By Vic Brown

Following these 10 injury-prevention commandments of endurance training will help keep you healthy and fit.

1. Rest and Recover

Include rest days in your training plan by taking a complete break from training both physically and mentally. Get off your feet, rest your mind, rest your body for the day. I recommend training no more than two weeks consecutively without resting. Novice and/or masters athletes may require “off” days more frequently. Recovery weeks, typically fewer hours spent exercising or less miles trained, should be included every third to fifth week. Recovery days, easy non-intense training, should follow hard training days.

2. Incorporate Recovery Techniques

There are a number of ways to incorporate recovery into your routine.Biofoam rollers and massage sticks help sore, achy or stiff muscles recover from exercise. Watching movies, spending time with family, reading, listening to music or socializing with friends can all be effective relaxation strategies that allow you to disassociate from physical exercise and reduce tension while developing positive mood states of happiness and calmness.

3. Sleep

Essential for physiological growth and repair, routinely physically active individuals are encouraged to aspire for eight to nine and a half hours of sleep each night. Cardiovascular performance can be compromised by up to 20 percent with sleep deprivation, which also reduces reaction time, the ability to process information and emotional stability. Naps are always icing on the cake.

4. Consume Post-Exercise Fuel

The goal of post-exercise nutrition is to restore muscle and liver glycogen stores, improve hydration, and repair muscle tissue. You should eat 15 to 30 minutes after exercise, preferably as soon as possible, when the muscles are most receptive to fuel. Muscle replenishment and tissue repair can be accelerated if you combine carbohydrates and protein together in a ratio of 4 to 1.

Weigh yourself before and after exhaustive exercise to determine how much water you lost. Stay hydrated by consuming at least 24 ounces per pound of body weight lost within six hours after exercise. Performance begins to decrease after only a two percent loss in body water. Include electrolytes to eliminate the risk of hyponatremia if engaging in activity for more than four hours.

5. Warm Up and Cool Down

A proper warmup is a key component to preparing the body for the demands of any training session or competition. Developing a pre-race warmup is unique to each individual. Performing a warmup will elevate heart rate and VO2, and increase blood flow to the connective tissue and local muscles to be trained. This in turn will raise muscle temperature and help decrease joint and muscle stiffness, therefore improving range of motion.

Warm-up periods of five to 15 minutes are recommended with the effects lasting up to 45 minutes. After 45 minutes of inactivity, re-warming may be needed. On the other side of the coin, the recovery process and preparation for the next day’s training begins with a proper cool down. Low-intensity aerobic exercise, such as aquatic-based training, light jogging or cycling, are effective cooldown activities for clearing lactic acid and lessening the severity of muscle soreness.

6. Integrate Strength Training

Strength training is essential for preparing the body for the rigors of training and racing. It facilitates bone health and enhances injury resistance, including factors that contribute to overuse injuries. It can boost lactate tolerance and assist with delaying fatigue.

7. Use Proper Equipment

Correct equipment minimizes unwanted stress. A bike should fit you, not you fit the bike. Cycling posture and position is individualistic formaximizing aerodynamics, power, efficiency and comfort while minimizing injury potential and discomfort.

8. Follow the 10-Percent Rule

Increase annual training hours, or training volume, by ten percent or less. If you are training according to time, for example, and your triathlon program called for 15 hours of training this week, it’s recommended training hours not exceed 16.5 hours the next week.

9. Interval Train

Proper interval training can improve VO2 and anaerobic threshold. Intervals allow your body to adapt to and eventually race at greater speeds.

10. Know That More is Always Better

Recovery allows your body to adapt to training loads. Conditioning should be specific to the event you are training for. Training volume can be defined as the combinations of how often you work out (frequency) and how long you train (duration).

Vic Brown is an associate strength and conditioning coach at Boston University and assistant coach for Boston Performance Coaching, a triathlon and endurance athlete coaching service. He can be reached at




Running: Muscle Imbalance & Common Overuse Injuries

by Robert Donatelli, PhD PT

An overuse injury in sports is very common. Pain in the front of the knee, patellofemoral pain syndrome, patella tendon strain, hamstring strain, hip strain and rotator cuff strain are conditions I treat on regular bases in my population of athletes. An overuse injury is difficult to diagnosis because of their gradual onset and intermittent pain. The most common cause of an overuse injury in athletes is muscle dysfunction. 

