow conversational pace. I want to be conservative, and I avoid doing my full favorite daily route (~11Km), hence at some point I turn back. The route included some light ups and downs and stairs. I end up running my first 7km fully pain free (also running down the stairs!!!). I AM SO HAPPY that I had no pain for the entire time that I am now motivated to strength train and stretch post run! I follow the Pilates for Runners by Garmin and add some additional strength and stretch exercises before calling it a day. Before going to bed, I apply one more time some ice and I go to bed think I am finally healing!

London, 16^th September 2023.

Yesterday I did another 7.5km run 99% pain free, some stretching and strength training, so today I am ready for the 5Km charity run organised by some work colleagues. The meeting point for the 5km is ~1h walk from my place, close to the Haggerston station and finish point is at the Elizabeth Olympic Park in Stratford. I walk to the meeting point thinking that would be a good warmup. When the other running group arrived, I run all the route by the canal with a friend of mine at very conversational pace. The knee wasn’t in pain, I only had a bit of dizziness at some point, but nothing to worry about. The finish point is close to a nice bar with a terrace where we spend a few hours eating, drinking, and socializing with the group (what a perfect day under sunny London). 

It is about 17:30 when my friend and I decide to head home. The plan for the evening is to meet at my place with another couple friends for some chill hanging and chatting around dinner time. I am ~6/7km from home, so I decide to run home and test my knee on 2 daily runs with a good break in between. The run goes smooth until the 5th Km when the dizziness appears again, I ignore it and keep going. That did not last for long, at some point I start having pain in my knee but not in the same IT band spot. This time the pain looks like it’s floating around my knee and keeps on moving from the outside to the bottom, to the back, then up…so weird. I try to walk for a bit and stretch, but I don’t feel any heavy tightness, so I start running again very slow, but right after the bottom-left corner of my knee started being very painful. At this point I was at the 6th Km and ~ 800m from home, so I decide to walk and cool down. Walking is not painful, but also not dizziness free. I was almost home, probably only 300m away, when I got hit by a bike who fully crashed into me hitting my back and my other leg and I fall to the ground from the crash. I am now so mad, this guy didn’t warn me with the bell, he wasn’t on the bike lane but on the opposite side of the road on the sidewalk and didn’t even stop to help me. He literally run away…truly unbelievable. Luckily it was not too serious, I could breathe, move my torso, and walk so I didn’t go to the ER. I finally arrive home and check myself… I “won” some burnt skin and scars on my leg, a bad scratch and bruise on the right side of my back, and random minor bruises on my butt…my back is in pain for every movement I do, but I don’t think I broke anything. At least my friends cheered me up in the evening gossiping in front of pizza and wine… what a day!

Luxembourg (LUX), 30^th September 2023.

It has been exactly 4 weeks since the day of the injury and I have just completed a 44km run with my friend Yunus. So far, I've been focusing as much as I could on my recovering. The first two weeks I cut down my running load from ~72km/week to ~25km/week, increased my swimming from 0 to 3 times/week and my strength + stretching sessions to at least 1h/day. The third and fourth week I slowly went back to running instead of swimming. From this moment, all my runs have been pain-free. In W3 I increased my mileage to 47km with a long run of 15km and I also included a 15km hike on hills. In W4 I run 88km with a long run of 44.5km with 700m elevation gain to test my legs for the race. I was so happy that my legs were feeling great, and the pain was not there anymore after such a long run. 

Nutrition wise, I've tried to eat better foods by increasing my protein intake and vegetables in my daily diet (i.e., eggs and red meat). I’ve been taking joint supplements rich in omega-3, collagen, and vitamins  daily, and I’ve tried to keep good hydration. 

Luxembourg / London, 8^th October 2023.

Recap of W5. This week I have been doing my daily runs in Luxembourg until the weekend. I enjoyed so much running on proper trails and with elevation that in London is very hard to find. Trails just adds so much fun! As if all this wasn’t enough, I had been running all the time with my friend Yunus who always makes every run together a real pleasure.

This week I’ve run ~65km with 1 hills training workout and a 22km long run. Overall, my legs are feeling good with normal soreness levels and no pain in the IT band area. This past week I haven’t focused much on strength until the weekend; however, I’ve been holding steady with stretching exercises post-run and supplements intake. Next week it’ll be the last week before the race where I will run 63km with elevation gain and a little bit of altitude (Salomon Cappadocia Ultra Trail). The goals for next week are to fully recover my body from the cold that I’ve had these past days and the travel I will do, to get some good quality sleep, and to maintain my running base until race day!

Jared YouTube videos for IT Band:

• Stretching: https://www.youtube.com/watch?v=c9uPHuLtkZI
• Foam rolling: https://www.youtube.com/watch?v=jVvUW4SAMuk