# IT Band injury



## onebratt08 (Jul 29, 2006)

I have an older IT Band injury from running that becomes irritated from most activity, esp. running. The left IT Band is worse than the right, but both get tight and pull my patella's to the outer side of the knee area, causing some tendinitis in the knees issues. Sometimes they tighten and get really sore while riding. My question is, has anyone had IT Band problems and how have you coped beyond the RICE method and stretching? I'd like to be able to run more than 2 miles without experiencing intense pain and I'd like to be able to bike without have sore knees later that day.


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## chuky (Apr 3, 2005)

Real sports massage from a pysical therapist-trained massaged therapist helps a lot. In My experience, effective massage therapy for a specific problem usually takes 2-3 sessions (as long as your problem hasn't progressed beyond LMP help)... Most Sports Physical Therapists will have in-house LMPs, or at least a list of recommended LMPs, and Columbus is a big enough city that you should have some good places to consider.

The IT band is quite difficult to self-treat - it is just too hard to get a good angle on it, unlike a calf problem. I have found that good massage can help correct old, chronic problems.

Cheers,
C


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## ferday (Jan 15, 2004)

active release therapy (offered by some chiropractors) has an excellent track record with releasing a "stuck" IT band. ask around with your physio.


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## *rt* (Jan 15, 2004)

onebratt08 said:


> I have an older IT Band injury from running that becomes irritated from most activity, esp. running. The left IT Band is worse than the right, but both get tight and pull my patella's to the outer side of the knee area, causing some tendinitis in the knees issues. Sometimes they tighten and get really sore while riding. My question is, has anyone had IT Band problems and how have you coped beyond the RICE method and stretching? I'd like to be able to run more than 2 miles without experiencing intense pain and I'd like to be able to bike without have sore knees later that day.


i feel your pain and wish i had some good advice to offer. i had IT band issues from years of gymnastics that was misdiagnosed as a torn lateral meniscus. a few months in a knee brace followed by arthroscopic surgery (in the nacent days of that technique) all to have the ortho tell me my meniscus looked great.  some PT followed and i haven't really had a problem since.

chuky's suggestion about sports massage by a PT or someone trained in ART (active release therapy) is a good one.

also, have you tried adjusting your position on the bike? maybe some pedals with a smaller Q factor (i know that crankbros makes some egg beaters with a shorter spindle) might take some of the pressure off?

rt


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## formica (Jul 4, 2004)

I had IT band issues that were misdiagnosed as patella-femoral syndrome for years. And you guessed it - stretching therapy is what really, really worked. It was a backpacking trip that I couldn't walk without pain for two months after that got me to the right MD. After 7 years of pain I finally went to see a gait specialists who gave me a stretching program. 
It is essentially this:
http://www.physsportsmed.com/issues/2000/02_00/fredericson.htm

You won't find a way out of this without stretching religiously, unless you want your IT band surgically realeased. I was totally committed to the stretching regime for two years. Now I only do it occasionally, usually only after the start of ski season.

formica


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## Madre (Mar 26, 2006)

I've had horrible IT issues for a few years.

A great physical therapist and a professional bike fit have set me on a course to 90% recovery.

I have to really stay on top of the exercises I've been taught and proper stretching..and things stay pain-free usually. Ice helps too after long efforts.


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## connie (Mar 16, 2004)

I'll third sports massage. I have a massage therapist who works at my physical therapist's office and she incorporates hot stone massage into a sports massage. Not the light relaxing type, but really digging in there and loosening things up with the hot stones and massage. 

I ended up with IT band problems after my latest knee surgery. For some reason things were just off balance and the more I exercised the worse it got. To the point where I couldn't sleep at all one night from the pain and thought my knee was seriously messed up again. Luckily, after a couple hours on the internet, I self diagnosed IT band, and did a few stretches and instantly the pain was 90% gone. From there I went to PT and she confirmed it and a combination of stretching, backing off a bit, and the hot stone sports massages helped me. 

