Iliotibial Band Syndrome

ditpoker

http://www.time-to-run.com/injuries/thebig5/itb.htm

After my first 10 miler on Sunday my knee was a tad sore, nothing major. Then went to do my usual 4m run home from work, my first mile was slower than usual and I just put this down to fatigue from my 10m at the weekend, but by the 2nd mile I was genuinely struggling to maintain the run, and ended up having to get a bus the last 2 miles which was quite depressing.

I had a physio appointment yesterday evening anyway which was fortunate, went in and explained my injury and she instantly pointed out the above injury and said it was a common injury. As you can see a google search above has found some results.

Currently my knee is lightly strapped (for 24-48hrs), then I'm to do a light jog on friday, and i'm back at the physio next Tuesday.

Does anyone have experience with this knee injury? Is it as common as suggested? any miracle cures? Suggestions? The website above says recovery time is 3-6weeks and my marathon is in 6-7 weeks.

--amadeus--

I personally think that your physio is being very conservative. Are they sports injury specialists? I've never heard of strapping for ITB problems (not that that means anything) and at a low level it's the sort of injury that can be managed away without having a huge impact on your training. I had a similar thing when I started running (about the same stage as you) that I self diagnosed. I iced and stretched and it was fine, the website you linked to has some excellent advice as well.

All of which is an unqualified opinion - a physio is a physio and if they have sworn you off running then the priority is to maintain fitness - swimming (or even aqua jogging if you can bring yourself to do it) are probably best.

Good luck - you have plenty of time yet!

louthandproud

You can run with an IT band problem, once you have given it enough time to start healing(3-4) days but you will have to run below threshold of irritation, i.e. slower and shorter distances and on level ground. You should ice it every night too. Stretching can also help. I have had this injury before and the above worked for me. Wrong shoes was the real cause for me as well as not running slowly enough on the weekly long runs (apparently a very common problem and cause of many injuries ).

I was back to speed in a few months once these were fixed and healing was complete and have had no re-occurrence in three years. Not a good prognosis for your marathon I know, so I would definitely make sure I saw a sports injury physio and one that runs too if possible.

tunney

I've suffered from ITBS for 6 years now.

It first flared up when I trained for the Dublin City Marathon with I first started running. It flared up 3-4 weeks out from the marathon. Despite physio treatment it didn't clear up and I didn't run the marathon. It took about 3 months to clear.

I've had it flare up once to twice a year every year since and I've read all that there is to read and gone to all the best people about it.

Basically I now catorgise my ITB issues into three groupings.

1) Fatigued legs: (recovery 1-2 weeks) I can generally predict when this will happen based on my annual training plan. If I pick the blocks with the biggest bike and run mileage (25-35 hours training per week) I can pretty much guarantee that at the end of the block I will have some ITB pain and it will limit my running towards the end of the block.

The ITB's purpose is to stabilse the leg during motion. It is effectively just a tendon that connects below the knee and runs up to the front and top of a hip to a very very small muscle called the TFL (Tensor Fascia Latae). When the rest of your legs are shot the TFL gets recruited to generate lift rather than just stabilise, it tires quickly, locks up and your ITB hurts.

Treatment is rest (nothing quad heavy, light cycling), massage, stretching, good food and sleep. Using foam rollers and tennis balls for the TFL can help

2)Proper flare up: (recovery 6-8 weeks) Generally comes on after periods of neglect of my body. I've not stretched properly, not changed my runners enough, not got a massage and ignored tired legs that need good food, sleep and some TLC. Ignoring knee pain or discomfort is a big player here. These bouts are what most people get. They take along time to shift as the TFL has to be released, the surrounding muscles need to get back to normal, the band itself needs time to calm down and the bursa around the hips and knees need time to stop being inflammed.

Treatment is rest, massage, stretching, good food and sleep. Using foam rollers and tennis balls for the TFL can help. Some anti-inflammatories during the inital phase can help.

3)Meltdown: (2-3 months) I've only had this bad a flare up twice. Once the first time I got it from running through the pain for a good few runs while not taking care of my body in general and once last year. I'm pretty much convinced that this larger flare ups that keep you out of action for much much longer are the same as type 2 flare ups but they occur at time when you have put your body under huge stresses - both as part of training and as part of poor diet, poor sleep, stress in work, stress in everything........

Stress and diet plays a HUGE role in the body recovering. Constant stress and sh!te diet suppress the production of the body's natural anti-inflammatories and in my opinion, and some of the professsionals that I've dealt with, this is something that must recreational athletes ignore.

