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Just had a debate with a running colleague and we couldn't decide which was a potential contributor to ITBS. We'd both read it somewhere that wearing the wrong shoes contributed but which combination?
Is it that a neutral-footfall runner wearing pronation control shoes risks ITBS?
OR
Is it that a pronating-footfall runner wearing neutral shoes risks ITBS?
Neither of us fancied experimenting by wearing the wrong shoes!!
I've suffered of ITBS for almost one year. During that time I read I think all existing literature on it. It is very well established that too much pronation (overpronator wearing neutral shoes) is often a cause of ITBS.
Many also argue that also too pronation could cause it, but this seems not to have general consensus. If true, not obvious to me why.
Have suffered from it for years- I over pronate. It is a pain of an injury, which I have found has led to other problems. I have bad bio-mechanics and have to run in stabilituy shoes which tent to sort the problem out.
Many different causes not just poor biomechanics but can't be bothered to go into them just now
I had problems when I whacked my hip whilst negotiating one of those chicane type barriers to stop bicycles tearing across busy roads.
It took loads of stretching to get rid of & I still do the stretching now to keep it at bay.
I know this has been covered before, but I think it might have been on the old forum.
People where talking about using foam rolls to help stretch the ITB?
Also any good stretches for it would be good.
Cheers
Stand up straight, cross legs, bad behind good then lean down and to the opposite side of your bad leg. e.g right behind left leg, lean down and left until you feel the strech down right leg.
Other is sit down. Cradle bad leg like holding a baby and pull towards you. Also rock over your arse bone seems to help a bit too.
Sit down, legs out straight. Bring bad knee up and over the good leg and twist core to opposite side whilst pushing your elbow on leg. e.g put right leg over the left leg. Right knee bent. Turn to your right, put left elbow on right knee and push.
Another, sit at your desk at work. Cross your legs so the ankle of bad leg is on top of leg of good leg. Now push down on bad leg until you can fit it under the table. Jam it under and leave as long as is bearable. (probably not one you will find on the internet but worked for my left leg :p )
Any others that people have I would love to know. My descriptions are a bit vague but I reckon you can get the idea?
Also, if you have itbs on one leg and not the other, make sure that you stretch both legs. I didn't and managed to cure left only for it to re-appear in the right. Doh!! :o
The ITB is a complex structure with attachments to bone and blending in with muscles particularly around you backside.
To effectively stretch your ITB you need to be stretching the surrounding structures also.
You should bare in mind that the ITB has a tensile strength higher than steel which when you think your average climbing Carrabina has a breaking strain of 14+KN you are talking some serious strength so stretching the ITB in isolation is futile if you ask me. ITBS and the ITB is one of my areas of special interest within Physio so like to think I know a little but by all means not everything its also something I have problems with from time to time mainly because I don't follow my own advise.
My way of stretching the ITB would be looking at addressing hip, knee and calf muscles along with isolated myofascial release which is essentially what you are doing with the ITB rollers or tennis balls.
I don't believe that the straps that some companies sell to "solve" ITBS would work due to the compressive forces it puts on the band thereby in effect shortening it and making it rub more either at the knee or around the hip.
I'll devide the stretches into different sections and other advise etc.
First stage in an acute flair up of ITB pain you need to be looking at settling down any accute inflammatory changes this would include your normal Ice and anti inflammatorys either in tablet or gels I wasn't a fan of gels till I tried them recently.
Onto the stretches
Stretching of the Glutes is in my oppinion one of the most important areas.
As well as piriformis
http://i112.photobucket.com/albums/n...ch-sitting.jpg My favorite piriformis stretch
http://i112.photobucket.com/albums/n...itus21/ex3.gif
http://i112.photobucket.com/albums/n...misStretch.gif
http://i112.photobucket.com/albums/n.../mlutemax1.gif
Continued in the next thread
http://i112.photobucket.com/albums/n...1/glutemax.gif
Next area of focus is the Quads
http://i112.photobucket.com/albums/n.../ProneQuad.jpg
With the above quad stretch the aim is to keep your pelvis flat to the floor it doesn't matter if your foot doesn't touch your bum
http://i112.photobucket.com/albums/n...tus21/quad.jpg
The above stretch can also be varied to stretch out the ITB. If you use your bottom foot it is possible to put pressure onto the upper leg increasing the stretch.
