Table of Contents

The 5 Magic Exercises........................................................................................................................................ 2

The 5 Magic Stretches........................................................................................................................................ 4

Nutritional Supplements.................................................................................................................................. 6

Water Running...................................................................................................................................................... 8

The Strap.............................................................................................................................................................. 12

Orthotics............................................................................................................................................................... 13

Cycling Modifications...................................................................................................................................... 15

Icing........................................................................................................................................................................ 17

The Foam Roller................................................................................................................................................ 19

The Heel Cup....................................................................................................................................................... 21

Physical Therapy............................................................................................................................................... 22

The Camber......................................................................................................................................................... 23

Food........................................................................................................................................................................ 24
 The 5 Magic
Exercises Click and Watch Video

After watching the video above, you may be tempted to launch immediately into performing
all 5 exercises every day of the week.

This would be a mistake.

It would result in over-use syndrome, further inflammation, and burn-out.

Instead, you need to gradually implement all 5 exercises over a 4 week period of time, as
follows:

• 4 days of week, perform • Continue with week 1 protocol

4x20-25 fire hyrants per side
• Add 4x20-25 side lying leg raises,
working back and forth between
WEEK WEEK side lying leg raises and fire
1 2 hydrants

WEEK
• Continue with week 4 protocol
• Add 4x10-15 hip hikes per side
4 3
• So by this time, you are performing
fire hydrants + side lying leg raises
+ standing side leg raises + elastic
band side-steps + hip hikes.
WEEK
• Continue with week 3 protocol, but
reduce to 3 days per week
• Add 4x20-25 elastic band or Gymstick
standing side leg raises and 4x15-20 elastic
band side-steps per side, continuing to work
through each exercise as a circuit
• Click here for an elastic band similar
to what I use in the video for side leg raises
and click here for a mini-band for the
side-steps.

IT Band Friction Fix! 2

Once your pain has disappeared (which will likely be around weeks 6-8), decrease the entire
Week 4 program to just one time per week. This continued program will be part of ensuring
that your knee remains bulletproof.

Try to do the program before you are fatigued. In other words, don’t do it after a run, or after
a weightlifting session. Use it for warm-up, or perform it in the morning when you are fresh.

And remember, never push through pain. If 4 sets begins to hurt, then reduce to 2-3 sets. If
your knee has become very weak, this may be necessary.

Summarized Plan of Action for Immediate Implementation:

start Week 1 immediately.

IT Band Friction Fix! 3

 The 5 Magic
Stretches Click and Watch Video

Unlike the exercises in Module One, you can actually implement all these stretches immediately.
Also unlike the exercises, you can and should be performing these every day of the week if
you are truly serious about completely eliminating your pain.

We’re talking about a 5-10 minute commitment every day.

Each stretch should be held over 10 seconds and up to 30 seconds. You won’t receive much
additional benefit by holding for more than 30 seconds.

The stretches will be more effective if you perform them while your muscles are warm.
However, if the only time that you can find to stretch is in the morning immediately after you
awake, you will still receive benefits.

I recommend performing Module Two before Module One if you experience any pain during
the exercises in Module One. Otherwise, you have the option of performing the stretches
after (as a cool-down), during (as you rest between exercises) or at a different time of day.

One you are able to begin running and cycling, I highly recommend the standing IT band
stretch as a stretch to stop and perform during your routine if you A) experience any IT band
tightness or B) want to play it safe and make sure the tightness never arises.

Another strategy that you can use is to break the stretches up throughout the day. They don’t
all need to be done at the same time, as long as you complete all 5 stretches within a single
day.

IT Band Friction Fix! 4

Once your pain has disappeared, choose the two stretches that you “feel the most”, and
continue to perform them on a daily basis. Typically the standing IT band stretch and lying
leg crossover stretch will be the deepest stretches that are most effective.

limited dorsiflexion and ankle mobility can drastically increase the knee’s pull
of force on the IT band. In addition to the stretches in the video, also add this
Update stretch.

Summarized Plan of Action for Immediate Implementation: begin all stretches

listed above immediately.

