Thursday, June 10, 2010

ITBS – from Ouch to Ooooo! – in plain English, Part II

Yesterday I described what ITBS is (Iliotibial Band Syndrome), how to diagnose it, and how to treat it.  Today’s post has the instructions for a proven exercise designed specifically for runners to prevent or mitigate ITBS.  I have used it myself and found it to be very effective.

The exercise is known as the Walt Reynolds Special, and all you need to do it is a step, and perhaps something to help you balance (I use a broom). For the purpose of the description let us assume that the left leg is suffering from ITBS (after all it’s not right!). If you are using this to treat a problem on the right side, just swap the descriptions around.

Firstly stand sideways on a step on the left leg which is suffering from the ITB problem. Balance holding on to a wall or broom with your right hand and keep your legs straight but relaxed

Keeping your legs straight, and without leaning your upper body, lower your hip on the right side by a few inches below the level of the step. This has the effect of raising the hip on the left side a little, as well as a small outward movement to the left. You may feel a tightening of the muscles in the hip on the left side as they are stretched. This actually mimics the position of your hips when your foot on the problem side is in contact with the ground whilst running. The hip is swivelling and acting as a pivot for the upper body.

Next, move your centre of gravity towards the right hand side, so that most of your weight is being carried on the inside of the left foot on the step. Again remain upright, and share your weight evenly between both your heel and toes. This process further mimics the running action, simulating the natural and essential pronation of the foot.

So far so good. Now bend your left knee a little by about 10-20 degrees. This lowers the right foot towards the ground, but not so that it touches it. Next comes the tricky part which can take a bit of practice to get right.  Keeping your weight on the inside of the left foot, the knee angle on the left leg the same, and the left heel on the ground, move the left hip forward a few inches. Obviously keeping the knee angle the same and with the heel on the ground, the only way you can achieve this is by rotating the hip forward, raising the front of the pelvis and slightly lowering the back of the pelvis. So as you move you hip forward, you torso should move backwards. I actually find it easiest to initiate this movement by moving the upper body backwards, and concentrating on keeping the problem leg static, so you have to tilt the pelvis correctly to avoid falling over.

When you have rotated your pelvis forward by about 4 inches, rotate it backwards by a similar amount by leaning your torso forward and return to the start position to complete one repetition.

It is this motion which accurately mimics the biomechanics of running from the ITB’s point of view without actually running, enabling you to strengthen and stretch your ITB in a controlled manner.

There are a couple of points to concentrate on during this exercise. Keep the left hip higher than the right, and keep the left hip out to the left side throughout. Also make sure that the movements of the hips are straight backward and forward, avoiding any lateral motion.

If you are doing the exercise correctly you will feel burn (or intense stretch) on the outside of the effected hip. If not, or you are feeling it elsewhere, just try again, and make sure you are following the important points mentioned above.

Whilst it may at first seem that from a simplistic biomechanical point of view the hips are the anchor point about which the legs swing. The reality is that the foot whilst in contact with the ground is the anchor point, and the hip is actually a pivot rotating around the foot. This action puts enormous strain on your ITB, because the forward momentum of running multiplies the effective weight of your body, which is carried mostly through this one area every time your foot hits the ground (which typically happens around 90 times a minute!).

So it’s no surprise that without a strong and flexible ITB, you could find yourself hobbling home early from a run, with a mass of red hot painful tissue which is going to have you out of action for a few weeks, perhaps even months.

When I first learnt this exercise I did use it to treat ITBS rather than in its’ prescribed preventative manner. You just have to go very slow and steady, a as always listen to your body. From a remedial perspective I would do about 5-10 reps every day, increasing the number gradually, provided there was no further pain.

If you are performing the exercise in a preventative manner, then I would suggest 15-20 reps on each side every day, and again listen to your body.

I know that many of us do not have the time to do this every day, so once you have understood the principles of this exercise you can adapt it into your daily life and routines. Perhaps whilst waiting for a bus you can do a toned down version, but be careful of your balance. I don’t want anyone falling under the bus whilst trying this out! You will be surprised at the benefit you will get from this sort of occasional activity, and after a time you may find yourself subconsciously standing in odd positions making the most of every available training minute without even knowing it.

Happy running!
Andy

“Success is not final. Failure is not final. It is the courage to continue that counts.” – Winston Churchill