Injuries
So what IS an iliotibial band?
(Besides a hard word to say?)
It’s a band that extends from the hip to the shin. In the hip region, it attaches to 3 muscles: gluteus maximus, gluteus minimus, and vastus lateralis. (Aka your butt & hip.) Then it stretches down the thigh, around the outside of the kneecap, and attaches to the top of the tibia. The bump on the bone it attaches to at the shin is called Gerdy’s Tubercle.
What do you mean by “band”?
It starts as a muscle (called the tensor fascia latae), then turns into a thick band of fibrous tissue as it goes down the leg.
What does it do?
It’s helps the hip muscles with abduction- moving the thigh outward. It also helps stabilize the knee.
What’s IT band syndrome/IT band friction syndrome?
ITBS/ITBFS (same thing) occurs when the band becomes inflamed- usually from the band rubbing across the knubby joint on the outside of the knee, called the lateral femoral condyle or lateral femoral epicondyle.
Symptoms?
Pain or a burning sensation along the outside (lateral) part of the knee, sometimes with clicking- which is the IT band snapping over the joint. Symptoms can range anywhere from “tight” to debilitating.
Who gets it?
Anybody. ITBS is typically caused by a weakness in the surround muscles- especially the hip abductors. Runners are known for weak hips, which might be why it’s seen in runners so often.
Triathletes may be prone to ITBS because of the time spent sitting on the bike before running, which keeps the hip in a flexed position (shortens the sarcomere and increases tightness blah di blah).
Other factors than can irritate the IT band:
– Running on the same side of the road all the time (roads are slightly tilted, which makes one leg reach farther than the other)
– Different leg lengths
– Poor biomechanics (pronation)
– Overuse/increasing training too quickly
Treatment?
Rest (ice!), stretching, strengthening.
Massage can be a useful means of tissue mobilization, 2-3x/week up to daily- foam rollers for us broke kids! Strengthening of the surrounding muscles- gluteus maximus, quads, etc- is also important for prevention of re-injury.
Those of you that have been through this before, anything to add?
Also for those of you that have successfully treated this- did you start wearing orthotics? Did they help?
Injuries
NO KNEE SURGERY!!!!
Can you hear me shouting in excitement?!
Yes, I took a picture of my MRI when the nurse pulled it up.
Actually, I took a ton of pictures, but didn’t look at them until I got home.
I was wondering why they all said “R” when my left knee is hurt….
umm, yeah….not my MRI…
(This one is….the others weren’t.)
Apparently I have a lot of damage in my knee, but there is no tear! (There might have been, but it’s healing.) The main problem I have is: iliotibial band friction syndrome.
{Please note: somewhere here I said “I’m pretty sure it’s my IT band.” Gosh I’m smart. ;)}
ITBFS (aka ITBS)
The IT band is a band of connective tissue that runs down the outside of the leg, from the hip to down under the kneecap. ITBFS is an overuse injury caused by the IT band rubbing across the lateral femoral epicondyle, a part of the knee area that juts out, causing friction, inflammation, and a general mess.
For my previous visits, I’ve been seeing the PA, but today they called in the big guy: the MD.
Although he left without giving me a chance to ask questions, I really liked him.
He barged through the door and said, “So I hear you think you’re knee is getting better. Of course it’s getting better, you’re not doing anything. But it’s not going to stay better.”
Blunt, but honest.
Resting and icing have helped the inflammation calm down, which is why it feels so much better, but it does nothing to address what caused the injury in the first place.
The treatment? Physical therapy, cortisone, and orthotics.
(Surgery is an option, but the doctor pointed out it really doesn’t help, and I’m not interested when there are other options.)
How do I feel about the treatment?
Physical therapy: Ecstatic. I love things that are fixable. I love preventing things even more. I think of PT as preventing it from happening again.
Cortisone cream: Probably would’ve been a lot awesomer 5 weeks ago, when it hurt insanely bad. Now, I can take it or leave it.
Orthotics: I’m iffy on this one. I’ve had my feet & gait assessed 1,000 times and have never been told I absolutely needed orthotics. I don’t even need to run in super supportive shoes. Plus, while I know the whole barefoot running thing is just a hot topic now, it does make me wonder if orthotics are really the answer. Oh well, guess I have to try.
This is all good news & I was hoping PT would be the answer, so why am I not jumping for joy? (Besides the fact that I literally can’t jump right now…)
Probably because I can’t start physical therapy for 2 more weeks. And then my big tri of the year is only 4 weeks away. My friends are starting marathon training today. My follow up appointment is after 2 of my next planned races. Oh. Yeah. That’s why.
Right after I left the office I called back to see if I could get the appointment moved up, but they were firm: not happening. Then I asked if I was still condemned to 100% rest. The first answer? I can do straight leg lifts & ankle tops. (I don’t know what ankle tops are. Neither did the receptionist. I suppose Google can help out…) My response (almost in tears)? No swimming? No biking? (I didn’t dare ask running. Not happening.) After being on hold forever she told me swimming & biking were ok. She must have told the doctor she had a lunatic on the phone & he better say I could do something.
YAY!!
And no Mom, I’m not going to go out and bike 20 miles tomorrow.
Only 19.
Just kidding.
