Damn if it doesn’t come to this…5 months ITB problems…and my right is flaring up a little to. Still no running, still no breast-stroke, swimming only 1600-2200 m 3 x week, no kick sets, and 1 easy ride a week to keep my wits about me, but no real improvements on the leg front. I still have “twinges” and tightness that keep me from going over an hour on my “rides” (tricycles go faster than I do) or from swimming more than about 6000m in a week. Running is a distant memory. I think I did at some point in August…
Who’s had this surgery? I’m going to schedule an appt. with my ortho next week, and he said if I wasn’t better in the past 2-3 months since I’ve last seen him, this was his next choice…
that would be the last extreme measure. You don’t say much about previous treatment/assessments?
I have had problems with ITB but have been managing through physio and extensive stretching. My advices have been that the ITB issues I have comes from lower back and core stability issues. I have no pain in these other areas but the ITB is a symptom of these othjer problems.
I wouldn’t contemplate surgery until you have had a complete physiological assessment done by an appropriately qualified professional. I have just had one done and it was really interesting to read results.
I haven’t had it, but I do it occaisionally. I agree with Shep’s post above - to answer your question would depend on what you’ve done already. Another question would be whether the diagnosis is confirmed somehow, for example by injecting local anaesthetic into the affected area and making sure it feels temporarily better.
The other problem with surgery for this condition in athletes is that it really doesn’t address why you have it in the first place. I think surgery could be part of the solution in the right patient, not usually the solution.
Remember that an orthopedist is trained as surgeon so that is going to be their answer to everything…cut it open. Every specialist sticks within his/her training boundaries.
Before you go to this last resort please find a good massage therapist who knows sports/deep tissue massage and go to him/her on a regular basis. I would give this several months of massage therapy before you make your next move. The problem could be something up in your hip or back that is causing the problem in your leg. Also, talk with the therapist about a good chiropractor and think about giving that a try also.
Don’t go the surgery route without trying other not-so-drastic methods first.
100% agreement with the rest - surgery should be an absolute last option, when you’ve tried everything under the sun and then some. A good massage therapist, physiotherapist, sportsmed doc, and even personal trainer (if suitably qualified) could very likely help you through this without the need for cutting.
While I appreciate your frustration at not being able to train, surgery is an extremely risky, irreversable approach that (IMO) should only be considered when all other options have failed.
A buddy of mine (powergyoza) has had good luck with the book “the pain free triathlete” as well as using “The Stick”, all manner of balls and rollers, and I believe he’s purchased Maylene’s video as well. PM him or search the board if you’re looking for specific ideas, but see a qualified therapist/doctor in person for “real diagnoses”.
so glad to see this forum is unanimous on this topic (so far…maybe no doctors have responded yet)…I have a friend working his way through to be an ortho and he’s adamant on the topic. I prefer to take a more pro active approach. Until you have tried everything…and I mean everything from chiro, to massage, to accupuncture, to ART to any other form of non invasive snake oil there is out there to try…stay away from knives. Yes the doctors know what they are doing but it isn’t always what’s best for you (I mean really, how natural is it to cut open and fix something that didn’t need to be cut open to make it injured in the first place?). Last resort. Doctors told me my back injury would require surgery (each time I got hurt) if I was ever going to do triathlons/ride a bike pain free again. And thus far…they were all very wrong. Even if they can fix the injury with surgery…there are less guarantees with it than with any other form of treatment which are less permanent. I hope you can find relief without it. But don’t just go turtle on this one. Stick your neck out and try another way.
I agree with the previous posters in that it should be an absolute last resort - however as a last resort it frequently saves an athletes participation in this type of sport. I battled ITB for 3 years (caused by my own stupididty) before having the surgery - simply put without it I wouldn’t be in the sport today.
one month without doing anything…then 2 monhts with just swimming. And one month of leave my leg the hell alone (no PT or stretching, just healing. I thought)
Tried a chiro (was going from July-October) stopped with that one to try the ART specialist that was a chiro, and the quick adjustment that lasted only 5 minutes plus the $55 each time session made me stop after 2 months since it didn’t seem to help, and was just too expensive to do 2x a week. I could go back to the chiro…
gone to 2 orthos, one said yes surgery, other one said just swim. going to see the latter on Monday.
Gone to two PTs, one that does massage and the ultrasound, the other has been taping my quad to try to retrain it (I have no muscular development in the front quad, only outer, so she thinks my IT is taking the brunt). However, its left me with a sore kneecap and no skin on my arse…she really thinks its all a bad right hip thing, which I tend to believe. and, my left kneecap points in. Hence, IT is doing work that other quad muscles and joints/bones aren’t.
I do have a foam roller and the stick, and for the past 2 months, have done my stretches and strengthening religiously (damn if I didn’t live in CA and could go to that place where they produced that great stretching site–yep, tried those too).
So…I’ve done a lot of stuff, hence the frustration. Both docs were listed as top docs in our local Washingtonian magazine, one is a triathlete (the one that wants to cut). I was able to bike when I got the cortisone shot…
Just to reinforce the surgery only as a last resort, I once went through a long process to try and determine the cause of some really bad pain. It came down to 2 different Dr.s in 2 totally different fields. They both guaranteed 100% that they had found the cause of the pain, and were ready to do surgery. One Dr. was ready to cut a major nerve! The diagnoses were completely unrelated yet both were ready to cut me open and gaurantee improvement.
what doctors would you recommend? i do have a physiatrist I could try, and I could retry the chiro…what do you think?