Muscle is the best force attenuator in the body. They initiate movements, slows down movements, and control movements of bones. In other words muscles are our best shock absorbers. Our joints are surrounded by muscle to accomplish the above functions. In order to accomplish the functions described above muscles must work in groups referred to as agonist and antagonist. One muscle group initiates movement and the other muscle group controls movement.

If some muscles fatigue because of prolonged activities such as tennis, the muscle is no longer an effective shock absorber. As a result of fatigue the muscle can become damaged, resulting in weakness, poor flexibility, and inadequate endurance. Muscle imbalance results from weakness, poor flexibility and inadequate endurance in either the agonist or the antagonist. For example, Elliot B and Achland, (Biomechanical effects of fatigue on 10,000 meter running techniques. Research Quarterly Exercise and Sports 52:160-165, 1981), used high- speed cinematography to study the effect of fatigue on the mechanical characteristics in highly skilled long distance runners. They found that, toward the end of the race, the runners exhibited less efficient positioning of the foot at foot strike as well as decreased stride length and stride rate. All of which is placing the runner at risk of developing an injury.

The knee is very susceptible to an overuse injury because of muscle imbalance. Weakness of the hamstring muscle group can cause increase strain to the anterior cruciate ligament (ACL).Play video on torn ACL. Hamstring muscle tightness in the presence of quadriceps femoris muscle (front thigh muscle) weakness has been associated with anterior knee pain. The tightness of the hamstrings increases the compressive forces to the patella femoral joint (Knee Cap). Quadriceps femoris muscle weakness, especially in the vastus medialis, (the inside of the thigh muscle group); can result in lateral patella tracking during knee flexion and extension. The patella (knee cap) should follow a grove on the end of the long bone of the thigh (femur). Muscle imbalance can change the patella’s ability to track effectively.

Quick Hamstring Strengthening Exercises, Protect Your Knees! 
Advanced Hamstring Exercises with Exercise Ball 
Mini Squats with the Physioball for Hamstring and Quad Strength 
The Plate Drag for Strengthening the Hamstring. 
The “Dead Lift” exercise for Hamstring strength. 
Quick Quad Exercises, Strengthen Your Quads, Protect Your Knees!  

In addition to the muscle imbalance between the quadriceps and hamstring muscle groups, muscle imbalances with the hip can also cause patella femoral tracking problems. We have observed that weakness of several key hip stabilizers such as the hip abductors (on the side of the hip) and hip external rotators (muscle that move the foot toward the opposite leg) have a devastating effect on the patella-femoral joint. A recent study demonstrated a significant correlation between weakness of the above hip muscles and injury to the lower leg in athletes. (Leetun, Lloyd-Ireland et al. Core stability measures as risk factors for lower extremity in athletes. Vol 36: 926-934, 2004). The athlete must possess sufficient strength in hip and trunk muscles that provide stability in all planes of motion. 

Prevention of Muscle Imbalace and Overuse Injuries 

Strength training is the best prevent of muscle imbalance and overuse injuries. We incorporate the use of free weights and machine weights in our hip and trunk exercises. Rotational exercises are not commonly seen in the gyms of America. However, strengthening the hip rotators is very important to the athlete. 

Quick Hip Strengthening, External Rotators  

Also, try the hip rotation exercises shown. Lie face down on a pillow and move the ankle to the left and right. Go all the way to the end of the range of motion by trying to move your foot toward the floor. You may want to use an ankle weight with the exercise to make it more difficult. 

Your hip is your center of gravity, and a weak hip can have disastrous effects—particularly on your lower limbs because the hip is where all motion in the lower leg starts. Hip muscles and ligaments are among the strongest in the body and they can affect gait, quickness, agility, and explosive power.

For athletes, balancing the hip muscles can be the difference between winning versus losing and between an injury-free season versus disabling muscle strains. I have observed numerous cases in which pain and muscle dysfunction were caused by major deficits in the hip muscles. I also have seen significant changes in athletes’ performances as a result of strengthening their hip muscles.

The following links provide SportsMD hip strengthening videos
Hip Strengthening Exercises: The Abductors 
Hip Exercises: Trunk Strength, Laterals 

By keeping your muscles strong, you will prevent an overuse injury. You know the proverb: “An ounce of prevention is worth a pound of cure.”

If you suspect that you have a muscle imbalance or an overuse injury, it is critical to seek the urgent consultation of a local sports injuries doctor for appropriate care. To locate a top doctor or physical therapist in your area, please visit our Find a Sports Medicine Doctor or Physical Therapist Near You section.

More Information

Read about sports injury treatment using the P.R.I.C.E. principle - Protection, Rest, Icing, Compression, Elevation.

