Dear Eden,

Since my last half ironman, I've been having trouble with my hips, IT bands, and knee pain - I hypothesize that it's a kinetic chain that the hips and IT band are putting excess stress on the patellar tendon, and causing the knee trouble. I've done a bunch of research as to how to correct it, so here's what I've been doing in hopes that it's useful to someone else. This details IT band stretches and hip and core strengthening.

Shout out to Vanessa for her physical therapy expertise and peer review.

Love from,
Alyie and the Exercise Phys Lab Rat files

First of all, your IT band is a fibrous tissue that runs from your iliac crest (hip bone) down the side of your leg, over the lateral femoral condyle, and attaches just below the knee. The glutes and tensor fascia latae anchor it in place; pain results when its rubbing on the lateral femoral condyle inflames it. If you have issues with it, here are suggestions for pre, during, and post run:

PRE-RUN: heat, heat, heat. Then when you land on a tight IT band, it isn't quite so tight. I have a heating pad and will lay on my hip on top of that for 5 min or so before I run. I also tend to stretch my

• hips (standing, put one ankle on the opposite knee, making a triangle. Sit back as if you're sitting in a chair)

• quads (normal, standing grab-your-ankle-and-stretch-your-quad routine)

• hip flexors (right knee on the floor, left foot on the floor so left knee is at 90 degrees, lean forward until you feel a stretch through the front of your hip)

RUN: I've been on the treadmill for everything. Cambered roads exacerbate IT band and hip issues. Flat is good. I'm still trying to decide rather hills (incline, rather) is aggravating, better, or doesn't seem to make a difference.

POST RUN: foam roll, stretch while it's still warm, then ice. The stretches I do are demonstrated here. The foam roller is easy - you lay on top of it on your hip and roll back and forth, hip to knee. Once you get all the stretch (and strength stuff: see below) done, ICE the bursa on the lateral knee. The IT band can rub over this and become irritated, manifesting itself in the pain we call runner's knee.

The strength stuff I've been doing:

Hip abduction and adduction - your thighs (quads) are composed of a bunch of muscles. An imbalance of those can result in injury. In my case, my hip adductors are weaker than the abductors (you can tell this for yourself: which side of your front thigh looks more developed, has more muscle? Lateral is abductor, medial is adductor).

• An exercise to help with this: leg raises. Standard leg raises, in which you lay on one side and raise the top leg, work the hip abductors (think 'abduction,' moving away). To work the adductors, move the top leg with the foot on the floor - it's there for support - and raise your bottom leg. I do 2 x 25. You can add ankle weights when this no longer feels challenging.

Bridges: click me

• From this pose, lift one leg straight up, keeping your knees level and your glutes tight. Your goal is to keep your hips flat, not dropped on the side of the leg you've just lifted. Try holding each leg up for 8-10 seconds.

Pelvic drops: Stand on a stair such that one foot is parallel with the edge and by 'dropping' one hip, your other foot goes down. Rotate up. Do 10 on each side.

Single leg squats: stand on one leg and put something (a small weight, a coke can, something of that size) in front of you. Do a squat... then try and reach down and touch the object. The better you get at it, the farther away you put the object.

Core: which is supposed to help your running and strength... my current routine involves, every other day:

• plain old crunches

• bicycle crunches (touch elbow to opposite knee: other leg extends)

• crunches on a fit ball

• oblique crunches on a fitball (one hand behind your head, other arm extended: crunch up to the side, your arm should raise over the opposite leg)

• double crunches (on a mat: normal crunch but bring your knees toward your chest as well)

• To hit the lower back: back extensions, which you can do over the ball (tummy/hips are on the ball, you'll be either on your knees or the ball depending on how big the ball is) or on a back extension 'machine' at the gym (it's more of a "stand" than a machine). On that 'machine' I also do extensions on each hip. Warning: these will make you good and sore the next day.
  Back extensions: I do 3 x 15 each way
  Crunches: I do 3 x 20 each way