ITBS

I was planning for a long time to share with you my experience with Iliotibial Band Syndrome. I’ve noticed that a lot of people are experiencing this problem and I think it is useful for a anybody experiencing this syndrome to get as many information as possible and to try to resolve it.

First of all – ITBS its not o problem of the knee. Although you will feel the pain in the knee area its not the knee hurting. That was pretty strange when I first begin investigating what I have. If you go to a specialist it will find pretty fast that you are suffering form ITBS. There are a lot of test that can be done to pinpoint this problem. You can search on Youtube and you will see the techniques. If you are living in Romania than it would be much helpful to search the web and try to find out yourself if you are suffering from ITBS. I’ve been to 3 medics until I was finally received the ITBS diagnostic . Althoght the doctor told me that I’m suffering from ITBS he said there is no treatment for it. I totally disagree with that …

What is ITBS?

First, this is your Iliotibial Band:

ITBS is:

• Excessive friction between your Iliotibial Band and your knee (or hip) bone.
• This causes a sharp pain at either the side of your knee or the side of your hip.
• Usually caused by increasing your running or biking too fast and/or with bad form.
• But is also associated with weight-lifting (standing squats), court sports (raquetball, tennis, handball, etc) and even pregnancy.
• Most commonly occurs in one or both knees , but can also appear at the hip joint. This is not uncommon at pregnancy, where the tendons loosen a bit and the weight distribution shifts [1]

Knowing what ITBS means now the next natural questions are:

How can I treat this problem?

How can I prevent it from reappearing?

I will try to respond to this questions based on my personal experience with this syndrome.

How can I treat this problem?

I’ve first experienced this problem in the summer of 2009. The first doctor that I’ve seen it told me that I have the Medial Collateral Ligament inflamed so he prescribed some anti-inflammatory (both pills and cream) . Although this helps it will not solve the problem and I’ve learned the hard way. After 1 month of recovery and pills and creams I’ve went to an easy mountain hike and when descending the same ITBS struck like I’ve never event took the anti-inflammatory. So that raised my first question mark in my head and I’ve begin searching the web and learning more and more about the knee and the problems that can appear at this joint. There are so many numerous sources that can be found… but it seems that the Romanian doctors don’t read anything because when I’ve went to second orthopedist he told me that I don’t have ITBS (what is that? ) … he said that I have lax joints and ligaments . I said… OK he has a diploma he must know more things than I do.   What happened? Well he prescribed some physiotherapy for 2 weeks. That was back in 2010. After that I’ve stayed an additional 2 weeks and after doing my test hike ITBS didn’t struck anymore. I was enthusiastic..

But in late 2010 ITBS struck again.  I’ve went to the same doctor… told him that although I have a small degree of  laxity in my arm joints that is not necessary a sign that my legs are the same. He prescribed again some physiotherapy, but this time he forgot to add ultrasound therapy. (I wonder why?). I’ve did some laser procedures and some strengthening exercises (like hiking, trekking and biking its not enough) and I thought I’m good as new… WRONG. After my test hike ITBS struck again. Went back to the doctor, asked him WHY no ultrasound this time? He said that this problem is beyond his understanding and he sent me to another orthopedist. This guy consulted me for 10 minutes and he said I have ITBS…. but although he was very good in the diagnostic part he said that there is no treatment for that. WTF? I was not prepared to give up mountains at the age of 28.

So, after almost 2 years of suffering I drew a line and reviewed what I’ve learned

1.  ITBS will not be solved with just anti-inflamatorty,
2.  ultrasound physiotherapy combined with anti-inflammatory gels (special for ultrasound devices) reeely helps in healing the inflamed area but will not solve ITBS.

Reading more about ITBS [1], [2] I’ve learned about the Patt-Strapp and after trying to get in touch with them I’ve tried to do some strap of my own. In parallel I’ve started to do stretching exercises which are targeting the ITBS. For a bunch of helpful exercises just search ITBS exercises on Youtube. I was quite a rigid person on my knee side… I couldn’t stay on my knees and touch the heels with my butt. My left leg was especially stiff and rigid. So I’ve started a weekly program of stretching and bought my own ultrasound device from China (was only 30 $).

Armed with this knowledge and with my ultrasound device I’ve had a successful 2011 … I was able to reach Mont Blanc du Tacul and a bunch of other nice places and I was really happy. However last autumn I’ve competed at Piatra Craiului Marathon and ITBS struck me down big time. Although I’ve finished the race I had reoccurring ITBS for 2 months until I was able to do a decent trek/hike without problems. Ultrasound + anti-inflammatory gels really helped to recover quickly.

In the mean time I’ve also bought a Patt Strap and started again to train (trail-running) since November last year. I had some successful runs with the Patt Strap until this January when I’ve put the Patt Strapp lower (closer to the knee). After a 10 km run my patella begin to hurt.  I was going crazy… no more ITBS and now patella. There is also a patella syndrome called runners knee (Google it for more info) and I was going nuts, but I’ve realized that because the position of the Patt Strap was not correct the patella rubbed against my femur and that caused the inflammation.

Since the marathon I’ve started to have a regular training program and added in my stretching routine some strengthening exercises which are targeting the muscles tied to the iliotibial band. I’ve read that the latest studies in sports medicine are showing that 70% or 80% of ITBS happens due to muscle imbalance. (I will update this article slowly and add all the reference materials).

Now I believe that ITBS is looking good on my side. I’ve been to some demanding treks with long descends and I was OK. I hope I will be after the April’s half marathon…

How can I prevent it from reappearing?

I strongly believe that ITBS is a life style problem. In my case I stay most of the day in front of a computer with my leg muscles relaxed. And after doing this for 5 days I’m trying to do a hard hike in the week-end and I get in trouble … my ligaments are getting stiffer, the muscles not being able to cope with the increase load and ITBS  appears.

So, how to prevent it? First give enough time to your body to fix the inflammation. Ultrasound therapy helped me a lot to speed up the healing process.

After that do some stretching exercises. This will help you even if you don’t have ITBS, trust me. Combined with the stretching exercises also add in you program strengthening exercises for the muscles winch are linked to your iliotibial band … to be updated.

This article is a stub to be continued …

References

[1] http://www.itbs.info/

[2] http://en.wikipedia.org/wiki/Iliotibial_band_syndrome

[3] http://www.orthogate.org/patient-education/knee/iliotibial-band-syndrome.html

[4] http://www.thestretchinghandbook.com/archives/knee-pain.php

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