IT Band Issue Fixed?

Brad, i have suffered with IT issues for decades.  I mountain bike, day hike, workout, something every day. I never have issues until i put a heavy pack (+20) pounds and go down, like a grand canyon hike.  I have found a simple solution for me. I just need to put a 30 pound pack on my back for a couple of days before the bigger hike. I do maybe 5 steep miles, then maybe 7, then 10.  I hike until it just starts to hurt, then stop. I am ready to go by the 4th day with no pain.  I guess it just needs more stretching than the yoga and gym type moves.  It certainly is no fun when it hurts. Glad to hear you found a solution. BTW, a roller is a waste of time for me too.

Brad, from everything I’ve read, I think exercises are the right way to address it.  I do a number of hip strengthening exercises every week.  I do yoga every day but I don’t think stretching is the solution.  It seems to be regarded as a compression syndrome so no way I’ll ever do any rolling on it.

http://denverfitnessjournal.com/it-band-syndrome-we-have-a-weak-link/

Here’s the general solution that applies to everyone:

(Want to see it again?)

I had ITB issues for a few years, and I think the only thing that really made a difference for me was rest.  Not just quitting for a while, though I had to do that after the worst flareups, but not overdoing it for a long while.

Good luck.  IT band pain is a pain.

It sounds like it’s still a mystery to the medical community. I wish everyone well in getting rid of it .

I had similar issues and went to a PT who gave me various stretches and leg and butt strengthening exercises, no rollers.  Worked like a charm and it has not come back for at least 5 years now.

Start at 5:15

Running Strength –

YMMV

Same boat, going downhill really can aggravate it.  Two things help me:

1. One foot over the other, bend over.  Similar to simply touching your toes, but with one foot over the other.  Stretches the upper outside part of the calf.
2. When you walk, have your foot swing up further in the back.  Don’t need to hit your butt, but further up.  Relax the foot, lift with the knee.

I suffer from IT band issues.  Like others, downhill really sets it off.  I’m working on doing a better job stretching and rolling it out.  It only seems to bother me on backpacking trips.  Good luck to everyone fighting it.  Lightening my load the last 10 years or so has helped.

I’m pretty sure that if you have that kind of pain you describe, especially when hiking downhill, it’s because your quads are weak. I have noticed that I get pain there once my quads start getting tired because I’ll start to walk subtly differently trying to ease off my weakened and tired quads. If you are doing training that is making your quads stronger, that only adds more evidence to my theory.

A really good book to read is called The Barbell Prescription by Jonathon Sullivan and Andy Baker. There’s an essay by Jon Sullivan that was written before the book came out that provides the same opening statement in the book. https://startingstrength.com/article/barbell_training_is_big_medicine It’s worth a read. The basic gist is that there’s a difference between exercise and training, and it is training the performs the magic elixir of health. The goal of training isn’t to build muscle for muscle’s sake, it’s about building strength, resilience and health.

I have done the Starting Strength program to the best of my ability. It has helped a lot. I have found it useful to add other exercises that strengthen the quads. I’ve tried doing quarter squats and leg lifts. I’m scared of the leg press machine, but that would probably work. I also sometimes put sandbags in my backpack and walk up and down the stairs. There are probably other things, maybe Bulgarian split squats or whatever they’re called. Whatever builds stronger quads.

It’s not really enough just to get exercise, you have to build strength.

I’m pretty sure that if you have that kind of pain you describe, especially when hiking downhill, it’s because your quads are weak.

That might do it too, but the downhill-is-worse pain is classic ITBF.  In my experience, the IT flareups are more likely when my legs are the strongest–because I’ll keep going and going and going till the tendon gets inflamed.

the IT flareups are more likely when my legs are the strongest–because I’ll keep going and going and going till the tendon gets inflamed.