For stretching, the most useful things were:

1. basically a quad stretch - stand on one leg, bend the other and grab your ankle in the opposite hand and pull it sideways towards your butt.

2. a yoga position that's basically like doing the splits with one leg straight behind but the other bent in front of you with your knee at probably a 120 degree angle - then lean forward.

3. one of those foam roller things. You're basically doing a side plank and rolling up and down on it. Excruciating, but effective.


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## sandracruz (Jul 3, 2006)

I had IT Band problems when I ran cross country in college. I tried sports massage, active realse therapy, yoga, ice, stretching, taking a lot of time off, and finally I went to a podiatrist and got custom orthotics. The orthotics cleared it up within two weeks, and I was able to finish the season without any pain. If you overpronate (feet roll too far to the inside when walking or running) you are more likely to get IT Band problems..but it could be something else biomechanical. I suggest you find someone to take a look at your feet, the type of shoe you are wearing, and if maybe orthotics could benefit you. Good luck!


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## Chewieez (Oct 10, 2004)

I just recently got over a case of IT band friction syndrom. 

What solved it for me was:

massages from a PT
stretches at home and using a foam roll 
stretches pre and post ride with an ice pack and ibprofen after each ride

The number 1) thing that finally made it stay away was getting inserts that changed the way my foot fit in my shoe. I am using the Specialized Body Geometry high performance inserts now in my SIDIs. I use two 1.5mm wedges in my right foot and one 1.5mm insert in my left foot. Now I am actually ride without doing many stretches and still have no pain during or afterwards. It still feels better when I go through my stretching routine but I don't always have time. 

So basically getting a varus wedge is what cured it long term for me. The stretches and PT massage helped in the short term. The PT watched me walk barefooted and diagnosed my poor foot alignment. 

Luckily the Specialized inserts worked well for me and saved me the cost of custom orthodics.

hope this helps!

there is a lot of information online about IT band friction syndrom.


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## snowangel (Jun 6, 2006)

The foam roller and having a great massage therapist were the cures for my IT band problem (of two years!). The diagnosed (by my physical therapist) cause of my IT band prob was custom made orthotics (not cheap!) that I was using in my bike and running shoes (oops!). So, now i use the foam roller two times a day and it keeps me from having any tightness or pain!


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## onebratt08 (Jul 29, 2006)

Thanks for all the info. I had forgotten the foam roller. I need to buy one - the PT I saw for tendonitis suggested using that since my IT Bands get tight. Orthodics were suggested, but I am trying inserts in my shoes from the running store - they help. Also bought 2 knee sleeves that I will wear to run or rollerblade. Orthodics were just going to be too expensive. The insurance company told me that they didn't know if they'd cover then until the bill was submitted. Nice.


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## formica (Jul 4, 2004)

I forgot to mention in my earlier post that part of my treatment was a "prescription" atheletic shoe. The MD was 50/50 about orthotics, he was very honest that they might now work for me, and to try the shoe-stretching thing first.

Formica


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## robdamanii (Sep 27, 2005)

First off, I'll recommend HIGHLY the ART route. You could also find someone trained in Graston Technique as well.

A sports massage will help ou substantially while out of the saddle.

On the saddle, stretching that IT band every so often will help prevent issues.

One more very important thing to consider is that if your patella is translating laterally (you said it was pulling to the outside during exercise), then you probably have a quadricep imbalance. The 3 large muscles of the quad are opposed by the small Vastus Med (the bulge on the inside of your thigh next to your patella). Strengthening that VM will help to keep your patella in line and reduce your pain symptoms.

A good athletic trainer, physical therapist, or sports specialist chiro should be able to help you a lot.


