Question for those who have recovered from a tough ITB case

Triathlon Forum
21

For what it’s worth, I had a bad case in Apr/May 2010 from bike racing. Pain was often 7-8/10 during warm up and then after hard rides and races.

Tried stretching, foam roller, etc with no results for 3-4 weeks.

Picked up some KT tape on a whim and used their “IT knee” technique on their website. Pain cut in half immediately, gone in the next week. Still gone when I took the tape off. No fit changes or any thing else in the meantime.

I realize yours is more of a running issue and mine was bike, but it was a pretty nice use of my $12 :slight_smile:

-Physiojoe

I have tried every method they list for treating IT (there are 4 or 5, I think) and none of them have worked for me. I keep trying it, but zero effect for me.

I’m gonna try Rocktape as well in my quest to try and and everything possible to improve it.

FWIW, I have yet to have anyone explain to me how a tape which neither provides support or restrictcs movement actually provides any benefit. I asked my ART guy the question the other day and his response was “If I punch you in the shoulder, you’d rub it to make it feel better. It is kinda like that.”

Uhhh…no it isn’t.

But plenty of people swaer by it. Maybe I’m just using the wrong color.

I have done this taping on my athletes many of times. I use it more as reminder tape and tape at the Gluteus Medius (which is usually the culprit in this condition) the proprioceptors in the skin are stimulated by the tape and help the athlete keep more normal biomechanics and neuromuscular firing pattern of the hip musculature.

They do have some IT band “Cho pat” straps which basically choke the IT band proximal to the lateral femoral condyle and somewhat reduce movement during contraction of the TFL (not the biggest fan of these)

22

FWIW, I have yet to have anyone explain to me how a tape which neither provides support or restrictcs movement actually provides any benefit. I asked my ART guy the question the other day and his response was “If I punch you in the shoulder, you’d rub it to make it feel better. It is kinda like that.”

Uhhh…no it isn’t.

But plenty of people swaer by it. Maybe I’m just using the wrong color.

Depends on the specific technique and yes people swear by it (remember placebo is 20%!). Techniques can open lymphatic systems and improve the clearance of swelling, thereby decreasing pain due to inflammation. Some techniques also improve the muscle firing patterns by facilitating certain muscle groups. It is not about support *from *tape, it is all about facilitating what you have. There are some techniques that will provide a small amount of bracing, but this is more about facilitating as well.

To the OP: you state you work in the ‘sports medicine’ world. I do as well as a PT and I find a separate PT to look at me and recommend treatment. It is hard to treat yourself even if you know ‘all the information’. Yes I am biased, but I do believe in PT. A good PT will do manual therapy (ART, etc), exercise and stretching, and give you guidelines for recovery. Have you looked at your hip, Hamstrings, foot structure, muscular balance, gait, cadence, core strength, bike fit, etc, etc. Just ideas.

In my experience it is more than just rolling the crap out of your ITB. And IMHO ITB friction syndrome is a catch all diagnosis for all lateral knee/hip pain.

Dana

23

FWIW, I have yet to have anyone explain to me how a tape which neither provides support or restrictcs movement actually provides any benefit. I asked my ART guy the question the other day and his response was “If I punch you in the shoulder, you’d rub it to make it feel better. It is kinda like that.”

Uhhh…no it isn’t.

But plenty of people swaer by it. Maybe I’m just using the wrong color.

Depends on the specific technique and yes people swear by it (remember placebo is 20%!). Techniques can open lymphatic systems and improve the clearance of swelling, thereby decreasing pain due to inflammation. Some techniques also improve the muscle firing patterns by facilitating certain muscle groups. It is not about support *from *tape, it is all about facilitating what you have. There are some techniques that will provide a small amount of bracing, but this is more about facilitating as well.

To the OP: you state you work in the ‘sports medicine’ world. I do as well as a PT and I find a separate PT to look at me and recommend treatment. It is hard to treat yourself even if you know ‘all the information’. Yes I am biased, but I do believe in PT. A good PT will do manual therapy (ART, etc), exercise and stretching, and give you guidelines for recovery. Have you looked at your hip, Hamstrings, foot structure, muscular balance, gait, cadence, core strength, bike fit, etc, etc. Just ideas.

