Overuse problems of the knee :
Quads wasting with ITBS - - Posted by cat (cat), 9 April 2003
I know I used to have one! I have a BAD case of ITBS and most exercises seem to aggravate it. Any suggestions for ways to get my quad and especially the VMO back?
cat
Posted by ATsoccergirl (ATsoccergirl), 9 April 2003
What are you doing for the ITBFS?
The key is to find exercises that keep the knee straight. Once the IT band settles down, it will become really important to begin stregthening exercises for the hip also. Have any clues to what caused your ITBFS?
Posted by cat (cat), 11 April 2003
I have tried straight leg raises both with my foot straight as well as turned out. I have also tried just contracting the quad without lifting the leg and I still get that burning feeling along the side of my knee. As for what caused the ITBS, I have REALLY tight IT band, kissing knees, somewhat flat feet, and all the knee bending from Ice skating didn't make a good combo!
cat
Posted by ATsoccergirl (ATsoccergirl), 11 April 2003
I think what needs to be done (you are not going to like this), is that you need to completely shut down your IT band. You need to be in a knee immobilizer and on crutches (NWB) until the pain goes away. I have done this with many track runners with severe ITBFS. It is the only way to get over the problem. In terms of PT, you need to only have symptomatic treatments, Ice and e-stim around the band. Even better would be iontophoresis treatments on the area. Once the IT band settles down, you need to begin an aggresssive stretching routine to keep the IT band as loose as possible. Myofascial release will help release the fascial restrictions which are one of the main causes of your problem. I would say that once you have a negative ober's test, you can start really aggressive knee and hip strenthening. Once you are able to run, you need to start out sprinting and work down to jogging. THis may seem really wierd, but at the faster speeds the knee spends less time in the impingement zone, so it will cause less damage. You might also want to consider orthotics.
Posted by cat (cat), 11 April 2003
Thank you for your reply. I have been on crutches. My OS doesn't like to immobolize knees but I tried it anyway when my PT suggested it. It did seem to help, certainly more then the crutches did. The pain is alot better though not gone and I haven't been doing anything in PT but ultrasound, stim, and ALOT of stretching.(Also did iontophoresis for a while). I still don't have a negative OBer though so I guess some of the exercices will have to wait. Haven't tried the myofascial. How often would you recomend it? Also, how long do you have your runners NWB- until the pain is comepletely gone even when standing? I am at the point where it doesn't hurt at rest but does still hurt (but not too badly) when I walk or stand on it.TIA, cat
Posted by hmaxwell (Heather M.), 11 April 2003
Cat,
I'm seeing a therapist for knee rehab, and after diagnosing severe ITBS he sent me to a doctor to perform acupuncture and a massage therapist trained in Rolfing and myo-fascial release. The combination of all these, plus the stretches and PT modalities has helped calm the worst of my flare down. It still hurts below the knee, where I have a lot of scarring, but the rest of the ITB up to the hip feels much better. I was starting to get serious back and hip pain--this can all be traced back to my knee problems!
Anyway, I am doing myo-fascial release and acupuncture 3X/week for 2 weeks, then once a week for three more weeks. I've had to slow down on things that flare the ITB, like adduction/abduction weight machine, side leg raises, and biking. I also have to focus on my gait and not walk with my toes pointed up (in response to knee pain) or in (in an effort to correct my habit of walking duck-footed, which has become worse since my surgeries).
Anyway, hope this helps. Myo-fascial release and Rolfing are NOT fun to have done, but the difference is really remarkable afterward. I'm having a 90 minute session tomorrow......
Heather
Posted by ATsoccergirl (ATsoccergirl), 11 April 2003
In terms of myofascial release, I guess it depends on how often you are going to PT. I see athletes every day, so for them I used it on an every other day basis. But if you are going to PT two or three times a week, you should be okay to have it done when you go to PT. As Heather said, it is not particulary fun. But often you feel immediately better afterwards. I will keep them NWB until they have no pain. Once the pain is gone, I will allow them to put progressively more weight on the leg and less on the crutches. I will not let them off the crutches until they have no pain with standing and putting at least 80% weight on the leg.
Posted by cat (cat), 12 April 2003
Wow, in that case I'll be getting reaquainted with the crutches again. What a drag! As for the Myofascial, my PT hasn't been doing that. I see the OS tommorrow. Maybe he can add that to my prescription. Thanx so much for the replies.
ATsoccergirl BTW, what is a IT band graft? And is there something else you would rather us call you?
Heather, thanx for the foot advice. I will watch mine and see if that helps and is that 90 minute session for both the myofascial and Rolfing or just one of the two? cat
Posted by ATsoccergirl (ATsoccergirl), 14 April 2003
When I had my posterolateral complex reconstructed, my surgeon used the middle third of my IT band for the graft. I've been told, I would have less IT band problems if he had used an allograft, but I also would never be able to play soccer again. As it is, I haven't played since Dec of 2001. I will play my first game sometime in June when I work at camp.
Posted by cat (cat), 16 April 2003
Wow, I feel so whiny complaining when it sounds like you and others here have had it pretty tough. Hope you get in lots of soccer games and lots of fun this summer!
cat
Updated Sat Nov 21 2009
