Recovery From ITB Syndrome

Hi Lads,

I've read a few of the posts on here about ITB and they have been really useful, lots of links and advice etc.

What I'd like to know is if there are many people who get ITB and are able to fully recover from it? And if there's many people who have passed out of training after getting the injury?

Some background about myself: I've got a final year left of uni before I plan to join the RM (providing I pass all tests/PRMC etc) and have been dealing with ITB for the last 6 months. Finding out about the related muscle-groups and strength training has really helped. I have also done a bit of work on 'running form' as I had a bad running 'technique', so correcting that has also been positive. At the moment, I can't imagine being able to run every day, let alone in boots with added webbing + weapon. So is this a permanent problem, or can people completely get passed it?

Cheers

 

Hello mate
I was in a very similar situation to you, and I know how awful this issue is because although you can train and there is no permanent damage from the it band pain, it is still incredibly irritating and damages confidence. It feels like it will go on forever and I felt really frustrated at the time, especially because all the information online seemed quite overwhelming and often contradictory.
I am sorry, Unfortunately I am at work at the moment so I will have to reply fully later this evening with what what helped me. I would really like to help you with this though because it caused me a lot of trouble at the time.
Thankyou

 

Hello

I am sorry to hear about your ITB syndrome, it can be incredibly frustrating. I am not a medical precessional at all and it is always recommendable you should visit a physio who specialises in biomchanical issues. Hopefully I may be able to provide some bits of information which might help because I had to do quite a lot of digging to get rid of the issue

Unfortunately It band syndrome was present with my running from February 2016 till about a month ago ( I was however able to train fully during this period ). I became really frustrate during because I tried lots of things and nothing seemed to work for me. What may work for someone may really be useless for someone else, so if you haven't already please have an individual assessment from a physio who can look for potential intrinsic causitjve factors for it band syndrome (just out of interest, do you exeperinece symptoms in both legs or just one? ) it is also really important to confirm your diagnosis with a professional, because what may be symptomatic as it band pain may in fact be something else, like entrapment of the peroneal nerve.

I think the key point regarding this issue is that the causative factor may be different from person to person, and therefore treatment and recovery is different. This can be confusing and a little disheartening because this multifactorial condition can be very perplexing. From what I gather the issues which have been known to precipitate the onset of it band syndrome are varied, and include-

-- Extrinsic contributory factors-

Running on crowned or cambered road surface

Inappropriate footware for the individual

Issues with trajning volume increases (e.g. Exceeding intensity and volume too rapidly beyond body's capability)

-- intrinsic factors

Leg length discrepancy

Lack of internal leg rotation owing to tightness in TFL muscle

Overpronation or oversupination

Weakenss in hip abductors and hip abductors

A lack of effective arm swing, or unbalanced arm swing causing rotation for the trunk during running

Compensating for lack of flexibility or pain inhibition from prior injury (like a previously sprained ankle)

Limited big toe flexibility

Shortened hamstrings

Tight or weak posterior compartment muscles

The actual shape of the leg bones and the hips themselves






Unfortunately this is all horribly complicated and I found with no specific anatomical expertise the whole process of working out the causative factor was a nightmare. I kept reading these online physio articles about having to find the cause and then the problem would go away but the body is so complicated and it is often to complicated to trace exactly what muscle is not doing its job. The itobial band performs many functions and so there are a lot of things to consider when treating it band syndrome, I foind the whole picture becomes clouded and overwhelming with lots of advice on the internet often confusing me further.

As far as i understand The it band controls rotation of the leg and stabilises the knee when the foot is placed on the ground on the stance phase of the gait. It also works as a long lever arm to the TFL muscle (effectively a hip flexor) as you lift your knee towards your body. Therefore, any issue with hip flex ion or excessive rotation could cause this issue.

From what I gather from your post, you have been strengthening the legs but the issue still persists. A lot of the advice online (which seems to benefit a lot of it band sufferers) focussed on working on hip strength and balance and coordination of the lower limbs, the idea being that this reduces the amount of stabilising work the it band has to do if the supporting muscles are stronger.
I felt rather downcast when months of strengthening made me a lot stronger but did not reduce my symptoms. This demonstrated to me that alhough strengthening helps some people it is not the answer for some.

I also attempted massaging the TFL muscle with a foam roller and hockey ball in the hope that this would reduce the tension in the attatched it band. This seemed to help some people but I just got some strange tingling sesnastions at the it band insertion point.

Foam rolling the it band seems controversial and although it shouldn't cause much harm it probably won't stretch the it band like some Internet articles claim (the it band needs to be tight to keep the knee locked in place and stabilised when you straighten your leg - as a consequence, the collagen fibres of the band combine to make a largely inelastic structure with a. Tensile strength higher than steel - it is therefore unlikely to stretch even if you wanted to)

However, even if foam rolling other muscle (like hamstrings or calves) s or strengthening the legs doesn't solve the issue for you, I still found they are still beneficial for general fitness so I kept them both up regardless.

