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Author Topic: illial tibia tightness  (Read 2172 times)

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Offline mlanger

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illial tibia tightness
« on: November 29, 2004, 07:58:36 PM »
I have been struggling with IT tightness for 9 years and keep hearing there is little that can be done beyond stretching or surgery that has low success.  Is this true?  Are there no other options?  This has impacted my athletic life dramatically and causes constant pain.  I am ready to try almost anything.  Please help.
If you want to be comfortable, hang around people who agree with you.  If you want to grow, hang around people who disagree with you.

Offline PattiAnn237

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Re: illial tibia tightness
« Reply #1 on: November 29, 2004, 10:04:35 PM »
I had terrible pain in my IT band after surgery, at PT the stetched me all the time, it would feel better for a few hours and then the pain would come back it was like having a horrible toothache in your leg all the time!  Anyway my PT was doign something to my leg when she accidentally hit a spot on the outside of my quad and i jumped in pain, upon further investigation she found that my leg was full of knots, and she explained that when it is tight like that no amount of streching is going to help, the knots have to be worked out first.

So everynight my mom would knead all the painful spots and work out the knots (it hurt a lot and left a big bruise) then after she was done I would do a crossover stretch 4 times for 15 seconds.  After three weeks that pain started to dissapear, and now I only have pain once in a while.

So good luck, I think the massage is worth a try.  

~Patti
25 y/o
Left knee- lateral tilt, lateral tracking, arthritis
LR 8/5/04 (failed)
Diagnostic Scope- 5/2/05 (scar tissue removed)
Holding off on TTT till I can get through school!

Offline mlanger

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Re: illial tibia tightness
« Reply #2 on: November 29, 2004, 11:03:30 PM »
Patti-
 Do you still have IT tightness pain when excercising/running/walking long distances after the surgery?
 Whenever I hike down steep hills my IT's hurt something fierce.  It can take me 5 times as long to descend a hill as it does other hikers.  Do you still experience these kinds of problems?
If you want to be comfortable, hang around people who agree with you.  If you want to grow, hang around people who disagree with you.

Offline islandgirl2

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Re: illial tibia tightness
« Reply #3 on: November 30, 2004, 12:13:14 AM »
Patti, that's pretty impressive.

Offline Heather M.

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Re: illial tibia tightness
« Reply #4 on: November 30, 2004, 01:21:19 AM »
I'm just wondering if you've seen an orthopedic surgeon who is a knee specialist?  I'm assuming you have, since you discussed surgery, and will assume also that you have rejected this prospect?  My next question would be whether you got a second, third, fourth opinion?  If you are willing to travel, there are some excellent sports medicine clinics scattered around the US that likely could help you a great deal.

Anyway, I just wanted to mention that I have had severe IT band syndrome for over three years--ever since an arthroscopic surgery to realign my kneecap.  I've unfortunately learned quite a bit about ITBS in that time...it's a very painful, very persistent condition.  In my opinion, it doesn't respond well to surgery...but the very best thing you can do for yourself is to find a fantastic physical therapist who is interested in the sports you do.  For example, I found a great PT working in a private spine clinic in Scottsdale, AZ.  He was a triathlete who was addicted to golf, and one of his specialties was helping bikers, runners, and golfers with special exercises that targeted areas stressed by their favorite sports.  He saw LOTS of IT band syndrome and his regimen was very specific:  rolling on a foam roller (min diameter 7-9 inches) four times per day, acupuncture, ultrasound/phonophoresis, and ROLF massage with at least 60mins per session spent doing IT band release.  It was very important to combine the acupuncture with the ROLF work (ROLFing is a very specific, very intense massage--sometimes tears of pain and relief are involved ;)  )

Anyway, go down to the Over-Use problems section and you will find several detailed threads on IT band syndrome.  I did one thread where I put a bunch of links to other web pages, including a fantastic paper that showed both tests for tight ITB and modifications of the tests to become stretches.  I never got relief out of the standard stretches--I had to have assisted ones done.  The Ober and Thomas tests done as stretches were sublime, as was the sash/dog leash one done lying on your back (it's pictured in the article).

I'll post a link if I can find them, but basically go through the pages of threads in the over use injuries section and look for ones that focus on ITBS.

Another thing that may help significantly is the realization that what starts as ITBS can evolve into serious lateral tracking or PFS...and that involves cures beyond stretching, I'm afraid.  Strengthen the VMO to provide counter traction and do massage/therapy to release the lateral tightness and you may get great relief.

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Heather M.

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Re: illial tibia tightness
« Reply #5 on: November 30, 2004, 01:39:23 AM »
Here are some threads that I found where we discussed problems and solutions:

This one has fantastic links--definitely read the Sports Medicine article and talk to a PT about the assisted stretches, foam roller, and leash/sash exercise.
http://www.kneeguru.co.uk/cgi-bin/KNEEtalk/YaBB.pl?board=overuse;action=display;num=1048452378

The real problem for me was that my pain was around the knee, whereas most of the exercises dealt with hip pain.  So they didn't help much, although since the IT band is one long, uninterrupted piece of gristle something that helps the area around the hip theoretically helps the other areas as well...

Here is the link to the great article I mentioned--read it, print it out and take it to PT.  These exercises done properly will help you so much if ITBS is your problem.
http://www.physsportsmed.com/issues/2000/02_00/fredericson.htm

Other stretches can also help with the ITB problem:  Piriformus, rector femorus, TFL or tensor fascia latte (sp?), quad stretch (lying on your stomach or go on your side in a 'runner's stretch,' and anterior tibialis (so-called 'shin splint' area).  I have myo-fascial pain syndrome...basically, very tight connective tissue due to scar tissue and contracture of everything because of trauma.  So anything that stretches and lengthens the muscles will help:  pilates, yoga, controlled stretching every day.  You probably will want to just stretch for a while until you get things to calm down, then you can work on strength training to prevent future flares.

