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IT Band Syndrome

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 munro 31 Mar 2015
I've been experiencing sharp pain in the outside of my left knee when going up and down stairs and sometimes when walking on flat ground - a quick check online suggests it's IT band syndrome and I was wondering if anyone has had experience of this and has any advice about when I can think about running again (obviously easing myself back in)?

It first flared up last Wednesday but felt fine by Saturday so I went out for a 5 mile run at a decent pace and since then it's been pretty sore... any advice much appreciated!
Ste Brom 31 Mar 2015
In reply to munro:

Foam rollers are worth their weight in gold for ITB.
 Bob 31 Mar 2015
In reply to munro:

I've had ITBS and it's not nice! Get to a sports physio and get some treatment (massage and ultrasound) after that it's rest as much as possible plus the exercises the physio prescribes. Usually ITBS is an overtraining injury brought on by a sudden large increase in training.
In reply to Ste Brom:

only trying to stretch your ITB is a pointless task as it is a non-stretchy tendon. One needs to roll/massage the muscles around the area - Glutes, quads, hamstrings and even the lower abdominals.

ITB syndrome tends to be caused by tightness and/or weakness in any of those groups of muscles.
 Roadrunner2 31 Mar 2015
In reply to munro:

Yeah its pretty common and sounds like it. I'd get assessed. Its rarely the IT band that is the issue but one of the groups attached/around it.

Lots of stretching, squats, strength work, but you need to find what the weakness/tightness is. I find rolling helps for sure.

Also as soon as you feel it back off... you can't run off IT band pain, it's inflammation, that inflammation needs to go down first, then sort the issue.

I did a blog post on this last year as it's something I get a lot of inquiries about.
http://iainsrunning.blogspot.com/2014/07/itb-issues-again.html


Ste Brom 31 Mar 2015
In reply to higherclimbingwales:

Really? Fancy that!
 The Potato 31 Mar 2015
In reply to higherclimbingwales:

I concur, I found for me it was tight hamstrings.
Foam rollers do feel nice but dont solve the problem.
 Adam_Turner 31 Mar 2015
In reply to munro:

Yep caused by weak glutes here. As said above, foam rollers are magic.
 Roadrunner2 31 Mar 2015
In reply to Pesda potato:

I don't think you ever solve IT issues.. you deal with them, with me if I don't keep up the stretching and rolling it comes back.

The one thing you get good at is feeling it really early and getting the rehabilitation started.
 nniff 31 Mar 2015
In reply to munro:

Foam roller. Failing that, a strong full bottle of fizzy pop works instead, but is even more painful. One of those 1-1.5 litre coke bottles works well. A towel as padding helps.

Simple stretch - stand on one leg, cross the other leg over (e.g. right foot positioned to the left of your left foot) and bend sideways to stretch the crossed leg. ie bend to the left in the example above, which stretches your right hip and ITB. If your raise your right arm over your head, the stretch is even more accentuated. Then do the other side.
In reply to munro:

https://www.painscience.com/articles/iliotibial-band-syndrome-stretch.php


"Despite the popularity of Iliotibial Band stretching as a treatment for IT band syndrome, there is no scientific or anatomical reason to believe that any kind of IT band stretch is even possible, let alone an effective treatment"
 Roadrunner2 31 Mar 2015
In reply to higherclimbingwales:

http://www.sportsinjuryclinic.net/sport-injuries/knee-pain/iliotibial-band-...

You can find quotes either way..

The best way is to see what works. You also stretch other areas with those stretches. Any IT band stretch will also work those other tissues connected, so that may be where the benefits come.
 Gael Force 31 Mar 2015
In reply to munro:

Cured mine with roller
In reply to nniff:
see the link above!
Post edited at 16:36
OP munro 31 Mar 2015
In reply to munro:

Hi all,

Thanks very much for all the advice!

Time to get stretching, rolling, strengthening muscle groups etc...