In my experience it is more than just rolling the crap out of your ITB. And IMHO ITB friction syndrome is a catch all diagnosis for all lateral knee/hip pain.

Dana

Yeah Dana,

I left out the specifics to spare the majority of the forum goers the medical jargon but since you asked.

My Dx would be lateral femoral condyle/ Gerdy’s Tubercle bursitis, which does fall under that general umbrella of ITBFS. The IT band itself looked good with no thicking when we did the Musculoskeletal US during the procedure for the guided injection. 8 units was injected in two seperate portals. 1 at Gerdy’s tubercle under the IT band and filling over the distal 4 cm. The second injection traveled trough the it band into the femoral condyle bursa and then filled over the ITB.

  • Trendelenburgs test statically + Ober’s + Nobles- Mcmurray’s - for all clinical laxity stress tests Thomas test indicates restrictions in psoas and rectus etc etc… can barely get my leg into a patrick FABRE test due to tightness my piriformis hates me. strength is 5/5 in all directions with noted weakness in Hip flex, Hip flexion with ext rot. and basically all other directions. So yes this is a hip problem for me. Greater Trochanteric Bursa has palpable edema accumulation. TFL is TTP from origin to the musculotendinous junction.

Postural: Left foot has noted navicular drop during fiess line or navicular drop test when compared bilaterally. Functional leg length discrepancy that has been adjusted at the SI by a chiro and has held pretty well.

Core strength - noted weakness in posterior and lateral musculature and have been targeting it appropriately

Bike fit - professionally fit

I agree with the comment on manual. I was desperate and went to a massage therapist today and asked them what the origin and insertion for the piriformis was before I started my session. As they stared with a blank absent look on there face I walked out. The foam roller can only do so much and is barely even a start . btw ever see the plunger technique? http://www.youtube.com/watch?v=Wwtw7-GUK6I no I have not tried it but I do kind of like the philosophy.

I should have done a lit review from all of the articles I have reviewed recently. But the PT minus the good manual (my number one person is not available right now) is on point and targeting all problem areas.

Really wasnt trying to turn this into another what to do for ITB thread. Just looking for insight on subjective information from people that have recovered. I love the stories of shared frustration and welcoming to the family… yes this sucks…

24

Thanks for the additional info…guess i missed the point of your original post! In that spirit - I too have suffered! Mostly Right knee, however at times, bilaterally. 2 weeks before my first marathon I could hardly walk. I had lateral release (manual therapy technique) done - basically think of a PT trying to stick his thumb through the lateral aspect of your knee, then leaning a little more! Hurt like hell, but I ran the marathon, except the down hills per instructions, and didn’t have ANY knee pain.

As you know, by the time you get to bursitis, things have been wrong for awhile. This isn’t going to get fixed in a short time. Don’t rush. Do your stretching - get your hip flexibility improved (also to avoid hip issues down the line) and take heart that you have time to train. The advice that I keep hearing…actually listen to your body. Two random tapings I have found help (not 100% on why): low-dye taping for the foot and McConnel taping for the knee…again only symptom management, but sometimes can really help to start to get you back, which for me mentally is often a huge thing.

We spend so much time preaching what we know…sometimes we have to listen. I am a chronic instability kid…just out of the sling from my second R shoulder surgery to hopefully prevent the chronic dislocations, chronic instability at the SI, spondy in my back…Hang in there! My surgeon just informed me that just because I know rehab does not mean I heal faster…I was *SHOCKED! *:slight_smile:

Hope you are feeling better soon!
Take care

Dana

25

Dana, thanks for the input. Since you mention “specific technique”, if you don’t mind, I would like your input on the following videos / taping methods. KT tape seems to ahve 4 or 5 different methods, while RockTape has theirs, etc.

Also, do you believe it is possible for the patient to tape themselves, or assistance mandatory? Many of the techniques call for the IT / leg to be in adduction, but is the benefit of that lost if the patient has to lean up to perform the taping?

http://www.youtube.com/watch?v=L3FSPx8TEtA

http://www.youtube.com/watch?v=sCReh8GCUjc&feature=related

http://www.youtube.com/watch?v=pu-_O4ODjx0&feature=related

Any input /insight appreciated. I’ve been struggling this for so long and am not seeing a light at the end of the tunnel. ART, Graston, foam rolling, PT, rest…you name it, I’ve done it. Nada.

