Iliotibial Band Syndrome...

[mnof1000v]

Anyone out there hike the AT with IBS? My local doctor thinks I may have this condition, and I'm hoping to ease any discomfort with some sort of knee brace...

I'm looking for suggestions.... Particularly if you've hiked the AT with this condition...:datz

[walkin' wally]

My wife and I have had a fair amount of experience with IT band trouble. She is a nurse with an orthopedic surgical background. She had trouble with her IT band during a hike over a fairly flat section in Western Maine. ( Four Ponds area) I did not know if we were going to make it back to the highway in either direction for a while there. It was quite painful at the beginning.

She talked with one of the surgeons, who is also a hiker, when we got back home and he gave her some stretches to do that really helped a lot. He said the IT band sort of acts like a brake on the downhills and can be sore at times. She has since done some strenous sections such as Baldpate and the Hall Mt-Moody Mt area with me and had no problems at all. I try to stretch the front and back of my thighs and also the back of my calfs before starting out in the morning. I think that really helps too.

After we are in "trail shape" for the season a lot of these pain problems don't occur.

Hope this helps. :sun

[Almost There]

Cho Pat makes a strap you wear above the knee, their knee brace also helps to alleviate this problem. Had problems with it back in March and April. Just finished a 55 mile sobo from Dickey Gap to Damascus yesterday, wore the strap half the time, and absolutely no problems. Stretching helps, but you also have to let it heal. My sports ortho said that it's due to micro tears where the band attaches to the knee, no permanent damage but your limit is determined by your pain threshold. I carry the strap just in case it starts to get sore. Did about 12 miles in 4.5 hours on the last day without the strap...NO Problems!!!

[Marta]

My son was a HS and collegiate cross-country and distance runner, until he quit because of IT troubles. It took about six months of daily stretching exercises before he was able to start running again. Stretching does work, but it's not an overnight fix.

[soulrebel]

I'm hating this for you. About a year ago, I was at the start of my ITBS. Of course, I've ignored it and continued to push it through my race season, to the point that now I'm sitting here while my wife is running a half-mary w/o me this morning. For me, it started when I dropped my weight training and continued with my high run mileage...

First, you'll need to rehab it RICE (Rest, ICE!!!, compression/massage, elevation). The ice part will be the best thing. you can freeze a styro cup w/ water in it then peel it back then rub it up and down the side of your leg. then massage afterwards--mega relief. Also pull out an old ball or cylindrical object and lay on your side while rolling the side of your quad and hamstring up and down the roller on the floor.

Second, you'll need to stretch and strengthen. Lay on your back and have your partner push one leg towards your head--w/o bending the knee. Good hammy stretch---then have partner continue to cross that leg over the other-bringing the foot down the floor while you stay on your back--thereby stretching the hip flexors---VERY IMPT...
To strengthen-Start doing regular squats/legpresses for overall strength then superset with a lighter, higher rep movement such as dumbell front and more importantly LATERAL lunges. If you don't have weights I highly recommend an ankle bungee so you can do skater jumps, squat down duck walks, and all types of lateral then squat movements that will strengthen the whole leg system, but in particular, the outer and lower muscles.

Ice, massage, stretch, strengthen, you can use nsaid's, muscle relaxers, cho-pat, but then you're just putting something on hold that can and will come back to bite you in the arse...

After trying weights/plyometrics and no weights/plyometrics with my run/tri training. It's my solemn belief that weight training really does prevent injury and at the same time improves overall performance.

Now, I must go get another cryopak icesheet to sit on b/c it starts lock up when i'm sitting too much....like now

p.s.-favorite stretch (yoga) put one hand on floor about 2 feet in front of you. Then stand on one leg while trying to raise the other hand and foot towards the ceiling. Kind of like standing on all fours then lifting one half of your body... alternate... GL

[walkin' wally]

I would like to say also that the stretching I was talking about is not the stretching the doctor told my wife to do. That stretching involves torqueing the the knee sideways while standing or laying in bed. Putting one leg in front of the other and bending sideways somewhat. It has to be done carefully and should be done with a physician's instruction. This limbers the tissues behind the knee cap. It takes a while to have the effect of the stretching work. The knee has to be conditioned over a period on time. It did not take her a long time to work through this problem though.

Also the doctor told her to take Ibruprofen the night before the hike and the morning before starting out. These are day hikes that I am talking about not hike over a long peroid of days.

