If the first question that a runner asks is “can I still run?” the second question is almost always “will this get better by the time I run my race?” Every time we get 6-8 weeks out from a marathon season, we get a new crop of athletes hoping that their ache or pain is just a little tweak instead of a debilitating injury that will take time to recover from.
Every injury has a unique recovery timeline, but today, we are focusing on IT band syndrome recovery time. We’ll be talking about factors that can influence your recovery. By the end of this post, hopefully you will have a better sense of what to expect when dealing with this injury. Not sure what IT band syndrome is? Head over to our other post “What is IT Band syndrome and how do you fix it?”
Factors That Impact IT Band Recovery Time
It’s no surprise that IT band syndrome recovery time can vary, but what are the variables? In my years of professional experience working as a physical therapist for runners in the Boston area, these are the biggest variables:
Duration of symptoms
This applies to many different injuries including IT band syndrome. The longer you experience symptoms, the longer it may take for your body to recover. If pain persists after the necessary time has passed for you to go through the phases of injury recovery (inflammatory, proliferation, and remodeling), then you likely have one or a combination of the following scenarios going on:
There continues to be tissue damage that never fully recovered
The nervous system has increased sensitivity to the area.
Increased sensitivity in your nervous system is like having a smoke detector that goes off every time it gets a whiff of steam when you boil pasta water.
There is some data to show that ITB recovery time can take between 2 weeks to 5 months. (1) The longer the duration of symptoms prior to treatment, the longer the recovery time will likely be, which means early intervention on these injuries is super important!
2. Anatomical Factors
There are certain anatomical features that can increase your risk of developing IT band syndrome. If present, these anatomical factors could also prolong IT band syndrome recovery time, or increase likelihood of recurrence of symptoms.
People who have excessive knee varus (bow legged), increased pronation, and leg length discrepancies have an increased likelihood of developing IT band syndrome because all of these anatomical features increase the amount of tension on the IT band in their own way, which increases the amount of compression of the IT band on the tissues beneath. These postural factors may prolong recovery because anatomical variables are sometimes hard or impossible to change.
In these cases, it can be helpful to use some sort of accommodation like a foot orthosis, or develop a new movement strategy to help change the load on the IT band at least temporarily to give these tissues an opportunity to calm down.
3. Current training conditions and environments
IT band syndrome can be especially tricky to recover from because, aside from pain and prolonged recovery, there is little concern of continued severe tissue damage with continued activity. As a result, people often train through pain for longer than they would with a bone stress injury which, conversely, has a high risk of worsening with severe consequences.
Running on a banked track consistently in the same direction or trail running on a narrow path can often cause increased knee varus forces on the outside leg, which increases strain or compression of the IT band against the structures beneath. If you are a track athlete or a trail runner who has to perform all of their training on this type of surface, it may take you longer to recover because you need to tolerate more strain through the IT band than a flat ground runner.
4. Inefficient running form
IT band syndrome recovery time can be prolonged when a runner continues training without addressing running form issues. Running form can often get blamed for injuries than it’s truly responsible for, over striding is a very common finding in runners with IT band syndrome and can relatively easily be addressed.
In my experience with my patients, focusing on increasing cadence (steps per minute) by 5-10% can go a long way at reducing over-striding, with the end goal cadence range to be 165-180 steps per minute. Running with a metronome and/or tracking your cadence with a garmin or other run tracking device can be a helpful way for runners to practice increasing their cadence. Learn more about running gait analysis at Alterra.
5. Training load and recovery
Sleep, diet, stress, and training load. All things that if not tended to properly, can make ANY injury take longer to recover from. It’s important to understand the relationship between all of these things.
For example, maybe a hard interval training session that you’ve done before without any issues causes a significant uptick in symptoms because you slept for 4 hours the night before and have been eating vegan recently without adequate protein intake.
6. Footwear
Choosing the right running shoe is an individual process that may require some trial and error, and what works for someone else may not work for you.
However, shoes with a thicker cushion on the heel may encourage you to continue over striding and landing with a heel strike. If you developed your IT band syndrome symptoms while running in a high cushion shoe, you may be able to decrease your recovery time by trying a more minimalist shoe AND working on your running form.
How To Decrease Your IT Band Syndrome Recovery Time
Summarizing the points above, here are some tips to decrease your recovery time when dealing with IT band syndrome:
Start physical therapy ASAP! The longer your symptoms go untreated, the more likely your recovery will be longer. IT band syndrome can often be easy to treat when caught early, so nip it in the bud before it gets bad.
Address anatomical factors. Consult with a physical therapist about any adaptive devices like orthotics, taping, heel lifts, or movement strategies to help decrease the significance of any anatomical contributors to your symptoms.
Adjust your training environment. Try to run on flat ground or on a slight incline. If possible avoid running downhill or on narrow paths where you have run “on a tightrope.” If you have to run on a banked road, try to vary the direction so that you balance which leg is on the downhill.
Increase your cadence. Whether you get a professional running gait analysis, or you just do some cadence work on your own, tracking and increasing your cadence 5-10% can help decrease over striding and help decrease the strain on the IT band.
Manage training load and recovery. Working with a coach or physical therapist to create a training plan that is progressive and supports your recovery, as well as prioritizing your recovery by sleeping 7+ hours per night and making smart fueling choices.
Try running in a more minimalist shoe. This doesn’t have to be a barefoot shoe! Just a shoe with less cushion in the heel and a smaller drop from heel to toe. We like the Altra Experience Flow, but there are many other options out there as well.
IT band syndrome can be a tricky injury to treat, but hopefully now you're equipped with the knowledge to help you recover as quickly as possible!
At Alterra, we specialize in helping runners resolve any and all of their injuries that limit their running ability or performance. If you're local to Boston's Back Bay area and are dealing with IT band syndrome, we'd love to help! Book a free discovery call to chat with a therapist today.
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Disclaimer: The information in our blog posts is not a substitute for professional medical advice. Consult a healthcare provider before making decisions related to your health. Use our content at your own risk.
Sources
Mulvad B, Nielsen RO, Lind M, Ramskov D (2018) Diagnoses and time to recovery among injured recreational runners in the RUN CLEVER trial. PLoS ONE 13(10): e0204742. https://doi.org/10.1371/journal.pone.0204742
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