26

Your story reminds me of something my dad once told me: He said that if IBM (where he worked at the time) wanted to make a baby, they would get 1000 women pregnant and they’d have a baby in 3 months. You got ITBS and you threw the book at it hoping to get better in a few days. It might work I suppose, but the underlying problem is that you need to stretch out your IT bands and strengthen your hips or it will come raging right back anyway.

August 2012 is a long way away. Take it easy for a few weeks while you do the PT: stretch and strengthen. Don’t do anything that sets it off in that time. If that means no running, then don’t run for a few weeks. Up your biking/swimming instead in the mean time. What you really need is to lose a bit of weight and gain cardiovascular fitness anyway. You’ll know when it’s time to start running again. If you treat it right it will be a minor setback and won’t ever bother you again. (I’ve had ITBS in my right hip and my left knee, both many years ago, and after doing the stretches they went away and never came back.)

27

Dana, thanks for the input. Since you mention “specific technique”, if you don’t mind, I would like your input on the following videos / taping methods. KT tape seems to ahve 4 or 5 different methods, while RockTape has theirs, etc.

Also, do you believe it is possible for the patient to tape themselves, or assistance mandatory? Many of the techniques call for the IT / leg to be in adduction, but is the benefit of that lost if the patient has to lean up to perform the taping?

http://www.youtube.com/watch?v=L3FSPx8TEtA

http://www.youtube.com/...&feature=related

http://www.youtube.com/...&feature=related

Any input /insight appreciated. I’ve been struggling this for so long and am not seeing a light at the end of the tunnel. ART, Graston, foam rolling, PT, rest…you name it, I’ve done it. Nada.

I hate to say this, but the most interesting thing I saw is that they both used small female models…from your stats you are anything but a small female! FWIW I use KT mostly at the shoulder or for swelling. I have found that most really muscular athletes have minimal relief in larger muscle groups. However, on these three videos:
#1 - The goal with the tissue on stretch and then taped (even with no tension on the tape), the tissue will be held in the stretch position while returned to a normal position - creating a tenting effect and hopefully giving a little more space for the irritated tissue to live in - i.e. less friction. The ‘m’ portion of the tape seems more directed at the lateral retinaculum of the knee - again trying to distribute the forces of the ITB, some lateral hamstring fibers and the ligamentous tissue of the knee to decrease friction.

#2 &#3 - long strip just tensioning the ITB on stretch to hopefully decrease friction in a more normal position. The ‘star’ pattern on #2 over the greater trochanter is trying to give relief specifically to that spot and get some room in there.

My opinion - without seeing you in person…my gut says you are beyond this point. Nothing wrong with the techniques, I just feel you aren’t going to get the relief you are seeking. I am not sure 100% what part of the sports medicine world you are in but if you want to try it, I would definitely have one of your colleagues help you. The positional stretches while taping are important, and I just don’t see a way of doing this to yourself and providing the same benefits. The exception might be #3, but you are still going to have to rotate your trunk, which inturn will rotate/tilt your pelvis, changing the line of pull.

I 100% know this is not what you want to hear but: you are in 3 weeks. The first strength gains are typically between 5-7 weeks and are about neuromuscular control (brain using what you have more efficiently). After the 6ish week mark you can gain muscle mass (hypertrophy). Tissue healing from damage (and yes inflammation indicates damage) can take up to 12 weeks. There is no quick fix. It may feel like this happened overnight, but this was likely months in the making, it wont be fixed overnight either. To strengthen your hip is going to take time and no they aren’t ‘sexy’ exercises, but it will happen and things will improve. This is time for rest, healing, recharging. Go back to what your Grandma used to say…if it hurts - don’t do it! Swim, bike, water run, strengthen, STRETCH.

Remember this is coming from someone who currently can’t abduct her dominant arm actively more than 30dg, can’t run, can put my hands on the handlebars when I ride on a trainer, can’t swim, can’t ski, cant…but I know if I heal correctly now, I will be back kickin’ it next year.

