IlioTibial Band (ITB) Syndrome. Anyone been through it?

Bobbinogs

Hi Folks,

Bit of a medical recovery query this but wasn't sure where to post it and couldn't find anything on search.

Has anyone been through ITBS and can offer me a realistic recovery target? I was diagnosed with ITBS by a very good sports physio after I probably overdid hill training. The symptom is a very sore leg, just above the outside of the left knee.

Thing is, under instruction from the physio I have had 3 weeks off cycling (probably no bad thing with the weather), had a few treatment sessions with various electrical things, have been stretching the band twice a day, using a foam roller, etc...Yet just been out for a light 10M spin on the flat and my leg/knee was hurting like it did 3 blinking weeks ago.

So, am I being impatient? Is the pain part of the healing process which should be ignored providing I keep my recovery spins light? My physio says it could all take time...but I want to know what time means! I certainly cannot afford to keep spending money on endless phsyio sessions and not doing active sport is driving me (and my wife) bonkers.

Many thanks.

16mm

Get a physio who will do massage and 2 person stretches with you.

I had a few weeks with a "hands off" physio, before I changed to a physio who worked for an ice hockey team...

It will bet better.

BDFun

When I did a lot of running, I suffered from the same problem at one point.

Unfortunately it does take time, it took at least a month of rest to go away with some stretching and exercises. I think the recovery time would be a lot shorter if you see a physio a few times who will tear into your muscles to really loosen it up. Recently whenever I have had problems with tight muscles I just see the physio a couple of times and I'm a lot better!

Rouge Penguin

I think ive got it, its not stopping me riding or playing football though.

Is it worth buying a Foam Roller, or will a bit of self massage (fnar fnar) help? Anything else you can do at home, like roll on a tennis ball?

Bobbinogs

Thanks Chaps. I am using a roller (which really does hurt so it must be doing some good!).

I have taken the advice about a more engaged treatment and have booked in for a visit to the osteopath and will try to avoid the bike for another week or so ( ). I will update afterwards...

d87heaven

Have you checked or altered your saddle position? This can help relive ITB as the ITB is used to stabilise the knee as it extends..
Although rollering the ITB is a good thing you may find it advantageous to massage the TFL as well. This is the muscle that attaches to the fascia which is your 'ITB' . Its best done solo by getting a hard rubber ball and laying on it whilst rolling on it or just getting working your thumb in it. Or a sports massage therapist should be able to give it a good seeing to and you can copy what they do.
Follow up with lots of ITB stretching and also do the glutes.
Then strengthen using exercises that stretch the glutes etc. Unweighted squats are good. Also strengthen the glute med. CLamshell exercises are a good start.
Core strength will help also.
If the pain comes on at say 7 miles then only cycle 6, Ice the ITB area around the knee to get inflamation down.

Brian B

I had this problem when I took up winter running and upped the miles too quickly. Only took a few days to go away but even after all the stretches that I had been recommended I could not do any more serious running after the initial event without it coming back again.

Luckily enough it only grumbled on the bike but it took me years to completely be free from this. It only troubled me on the bike in Spring when I was upping my miles. Last 3 years though pain free - no winter running though.

Bobbinogs

Thanks Brian and Ray. I am hoping there is light at the end of the tunnel after the osteopath diagnosed a knee ligament/tendon issue rather than the ITB itself, although the treatment for the last few weeks would have been exactly the same as what I have been doing (resting/stretching/electro-stuff, etc.).

I got loads of deep massages and re-assurance that this was really good advice:

If the pain comes on at say 7 miles then only cycle 6, Ice the ITB area around the knee to get inflamation down".

As in, get on the bike on the turbo, exercise, take it easy and stop before the pain point, so a week of that for me. -5 and more snow at the w/e so it will also stop me being tempted to try the skidpan outside.

d87heaven

That advice only reallies to ITB problems .Ligament/ tendon advice can differ depending on exactyl what is wrong as a damaged ligament would be treated differently to tendonosis/tendonitis.

Rouge Penguin

Dumb question, without a visit to the Docs, how do you know its an ACL or ITBS injury?

Will an ACL stop you running/cycling? Is the pain that much more pronounced, or can they be confused?

Bobbinogs

Rouge Penguin wrote:

Dumb question, without a visit to the Docs, how do you know its an ACL or ITBS injury?

Will an ACL stop you running/cycling? Is the pain that much more pronounced, or can they be confused?

Fair point. To be honest, I am always very underwhelmed by GP visits and only bother when I have to. I had some knee issues last year and went to the GP. She said, it looks like you have a knee problem and referred me to a consultant. I have also had the same thing happen when I had patella tendon issues a few years ago in that the GP only really confirmed there was an issue and passed me to someone else rather than actually diagnose anything.

Anyway, my injury is the bit where the ITB meets the top left of the knee so I think (on reflection) that both bits were probably inflammed originally (hence the slightly varying diagnosis). The Osteopath does specialise in sport injuries, as does the Sport Physio. Both are saying exercise is good now that I have rested/recovered sufficently but that I should not go beyond the pain point.

ridelikeapro

Hey Bob

I've had exactly this sort of pain (which also came on after lots of hill training)... and I've had it for 3 years!!!

