Hiking with IT Band Syndrome

[sharky]

Has anyone ever dealt with IT Band Syndrome? I'm a runner and backpacker who has been dealing with ITBS for a few years off and on. Lately it has been very much on. I've been seeing a physical therapist for three months and admits to pulling out all his tricks to no avail.

I'm planning on doing a four week backpacking trip in a few months. Long day hikes have not bothered me in the past, but I'm still concerned about how I will react over 25 days.

[Praha4]

I had a major problem with ITBS back in fall 2009 on the AT. I had to get off the trail, and undergo a month of physical therapy and rest it up. You have to really work on proper stretching and strengthening exercises. My problem was basically not ever learning the proper stretching. It hit me on the north side of Blood Mtn in GA, on the rocky descent, my knee was completely frozen up by the time I got to the bottom, with a terrible ache and pain on every step.

its difficult to ease off the training and hiking to give it time to rest. It will usually hit you on the downhills, hiking on flat terrain is typically not a problem. I still do stretching along the trail every 1-2 hours to try to head off any tightening of the ITB while hiking onthe AT.
good luck

[Jersey Tim]

As a track coach, I see it every season, even in our superstars; this year we had a sub-4:20 miler get it. It's important to know that "syndrome" is something of a misnomer: it is not a chronic issue, but rather a symptom of something else that may be chronic and creating tension in the leg, thus causing your IT band to act up over a long period. The star miler turned out to be overpronating, which pushed his knee out of line and stretched the IT band funny; orthotics in his shoes fixed him right up.

As for diagnosis and treatment: a lot of people think it's witch-doctor stuff for some reason, but there's a chiropractor in my town (who also has strong regular sports-medicine credentials, even traveled with the national team) to whom we send our dinged-up athletes. While a therapist or an ortho will most often shut you down to try and let the issue resolve itself, a sports medicine doc will try and keep you active through the treatment. I recommend it because I've seen it work over and over again, including for me personally.

Here's my guy's website. It's got some good info if you want to take a look through. He has contacts all over the place, so you could even take a shot e-mailing him and asking if he knows someone near you.

http://www.backfixer1.com/

[Jersey Tim]

Just an additional note: when I say "sports medicine doc", the term I was looking for was CCSP, or Certified Chiropractic Sports Physician, which is the official licensed specialty.

[map man]

I had a lot of trouble with my IT band on my first backpacking trip. The two things that have prevented it since then:

1) Wearing the lightest footware I can

2) Wearing the Cho-Pat Dual Action Knee Strap when I backpack

I do a lot more running now than I did when I first started backpacking and I suspect that has strengthened/stabilized the IT band as well.

[JAK]

I have what might be IT Band on my left side, but more in the form of bursitis in my left hip, and not so much a problem with the left knee. Cannot sleep on that side at all now, which is the side I used to lay on when reading which probably contributed to the problem. Now sleep on back or stomach or other side.

[gumball]

I agree with the Cho-Pat band--has completely eliminated knee issues for me on the trail (and when I run).

[soulrebel]

Usually comes from muscle strength imbalances and/or overuse. Try squats and various lateral step movements (monster walk, duck walk, etc) to help build up strength and stability in your joints. And of course, R.I.C.E. to manage it if it's aggravated...

[sharky]

I must be the polar opposite from what everyone else is saying because I don't pronate at all. I supinate (roll out). It gets painful on flat and down hill sections but feels great going uphill. I have been running for 14 years and it has gotten worse the last month doing PT.

I did realize that it it first took off on me two years ago when I switched from the green to orange superfeet. I know it's a loose end, but could it be that simple? I suspect I will end up having an MRI done because the pain has been all around the knee, but never running up my hip like ITBS usually does.

Anyone seen a chiropractor for something like this?

[Chomp09]

Usually comes from muscle strength imbalances and/or overuse. Try squats and various lateral step movements (monster walk, duck walk, etc) to help build up strength and stability in your joints. And of course, R.I.C.E. to manage it if it's aggravated...

Exactly what Soulrebel said. By focusing on strengthing your core and the stabilizing muscles you should see an improvement. The first doctor I went to told me the same thing, "nothing more I can do for you, it just is what it is." I didn't really like that answer so I did my own research. Turns out the doctor didn't know what he was talking about.

Needless to say I was shocked...

[sharky]

I've been doing planks and walking with bands around my knee and ankle to strengthen my hips. If the only place its acting like ITBS is in the knee (nothing in the hips), could it be something else?