PM me if you need anything! Hang in. I know it’s tough, really I do. I want to run so bad! Your body is telling you something…listen to it.

28

Saw this link today - pretty interesting…using a plunger to pull the IT band away from the thigh as part of the treatment… I guess it makes some sense:

http://www.youtube.com/watch?v=Wwtw7-GUK6I

I’ve had a couple of bad bouts of ITBS, mostly I just used rest (no running, and avoiding things like seated climbing), foam roller, mild stretching, and a really conservative return to running - like 5 minutes max to start out - you never want it to hurt even a little when you start running again, otherwise you’re back to square one…so you have to sneak up on it, which is a little nerve wracking…you’re always wondering if you could do a couple of minutes more, but you absolutely have to stop every time before it starts hurting at all. So it’s slow going at first, kind of like winding a Jack-in-the-Box as much as possible without it going off.

29

I went through a bough of ITB Syndrome two summers ago. I fought with it for a month until I would continually aggravate it. Would have the tell-tale 10-15 minute knee pain when trying to run. Finally took a month off running hard or long and stuck to swimming and biking. Along with stride and lower leg strengthening with my 5-Fingers (1-2 miles at a time). While I’m not sure the 5-Fingers had anything to do with it, I think making my stride more efficient was a major factor, but actually giving the time to heal might be the result as well.

Stretching and rolling over this period was a must as well.

After this time off, I spent the next few weeks “testing” to see where it was by doing some moderate track workouts before letting myself go hard.

When this was happening, I weighed around 210, down from 240. Since then, I’ve dropped to 180-190, depending on race time, and the problem has gone away. There was just something magical that happened where over-use injuries nearly went away after dropping below the 200 pound range.

Good luck in healing up!

30

Dana, thanks for the input. Since you mention “specific technique”, if you don’t mind, I would like your input on the following videos / taping methods. KT tape seems to ahve 4 or 5 different methods, while RockTape has theirs, etc.

Also, do you believe it is possible for the patient to tape themselves, or assistance mandatory? Many of the techniques call for the IT / leg to be in adduction, but is the benefit of that lost if the patient has to lean up to perform the taping?

http://www.youtube.com/watch?v=L3FSPx8TEtA

http://www.youtube.com/...&feature=related

http://www.youtube.com/...&feature=related

Any input /insight appreciated. I’ve been struggling this for so long and am not seeing a light at the end of the tunnel. ART, Graston, foam rolling, PT, rest…you name it, I’ve done it. Nada.

I hate to say this, but the most interesting thing I saw is that they both used small female models…from your stats you are anything but a small female! FWIW I use KT mostly at the shoulder or for swelling. I have found that most really muscular athletes have minimal relief in larger muscle groups. However, on these three videos:
#1 - The goal with the tissue on stretch and then taped (even with no tension on the tape), the tissue will be held in the stretch position while returned to a normal position - creating a tenting effect and hopefully giving a little more space for the irritated tissue to live in - i.e. less friction. The ‘m’ portion of the tape seems more directed at the lateral retinaculum of the knee - again trying to distribute the forces of the ITB, some lateral hamstring fibers and the ligamentous tissue of the knee to decrease friction.

#2 &#3 - long strip just tensioning the ITB on stretch to hopefully decrease friction in a more normal position. The ‘star’ pattern on #2 over the greater trochanter is trying to give relief specifically to that spot and get some room in there.

My opinion - without seeing you in person…my gut says you are beyond this point. Nothing wrong with the techniques, I just feel you aren’t going to get the relief you are seeking. I am not sure 100% what part of the sports medicine world you are in but if you want to try it, I would definitely have one of your colleagues help you. The positional stretches while taping are important, and I just don’t see a way of doing this to yourself and providing the same benefits. The exception might be #3, but you are still going to have to rotate your trunk, which inturn will rotate/tilt your pelvis, changing the line of pull.