The other way is in standing with your knee on a chair whilst doing a traditional quad stretch the move your hips over in the direction of the knee on the chair. There should be more stretch felt at the knee end of the ITB.
http://i112.photobucket.com/albums/n...itus21/itb.gif
Another traditional stretch.
The purpose of using a roller or tennis ball is really to perform a deep massage on the ITB. My prefered method is to use a tennis ball and starting at the hip end of the ITB and lie on your side with pressure through the ball. Gradually work your way down the leg with the ball. Apply as much pressure through the ball as you feel comfortable and leave for approx 10 seconds what you should find is the pressure appears to get less put more pressue through and repeat two to four times. The other way is to roll up and down the ball which will provide more of a frictional massage which in theory will help stretch the ITB.
I'll see if I can find a the stretch pictures I used for my dissertation anywhere when I get some time after training tonight. Hope this all amkes sense I know its probably abit OTT but I feel that if its going to be stretched it might as well be throrough
Cheers for that plenty to be going at there.
I'm doing all these stretching and I'm still struggling like hell. :(
How much are you running at the moment?
I know its not ideal but you may need to rest it then gradually build up again. Its taken me over 4 months to be confident with mine after my last bout.
I had to rest for a month then gradually build up. Everytime I felt my knee starting to even feel as if the sensation of the pain was about to start I'd stop running and walk back. I'm now back to full training except my calf has pulled so not because of that. The reason for stopping is if you carry on you end up causing more irritation. The more irritation you create the worse the problem becomes
Other things that might be worth a try are anti inflammatory gels over the area of pain or Ice. My method of icing would be to get one of them polystyrene cup jobbies fill with Water and stick it in the freezer. When frozen peel back the poly to reveal the ice then rub directly onto the area for a maximum of 5-10 mins. Be warned Ice can leave a nice burn if you keep it still. Repeat as and when but no more than once an hour.
Just keep going with everything. ITB probs are a right bummer to shift
It takes quite some time. As it is the IT band and not the muscle it takes a lot more to actually stretch and make a difference. Stretch it whenever you can not just after running. If sat on couch try to stretch it with one leg on other knee. If waiting for the kettle put bad leg behind good and stretch. Basically just keep at it and you will notice an improvement.
Once it doesn't hurt any more, keep stretching, stretch some more then some more.
Again don't do the stupid thing like me and only stretch one side. Do both as it will just transfer to the other knee.
Think the explanation of the IT band being as strong as steel by detritus21 shows how long it will take.
Good luck with it! Really takes some perserverance to shift it.
There's always the option of an ITB release if the problem doesn't shift or reoccurs - the band would have several incisions made into it to 'free-up' the affected area, but that would be a surgical matter for an orthopaedic referral, and a last resort I guess.
However, there must be an underlying issue such as poor pelvic/hip/knee/ankle control during your gait/running causing the ITBS over a long period of time until one day you notice pain. You need assessing by a physio who knows what they're looking for, as unless the underlying cause is identified and addressed (such as poor hip control for one of many examples), you can treat the symptoms all day long but you'll always have the problem re-occur-you'll just be papering over the cracks!!
Check out the following for a list of causes http://www.time-to-run.com/injuries/thebig5/itb.htm
Just been on a course and the tutor mentioned one of his aussie female tri-athletes had a release six-weeks before taking silver at Athens, impressive!
Good luck
Hopey,
Duncan fixed my ITB. Stretching and strenghtening gluteus and quads does the trick for me. I'm still doing them more than one year after they solved it.