I work my legs as hard as I can at the gym with weights while she uses the treadmill. I think the weight training helps me a lot.

[C-Stepper]

A foam roller also helps. It allows you to give yourself something similar to a deep tissue massage over the tight portion of the ITB in your thigh...hurts like HELL the first few times you do it, but you can build up. I've heard of folks substituting a Nalgene bottle for the roller. Alternatively, you could get a professional to do it, if you have time and $$$.

Sometimes it can be your shoes, or adding insoles (like Superfeet) or getting a custom orthotic can help.

Oh yeah...trekking poles REALLY help hikers (but not us runners!).

A strap helps some people...a Patt strap ( http://tinyurl.com/dz89l ) helps lots of folks, but for me they are not durable enough. Mine always fall apart in about a month, too expensive for what I'm getting out of them. I bought this strap, very similar but more durable, at my local Dick's Sporting Goods, but I strap it above my knee to hold the tendon in place to keep it from snapping back across my knee ( http://tinyurl.com/8lscx ).

It can be a frustrating injury!:( I hope this helps, at least some! Stick with it...you can get it to improve, though it may still flare up occasionally.

Here are some stretching, strengthening, and how to foam roll links that help me (note I'm a runner, too, which is where some of the links come from).

http://www.runningtimes.com/issues/04may/itb.htm
http://www.sportsmed.buffalo.edu/info/iliotibial3.html
http://www.physsportsmed.com/issues/2000/02_00/fredericson.htm

[mnof1000v]

I've been looking online for information for weeks, and while I've certainly found some helpful insights, I've not recieved this much useful information until I posted my thread...

Thanks! :)

[gumby]

Found some links that might help.

http://www.itbs.info/
http://www.rice.edu/~jenky/sports/itband.v2.html
http://orthopedics.about.com/cs/sportsmedicine/a/itbs.htm

All of these have some good info. Good luck, I know what you are going through. I have only 10% of the meniscus in both knees, no PCL in my right knee, and severe osteoarthritis in both, my ortho surgeon is trying to put off bi-lat knee joint replacement until I'm at least 50. I turned 49 in October this year. Then we have to get the VA to agree to it because I have a disability rating from them for the 21 years in the Air Force. I've got a feeling the red tape will be longer than the AT.

But the cho-pat straps really help.

l8tr gumby:rolleyes:

[DLFrost]

After trying weights/plyometrics and no weights/plyometrics with my run/tri training. It's my solemn belief that weight training really does prevent injury and at the same time improves overall performance.
Damned straight. Extra muscle acts like springs, protecting your joints by absorbing "peak" impact shock which will otherwise tear connective tissue with repetitive exposure. And any damaged muscle repairs itself in days rather than months.

Doug Frost

[walkin' wally]

Damned straight. Extra muscle acts like springs, protecting your joints by absorbing "peak" impact shock which will otherwise tear connective tissue with repetitive exposure. And any damaged muscle repairs itself in days rather than months.

Doug Frost

I agree. At my age I will take any conditioning help I can get. I have used the leg machines at my gym and they have strengthened my legs considerably. I use the horizontal leg press, the 45 degree leg press with heavy weight, and the knee extension machine for my quads as well as machines for my hamstrings and calves. It works for me. I have few issues with muscle soreness after a long hike day after day. I do stretch in the morning before starting out though.

[oliander]

I got ITB syndrome 1.5 years ago, from running. I was 2 months out from a section-hiking trip, and worried I wouldn't be able to do the hike at all, as it hurt to walk downhill. Went to an exercise physiologist who is a backpacker herself and had a lot of experience with ITB syndrome. I followed her instructions religiously and they WORKED!

1. Bought and used a trekking pole, particularly downhill.

2. Prior to my trip, I worked back up to longer walks, and downhill stretches, VERY GRADUALLY. (No running.)

3. Roller, stretches, and strength-building exercises EVERY DAY prior to my hike. There is a very specific way to use the roller, so you might ask someone to help you. Illustrated stretches and strength-building exercises for ITB syndrome are easy to find by just doing a Google search. Muscles that require strengthening, to prevent further ITB syndrome, include hip abductors, hip adductors, hamstrings, abs - the very muscles that do not build up sufficiently through walking/running alone. Stretches: anything that stretches the hip flexors (twists on the floor, yoga hip-opener poses) is particularly good.

