ITBS in both legs- Months of PT w/ no running and it's even worse. Desperate for help!

I had bad ITB problems in college, but it was just in one leg, not isolated at the knee/hip, dispersed. Mine came on quite suddenly, I thought I tore something during a run type of thing. That is unusual, though.

I suffered but continued to run through it for a long time. I took unhealthy amounts of ibuprofen and did lots of Jane Fonda-esque hip routines. But I didn't have a breakthrough until I switched from wearing posted trainers to neutral-cushioned shoes. I was/am an overpronator, and I had worn the same model for four or five iterations, but I had minimal problems after switching to the Pegasus.

You might try experimenting with different shoes as well. Best of luck.

What does your PT think? Surely, he would have had some sort of expectations regarding your recovery. Maybe you should talk to him about your perceived lack of progress and potentially different therapies to help move things along.

Also, what about getting an opinion from another doctor? Or, talking to the doctor who originally diagnosed you?

Quit PT. Buy a massage tool and dig deeply into both legs. Also, try ART, if you haven't. The PT is obviously inflaming the ITs. You need to break up the adhesions. Also, make sure you are aligned. Roll on a tennis ball placed under SI joint to achieve alignment.

Are you a complete idiot trying to cripple him?Excessive foam rolling will only aggravate the condition and don't even get started on "ART" which is complete BS.

runnerwhoprofesses wrote:

Quit PT. Buy a massage tool and dig deeply into both legs. Also, try ART, if you haven't. The PT is obviously inflaming the ITs. You need to break up the adhesions. Also, make sure you are aligned. Roll on a tennis ball placed under SI joint to achieve alignment.

Forget the pt and doctor. First of all, stop heel striking. Get some normal shoes, without a huge heel on them. Run a little bit, a few times a week. This might be hard for you but it's just a few days.

For bonus points maybe you could think about looking at or touching a barbell. For icing-on-the-cake points maybe put that barbell on your back. For musical-chairs-birthday-party points maybe squat down with that barbell past the point where the crease of your hip joint is parallel with your patella. For pin-the-tail-on-the-donkey surprise present points stand back up and repeat four more times.

You're weak. That's why you aren't getting better. Fix it.

I had ITBS in both legs for 18 months. I went to a doctor, was prescribed orthotics, did PT, and none of it helped. I gave up on running and started lifting weights. After about seven months of consistent lifting, I couldn't resist trying to run again, and, to my surprise, I was able to run two miles without pain. That was 1998. The ITBS never came back, and I attribute it to squats and other basic leg strengthening exercises. Stretching and other high repetition, low weight "therapy" didn't do a thing for me over a long period of time.

I don't know how long you would have to stick with the strength work. I was so fed up with trying to get healed that I gave up on running and didn't even bother trying to test my progress for seven months. It's very possible it would take less time. Don't give up! Good luck.

Bromelain is an enzyme extracted from pineapple stems and is the key ingredient in meat tenderizer. Take 500mg - 1000mg with a big glass of water BETWEEN MEALS 2x a day. It breaks up scar tissue. Works great. Also, Connect-All can be bought. It also has tendon/ligament healing ingredients. http://www.evitamins.com/connect-all-natures-plus-1109

Time for a different perspective. Where do you live?

ITBS is complicated but simple to treat with the correct combination of care.

I live in Wisconsin! So I would typically run on the occasional hill but my routes were pretty flat when this all happened. What combination do you suggest?

Akanthos wrote:

Time for a different perspective. Where do you live?

ITBS is complicated but simple to treat with the correct combination of care.

I live in Maryland and have had ITBS for a year. Do you have suggestions of good PT/ortho people near me?

Where and when do you get the pain?

Has your PT done an Ober's test? Sidelying, hip extended, knee flexed and then hip adducted.

Can you do a single leg squat without pain? Does you knee maintain alignment with your foot and hip with the squat?

Can you hold a plank prone and sidelying for a minute?