Cheers
In reply to Roadrunner2:

of course - you can find websites that will claim that the earth is flat, that climate change isn't real and that 9/11 was an inside job hence why I tend to choose the sites that have references to other studies which your link seems to lack.
1
 Dave the Rave 31 Mar 2015
In reply to higherclimbingwales:
I agree that you would find it quite hard to stretch the itb. Studies have tried by hanging heavy weights off ITB's from cadavers.
BUT.
By rolling the lateral leg, you will be stretching other soft tissues including the very important 'fascia', all of which, if tight, benefit from tissue release by releasing their pressure on the ITB.
Hence foam rollers are good for ITB syndrome, but are by no means the only therapy that needs to be performed.

 Roadrunner2 31 Mar 2015
In reply to higherclimbingwales:
http://www.archives-pmr.org/article/S0003-9993%2802%2909364-4/abstract?cc=y
Abstract

Fredericson M, White JJ, MacMahon JM, Andriacchi TP. Quantitative analysis of the relative effectiveness of 3 iliotibial band stretches. Arch Phys Med Rehabil 2002;83:589-92. Objective: To compare the relative effectiveness of 3 common standing stretches for the iliotibial band (ITB): arms at side (stretch A), arms extending overhead (stretch B), and arms reaching diagonally downward (stretch C). Design: Each subject's biomechanics was captured as a 3-dimensional image by using a 4-camera gait acquisition system with a forceplate. Setting: University biomotion laboratory. Participants: Five male elite-level distance runners. Interventions: All participants performed each of the 3 standing stretches for the ITB. Main Outcome Measures: For each stretch, change in ITB tissue length and the force generated within the stretched complex was measured. Data were then combined and analyzed by using kinetic values assessment. Results: All 3 stretches created statistically significant changes in ITB length (P
Post edited at 17:13
 Roadrunner2 31 Mar 2015
In reply to Dave the Rave:

it really depends on each instance, how it was caused, the persons history, their anatomy.. it's quite incredible how much variation we have in our anatomy person to person.
 steveriley 31 Mar 2015
In reply to munro:

Good luck, it's horrible but fixable. I got rid of mine with the stretches, or time, or stretching something else. But I got rid of it. And I've had a paper in the J of Biomechanics
 nathan79 31 Mar 2015
In reply to munro:

The bane of my early hillwalking endevours! Oh how I remember that knife-like stabbing sensation as I hobbled down back to the car.

As has been said, strengthening other areas can help- I put time into abductor strengthening. Foam rolling is worth a shot as is stretching.

Main cause of mine was flat feet. I'd had previous bother with patella tendonitis (or rather tendinopathy as it should really be called) which also was related to the flat feet. Insoles in my boots and running shoes for overpronators also help keep me pain free now.

Good luck with yours,
 Chris Harris 01 Apr 2015
In reply to munro:

I had it & tracked it down to bad posture sat at my desk - I tended to have my legs tucked backwards & toes hooked over the "legs" that the wheels are on.

I now make absolutely sure I sit with my feet flat on the floor, straight in front of me. This sorted it out & no recurrence.
 zephr 01 Apr 2015
In reply to Roadrunner2:

If youre going to start quoting research at each other, try Falvey et al 2010.
Iliotibial band syndrome: an examination of the evidence behind a number of treatment options...
which basically concludes...
"The ITB was uniformly a lateral thickening of the circumferential fascia lata, firmly attached along the linea aspera (femur) from greater trochanter up to and including the LFC (and that) Our results challenge the reasoning behind a number of accepted means of treating ITBS. Future research must focus on stretching and lengthening the muscular component of the ITB/TFL complex"
 Roadrunner5 01 Apr 2015
In reply to zephr:
You can find loads though..

http://scholar.google.com/scholar?as_ylo=2011&q=ilio+tabial+band&hl=en&as_s...

861 papers since 2011.

