Not recovering IT Band Friction Syndrome!

I was wondering if anyone out there has any advice or suggestions for chronic IT Band Syndrome. I am only 21 years old and have had this problem for about two years now. I have tried the foam roller, stretch, and exercise technique but with little success. I originally did this potentially to excess of about 3 or more times a day with very limited training to eventually stopping all training together. I have tried graston and ART and even had a cortisone shot. Eventually due to seemingly worsening conditions I decided to give up stretching and rolling for around 5 months assuming that they were contributing to the irritation and inflammation. It seemed to help a good deal but did not get rid of the problem. Currently I have returned to light stretching and rolling only once a day and after warming my muscles thoroughly in the hot tub and I use some type of heat therapy various times a day. I feel that it is working a little, but the bursa still gets quite inflamed with fluid from time to time with no change in activity level. I know my genetics have not bestowed on me very flexible muscles but I would not say I was very inflexible, because I stay on top of it and do yoga and such. Also, the fact that I am so young and can not recover even after complete rest is baffling. Has anyone out there experienced similar problems and/or have any ideas of how to nip this stupid thing in the butt? Would electrical stim help at all or what about PRP therapy?

Thank you very much for any help you offer.

See if this helps something I put together on the topic http://irepathletics.com/Articles_and_Resources.html#band The search function will provide you with a ton of IT band stuff as well.

This might sound odd, but any chance you belong to a gym? Mine went away when I focused on Strengntening my leg muscles…like squats. Remember…form is key. Dont get into trying to impress anyone dl your own thing!

Its all about form indeed.
All your massage, trigger points, dry needling etc are for the symptoms not the cause.
Fix up your biomechanics and it will be gone.
As the above poster said, some gym work will do wonders, particularly things such as 1 leg squats, lunges, 1 leg lateral pelvic tilts over a step.
This may also require some body awareness.
you pelvis needs to stay flat laterally when you run not drop to the side which is in the air.
Overstriding may also play its part.
Get all nerdy video your running and post it here. There are enough people with biomechanical knowledge to tell you what’s not quite right.

You can beat this one

Sproscia, this is an awesome blog post. Thanks a lot!

Its all about form indeed.
All your massage, trigger points, dry needling etc are for the symptoms not the cause.
Fix up your biomechanics and it will be gone.
As the above poster said, some gym work will do wonders, particularly things such as 1 leg squats, lunges, 1 leg lateral pelvic tilts over a step.
This may also require some body awareness.
you pelvis needs to stay flat laterally when you run not drop to the side which is in the air.
Overstriding may also play its part.
Get all nerdy video your running and post it here. There are enough people with biomechanical knowledge to tell you what’s not quite right.

You can beat this one

^^^ This ^^^

Also, see what “littlefoot” wrote. IT band issues can be the result of muscle deficiencies or imbalances. All of the exercises mentioned above are great, the key being that you focus on proper form. Something else that helped me was switching over to Bont shoes as they have proper arch support. My left leg was pronating throughout my pedal stroke, causing the knee to track inward and therefore irritating the IT band.

Anyway, good luck, and patience! It’s not a quick fix.

Its all about form indeed.
All your massage, trigger points, dry needling etc are for the symptoms not the cause.
Fix up your biomechanics and it will be gone.
As the above poster said, some gym work will do wonders, particularly things such as 1 leg squats, lunges, 1 leg lateral pelvic tilts over a step.
This may also require some body awareness.
you pelvis needs to stay flat laterally when you run not drop to the side which is in the air.
Overstriding may also play its part.
Get all nerdy video your running and post it here. There are enough people with biomechanical knowledge to tell you what’s not quite right.

You can beat this one

This…again!!!

You need to figure out the root cause, and it is likely weak glutes. As others suggested, use the Search function and you can find a wealth of info. I have numerous posts with different glute exercises and tigerchik has a great sequence of glute exercises as well.

All the rolling, stretching and icing in the world will only alleviate the symptoms. Find the cause and beat the problem.