Treatment for this type is complete rest, improved diet, removal of stresses and generally kicking back with a few good books and realising that your out for a while, roll with it (and try not to put on weight).

Breast stroke swimming and cycling *can* make things worse.

YOU CANNOT RUN ON AN ITB INJURY. When your ITB flares up, forget about running for at least a week.

Bad shoes and running alot on the same side of the road can aggreviate it.

What helps long term wise to deal with it is a proper gym routine that strengthens the glutes - improper recruitment of the glutes is a factor in ITBS as well.

I'm not an expert in sports injuries or anything so the above is just from my personal experiences.

--amadeus--

Ouch - I think with that history I'd have given up running by now.

Have you considered surgery? I know it is only for extreme cases but surely you would qualify at that level.

A selected group of 23 patients underwent surgery for iliotibial band friction syndrome. Among the patients presenting with this exertional pain syndrome were runners, football players, and cyclists. Diagnosis was clinical since radiographs were negative and an ultrasound examination was positive in only one case, showing an aberrant picture around the lateral femoral epicondyle. Although conservative treatment is effective in most cases, an alternative is needed for patients with complaints that are resistant to conservative means.

Surgery was done with the knee held in 60 degrees of flexion and consisted of a limited resection of a small triangular piece at the posterior part of the iliotibial band covering the lateral femoral epicondyle. The uniform good results, low morbidity, and quick return to sports demonstrate that this type of surgery offers a solution for selected cases of failed prolonged conservative treatment.

http://www.ultrunr.com/itb.html

ditpoker

thanks for the posts.

any suggestions as to what type of training to do to keep some degree of fitness up? swimming and cycling come to mind but i'd imagine cycling involves alot of knee work, and as far as swimming goes would you recommend hitting the pool this evening, or giving it a few days? i really dont wanna lose the base fitness..

Stupid_Private

tunney wrote: »

What helps long term wise to deal with it is a proper gym routine that strengthens the glutes - improper recruitment of the glutes is a factor in ITBS as well.

I'm not an expert in sports injuries or anything so the above is just from my personal experiences.

I've been struggling with the glutes since my long run on Sunday and toying with the idea of having an unscheduled rest day today to give them a chance to recover. This post made the decision for me... day off it is!

jeffontour

Personally I was stopped in my tracks by ITB round April last year for around 2 months. For me the root cause was too rapid an increase in mileage made all the more troublesome by a lack of stretching on my part.

The solution for me was rest, time with a good sports massage person(can't emphasise this enough) and the 2nd physio I attended took one look at me running style(the 1st didn't look at all) and told me I was leaning forward too far from the hips(straining the ITB even more) whilst running. She suggested I take a look at chi running and it helped me greatly.

Every case is unique but that's what worked for me. As already said strapping sounds weird, only time I strapped was for a long race and that was to ease the pain as opposed to aid recovery. In my opinion most injuries can be related to a soft tissue problem, be it tightness due poor stretching habits or poor running form due to an imbalance in muscle development.

Good luck with the recovery and hope you make the race.

tunney

A thing call a Phat-Strap exists that goes on just above the knee and it alleged helps with ensuring the ITB doesn't scrap over the bone and flare up. I never tried it as it sounds like avoiding the problem.

Technique is a huge player as well. Lift using your psoas and concentrate it it. A spasmed psoas will rotate your leg and recruit the TFL.

ditpoker

http://www.youtube.com/watch?v=5RC7VH3bEB4

i dont have sound in work but this looks like something that could help. will watch it with sound later.

Amazotheamazing

I suffered from ITBS for the best part of 4 years, initially it was misdiagnosed but after continuing reoccurance I finally changed doctors and got it correctly assessed.

what eventually cleared it for me was a Patt Strap, going to Amphiban King for proper shoes, and stretching. I wouldn't run on it (but then I used to try and run through it and wouldn't be able to walk for the next day), plenty of rest and when you do go back, go back slowly.

--amadeus--

Reading through this thread, other internet stuff, my own experiences and books it seems like there are two types of ITB trouble.

For some the ITB flares up early in there running career as miles first start to build or later on as a symptom of overtraining. These people can rest and stretch thier way back in a fairly short time and may even run at very low intensities during the recovery phase. These people may only suffer once or twice in thier lives.