[JAK]

Usually comes from muscle strength imbalances and/or overuse. Try squats and various lateral step movements (monster walk, duck walk, etc) to help build up strength and stability in your joints. And of course, R.I.C.E. to manage it if it's aggravated...

I would second that, both from the experience of what has helped, and where I have likely gone wrong over the years in not maintaining core strength and squat type strength as I have gotten older and gone through cycles of sedentary periods and more active periods. Things get out of whack, and it is increasingly difficult to recover as you age, but it is never too late to do what you can to maintain and compensate and recovery where you can.

[gregpphoto]

I have some issue with my knee. Went to ortho, had x ray and MRI, both negative for structural damage. But I have this tightness/stiffness in my right knee, mostly when I bend it, mostly in the patellar tendon area, and also behind the knee cap. Ortho said Patello-femoral pain syndrome, which is like a catch all. Any idea if it could be ITBS and in any event, I plan on hiking through it, is that a bad idea?

[SawnieRobertson]

I had a major problem with ITBS back in fall 2009 on the AT. I had to get off the trail, and undergo a month of physical therapy and rest it up. You have to really work on proper stretching and strengthening exercises. My problem was basically not ever learning the proper stretching. It hit me on the north side of Blood Mtn in GA, on the rocky descent, my knee was completely frozen up by the time I got to the bottom, with a terrible ache and pain on every step.

its difficult to ease off the training and hiking to give it time to rest. It will usually hit you on the downhills, hiking on flat terrain is typically not a problem. I still do stretching along the trail every 1-2 hours to try to head off any tightening of the ITB while hiking onthe AT.
good luck

Praha, I am assuming that you do not remove your pack and lie down to do the stretches every 1-2 hours on the trail or in the brambles. Please tell me that you have a group of stand up stretches that you can do handily whenever you reach a suitable spot next to the trail. Then please share how they are done or a link to a place that illustrates them. Thanks.--Kinnickinic

[Dances with Mice]

I had total hip replacement surgery in January and experienced ITBS during rehab as my leg muscles started to regain strength. The ITBS caused pain on the outside of my knee that was constant, irrespective of knee position and whether sitting
or standing. It hurt so much I was not sleeping without medication.

Due to the thr I couldn't do the recommended stretches that call for crossing the legs. So the Phys Therapist recommended The Stick.

It looked like a gimmick meant to separate me from my money. But I was also hurting. I bought the 20" yellow handled one.

It's incredible. My IT band related knee pain went away within a week. I used it first thing in the morning, a couple times during the day, after Phys Therap, I even carried The Stick with me to work. I also carried it on my first backpacking trip (Memorial weekend, 11 miles, Hog Pen to Chattahoochee Gap in GA) since the surgery.

It may not work for everyone but you cannot take mine from me.

[sharky]

So I saw a doc and they are going to do surgery to repair the meniscus and take a piece of my IT Band off. I was told I would be out of commission two weeks. I would still like to go through with my plan of hiking the Long Trail in 24 days starting Sept 6th. Is this overly ambitious?

[mudhead]

I did realize that it it first took off on me two years ago when I switched from the green to orange superfeet. I know it's a loose end, but could it be that simple? I suspect I will end up having an MRI done because the pain has been all around the knee, but never running up my hip like ITBS usually does.

Might be that simple. Before I let them carve on me I would be looking for a physical therapist that runs, and a podiatrist.

[Snowleopard]

I have what might be IT Band on my left side, but more in the form of bursitis in my left hip, and not so much a problem with the left knee. ...

I have bursitis in both hips and the treatment is stretching exercises for the Iliotibial band. So it may not be ITBS but the stretches are the same. These are not the easiest stretches to learn to do properly and a physical therapist is very useful.

My knee problems are entirely separate (patellar chondromalacia). Many knee problems need exercises that keep the strength of quadriceps and hamstring muscles in balance

Diagnosis by a good orthopedist/sports doctor is pretty much required to know what to do. It seems that treatment is usually

[sharky]

I have a very good PT who is not only a runner but accustomed to dealing with elite athletes who need an active recovery. He does dry needling on me to release tight spots in the muscles on pretty much every part of my leg except the IT band itself. Seemed to work for a little while.

[Lint]

I used to suffer from IT band problems all the time. By lightening up my pack to an 8 lb baseweight, I alleviated the issue. Now I only have IT band issues when I run downhill too fast or start out doing big miles on a thru without taking time to stretch. http://runningtimes.com/Article.aspx?ArticleID=6099 This link has good stretches. I do #3 quite often and it helps.