Related Articles

Stress Fractures and Sports

Shin Splints (Medial Tibial Stress Syndrome)

Shin Splints Stretches

Simple Steps to Avoid Muscle Imbalance and Injury

Related Videos

Shin Splints Video

Tennis Elbow Video




Strength Training

Elite runners consider regular strength and conditioning work a crucial part of their training. Three-time Olympian and physiotherapist Jo Pavey shares eight exercises for improving muscle strength and preventing injury.

Complete Article:



Running: Preventing Overuse Injuries

What causes an overuse injury in a runner?

Overuse injury in a runner most often occurs because of a training error (running too far, too fast, too soon). With every mile that is run, the feet must absorb 110 tons of energy. Therefore, it is not surprising that up to 70% of runners develop injuries every year.

How can overuse injury be prevented?

You can decrease your risk of injury by following these recommendations: 

  • Do not increase running mileage by more than 10% per week.
  • Do not run more than 45 miles per week. There is little evidence that running more than 45 miles per week improves your performance, but a great deal of evidence shows that running more than 45 miles per week increases your risk for an overuse injury.
  • Do not run on slanted or uneven surfaces. The best running surface is soft, flat terrain.
  • Do not “run through pain.” Pain is a sign that should not be ignored, because it indicates that something is wrong.
  • If you do have pain when you run, place ice on the area and rest for 2 or 3 days. If the pain continues for 1 week, see your doctor.
  • Follow hard training or running days with easy days.
  • Change your running shoes every 500 miles. After this distance shoes lose their ability to absorb the shock of running.

What about orthotics to reduce the chance of injury?

Orthotics are inserts that are placed in shoes to correct bad alignment between the foot and the lower leg. You will probably need orthotics if the inside of your foot turns in, a problem called pronation. If you have bad alignment but no pain with running and you do not suffer from repeated injuries, you probably do not need orthotics. Many world-class athletes with bad alignment do not wear orthotics. Your doctor may suggest orthotics if you have bad alignment, become injured and do not get better with other measures, such as rest, ice application and cross training.

What exercises help prevent or treat injuries?

Before and after a run, perform specific stretching exercises. See the pictures below that show stretching exercises. These exercises may also be part of your recovery from an injury. Do not bounce with each exercise. Stretch until you feel tension but not pain. 

If you do develop an injury, your doctor may suggest particular strengthening exercises. Every day you should do 3 sets of each exercise, with 10 repetitions in each set. Be sure to exercise each leg, not just the leg that is injured. For the exercises that involve straight-leg raises, you will want to add ankle weights as the exercises become easier for you. These exercises may also be done as part of your overall exercise program.

Stretching exercises

Hamstring stretch

Hamstring stretch
Sit with your injured leg straight and your other leg bent. With your back straight and your head up, slowly lean forward at your waist. You should feel the stretch along the underside of your thigh. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful for
 patellofemoral syndrome (pain under and around the kneecap), patellar tendinitis (inflammation of the tendon that connects the patella and tibia) and hamstring strain (overstretching or tearing of the muscles on the back of the thigh).

Iliotibial band stretch

Iliotibial band stretch
Sit with your injured leg bent and crossed over your straightened opposite leg. Twist at your waist away from your injured leg, and slowly pull your injured leg across your chest. You should feel the stretch along the side of your hip. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful for iliotibial band syndrome (knee tenderness from irritation of the thigh’s iliotibial band) and adductor strain.

Groin stretch

Groin stretch
Sit with your feet together, your back straight, your head up, and your elbows on the inside of your knees. Then slowly push down on the inside of your knees with your elbows. You should feel the stretch along the inside of your thighs. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful for adductor strain (overstretching of the groin muscles).

Quadriceps stretch

Quadriceps stretch
Stand straight with your injured leg bent. Grasp the foot of your injured leg with your hand and slowly pull your heel to your buttocks. You should feel the stretch in the front of your thigh. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful for
 patellofemoral syndrome, iliotibial band syndrome and patellar tendinitis.

Calf stretch

Calf stretch
Stand with your hands against a wall and your injured leg behind your other leg. With your injured leg straight, your heel flat on the floor and your foot pointed straight ahead, lean slowly forward, bending the other leg. You should feel the stretch in the middle of your calf. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful for Achilles tendinitis (inflammation of the Achilles tendon, the large tendon at the back of the ankle),
 plantar fasciitis (heel pain) and calcaneal apophysitis (inflammation where the Achilles tendon attaches to the heel, usually in children).