I went to a neurologist back in January for my back ( I know its back/hip issues) and he did one of those electrode tests all over my legs. nerve endings were fine. He just wanted to give me muscle relaxers…
Turtlegirl, your treatment so far sounds reasonable; if the cortisone injection helped, you probably have the right diagnosis. The two things missing from the list of things you have done that I can think of are gluteal strengthening and trying orthotics (if appropriate).
I guess the bottom line is that almost all of us had had this at some point, and very few people need surgery, so one way or another most of us get rid of it. On the other hand, the surgery is not a big operation, has good results, and despite the dire warnings above, is not particularly mutilating. I would talk it over with the other people you have seen, eg RMT, PT, Chiro in addition to the surgeon.
I’m going to go slightly against the grain here and say that surgery is NOT the last resort. I would put living a miserable life because other people insisted surgery is so horrible behind it. I had a ruptured disc about ten years ago and limped around in agony much longer than I had to because of such people, when it was clear nothing else was going to make me better.
I wouldn’t give up on non-intrusive treatments until I had tried them, but I wouldn’t desperately try every snake oil salesmen out there to avoid the knife either.
Any good orthopedist will not knife-happy; they will be as proud if not more proud of their patients that recovered without surgery. As the doctor who preformed my surgery told me, “don’t get me wrong, I’m a surgeon and surgery is what I like to do, but I will NOT cut on you unless I think you need it…I get enough surgeries from the emergency room alone to keep me from wanting more.” I think its much more likely that most patients are quick to resort to surgery rather than trying therapy because it requires so much patience and determination.
Before I selected him to be my doctor I asked around and found out how many people I knew who had seen him, and made sure he had success stories for both surgical and non-surgical solutions.
One last suggestion is to look for medical professionals who are in sports medicine. They are much more likely to understand your desire to return to fitness activities and how it effects your recovery. Good luck!
As a recent former ITB victim I can understand your frustration level.I really thought I would have to give up my running all together as my knee pain was so brutal.
It sounds like you don’t have enough front quad muscle as well as glute,and hip abductor strenght so you’re IT Band is taking all the shock,which , at this point is as stiff as a surf board.
Try to re-focus your efforts on that core group of muscles…it will really pay off dividends.Spend a month in the gym doing just that and pilates.If you can’t give up running…run in a pool with a belt.Go back a few pages in this forum and look up my ITB solution post.I have recommended this approach to a few friends who have also gotten rid of their pains…i’m sure it will help you.
And lastly,please avoid the surgery at all costs!!!
It is not gauranteed to do anything but forever float your kneecaps in limbo.I know of at least 1 runner who can no longer run anything over 3 miles because of the surgery.
Good Luck…it will pass
the biggest problem with us is that we don’t know how to “take time off” with injuries. we think that backing off, or only doing 6000m per week of swimming is time off. any injury this severe needs complete rest. nothing, no swimming running or biking. until a true assemsment can be made of the ITB when it isn’t under starin. i know it’s har to do nothing, but look how long you’ve been with it. i’d say find a new hobby for a few months… online euchre is fun!!!
again, with the rest of the group… surgery is an absolute last resort. I’m sure your ortho said go ahead, but he/she wont make any dough if you dont do it.
It seems that surgery is addressing the symptoms but not addressing the source of the problem. I would not get cut until I understood how it was going to solve the source of the problem.
Maintain flexibility.
Build or maintain strength, whichever is necessary in your case. I would lean more towards body weight exercises.
If flexibility is good and strength is good, and the problem is not getting better then I would be very suspicious of mechanics. Get video of cycling and running. Cycling video on a trainer is likely fine, but video of running on a treadmill may not be helpful. Video of your walking may help as well. If you injured the IT, then walking may keep it aggravated enough not to heal quickly even if you are “resting”.
Question your rest periods. It is hard to know what is the correct amount. Most of us do too much when we call it resting.
I would not rule out surgery, but I would make sure I had tried everything else. It doesn’t sound like you have spent enough time on mechanics to go to surgery yet.
The biggest hurdle I would have when contemplating surgery is how do you trust your Dr? I’ve lost virtually all faith in the medical profession unless I have a clear cut simple case i.e. my arm is broken. Muscle and tendon problems are difficult to diagnose correctly and difficult to fix. God knows patients are difficult to work with. However, I’m sick of hearing Dr’s with full confidence in their answers when it really seems like what they have is a guess. I’m fine with a guess but tell me that it is a hypothesis and lay out a plan for testing the hypothesis and explain what the difficulty is. If all you have is a hypothesis, the situation would have to be dire indeed before I would go under the knife to test a hypothesis.
My concern for you is that you have an easy to fix mechanical problem and you will get surgery instead. After healing from the surgery you go right back out and start running again using the bad mechanics and end up in the same place in 18 months. It seems that surgery is addressing the symptoms but not addressing the source of the problem.
I did not scan through all the posts, but I did not come across the most basic and straightforward solution - check your shoes! A significant percentage of ITB problems are cause by people running in shoes with major medial support that don’t need major media support. Pronation has been given a bad name. A certain amount of pronation is a good thing. What you want to stop is excessive pronation.
I would suggest that if this is you ie you are running in a shoe with medial support, try a neutral cushioned shoe. However, first you need to do some major stretching, and deep massage at the point of insertion( deep in the glutes) of the ITB.
I second the muscle strengthening and the pilates. It sounds like you really have an imbalance going on. As a side note, I tried the pelvic drops on the IBS page that was posted, and discovered that my left hip muscles are much weaker than my right (where I have been struggling with pain and tightness for, like, forever!). Imbalances will get you every time IMO.