ITB Syndrome my recovery

Discussion in 'Common Training Injuries' started by aliB, Jun 16, 2017.

  1. aliB

    aliB Active Member

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    Had a couple of messages about when I had the injury so I will post how I personally sorted it and what my phsyio at the time told me to do if anyone else is struggling.

    I had ITB Syndrone in 2015 a couple weeks before my prmc. You can tell it is ITB when on either knee the lower right/left side ache when you run and if you continue it becomes a pain. You can also tell if you press at the top of your legs youll feel the it band in pain as its very tender.
    So how I eventualy got rid of it:
    You will read countless websites saying different things on how to remove it. I tried pretty much all of them with no avail.
    Websites say stretch 5 times a day and in 2 weeks youll be fine. You might but itll come straight back once you hit the miles. Itb syndrome is a muscle inbalance and can be due to overuse or a weak gluteus maximus on either side.
    So how I fixed it;
    When you feel the tenderness at the top of your leg remove the foam roller for the time being and get the kitchen rolling pin and do 5 times a day 30 seconds or more hard rolling. Hurts like hell but that tenderness goes fast. 2 days for me however after your 3rd day havs a day or two of static stretching with no rolling as it will recover on those days and hopefully youll feel it go.
    The pain in the knee for me was the longerhall.
    You need to do itb leg exercise like lying on your side lift your leg up and down try for 200 reps a day on and off or 200 a day everday if your feeling it and increase if you need. Also do one legged squats and if your gym isnt too far away power walk their and maybe even run a couple hundred metres as long as no pain is there! At the gym use squat machine leg raises leg abduction any leg workout but mainly ones that focus on your glutes, back of your legs and sides. The main thing is strengthening. It took me a while but that combination was the best.
    Also check your shoes. Are you wearing the right shoe for your foot? High Arch Neutral Arch Low Arch? Are you trainers due for a swap?
    I hope this helps someone as it did for me
     
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  2. A350-800

    A350-800 Member

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    thanks, this is very helpful :)
    Please can I ask, Did you roll on the actual it band itself, or just the surrounding musculature/quads/TfL? :)
    There is loads of debate on running websites about how the it band is tough and impossible to stretch and about how you shouldn't foam roll directly on it but the band itself runs over the top of the vastus lateralis quads and lower leg muscles and so I guess if these muscles are tight, the it band Get sore too!
    What makes me worry is the that if I use foam rolling to get rid of it and then apply and join the marines I will constantly have to rely on foam rolling all the time which is not something that is sustainable. Like you said with the shoes and strengthening, ITBS is a multifactorial condition and I think my issue itself is caused by a muscle imbalance in the shin muscles (tibialis anterior etc) because my glutes are working ok now ( they weren't before haha :) )
    Thanks for the advice.
     
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  3. aliB

    aliB Active Member

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    I rolled on the top of my hip down to middle of my leg and really pushed were it hurt the most
     
  4. "Crikey mate"

    "Crikey mate" Member

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    Spot on advice mate, got rid of the problem doing a very similar thing myself!

    Bit more insight into the issue from my experience, yours could be due to a completely different reason and its always advisable to go see a physio (ideally non NHS you can probably guess why...)

    Pretty much as aliB has said you're getting ITBS lads its likely that your glutes aren't activating and you're TFL is doing the job of the glutes which is to stabilise the knee and keep it tracking over your second toe. Chances are if you're glutes aren't activating you'll have an Anterior Pelvic Tilt too. (not always the case but majority of the time)

    To explain why the ITB band is swelling. The TFL is connected to the ITB. This is fine for people who don't do intense phys but after time doing intense phys such as lots of running/walking the ITB will start to tighten and swell from the TFL getting super tight and in turn causing the ITB to tighten and then you get the pain on the outside of the knee cap where the ITB is swollen and its going through the knee joint.

    Roll out your TFL, Quads and hip flexors. Stretch them. Then work on Glute activation exercises. I've always found clams, bridges, kettlebell deadlifts and squats focusing on squeezing the glutes at the top and holding works best for me personally. (after a while 1 leg squats and dumbbell deadlifts too but don't start on them as you'll be doing them very wrong)

    As A350-800 said (& I've been told by physio's) its generally advised to avoid rolling the ITB directly as its not the cause of the issue and will only cause temporarily relief and can actually damage the band. If this is your fix guys you'll constantly just rely on rolling just like A350-800 is worried about (doesn't sound like that's been the case for you though aliB?)

    The idea of rolling the TFL/Quads/Hip Flexors is to stop them activating before the glutes/hamstrings so you can actually train your glutes/hamstrings.
    Its a muscular imbalance and won't be fixed with just stretching/rolling. Its all about making the glutes learn to do their job and strengthening the hammys.
    But to do that you need to stretch/roll before you work them or you'll just be working your TFL, hip flexors and quads. Its also advised to roll/stretch after working them.