I 100% know this is not what you want to hear but: you are in 3 weeks. The first strength gains are typically between 5-7 weeks and are about neuromuscular control (brain using what you have more efficiently). After the 6ish week mark you can gain muscle mass (hypertrophy). Tissue healing from damage (and yes inflammation indicates damage) can take up to 12 weeks. There is no quick fix. It may feel like this happened overnight, but this was likely months in the making, it wont be fixed overnight either. To strengthen your hip is going to take time and no they aren’t ‘sexy’ exercises, but it will happen and things will improve. This is time for rest, healing, recharging. Go back to what your Grandma used to say…if it hurts - don’t do it! Swim, bike, water run, strengthen, STRETCH.

Remember this is coming from someone who currently can’t abduct her dominant arm actively more than 30dg, can’t run, can put my hands on the handlebars when I ride on a trainer, can’t swim, can’t ski, cant…but I know if I heal correctly now, I will be back kickin’ it next year.

PM me if you need anything! Hang in. I know it’s tough, really I do. I want to run so bad! Your body is telling you something…listen to it.

Whoops…sorry for the confusion. I’m not the OP. I’m just a guy who has been struggling with ITBS since March.

Thanks for the input on the videos / taping techniques.

31

I have also battled ITBS. I tried a number of things - it’s not exactly clear to me which one or what combination helped but I’ve been pain-free for a year. For me, the pain started about half an hour into runs on the treadmill. I took several weeks off and it wasn’t getting better so got a cortisone shot (the Doctor told me I had bursa inflammation deep in my knee). It helped some but the pain started coming back so I tried several new approaches in conjunction with the medical treatment.

First, I went to a local Egoscue clinic (works with several pro athletes from golf, tennis, NFL, etc.) which found that my posture was pretty significantly out of line - they gave me exercises to correct the postural imbalances which took about 30 mins every day to follow. Second, I started going to an accupuncturist that was highly recommended. At first I had significant pain up and down my ITB when the needles went in but over a few weekly sessions the pain significantly decreased and it felt like the soreness/tightness decreased in line with the changes I felt during treatment. Third, a few times a week I did exercises from a physical therapist to strengthen my gluteus medius muscles. When I started running again, I started with short runs and followed the Chi Running and Natural Running approach (more of a forward lean, some postural change and increased cadence) to transition to a mid foot strike. Followed runs with icing the knee and upper ITB and Motrin. It’s hard to say which of these helped the most but if I had to guess I think the icing and accupuncture probably helped most with the short term inflammation/soreness issues and the Egoscue/running technique changes have helped keep it from coming back once the acute issues were under control. Hope this helps.

32

There are a bunch of posts that I don’t have time to read so this may be redundant but I used to suffer from terrible ITBS. That’s what got me into cycling. I got over it by doing a bunch of stretching. I would often try to sit “Indian-style” while watching TV in the evening or after runs when I did recover. Helped stretch things out sufficiently. After 6-8 off running I went out and tried to run 1 mile on the grass inside the track. I gradually added distance and then started running on the track. Went back to the road once I could do 5 miles pain-free (perhaps 3 months after I started running again). Ran my first marathon about a year later. Good luck with it.

33

My advice, stick to the track or treadmill until you KNOW it’s not gonna hurt. It’s much less painful to get back to you car if it’s no more than a 1/4 mile away!

34

Sorry, my bad! Hope it helped…even if you have to apply it to a different situation!

Take care

Dana

35

ITBFS HELL

Profile– Training 17-22 hours a week for 7ish months with the goal of qualifying at Ironman AZ, Nov 20th, 2011. Running on average 40-55 miles a week. Started Chi running about 2 years ago and loved every step of it. Never had an injury that has sidelined me for more than a week. Have done 6 marathons and have been doing HIMs (FOP on a good day age grouper) for about 2.5 years – 31 year old male - 6 ‘ 3’’ - 165-180 lbs - depending on time of the year and amount of training. No medical Knowledge so forgive me for not using the right terminology or mixing things up.

Back Story - On August 7th, 2011 last minute flight to Belgium to help my brother with a divorce and helped him move. Very stressful and very little training… When I got home from a week of paying my family dues I was tighter than a tiger due to sitting in Airports and Airplanes from the last 30 hours of traveling.

