See my more recent thoughts, on ITBS, at this link!

Hi folks,

Sites of ITBS and PFPS pain. The correct diagnosis of such conditions is critical. From: SaveYourself.Ca

A friend of mine, Dionne, is continuing to suffer real problems with symptoms of ileo-tibial band syndrome (ITBS). I know that endurance sports come with these kinds of problems and that we have to learn to work through them somehow. Having undergone two knee surgeries, and a bunch of physiotherapy, for generally self-induced training injuries I feel for my friend as ITBS really sucks. My eldest son, Nick, complained of similar knee problems, which prevented him from running, after he became seriously involved with kite boarding, that comes with it’s own biomechanical challenges I am sure. Nick has almost fixed this problem using rollers. Early in my triathlon training as a beginner I also suffered from mild ITBS, but it was soon corrected by a good sports masseuse, and what I called ‘her elbow from hellbow.’ A while ago I wrote a blog post about my one serious encounter with ITBS, and how it went away, melting like butter on a hot summer’s day. I was going easy in the marathon at the Lake Placid Ironman because I had psyched myself out at the tail-end of the bike leg. I was running too slowly or cautiously, and not as I had trained to run. As soon as I realized this around the 14-mile mark, I picked up my normal pace and that ITBS was gone within a mile. This tells me that modification of one’s running mechanics may be one road to a cure.

There is plenty of advice out there for this condition, and here is some that I like the sound of from Dr. Pribut:

“Self treatment for Iliotibial Band Syndrome:

• Temporary decrease or stopping training
• Side Stretching
• Strengthen your hip abductors (gluteal muscles especially the gluteus medius ). This is critical.
• Gentle foam rolling (not too hard a roller and not too painful)
• Avoid crowned surfaces or too much running around a track
• Shorten your stride
• Wear motion control shoes to limit pronation or if you have been wearing motion control shoes, try less controlling shoes.
• Carefully examine your training regimen (if you’ve been keeping a running diary – check it for possible training errors).

See: Dr. Pribut’s Tips for ITBS 

Side Stretch

The side stretching is performed while standing as follows: Place the injured leg behind the good one. If the left side is the sore side, cross your left leg behind your right one. Then lean away from the injured side towards your right side. There should be a table or chair that you can hold onto for balance on that side. This stretch is the best of several that exist for this area. Be careful not to overstretch. Hold for 7 to 10 seconds and repeat on each side 7 to 10 times. The side stretch stretches the lateral hip capsule, the tensor fascia lata, iliotibial band, and the latissimus dorsi. You’ll feel it on your side above your waist in addition to your hip.“

Most importantly, Dr. Prubit provides a differential diagnostic list, or a list of other problems that might be mistaken for ITBS. It is clearly essential to get the right diagnosis if you want to apply the correct therapy.

“Differential Diagnosis of Lateral Knee Pain and ITBS

• Lateral meniscal tear
• Lateral collateral ligament sprain
• Biceps femoris tendinopathy
• Patellofemoral pain syndrome
• Lateral patellar compression syndrome
• Popliteal tendinopathy
• Stress reaction or stress fracture
• Proximal tibial-fibular joint sprain
• Referred pain from lumbar spine
• Referred pain from peroneal nerve injury“

Dionne has a sprinters background not endurance running. So I wonder if she is using a running technique that is triggering her painful ITBS. My race experience would support this as a potential area of investigation.

All advice and input for Dionne would be very much appreciated.

-k @FitOldDog

Today’s workouts:

Workout PLAN Coach: Chris Hauth

Run

mi Duration: 01:05:00

Description: aerobic run

Swim

Distance: 3100.0 yd Duration: 01:00:00

Description: 3100 Warm-up (500) 500 Choice Set #1 (800) – on :20 rest Two times through: 200 pull b.p. 3, 5 by 50 200 kick Set #2 (500) 10 x 50 on the fastest send-off interval you can maintain with only about :05 rest Set #3 (500) 5 x 100 (25 R, 25 L, 25 choice drill, 25 build) on :20 rest Set #4 (500) 10 x 50 trying to do the same send-off interval as the first 10×50 Set #5 (300) 300 easy – swim or pull – with perfect technique (long smooth strokes).