ITBS And Plantar Fasciitis – Really?

ITBS And Plantar Fasciitis?

ITBS and plantar fasciitis

I don’t believe it!

Proprioception will alter pain because the brain will recognize certain body positions as indicating danger, and others as being safe. 
– Todd Hargrove, Guide to Better Movement

It was a long time ago, in a previous life.

Before I found my abdominal aortic aneurysm in 2010. Was it 2007 or 2008? I forget. I wasn’t blogging in those days, so I have no written records. But I remember it well.

ITBS and plantar fasciitisI was a Lake Placid Ironman-distance triathlete newbie. It’s a long day. First the 2.4-mile swim. Then a 112-mile bike ride through the Adirondack Mountains. Finally a full 26.2-mile marathon. A challenging but exciting day, if you’re trained for it. I was kind of ready!

Coming off the bike course, I started to feel a little less sure of myself, thinking, I’ve got to run a marathon. But my legs are shot! Can I do it?

Self-doubt can be a problem in endurance races. Reasonable caution is fine.

As I started to tackle the run, I met a friend. A steady runner, and an accomplished triathlete. I thought, If I go easy, and run at this pace, I’ll be fine.

Go steady we did, chatting to take our minds off our legs. At about mile seven, I developed intense pain on the outside of one knee. It was classic ileotibial band syndrome (ITBS). I’d never had it before, or since for that matter, but I knew it as a bane of distance runners.

The ileotibial (IT) band is a thick strip of connective tissue. It joins to several muscles in the lateral thigh. Ileotibial band syndrome (ITBS) causes a pain on the outside of the knee during running. Tightness or inflammation of the IT band is believed by many to be the culprit. This is reminiscent of acute morning heel pain being attributed (incorrectly) to inflammation of the plantar fascia.

In response to this knee pain, I slowed down some more, to a walk-run. Hobbling into the turn around at mile-13. It’s a double half-marathon loop. I considered pulling out. But there was my excited support crew, ready to run the sidewalk alongside me as I headed out on the second loop.

Oh boy! What’s to do?

Then a thought popped into my head. What am I doing? I’m not running as I trained.

I can do this.

ITBS and plantar fasciitis

Support crews make all the difference.

My support crew were running and shouting encouragement. Then, I remembered how we ran the trails together around our neighborhood. I felt obliged pick up my pace. Sometimes pride can be helpful!

Finally I started to run as I’d trained, and as I should have all along.

Here comes an important clue as to the probable nociceptive or neural nature of ITBS.

To my complete surprise, the pain in my knee melted away once I got moving. Gone! It was like magic. All I did was change the way I was running, and thus moving my body. I negative split that Ironman marathon by 22 minutes. This means that I ran the second half marathon 22 minutes faster than the first. An unusual feat.

I’ve never had this knee pain since.

  • No rolling.
  • No trigger point work.
  • No metal scrapers.
  • No huge physical therapist bills.

A simple kinematic (how you move) change. This observation is inconsistent with inflammation or tightness of the IT band.

ITBS and plantar fasciitis

Was this single observation just an anecdote, junk science based on BS, or did it help solve the riddle of how Cholera is spread?

You might call this anecdotal data. Not me! This observation is of value for our understanding of exercise-induced aches and pains. Think about Dr. Snow’s single observation about the spread of cholera. Based on a hunch, he persuaded a group town elders in London, England, in 1854, to remove a pump handle. This terminated a cholera outbreak. A single observation demonstrated that cholera is a water-borne disease.

A single observation can be a game-changer, when studying disease.

Question the obvious, especially when it comes to pain.

PS Whether I’m right or wrong about ITBS, isn’t important. It’s whether I’ve got you thinking about it that counts.


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Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.