IT Band Friction Fix! 5

 Nutritional
Supplements Click and Watch Video

In my experience, many athletes and exercisers underestimate the healing power of dietary
supplements. Here are the actual dosage recommendations from the video above. Please
understand that your unique physical condition, allergies, intolerances and medical state
will influence these suggestions. Do not consider them a medical prescription. Speak with
your physician if you are taking pharmaceutical drugs, which may interact with any of the
following supplements.

Branched Chain Amino Acids (BCAA’s) - Most of the research that shows benefits
of BCAA’s use dosage of 10-20g/day. Look on the label for leucine, isoleucine and
valine. I personally use BCAA’s from a company called “Wicked Fast”. They’re called
Recoverease, and you can find them here. Recoverease also contains two proteolytic
enzymes - papain and bromelain.

Proteolytic Enzymes - Wobenzym are the most popular brand, and contain trypsin,
chymotrypsin, papain and bromelain. A good discussion of this brand can be found
here.

Glucosamine Chondroitin - Consider this a “joint lubricant”. Two brands that I

have been impressed with are Hammer Nutrition’s “Tissue Rejuvenator” (use 15%
discount code 80244) and Mt. Capra’s “Capraflex” (use 5% discount code BGF).
Typical effective doses are 1500mg of glucosamine and 1200mg of chondroitin.

IT Band Friction Fix! 6

 Vitamin C - if you are eating fruits and vegetables, a dose of 1,000-3,000mg per day
should be sufficient. I do not recommend more than 6000mg per day, as this can lead
to gastrointestinal upset. Vitamin C is very common and easy to find in effervescent
tablet, pill, tablet, or capsule form.

BONUS: While you’re at the health store, you may also want to look for a very
powerful topical anti-inflammatory called Arnica. One wonderful Arnica containing
product is called Traumeel, and can be massaged into the affected area several times
per day.

BONUS 2: 30-45 minutes prior to exercise, you can also rub a natural muscle-
warming agent into the skin. Try Greyhound Juice.

Summarized Plan of Action for Immediate Implementation: begin a nutrition

supplementation protocol as soon as possible, and include topical anti-inflammatories.

IT Band Friction Fix! 7

 Water
Running Click and Watch Video

An IT band injury can require low-impact or non-weight bearing exercise to maintain fitness
until your knee is pain-free (since the alternative, highly non-attractive option is to run
through the pain and destroy your knee forever).

Sometimes creative, non-traditional methods are necessary to maintain peak aerobic fitness
without causing damage to an injury. Research has shown that non-impact water exercise
offers this benefit, and this activity is utilized by quite a few pro triathletes and marathoners.

There are two different types of aqua jogging: 1) running in a deep water where you cannot
touch bottom of pool; 2) running in shallow water with feet touching bottom of pool.

The first method of aqua jogging is the non-impact version that I highly recommend and that
I will introduce in this module. The second version is relatively low-impact when compared
to running, but can still cause pain in the knees during the initial stages of something like an
IT band injury.

Non-impact aqua jogging requires a few different pieces of equipment:

1 Aquatic Shoes (optional). I wear the AQX Aquatic Training shoe. With strategically
placed vents and fins,these shoes allow you to achieve 2-3x the cardiovascular
intensity when compared to simply running in your bare feet. Trust me, I also tried
wearing an old pair of running shoes and they were soggy, heavy, and very non-fluid.
They actually hurt the knee. These shoes make it so easy to actually get your heart
rate up and keep it there, which for me was one of the more frustrating aspects of
water jogging before I started wearing them. In bare feet, you have to pump and

IT Band Friction Fix! 8

 pump and pump the legs at a very high turnover to achieve any type of training
effect heart rate. The shoes fix this, and providing resistance, flow impedance, and
increased muscular recruitment.

2 Flotation Belt (required). Some pools actually have these available, typically
somewhere near to the pull buoys and kickboards. I personally use the Speedo swim
belt, which is comfortable and doesn’t leave the little rubbing marks and blisters
on my stomach like some of the belts at the pool. A belt is a must, since you must
ensure that a part of your torso is above the water or you will spend too much energy
attempting to stay afloat.
3 Tunes. In my opinion, audio is a must, since there is not much to look at while aqua
jogging (although I have been tempted to bring all my aqua jogging gear to a local
lake on a sunny days). Here is what I do:

• take a small sandwich ziplock bag

• drop an mp3 player inside the bag

• thread the headphones out the top of the bag

• seal the bag

• then affix the bag to the side of my head with my goggles strap

This homemade solution works pretty well. Another option is an actual underwater mp3
player. A relatively new one on the market, the Nu Technology 2 GB Waterproof MP3 Player
is convenient because you can also use it while freestyle swimming, and it doesn’t actually
mess with the audio quality like some of the other brands.

