Have you tried strength training and the whole laying on the tennis ball thing?

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"What the mind can conceive and believe, the mind and body can achieve; and those who stay will be champions."

This foam roller cured my IT band problems.

http://www.performbetter.com/...2K510022B3NG95WE7H0F

You just lay on it sideways and roll on it from your knee to your hip. It is quite painful at first, but it really works nice.

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"No one ever told me they made black fondant!" - Duff Goldman

In addition to strengthening any muscle imbalances, I would suggest trying ART treatment. I too was at my wits end with ITB problems (no running for 5 of an 8 month period) and this was suggested to me. Hurt like a SOB the first couple of times, but after 3 treatments I was pain free. Bruised, but pain free. Now I go in for maintenance when I feel it starting to tighen up and have not any any problems with it for almost 2yrs now.

I would save the cortisone as a truly last ditch effort.



Good luck

Colin, ITBS is one thing I can unfortunately speak authoritatively on. I have had ITB off and on onboth sides since 1989; it has been THE number 1 thing that has kept me from going to the next level in triathlon and running. I've never gotten a steroid injection because in general I don't think it works for this sort of thinkg ie it will alleviate your pain on a temporary basis only. If you do get it, don't immediatley start running again just because you feel better. I have much to say on the subject but will leave you with two comments:

1. Do this exercise religiously: lay on the floor on your side and prop your head up with your hand. Fully extend your legs. Lift the affected leg at the hip towards the ceiling so you form a "V". Start out with 3 sets of 10 and work up to 25. Go ahead and do the other side while you are at it. This will STRENGHTEN your ITB which is what you need....not just stretching. Yes, it shortens during the times when it is bothering you and being "longer" may prevent that, but it needs STRENGHTENING more than anything.

2. I learned about this exercise 6 months ago on the forum at www.letsrun.com and although the results are preliminary, I am having no problems whatsoever and have done some decent training in that period. I do these RELIGIOUSLY and I am not one to do anything like that. I hope this exercise is really working and that is why I am feeling better. DO go to wwwletsrun.com and POST on the forum. you will get immediate replies (within minutes...there are guys who live on that board) and they will be extremely helpful. Lots of ITB sufferers in the running crowd!!

PLEASE do try this exercise and website.



Chip

WOW!! Thanks everyone for the feedback. I have been doing the roller treatment on a foam tube thingy, but not very consistently as I didn't feel it was a key element in treatment. I will improve that. I have been doing the leg lifts, but again not as consistently as I could, and will improve that. I am doing LIGHT weight workouts, squatting 80-100 pounds @ 3 x 20 and doing lunges with 60 pounds. I don't have a leg extension at home for knee lifts and hamstrings, but will probably add one. I plan to keep the weights light.

I'm still curious about long term drawbacks to cortisone. Has anyone taken a shot and later regretted it (ie, masked the pain and created a worse problem later, ruptured something during the injection, etc??) I am doing IMCdA in June and am starting to get nervous about my inability to increase my running mileage due to the ITB. On the other hand, I am only 32 and want to still be running when I'm 82, so I'm concerned more about staying healthy than I am about IMCdA. But...I am really torn between the desire to train hard for IMCdA and the long term treatment I know ITB requires and it seems like Cortisone is the magic bullet. I'd say my bad leg is 90% back from ITB and the pain isn't unbearable, and in fact seems to loosen up after 30 minutes of running if I strech during the run. To get to 100% w/o cortisone probably means 1 month with no running, then a very slow build-up. The "IM" side of my brain is saying "get the shot and you'll be out there doing 15 mile training runs in 2 months" and the "82 year old runner" side is saying "take the time off, go into IMCdA undertrained and do your best." I'm out of brain space for independent thought, so I'm leaving it up to others non-biased experience to get some guidance!

THANKS!!!!

What is the ART treatment you mentioned?

Sorry, no experience with the shot.

I had a bad flare up of ITB after IMFLA. I went into physical therapy 3 x week, and also did tennis ball massages, which I believe are the same as the foam roller. It took 4 - 6 weeks for me to get back at it. I feel like the massage got me to the point where I could continue my training, and the strength training has helped fix it long term. I had 12 sessions of the physical therapy, and they kicked my a$$. I would be in with them for 2.5 hours, doing all kinds of different excercises for my legs. Now I weightlift twice a week doing adductors, 2 and 1 leg press, and calf raises just to maintain my strength. FYI, the PT told me to stay away from leg extensions.