Plantar fascia stretch

Plantar fascia stretch
Stand straight with your hands against a wall and your injured leg slightly behind your other leg. Keeping your heels flat on the floor, slowly bend both knees. You should feel the stretch in the lower part of your leg. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful forplantar fasciitis, Achilles tendinitis and calcaneal apophysitis.

Strengthening exercises

Straight-leg raise

Straight-leg raise
Lie down with your upper body supported on your elbows. Tighten the top of the thigh muscle of your injured leg. Raise your leg on a count of 4, hold for a 2 count, and then lower the leg on a 4 count. Relax your thigh muscles. Then tighten the thigh and repeat. Do 3 sets of 10 repetitions each day. Once your leg gains strength, do the exercise with weights on your ankle. This strengthening exercise may be particularly helpful for
 patellofemoral syndromeor patellar tendinitis.

Straight-leg raise

Side leg lift
Lie on your unaffected side, tighten the thigh muscle of your injured leg, and then slowly raise the leg off the floor. Hold the leg up for a 2 count, and lower it on a 4 count. Relax your muscles. Then tighten the thigh and repeat. Do three sets of 10 repetitions each day. Once your leg gains strength, do the exercise with weights on your ankle. This strengthening exercise may be helpful for iliotibial band syndrome.

Straight-leg raise

Inner thigh lift
Lie on your affected side with the unaffected leg crossed over the knee of your injured leg. Tighten your thigh muscles and raise the injured leg about 6 to 8 inches off the floor. Hold for 2 seconds, and then slowly lower your leg. Relax the muscles. Then tighten the thigh and repeat. Do 3 sets of 10 repetitions each day. Once your leg gains strength, do the exercise with weights on your ankle. This strengthening exercise may be helpful for adductor strain.

Standing wall slide

Standing wall slide
Stand with your back against the wall and your feet 6 to 8 inches away from the wall. Slowly lower your back and hips about one-third of the way down the wall. Hold the position for about 10 seconds or until you feel that the tops of your thigh muscles are becoming tired. Straighten and repeat. Perform 10 repetitions each day. This strengthening exercise may be helpful for
 patellofemoral syndrome or patellar tendinitis.

Straight-leg raise

Lying leg raise
Lie on your stomach. Tighten your thigh muscles and slowly raise your injured leg off the floor on a 4 count. Hold the leg up for a 2 count, and then lower the leg on a 4 count. Relax your thigh muscles. Tighten the thigh and repeat. Do 3 sets of 10 repetitions each day. Once your leg gains strength, do the exercise with weights on your ankle. This strengthening exercise may be helpful for hamstring strain.

Lateral step-ups

Lateral step-ups
Stand with your injured leg on a stair or platform that is 4 to 6 inches high. Slowly lower the other leg, striking the heel on the floor. Straighten the knee of the injured leg, allowing the foot of the other leg to raise off the floor. Repeat. Do 3 sets of 10 repetitions each day. This strengthening exercise may be helpful for
 patellofemoral syndrome and patellar tendinitis.


Written by editorial staff.

American Academy of Family Physicians



How to avoid (and recover from) the most common #running injuries

By Christie Aschwanden

From the March 2011 issue of Runner’s World

In an ideal runner’s world, every step of every mile would be 100 percent pain-free. No aches, no twinges, no lingering soreness from yesterday’s workout. The reality is that many runners constantly deal with a slight (or not so slight) disturbance—a tender foot, a tight hamstring, a whiny knee. While these nagging issues often aren’t serious enough to require a time-out, they are annoying, especially when they don’t let you fully enjoy your time on the roads.

Think of running pains in terms of a spectrum. At one end you have severe, full-blown injuries—call it the red zone, which includes stress fractures that require time off. The other end, where you’re in top form, is the green zone. Mild, transient aches that bug you one day and disappear the next sit closer to the green end. Unfortunately, many runners get stuck in the middle—the not-quite-injured but not-quite-healthy yellow zone.

Whether you land in the red, linger in the yellow, or return to the green end of the spectrum depends largely on how you react when that first stab of pain hits, says Richard J. Price, M.D., a sports physician at Rocky Mountain Orthopedic Associates in Grand Junction, Colorado. “Often it comes down to whether you take a little time off now or a lot of time off later,” he says. You can reduce your risk of ending up in the red zone if at the first sign of an issue, you back off your mileage, reduce the intensity of your runs, start a treatment program, and develop a proactive long-term injury-prevention strategy, such as strength training, stretching, and regular foam-rolling. “Physical therapy is like homework,” Dr. Price says. “None of us likes having to do it, but if you don’t do it, the issue will come back.”

