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ITBS and/or TFL syndrome...what worked for you? (Read 153 times)

FlippyNoodle


Not a dude

    I started running in April 2012, so I've been running for less than a year. I've been dealing with pain in my right hip since around August or September and I stubbornly ran through it in order to finish my first half marathon in November. At my peak, I was running 25-30mpw. In December I had a total lack of motivation and ran fewer miles for most of the month, but started ramping up again toward the end of the month. On January 2, I decided to do 2x1.5 mile LT intervals a la Pfitz. I felt something go terribly wrong when I went into my recovery after the first interval. My left hip just below my butt hurt, both hamstrings were stinging, and my right hip hurt where it always had, which I later learned is the tensor fascia latae (no, you can't buy it at Starbucks).

     

    I substantially reduced my mileage, started stretching the TFL, and had a deep tissue/sports massage. I continued on that path for most of January, but suffered a relapse when I tried to increase my mileage again AND my left knee started to hurt. Dr. Google said I had ITBS on both sides with TFL syndrome on the right side as well. I'd heard good things about Graston for ITBS, so I located a local PT who was certified in it and got a referral from my doc. This is my 5th week of PT and Graston and it seemed like I was substantially improving, but that doesn't seem to be the case as I've suffered an apparent setback with pretty significant pain today. My PT said I need to stretch even more frequently than I have been and to really focus on strengthening the surrounding structures, which I am...and I'm also running very low mileage.10 full days of rest did nothing to help.

     

    Overall, this is just such a nagging injury and I'm at a loss for trying to figure out what to do from here. I know this is a very common issue, but it seems that I've suffered with it longer than most and I'm trying to find out why. Is it possibly because it's in the TFL and not just the IT band? What did you all do to help with this stuff? I know that I can't expect an overnight fix to a problem that developed due to months of denial and ignoring it hoping it would go away, but I'm open to any and all suggestions. I just want to run without pain, damnit!

    Coastal


      This sounds frustrating.  Perhaps you could try going to a running sports doc for a second opinion?

      cookiemonster


      Connoisseur of Cookies

        Doctor Google is a quack.  Definitive diagnosis from a real physician is a good idea.  If you're still having trouble following up with your physician, or a second opinion, may be in order.

         

        If you are already working on a diagnosis of IT band issues (as you've already seen your doc for the referral?) then what you're doing is the main treatment.  Stretching, strengthening (really important!) and PT are the mainstay treatments.  If you're not using a foam roller this may be something to consider as well.

         

        If you are still having problems there is the chance of another underlying issue.  This would be best handled by seeing your doc again.

        ***************************************************************************************

         

        "C" is for cookie.  That's good enough for me.


        Chasing the bus

          Foam roller. It's really helped keep me running. Started with IT bands, then the hip, now the calves...I doubt I'd be running without it.

          “You're either on the bus or off the bus.”
          Tom Wolfe, The Electric Kool-Aid Acid Test

          MJ5


          Chief Unicorn Officer

            I also say see an actual sports doctor. You mentioned that you got a PT referral but didn't mention if you actually saw a sports doctor or orthopedist. For as long as this has been going on for you, and the fact that you've been sidelined because of it, see an actual doc--at this point you might benefit from an MRI or something a PT can't do for you.

            Mile 5:49 - 5K 19:58 - 10K 43:06 - HM 1:36:54


            Hip Hip Hooray

              Assuming that the diagnosis is correct, here's what I've done:

               

              - PT to strengthen the hip girdle area - glutes, hips.   Weak hips contributes to the ITB issue (knee issues in general)

              - Graston, foam rolling, acupuncture cupping on the ITB itself, to try to break up adhesions and what not

              - Stretching the glutes, hips, and the ITB, as much as is possible with that

              - Paying attention to my shoes  - it seems to be that shoes with heels aggravate it for me, I guess because of the position it puts my knee which increases the symptoms?   I spend a lot of time in my sneakers with my orthotics!

              - Running as much as I can on flat roads - no hills, no cambers - during rehab.  Avoiding other ITB irritating exercises like squats.

               

              And supposedly, it takes 6 weeks to see a change in something like the IT band, since it's a tough tissue area.   And probably about the same amount of time to see enough strength gains.   It's a long, slow, slog back, at least for me it has been (both times).