    Also incredibly important to create a mind-muscle connection to the glutes and learn to use them. Supposedly the strongest muscle in the body so if you're not using them you're preventing yourself being the best you can be. Really focus on feeling them work when you're training them, when you're walking and when you're standing focus on squeezing them and pushing your hips forward.

    Concentrate on lower ab exercises that don't activate the hip flexors too. (this is mainly if you have the Anterior Pelvic Tilt)

    Heres an interesting read if you *text deleted* look further into it:

    http://www.higher-faster-sports.com/noglutes.html

    Also found this bit of kit a bit safer for preventing any damage a kitchen rolling pin might cause as its so hard if you've got the cash and if you don't want to look a plonk at the gym/in RT with a kitchen rolling pin.
    http://www.tbo.com/storyimage/TB/20131019/ARTICLE/131019086/AR/0/AR-131019086.jpg

    Theres no quick fix it takes discipline and hardwork.

    Best of luck lads.
     
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  5. A350-800

    A350-800 Member

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    Thanks :)
    What you said about the anterior pelvic tilt as particularly helpful, the physio I went to see picked it up on me. Almost half the difficulty involved in the exercises is learning the movement and getting the brain used to activating the muscles properly, and in the right order/time. After this, one can work on strength and muscular endurance. I guess we all have muscle imbalances and subtle ways our body compensates for tightness or weaknesses everywhere, it is just if we push ourselves a little beyond our body's ability to adapt and compensate we start having issues like ITBS.
    I find it is a challenge to do core strengthening and particularly sit ups without TFL activation; I guess it is all part of balancing any additional TFL loading with extra glute activation. My TFL will cramp up after a few sets of sit ups.
    Cheers :)
     
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    Last edited: Jun 17, 2017 at 10:07 PM
  6. A350-800

    A350-800 Member

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    Another funny subtle little thing I have noticed which I feel is contributing to the issue is when I go to balance on one leg or do a single leg squat, my little toes and the fronts of my feet (not the bog toe) lift off the ground, rotating my lower leg with me consequently putting all the weight through my big toe and inside of foot and causing my knee to twist inwards slightly. this results in sore ankles and sore knee. I think some work on balancing, improving foot posture and careful barefoot single leg work in front of a mirror are in order for me :)
     
  7. aliB

    aliB Active Member

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    How long did it take you to rid of it?
     
  8. Bellionaire679

    Bellionaire679 Member

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    Sounds like a glute weakness to me mate. weak glutes can cause a internal rotation of the knee. I have it and currently fixing it.

    Look up glute strengthening exercises. It will help a lot
     
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  9. john lewis

    john lewis Well-Known Member

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    Specially glute medius
     
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  10. "Crikey mate"

    "Crikey mate" Member

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    To get rid of the ITBS and associated pain? Only took about a month tops just doing what I described.

    To correct my muscle imbalances which cause the ITBS? An on going battle that will last years for most people. It's not a simple case of 'just turning on a muscle' when running or walking. Its having to re-train the way the body does absolutely everything from sitting to standing to sleeping (biomechanics).
    Theres no quick solution to solving muscle imbalances and will constantly be working on it. In RT I will spend 10-20 minutes every evening when possible working on glute activation and settling down the TFL. I've made great progress as measured by my physio but as I said, it's going to be quite sometime before I can fully correct it.

    With the internal rotation of the knee on top of concentrating on the glutes (as john lewis says specially medius)
    I've found it really helpful stretching the outside of the quad (vastus lateralis). I personally use this stretch:

    http://www.catalystsportstherapy.com/wp-content/uploads/knee-stretches-quadstretch-2.png

    And I'm also told strengthening the VMO (Vastus Medialis) will help stop the knee collapsing inwards (don't personally do this but should and will be working into my workouts)
    But start with the glute medius.


    Are you sure its the TFL or is it possibly the front hip flexors that are cramping? If its the front hip flexors, give them a good stretch before you do your situps and between sets. Also try without anything weighing your feet down. If its the TFL I'm not certain as I don't have the issue. This bloke makes me laugh but I've personally found some of his stuff helpful for relaxing/stretching the TFL -
    Hope that helps a little bit, sounds like you've got a lot of things going on. If you're in the hands of a good physio I'm sure he's already got you on a good correction program though? So don't do anything you read on here or net without consulting him.
     
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  11. A350-800

    A350-800 Member

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    Thanks, thanks very helpful :) quite a lot of core exercises do work the TFL, sit ups less than others but still quite a bit of TfL activation. I think decreasing the number of reps I do and strengthening my stomach will decrease the amount of work the TFL and hip flexors do. The TFL works essentially like a hip flexor when running, but is a really short ribbon like muscle with a long structure acting like tendon (but weirdly not a tendon) attactched, which is the itb. I have been doing most of the glute exercises for a long time and they are ok now, the knee collapse isnt bad at all if I keep my foot positioned correctly, if I let it pronate, I get the inwards knee movement. It really helps having someone's watch you when you do the exercises :)

    The vastus lateralis stretch you mentioned is helpful, I think that muscle goes underneath the ITB which may explain why we find it helpful to stretch. Cheers :)
     

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