For others though there seems to be a chronic problem, maybe biomechanical in nature, that means that flare ups are a regular and predictable occurrence. Serious interventions are needed, running on the injury is a strict no-no and surgery can be considered as an option.

Sound right? If so then the advice given out would be very different, wouldn't it?

ditpoker

From Jeff Lisson:

Wanted to let you know that there is hope for ITBS sufferers who want to run!

As I told you, I developed ITBS in my left knee about 4 weeks before my
marathon, which was last Saturday (December 11 in Kiawah Island, SC), after an 18-mile training run. Planned to do 20 the next weekend, and had to quit after 3 - pain was too great. Rested a week, stretched, tried to run, and couldn't. Rested another week, stretched, ran seven, and it struck again.

I then bought the PattStrap from Fabrifoam, after seeing the USNA review linked from your site. Got it, ran 7 miles and two 3-mile trainers without problem.

Well, on Saturday, I ran the complete marathon! Finished it without any ITB pain at all. I was sore all over, no question. Still am. Left knee hurts, but no worse than the right. My time was poor - 5:45, but I did it. My first. I focused on finishing, not time.

The PattStrap was amazing for me. When I developed the ITBS, I thought I was through. I couldn't believe how such a simple device could work. It's just a piece of fabric with a hook-and-loop fastener which wraps about 2-3 inches above the pain area. It shortens the muscle/band flex point, relieving the friction.

That said, there are others which do the same thing, many of which are more commonly available in running stores (not necessarily advertised for this purpose; many are for use below the knee for bursitis, e.g.). However, I don't think they would work as well, due to their design, which relies on the calf expansion to help keep them in place.

I am sure the strap cost me a lot of time. I had run a 10-minute pace
consistently in training, on long and short runs. With the strap, I
consistently ran 12 minutes. Why? The strap not only shortens the ITB, it shortens all the other upper leg muscles as well. That shortened my stride, which meant each footfall covered less ground, and I needed more footfalls to finish the race.

Also, I didn't have adequate time to strengthen the shortened upper leg
muscles. It's like asking 16 inches of an 18-inch muscle to do the same
task. Believe me, I felt the difference.

But all that said, my goal was to finish. I didn't think I'd even start.
The strap let me do it. I can't say enough about it, helping me accomplish a goal I'd worked so hard for when things looked so bleak.

found the above, and figure in a weeks time when i go back to running i'd like to do so with the aid of the patt-strap to get me through. I'm gonna go google hunting for best place to buy this strap but recommendations would be great. would amphibian king stock it?

since my 10miler (10 days ago) i got this injury diagnosed on tuesday, so 1 week ago. Since I used a cross trained in the gym and did 3-4m on that, thats all i did. i've been stretching every spare moment i can and have noticed an improvement but have noticed in even a week my fitness has dropped. planning on going for a swim tomorrow. does cycling help? can i cycle with ITB issues. Am going back to physio tonight and will hopefully get the green light for light running on flat.

tunney

--amadeus-- wrote: »

Reading through this thread, other internet stuff, my own experiences and books it seems like there are two types of ITB trouble.

For some the ITB flares up early in there running career as miles first start to build or later on as a symptom of overtraining. These people can rest and stretch thier way back in a fairly short time and may even run at very low intensities during the recovery phase. These people may only suffer once or twice in thier lives.

For others though there seems to be a chronic problem, maybe biomechanical in nature, that means that flare ups are a regular and predictable occurrence. Serious interventions are needed, running on the injury is a strict no-no and surgery can be considered as an option.

Sound right? If so then the advice given out would be very different, wouldn't it?

Me thinks you're trying to convince yourself that its okay to run on an ITB problem.

tunney

Wish I'd never mentioned the phat strap now.

Address the underlying issues, don't dodge them.

--amadeus--

Me thinks you're trying to convince yourself that its okay to run on an ITB problem.

No, far from it. I think that everyone's first resource is there own body and if you are in pain then don't run, regardless of what you may have been told or read.

What I do think is that all injuries (like all runners) cover a spectrum. In "The Lore of Running" Noakes categorizes injuries into groupings ranging from 1 (mild discomfort when running) to 4 (cannot run at all). Ignoring a cat 1 injury can progress it, eventually up to a Cat 4. His argument is that early but light intervention (at stage 1) means that an athlete can continue to train while managing the injury and recovery.

