Possible ITB problems??? Help!

[lindrusso]

Hi runners! I've been continuing (sporadically) to go on with my running program, but I've encountered an "injury" twice now that I'm thinking is Iliotibial Band Syndrome. The pain occurs on the outside of my knee, mostly, and last time it took at least a week to heal. At first I just thought I was just really sore, but when it took that long to heal, I realized it was more than that. Then I remembered someone talking on this board about an injury that can effect a tendon (?) on the outside of the knee.

Anyway, I did a bit of Internet research and this seems to jive with what I am feeling. Can this really happen to someone who is only just reaching 1 1/2 miles at a time??? Both times, my hamstrings have been very tight afterward as well. I saw on a site that this is a possible cause, so I will at the very least start concentrating on strengthening my hamstrings - they've always been much weaker than my knees.

I don't know if I'm looking for advice or what - or just a place to express my disbelief that my little bit of running could cause injuries! It felt like I'd be able to stretch and work this "kink" out, but after reading that stretching is not particularly effective for this type of injury, I now know why my efforts don't seem to be bringing much relief!

Anyone else had this problem? At least one of the times I was running, it was on the treadmill, so that rules out any road problems.

[SusanT]

My husband got the same injury after he did an ultramarathon last year and it took about four months to heal (injured runners are h**l to live with).

Who said stretching didn't help? It helped him tremendously and now he stretches before each run and has had no more problems with it.

I'm sure Emilycat will chime in soon with more info.

[emilycat]

Hey, Alysha!
You can definitely develop an injury, even when you're not running high mileage -- ITB syndrome, in particular, can be caused by lack of stretching or increasing mileage too quickly, which is how I developed it. The good news is, if you don't screw around on it, it shouldn't take that long to heal. Mine lasted about a month, and I only took about 3 weeks off from running (the sports-medicine doctor I saw told me that I could run on it, but with less mileage). The best thing to do is stretch your IT band before and after you run (RW has some great descriptions of some you can do), and ice it afterwards. If you're not anti-anti-inflammatories :D you can take up to 800 mg to dull the pain. I know a lot of people don't agree with that, but I think that as long as you're not exceeding the recommended daily dosage and you're not pushing your body past its limits, there's nothing wrong with a little help. When you're not running, any other activity, except for stair climbing, is fine to do, because it won't stress the IT band.

Wishing you a speedy recovery! :)

Emily

[Natasha]

Originally posted by SusanT
(injured runners are h**l to live with).


We are?! Really?!?! ;)

Susan, you're SO right. It's also no fun to be the injured party... :)

Alysha, sorry to hear about your pain. I can empathize with the frustration. Can't say that I've ever heard of a case where someone with relatively little mileage got ITBFS, but that doesn't mean it couldn't happen. Ramping up your mileage too quickly, wearing the wrong shoes, running on uneven surfaces...a lot of things can make ITBFS happen.

Keep us posted and best of luck. Have you considered seeing a sports doc? Once I read up and consult my running buddies/fellow jocks, I generally follow up with a visit to one of my sports docs for a knowledgeable opinion. Just me...

All the best!
Natasha

[lindrusso]

Hmmmm... all of the comments about needing pain killers and how long you said it can take to heal make me think maybe it's not ITB. It's irritating, but not to the point of needing anti-inflammatories (it's annoying, but tolerable). And the last time, it only took a week or so to heal.

I did think about going to see a doctor, but I guess I feel foolish since I'm still a wannabe!

As for stretching not helping, that seems to be a disputed claim. One of those things where some say it helps, some say it doesn't. In any case, I didn't read anyone saying it would hurt, so maybe I'll try some of the suggested stretches.

For now, I'll just be walking - or gimping anyway. Thanks for your input everyone!

[lindrusso]

Originally posted by lindrusso
I saw on a site that this is a possible cause, so I will at the very least start concentrating on strengthening my hamstrings - they've always been much weaker than my knees.

Some of you may have been perplexed by this statement - I meant my hamstrings have always been weaker than my quads, NOT my knees! Duh!

[cindyluwho]

I noticed that when I first started running, I would get a slight pain in my knee also. It wasn't terribly painful, just a little bit annoying. I'm not sure what it was, but noticed as you did that my hamstrings were very tight. They were like giant knots, in fact, and were very hard to stretch out without pain. I'm certainly not an expert in these things by any stretch of the imagination and am still a beginner runner, but I think this was happening as I was trying to strengthen my very wimpy leg muscles, and not being very diligent about stretching. According to RW, chondromalacia (softening or wearing away of cartilage under the kneecap) can be caused by an imbalance of leg muscles:

Causes: Excessive pronation (when the arch collapses too much and the foot rotates too far inward) can cause the kneecap to twist sideways. Fatigued or weak quadriceps muscles, which aid in proper tracking of the kneecap, can prevent the kneecap from tracking smoothly. A muscle imbalance between weak quads and tighter hamstrings can also pull the kneecap out of its groove. Hill running (especially downhills) can aggravate the condition, as can running on the same side of a cambered road, or, in general, overtraining.

