Ilio-tibial band friction syndrome

Does anyone else out there have ITBS? I've had it more than half my life, since I was 12. I was very active before and I haven't been able to do anything impact since. I was on crutches for 9 months, had several rounds of anti-inflammatories, several cortisone-novocaine injections, and more than 2 years of physical therapy. I'm able to function now, but sometimes I step wrong, my band snaps, and I can barely walk for several days. I want to get the surgery to lengthen the band, but I can't find a doc who'll do it. Also, my oldest neice, who is 12 years old now was just diagnosed with it. I can't imagine that ITBS would be genetic, but talk about coincidence! Does anyone have any experience with ITBS? Thanks in advance.

Tue. Jan 22, 7:56am

If you're interested in trying something "alternative", there's a style of bodywork - which I consider more like physical therapy than massage therapy, but it's usually classified as the latter - called Rolfing. Rolfing focuses on realigning and lengthening connective tissue through manual manipulation, and if memory serves me right, the IT band is connective tissue.

You can read up on it and find a practitioner at rolf.org and rolfing.org. Just so you know, it's rarely covered by insurance and, as a guideline, tends to cost a little more than what you'd pay for a massage (no point quoting you a price, since that varies with geography).

Tuesday, January 22, 2008, 10:23 AM

My experience with ITB problems

I must really have a vested interest in replying to your post, because this is the THIRD timeI have tried to type a response- the previous attempts were not able to be posted and lost.
OK, in my earlier years I infrequently experienced what I thought was my left hip 'giving out on me', and I went to variuos doctors and fitness professionals but no one knew what to do for it.
Now 54 years old, with 40 pounds to loose, and still actively exersizing, the problem came back in a worse way. I was accompanying friends searching thru a huge furniture store (with a lot of stop and start walking). I found that when I would go to take a step in an unexpected direction, from a standstill position, my left leg would crumple out from under me, hurting to the point that I would yelp.
I went to an orthopedist who examined me, did MRI's etc. He suggested constant use of custom orthotics and sturdy supportive shoes, and sent me to PT for 3 months. Frankly, only one of the exercises at PT did anything for the problem. ( I would be happy to provide more specifics but don't want to bore you with too many details).
Eventually I ended up with a medical masseusse also trained in Oriental medicine (interesting as the second poster wrote about Rolfing as a treatment).
After one minute of moving my hip and left leg around on the massage table she flatly stated "The problem comes from your Ilio-Tibial Tendon, not your hip" Then she proceeded to push her fingers, it felt like to the point that her knuckles werre disappearing into my thigh, and said "Now you are going to feel this here (upper thigh)" Ouch,! "and here (lower down the thigh)" more Ouch! and so on all the way to below my knee. The treatment hurt, and the next day where she had pushed looked like the color of an eggplant but I could walk with less pain and the leg was not crumpling out from underneath me so often. I came to understand she was actually pushing on the tendon to strengthen it, much as a person does when exercising. I saw her for 3 long sessions over a month long period. I go back for a 'tune-up" when it starts happening a lot.
No one has ever used the word "Friction" when naming my ITB problem, so I don't know if you have the same condition in more severe form, or if it is different.
I really empathize with you, because as much as my problem was /is very disruptive when it occurs, your situation sounds so much worse.
I am posting because so few people, on the patient end or the healing profession end, seem to know about ITB.
Looking forward to hearing from you,
Chalant

Tuesday, January 22, 2008, 11:26 AM

I just strained my IT band last night - luckily I am a receptionist at a physical therapy clinic so I had someone to get free professional advice from first thing this morning. Ice and Advil - stop running on it for a few days and see if it gets better. Physical or massage therapy can help but can also be expensive. There really isn't much you can do for IT bands. (I dont know much about it - but I have heard rolfing is really painful.)

Tuesday, January 22, 2008, 1:05 PM

I feel for you, OP. I had ITB problems when I trained for my first marathon - never knew about them until I was pretty much hobbled from running! For the next marathon we found specific stretches and that helped us complete the training and run the race w/o a problem, but it was awful that first time around. I can't imagine dealing with it all the time. And, that stinks for your niece. That does seem like more than a coincidence.

Tuesday, January 22, 2008, 1:33 PM

Last Poster,
If you wouldn't mind could you say more about what the specific stretches were that helped your ITB problems?
Thanks, Chalant

Tuesday, January 22, 2008, 11:32 PM

As a physical therapist I've had some experience with the IT band both personally and professionally. The friction someone referred to was probably friction massage, where you rub fingers, knuckles, and/or elbows over the band. I had a myofascial specialist run either his knuckles or elbow down the length of my ITB (hip to knee) and it hurt so bad I almost cried out in pain but it did help. And yes, it did leave bruising on my leg! I have seen people use the heavy styrofoam rolls at the gym to accomplish the same thing. They place the roll perpendicular to the side of the leg while in sidelying and move the weight of their body along the roll, although OP, your case sounds very severe so I'm not sure how much of a significant difference this would make. Someone grinding their elbow into would make an impact though!

Wednesday, January 23, 2008, 1:02 AM

11:32 - there were two stretches I remember doing. One involved crossing one foot in front of the other and touching my toes. I would feel the stretch along the hip opposite the leg that crossed in front. The other one involved crossing one foot in front of the other and leaning against a wall, tree, lamp post etc - away from the foot crossed in front. So, if my right side if facing the wall - about a foot away, I'd cross my right foot in front of my left foot, then I'd place my right hand on the wall slightly above my shoulder, and push my left hip away from the wall (my rib cage pressing toward the wall). Does that make sense?