It is usually a combination of three issues: Flexibility of quad and hip; Strength of hip and core; Neuromuscular control. Flexibility and strength are easy. Teaching muscles to contract and you to move the correct way is the challenge. Gluts need to engage at the correct time.

Sorry so long, trying to put pieces of puzzle together. Have more questions, but will quit here.

Are you close to St Marys county?

Now that all the idiots have spoken a professional will chime in. For one, nor all cases of ITBS are caused by weak glutes. Your lack of progress and when you have pain shows this is not the case. Stop doing those exercises for now. Second, stop foam rolling. It is inflammatory on the IT band and you are provoking the hell out of it. 2x a day is murder for that. Third, see a sports medicine doctor to consult about an injection into the bursae. It might be involved. Lastly, find someone to do Graston (www.grastontechnique.com). Yes, it can irritate the tissue similar to foam rolling but it is much better controlled and done a max of 2x per week. In all my years of practice I have had only 1 case of ITBS not heal with Grafton and ART and that healed with a bursa injection after treatment. And one more thing...have someone evaluate you for overpronation. Excess internal tibial rotation can provoke IT pain.

When you have chronic IT pain, you likely have thickening of the tissue from adhesions. Graston can break down these adhesions and can increase gliding and reduce friction. You will never be able to foam roll your lateral knee properly nor are you trained to just get a tool and do it yourself.

There is no bursa. Great article.

J. Anat. (2006) 208, pp309–316

The functional anatomy of the iliotibial band during

flexion and extension of the knee: implications for

understanding iliotibial band syndrome

Graston technique is a tool that can be effective. There are several tools that may be of benefit.

I'm in Montgomery county, 49 years old and have been running for years.

"It is usually a combination of three issues: Flexibility of quad and hip; Strength of hip and core; Neuromuscular control. Flexibility and strength are easy. Teaching muscles to contract and you to move the correct way is the challenge. Gluts need to engage at the correct time."

This is very true.

In the beginning, I had ITBS for years that I controlled with just flexibility. Last year I got bursitis and had to take time off and the ITBS got worse when I tried to come back. I did lots of strengthening, it didn't help. Strengthening just seemed to tighten the band more. I tried foam rolling and specific flexibility and go nowhere. I tried strides on grass to loosen things up and create timing. I did not improve but was able to hang on.

Over the winter I took 4 months off to reset things. It has kind of worked and I can do most exercise now without pain if I don't try for many reps. I am balancing strengthening, general flexibility, grass strides and running. Maybe it is just supposed to take this long at 49 but I am looking for a good PT to poke around and point out current weaknesses and cures.

Thanks for the tips-- I think I'm going to consult another PT and look for places that do graston and ART near me (assuming it's more effective to have them done together?). Have you ever seen any cases where someone had both IT bands causing pain (in other words is this common?) That's interesting about the foam rolling because it seems like everywhere I turn people (runners, coach, doctor) tell me to do it

At 49 chances are it is more of a flexibility issue rather than strength, especially the hips. Lunge matrix, runner's lunge, Brettzel may be of benefit. We stiffen up as we get older. It is difficult to stay flexible if all we do is run.

I am in St Mary's County.

Don't totally abandon the foam roll. It should not cause pain. Roll your quads and gluts.

Yes, I have seen it in both legs. I am guessing your core is weak and you have some mechanical issues with your pelvis and hips. More of a neuromuscular issue.

The right PT can help you.

The itband is connected to the tensor fascia latta. That is the muscle that is tight and pulling on the itband. Go to a massage therapist and have them work on that.

I had this years ago and had a marathon scheduled. I went to a therapist a couple days before and it really helped but the pain came back at 10 miles. Thought I was going to have to drop at halfway. At the turnaround, I started to run in the grass and the pain mostly went away. Of course it came back afterwards but the point is that it may help to run on softer surfaces.

I took 8 weeks off for a stress fracture and the Itband pain went away and never came back. Since it was an overuse injury, I didnt do any goofy strengthening or stretching exercises.