On forums like this we all throw out amateur advice based on what we are told and our own knowledge and experience. I personally think that the OPs physio was overly conservative and that a sports injury specialist may have given very different advice. Based on my own personal experience I know that stretching and reducing the intensity and duration of training can give the ITB time to recover without the need for a total break. Other people - like yourself, based on your post above - have very different experiences and so would give very different advice. It's up to the OP to balance all these opinions with that of the medics he has seen and make a decision on what to do next. Right or wrong this decision will give him the experience to deal with the problem if it ever comes up again.

The other thing I would strongly agree with is to address the underlying cause of the problem, be it shoes, gait or over-training.

Amazotheamazing

It depends on the type of runner you are to, to a degree. My ITBS flared up about 7 miles into a half marathon once, after 10 miles I was in serious trouble, I spent the last mile counting down the seconds in my head, I was in utter misery. Race over, could barely walk, had to helped onto my borthers bike and free-wheeled down to Hueston station (race was on in Phoenix park). Got home to Limerick, had to collected etc. Went to the doctor the next day, he was nice about it but he gave me a lecture on listening to my body etc.

It seems most people would have had the good sense to stop at 7 miles, rest, ice and not do the damage I did by listening to my ego and not my body. I'm not a fast runner, or a particularly good one, so no idea why I didn't just stop, but as Top Gun taught us, my ego was writing cheques my body couldn't cash.

My advice is to be over-cautious with this type of injury, respect it and if it doesn't feel right then don't run on it.

ditpoker

Sunday- did 10m, after knee hurt.
Tues- went for run but had to stop cos of knee
Tues- went to physio
Wed- posted this topic here
Fri- did cross trainer, very light session. knee no worse or better after it
Mon- first thought my knee was ok...
Tues- went back to physio, told to try a ligth run session.
Wed (today)- up at 6.30 and did 2.5m , was meant to be a 3m but at 2.4 knee started to hurt so stopped immediately. first thing i did in work was order this patt-strap (sure its only $12). will not run on it again for a few days. very concerned about losing the fitness i built up though so will probably be looking at swimming in the next few days.

if/when this strap arrives, prob 5 days, i'll give another 2-3 light session a go with the strap. if it helps, i can keep training. if it doesnt... i'll seriously look into putting off marathon plans til october and just stay off the knee for a long time.

--amadeus--

Check out aqua jogging as a way of maintaining fitness.

That said this seems to be getting worse rather than better - if it was a mild bit of inflamation brought on by the long run then you would have expected it to have calmed down enough for you to run a short distance without having to stop (shown by the physio giving you the green light to try running again).

Be very careful with this strap - it may only mask things, buying you some breathing space only for this to flair up again a lot closer to the race.

You still have 6 weeks and your aim (IIRC) was to finish rather than run a fast time. Why rush recovery and risk not making the start line - you tried resting, stretching and then a low intensity run. It didn't work so more rest and more stretching seem to be called for rather than more running.

Is your physio a sports injury specialist? If not a 2nd opinion might be worth getting.

ditpoker

no, physio is not a sports specialist but has done marathon(s) and a triathlon (chicago i think?). gonna stay off it for a few days and try a short run when the strap arrives but without wearing the strap, if problem persists the next run after that will be with the strap.

i should note i am pretty injury prone in general in my football and with specific regard to my right leg i have sprained my ankle badly 3 times and done light twists numerous times as well as i missed 9 months when i severely damaged by right big toe when i was 16-17, and i'd say this affects my stride even now. i'm quite the fan of "the quick fix", i.e. wanting to get things done quickly but have always sworn by a lot of physio before even considering drastic things like surgery. I dislocated my shouler (right side again) about 18 months ago and opted against surgery, preferring physio and my shoulder was back to normal 3-4 months after so im very pro physio as a solution. a variety of stretches and exercices to strengthen or offload the pain is my ideal, something like a strap i would consider a short term solution, and given that my target (london marathon) is in next 6 weeks im looking for a solution in those 6 weeks followed by a focus toward more long term solution, i.e if i were to run dublin i would pre-empt any running training with alot of knee work or ITB work to get it right as rain before my first step of training.... i should have used paragraphs for this!

topper75

Orthotics.

tunney

Ah Orthotics - the first resort of the bad or lazy physio.

topper75

Fixed me.

When it comes down to it, injuries have only two sources:
-overdoing it
-mechanical distortion in legs

The first one you fix yourself and orthotics go a long way to sorting out the second.