According to Price and a team of doctors and physical therapists consulted in the following pages, there are seven injury hotspots that most frequently plague runners. If you don’t get a handle on them, these issues can trap you in that nefarious yellow zone, or worse, turn into an acute injury that forces you to take a layoff. Here’s how you can keep annoying pains in check so you can move into—and, with hope, stay in—the green zone.

Complete Article:



Follow these time-tested principles and you’ll spend more time on the roads—and less in rehab.

By Amby Burfoot (@exerscience)

From the March 2010 issue of Runner’s World

The 10 Laws of Injury Prevention

In the mid-1970s, Runner’s World medical editor George Sheehan, M.D., confirmed that he was hardly the only runner beset by injuries: A poll of the magazine’s readers revealed that 60 percent reported chronic problems. “One person in 100 is a motor genius,” who doesn’t have injuries, concluded the often-sidelined Sheehan. To describe himself and the rest of us, he turned to Ralph Waldo Emerson: “There is a crack in everything God has made.” With all the amazing advancements in sports medicine, you’d think that our rates of shinsplints and stress fractures would have dropped since Sheehan’s era. But 30 years after running’s first Big Boom, we continue to get hurt. A recent poll revealed that 66 percent of respondents had suffered an injury in 2009.

Still, I figured medical science must have uncovered lots of little-known prevention secrets. So I went searching for them. After reviewing hundreds of published papers, I was surprised to find few answers. Most of the studies are retrospective, looking back. A few are prospective, looking forward. Even then, they’re not the gold standard, which are randomized, controlled, double blind experiments. And conflicting results make it difficult to draw meaningful conclusions. I learned, for example, that running injuries can be caused by being female, being male, being old, being young, pronating too much, pronating too little, training too much, and training too little. Studies also indicate that the “wet test” doesn’t help shoe selection, old shoes don’t offer less cushioning than newer shoes, and leg-length discrepancies don’t cause injuries (but too-little sleep does). Oh, here’s good news: To get rid of blisters, you should drink less and smoke more.

Clearly, the medical studies wouldn’t offer much help. So I switched to Plan B: I interviewed nearly a dozen of the best running-injury experts in the world. They come from the fields of biomechanics, sports podiatry, and physical therapy. Like the medical studies, these experts didn’t always agree. But the more I talked with them, the more certain principles began to emerge. From these, I developed the following 10 laws of injury prevention. I can’t guarantee that these rules will prevent you from ever getting hurt. But if you incorporate these guidelines into your training, I’m confident you’ll be more likely to enjoy a long and healthy running life.



Beating the Band

New Treatment for IT Band Syndrome Yields Results

By Brian Fullem, D.P.M. As featured in the May 2004 issue of Running Times Magazine

Beating the Band. New Treatment for IT Band Syndrome Yields Results

Iliotibial band syndrome (ITBS) can be a debilitating injury to a runner. The IT band, as it is more commonly known, can become so painful that a runner is unable to train at all. Mark Fadil, the Director of Sports Medicine Institute International (SMI) in Palo Alto, CA, knows this injury both personally and professionally. As a high-school senior, Fadil won the New York state 3,200m championship in 9:10. After one successful collegiate year, Fadil developed pain on the outside of his knee on the fourth day of his sophomore year. He was diagnosed with IT band syndrome and, even though he was receiving regular treatment—including NSAIDs, ultrasound, stretching, and two cortisone injections—the pain progressed to the point that he could not even run a mile. Nine months later, he turned to physiotherapist Gerard Hartman, and after 11 days of deep tissue massage, stretching, and strengthening, he was able to train again, finishing his career at Stanford as a team captain with an 8:50 best in the 3,000m steeplechase.

What It Is, What It Does, What Goes Wrong

The IT band begins in the hip as the tensor fascia latae muscle and has attachments at the origin from three different muscles: the gluteus medius, gluteus minimus, and vastus lateralis. The muscle becomes a fibrous band of tissue as it progresses down the thigh, then crosses the knee joint, and inserts along the lateral (outside) portion of the patella (knee cap) and into the tibia (shin) bone on a bump known as Gerdy’s Tubercle.

The classic symptoms of ITBS are pain along the lateral (outside) aspect of the knee joint, sometimes accompanied by a clicking sensation. The click is a result of the ITB tightening and snapping across the joint during running. The symptoms are often worse when running up or down hills.