I would consider Nu Technology the cadillac of underwater mp3 players. But check out this
link for a wide range of other waterproof/underwater mp3 players.

Form will be important. The AQX Aquatic Training shoes include a DVD that teaches proper
form for regular deep water running, deep water cross-country skiing, and shallow water
plyometrics/running drills. The video on this module will also be helpful.

Here is the basics of proper deep-water running form:

• Lean forward.

• Bring the knees up towards the chest and kick back through full range of motion,
exactly as you would when running, but slightly more exaggerated. Imagine you’re
running up a steep hill.

• Pump the arms vigorously, but leave the fists closed.

IT Band Friction Fix! 9

 • Avoid a straight up-and-down posture with a piston like up-and-down movement
of the legs. This is more like bicycling, and won’t stimulate the running muscles as
much as leaning forward and kicking through the range of motion.

• And yes, for those of you wondering, you can jog in a stationary space, but it is more
interesting and beneficial to actually move forward, such as down and back in a lap
lane.

Finally, let’s look at workouts for aqua jogging. Depending on your level of physical activity
prior to injury, you should comfortably be able to perform 2-4 water workouts per week. Do
not push through pain. You can use The Strap (Module 5) in the water.

Skills
This workout offers multiple benefits - it works on running form, intensity, and muscular
strength:

5 minute warm-up (i.e. 3 laps running)

1 HARD exaggerated running effort at max capacity for 1 length of the pool, then easy jog
back

1 HARD heel-to-butt kick effort for 1 length of the pool, then easy jog back

1 HARD high-knees-running effort (knees come all the way up to chest), then jog back

1 HARD cross-country ski effort (straight legs, straight arms), then jog back

Repeat these HARD efforts as a circuit, going 2, 3, or 4 times through. Workout time will
range from 15-30 minutes, depending on how many circuits you perform. Cool-down jog for
5 minutes.

Aerobic
This is a steady-state cardiovascular workout.

Warm-up: 10-minute easy jog

Main Set

2 minutes straight leg kick; driving from the hip with toes pointed down

10-minute steady-state run

2 minutes straight leg kick; driving from the hip with toes pointed down

10-minute steady-state run

IT Band Friction Fix! 10

2 minutes straight leg kick, driving from the hip with toes pointed down

Cool-down: 10-minute easy jog

Intervals
This is a hard-easy interval style workout.

Warm-up: 10-minute easy jog

Main Set

5x 20 seconds hard, 40 seconds easy

4 to 6x 90 seconds hard, 3-minute easy

Cool-down: 10-minute easy jog

Workout Total: 43-52 minutes

Pyramid
Warm-up: 10-minute easy jog

Main Set

1 minute hard, 1 minute easy

2 minutes hard, 2 minutes easy

3 minutes hard, 3 minutes easy

4 minutes hard, 4 minutes easy

5 minutes hard

Cool-down: 10-minute easy jog

Since water-running is non-impact, if you are pain-free with this type of activity you can
perform sessions every day if desired.

Summarized Plan of Action for Immediate Implementation: if water running is

100% pain-free (remember that you can wear the Strap from Module 5), and you want
to maintain fitness, find a pool with deep water, get your gear, and begin at least one
time per week.

IT Band Friction Fix! 11

 The Strap
Click and Watch Video

I’m a big fan of the Pro-Tec IT Band Compression Strap. Here is a detailed video with application
instructions.

You can use the strap while cycling, running, water-running, walking, sleeping, or anytime
you want to control friction of the IT band against the femoral condyle.

Some athletes that I coach have literally worn it throughout the day, every day, until pain-free.

While you wait for your compresson strap to arrive, you can make-do with an Ace Bandage
wrapped around the same area.

In either case, when wearing such a device, you risk chafing and blisters, especially in the
back of the knee. To eliminate this risk, simply use an anti-chafing cream, lotion or topical
application like Vaseline, Chamois Butter or Bodyglide.