What I found helpful

What I found solved the issue for me may be completely useless for you but it may be worth trying

I tried insoles, changing shoes, strengthening, foam rolling and modifying running form (the last of which is hard because lots of advice I found from online running g websites talks about 'runnking tall' or 'light', whatever that is because at the end of the day I found trying to deliberately modify y technique made my whole running pattern even clumsier. I even tried forcing myself to run at 160bpm cadence which was awkward and silly of me when I was nowhere near that cadence).

It really helped me to keep things really simple and to stop over analysing everything.

If possible, keep running even if you still have it band pain. It band pain is horrible, but there is no permanent damage from the soreness (the fascia of the it band just compresses nerve rich fatty adipose tissue on the lateral knee) and it is not like an acl tear or menisval tear where you have to wait for it to heal. You can keep running but remove the pressure and just keep everything relaxed. I did 5 6 km runs a week when I had it band syndrome and it really made me feel better when I was still getting a run in, even if the pain was still there.

I found hill spirits really helped me improve running technique because you have to engage your glutes and drive your arms hard.
I improved my hip internal rotation with foam roller, which increased the amount of rotation at my hip and meant that during running my foot wasn't rotating on the floor due to s tight hip, and causing me pain in the it band. I also worked on my arm drive and made sure each arm was driving forward and not across the body (excessive arm movement across the body rotates the trunk and consequently then the it band, causing pain)

With these simple changes I feel much better now and i am back training. I got frustrated with all the info online so I just waked in front of a mirror and found my arm swing was wrong . Maybe you could try walking in front of a mirror, just to see if you spot any differences between your arms in legs on either side if your body. I found in my affected side I wasn't swinging my arm much.



I am sorry about the length of that of that but please don't feel disheartened if you are not finding eh magical cure advertised so much on those ghastly American running forums ( which I swear all the online physio websites take all their info from). Please try some hill sprints, keep up the strengthening, see a physio and keep feeling positive because this will pass and you will be back stronger than ever.

Thanks

 

That's some awesome info, thanks very much for that mate. That sounds very much like the situation I'm in, so much yank info online it's hard to tell what's useful/what's not. I have the pain only in my right knee, and I did think that it may not be ITB, but I was lucky enough to get a scan on it due to a last minute cancellation and they were able to confirm it was ITB.

I've had one session with a physio, and have been told my glutes are really weak, so hill sprints could be really helpful; and I have not considered my arms whilst running, or internal hip rotation, so I'll also look into that.

It's great to hear that there is a way out of the ITB problem, and that it doesn't rule me out of a career in the RM. Out of interest, how far along the app stage are you? And are confident you'll be able to take on RT without any ITB problems in the future?

cheers

 

Thanks
It's really good you have got a scan to prove there is nothing nasty going on, it band syndrome is really painful but it doesn't cause any permanent damage, so you can keep training I got rather disheartened by how stubborn it was but I adopted the approach that I would come back stronger afterwards because I had worked on flexibility and strengthening, so though a complete pain at the time my issue with it band syndrome has left me running much better than before.

I am just about to submit an application, I am doing lots of runs and recording them at the moment so I can show my careers advisor at interview, I saw an NHS physio who was excellent and who has kindly said she will write a letter if the is an issue during the medical stating my Itbs never stopped me training and that it dosed bother e anymore I found the it band syndrome blunted my confidence and the stubbornness of it made me fear it woukd keep cropping back up, but I find I can do long runs now and it is not s problem. Occasionally I get the odd twinge in the itb if I am really fatigued and my arm swing deteriorates, but it band pain is like instant feedback because as soon as I swing my arms properly again it disappears again almost immediately!

Please can I ask, have you had a hair analysis done by a professional? I am not an expert but if your it band syndrome is only in one side of your body did your physio access any reason why that is? Is this side of your body compensating for something, because of you walk in front of a mirror or ask your parents/friend/ partner to film you walking and running you may be able to spot you are moving differently on each side of your body. I noticed from waking in front of the mirror I wasn't swinging my right arm properly, so my right ITB hurt as I rotated my left arm across my body to compensate. Maybe just try waking in front of the mirror to see if you notice any differences between each side of the body

 

Great best of luck with your application. Yeah probably best to see the GP beforehand to prevent any hold-ups on the medical stage, I've heard it could take ages. It's good to know that you were where I am with it, and now you can do longer runs without any issues.

I'm not too sure specifically why it's on the one side; he said that my glutes are really weak, and that I have quite a flat left foot and pronation in my right. I also have terrible running form, but pretty good cardio from a few years of cycling. So it's a combination of things, but I was basically pushing it too far/overtraining.

I'll keep cracking on with my recovery plan, improving basic form, and will also be taking the things you mentioned on board.

Good luck with you application!

 

Thankyou very much, good luck with your application too I think the point you mentioned about overtraining is one of the reasons I had itb syndrome, I think the body can cope and conepensate for all the weird little assymetries we all have to a certain degree but I pushed things a bit to far and My body couldn't compensate anymore!
I hope you feel better soon.