Illiotibial band syndrome

[mzvarner]

I just started running again so i am sure my muscles, ligaments, tendons, and bones are not used to it yet. I experience sudden onset pain on the lateral side of my right knee. It tends to occur with in 10-15 minutes if beginning a run. I also experience pain there and above the patella on long downhill descents as well. Here is my question about it

 

1. Would a knee brace help, and if so what kind?

2. Is the pain in two different locations related or different problems?

[W]

For the lateral pain, which sounds like a tight IT band, try using the foam roller. You'll have to do it regularly, it will hurt like hell at first, but persevere- I had crippling pain from IT issues and this fixed it, but I still have to do routine maintenance.

I don't know if a brace would do much, stability isn't usually the issue with IT problems.

The other pain sounds like some sort of tendonitis, patella pain on descent is often common irritation of the underside of the patella from the femur impacting it repeatedly. Try ice massage and Ibuprofen, and also minimize downhill running if possible. In this case one of those neoprene knee sleeves might help also.

[mzvarner]

W and you explain what the foam roller is? as for the knee problem, I dont notice patella pain from running, its from long descents like coming down from Muir or Adams. do you still think it is irritation from bone one bone?

 

Zach

[W]

This video is good:

 

[video:youtube]RoHBDim_fzk

 

You can get one online for cheap. I have a much shorter one than the one in the video but the longer ones are nice for rolling out your back, also.

 

Yes indeed, downhill hiking, running, walking even, especially if carrying a big pack, can irritate the hell out of your kneecaps- imagine the femur jamming repeatedly under your kneecap and irritating the articular cartilage under the patella.

 

Here's a primer on Chondromalacia as it is called:

 

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001488/

 

I haven't had this issue in years but when I have I find that ice massage directly on the patella helps calm it down, along with IBU. If you are doing a lot of training hikes with big packs, one thing that helps that I used to do is carry gallon jugs of water uphill, but then dump them out on top (like on Mt. Si for example) and then descend with almost no weight. But for Muir obviously that doesn't work. In that case, at a minimum I'd do a lot of stretching before during and after, and try to modify your downhill stepping techniques- smaller, lighter, quicker steps, and avoiding big lunging plodding steps.

[mzvarner]

THANKS! That link was very helpful. I definitely think I need to add more stretching to my routines.

 

 

[W]

I definitely think I need to add more stretching to my routines.

 

 

If you're over 30, you bet you do. But even if you're not, don't wait til then or til you're developing chronic injuries to get in the habit. Do it now.

[TobiasT]

Is the IT issue on the same side as you carry your wallet? I had IT issues until I stopped carrying my wallet in my back pocket. I was aggravating the muscles attached to the IT band which tightened it.

[sobo]

I had IT issues until I stopped carrying my wallet in my back pocket.

Sorry, couldn't help it. It's the first thing that came to mind after reading Tobias's post...

 

[video:youtube]http://www.youtube.com/watch?v=a74lj24Wx8Q

[jordansahls]

IT band syndrome can be really tricky. Using a foam roller is a great way to relieve acute pain, but is not neccisarily great at correcting underlying biomechanical disfunction. There is a bit of debate regarding conventional wisdom surrounding ITB friction syndrome. The current thought is that ITBS is caused by the lateral rubbing of the lower IT band against the femoral condyle. More recent research has thrown this into question. Not saying that the above things wont work, and they most certainly will make things feel better, but it is essential to address the core issues or things are going to reoccure and cause more frustration.

 

Here is a great article written by an exercise physiologist on the more current research regarding ITBS:

http://www.be-fit-now.com/iliotibial-band-syndrome-itbs-myths

 

Here are a couple of links to the research articles referenced in the above link (these are also at the bottom of the above article, worth checking out):

 

Is iliotibial band syndrome really a friction syndrome?

http://www.jsams.org/article/S1440-2440(06)00117-4/abstract

 

The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2100245/

 

Suspected Mechanisms in the Cause of Overuse Running Injuries: A Clinical Review

http://sph.sagepub.com/content/1/3/242.abstract

 

 

[marc_leclerc]

Don't know much about IT band syndrome. But another thing to consider for the pain below your patella is 'Patellar Femoral Pain Syndrome'. I thought I had tendonitis, had all the symptoms of tendonitis and was actually diagnosed with tendonitis by a physician, but after two months with no inflammation and persisting pain that began to move from below my patella to all around my knee I was re-diagnosed with Patellar-Femoral ect ect. Started doing physio for it and I've been getting noticeable results in only a week, can't wait to get rid of it for good...

 

If it doesn't hurt riding a bike, or running on flat surfaces, and hurts on the downhill, PFPS is more likely than patellar tendonitis.

[mzvarner]

@ marc leclerc- I think I might have both. I notice knee pain while descending from climbs. But while running I have laterla pain.

 

@ W- THANKS a lot for telling me about that foam roller stretch. I had to improvise a little because I didnt want to buy a foam pad, so i am using a football instead!

[W]

 

@ W- THANKS a lot for telling me about that foam roller stretch. I had to improvise a little because I didnt want to buy a foam pad, so i am using a football instead!

 

That's ok, once while on a trip to Squamish sans roller I had a flare up in my IT band, after hiking down the Chief trail in pain, I used a steel propane gas stove canister to roll it out. It hurt like hell! though and I'm not sure I recommend it, though it did do the trick...

[jordansahls]

I find my Nalgene works in a pinch.

[E-rock]

I had IT band problems years ago from descents on hikes. It usually took about 30 minutes before it started. Stretching, and a transition to cycling rather than hiking as my primary cardio exercise seemed to solve the problem.

[Matt Kidd]

Check this out. This guy really knows his stuff. Search your problem and watch the vids.

 

http://www.mobilitywod.com/