ITBS is winning

ITBS not Irritable Bowel Syndrome (IBS) is kicking my ass right now. I am fortunate so far that that pain remains in the manageable/tolerable phase. However, I don't think I continue to defy its on set.

I am trying to be proactive about this. I am popping anti-inflammatory medicine, stretching about 4-5 times a day and hitting the foam roller 2-3 times a day. It isn't for a lack of trying. This issue is, of course, compounded by the fact that I can't just take off 3-4 weeks of running. I need to build, build, build for Belgium right now.

The pain is just one of the oddest sensations. It rests on the lateral side of my right knee and is comparable to someone stabbing you. But it ends the moment you are done running. Then for the next 12-24 hours, you just deal with stiffness in that area.

I will beat ITBS, I just might go broke from all the visits to the chiropractor, massage therapists and doctors. UGH!

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From wikipedia:

Iliotibial Band Syndrome (ITBS or ITBFS, for Iliotibial Band Friction Syndrome^[1]) is a common thigh injury generally associated with running. Additionally it can also be caused by biking, hiking or weight-lifting (especially squats).

Definition

Iliotibial Band Syndrome is one of the leading causes of lateral knee pain in runners. The iliotibial band is a superficial thickening of tissue on the outside of the thigh, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running, moving from behind the femur to the front during the gait cycle. The continual rubbing of the band over the lateral femoral epicondyle, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed.

Symptoms

Iliotibial Band Syndrome symptoms range from a stinging sensation just above the knee joint (on the outside of the knee or along the entire length of the iliotibial band) to swelling or thickening of the tissue at the point where the band moves over the femur. The pain may not occur immediately during activity, but may intensify over time, especially as the foot strikes the ground. Pain might persist after activity. Pain may also be present below the knee, where the ITB actually attaches to the tibia.

ITBS can also occur where the IT band connects to the hip, though this is less likely as a sports injury. It commonly occurs during pregnancy, as the connective tissues loosen and the woman gains weight -- each process adding more pressure. ITBS at the hip also commonly affects the elderly. ITBS at the hip is studied less; few treatments are generally known.

[edit] Sports activities to avoid while symptomatic

• Running
• Stair stepping
• Dead lifts or squats
• Court sports, such as tennis, basketball, or similar
• Martial arts, such as karate (especially where being bare foot emphasises any symptoms being caused by leg/foot abnormalities)
• Cycling

Causes

Iliotibial Band Syndrome is the result of poor training habits, equipment and anatomical abnormalities.

Training habits:

• Running on a banked surface (such as the shoulder of a road or an indoor track) bends the downhill leg slightly inward and causes extreme stretching of the band against the femur
• Inadequate warm-up or cool-down
• Increasing distance too quickly or excessive downhill running
• In cycling, having the feet "toed-in" to an excessive angle
• Running up and down stairs
• Hiking long distances

Abnormalities in leg/feet anatomy:

• High or low arches
• Overpronation of the foot
• The force at the knee when the foot strikes
• Uneven leg length
• Bowlegs or tightness about the iliotibial band.
  • Excessive wear on the outside heel edge of a running shoe (compared to the inside) is one common indicator of bowleggedness for runners.

Muscle Imbalance:

• Weak hip abductor muscles

Treatment

As with any injury or ailment, one should see one's physician, physical therapist, chiropractor or athletic trainer for diagnosis and treatment.

For a runner with acute ITBS, reduce weekly distance training to 50% for 2 weeks, and only run on flat ground. After, in the absence of ITBS pain, slowly begin to build distance again. If ITBS pain remains or is chronic, one should stop running immediately for two weeks (minimum). If the pain and inflammation are still present, another month of rest may be needed. Once the injury begins to improve, resuming activity can be possible, doing low distance, low speed jogging on flat terrain. Also, changing one's route may help counteract re-injury, as running a common route may put increased stress on the iliotibial band of one leg.

To prevent, or cure chronic ITBS there are some essential exercises:

• Strength building of the hip abductors (especially the gluteus medius), which control ITB tightness
• Performing specific stretches; Iliotibial band stretch, stretching the gluteal muscles, and other leg based static stretching

To create a good treatment program, proper assessment of injury severity is critical. Once the injury has been properly assessed, a treatment program (usually consisting of three steps) can be planned. The length of time spent on each phase varies depending on the athlete, the reasons for the initial injury, and the severity of the injury.

Immediate treatment

After noticing symptoms, the important task is controlling pain and inflammation. For these symptoms, treatment of rest, ice, compression and elevation (RICE) works well. Stretching is second in importance, to make sure that the iliotibial band does not become taut. Next, examining what may have caused ITBS is important. Issues range from poor training habits to structural abnormalities, but the shoes a runner uses are another consideration. For example, after 500 miles most shoes retain less than 60% of their initial shock absorption capacity, increasing the chance of ITBS injury. Massage therapy can also improve the chance of a quick recovery. Lastly, anti-inflammatories or ultrasound may be helpful to relieve symptoms.

Short-term treatment

If the pain and inflammation do not subside, all painful activity should stop while continuing immediate treatment. A regular stretching regimen is important. A video analysis of running movements may provide insight into problematic running mechanics. To retain fitness, a number of options will work at this stage, as long as they do not promote pain. Altering these exercises will minimize overtraining:

• Swimming, though abstain from the breaststroke as it may aggravate symptoms
  • Optionally, wearing a life jacket, one may run in the pool (depth allowing)
• Cycling, though with care, as it may aggravate symptoms
• Speed walking, especially straight-legged to discourage pain
• Cross-country skiing
• Yoga, or similar low-impact aerobics

At this stage, steroid injections may be helpful, though some risks are involved.