The Flare Up - Two days after I got home, August 16th I went for an easy 6 mile run. Mile 3 of the run I started to feel a burning sensation on the lateral side of my knee. I fought through it for half a mile and it got to the point where I thought I got shot and expected to see blood running down my leg. Limped 2.5 miles home.

Self Help – Upon arriving home I immediately jumped online to begin my self-diagnosis and self-prescriptive plan to get back on the road. I was already anxious after missing a week of training in Belgium so I gave myself 10 days off of running while continuing swimming and biking. I was also abiding by R.I.C.E. plus taking NSAID’s (ibuprofen) at 600 mg - 3x a day for 10 days. I also looked up all the normal stretches for ITB issues and foam rolled every day. Every time I stretched / rolled out I felt better but each morning I would wake up and be tighter than the day before. The goal was of course to not lose too much fitness to keep my qualifying dreams alive. This did not happen. After 10 days I felt worse – my entire right side was pulling from my calf all the way to my shoulder to the point it hurt to sit at my desk at work.

Harsh Reality – I had read to take the time off EVERYTHING and wait for the swelling to subside but I didn’t have time! But when I couldn’t even sit without pain I decided it was time to just rest. After another ten agonizing days of doing nothing – and I mean nothing I was still in the same situation. Pulling on the right side of my body from calve to shoulder. I scheduled a massage which did nothing, I went to a chiropractor to have realignment and Graston multiple times to no avail, and finally on Sept 16th I went in to get acupuncture at http://www.sdsmacupuncture.com/. Greg Bourque out here in San Diego used to be a professional cyclist and is awesome. He felt it was an issue with my hip flexors (http://www.sports-injury-info.com/hip-flexor-injury.html ) shortening during my unusually long time sitting on the flights which in turn caused my gluteus medias to spasm which was pulling on my back up through to my shoulder and down my hamstring all the way to my calf. After getting acupuncture treatment once the pulling on my lower back immediately stopped and I felt much better!

Ramp Up Round 1 – For the next few weeks I road my old road bike which has a very relaxed fit in my street clothes (so I didn’t feel obligated to hammer the pedals) in the highest gear possible. I also began to foam roll and got a lacrosse ball to roll out my hips and gluteus muscles (very painful!) After a week I began to ramp up slowly. On the 23rd I got another acupuncture session to ensure everything was going well. It helped and I felt confident I would still be able to be competitive for Ironman AZ. After two weeks of ramping up the bike I went for a 500 yard run, all good. Then two days later a 1000 yard run, all good. Two days later a mile run, all good. Two days later a 1.5 mile run and FLARE UP!!! Went home and iced, compressed, elevated, and in the morning I was back to square one!!! Pulling from calf to shoulder, SH!T!!!

To the Doctor – Sept. 30th 2011 Ironman AZ is 50 days away and I can’t run 1.5 miles! Now that I knew my hopes and dreams had been flushed down the drain for Ironman AZ I just wanted to be able to train again no matter how long it took. I no longer had an agenda and was willing to follow anyone that had the right answers. I went to see Doc. Taylor at USCD (http://ucsd.photobooks.com/directory/profile.asp?setsize=10&dbase=main&pict_id=1609155) on the 7th of Oct. who diagnosed me as ITBFS and prescribed me 6 weeks of physical therapy. Nothing I didn’t expect, it was just nice to have a doctor tell me I wasn’t going to die.

The Real Issue – Oct. 10th – San Diego is awesome and I have access to http://www.rehabunited.com/index.html which is a really cool place. Upon my initial consult my therapist did a stride analysis and noticed I have a overpronation http://www.runnersworld.com/article/0,7120,s6-240-319-327-7727-0,00.html on my right foot which I never had before. Forgive my lack of medical knowledge and I will do my best to describe in laymen terms why. Essentially what happens when you walk or run is that your stride starts as your foot lands and rolls in, followed by the tibia and fibula rolling in, followed by your femur which rolls in, and then your hips that roll in. But due to my Hip flexors shortening which caused my Gluteus Medias to spasm, and over time shorten, my femur would not naturally roll in. This in turn caused my IT band to lengthen as the lower leg rolled while my femur and hip would not. That lengthening of the IT band during running caused the IT Band to rub on the lateral side of my knee causing friction hence the name Iliotibial band friction syndrome. So there you go, that was the issue as best I understand it. Better article than my confusing description - http://runningtimes.com/Article.aspx?ArticleID=18359