I have noticed that being a little more diligent about stretching has helped, though I still get a little bit of pain from time to time. I know you said that stretching didn't help, but I thought this sounded a bit closer to the problem than ITB.

[lindrusso]

cindyluwho -

I had to giggle when I saw your screename - I used to get called that in college. Not sure why - I like to think it was only because I have big blue eyes ;) . Thanks for your input.

The pain I have is not really in the kneecap - it runs along the side of the leg starting mid-thigh with the most pain near the side of the knee. That's what made me think ITB, because it's to the side of the knee, not the actual knee or kneecap itself. If I hold the leg straight and walk without bending my knee, there is no pain - something else they said can be true with ITB.

This pain also is not so bad that I need ibuprofen, but it's bad enough that I can't run on it or do any exercises that involve that area. Anything more than slow walking really aggravates it.

All I know is that I don't need anything, whatever it is, to keep me from exercising - I come up with enough excuses not to on my own!

[emilycat]

Alysha,

Sorry, maybe I was a bit confusing about the ibuprofen. If you do have IBT syndrome, your leg shouldn't hurt when you're not running -- it should disappear immediately after you stop. So when I mentioned taking pain killers, I meant that you could take them before you run to make running tolerable. Is that less cryptic?
Emily

[lindrusso]

Emily -

Gotcha! Can't you just tell that I'm not a dedicated runner yet since taking the ibuprofen to make running more tolerable didn't occur to me????? :D

[Gina O]

Hey Alysha-

Thought I would add my experience with ITBS for further insight. I got ITBS very early into my running, for sure before I was doing two miles without stopping to walk. It was not from the surfaces I was running on, or the shoes, but simply from weak muscles in my leg and maybe from trying to do too much too soon. (And it did not make a difference if I was running on pavement, a track or a treadmill, I tried them all.) The pain would occur at nearly the exact same moment when running (after about 11 minutes) and lessen when I stopped running. I tried many stretches and tried to keep running until it finally got so bad I had to stop completely. I wound up with two months of physical therapy, lots of strengthening and stretching exercises and some funky electrodes on my knee for 20 minutes 2-3 times per week.

One interesting thing I noticed while in PT.... he would have me warm up before each session on a stationary bike for about 10 minutes. One day I noticed that the affected leg (especially visible by watching my knee) would turn in while biking. That was a "symptom" of the muscle weakness which led to the ITBS.

Another note... while I say it wasn't the shoes, I am not completely sure on that one but not because of a pronation problem but padding. I bought new shoes when I started running again, and the sales person said to alternate them. I found that I experiences a tiny bit of discomfort in my old Asics, but none in my new Adidas. Recently, I started wearing the old
Asics at Curves and my knee is most uncomfortable when I am there. This weekend I am headed back to Fleet Feet to discuss this situation. My guess is there is not as much padding in the Asics, which puts more stress on my knee.

To the ibuprophen issue... I was told to take it regularly by the Dr.s not to assist with running/pain releif (I did that once and it bothered my stomach too much) but rather to reduce the inflamation of the ITB.

My experience with pain.... when running it was acute, and got to a point that I could, in no way, continue running. But, it did not stop completely when I was not running. There was a nagging slight soreness in the spot nearly all the time. The bad news is that soreness is back, but none of the acute pain.

On stretching.... I stretch my hamstrings and ITB before and after every run with the stretches my PT told me to do. I think it helps tremendously.

And a question to all.... how often do you replace your shoes? I looked on RW the other day but perhaps was not looking in the right spot because I could not find an answer.

I hope some of this helps, Gina

[emilycat]

I guess I should clarify -- when I overdid it during the beginning of having ITBS (read: running too farwhen I definitely shouldn't have been) it hurt all day. I even started walking oddly because I couldn't bend my knee without pain. But if you catch it early and stay off of it, it should be fine when you're not running.

Gina -- I think the general rule is to change your shoes every 400 to 500 miles, depending on how quickly they wear. I buy a new pair every 3 months, so I actually push mine to about 600 miles, but considering that a pair of shoes puts me back $100, it would pain me to buy them more often. :)

Just a little FYI: it's really interesting to place one of your old shoes next to a new shoe side-by-side on a flat surface -- by looking at how the old shoe tilts, where it's worn the most, you can find out a lot about your stride and your form. I think it's neat. :D