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## CHUNKY NUGGET (Jan 23, 2005)

I too suffer from the Dreaded ITB problem. My problem arrose from having flat feet and doing a **** load of stairs at work, a good 8000 stairs in a 12 hour shift. I was fine for the first couple of years but eventually started getting sore and swollen knees. I was too scared id lose my job to let on i had a probem with my knees so i pushed on until the day i literally had to lift myself up the stairs. I went on workers comp' and battled for a year to get covered by my works insurance company and had to try and Fix myself, eventually they accepted liability and i could get the treatment i needed. Now i have a strict exercise program which strengthens my VM muscles to help pull my knees straight and i also wear custom insouls. I must say its touch and go some days and the IT band is still pulling and sometimes so tight it feels like a iron bar. The worst thing i can do is not exercise, when i initially hurt my knees i spent my days off resting my swollen knees - inturn my legs got very weak and things went downhill alot quicker. The best fealing i get is when i do serious leg weights; leg press, deep squats, straight leg dead lift, leg extentions and leg curls. All if done correctly target my VM muscles and other muscles that somehow keep my knees tracking close to true. The more pain i feal in my leg muscles the better my knees feal. It took me years to get to this point but its so much better the fealings bad knees give me, mentally and physically.


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## bikerbert (Aug 28, 2004)

One of the things that causes a tight IT band is weak glutes. When I went through PT for a knee surgery last summer, this is one of the things that was drilled into my head. If the glutes are weak the IT band will tighten up to protect the knee taking the knee cap to the outside causing patella pain.

Try stretching your outer hamstrings, hip flexors and strengthening you glutes. Check out this link, it will help you with your IT band issues:
http://www.nasm.org/ContinuingEducation/Articles/GluteusMaximusPT2.aspx

I'd be more than happy to answer any questions that you have.


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## bikerbert (Aug 28, 2004)

Also, STAY AWAY FROM SEATED MACHINE WORK (leg press/extension/curl, etc). These will make your muscles tighter from only working them in one plane of motion, and literally disconnect your brain from the muscles that help to stabilize your hips which in turn make the knees happy. 

Acupuncture is also a great way to help with IT band issues. Most personal trainers who actually understand how the body works will answer any of your questions and help you with some exercises without charging you. PT clinics are also good places for information too.


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## CHUNKY NUGGET (Jan 23, 2005)

bikerbert said:


> Also, STAY AWAY FROM SEATED MACHINE WORK (leg press/extension/curl, etc). These will make your muscles tighter from only working them in one plane of motion, and literally disconnect your brain from the muscles that help to stabilize your hips which in turn make the knees happy.
> 
> Acupuncture is also a great way to help with IT band issues. Most personal trainers who actually understand how the body works will answer any of your questions and help you with some exercises without charging you. PT clinics are also good places for information too.


I appreciate what you are saying there Bikerbert but i actually do alot of the exercises you mention. I do leg press with a wide stance and toes pointing outwards which uses my inner thigh muscles and seems to help my knee allignment. Also leg extensions with a lite weight and trying to focus on the VM muscle and i also do leg curl and many other leg exercises, all targeting my inner leg muscle other than Hamstrings exercises. Another favorite is wide stance deep squats, i squat 60-80kg and do it slow and with good form, i can press 120kg but my form aint flash and it can strain my ITB. I must say i found the more weight you press in any exercises the more likely you are to use or strain your ITB so start slow and work your way up with FORM most important.
Im no doctor this works for me and has helped change my life.


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## bikerbert (Aug 28, 2004)

Any single motion with a cable pulley where you are bringing your leg toward the mid line of your body will also help out the VM quite a bit. Try squeezing a ball as you squat, this willl definitely help your adductors.


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## pwrtrainer (Oct 23, 2005)

bikerbert said:


> Any single motion with a cable pulley where you are bringing your leg toward the mid line of your body will also help out the VM quite a bit. Try squeezing a ball as you squat, this willl definitely help your adductors.


i dig those variations. new mode of butt kicking will likely ensue. nice signature also.


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