I was in your position. Lots of managing the problem but not a lot of addressing the problem.

Finding the cause is key.

For me … changing my stride (too much overstride, too much heel strike, to much up and down body movement), changing my shoes to neutral (from stability - every shop told me I needed stability shoes, my physio told me otherwise and when I eventually went with his advice I noticed a marked change for the better with any issues) and then to a lower drop provided a more stable platform. This was done over a period of a year, each of those steps helped a chunk.

These helped me, you need to find your cause. But look at it logically from the ground up.

I had itbs on one side for a year then the other for a year and a half, managing or having ITBS in various levels of discomfort until I stated to look at the cause. It went away quite quickly after that.

Keep the faith :slight_smile:

Tried everything. Strengthening, stretching, rolling, icing.

I can squat twice my body weight and glutes hips are as strong as ever. Kept coming back

Switched to minimalist shoes… That worked for a bit but it nope, it came back

But finally, FINALLY I fixed it

It was all thanks to a bad race picture I had. I was rather hunched over in my running posture. Not major but not ‘tall and proud’ like when I watch crowie or other pros

I read somewhere to imagine you have a string attached to your belly button and it’s pulling you along

This did it! Hips forward, shoulders back, running tall while not over striding

I just did a 15k run on Sunday without pain. I am so freaking thrilled.

Good luck. I’ve dealt with this for 2 years and know your pain, literally.

Note: I still have to check my posture every km or so, old habits take a while to break .

This is one of the best threads I’ve ever read on any forum.

Seriously, nice job all!

It’s so refreshing to see such great advice. Find the root cause!

Try switching to a lower profile shoe and run with a metronome so that you maintain a 90 step per minute run cadence. And ease into it, because while you won’t have issues with the ITB, you will be very suceptible to something else getting hurt. You should do a search of my name to see several posts I’ve had on the subject, starting around 2004/2005.

I agree it is clear your biomechanics are off.

I was wondering if anyone out there has any advice or suggestions for chronic IT Band Syndrome. I am only 21 years old and have had this problem for about two years now…

Conservative treatment that involves modified activity, correction of training errors, selective progressive stretching and strengthening, and manual therapy is associated with return to prior functional status after less than 8 weeks in most cases of ITB bursitis. You can try some of the good advice posted in this thread, if not already. Unfortunately, your bursitis likely has degenerated into a hypertrophic fibrotic condition. The only effective management may be bursectomy. In sports medicine, elective surgery follows failed conservative treatment for most training-related chronic conditions. It might be time for you to look into ITB bursectomy.

Good stuff in this thread. I suffered through a horrible case of ITBS earlier this year (along with hamstring and low back issues) and eventually made my way to PT after an MRI ruled our other knee issues. My IT pain was so bad on my left side I had trouble standing up, going up/down stairs, etc. The PT used ultrasound and stim for about 2 mths and I had a series of exercises to strenghten hips, glutes, etc as others have described in this thread (and I continue to do today). I think the combination of the ultrasound/stim and the exercises helped get rid of the IT pain - however after the initial eval the PT suspected I had other issues at the root cause of my lower body pains (hammys were also chronically tight and sore) and had me check my low back with the ortho when I went back for a follow-up. After another MRI we discovered that I have a bulging disk in my low back pressing on the nerves running down my legs - most likely the cause of my hamstring issues and I’m sure somehow related to my IT issues from earlier in the year.

I mention the back part because I think that the ultrasound/stim could help your IT issues but it would probably be wise to be checked out to see if there is an underlying cause of all your problems (as others have also noted). It’s interesting that you indicate that you can’t recover after the extended rest as thats exactly what led the PT and I to have me go back to the ortho for my back. Even as my IT band loosened, I could not get my hamstrings to loosen up - which seemed odd to me since I wasn’t really doing much (light biking as IT felt better, no running). I don’t think my lower body would have ever really recovered without addressing my low back issues (I’m not saying you have low back issues - that’s just my example of the underlying cause). My knee hurt so much when I first visited the ortho - I only mentioned my back/hamstrings in passing so it wasn’t really addressed the first go around. Good luck with your recovery.