ITBS is typically progressive, starting with tightness and often advancing to the point where the pain is debilitating. The traditional view on the cause of this injury has focused on the tightness of the structure and overtraining. There is no doubt that the ITB will become tighter when it is injured. The tightness, however, is more than likely a result of the injury and not the actual cause. The cause of this injury actually lies in the function of the ITB.

The main functions of the ITB are to assist the hip muscles in abduction (outward movement) of the thigh and to stabilize the lateral side of the knee. The ITB is not a strong structure, and if the surrounding muscles have any weakness that can lead to injury and ITB syndrome. Runners are notoriously weak in their hip and core muscles, particularly if strength training or participation in sports that involve side-to-side movement are lacking.

In a study published in the Clinical Journal of Sports Medicine (July 2000), Dr. Michael Fredericson, a physical medicine MD at Stanford University, compared 24 runners with ITB syndrome with 30 healthy runners and found the injured runners to have statistically significantly weaker hip abductors (mainly gluteus medius and minimus) than the non-injured runners.

Phases of Treatment

Traditional treatment of ITBS has focused mainly on stretching. While stretching plays an important role in the treatment of this injury, there are several other forms of therapy that need to be incorporated.

Given current research, treatment for ITBS should be in phases. The first phase requires a proper diagnosis and the identification of any causative factors. Once this is established, the next phase is aimed at reducing the pain. Rest may have to play a part during this phase, which also may include physical therapy modalities, ice, and stretching three times a day. Cross training that does not aggravate the condition can be done to maintain fitness.

Deep tissue massage along the full length of the ITB can be started in this phase; Dr. Fredericson refers to this as mobilization of the tissues, and it is a necessary step before moving on to the all-important third phase of strengthening the hip and thigh muscles. Fadil recommends very frequent massage: up to every day for elites, and 2 or 3 times per week for recreational runners. If you cannot afford the expense or time of going to a certified massage therapist, a foam roller can work very well for self massage (see to obtain rollers).

In Dr. Fredericson’s study, the injured runners were enrolled in a six week standardized rehabilitation protocol with special attention directed to strengthening the gluteus medius. After rehabilitation, the females demonstrated an average increase in hip abductor torque of 34.9 percent in the injured limb, and the males showed an average increase of 51.4 percent. After six weeks of rehabilitation, 22 of 24 athletes were pain free with all exercises and able to return to running, and at a six-month follow-up there were no reports of recurrence.

Exercises for Recovery and Prevention

If your pain has successfully been reduced, the first exercise that can be performed is side leg lifts. Fadil instructs his patients to use a thera-band for strength work. These large rubber bands come in different strengths and can be ordered from any medical supply store, or one with handy clips and cuffs can be purchased at Detailed instructions and photos of all stretches and exercises are available at Stretching and Strengthening Exercises for Iliotibial Band Syndrome.

Not a Pronation Issue

In some cases, after therapy, stretching and strengthening have been performed then a custom orthotic device may be considered. Patients may benefit more from a cushioned type of orthotic as opposed to a rigid, motion-controlling device. Dr. Doug Richie, President-Elect of the American Academy of Podiatric Sports Medicine (, has never been able to establish a clear-cut relationship between any foot types and the propensity to develop this injury. He states, however, that he has almost never seen this injury in runners with flexible flat feet that overpronate; most runners with ITBS would be classified with feet nearly normal or with a slightly higher arch.

Run Fast, Not Long

Fadil credits Vin Lanana with the finding that faster running is less aggravating to this injury, so strides may be initiated when the pain level has been sufficiently reduced and until the ITB is healed enough to begin normal running. As with most injuries, the longer you have experienced symptoms the longer it may take to recover. Adding strength work in addition to the previous treatment mainstays of stretching, icing and massage should get you back to form much quicker.

Dr. Brian Fullem ( is a sports podiatrist in Newtown, CT. He has captained the Bucknell Alumni team that won the last two Reach the Beach relays.



Study of Long Distance Runners Suggests It’s Sometimes OK to Push on Despite Pain.

By Charlene Laino
WebMD Health News

Nov. 29, 2010 (Chicago) — Contrary to what’s been taught, you can run through pain.

So say researchers who used a 45-ton mobile MRI unit to follow runners for two months along a 2,800-mile course to study how their bodies responded to the high-stress conditions of an ultra-long-distance race.

"The rule that ‘if there is pain, you should stop running' is not always correct,” says study leader Uwe Schutz, MD, a specialist in orthopaedics and trauma surgery at the University Hospital of Ulm in Germany.