Ramp Up Round 2 -To fix this I have been doing some functional stretching focusing on my hips, hamstring, calves, and gluteus muscles every day along with gluteus specific strength training. I will post when I get home the exact stretches I have been doing along with the strengthening exercises. After one week of rehab I began to ramp up riding my bike again (this is about 15 days since last flare up) and swimming again. I am feeling stronger and am glad to just be able to train at all again. I am now into my 3rd week of rehab and today I will be running for the first time on the treadmill for one minute on, one minute off for ten minutes. A total of 5 minutes of actual running (more like jogging.)

New Goal - I have literally 19 days until Ironman AZ so hopefully my swimming and biking will get me out of the water and off the bike fast enough to be able to walk a marathon under the 17 hour cut off time. I am just as excited to try and finish as I was to qualify. My definition of hitting my goal has changed from 9:30 to 16:59!!!

Specifically to answer your question – My knee does not hurt at all while swimming or biking. If you feel ANY pain on the knee then you should NOT run based on my experience. And my advice would be to take it serious as there does not seem to be a quick fix (that I know of and I tried a few.) Take the long road and figure out the root of the issue for long term success.

36

Thank goodness you are a multi sport athlete. Stop running or any type of training that makes it hurt.

I had a severe ITB problem back in 1992. Cortisone, ice, etc…kept running on it to finish off my last season of track in college. Never healed from Feb-Sept (when I had surgery). I regret the cortisone shots and trying to run through the issue. Once you have surgery, you are never the same.

I would guess that the point of pain is not the malfunctioning part of the body. The hip is where I find the center point of these injuries. We continually treat the point of pain, which is typically the condial where the IT band is irritated from the constant friction with each step.

While riding the bike, we continually hear the chain rubbing the front derailur, we do not put WD 40 on the chain to stop the problem- we take the tension off by going to the small chain ring allowing the chain to run is straighter line, not rubbing the IT band of the bike, the front derailur.

I have a nice 3 inch scar on my right knee to remind me to take care of injuries before they run out of control. Stop doing efforts that irritate it. Again, that is the advantage of being a multi sport athlete. Swim, ride or twiddle your thumbs. Feel free to contact me if you think you have any questions.

37

Just my 2c from having extended ITB issues. Again, just opinions but they are based on a reasonable amount of research.

You can not stretch your IT band, at least it would be highly difficult to. It is a band of very thick connective tissue that aint goin’ nowhere.You do not run on ITBS. It hurts and for every 5 minutes you run on it you can throw a few days or week onto recovery.You should not foam roll your IT Band. Recent research has shown this to aggravate the bursa further. Roll the hams and quads either side. Your ITB will not have ‘got tight’ it either is or it is not. If it was not before then it is not now. Your hams and quads can get tight.Weak glutes are such a high probability cause of IT band issues that I would put money on that being the case.I would also put money on the fact that any strengthening exercises you are doing you are doing in such a way that it favours your already strong muscles (ie TFL for lateral raises etc). Don’t waste time doing them wrong. Do them right, even if you can’t do many, which you shouldn’t be able to because they are likely weak! The object of a lateral leg raise for example is not to lift the leg laterally. It is to strengthen the weak glute muscles. If you use something else like the TFL you are missing the point.A remarkable number of people state that ice makes it worse. Including me.Foam rolling, cortizone, NSAID’s etc all work on the symptom. Focus on the cause.You can start running again straight away. You just have to know exactly when things start to go the wrong way and stop before it goes any further. Don’t keep upping the distances. You will constantly stress the area. Do a safe distance a few times, let your knee get used to it. Then up the distance and do that a few times. Repeat. Don’t always build.I would never get an injection unless I had a massively important race and even then I would think twice.ITB surgery is for people with short IT bands, not people who have developed ITBS. They have another issue entirely.There are a number of links to ITBS, anywhere the structural chain breaks down from foot to hip causes the ITB to be overused. Find the source.See the point above. Find the source. Save yourself some time by starting at the glute.