4. When you are choosing stretches or strength-building exercises, be careful to choose ones that don't aggravate your problem. Lunges are great strengtheners if you are at a point when your ITB doesn't hurt. If your ITB hurts a little, though, lunges can make it worse. I did too many lunges 2 weeks ago and they triggered ITB pain (after I had been ITB-pain-free for 8 months).

5. If you are in ITB pain now, generally avoid jumping, lunging, skipping, tennis, etc. - anything that requires you to jump off one or both legs with a lot of force. However, those exercises are great to return to once you feel you are COMPLETELY ITB-syndrome free.

6. Insist on doing shorter miles and perhaps a section with fewer and/or less steep hills.

7. In general, don't push it. If you build back up gradually, in teensy weensy steps, you will gradually get stronger and your ITB syndrome may go away in 1-3 months. It only takes one particularly stressful workout to reinjure yourself and then you will be back to square one.

8. I continued to do my ITB stretches on my hikes, both in the morning and in the evening. I also brought my foam roller with me (cut it in half beforehand). It weighs nothing and is a fun conversation piece. It made a BIG difference and IMO, allowed me to complete my hike. I still bring it on my of my long-distance hikes, as preventative medicine. The roller makes your ITB less tight and prevents or lessens inflamation.

Good luck!

[Vi+]

Almost There,

You advised, 11-24-05 (Post #3), “Cho Pat makes a strap you wear above the knee ...”

You may be using a quite different knee brace than the one I have.

I have seen people use the same brace at the gym, applied above the knee, but wondered about its usage.

The instruction which came with my brace and the instructions I’ve read on Cho Pat sites have all directed the brace to be applied “below” the knee.

[burger]

I'm just getting over a bout of ITBS (from running, not hiking). I found the exercise described here (http://www.sportsinjurybulletin.com/archive/runners-knee.html) to be extremely helpful. It's a long article, but there's a lot of good info. The specific stretch is described down towards the bottom.

[Almost There]

Vi, It is a tan strap, works well, but found when cold it tends to slip. I purchased their dual action knee brace which works above and below. This holds in place much better. You don't need alot of pressure on the band to ease pain around the knee...and so far this has done the trick. I have gone back to hiking without the brace, but carry it with me just in case.

[Vi+]

Almost There,

You further advised, today, Post #15, that you “... purchased their dual action knee brace which works above and below. This holds in place much better.”

The strap you described as the “tan strap” is probably the one I have. It has a round section to pass in front of the knee and a flat section, with velcro for attachment, which passes behind the knee. The X-Ray of my knee shows cartilage has rolled up exposing bone-on-bone contact. It doesn’t bother me much at all until it bothers me (if that makes sense), and at that point the “bother” causes tears to squirt involuntarily from my eyes with each step.

I carry the strap with me, as do you, but haven’t needed to use it. The pain is enough when it arises, however, that I would like to find the one you prefer. Is there a full name I could look for?

Thanks.

[Almost There]

No your strap that you have is specifically for below the knee. The one I have is merely a tension type strap...there is no tubing in it.

The other one I just purchased is called the Chopat Duel Action Knee Strap. This one is black and does have tubing both above and below. Retails for under $20. I bought it at Mountain Crossings at Neel's Gap, but you can get them on line...just Google it.

[mjbboy1]

I have a question about a knee injury I sustained...
I know you're all thinking that I should go see a doctor before posting on a forum about my injury, but...I did. And it's gotten me nowhere so far. Here's what happened:

Last summer, I went on a trip through the Del Water Gap. Before this hike, I had always used trekking poles, but for some reason, the idiot inside me said to just leave them at home. On the third day, a pain built up in the side of my knee until it felt like I had been stabbed with a knife.
I never reached High Point...instead I had my pick-up person come and get me earlier (don't remember which road...unimportant). I went home and did the RICE thing, all the while wondering what would become of my knee.

Two weeks later, the pain disappeared.

Later that summer, I went on a long trip to Maine, and while there I decided to hike Khatadin. Bad move...the pain came back shortly before reaching the summit, and of course, the way down was not much fun at all.

For the past year, I have not engaged in any running or hiking (aside from daily life in NYC), and it's driving me CRAZY. I still feel it faintly sometimes...some days I don't feel it at all. I'm really afraid to do anything, though, because I don't want it to flare up. I am out of shape and antsy.

