IT band syndrome (Full Version)

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nryan63 -> IT band syndrome (October 21, 2004 7:48:00 AM)

I believe it is also called 'runner's knee.' I used to run about 15 miles a week and was trying to get into marathon shape when a few months ago my knee began to bother me. I ran through it for about two months, icing afterwards. In the past few weeks it has completely stopped my running and I have decided not to run for the next month and let it heal.

My concern is that I leave for Army basic training in less than three weeks and I want to be sure that it does not follow me there. I do a few stretches for my condition and continue to ice it daily. I am a former college athlete so I know a little bit about caring for injuries but is there anything else that I could possibly do to fast forward my recovery? Such as strength training or any other cardio that wouldn't be hard on it?

Any help would be greatly appreciated. Thank you



Brian Schiff, PT, CSCS -> Re: IT band syndrome (October 21, 2004 10:28:00 AM)

I have worked with several athletes who have experienced such a problem. In my experience, this inflammation can be very stubborn and difficult to resolve without the appropriate rest. By rest, I mean simply avoiding the activity that provokes the symptoms.

For some it is only running, while others may experience irritation with repetitive motion activities icluding biking, elliptical trainer, stepper, everyday stair climbing, etc.

I suggest attempting a bike and/or elliptical (non-impact) machine for cardiovascular conditioning and seeing what kind of response you get. Obviously, if you experience the same pain, you should stop. Swimming might be another alternative to get some aerobic work in.

With respect to strength training, I would target the hip/thigh musculature, but again in such a way as to not increase symptoms. Some sample exercises might include stationary FW lunges, straight leg raises, leg press, hamstring curls, single leg balance on a bent knee, etc.

I would also examine your footwear and be sure you are running with the appropriate shoe (i.e. forefoot/rearfoot support and pronation/supination control as this may affect your symptoms with the longer distances.) I would definitley avoid hill or incline running until the symptoms are completely resolved.

These are just a few suggestions. Continue with the ice. Stretch at least 3 times per day and be sure to include some for the glutes and piriformis as well. Best of luck!

-------------
Brian
[URL=http://www.thefitnessedge.cc]www.thefitnessedge.cc[/URL]



nryan63 -> Re: IT band syndrome (October 21, 2004 10:42:00 AM)

Thank you very much Brian. Those are exactly the answers I was looking for.



FLAOrthoPT -> Re: IT band syndrome (October 21, 2004 12:45:00 PM)

also keep in mind a thorough evaluation from a qualified therapist may be needed to see if there are any lumbar, ilio-sacral, hip, or foot biomechanical problems that need to be addressed. All the rest in the world will not correct a biomechanical dysfunction, neither will the best strengthening in the world. These are ok ideas to prevent further damage and inflamation, but many of the strengthening techniques may aggravate the biomechanical problem and enforce an already altered neurobiomechanics. Many small biomachanical faults like 10 degree of rearfoot valgus off of nuetral positioning in weigthbearing may not be noticed in an average person, but you put that foot through pounding over 15 miles several times a week, then these small weaknesses in the chain begin to manifest themselves. If you are serious about doing this marathon, or any other marathon in the future find a good orthopedic and preferably manual trained therapist who can give your whole lower half of your body a thorough eval to see if there are any significant problems up and down the kinetic chain.
Good luck-
Benjamin Galin, MPT, OCS



nryan63 -> Re: IT band syndrome (October 21, 2004 3:37:00 PM)

Thanks for your advice. I do have a condition that hindered me for years in college. My left leg is shorter than the right. That led to a lot of hamstring problems and hip problems. This just happens to be on the same side as my knee problems. I'm guessing that it has something to do with it. Any advice on what I can do for this condition? Thanks again.



FLAOrthoPT -> Re: IT band syndrome (October 21, 2004 4:37:00 PM)

Too hard to tell, but I'd say let a good therapist look at you, it may be as simple as building an orthotic with a lift. Look for an OCS, a CFMT, a CMPT, COMT after a PTs initials. This means they have gone above and beyond normal coursework. Not that a PT without those initials cannot have the knowledge, but it is hit or miss. If you look for those initials after the PT, you will be in the hands of a therapist well qualified to handle this. Ask them how they are with orthotics, if they are not good have them refer you to a PT (not an orthotist/podiatrist) who makes orthotics. Good luck,
Benjamin Galin, MPT, OCS



FLAOrthoPT -> Re: IT band syndrome (October 21, 2004 5:09:00 PM)

Hope I am not breaking any forum rules, but here's a start: just using superpages, not promoting these individual therapists but just showing you what I mean:
Dan Bankson CFMT Minneapolis 507-238-8196
Bookhout Mark Ms PT OCS Minneapolis(612)872-2700

call local places ask them if they are certified in any of the above initials i mentioned and you should be on your way to good answers...