Another thing to seriously consider is a prescription for Lidoderm patches--they are about the only thing that helps when I'm having a bad pain flare.  They go right on your skin--kind of like a moleskin product--and put small amounts of lidocaine into the area.  They calm and cool things down--they are awesome.  The other thing which gave me great relief during a flare, in addition to massage & stretching, was phonophoresis.  This was done with ultrasound, but instead of using the ooky gel, they used cortisone cream...HEAVEN.  My last PT also mixed Bio-Freeze gel (like Ben Gay, but better) with the ultrasound gel and I got hours and hours of relief.  It was great.

Heather



« Last Edit: November 30, 2004, 07:47:26 PM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline mlanger

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Re: illial tibia tightness
« Reply #6 on: November 30, 2004, 07:29:43 PM »
Heather-
 Thanks for all the great information.  Sounds like you experience the same severe ITB pain as I do, but you've obviously done a lot more research for relief.
 I live in Tucson, Arizona and would be interested in contacting your PT in Scottsdale.  Perhaps he can connect me with a PT with his experience in Tucson.  I'll read all your threads today and get back if I have other questions.
 Thank you very much.

Matt
If you want to be comfortable, hang around people who agree with you.  If you want to grow, hang around people who disagree with you.

Offline mlanger

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Re: illial tibia tightness
« Reply #7 on: November 30, 2004, 07:37:24 PM »
Heather-
 I forgot to answer your questions:
  1.  I have met with two orthopedic surgeons, but each said the surgery was a 50/50 chance and required extensive therapy afterwards.  Neither had performed many ITB surgeries and neither could recommend a surgeon that had ITB experience so I did not have enough confidence in them to let them cut away.
  2.  I will consider surgery with an experienced ITB surgeon when I locate one.
  3.  I've only had the two opinions so far, but actively looking for 3, 4, 5th.
  4.  I need to locate the great sports medicine clinics around the US.  The few I've been to had far less information about ITB tightness than you already provided.

Thanks again.

Matt
If you want to be comfortable, hang around people who agree with you.  If you want to grow, hang around people who disagree with you.

Offline Heather M.

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Re: illial tibia tightness
« Reply #8 on: November 30, 2004, 08:01:24 PM »
Matt,

I'll send you a private message with some names.  I'm in Sedona, and unfortunately have been through just about all of the orthopedic practices in Phoenix (I lived there until last spring).  I have pretty much been to all of the best ones, and none that I found really had a lot of experience with PFS and lateral tracking, which ITBS unfortunately can fall under.  But this therapist that I worked with in Scottsdale is a true genius with ITBS.  He had people that were on crutches looking at surgery back biking and running again.  People drive from all over the state to see this PT, so I would strongly recommend that you do the drive a couple of times to get some of the basics down and work with him on finding an excellent PT in Tucson.  My ex-PT used to travel down there for bike races a lot, so I'm hoping he can help you find a good person there.

As for doctors, I finally ended up going to Salt Lake City and then Vail, CO.  Dr. Steadman in Vail is the best of the best.  You could be in no better hands.  I traveled 1000 miles to have surgery with him, and he got me walking normally again after 15 months of repeated surgeries.  Unfortunately, I have long-term problems with the IT band and other structures being scarred down, and now will likely need a big, open patellar realignment.  And Dr. Steadman doesn't do this, so he's helping me transfer my case to another doctor.  He never abandoned me, as did quite a few docs in Phoenix....

Check your inbox.

Heather

PS the PT clinic I went to also had a ROLF practitioner who worked in conjunction with the therapists and she was truly key to calming the flare of pain.  She was on maternity leave when I left, so I'm not sure if she's still there or not--she was awesome.  
« Last Edit: November 30, 2004, 08:06:21 PM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline mlanger

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Re: illial tibia tightness
« Reply #9 on: November 30, 2004, 10:27:49 PM »
Heather-
 Thanks for all the information, I'm still reading and making new contacts.  As you can see I am a microgeek, so I'm not sure where my in-box is located to check the private message and list of names...??..

Matt
If you want to be comfortable, hang around people who agree with you.  If you want to grow, hang around people who disagree with you.

Offline Heather M.

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Re: illial tibia tightness
« Reply #10 on: December 01, 2004, 12:49:58 AM »
Matt,

Your private inbox always appears on each screen--go to the very top, righthand corner of the page.  You will see in black font the words "Good morning/afternoon/evening mlanger, you have..." and then there will be words in blue font.  It should say "X# messages."  Click on the blue text and it will take you to your inbox.  Once there, you will see you have an inbox, outbox of sent messages, and a couple of other options.  The messages are there until you delete them, so be sure to clean it out once in a while to save the KNEEguru's server space.

To send a message to someone, all you have to do is click on their name as it appears in a message they have posted or sent to you.  If you are actually at your inbox, you can reply to their messages or draft new ones.  The only caution is that people's screen name isn't always the same as their member name!  So for example the KNEEguru signs her posts as KNEEguru and that is what is written on the side of each of her messages.  But to send a message to her, you have to put "Admin" in the 'to' column in your inbox.  Just a little confusing there--I avoid the problem by always finding a post from a certain person and clicking on their name as it appears to the left of their message text.  That takes you to that persons profile, and if you go to the bottom of that you will see a blue text sentence that says "Send this member a private message" or something like that.  Click on it and you will find yourself in your inbox, drafting a message to that person.

BTW, one other keyword you will want to use in looking up your condition on the link I sent you in the private message is "runner's knee" which seems to be a more common way of refering to ITBS.

Heather
« Last Edit: December 01, 2004, 12:50:26 AM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell















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