Change your breathing rhythm to fix/prevent ITB problems


When we first took up running in 2001, I made all the classic mistakes: too fast, too far, too soon. The end result? ITB syndrome. I went from one physio to the next and finally one casually mentioned that my one leg is longer than the other. The said leg presumably is taking all the hammering resulting in ITB problems. No other explanation was given at the time.

Fast forward a few years and another physio came to the same conclusion. Only this time I was told that my pelvis rotates and that that is the cause of the leg discrepancy. I tried all the exercises, stretched religiously, was very cautious not to overdo my training, and even put a heal-raise orthosis in the shoe of the short leg, but the end result remained the same. An iliotibial band that is stretched to its max and often inflamed, always sore, sometimes just more bearable than other times.

Through the pain I managed to continue training and ran a few marathons, ultras and also a 5 day 200+km event. I have just about learned to live with the situation when we relocated and I had to find yet another new physiotherapist. But this time I’m very happy to report that she got to the bottom of the problem in the first couple of sessions – finally an answer as to why my one leg is longer than the other one. I have the dreaded S-curved spine. This was later confirmed with the help of X-rays at a chiropractor.

Sadly while knowing the cause of the trouble, there really appears to be no solution. This is just the way it is and always will be.

Then some seven or so months ago, I read in the Runner’s World that the ideal breathing rhythm is to breathe in for 3 strides and out for 2 strides. I’ve always been one that just went with the stock standard 2 strides in, 2 strides out. Am I wrong to assume that most runners breathe like that? Not knowing for certain why 3-2 is better – if Runner’s World gave an explanation at the time, I wasn’t reading that far so had no clue why this is better – I still decided to give it a go.

So I started on the 3-in-2-out method, finding it fairly difficult at first and also needing to concentrate real hard. When you’ve done the same thing for 12 years, it becomes habit, especially when you’re tired or go into auto-pilot. But after a few months, I one day suddenly realised that my ITB seemed to be doing okey. I thought it was all the concentration on the breathing that was keeping my mind off the ITB pain! Still not knowing why the 3-in-2-out method is better, I stumbled upon another runners’ blogpost (forgive me, dear runner, for not taking note of who you were and now I can’t remember!) who explained that when you breathe in, your diaphragm and core muscles are contracted and stronger, making you run stronger and be more in control of your strides and movement, while when you breathe out your muscles are relaxed and your posture more slack and weak. Therefore, during the relaxing breaths, your body is not as stable and strong which can cause all sorts of problems. Hence if you reduce your time in the “relaxed muscles zone” and increase your time in the “contracted muscles zone”, you will run stronger.

What also happened (with me) is that by breathing in for three strides and out for only two, I automatically shortened my stride, had a better turn-around rate and ended up having more of a mid-foot strike. Therefore I hit the ground with my feet right below my shoulders, instead of a fraction in front of me, which seems to have been the cause of many years of ITB syndrome. Well, that’s my story and I’m sticking to it! 😉

We are one month away from a marathon and despite upping our weekly mileage quite a bit over the last couple of months, my ITB is still holding up. No issues whatsoever so far. Who knows what will happen a week or two weeks or two months from now, but for the moment I am a hundred percent convinced that changing my breathing is the cure to my ITB problems. Who know’s what other niggles could be fixed by just changing your breathing, posture, running style etc.

If you had a similar experience, please do share. I’d love to know if there’s more to this than just my isolated experience!


[It has been four years and I haven’t had any ITBS problems since I changed my breathing rhythm. I was also made aware of the original Runner’s World on-line article (the one I read was the hard copy) – thanks Rob!, which explains the whole rational behind the theory.] – 26 April 2018

2 thoughts on “Change your breathing rhythm to fix/prevent ITB problems

  1. I find this most interesting. Recently due to increasing arthritic pain in my knees, I altered my walking style. I fully engaged my core, buttocks, stomach and kept back and head straight ane walked more from my hips. Instant improvement!! Now I’ve added the breathing mentioned here, and even better, many thanks.

    • Sorry to hear about your knee pain, Sue, but I’m glad you are finding ways around it! It is not nice to be sidelined due to injury. I found that it took a very long time to change my breathing rhythm, but I’m glad I stuck with it. All the best!

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