iliotibial band syndrome

RUNNING INJURY PREVENTION

Over many years of coaching junior and masters runners I have seen the same recurrent injuries year after year that sideline runners for weeks to months. 65-75% of runners are injured annually (Hanlon, 1987).     Think about that for a second, 3/4 of runners are sidelined with injury each year.   Through my experience most of these injuries are preventable with a well-designed training program that integrates core stability, mobility, strength, and sound training principles with technical development.

Taunton et al. (2002) compiled a list of common overuse injuries suffered by runners:

 

●      Patellofemoral pain syndrome

●      iliotibial band syndrome

●      plantar fasciitis

-       the above accounted for 32% of all running injuries

●      meniscal injuries

●      patellar tendinopathy

●      Achilles tendonitis

●      Shin splints

●      knee/hip pain

●      stress fractures

Most of the injuries mentioned have a few commonalities in their root cause.  Once such commonality is over striding.  Over striding while running refers to the athlete reaching or placing the foot too far out in front of the body (center of gravity) causing the foot to slam down into the ground.  The result is an inefficient running stride, characterized by larger than optimal breaking forces applied to the lower body.  The reasons for over striding can vary from person to person but are typically driven by mobility, stability and strength imbalance factors Souza (2016), Milner (2006), and Noren et al. (2014), (2012)  Where the breaking point (injury) occurs is largely a function of individual makeup and training idiosyncrasies.

 

 

As a physiologist I have spent most of my career developing methods to prevent injury. In doing so, a fundamental understanding of the mechanisms of injury are requisite to the design of an effective training program focused on injury prevention and performance.  As previously noted, most injuries are caused by fundamental imbalances of optimal mobility and stability.  The dysfunctional interplay between these two essential elements of locomotion can lead to a laundry list of issues to include:

 

-Increased impact forces (due to overstriding)

-Altered/compensated muscle firing patterns which put additional stresses/activity on adjacent muscle groups

-Restricted range of motion of joints specifically ankle, hip and spine

-Inability to have proper body position

-Inability to balance and have dynamic stability

-Inability to transfer and manage forces generated by our muscles 

 

 

“A potential driver of poor running kinematics are a lack of, or simply inefficient reflexive core stability strategies.  This issue fundamentally prevents an expression of the full range of motion of the lower body.  To understand this concept, an assumption is made that the human body is inherently designed to covet stability over mobility. 

When the reflexes that drive the stabilizing muscles of joints crucial to locomotion  - in this case we are talking about the central core - have become slow or neurally pruned (due to lack of use or previous injury) the body seems to compensate by using prime movers to stabilize the involved joint(s). 

Since these muscles can not be movers and stabilizers at the same moment in time, the body will default to stability over mobility and a loss of range of motion can be noted. 

Hence sub-optimal reflexive control of the core leads to compensatory movement and stability strategies in an attempt to provide the articulating limbs with a solid base of operation.   The net result to the end user of said strategy is one of restricted range of motion or in a worst case scenario - pain and injury.” (Shropshire, 2020)

Poor mechanics due to mobility deficiency or  poor running technique in turn results in over-striding which dramatically increases the impact forces while running.  All this extra pounding will result in stress related injuries such as shin splints, plantar fasciitis, and joint injuries.  Injuries related to mobility and core strength deficiencies tend to be iliotibial band syndrome and gluteal medius injuries.   

So how do you prevent these injuries? Start with an Original Strength or FMS evaluation, then have your stride mechanics assessed. Once you know what deficits you have, address them, start an corrective exercise program to improve your mobility and stability imbalances. Then improve your mechanics with stride development drills.

Copywrite ©  2019 Stuart Kremzner