Please help re knee pain with running (iliotibial band)
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Anonymous
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A few months ago I started having pain on the outside of my right knee while running. The pain started during a run, persisted for a few days after, got better - then I'd go for a run again and the same thing would happen. After the third or fourth instance the pain lasted for nearly 3 weeks and was pretty severe at times, especially at night - I'd try to roll over in my sleep and the pain was so bad I'd wake screaming. Once the pain finally went away I took three more full weeks off from running, then tried to run again today - and 1.5 miles in the pain started again. F***! I just want to be able to run!!!
From reading online it seems pretty clear that the pain has something to do with the iliotibial band, but ther's conflucting information on what helps and what doesn't. Some sources say certain types of stretches help, others say the stretches don't help anything. Some say foam rolling, others say foam rolling does nothing. Some say dry needling (not even quite sure what that is) helps. I just want to figure out what to do about this so that I can run regularly again. So - if you've dealt with this, what helped? Should I see a physical therapist? Orthopedist? I've read the wiki list of training habits that can contribute to iliotibial band syndrome, and none apply to me. I do potentially have anatomical issues that could contribute (high arches, and I was once told at a running clinic that one leg is probably slightly shorter than the other). I wear good running shoes, had my support insoles replaced when this pain first started (shoes did not need to be replaced yet), I walk and stretch to warmup, walk and stretch to cool down, do body weight exercises to strengthen supportive muscles, run on different types of surfaces, etc. I don't think I'm doing anything "wrong" and I've never had this pain before - but now I can't seem to get rid of it. Help, please!! |
Anonymous
| I had this. I went to a physical therapist and we did a lot of stretching. It helped a lot. |
Anonymous
Thank you. Can you (or anyone) recommend a physical therapist in Montgomery County that would be good for this? |
Anonymous
| I went to a physical therapist for this too, but ages ago. I learned some good exercises, but I'm fairly convinced that what prevented the problem from reoccurring when I got back into running sometime later was (1) getting fitted for a good pair of running shoes by someone who knew what they were doing, and (2) increasing my weekly mileage very slowly - by no more than 10% a week. |
Anonymous
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I've had IT band issues in both knees off and on for years, so I completely understand how you're feeling!!! I got it for the first time during my very first marathon, and I ended up going to an ortho and getting a cortisone shot after the race. It helped for the time being, but it coincided with a big decrease in my mileage following the race, so it's hard to say how much the shot actually helped. Then I got it in the other leg about a year later and I didn't want to get another shot. The ONLY thing that has worked for me to keep it from flaring back up (in either leg) is icing the area and using a foam roller daily. I also make sure that I'm not running on worn out shoes -- after 6 mo. or 500 miles, most running coaches will tell you to replace your shoes. Now when I start to notice a twinge in one of my IT bands, it's usually time to replace my shoes.
Have you recently ramped up your mileage or started doing speedwork for the first time? That could be part of the problem. Do you do a lot of cycling or spinning as well? That could be aggravating your IT band also. It sounds like you're doing everything else right in terms of wearing correct shoes, warming up, stretching and strength training. It sounds pretty bad right now if you can't even run 1.5 miles without it flaring up, so you may want to take a few (or more) days to ice it and completely rest. Start with the foam roller and just give the inflammation some more time to die down. If the pain persists, though, it's probably time for a doctor. |
Anonymous
| Have you replaced your shoes? Tried different shoes? Gained weight? Those are the things that will trigger mine, so I get new shoes or lose weight |
Anonymous
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I had BAD IT band issues. I took six months off running, saw an ortho, went to PT, then tried some new things.
Two things helped and one of them 'cured' me. One: I had enormous help from ProAaction PT / Rachel Miller -- http://www.proactionpt.com -- her team is running specialists and they will evaluate your gait, movements, etc. and teach you amazing stretches. Two (and this has fixed my problem for 6 months now, knock on wood): Dry Needling with Therese McNearney at http://www.precisionhealthandfitness.com/ Seriously, one session FIXED my IT band issues. I cannot say enough good things about this. Good luck OP!!! |
Anonymous
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This is OP - thanks so much for the feedback. I have my shoes fitted at Fleet Feet and get the high support inserts for my high arches, and when I went in to get new inserts when the pain started they confirmed that my shoes didn't yet need to be replaced - so I don't think my shoes are the problem. I got these shoes *right* before I became pregnant, couldn't run while pregnant (exercise restrictions and bed rest), and had run only inconsistently postpartum - so the shoes don't have much mileage on them. My weight is currently a touch lower than it was pre-pregnancy (130 lbs), so I don't think that's the issue - but of course there are probably changes in my body shape and how the weight is distributed. I had indeed ramped up my mileage when the pain started occurring - I went from running a few miles (about 3) twice per week to doing one longer and two shorter runs per week, trying to increase my stamina again. So I'd gotten up to doing something like one 6 mile run per week plus two 2-3 mile runs per week. Still not nearly the mileage I was doing pre-pregnancy (about 20 miles/wk), but more than I'd been doing for quite a while. I have no doubt that contributed to the problem, but I was only adding about a mile per week so I thought I had ramped up slowly enough. And now I can't go two miles without the pain starting, even after taking 6 weeks off!! Ugh.
