Not my ITB

January 12, 2014

rhian asked The Guru for the following Physiotherapy Advice:


2 months ago I sprained my ankle mildly while on holiday. After I got home I started to run again (I’m training for the marathon) and after my first run, I had extreme pain on the anterior lateral aspect of my knee. Every time I’ve tried to run since the pain occurs, so much so that I can’t run, and I am limping for the day after I try! I have been to a physio that said it was just a tight ITB, but none of the stretches/exercises are helping and the pain is getting worse. I’m at a loss of what to do and would love some advice!



January 12, 2014

Hi Rhian

All sounds very plausible, but I think it’s a case of having an tight ITB due to a sprained ankle, but only dealing with the ITB and not looking at the ankle – and what you’ve done to accommodate to the sprain.

Have a good look at your foot posture and can you control it post sprain – and do your running shoes still give enough control? Have you done loads and loads of balance work? what about single knee squats – are both sides the same (I’d doubt it!).

Stretching your ITB is near impossible. You can stretch the top (TFL) or the bottom (lateral reticulum) but not the middle. Using Glut med better (not getting stronger) will offset a tight ITB (a la single knee squat test). Foam rolling shoudl help, but not cure.

So, check your shoes, looks at your glut function a la single squat, go nuts on balancing on 1 leg, foam roll and just maybe feel if you’ve got a really tight kneecap….

Guru Responded

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