ITBS - advice please - Health + Injury

charleypenguin

19/05/2012 at 19:54

Hi,

Any advice on this please? I'm quite sure I have ITBS, the sharp pain in the outside of the knee when it is bent seems conclusive from reading other posts but can anyone answer the following please?

I've got stretches from other posts in this forum, including the roller on the hip/thigh, should I do them now or wait until all pain is gone?

If the pain is dull or fainter, and not so sharp, can I start running again? Will I do more harm?

I rested for a week (no sretches either) and thought it was gone so did a short run and a lot of stretches afterwards and the next day could hardly bend my knee due to the pain! What caused it? The run or the stretches?

Any advice greatfully received. Thank you

Charley

tricialitt

20/05/2012 at 18:07

Try a cho pat strap, and walk/ running so that you don't try to push through the pain.- Think it just makes it worse if you do that.

Running down hill seems worse.

Tom Goom

20/05/2012 at 18:18

Hi Charleypenguin,

Congratulations on getting to run with the Olympic flame!
You can use your roller now but I'd start above the area of pain in the front and outside of the thigh and anywhere that feels tight. If you roller the actual tender area it can be very sore and make things worse.

You can run but as Tricialitt says don't run through pain. The trick is to try and vary your running to make it pain free if possible. You can do this by varying your speed and distance, regularly changing running surface, adding in walk breaks and avoiding hills. I have found reducing my stride length really helpful. With ITBS you won't cause "damage" as such even if it is painful. It's not like a ligament tear or something that involves tissue damage, it's more of inflammation. That said if you keep irritating it, it will take some time to settle.

When you aggravated it, it could have been the combination of running and stretches that made it so sore. It's about finding the right level. Run too far or stretch too much and it can make it worse. Stretching inflamed tissues can be painful so start gently, usually around 3 reps, holding for 30 seconds.

Tom Goom

20/05/2012 at 18:20

There are lots of things you can do to help this and by dealing with it now before it becomes a chronic problem you have a good chance of getting past it.

I've written a detailed blog post on it with stretches, taping and treatment advice available here;

http://runningphysio.wordpress.com/shin-pain-part-one-2/

Hope that helps

Tom

Tom Goom

20/05/2012 at 18:21

Oops sorry...wrong link!
The ITB info is here;
http://runningphysio.wordpress.com/itb/

Also-ran

20/05/2012 at 21:00

I would guess its the run, rather than the stretching that inflamed it - continual friction. I ice the sore point after getting in. Later I stretch and roller my legs and that really eases the pain. A dab of ibuprofen gel helps too

None of this is addressing the issue but you should easily be able to run the distance., and before you know it you will get the problem diagnosed along with a Re-hab program.

I occassionally use a Mueller itb strap. Thankfully the problem is becoming less an less of an issue due to the strengthening programme I was given. 23 miles yesterday and not a peep out of the knee

charleypenguin

20/05/2012 at 21:34

Hi,

Thanks for the advice, especially the link Tom, which is great. It's got all the info I need and is quite reassuring since I can see what wil help and what will make it worse. I'm still getting a bit of pain from walking even now which is worrying so I might bite the bullet and see a sports physio just to make sure it is ITBS. It is a pain mainly on the lower outside of the knee,which only hurts when my knee is at a broad angle (almost straight but not quite). Quite hard to pinpoint where exactly but defnitely not on the front. Hopefully it is ITBS (if you know what I mean!).

I have a theory that it was caused by blisters on the sides of my feet so I was running with the opposite pronation to normal (I normally roll in slightly) to avoid the pain of the blisters. I was a bit foolish because the ITBS pain came on halfway through a marathon and I still finished it even though it was very painful. Actually more than a bit foolish...

Thanks again,

Charley

ps I've ordered a pattstrap as well thanks for that tip too

Tom Goom

20/05/2012 at 22:00

Good luck with it.
The strategies I've mentioned above about modifying your running are a way of reducing pain and continuing to run but are only a short term measure.
Once you've identified the cause and any areas of weakness you can address this then gradually return to normal running.

Millsy1977

24/05/2012 at 16:39

Rest, do the stretches as detailed above. Well done on running with the Torch but you will only be carrying it for about 300m with it so even if the injury is not 100% healed you should be able to do it no problem.

charleypenguin

28/05/2012 at 20:23

Hi,

Went to a physio who confirmed it as ITBS. I've been resting and crosstraining to keep me fit and sane but I stopped as soon as I felt even the slightest twinge. Plenty of stretches, ice and heat. Another apt tomorrow, hopefully will be told I can run again! Had to run for the bus yesterday and no pain! Then gait analysis so I can make sure I'm injury free in future. Have to make sure I build up slowly though...