I'll obviously not run again until I've been pain-free for a few days, but I need to find something that stops the pain from occurring or heals this injury. I don't have a foam roller but my MIL offered me hers, so I'll take her up on it. I also just made an appt with a physical therapist, so I'll see what they suggest too. |
Anonymous
This is OP and I was writing my post when you made this one. So glad to read it!!! ProAction PT is where I just made the appointment. So great. I really hope they can help. Thank you for giving me hope!! I will see how that goes and make a not of the recommended therapist for dry needling if I need it! |
Anonymous
| Be careful where you run. If the surface cants either direction, you can irritate your ITB. For example, if you routinely run on the edge of the roadway, the foot on the edge of the road is very likely not landing level, but with the outside of your foot lower than the inside, which can kill your ITB. I had success with stretching and icing, but mostly with running right down the middle of the trail (Capital Crescent). |
Anonymous
| I've been running consistently for the last 20 years and I've had period IT band problems. Stretching has been the key for me to deal with it. It can be an awkward area to stretch. The best one is where you lay on your side on a bed our couch and let your top leg dangle over the side. I agree with others that recommend that you get fitted for proper running shoes for your gait. |
Anonymous
| I also second Pro Action. A few years back, I started a 1/2 marathon program and I just was not ready. I had to drop out when we got to about 10 mile long runs. I went to PT, learned some strengthening exercises (incl core) and cut way back on running. I was back to 1-2 mile runs. I then joined an 8K program, followed by a 10K program and am now back to running 1/2's with no issues whatsoever for the last 2.5 years. Good Luck! (Maybe swim or bike while you are strengthening your knees/hips/core.) |
Anonymous
| Oh OP I've been there- I ended up taking some time off from running and did a LOT of stretching. Was in grad school at the time and had crap insurance so never went to see an orthopedist, but thankfully the rest and stretching helped and I haven't had it reoccur since. Good luck! |
Anonymous
| OP here, and I wanted to update this thread in case someone else who is having the same issue comes across it. I saw a PT at ProAction PT in Rockville, who agreed the issue was probably my iliotibial band. She showed me some specific stretches, but also sent me to an orthopedist to confirm iliotibial band syndrome rather that some sort of knee injury. Saw Dr. Dan Pereles at Montgomery Orthopaedics, had a few x-rays and knee looks "perfect" - so just IT band syndrome. (Both he and the PT looked at my shoes, and agreed they're fine.) He gave me a 9 day course of Celebrex to reduce the inflammation, recommended a foam roller, recommended a strengthening exercise (step-ups), and said I can start running again a few days into the Celebrex. Will be seeing the PT as well for a bit for stretching plus strengthening. Once I can do 3-4 miles at a time 3 days per week without pain, I can start increasing mileage again. If the pain persists despite the PT, exercises, stretching, Celebrex, he'll do a cortisone shot. That's the plan as of now... we'll see how this goes. |
Anonymous
OP - I'm the one who recommended ProAction and Therese McNearney. I would really, really caution you AGAINST a cortisone shot. It's not going to do anything good for you other than mask your pain for a time. The pain will come back, bc the problem isn't fixed. Even with good stretches, PT, foam rolling, and anti inflammatories, I never got to the point that I could do 3-4 miles without pain. I couldn't run 10 feet without pain. It hurt when I was driving my car! Seriously, please PLEASE call Therese McNearney and see her about dry needling before you consider cortisone. She completely fixed my leg with ONE SESSION. I couldn't run a few feet in June and I'm back running 5 days a week now, 100% pain free. It feels like a miracle bc I was starting to despair that I'd ever be able to run again. |