Good luck.
detritus21 I'm running for 20-30mins every other night, but I think I've been doing to much.
The place where I'm getting pain is just above the ankle spreading into my ankle on the outside of my left leg. After every run I ice the affected area which seems to help. But I'm not patient and I want to be out running.
I had the same problem a couple of years ago in my right leg and it kept me out for 6 months.
Ian the problem comes from my pelvis, as do all my injuries!! Last year when I was injured I went to Duncan Masons core stability classes and they did seem to help, but with one thing and another I've not been doing the excerises!!
Maybe it's time to work on the core stability!
Did you mean knee or ankle hopey if its ankle it ain't ITB
It's the outside of the leg leading from the knee down to the ankle?
I was told that stretching the IT band that it would sort it?
Where abouts does the pain start and where exactly does it run then I might be able to hazard a guess more as to what it is. ITB stuff you'd expect to affect the outside of the knee most commonly and occasionally your hip. What does the pain feel like and when does it seem to affect your most?
Are then any foot movements that seem to make the pain worse like pulling your feet up or pushing them out like you are trying to point the soles of your feet away from each other?
No pain when the foot is moved, but the area is sore to touch.
There seems to be a banned running from my knee to the ankle and the pain runs along that, I get a bit of pain in the knee and the hip.
If you can understand the next bit give it a try.
1.
Sit in a chair and slump yourself forward with your head on your chest
Then straighten the affected leg (whilst staying slumped) and pull your toes up. Does that reproduce your pain?
2.
other thing to try is push your foot out to the side like you are trying to point your soles of feet away and you should be able to feel a tendon is the tendon sore or reproduce your pain?
I've tried but it's a bit hard to tell, the pain is very hard to feel unless I touch the area or if I run on it.
What do you think it could be?
Thanks
Its a tricky one as it sounds unpredictable it could be one of a number of things. Could be peroneus problems a muscle that controls the movement of the foot in eversion and pointing your toes away and also stablising your foot. Its not uncommon to strain if you've been doing a lot of contouring or going from road type shoes to a fell shoe like a walsh.
Other thing it could be could be a nerve irritation as your peroneal nerve runs near there.
Its a bit tricky to tell really without looking at it. Carry on with other stretches and it might be worth playing around with calf stretching as well. Sorry I can't be much more help. sounds an interesting one to me.
Thanks, I will carry on with the stretches and hope it settles down.
I'll ask the physio who I saw what he thought it was, I've been told just to keep stretching etc, but it's been nearly a month now and it's not getting any better.
Where are you based?
I work in wonderful Wigan for the NHS (for my sins thats for the NHS and Wigan) but occasionally I'll see people as a favour ;).
I presume your out towards Bolton somewhere I can ask my colleagues if they know anyone they'd recommend out your way if you wany
Cheers I'll keep stretching it and give it a couple more weeks and pray!
Thanks
Has anyone any advice on this, I'm starting to get the feeling this could be the problem with my knee.
I can control the shooting pains when I run on soft flat surfaces, I then get a little bit more confident and introduce some slight downhills and thats when the pain shoots through the knee.
I have tried on and off resting it for two weeks and then getting back to it, perhaps sometimes a bit too keen. The root of my problem seems to be running flat for a week then hitting the fells. Thats when I get caught out.
I intend to revisit the physio when I get paid, but for the minute I plan to avoid the hills and just run on the flat for 3 miles twice a week and see if I can control it.
reading back through this thread there are some good stretching tips which I'll work on.
Am I still welcome on the forum even if i'm running on the roads feel such a fake.
Tra
Jamie
No bugger off.
Only kidding Jamie:D.
now then notonurhelly ,ive been the same since december,i'l get 2 wks in on flat grass then stabbing pain on outside of the knee and an ache under the knee cap. r u getting fat aswell. ive got a standing order at asda for ibro's.Quote:
Originally Posted by NotOnUrHelly
Tell you what old un its a bugger to shift.