ITBS is just a syndrome, inflammation at that point, its actually a number of causes, ITBS is just the symptom, so I don't think the 'do X and you'll be OK' approach works. Not that you are saying that. Shin splints is similar, probably even more so, in that it's the all encompassing term for shin pain, which is actually a number of conditions.
Post edited at 14:19
 Roadrunner5 01 Apr 2015
In reply to Chris Harris:

> I had it & tracked it down to bad posture sat at my desk - I tended to have my legs tucked backwards & toes hooked over the "legs" that the wheels are on.

> I now make absolutely sure I sit with my feet flat on the floor, straight in front of me. This sorted it out & no recurrence.

Yeah sitting just is not good for us, It's an unatural position so causes us issues.

I have piriformis issues which are exasperated from driving with my wallet in my back pocket.. I can now even feel when its twisting me and try not to put it there anymore.

A good sports physio will look at all this though and not just your sporting history and work out what is going on.
 The Potato 01 Apr 2015
In reply to Roadrunner5:

exasperated!

I find driving worsens my leg and knee issues too, not much can be done beyond making seat adjustments though.
Some people working in offices use Z chairs or saddle seats.
 Roadrunner5 01 Apr 2015
In reply to Pesda potato:

oops wrong work.. exacerbated.. better

Yeah I have to make sure I don't sit with one buttock on its side. I drive a big US sedan, 3 front seats so you aren't kept in a proper seated position like in typical US cars.
XXXX 01 Apr 2015
In reply to munro:

I've really struggled with this. I irritated the bursa on the outside of the knee and it took ages for the inflammation to come down. The route cause is normally elsewhere.

Sadly, the internet is terrible for giving you advice on this. There seems to be a million causes and a million treatments. It's very individual. You just have to work through it all.

The only consistent thing is DON'T RUN THROUGH IT.

(Mine comes from weak glutes)

 Harry Ellis 01 Apr 2015
In reply to munro:

Mine was weak hip abductors. lying on my side and raising my leg sorted it pretty quickly
 Roadrunner5 01 Apr 2015
In reply to XXXX:
Yeah my wife gets IT issues from irritated bursa in her hip from gluteus medius issues.

It's not so much bad advice on this more there's just so many causes. But its why its worth seeing a physio, at least the first time, once you've got rid of it once the same issues often bring it back so you know how to treat it. But yeah the stop running is crucial.
Post edited at 15:49
 Dave the Rave 01 Apr 2015
In reply to XXXX:
Yeah. Weak gluteals(mainly the smaller ones medius and minimus) are a major cause of both ITB problems at the knee, and with trochanteric bursitis.
They are aBductors of the hip, keeping the pelvis in good alignment during stance phase. Weakness causes excess pressure on structured underlying the ITB like the knee and hip bursae.
Also during swing phase when the hip is flexed and the foot off the ground with knee flexed, they prevent over aDuction of the hip. This is when the ITB is at most stress, along with weightbearing flexion of the knee and hip.
Clam exercises are paramount in the treatment of these weak gluteals.
 Roadrunner5 02 Apr 2015
In reply to Dave the Rave:


> Clam exercises are paramount in the treatment of these weak gluteals.

Clams are great but you look a right muppet in the gym..

I get so bad on one side I just can't do them, I cheat by using other muscles. I then have to do them constantly and really try and isolate them.

I also do side steps and partial squats with a theraband. Again you look an idiot.. But it really isolates the glut medius
 mrdigitaljedi 02 Apr 2015
In reply to munro:

ive the same problem and its down to a mis-aligned hip, get to a sports phsyio to manipulate it back, will take a few visits but worth it m8.
In reply to munro:

I'm not sure I'd want to call this advice, but here's what I did which coincided with it getting completely better:

Started doing deep squats at the gym.
Foam roller.
Always put my wallet in my front pocket.

I carried on running, but I only do about 20 hilly off-road miles a week.
 steveriley 02 Apr 2015
In reply to Turdus torquatus:

I got the wallet thing from an old episode of Homicide on the telly. Funnily enough a group of us were doing deep squats last night - most people were truly rubbish. Hurrah, something I'm good at.

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