I tried the "Pat-Strap" (I don't know if it's still being produced), but it bunched up behind the knee (uncomfortable), and was not effective in preventing the pain anyway. I went to the doctor, got an MRI, and I was diagnosed with a minor strain in my ACL. I don't get it though...the ACL is nowhere near the part of my knee/leg that hurt. I want a second opinion, but unfortunately insurance is a big hassle.

From what I've read, I think I have ITBS, but I'm curious if all of you confirmed ITBS sufferers had similar symptoms, especially the sharp pain at the tibial head. I've read that injuries in the ACL cause instability, and I have had no issues at all with that.

Is the Cho-pat band more comfortable/effective than the flimsy "pat-strap"? What about the Cho-pat dual action? I just want to go hiking again, please help!

P.S.: I did manage to get a perscription for physical therapy, although it's for treatment of the ACL. I'm hoping that a good PT will help me get better whether the initial diagnosis is correct or not (I'm not ruling it out, just skeptical). Does anyone here know of a good PT in Jersey??? That would help me out a lot.

Thanks,
Mitch

[Dharma]

Anyone out there hike the AT with IBS? My local doctor thinks I may have this condition, and I'm hoping to ease any discomfort with some sort of knee brace...

I'm looking for suggestions.... Particularly if you've hiked the AT with this condition...:datz

I had on an off discomfort from my IT band. I met a southbounder named Sky who was a massage therapst. He showed me some stretches to target that area. Those probably worked the best. (Wish I could remember them now.) Don't forget the vitamin I. :D

[orangebug]

Well, you've been to the doctor, and at least no one has suggested surgery. Excellent move.

Call/interview a few PTs and find one who works with sports injuries primarily, rather than little ol' peeps. You don't mention which side of your knee hurts, lateral or medial, or what areas of the tibial head are sore (large table of real estate there). I'd suspect that there was overuse, reactive underuse and you've gotten out of shape and more prone to injury. NYC walking barely counts as there are so few good downhills, unless you are smart enough to take the stairs at every opportunity.

[dreamhiker]

Can some one explain this condition for me I'm not sure but I may have an issues like ITB. It started this weekend on the second day of my hike during the down hill sections my knee started to hurt and then about an hour later I couldn't bind it without alot of pain there didn't seem to be any one twist or fall or slip just started hurting outside lower part of the left knee. It has gotten better in the last two days but still hurts to go down stairs.
DreamHiker

[gravityman]

I got ITBS training for a marathon. It was pretty clear that that was the problem. If you lay on your side with the bad knee "up" and you bend it perpendicular to the floor it will hurt like hell. Also, going down the stairs is very very painful, but up isn't that bad. If that it has those symptoms, that it's most likely ITBS. If not, then maybe it's something else...

Gravity

[ilanes]

regarding bicycling and ITB:

facts:
1 - i started riding a bicycle basically everywhere around town over a year ago
2 - some time after changing to this biking-heavy lifestyle, i developed down-hill hiking associated iliotibial band syndrome (as confirmed by physiotherapist, negative MRI, and orthopedics), but there was never felt it while biking, and even found biking was the best way to get around whenever the ITB did come back
3 - when attempted a jog, could not go for more than 10 minutes without pain
4 - got some alleviation from liberal *foam roller* usage (even carried a knifed off edge of it hiking once)
5 - stopped bicycling 2.5 months ago, havent felt pain since, and test jog was succesful without any pain

my conclusion: my ITB was brought on either by bicycling (although i was quite conscious of seat height, which i kept at good level), or possibly the LACK of walking. because i used bike to get door to door at work, and to meet people socially, i was under the impression that the lack of action my legs/knees were playing contributed to my ITB. just wanted to throw that out there, in case anyone else came across this weird bicycle/ITB connection that i think was my issue...

[The Old Fhart]

You said you had IBS (see link) (https://health.google.com/health/ref/Irritable+bowel+syndrome) but that is different than ITBS. I met someone who had IBS and had to leave the trail. A knee brace won't help IBS. :eek:

[JJJ]

I started developing some knee pain last year, but caught it early and like C-Stepper said the roller/massage fixed me up amazingly quickly.
But as I understand it, if the tendon at the knees gets damaged -not just inflamed -it can take a while to get back on track .