Hey everyone. I cannot thank you enough for your ideas, help, and most importantly encouragement. I am new to Slowtwitch, so it is great to see how useful of a tool it is. There most certainly is a root cause to the problem that I have not devoted enough energy to figuring out. Since having this pain I have also developed or have had some other minor problems such as medial knee pain mostly on the right knee but every now and then my left knee (the one with ITBS) will tighten up medialy and practically lock up. In addition I have some medial hip pain as well on both sides. Originally I thought that this pain was due to overstretching but it may be a sign of something else. Strangely about once a month my symptoms will go away for everything and I will feel pretty great, and whether I work out or not during that time the symptoms reoccur generally within the same time frame. The fact that I have not run or biked and only just started to swim again after about a year makes me think that the biomechanics of those activities are not the primary causes (but will certainly look into it and post a video soon) and may think that the advice that pedalhead gave about surgery may be a necessary plan of action sooner or later. I am just trying to avoid that as much as possible and have had various doctors and chiropractors tell me I should hold off. In any case, I will continue to try the more conservative road for a bit more and investigate a cause. The times when it does seem nonsymptomatic give me hope that I can overcome it without an invasive technique.
Again, thank you very much for all your help and encouragement.

Thank you for posting, I’ve been feeling pretty down on myself because I’ve been battling what is now the most protracted injury of my admittedly modest career, having been hampered with ITBS and piriformis for going on 4 months now, pretty much has shut down my entire season.

As with the others, I’ve had reasonable success with addressing symptoms, but the agitation has quickly returned without sufficiently addressing the root cause, which sounds like it is often different for everyone. In my specific case, I have functional (nonstructural) scoliosis caused by a leg length discrepancy that is also believed to be largely functional. It’s been slow going and I still have a ways to go yet, but as with most other cases the solution still is in primarily in strengthening and addressing muscle imbalances, so generally pretty hard to go wrong in that department.

My it band problem ended up not being my it band… I guess my right butt check gets all twisted after a workout. I found some stretches which fixed my butt, in turn also fixed my it band. Good luck!

To echo what others have said, the root problem is likely weak core muscles, particularly the glutes and hips. I had similar issues and did this workout (http://www.runnersworld.com/workouts/ironstrength-workout) twice a week for six months (and continue to do it once a week). Problems solved.

I have dealt with ITBS in the past and done many of the things above to help them. One thing that was only briefly mentioned, but has been a huge help has been e-stim, using my Compex. When using it in recovery or recovery plus mode, I slightly modify the hamstring electrode placement, and rotate it outside a little bit further, this basically will help to engage the TFL. I am a firm believer that many people who suffer from ITBS is due to this muscle. It is used when cycling, more so in a TT position. It is also used when running and can be a challenge to stretch.

The typical stretches given do not focus on the muscle, but more so the band. Think about the times you have crossed your legs and push a hip out to try and stretch the IT band, now roll your pelvis forward a little to stretch the TFL more than just the band as it attaches to your hip.

That being said, when I run the Compex, I feel it engage the muscle up near my hip, and even though the electrodes are placed above my knee, since the TFL attaches to the ITBand, I also “feel” it in my outter knee. Being sure to use this after hard workouts especially when I come home and feel a slight pain in my ITBand, or just general tightness has been a huge help as my mileage has increased this year.

Great insight in this post…

I did all the same things you did with no improvement. Ortho and PT were just treating the knee area even though I was pretty sure it stemmed from my hip (old motorcycle accident). Once I started strengthening my hip and stretching it so much that I was constantly sore, that did the trick. I also improved my running form to help ensure it didn’t flare up.

Bottom line, find the root cause.

My issue was eventually linked to my gait - specifically my cross-over gait. My right foot and left foot when running in a straight line would cross over each other. Check out the Gait Guys for a better explanation and video.

I coupled better running technique (forcing myself to have a wider gait) and muscle strengthening exercises (single leg squats).