Charley

Tom Goom

28/05/2012 at 20:35

Great plan, good luck with it!

Lost Prophet

28/05/2012 at 21:37

Hey, check out my post on RunnerWorlds.Com forum - I was going to repost on here but I can't get on at the moment

I was diagnosed with ITBS about 2 months while at the peak of training for a marathon. I ran that marathon yesterday and documented my painful experiences including having to run 4/5 of the marathon with a mild form of it!

fpd

29/05/2012 at 16:46

Hi all - I have a related query, if anyone can help...

Approx. 6 weeks ago I ran a 10k race got apb), first of the year and had a strange feeling in kneefrom the 2 mile mark and stayed with me until the end of race, no pain but just not the norm. Next day the leg felt a bit tight but nothing too concerning, 3 days later I ran a 5K (with another pb) but stupid me got a very sore knee after 2 miles and ran on with it although slowing down a bit.

Since then I have seen a physio who suspected ITBS and gave stretches and exercises, these I have followed but with no joy. I have did a number of runs on the flat with either a week or fortnight gap inbetween but always at the 2 mile mark the knee flares up and I need to stop, ther eis no swelling or major pain afterwards, just sore when pressing on outside of knee but this is away after a day or 2. My runs are always on the flat and taken at a slow speed.Can't seem to shift it at all, getting a bit concerned now.

There is no pain at any other time.

One further point to note - I am an office based person and before any of this happened, I had a few instances of a strange feeling in my knee/thigh once I got up from sitting at desk for a period, slight knee/thigh discomfort and awkward walking, but this would leave after a 20/30 minutes - purely random but feel this maybe was a precursor to the injury described above.

Please any thoughts appreciated....

Edited: 29/05/2012 at 16:57

Tom Goom

29/05/2012 at 18:07

Hi fpd,
What stretches and exercises are you doing?
Have you tried taping the knee when you run?

fpd

31/05/2012 at 10:49

Hi Tom Goom, when standing - bringing leg to stretch behind and past other leg and then lean to the same side to stretch the sore leg, also went sitting on floor with legs out in front, bring sore leg over on top of other leg and bend in so foot is on floor but up at hip and knee under chin. Foam roller is used regularly also.

Although stretch mentioned earlier looks good and will try.

Any thoughts on how to tape and what you think of my woes??

Tom Goom

31/05/2012 at 18:20

Hi Fpd,
Sounds like you're doing the standard ITB stretch and a Glute stretch. That's fine, you could also stretch your hip flexors and do a kneeling ITB stretch. There is some info on this and taping (including a video) on the link I posted earlier on this thread for Charleypenguin.
The other thing is you've not mentioned any strength or control work. Gluteus Medius is often weak with ITB issues and strengthening it helps reduce ITB tightness. There's an article full of glutes exercises you could try here,
http://runningphysio.wordpress.com/gluteus-medius-evidence-based-rehab/

With ITB issues you need to address the cause otherwise it can keep coming back, that can be weakness, muscle tightness, poor movement control, poor biomechanics or just simply overtraining. Hopefully the links above will help you work out what your cause is and how to address it.

steven maskell

31/05/2012 at 21:51

I got ITBS marathone training - all runing no core exersises, little stretching.. and havent been able to run for more than a mile for months

Takes discipline to get back to recover - no going to do nothing but non-weight bearing core exercises and strecthes twice a day for the next three weeks - may go out of my mind!!

Lost Prophet

31/05/2012 at 21:52

I'm unsure if you are doing this already, but a massive part in my recovery (and recommended on various site) is to see a Sports Injury Specialist

The deep tissue massage was initially extremely painful but towards the end of the block of sessions I wasn't feeling much pain at all. Also, I found that he bent my leg into places that I didn't realise it would go. Definitely sped up my recovery

Lost Prophet

31/05/2012 at 21:55

Steve, other things you could do to maintain fitness is spinning (it didn't cause any problem with my ITBS although some people I've read it does) and also swimming.

When buying some running shoes I was also told "If you can't go out and run the 20 miler, go and walk it as it doesn't matter what time you do it in, as long as your muscles get the mileage". While, it is better for training to run, walking 20 miles as opposed to sitting down doing nothing is much much better

Canute

31/05/2012 at 22:00

Sympathy... do what tom says. He's the man.