I'd be leary about quick fixes, as they don't alleviate the problem at hand. You may be where you are now in a few weeks, and lose even more training because of it. I'd try to fix it now while you still have time, if it isn't bothering you bad, I'd think you could still train at a moderate level and still be doing 15 mile runs in two months.

Good luck

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"What the mind can conceive and believe, the mind and body can achieve; and those who stay will be champions."

It makes sense then....I used to notice that the leg extensions seemed to make it worse....I never read/heard anyone else say that.....good comment.

I got a cortisone shot for ITB, its positive effects lasted for about 10 days....then I was right back where I started. The doctor who administered the shot wasn't weary of using cortisone, especially since it was my first injection in that region. Apparently the current thinking is that repeated usage of cortisone can be problematic, but this is also dependent upon the size/strength/type of tissue it is being injected into. Back in 1999 I had a cortisone shot administered in my right wrist tendons, the doctor told me twice was the limit in this area and that he would not do it again. I used the shot as insurance....I was doing a very long motorcycle ride (11,000+ miles/11 days) and would not have been able to complete the ride otherwise. The effects wore off, like clockwork, exactly 8 weeks later.

Ultimately, stretching every day, massage as much as I could afford, and doing the rolling pin thing everyday worked....I haven't had a flare up since the problem vanished over 6 months ago. I continue to use the rolling pin/stretching every day, regardless of whether I feel tightness in that area....cheap insurance.

Hope this helps....

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"I spent a lot of money on booze, birds and fast cars, the rest I just squandered" -George Best

You are treating the symptoms, not the source of the problem.

Your problem is originating (MOST OF THE TIME) from the Tensor Fasciae Late muscle. It is a short muscle that attaches to the front of the hip bone and then the It Band that runs all the way down the outside of your quad and inserts under the knee. Part of this band also crossed your quads a few inches above the knee as well. This is a very common problem with runners. If this little muscle gets tight or develops spasms in it, all the attention in the world to the IT band itself will get you NO relief, as you are now experiencing.

There is a large thread on how to fix this at

http://pub47.ezboard.com/...sage?topicID=8.topic

There are people on that thread that have even gone the cortizone route with no results and ended up getting relief from the treatments discussed there. If the link doesn't work for some reason. Go to www.julstro.com/18.html and click on "Discussion Forum"

I highly recommend you check out that forum. Good luck.

Colin

I've had a number of cortisone shots, although not to treat ITB. I didn't find it very helpful in the long run. I think cortisone is often used as a last ditch by a doc who doesn't know what else s/he can do to help you. The cortisone may get you back to long runs in the short term, but the underlying muscle imbalance/tightness/form problem/whatever that's causing your pain will still be there when the cortisone wears off.

After going through all the standard therapies for a nerve impingement in my hip (couldn't run or ride or even sit without pain) I had the maximum number of cortisone injections in my hip. Each one wore off and left me with the same pain. The doctor operated on the hip after cortisone failed and put still more cortisone into the joint (so there's a pretty good chance my left hip will be degenerating some day). The cortisone also thinned the skin to such a degree that I've got stretch marks on my left hip, but not my right. My hip was better after the surgery, but only until the cortisone wore off. I kept trying ever-more peculiar therapies, and almost ten years later I've been pain free for two years. What finally fixed it for me was as osteopath.

I'm sure that you're receiving no end of free advice about chiropractors/physios/massage/whatever that cured someone else. I don't know if an osteopath can help you, but I'd keep looking for someone who can treat the underlying problem, rather than just the quick fix.

Good luck.

colin - i've had the 'pleasure' of dealing with itbs in both knees (luckily at different times). in both cases i had a cortizone injection, and it worked out well for me. think of it as a major dose of anti-inflamitory/analgesic localized at the problem area. i found it takes care of the pain for about a month, and as long as you don't push too hard (remember, at this point you're healing, not training), it will be fine after. my knees have been pretty solid since then, and i have not ahd to return to the dr for either knee after.

remember though, it's not a silver bullet, you won't be back to 100% for a while still. it's a more powerful treatment, but it still takes time.

another consideration, my orthopedist would only allow me to get two injections in any one spot, after that other options would need to be explored (possibly surgery). i'm not sure if there's a time frame here, but it should be a concern, more so if you end up going back for a second shot.

the potential problem with cortizone is that it's a very strong analgesic, and it will mask pain. because of this, you have to remember that you're not better yet, and to take it easy, otherwise you can further damage your knee without the benefit of the pain to remind you of it.

later,

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mckenzie

Cortisone as a steroid antiinflamatory is only good if there is active inflammation in the area and if the doc is skilled enough to get the needle near the site of inflammation.

