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urgent ITB advice

Hi Folks,

Most of you will be tired of hearing about my injuries since I seem to mention them in one form or another every time I post. Anyway for those of you who have missed out the history is this:

Since January I have been taking myself from complete newbie to Ironman hopeful preparing for IMUK on the 2nd August. Back in March I developed a nasty stress fracture just above the ankle in my right fibula. After a couple of weeks completely off I recommenced run training using the cross trainer to avoid any impact, and gradually built in time on the treadmill as I felt able. Rehab seemed to be going great until I tested my ankle at a half IM in late June. The swim and bike both went well and based on CH’s advice I only ever planned to do the 1st 5k of the run. The run course involved a mixture of on and off road and the surface under foot for the off-road section was fairly uneven. Miraculously the ankle seemed absolutely fine , but during and after the run my left knee was pretty sore. The soreness persisted for the next couple of weeks so I cut my run training right back before testing it out again. After the couple of weeks rest I tried again and got the same soreness so took more rest. On Sunday I tried again... At first I could only manage running 5 minutes followed by 5 minutes walking but as I continued this decreased to 2 minutes run 2 minutes walk. I’ve been uber cautious of it so the pain isn’t crippling at the point where I stop, but the pain seems to crescendo in such a way that I feel it would be unbearable if I carried on for much more than a minute further.

Queue today’s trip to the doc. First off what a fantastic doc! I’ve been to see GPs before about the odd injury here and there and am always met with apparent boredom and the response that I should just rest irrespective of what races I have coming up (generalising I know, but not good past experiences). Today was completely different. I registered as a temporary resident and the doc squeezed me in between two other patients. He was very low on time but his preliminary diagnosis is Iliotibial Band Syndrome. I think my health insurance helped but he said he would do everything possible to try and make sure I’m ok to do the race in two weeks time. I am going back tomorrow to discuss options which I think include cocktails of anti inflammatories, injections? , and intensive physio. He also suggested I read up on the subject which is where you lot come in.

So... here goes, open question to any doc’s/coaches or anyone else out there with experience with dickey ITBs: How do I get my knee better for IMUK in less than 2weeks? Any advice, particularly on the available treatments and their pros and cons would be HUGELY appreciated!

Cheers in advance, you guys have come up trumps in the past!

Ewan

p.s. I know there was an ITB thread a while ago but the search feature has let me down, and sorry for the long post.

p.p.s obviously after the last 8 months training missing the race isn't an option... I should have 9 hours spare for the run and I'll just crawl it if neccessary.

Comments

  • [toPh][toPh] Posts: 244
    Get yourself a foam roller and use it twice a day from now until the race.

    It hurts but it works!
  • risris Posts: 1,002
    i'm pretty sure i've got a bit of mild itb in my right knee, although when i spoke to my doc (on the 'phone, no high falutin' visits at my place) he wasn't convinced. i've got all the classic symptoms though - sore knee and the pain stops immediately if i stop, some discomfort walking down stairs.

    i looked around online and spoke to a physio and currently do a series of simple stretches around the thigh, hip, arse and lower back muscles. as i understand it itb is a weakness in the gluteus medius (arse) muscle and perhaps the quads.

    my current stretching routine is single leg bridge lifts, clams (lying on side, legs bent, lift knee with hip rotation leaving ankles together) and some yoga postures. if i do them a few times a week, particularly before and after days when i run, then i generally avoid problems. a lot of people swear by foam rollers but i've never used them myself - i see [toPh] does!

    in the short term then i think ibuprofen can help as it reduces inflamation, although i've heard different schools of thought about whether gel should be used as rubbing the it band can aggravate the inflamation. problem with the interweb is that it so often contradicts itself
  • durhamvamdurhamvam Posts: 246
    The foam roller thing should work - you can use a rugby ball instead if you don't have a roller right now this second

    As ris said general strengthening and stretching will also help - I know someone with this problem whose knee would give way from time to time walking downstairs who was really helped by pilates - he had to do the foam roller thing, nothing like seeing a grown man weep first thing in the morning but it does really work - as well as other exercises

    Good luck!
  • [toPh][toPh] Posts: 244
    I was also give clam style exercises like Ris has described to strengthen the supporting muscles.
    Both of these regularly combined should help loads.
  • ShaggyShaggy Posts: 140
    Hi Ewan

    Doing similar to yourself, and my ITB knocked me over during the full beaver run. Was starting to build up my running after 2 weeks. This is what I did:

    Physio - he used shortwave and ultrasound. No stretching or manipulation for 2 weeks. Then he did some stretching of my tight right hip.

    No running or biking at all for 1 week, still swam and used stretch cords. No bending of knee at all if possible. Sat down whenever possible. Stretched all day. Even at back of exam hall when invigilating.

    Second week light spinning, run/walk set watch to beep on 7min/1min intervals. I'm probably going to do the Ironman run on a 10min run/1 min walk anyway. Ice pack after every workout on side of knee.

    Ibuprofen, full course everyday for anti-inflammatory

    Foam roller. As often as I could. Amazingly painful.

    Stretches - favourite is an offset lunge (can't find a diagram) and 'the world's greatest stretch' here http://www.coreperformance.com/knowledg ... nstep.html (really good site)

    I now use a PT strap like this when running, highly recommended
    https://www.physique.co.uk/dolc_product ... 0&PCId=515

    good article here - now I am better I do Walt Reynold's ITB special regularly
    http://www.sportsinjurybulletin.com/arc ... juries.htm

    Hope that helps, good luck.
    Ade

    I finished the Beaver run in 2 hours. My knee collapsed under me after 45 minutes and I developed a funky shuffle that meant I hardly bent my knee. Still a reasonable amount of hopping to get to the end. 10 min/mile instead of 7'30 - But I was going to finish - just so I knew I wouldn't give up on 2nd August.
  • GHarvGHarv Posts: 456
    Another thumbs up for the foam roller.

    Had this come on in my marathon training earlier in the year and this sorted it.

    G
  • jmurt71jmurt71 Posts: 46
    Hi,
    Was at a running course recently (Chi running with Catherina McKiernan, very good) and one of the guys had major ITB problems. It turned out the main issue was his posture,he stood, walked and ran with his toes pointed out away from his body. To get rid of the ITB issues he needed to adjust so that his feet were in line with his body. Apparently the best way to do this is to work on it not while you're running but in normal day to day when walking, driving, etc and get the body muscles adjusted to straighten up the feet . Not going to sort you out in the short term but might be of use in the longer term.
  • Awesome thanks for all the advice folks. It looks like foam rollers/ posture are the way to go long term (after IMUK I was considering getting some running technique coaching and maybe experimenting with forefoot running?). But in the short term the doc felt they might aggravate things.

    What the Doc says:

    Rest: (:roll: why do doctors always say that??) No running on the road until race day... If I MUST run do it on the cross-trainer.

    Stretch: a few simple stretches just done lightly

    Drugs: Full [email protected] maximum dosage of some industrial strength anti inflammatory/painkillers taken 3 times a day up until the race. He didn’t much like the idea of me taking them during the race but suggested I could pop paracetamol instead.

    Cream: Local anaesthetic cream on knee in T2... If it’s still going to hurt after the above I don't want to know!

    Injections: After all of the above if it is worse come a few days before the race he’ll pump my knee full of hydrocortisone.

    Will I be able to finish the race? The best I could get out of him was a fairly concerned looking “maybe” and an equally worried looking “good luck” as I left... I reckon he was just trying not to get my hopes up; I'm sure what he really meant to say was “Definitely, No problem at all!”

    Bring it on
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