Summarized Plan of Action for Immediate Implementation: get a strap and begin
wearing it immediately.

IT Band Friction Fix! 12

 Orthotics Click and Watch Video

During the process of overpronation, especially if one has a flat foot, the tibia (shin bone)
internally rotates and pulls the IT band along with it, which increases the distance the
attachment of the band must travel to its insertion point on the tibia. This causes pain and
inflammation.

To determine if you overpronate, go to a shop that specializes in running shoes, and have
them observe your gait. Alternatively, you can have a friend video-tape you, then watch in
slow motion. You’ll be looking for your foot to tilt towards the inside when you have the
greatest amount of weight upon it, preferably while running.

In this case, you can wear shoes that are called “support” or “motion-control” shoes. There
is also a good “over-the-counter” orthotic called “Superfeet” that you can place into your
shoe. Follow this link to find a Superfeet dealer in your area OR simply click here to order
immediately from Road Runner Sports (just do a search for “Superfeet”). Finally, you can
actually go to a physical therapist, podiatrist, or sports medicine doctor and be casted for a
custom orthotic, but this often requires a doctor’s prescription. A custom orthotic will likely
be an investment at $300-400.

But just think - you’ll have a custom cast of your foot for the rest of your life.

Less common is a high arched foot that supinates, pulling the iliotibial band in the opposite
direction. In this case, your foot would be tilting outwards in midstance and you would want
to look for a neutral cushioned shoe, and most importantly, not a motion-control shoe (this
would be a mistake!).

IT Band Friction Fix! 13

You need to take care of the foot-ground interface as soon as possible, because many of the
exercises and modifications in the other modules are performed while standing on your feet,
and will be far more effective if you have the proper support.

Summarized Plan of Action for Immediate Implementation: go to a running store

or have a friend video tape and find out whether you pronate or supinate, then get a
proper shoe and orthotic immediately.

IT Band Friction Fix! 14

 Cycling
Modifications
Click and Watch Video

Lateral knee pain while cycling will typically arise when:

the cleat position is too narrow or rotated externally, causing your foot to be held in
1
an internally rotated position (toes pointed in)

2 too little pedal float (which results in excessive knee frontal plane motion)

a saddle which is too high (causing the tibia to internally rotate at the bottom of the
3
pedal stroke and pull the IT band along with it).

4 a saddle which is too far back (same reason as #3)

The solution is to widen foot position (also known as “increasing the Q angle”) by moving
cleat towards the inside of the shoe, make sure the cleats are not rotated externally, adjust
the pedal float to be 6 - 8 degrees and ensure your seat is at a correct height and fore/aft
position.

You may also need to use an orthotic or wedge to correct foot alignment (typically involves
placing a “varus” wedge on the inside of the shoe, or wearing a custom-casted cycling orthotic).

As you make adjustments, do so in small increments, and use an indoor trainer so that you
can simply get on and off the bike to make the slight modifications.

When you adjust your saddle height , try to be at 30-35 degrees of bend at the bottom of the
pedal stroke. To get a good starting point, take your inseam (in centimeters) and measure

IT Band Friction Fix! 15

by 0.883. This should be your distance from the top of the seat to the center of the bottom
bracket. If you place your heels on the pedals, have someone else hold the bike, and pedal
backwards, your hips should not rock back and forth.

A less common, but possible contributor to your pain is the seat fore/aft position. Saddles that
are too far back will cause you to reach for the pedal and stretch the IT band with resultant
knee pain. This would really be the same scenario as having a seat taht is too high. You can
evaluate your pedal position with the “plumb bob technique”. Sit on the saddle with the pedal
in the 3 o’clock position (parallel to the ground), and hang a straight line (“plumb”) from the
most forward portion of the knee. This line should intersect the ball of the foot and the axle
of the pedal.

So returning to the concept of cleats with float, which are the best?

I’m a fan of Speedplay or Look Keo (beware, the black Look Keo cleats have zero float, go for
Gray or Red).