A hip injury won't necessarily affect your feet but an arch problem may feed right up into your lower back. When your whole body weight is landing on your feet thousands of times over as you run, you better make sure that foot is well-formed at every contact. The consequences are obvious if you don't.

If not for the 'lazy/bad' physio who prescribed them for me, my running career was finished.

tunney

More often than not its caused by a weakness or imbalance in muscles. Identifing them and then prescribing the correct exercises is not, in my experience, something alot of physios are arsed doing.

topper75

tunney wrote: »

More often than not its caused by a weakness or imbalance in muscles. Identifing them and then prescribing the correct exercises is not, in my experience, something alot of physios are arsed doing.

So what exercises are there for those who overpronate?!

ditpoker

i figured it'd be rude to take all the advice I was given here and not report back with an update.

I peaked my training at 10m in 94mins, which i was delighted with, but was stopped short by my knee injury. Sadly i tried resting for 2 weeks, went back to running and knee hurt after 1m. then 3 week rest so effectively a 5 week rest with a 1m run half way through. then went out to do a run on flat UCD running track surface and after 1m+ the knee went again.

beyond saying "yes your knee is sore" my physio had no miracle cure, the stretches and straps and everything i did/tried hasn't worked.

With this in mind i deferred my london marathon place til 2009 and have booked into to see a knee specialist who used to work in blackrock clinic but now works in santry (apparantly ) on April 28th so I'm hoping he can point me in the right/better direction so my knee has a chance of training for the 2009 race. I am tempted, if he suggests a plan that would allow it, to give Dublin a go in october.

As I had my flights and everything booked for london i went over and watched the finish line for a bit on the day. The day before i was getting a taxi past london bridge area and there was a load of barriers up and the 35km sign and that for some reason really triggered an urge to get this knee sorted. Then after the marathon while walking around leicester square I saw a woman walking around in her marathon gear and a complete stranger walked past and shook her hand and said "congratulations, i'm delighted for you" which almost had the woman in tears given that a stranger had acknowledged her achievement.

in summary... my knee hurts and i wanna run a marathon!!!

tunney

Sorry to hear that.

But get the ideas of dublin out of your mind. You won't be able to do it. Dublin is 6 months our and you have a good 2-3 months recovery left. You won't be able to recover and train for Dublin.

Concentrate on London. Hit the gym 3 times a week. Do core exercises and exercises for your glutes, ankle and knee stability, quads and hamstring. I cannot stress how important being strong is.

Get a foam roller and massage the quads, hamstring, back and ITBs twice daily. Stretch every day as well. Build a routine that you can use to maintain yourself once you start back running.

Learn to run properly. Ditch the mp3 player and focus on your form. If you don't understand form then find a good runner and watch what they do. You want your pelvis and trunk to remain steady and unmoving.

Swim and cycle as well and watch the weight. You're injured but you still have goals so watch your weight.

paulksnn

Really sorry to hear about the lack of progress ditppoker.
I hope things improve soon for you, I really do. I was out for 4-5 weeks and was chomping at the bit to get back. I can only imagine what you're going through.

BTW - I still have my ITB. Have done all the stretches in the world and hasn't improved.
The only thing that works is to take it very easy for the first 20-30 mins of the run.
After that lengthening my stride to go faster (which is what sets my knees off) doesn't seem to generate as much pain.

ditpoker

i'll knock the dublin idea on the head right now so. I really want to get this right... going to go on to amazon now and order a foam roller. With regard gym work and strength training I assume any leg work will be beneficial, focusing on glutes,quads, hamstrings as you say.

"running properly" is probably easier said than done, any online resources? or even somewhere that can advise on technique in dublin?

thanks again.

jenc

Hey think your right to give Dublin a miss. It is coming around the corner now and as Tunney said you just don't have enough time to recover and get back training now.

What worked for me was joining a Yoga class in Total fitness and attending that for 10 weeks which I believed helped with my flexibility I also got fitted for the correct runners when I went back running I took it very slowly at the start.

Ciaran_D

I wish I had found this thread sooner, very useful advice here. Thanks all.

I've had ITB problems since last August whilst training for the Dublin marathon. By that stage I had been training for almost a year (though from a very sedate lifestyle) and was up to a weekly total of 100km+.

I thought all was going well when myself and my wife went on holiday for a well-deserved break in late July, and after getting back I went out for a short run to ease myself back into training. Then the problem started.

