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T I Band syndrome remediation
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jkbond posted:
I've been having trouble with my knee for a while and my doctor has diagnosed my problem as IT band syndrome. She has recommended exercises to stretch the hamstrings and also the use of a foam roller to loosen the band. However I'm not sure I understand what this is or how it works. I'd be interested in anything that you could tell me about how to use the foam roller and also about any other exercises that might help with this problem.
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Rich Weil, MEd, CDE responded:
Here's the best image I could find for you http://runningtimes.com/Article.aspx?ArticleID=9911 Keep inm ind that this type of work can be very painful, and you may be disinclined to do it because of that. Maybe you can try it out somewhere first, like at your gym or a sporting goods store. An alternate to the roller is to have a massage on the ITB followed by ice. You can have a professional massage or have a family member massage it for you at home. Massage followed by ice for 10-15 minutes really works best for ITB syndrome. Good luck. Rich
 
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RoyPT responded:
"IT Band Syndrome" refers to a long tendon that arises at the top of the pelvis, attaching to both the gluteus maximus and tensor fascia latae muscles. It then runs along the side of the thigh and inserts on the outside edge of the tibia, inferior to the knee joint.

This syndrome, typically, is an overuse problem arising from people pushing themselves too far, too fast. It is mostly seen with runners, cyclists and long distance walkers, but it can definitely cross into any sport spectrum.

I am a Doctorate of Physical Therapy (candidate), practicing now for 5 years and a Fellow of the American Academy of Orthopedic Manual Physical Therapists. IT Band Syndrome is a medical diagnosis that I commonly see walk thru my clinic doors. From my professional experience it rarely needs surgery. Conservative treatment, usually, is very successful for this diagnosis; with only one caveat. It is imperative that the CAUSE of the pain be resolved first in order to prevent any reoccurrence. Causative factors could include: poor hip/knee tracking, muscle imbalances, muscle weaknesses and even lumbar nerve root pathology. Which brings me to my next point.

Medical Doctors, although highly qualified in the micro-biological pathology, are not trained in the macro-biological movement sciences. In layman's terms, MDs are versed in providing clinical diagnoses that describe symptoms but fail to provide any causes to the problem itself. Case in point, your MD recommended use of a foam roller and hamstring stretches; which only addresses the symptoms BUT NOT THE CAUSE. Physical Therapists are highly trained doctorate level professionals that can examine, evaluate and diagnose the musculoskeletal system as a whole. Fear not, Physical Therapists are also trained to medically screen and detect for any red flags. If need be, we can then collaborate with your MD to discuss any pertinent findings.

After performing the initial evaluation and differential diagnosis a Physical Therapist will provide a "Movement Impairment Diagnosis." This diagnosis will guide all physical therapy interventions to treat the cause of your pain for long term results. In your case it might be probable that the interventions will necessitate strengthening of the gluteus maximus/medius in combination with manual therapy to improve joint mobility/tracking of the lumbar, SI, hip and knee chain to decrease the stress being placed upon the IT band.

However, this can only be accomplished by seeking THE ONLY qualified provider that can diagnose and prescribe a movement impairment diagnosis; a Physical Therapist.

Another important point. Consumers, in 49 states, can directly consult with a Physical Therapist without a physician referral. If the physical therapy profession is vague to you, please visit www.APTA.org to find a provider near you. You may also visit www.aaompt.org to find a Physical Therapist near your area that is fellowship trained in orthopedics.

I hope this information is helpful and that everything works out well for you. If you have any questions or concerns please do not hesitate to ask.

Roy D. Garza, PT, DPT-candidate, FAAOMPT
 
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jkbond replied to RoyPT's response:
Thank you for a lot of interesting information!!
 
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HeidiM84 responded:
Hi!
Foam roller work really helps to loosen the whole IT band and is bst used in conjunction with an inbetween professional massages. You can also stretch the IT band although it is a tricky one to do.
You can also buy an IT band strap (runners knee strap) which sits just above the knee to apply pressure to the band and reduce the flicking back and forth across the outer knee.
You can find example stretches and more IT band syndrome rehabilitation exercises here.
 
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RoyPT replied to HeidiM84's response:
The IT band cannot be stretched. It's a type 3 collagen fiber and research has proven that it takes anywhere from 21 to 142 kg of tension to even begin to stretch the IT band, and if you are able to achieve this kind of tension you will more than likely rupture it. The IT band is a very, very strong structure; make no mistake about it. There is some thinking out there that maybe the foam roller can be used to elicit a parasympathetic response resulting from chronic IT band issues. However, considering all said; that is, stretching, icing, use of runner's band you are still NOT addressing the underlying cause. Believe me when I say this, time can heal injuries but they will reoccur with greater frequency if not the cause is not found and fixed.


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