I've spent a fortune on various treatments etc. I get the pain when increasing the tempo on a hill - a burning pain. Haven't even pinpointed what the cause is yet! It could be the ITB, Illiac artery, or even a trapped nerve in the back.
Firstly you need to pinpoint what the cause is. A good starting point is to ask your physio what tests you should get. Options are to see your GP and get a few scans and Xrays - even perhaps an MRI.

Generally core stability work is going to help, the clam etc.

Like yourself I also took some time off the bike - and merely lost some fitness, the pain came back.

Good luck, I hope you can get it sorted quicker than me.

d87heaven

To recap - what you have is (by your description) ITBS, The osteopath saying its the ligament is just saying its ITBS. The illiotibial band inserts on the outer shin. The pain is caused when the lower part of the ITB flicks over the knobbly bit of the femur, commonly when the knee is at 20~30 degrees. The top of the ITB attaches to the illiac crest (hip bone) AND the Tensor Fascia Latea. There is some thought that the thick fiberous tissue of the ITB can't be lengthend to any degree by stretching although it may be made more supple. The TFL on the other hand can get tight, sitting helps this by putting the tfl in a relaxed state allowing it to shorten.
You might find that a different riding position helps enormously. But mainly ride up to the point of pain, massage the TFL and glute area, stretch and strengthen.

steveadi

First you need to find the cause,I had this 2 years ago after i had a biomechanical check for running shoes,i had always run in a neutral shoe,after the check i was told i needed a stability shoe,i ran in the stability shoes for a few runs until my itbs went,i went back to a neutral shoe,but in the following 6 months i had no pain when walking, run for a mile pain again couple of weeks off same again month off and again it came back. as you have read above its inflammation,What i did was i popped into lidl bought around 3 packs of ibuprofen took the maximum does i could take (think it was 4 a day for 10 days).may have been more a day cant rememeber what the instructions quoted,i left the running until around a week later and i have been trouble free,i do feel a slight burning sensation sometimes but nothing to worry about.since i have taken up cycling i have had a sore hip i have put this down to itbs but it is not as bad as the knee was.I tried knee straps foam roller but only the above worked for me.You do the above at your own risk

antikythera

Sorry to hear of you situation, unfortunately I cant give any good news.

I suffered from ITBS a few years back, I'd trained like mad for a Alpine ride. Being a bigger build, I trained for endurance and strength but big hills weren't close at hand so it was mainly hill intervals, up and down the same hill multiple times. When it came to the ride itself the ITBS symptoms hit without warning. Happened in the last 6km of (a day before) training ride, I couldn't even turn the pedals on a flat! Fortunately I was with a bunch of doctors with lots of meds

The actual recovery was difficult and lasted for about 9months. It involved physio therapy, massage, orthotics and definitely no hard riding.

Turns out that a combination of tight calves, a tendency to pronate and a rapid change in muscle mass (in my leg relative to the tension of the ITB). Contributed to an acute case of ITBS. Even now I still make special allowances for it, with ITB specific stretches, massage and always wear an orthotic. I only hope you get through this, my only advice is to take whatever therapy works and keep at it, coz ITBS can take you off the bike for a long time

Rouge Penguin

Well, after thinking it might go away and it didnt, still riding and playing football without to much discomfort and then reading this, i thought id give a foam roller a go.

Arrived yesterday, gave it a go last night and in combination with the basic stretches over the last few days, today it feels a lot better. Would suggest buying one and giving it a go, good for all the legs muscles.

Bobbinogs

Folks,

Sorry to bump this but I thought I would close it off. My leg is now fine and I am back up to decent mileage. Did a flat 75 a couple of weeks ago and a lumpy 65 yesterday without the leg playing up. It moans a bit in training every now and then but I find that regular use of the roller helps a lot, as does the occassional visit to an Osteopath for a decent massage and stretch. So, injured last week in October and back to fitness in Feb (with lots of rides/turbo use in between, building up etc.).

So, anyone in the same position, hang in there. Some things take a while to heal up but heal up they do. Thanks for all the useful advice and support posted.

RickyG

Thanks for the update Bobbinogs.

I've just had ITBS diagnosed by my physio friend so will be investing in a foam roller and doing the regular stretching.

Did you ever get a bike fit session to fine tune your motion on the bike? I'm booked in for one of these on Thursday but i think the main cause is probably just building up the mileage too quickly and being too 'toed-in' during the long ride when the pain first appeared.

Thanks,
Rich

Bobbinogs

Hello RickyG,

I had a bikefit over a year ago which I found to be very useful but my ITBS was probably brought on by lots of hills, so climbing either in or out of the saddle putting a lot of pressure on the knee joints and muscles, etc.

My physio diagnosed that I get quite ragged (as in uncontrolled) when standing on the pedals so recommended regularly standing one legged on a small step and dropping my other foot to the floor whilst concentrating on making it smooth and controlled. Bear in mind that this is a strengthening exercise and not one for straight after having the problem because it could exacerbate the very area injured. Might be worth mentioning to your physio to check but I suspect he/she is well on top of that anyway.

Best of luck with your recovery.