Unfortunalty many of the things that cortisone is used for (inc. ITB) syndrome are not even itis' s(itis means inflammation) but osis's(tendonosis referes to chronic changes in the tendon) In these cases cortison would not only be largely unhelpful but may contribute it and increase in the tendon pathology.

There is a good article on the physician and sports medicine web site called itis, osis I dont knowosis. It summarizes the difference between the two.

In my sports med experience cortisone is used way more often than it should be and in many cases when it is contraindicated.

I would go with the Active Release (ART) treatmens already mentioned this treatment can be very helpful in managing ITB syndrome.

Well I have had the shot for tendonitis in the wrist...I was really happy I did it....BUT I think that a very important issue to consider the doctor and the rehab that should follow after. Like a previous post mentioned...the cortisone can help the area heal because often the inflamation itself helps to keep the injured area inflamed...but thought the swelling is down you still need time to let it rest. I had the shot followed by 3 weeks of physical rehabilatiation several times a week and regular at home exercises...that was 3 years ago without reoccurance. For this type of thing I would find the absolute best Dr. you can find, I think that the shot itself is only a small part of the healing but rehab and strengthening exercises can make the larger difference...cortisone can be a bad thing and it isn't for every situation......

you can find information about it at http://www.activerelease.com . It's basically deep tissue massage that they do while moving the affected area. (hence the active part)



One tip.... don't hit your doc when he's doing it. ;)

an hour of deep tissue massage cleared mine up. it honestly felt like the instant miracle cure, just wish i hadn't wasted a month stretching and icing and running 1.5 miles.....do it now, worst case you'll be down $60, but your bum/thighs will feel great

Let me state up front that I personally, would never get a cortisone injection anywhere. Roundly discussed when I was an athletic trainer and that's been my opinon for 15 years.

I had A.R.T. for ITB troubles in my hip. Nine sessions cleared it up and it has stayed away (knock wood). I would definitely give A.R.T. a try.

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clm
Nashville, TN
https://twitter.com/ironclm | http://ironclm.typepad.com

I wanted to post an update to this because the feedback I received in on this forum changed my mind. My orginal post was looking for feedback on cortizone to treat ITB problems. Most people replied with similar ITB pain and discussed their recovery. All but one or two recommended staying away from cortizone. After reading about the successful recovery plans of other triathletes, I cancelled my Dr. appt. for the cortizone shot, and I'm glad to say I did a hard 14 mile run this week without knee pain! I know I'll drive the forum doctors nuts with this post because allowing my medical future to be decided by strangers isn't a great idea on paper, but I thought it was important to point out that the group concensus in this case gave me the info. I needed to a make a complete, cortizone free recovery. Thanks to everyone who takes the time to post solely to help others!! Your time is appreciated.

But you didn't tell us what course of treatment you ended up taking. I'm two weeks into my own ITB rehab and I'd love to hear what got you back to 14 miles so quickly.

It wasn't a speedy recovery by any stretch! My knee bothered me all last summer, but never bad enough to force me to stop running. I did a 1/2 marathon in October, then took 2 months mostly off (1 month totally off, one month running once a week) because I've been down this road before and knew the knee would get worse if I didn't get on top of the ITB. 2 months didn't do it. Went to PT twice, but got sick of paying $90/visit to have someone watch me do stretches. Was advised by my podiatrist to get cortizone, which led me to my original posting.

I think what finally worked was the following combination, listed in order of their perceived benefit:

1) stretching twice a day pretty religiously. I've only missed this a few times in the last 4 months. Even though I feel better, I still do it and will continue to do so.

2) Ice 4 times a day.

3) Leg lifts 4 or 5 times a week as described in one of the posts in this thread. These seem to be very helpful.

3) rolling on the foam roller as described in earlier posts. This hurts and feels like it is doing something.

4) started wearing my orthotics all day, ever day, not just during runs

5) about a week of taking a prescribed anti-inflamitory, Celebrex.

I've also changed my running schedule to no more than 4 times a week and never on back to back days. I also do not do track work. My speed work is built around tempo runs and only after a 2+ mile warmup generally. I'm training for IMCdA, so speed work is just something thrown into the long runs to make them more interesting.

Good luck!!