Randy Dixon -> Re: IT band syndrome (October 21, 2004 8:56:00 PM)

I think following Benjamin's advice is probably the best thing to do, but since I've already talked about pelvic rotation being my pet condition today I thought I should mention it here.

Leg length discrepancies are usually apparent and not anatomical, that is the may look and act like different lengths but the bones themselves are not significantly different. There are several causes for this but the most common one is a pelvic rotation. This is correctable through manual therapy and therapeutic exercises, and even can be done by yourself.

I generally don't like lifts to treat leg length discrepancies unless it has been verified as an anatomical one, although there are times when it is the best solution. The reason is because if you change the mechanics at the foot-ground junction then you change them all the way up the kinetic chain in unpredictable ways.

Anyway, the best solution is to take Fla's advice, but the question then is: Will you do it, or is the money/convenience factor to big an issue?

You can email me if you would like some rather simple "tests" to see if it is likely that pelvic rotation is the problem, although it is no substitute for a professional or I could post them here, although I think it would be too lengthy.
wolhund@aol.com



Randy Dixon -> Re: IT band syndrome (October 21, 2004 8:57:00 PM)

In case it wasn't mentioned, both LLD and pelvic rotation are very good candidates for your ITB problem.



Sebastian Asselbergs -> Re: IT band syndrome (October 22, 2004 3:51:00 AM)

FLAPT, I second Mark Bookhout (don't know the other..). And I second your advice. Randy, leg length issues ARE contentious, and there is very little to no data on the incidence of leg length differences in regular populations - so, yes, it could be the lumbo-pelvic - and Mark or any FCOMT or COMT PT (and let's face it, some ATs and DCs I know) can evaluate this.

nryan63: just a question: when you run, do you run on opposite sides of the road? - most roads have a curved profile and consistently running on the side against traffic (for safety) can give an asymmetry of stride that can become significant when running often and far. I've seen this a few times as the sole trigger for ITB...



nryan63 -> Re: IT band syndrome (October 22, 2004 6:03:00 AM)

Thank you all for all of your help. This is really getting some good attention. I spent an hour on the elyptical machine yesterday with absolutely no pain, so that is promising.

Sebastian: I run around lakes up here that have paths around them. I change up my directions mostly because I was afraid that very thing was causing my knee problem.

Randy: I will most likely go see either of the above PT's next week if it does not feel better. I will say with all of the stretching and icing I have been doing, it has been a lot less noticeable.

I actually wore a 1/2" insert in my shoes all through college. If I didn't, my hips would become so fatigued that I couldn't even pick up my legs. Our trainers were worthless, never even diagnosed the problem, they thought I pulled my hip flexer. I believe the problem is not that one leg is shorter than the other, but rather the lumbo-pelvic condition that you guys mentioned. I say this because it did not start to bother me until I got really big and heavy in college. I pulled my hamstring for the first time my sophomore year and the problems kept coming. More hamstring pulls, quad pulls, hip flexer trouble throughout my career. Since then I've lost about 80 lbs. and thought that would cure any ailment that had bothered me in the past, but then this mysterious IT band trouble came. As I speak to more of my running friends and more PT's, it is VERY common among runners. So there is comfort in knowing that.

Aplogize for the length, just trying to give you an accurate medical history. Thank you again for all of your help, this forum has been a real find.



Alex Brenner PT MPT OCS -> Re: IT band syndrome (October 22, 2004 6:43:00 AM)

Hi. First of all, I commend you on serving your country. It is a great and noble thing.

I used to work at a basic training post and IT band syndrome was VERY common. You will most likely experience these symptoms sometime throughout the training. The above advice is good and I would add to be sure you have a good pair of running shoes that match your foot type and running gait. If you are allowed bring a good pair with you. You will be spending a lot of time in combat boots too which traditionally do not have much arch support. Reception into basic training is much like the movie Forrest Gump when he gets on the bus and the drill sargeant starts yelling. You will be hurried through the clothing issue facility. When they issue you the boots be sure they are a good fit. Try not to accept an ill fitted boot. Very important.

Good luck in your military career, airborne.

ArmyPT



nryan63 -> Re: IT band syndrome (October 22, 2004 6:58:00 AM)

Thanks ArmyPT. I could not be more excited to begin my Army career. I have a long road ahead of me that I need to be healthy for (16 weeks OSUT, 3 weeks ABN and 4 weeks RIP). Everyone has told me to make sure I am healthy because injuries can really hinder your training. I wear some quality Asics running shoes currently and though they are the most comfortable shoes I've ever had and they were recommended to me by some in the running community, I can't help but notice that my problems came shortly after I began wearing them. From now until I leave Nov. 9, I will stick to the elyptical machine to reduce impact on my knee. My fear is that there is little or no time for rest in OSUT and if my symptoms persist, I could be in bad shape.

Thank you for your service as well and I look forward to contributing my part for our country. Thanks for all of your help.



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