A pain in my left knee got worse and worse during the run that eventually, I had to stop and walk home. Thinking I just hadn't stretched enough, I tried again the next day after more extensive stretching but the pain came again.
After a couple of weeks of trouble, I eventually went to see a physio in town. I was still hoping for a quick fix that would allow me to run the marathon in October.

Since then, I've changed physio as I was happy with the initial and although I've been stretching, resting and doing the prescribed weights, I'm still unable to run 10km - a distance that I could easily run 6-days-a-week a few months before! During the intervening months, the ITB pain has switched to my other leg and has brought about patellofemoral issues too. Needless to say, I couldn't run the marathon in October either.

I'd love to run in Berlin or London this year, but until I can tackle this problem I feel registering is just a waste of money. At this stage I'm thinking that the stability problems that the physio identified might be better addressed with orthotics or even better running shoes. I'm going to try Amphibian King at the weekend.
Why this issue arose after a year of running still confounds me.

tunney

Ciaran_D wrote: »

I wish I had found this thread sooner, very useful advice here. Thanks all.

I've had ITB problems since last August whilst training for the Dublin marathon. By that stage I had been training for almost a year (though from a very sedate lifestyle) and was up to a weekly total of 100km+.

I thought all was going well when myself and my wife went on holiday for a well-deserved break in late July, and after getting back I went out for a short run to ease myself back into training. Then the problem started.

A pain in my left knee got worse and worse during the run that eventually, I had to stop and walk home. Thinking I just hadn't stretched enough, I tried again the next day after more extensive stretching but the pain came again.
After a couple of weeks of trouble, I eventually went to see a physio in town. I was still hoping for a quick fix that would allow me to run the marathon in October.

Since then, I've changed physio as I was happy with the initial and although I've been stretching, resting and doing the prescribed weights, I'm still unable to run 10km - a distance that I could easily run 6-days-a-week a few months before! During the intervening months, the ITB pain has switched to my other leg and has brought about patellofemoral issues too. Needless to say, I couldn't run the marathon in October either.

I'd love to run in Berlin or London this year, but until I can tackle this problem I feel registering is just a waste of money. At this stage I'm thinking that the stability problems that the physio identified might be better addressed with orthotics or even better running shoes. I'm going to try Amphibian King at the weekend.
Why this issue arose after a year of running still confounds me.

It arose because you came from a sedentary lifestyle to trying to train for a marathon Practically a guaranteed way to get ITBS (cue hunnymonsters et als "But I didn't" ).

I'd venture a guess that your form is not fantastic and that your core is rather and you're probably in the wrong shoes.

I don't know where you are based but if you are based in Dublin I can give you the number of the best soft tissue guy around. He gets me back running in under two weeks, usually one. (However if the bursa are inflammed it will be a while before you can run again).

I'll miss these marathon threads once the tri - marathon split happens... *sob* *sob*

Ciaran_D

tunney wrote: »

It arose because you came from a sedentary lifestyle to trying to train for a marathon

I'd understand that if I developed ITBS soon after starting, but after a year? Maybe it arose only after reaching those levels of training...
You're right though - I did just get off the sofa one morning and went running, but I started very gently. It took four months to be able to run 10km in a single session.

tunney wrote: »

I'd venture a guess that your form is not fantastic and that your core is rather and you're probably in the wrong shoes.

Funny that you mention form because neither of the two physios that I've been to has asked to look at me run. I would have expected this was quite important!

tunney wrote: »

I don't know where you are based but if you are based in Dublin I can give you the number of the best soft tissue guy around.

That'd be great. I'm based in south Co. Dublin but travel is no problem if I thought it'd help. Thanks.

shels4ever

tunney wrote: »

I'll miss these marathon threads once the tri - marathon split happens... *sob* *sob*

If the split happens hope you'd still visit us ....

looseliver

I've had this in the past and had it fixed by some good physio. if you can get to an injury specialist i'd recommend it, if you can't then try this at home.
Get your legs warmed up and then with a rolling pin go up and down on your IT band, stopping for extra work where it's tender. this will give you some relief.
keep in mind that you got this injury (as did I) through bad form. unless you correct it you'll continuously be receiving treatment.
the injury is caused by your hips rocking from side to side while you run. picture the way a supermodel walks for an exaggerated image of this. each time your hips rock they're creating tension in the IT band, over distance this causes pain.
i would recommend going for a short run and focus on keeping your pelvis level from left to right and back to front. rotate your pelvis to the front (using your lower abs)to make it level before you begin, keep it this way while you run and this will become easy.

Good luck in the Marathon
ll