Any Clydes Suffering from ITBS?
 

I have Iliotibial Band Syndrome. If you have it, you'll instantly know what I'm talking about, if you don't it's probably something you've never heard about (or remembered). Anyway, it's been a battle, I know there are a lot of threads in the road forum but I can't help but thinking a lot of my problems (this and other health ones) stem from being a tall Clyde, growing so tall so fast. I'm not overweight though, so that's probably not as much of an issue.

Have any of you found some of the multitude of suggestions that work? I've tried a lot, and seem to have mitigated it in my right hip where it originally showed up. But now it's in my left knee. Note that it's actually fine when cycling, it's hiking and running that brings it on. But I think cycling contributes to the tightness or the problem.

So far this is my list of stuff to do:

• Stretch
• Exercises (Walt Reynolds's ITB Special, Inner Quad strengthening, etc.)
• Foam Roller
• See a podiatrist to see if I need orthotics, have leg length discrepancy, etc.
• RICE
• Ibuprofen
• Cho-Pat Strap
• Break down and go to a physical therapist to coordinate all of this. I don't really feel like taking that much time off work for PT visits but if I must...

Apart from physical therapy, two things that have helped me are wedges in my shoes so that foot is effectively flat and then I have a 2cm spacer on the left crankarm, so that the foot is further out and toe in is less - both recommendations from a professional bike fitter and then supported by my consultant orthopaedic physician.
Huw

What kind(s) of doctor(s) have you seen thus far? If you haven't seen one already, I would suggest a doctor that specializes in joint replacements. (The vast majority of total joint surgeons perform mostly total hip replacements, and total knee replacements. As you know, the IT-band extends from your hip to your knee, and therefor the total joint surgeons have incredible experience with this muscle/tendon. They literally see it every time they operate. ) I think the big thing would be to decrease inflammation no matter what. Every time you exercise, you can count on inflammation. You want to reduce that as much as possible with ice, and ibuprofen. Im willing to bet without an intense couple months in PT it will be a balancing act of how much pain you can indure vs. how much you exercise. Its also really important to have a substantial warm up, and an adequate cool down period EVERY TIME you exercise.

on a bike putting the feet further out would probably help, however you say its the running that is making it worse so obviously first solution is stop running. you need to do major strengthening of your inner thighs which means using the thighmaster machine at the gym that men never use because it's not manly enough. Foam roller hurts like hell but definately helps. PT can help because they can use electric stim on the afflicted area.

Thanks. I don't really run anymore, but I like to hike. I have a couple of 14er hikes planned in about three weeks. It was on a 14er hike yesterday that I had problems. Given that time frame about all I can plan on doing is rest, ice, ibuprofen, and hope the Cho-Pat strap works. But for the long haul I'm considering those other options mentioned above.

Now I'm trying to figure out what doctors to see. I have a PPO so I can go to whatever doctor I want to. I'm wondering if I should see my primary care general doctor first or attempt to see another one. I'm really confused because so far I've had recommended a physical therapist, a joint replacement doctor (what is that, orthopedic?), and a podiatrist. Where to start? For that reason alone I'm considering going to primary care first then moving on from there, any suggestions?

It depends on your insurance. some policies require you to go to your primary care doc first for a referral to a specialist. General procedure would then be go to an orthopaedic first who then would write the prescription for physical therapy. It can be a bit of a pain in the ass.

I guess that's what I was trying to say. I know for a fact that my insurance lets me go see whatever specialist I want without a referral. I just don't know which specialist to see of all the ones mentioned. I think I'll start off with a physical therapist and ask him if it's worth going to a podiatrist.

While we're on the subject, anybody ever have a strong itch the IT band area? My right leg has been doing that lately; slightly tender, no real pain, but it will vary from feeling like a mosquito bite somewhere along the side of the thigh that just can't be scratched (because it seems to originate well under the skin) to feeling like a rash the full length of the IT band. With moderate pressure, it just feels like any other sore part after exercise, but the itch can be really annoying.

I thought I'd give an update. I said this in the other thread on running and cycling but it fits here better. Providing this info for others who might have this problem:

My physical therapist is one of the guys that works on the Avalanche pro hockey team. He says in his practice he sees ITBS ALL the time and felt confident we could get me going again with a few visits and my stretching. His personal opinion was stretching is the best thing I can do at home. I asked about strengthening other areas, the ITB strap, and a foam roller. He didn't discard them completeley but found them less useful than stretching. The foam roller he said primarily just causes pain. The strap masks the symptoms but doesn't treat the underlying problem. And he felt stretching would be of more use than strengthening. He gave me an IT band stretch* that I was different from what I'd seen most often recommended online and seems to work better than any of the ones I was trying. He also gave me another IT band stretch and three hamstring stretches. He said cycling can tighten up the IT band.

He did some kind of massage around the area and the knee. I don't know what it's called, one was active point release or something. The other one was more like pushing then holding for a while. It was interesting that some was around the IT band but it was also just above and below the patella. He said a tight IT band can make the patella track where it shouldn't. Anyway, my regular doctor's eyes bulged when he saw/felt my IT band. He said it was very tight. He was wishing that he had an intern around that day so he could use me as a clear example of where the IT band is. He very discretely seemed to hint that it was so tight that genetics might be at play and I may only get so far with physical therapy. Like I said though, that was me really reading between the lines, my PT seems to think we can straighten this out.

* Here is the stretch (mostly) from this site:

Two others are done lying down. In the first you lie on the left side of the bed to stretch your right leg. Keeping your back flat on the bed, you extend your right leg and cross it over your left (keeping it straight) so it hangs over the side of the bed. You will feel the pull on your ITB esp. near the hip. Go to the other side of the bed to stretch your left. [My PT said to get a belt and wrap it around the foot of the leg in the air to the side and pull on it. That's a necessity, I don't see how this stretches the IT band otherwise. Keep hips flat on the bed as much as possible]