If your IT Band Friction Syndrome is related to a leg length discrepancy or “rotated

hip”, it may be necessary to “shim” the shorter leg, which is typically the side that
is experiencing the IT band pain. In this case, if the leg length discrepancy results
in a discrepancy of more than 6mm, a shim may be indicated. You can get a shim,
Update which is inserted between the cleat and the shoe, from many local bike ships,
or a website like www.bikefit.com. To ensure you can maintain equal muscle
distribution between the affected and unaffected sides, begin by making sure
that your cleats on both shoes are in the same location for each side and then
move the “shimmed” side cleat back 1mm for every 5 mm that you shim your leg.

Summarized Plan of Action for Immediate Implementation: if you’re a cyclist get

your shoes and make the modifications, then find a friend with a goniometer or a bike
fitter and make sure your seat is set up properly.

IT Band Friction Fix! 16

 Icing
Click and Watch Video

Doctors have prescribed cold treatments for injury since ancient Greek times. Icing slows the
inflammation and swelling that occurs after an injury, numbs sore tissues for pain relief, slows
nerve impulses to an injured area (which reduces a “pain-spasm” response) and decreases
tissue damage.

But many people hear that they should ice a sore joint, then simply place a plastic bag of ice
or perhaps an ice pack on the injured area for 10-15 minutes after a workout.

Active management of an injury dictates a much more dynamic icing approach. Ice massage
requires less time per session and introduces a faster healing response.

Here’s what to do:

• Use a small dixie cup, or cut off the top half of a styrofoam cup, and freeze some
water inside. When you use it, peel back the top part of the cup.

• Rub in quick circles around the the area where you experience the highest degree of
pain when the knee is slightly bent, until the area feels numb.

• Stop if the skin starts to feel burning, and avoid bony parts, like the front of the knee.

• Attempt for 3 ice sessions per day.

My favorite time to ice is while driving (use caution and common sense), watching TV, or
talking on the phone. By multi-tasking while you ice, you’ll be more likely to keep up the habit
until the pain subsides. Once you are pain-free, you can stop icing.

IT Band Friction Fix! 17

 do not ice directly prior to a workout. You may experience even more IT band pain
! because ice will reduce muscle elasticity. Ice after a workout, or when you know
Cautions you’ll have a long time to warm-up the knee prior to vigorous exercise.

Summarized Plan of Action for Immediate Implementation: begin ice massage 3x

daily. If combined with exercise, always post-workout, never pre-workout.

IT Band Friction Fix! 18

 The Foam
Roller Click and Watch Video

The best place to get your foam rollers is at Perform Better, which sells a PB Elite Foam Roller
that offers ultimate compression and durability. Sometimes called “The Poor Man’s Massage”,
the foam roller is a form of self-myofascial release, and can help your IT band to be far more
pliable.

With just a few minutes a day, a foam roller can ultimately provide a kind of stretch that not
even massage can provide. Just like massage, it may be slightly uncomfortable at first, but
once the muscle tension has released, it will be easy to maintain elasticity by rolling the tight
spots along the outside of your leg just a minute or two each day.

Eliminating tension will also reduce the formation of scar tissue in the IT band.

Perform the foam roller exercises in the video every day, preferably prior to a workout.
Continue until pain-free, then begin to roll 2-3x/week, preferably on days that you run or
perform hard bike rides.

While we’re on the topic of massage, you may want to approach a massage therapist or
physical therapist about hands-on manipulative therapy, which can also be effective in
treating areas of restriction and repairing the biomechanical flaws that led to the knee pain.

Your therapist should be encouraged to perform massage or deep tissue massage to the
tensor fascia lata, hip flexors, and piriformis muscles, in order to restore ranges of motion in
hip adduction, extension, and internal rotation. For IT Band Friction Syndrome, other specific
areas to address with manipulation include the T12-L1 vertebral segments (origin of the
iliopsoas) and the fibular head (partial insertion point of the IT band).

IT Band Friction Fix! 19

Feel free to simply copy the paragraph above and give it to your therapist.

Summarized Plan of Action for Immediate Implementation: get a foam roller and
begin rolling every day.

IT Band Friction Fix! 20

 The Heel
Cup Click and Watch Video

In the video, I am using a simple 1/4 inch heel cup made by a company called Spenco. You can
find these at any common running or sporting goods store, or here. This is a good strategy
if you find that you simply have to train for an upcoming event, or must somehow complete
the event. This method can be highly successful if combined with the cambered road running
outlined in Module 12.