I'm managing mine quite well at the minute, I'm running three times a week and icing and stretching. Its ki-boshed my training and plans quite significantly and im certainly not confident enough to be crashing down hillsides at breakneck speeds(ahem).
What do you put yours down too, I'm guessing mine could have be a combination of over doing it and bad shoes. I think I can stem this back to some road shoes that I bought that are different to my normal ones.
I cant use Ibroprofen they make my nose run and sneezing fits. Guess Im alergic to them.
Let me know how you go, Im currently happy at the minute with my low miles it certainly gives me time to do other things. Im going to target the chorley road series on wednesday nights to keep me focused till Im hill confident again.
Cheers
Jamie
I bet that it is something to do with your gait. And I'd hazard a guess at over-pronation the main cause of knee problems in runners. If it is, no matter how much rest/stretching you do it will come back if not corrected.
The good news as easy to sort out. Get a gait analysis - if your not sure go to a running shop and get them to look at your gait for free. The unfortunate bit is that if you do over-pronate then the only way to sort it out in fell shoes is to get Orthotics made - expensive. But then I'm sure you'd pay lots of money to get back running again.
I'm in the process Almadablam, had my gait analsyis checked and I do run funny.
Im going to be sized up for ym orthotics very soon. Im only going to get them to fit road shoes and everyday shoes. I'm not sure they can get them to fit both fell shoes and road shoes.
Its funny though I have run for 5 years without this problem and sometimes at reasonably high miles. I cannot understand why it did not come along back when I was running further.
Cheers for your advice.
Jamie
I wear my orthotics in fell shoes without too much problems, although they don't work very well in walshes.
I ran for almost 3 years without any problem at all; then a bit of knee pain and I struggling to run at all. It's amazing that these chronic type injuries take years and years to develop.
Hope you get it sorted soon
http://runningtimes.com/rt/articles/...9&page=1&c=372
Try this link it may useful - but perhaps more of the same. Came from a friend (a physio) advising a friend who has a problem.
I've been running for some time (9 months probably) with a dull ache below and underneath my right knee cap that comes on after about three miles. As it wasn't getting any easier I went to see my physiotherapist who immediately told me it was caused by ITBS. He's given me a series of stretches to do plus the icing twice a day, and initially we're hoping to beat this while I keep running. Three weeks on from my first appointment with him, the problem isn't getting any better, and as I'm now only running twice a week its stating to get me down. I run with orthotics in my shoes which I was fitted with two years ago following tendonitis in my left achilles.
Has anyone any advice on whether or not this ITBS complaint can be overcome quickly, or am I realistically looking at giving running a rest for a couple of months and seeing if that helps.
It took me half a year of no running before I solves it.
What has worked for me is core stability exercises, stretching, quad and gluteus strenghtening, custom made insole.
Just rest will not help.
Good luck.
Gambatte has got it spot on- the lucky ones may not need so much attention in terms of treatment but the majority will fall into needing most of what gambatte done. Both physio and sports podiatry complement each other very well for ITB treatment.
Exactly the same for me too, save I never got the custom orthotics - wasn't suggested, and at the time I never knew they existed. It was a complete break for 3 months before I started again.Quote:
Originally Posted by Gambatte
Still keep up the stretches for the glutes and the outside of my thigh and will always hold these longer than any other.
Still find I get the odd niggles now, but think that was mainly because I never kept the strengthening work up once the problem went (weight work on my legs bores me). But following my recent introduction to the fells, I've started this up again in an effort to prevent ligament injuries over the rough terrain.
Hope you get it sorted.:)
I had an ITB problem about a year ago and stopped running all together for a good 6 months. I still played hockey, but that never seemed to aggrevate it. Now i've been running for 3 months or so and it seems to be coming back. I haven't had any problems until this week, when it's become painful again. I never really learned any stretches so has anyone any idea where I can get hold of a stretching guide for ITB without going to a physio...can't afford to go see someone about it :( I'm really started to get into my running now and don't want to have to stop again.