I checked Runner's World online - I think that's where I got the stretches the first time around. They're not there, but they've got another stretch - check it out.

OP - there was also an article about ITB and relief through surgery, where the band is surgically released. It sounded like runners generally aren't happy with that option b/c it can lead to a floppy knee, but maybe that's something to look into?

Link

Wednesday, January 23, 2008, 8:29 AM

ILIOTIBIAL BAND FRICTION SYNDROME

I have had trouble since 1990 with ITBFS. The condition was created by orthotics which were intended to make me become a profitiable surgery case.

My Orthopaedic surgery would not do surgery, he said surgery could leave me with a limp.

isbn 0-07-246211-6 Therapeutic Modalities for Sports Medicine by William E. Prentice, PH.d., P.T., A.T.C. is the best book for self education on how to use various modalities for treatment. Make sure you get semi-ridgid orthotics.
Understand your personal bio-mechanics as explained by a orthopaedic surgeon of the foot and ankle. Forget podiatritsts. They make ridgid orthotics.

I repair patient related equipment in the IU Medical Center, and I am a member of the National Institute for Fitness. Join a similar organization. Get a outstanding sports massage therapists.
This is one tough condition to deal with. I have been able to make my own condition 90% better. Physical therapists can be of very little use.

GET A LOW LEVEL LASER THERAPY DEVICE AND STUDY DOSAGE. This is explained in the book above. If you get yours to be better....1000% healed, tell me!! James Martin Teasley (317)-856-7391. 5243 Honey Comb Lane
Indianapolis, IN 46221

Wednesday, April 30, 2008, 8:03 PM

Sure enough, the spam bit gets thrown it at the end.

Thursday, May 1, 2008, 12:43 PM

Iliotibial band friction syndrome (ITBFS ) is an overuse injury caused by excessive friction between the iliotibial band (ITB) and the lateral femoral condyle. The iliotibial band is a confluence of fibers from the tensor fascia lata, gluteus maximus, and gluteus minimus muscles. Its origin is the greater trochanter, and its insertion is just lateral and proximal to the tibial tubercle. Runners typically complain of persistent lateral knee pain not associated with swelling, usually occurring one to two miles into a run and worsening while running downhill. Anatomic variations such as genu varum (bow legs), iliotibial band tightness, iliotibial band thickening, leg length discrepancy or excessive foot pronation may predispose runners to ITBFS. Physical examination reveals tenderness over the lateral femoral condyle. The Noble compression test is often positive. MRI, if performed, may demonstrate thickening of the distal aspect of the iliotibial band. Treatment consists of altering the initiating activities, controlling inflammation, correcting abnormal biomechanics, strengthening and stretching the involved muscle groups, and modulating the return to activity. Inflammation may be diminished by using NSAIDs or, in some cases, steroid injections. Orthotics and shoeware modifications are helpful for athletes with structural problems. Hip abductor strengthening exercises and ITB stretching exercise are essential to avoid re-injury. Resumption of running should be gradual. Surgical therapy is usually not necessary. Martens described a surgical procedure which involves resection of the posterior strip of the ITB directly over the lateral femoral condyle. Noble described a procedure which involves release of the posterior segment.

Introduction
An athlete presents to the clinic with recurrent knee pain that is difficult to describe and only occurs while running. Symptoms have been present for approximately 6 weeks. The pain is not getting better, and the athlete's performance is suffering. On physical examination, the physician notes lateral knee tenderness. There is no effusion and no gross instability. There seems to be mild generalized tightness of all muscle groups. Radiographs are normal, and an MRI scan reveals normal menisci. The athlete is given a brace, advised to rest, and prescribed anti-inflammatory medications. Two weeks later, the athlete attempts to run, but experiences the same symptoms.

Does this scenario sound familiar? It depicts the classical presentation of iliotibial band friction syndrome (ITBFS ), the most common cause of lateral knee pain in runners.[1] It has been estimated that one-third of running injuries involve the knee.[1] The vast majority of running injuries are related to overuse, and often respond to a well-designed rehabilitation program. Establishing a precise diagnosis, however, can be difficult.

In my experience, ITBFS is under recognized. A famous proverb states, "The eyes do not see, the hands do not feel, and the ears do not hear what the mind does not understand." Our task, therefore, is to better understand this common overuse injury.

First described by Colson and Armour[2] in 1975, ITBFS is an overuse injury caused by excessive friction between the iliotibial band and the lateral femoral condyle. The anatomy of the syndrome has been well-described.[3,4,5] The iliotibial band is a confluence of fibers from the tensor fascia lata, gluteus maximus, and gluteus minimus muscles. [3,4,5] Its origin is the greater trochanter and its insertion is just lateral and proximal to the tibial tubercle at the tubercle of Gerdy. [3,4,5]

Link

Monday, June 2, 2008, 5:48 PM

some context for the last post- I was researching this and wanted to add to the thread. This was from a Medscape article and seemed very helpful. It seems like stretching based activities like yoga, pilates, rolfing etc would be very helpful.

Monday, June 2, 2008, 5:54 PM

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