The heel cup should be inserted into the shoe of the non-injured leg.
Important

Artifically increasing leg length via the heel-cup method can lead to far different
forces in the ankle, hip, and knee than your body is used to. I highly recommend
only using the heel cup for runs until you are pain free. When you initially use the
! heel cup, do not stand or walk for more than 2 hours. You can eventually progress
Cautions to keeping it inserted through-out the day, but remember, only until pain-free.
Do not use a one-side-only heel-cup “for life” or you will likely experience hip or
lower leg problems.

Summarized Plan of Action for Immediate Implementation: call your insurance

company or speak with your physician about getting these treatments into your
program as soon as possible. Yes, you can be insistent. You are the customer and you are
boss, even in medicine.

IT Band Friction Fix! 21

 Physical
Therapy Click and Watch Video

You will likely need a physician’s prescription prior to utilizing the physical therapy
modalities discussed in the video. You will also need to speak with your physical therapist
about the individual settings and intensities for ultrasound, electrical stimulus (e-stim) or
e-stim combined with compression icing.

If used properly, these modalities can be highly successful at decreasing inflammation and
rapidly accelerating healing time.

The ultrasound and e-stim methods can also be used to “warm the muscle” prior to competition
or training, as both will improve tissue elasticity

Other electrotherapeutic treatment techniques you may find useful at the physical therapist
are TENS, ultrasound and interferential. Some therapists will combine this treatment with
hydrocortisone or a similar topical steroid preparation.

You may need 4-6 weeks of these treatments for complete healing, and they should be
combined with the other modules for ultimate success.

Summarized Plan of Action for Immediate Implementation: call your insurance

company or speak with your physician about getting these treatments into your
program as soon as possible. Yes, you can be insistent. You are the customer and you are
boss, even in medicine.

IT Band Friction Fix! 22

 The
Camber Click and Watch Video

In most cases, the left side of the road has a left-leaning camber and the right side of the road
has a right-leaning camber.

Therefore, if your knee pain is on the left side, you will want to run on the left side of the road,
which will reduce the amount of bend in your left knee upon impact. Vice versa for the right
side.

Other changes you can to maintain running fitness while limiting pain and inflammation in
the IT band include:
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Summarized Plan of Action for Immediate Implementation: identify any run

circuits that do not allow you to adjust the camber, and eliminate them. Until pain-free,
choose cambered circuits only.

IT Band Friction Fix! 23

 Food
Click and Watch Video

Diet is a key part of your inflammation-fighting plan, and some foods have amazing anti-
inflammatory properties. Summary of the video:

Avoid cereals and grains. Among the top culprits are breakfast cereals, non-
sprouted bread, and pasta. Instead, choose gluten-free cereals, or whole grains like
quinoa, amaranth, and millet.

Eat dark-skinned fruits and vegetables. Pomegranates, cherries, blueberries,

plums, artichokes, spinach and broccoli are excellent.

Eat cold-water fish. Salmon and mackerel are best.

Drink green tea. Or take a green tea extract, like Thermofactor.

Eat nuts. Walnuts, almonds, pecans, pumpkin seeds, and flaxseeds are highly
effective.

IT Band Friction Fix! 24

Here is a sample daily meal plan that fights inflammation:

Breakfast: 1 cup cooked quinoa with handful of blueberries, 1 tablespoon almond

butter and dollop of yogurt. Take glucosamine chondroitin prior to
breakfast.

Mid-morning Plum, 1 cup unsweetened pomegranate juice, or handful of cherries.

snack: Include 1 handful of walnuts, pecans, or pumpkin seeds.

Lunch: Steamed broccoli with one baked sweet potato and 2 boiled eggs.

Mid-afternoon One slice sprouted bread with goat cheese and avocado.
snack:

Dinner: Steaded spinach with salmon cooked in olive oil and seasoned with sea
salt, cayenne and turmeric.

Dessert: 1/2 bar dark chocolate dipped in yogurt.

Summarized Plan of Action for Immediate Implementation: throw out grains

and cereals, stock your shelves with the items listed above, and change your diet
immediately.

IT Band Friction Fix! 25