               


              Mmmmm...beer

                For my ITBS, the cause seemed to be road camber (ran my first 1300 miles almost exclusively on the left side of the road ,and only had issues with my right leg).  Switching to the right side of the road and using a foam roller has taken care of the problem for me.  I'm with MJ, at this point I'd go to a sports doc/ortho and find the root cause so that can be addressed.  Hope you can get it sorted out and get back on track.

                -Dave

                My running blog

                2014 Goals | sub-19 5k done! | sub-40 10k done! | BQ done! | sub-3 M

                FlippyNoodle


                Not a dude

                  My PT agreed with Dr. Google that I have IT band issues on both sides and it's being treated with Graston, stretching, and strengthening the hamstrings, quads, and hips. I think you guys are absolutely right - I've tried PT alone and now I need to move forward with trying to figure out the root cause of these problems. I've emailed my PT to ask if any of the sports medicine docs she works with specialize in running injuries.

                  Jack K.


                  I love sponge cake.

                    Stretching, rolling, massage, rest...

                    2014 races

                    Santa Anita Derby Day 5k - 5 Apr  

                    Mountains to Beach Marathon - 25 May

                    RunSaintRun


                      Strengthening, stretching and foam rolling has prevented any IT band relapses. My PT used Graston initially and showed me numerous strengthening excercises for the hips, glutes which I believe has helped long term. He also showed me how to properly use the foam roller. I had a severe bout of IT band pain about 8 weeks from my first Marathon. All of the above got me through my marathon pain free.

                       

                      Good luck

                      ultratom80


                        I recently suffered from ITBS. My ITband got so wollen it was snapping. I held out till after I finished my first 50 miler. I went to an orthopedic doctor who referred me to a sports PT. She found out that my hips were uneven, and after some narly stretching, was able to even them out. I then spent a month strengthening my core and all the muscles in my legs. The issue I was having is that my upper legs, which you primarily use for stability, were weak. Since I do alot of trail running, it only aggrivated more. After a month of therapy, some cross-training, and light runs on even surfaces, it is all better.

                         

                        Unfortuanely, there is no easy fix. Thanksfully, my PT is a runner, so she understood how to treat it.


                        Sultan of slug

                          Foam roller. Seriously. I was out for over a month last year before I finally heeded everyone's advice and got it. It solved my woes almost immediately, and I've had virtually no problems since then. It will occasionally start to feel a little tight, but a little preventative foam-roller maintenance will completely take care of it.

                           

                          Stop reading and get a dang foam roller already.


                          Hip Hip Hooray

                            At some point, the foam roller stops working.    It's good for maintenance or for heading off issues, but when I was in the midst of a major ITB issue, foam roller was not enough.


                            Flippy - feeling any better?   I had a massage Monday and she really got into my TFL - feels tons better now.  I am still doing the Graston and have started to use a lacrosse ball in place of the foam roller with good success.  My leg is bruised to hell though.

                             

                            FlippyNoodle


                            Not a dude

                              I ended up going to a sports medicine doc who is also a runner.  Despite the issues with ITBS, the spot on/near the iliac crest that was hurting was something she'd never seen before. She did note that I have a lot of tightness in my lower back. She advised me to stop running until after an MRI to rule out a stress fracture. I went in for my MRI on Wednesday and the doc's nurse called me today to tell me that the only thing they found was trochanteric bursitis, which seems to be related to ITBS so I guess that makes sense. I'm very glad to know that I don't have a stress fracture! That said, I still have no real idea as to what is causing the pain in the upper part of my hip that may or may not be related to the TFL after all. I see the doc again on Monday to follow-up. She may opt to do a cortisone injection into the bursa to relieve the bursitis.

                               

                              FWIW, I have a foam roller and The Stick.


                              Hip Hip Hooray

                                I ended up going to a sports medicine doc who is also a runner.  Despite the issues with ITBS, the spot on/near the iliac crest that was hurting was something she'd never seen before. She did note that I have a lot of tightness in my lower back. She advised me to stop running until after an MRI to rule out a stress fracture. I went in for my MRI on Wednesday and the doc's nurse called me today to tell me that the only thing they found was trochanteric bursitis, which seems to be related to ITBS so I guess that makes sense. I'm very glad to know that I don't have a stress fracture! That said, I still have no real idea as to what is causing the pain in the upper part of my hip that may or may not be related to the TFL after all. I see the doc again on Monday to follow-up. She may opt to do a cortisone injection into the bursa to relieve the bursitis.

                                 

                                FWIW, I have a foam roller and The Stick.

                                 

                                Ugh.  I'm sorry. Sad   Good news on no SF though.

                                 

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