I could go on for hours!! Once you nail the source of the issue it can be a quick thing to recover from. Good luck.

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Just my 2c from having extended ITB issues. Again, just opinions but they are based on a reasonable amount of research.

You can not stretch your IT band, at least it would be highly difficult to. It is a band of very thick connective tissue that aint goin’ nowhere.You do not run on ITBS. It hurts and for every 5 minutes you run on it you can throw a few days or week onto recovery.You should not foam roll your IT Band. Recent research has shown this to aggravate the bursa further. Roll the hams and quads either side. Your ITB will not have ‘got tight’ it either is or it is not. If it was not before then it is not now. Your hams and quads can get tight.Weak glutes are such a high probability cause of IT band issues that I would put money on that being the case.I would also put money on the fact that any strengthening exercises you are doing you are doing in such a way that it favours your already strong muscles (ie TFL for lateral raises etc). Don’t waste time doing them wrong. Do them right, even if you can’t do many, which you shouldn’t be able to because they are likely weak! The object of a lateral leg raise for example is not to lift the leg laterally. It is to strengthen the weak glute muscles. If you use something else like the TFL you are missing the point.A remarkable number of people state that ice makes it worse. Including me.Foam rolling, cortizone, NSAID’s etc all work on the symptom. Focus on the cause.You can start running again straight away. You just have to know exactly when things start to go the wrong way and stop before it goes any further. Don’t keep upping the distances. You will constantly stress the area. Do a safe distance a few times, let your knee get used to it. Then up the distance and do that a few times. Repeat. Don’t always build.I would never get an injection unless I had a massively important race and even then I would think twice.ITB surgery is for people with short IT bands, not people who have developed ITBS. They have another issue entirely.There are a number of links to ITBS, anywhere the structural chain breaks down from foot to hip causes the ITB to be overused. Find the source.See the point above. Find the source. Save yourself some time by starting at the glute.

I could go on for hours!! Once you nail the source of the issue it can be a quick thing to recover from. Good luck.

Could you share your source on the Foam Rolling? I would assume this reserach makes mention to foam rolling over the bursa vs foam rolling the proximal segment of the Iliotibial Band tract and the musculotendinous junction of the TFL. Rolling over an inflammed bursa would obviously be contraindicated.

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A couple of justifications.

  1. Reasonable amount can be assumed to be a reasonable amount for an AG athlete looking into the subject.
  2. ‘of research’ … I would like to add a disclaimer that the research in questions was my own ‘looking into’ rather than scientific studies with ‘N’ being greater than 1 :slight_smile:

I was at a training recovery clinic at a Physiotherapist. The Physio is currently aiding the Olympic team at the Pan Am Games, is an Olympic athlete and also had on hand another Olympic Athlete (just won a medal at the Pan Am Games). As much as I trust their knowledge and expertise I do not have the data to back up the bullet point below. I am just repeating what I was told. I can try and find out though.

Glad I added ‘just opinions’ to my opening gambit now.

I am assuming that directly rolling the ITB may negatively impact and already inflamed bursa, although possibly not to the extent rolling direct;ly on the bursa would?

Could you share your source on the Foam Rolling? I would assume this reserach makes mention to foam rolling over the bursa vs foam rolling the proximal segment of the Iliotibial Band tract and the musculotendinous junction of the TFL. Rolling over an inflammed bursa would obviously be contraindicated.

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Weak glutes are such a high probability cause of IT band issues that I would put money on that being the case.I would also put money on the fact that any strengthening exercises you are doing you are doing in such a way that it favours your already strong muscles (ie TFL for lateral raises etc). Don’t waste time doing them wrong. Do them right, even if you can’t do many, which you shouldn’t be able to because they are likely weak! The object of a lateral leg raise for example is not to lift the leg laterally. It is to strengthen the weak glute muscles. If you use something else like the TFL you are missing the point…
Quoted for emphasis.

My last trip to my ortho resulted in pretty much this above. My other muscles were helping in the work, not my glutes. I now have only 4 exercies I am doing, but I am focusing on doing them correctly. I am concentrating on the “dimple” in my butt cheek as my cue. If I am feeling it, then I am doing the exercise correctly.