But the idea of strength training is that you stress your legs with acute stress over and above (MUCH over) what you would be able to do repetitively for hours. Acute meaning with a weight you can only lift 3-5 times before failure. This acute stress forces an adaptation in the body. Your body adapts by building muscle so if that happens again, you won’t fail. This adaptation is an evolutionary thing that is built in to all living organisms. Your body adapts to the stress so you will live long enough to be able to reproduce.

Repetitive stress that you sustain for hours has an opposite effect. At first when the stress is new and unusual, your body responds in the adaptation mode, getting stronger. Building muscle so you won’t die so you’ll be able to reproduce. But over time doing the same level of stress, the adaptation response won’t be provoked. Instead you will probably try to add more time at the same level of stress in order to build your endurance, This will work for a while, but eventually you will wear yourself down and create overuse injury. Or you might just find that you sort of hold steady without improvement or slowly decline as you age.

This is why strength training is so worthwhile. It’s also very misunderstood. You apply acute stress to force an adaptation response in the body. You have to add weight to ensure the stress is always acute, always new. You don’t add repetitions or time. You just add weight. You also have to give yourself time to recover so that you can apply the stress again and provoke the adaptation response without provoking the wearing out and declining response. Done right, little-by-little you improve. Then when you go out and do something relatively less stressful, like walking 10 miles, you’re strong enough to do it.

Todd, you said –

“In my experience, the IT flareups are more likely when my legs are the strongest–because I’ll keep going and going and going till the tendon gets inflamed.”

Something that can happen as you get “stronger” is the lengthening of your stride. If hip stability is poor the drop in the leading hip as you step forward will over-work the opposite IT Band, which can lead to inflammation.

I combat this with stability exercises And keeping my stride the same, while increasing my cadence.

YMMV

It’s only anecdotal evidence, but strengthening my legs is the only change I’ve made and the pain has not come back.

Far as I can tell, it’s all anecdotal.  ITBF syndrome is a very frustrating injury.  In researching for my own, I’ve concluded:

• The causes are myriad(*)
• The symptoms are almost universal
• The solutions are myriad(**), but most aren’t much/any help for a given individual

The silver bullet hasn’t been found.  Anyone wrestling with it for the first time is well advised to read all the testimonials and look for common denominators with his/her own case.  I’ve gotten to know mine well enough that I can manage it, and haven’t had a flare-up in several years.

(*) Including, sometimes, strength training, especially for quads.

(**) Including, sometimes, strengthening quads.

Itb is tendonitis

Overuse injury. Caused by repetitive strains in excess of what tendon is conditioned to accomodate , and can recover from on ongoing basis.

Healing of all tendon injuries is slow (weeks) due  to lack of bloodflow. This is where stretching and massaging assist in promoting bloodflow to the area.

cause?  Repetive shocks from hiking. Especially downhill.

Why? Often some other muscle is tired or sore, gait shifts to lessen load on it, placing new type strain on other parts.   When a part of leg gets sore….everything goes south quickly.

Solution:  slow down, plant feet gently. Use poles to assist in taking load off when going downhill. It is impossible to walk downhill without poles without  literally falling onto downhill leg, producing shock on impact.

Prevention:   acclimate to higher repetitive impacts.  Running is by far best you can do on readonable time basis  for lower legs to avoid repetitive motion injuries.

Some good info on the IT band.

Solution: slow down, plant feet gently. Use poles to assist in taking load off when going downhill. It is impossible to walk downhill without poles without literally falling onto downhill leg, producing shock on impact.

MB, I think you nailed it there. On my usual weekend hike I seldom have IT band problems. Last weekend I hiked with someone faster than me. More jumping, hopping, and stepping down hard on the downhill sections. I had significant IT band pain.

I know from reading about Achilles tendon injuries, when running and jumping “the Achilles tendon is subjected to tensile loads as high as 6 to 12 times body weight.”

https://www.jospt.org/doi/full/10.2519/jospt.2015.5885

So it makes sense that moving faster on downhills (especially with more hopping, jumping) will place a higher load on the IT band.