# Iliotibial band syndrome



## private_007 (16 Jul 2007)

i kind of ran into a problem the other day with a knee injury on the lateral side. anyone else with this problem and how long it takes to recover? It's been 2 and half weeks. im gonna push it to 3 before i try running slowly again. im just scared if i run into problem while in bmq. my other questin is, do they kick you out if u injure yourself during bmq or do they have their own doctors who try to help you out to get you back on track.


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## BC Old Guy (16 Jul 2007)

How bad was it hurt?  Did you see a doctor when you got hurt?  Knees are important, so do what you can to keep your knees healthy.  Work up to any exercise very carefully.  If you belong to a gym, talk to the trainer, and try working out on a treadmill, starting with a walk, before you start running.

     If you get injured on BMQ, the medical staff will assess your injury, and provide the medical care to heal the injury.  However, you will be pulled off training if the injury is of any significance at all, and time awaiting training is not the most pleasant.


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## private_007 (16 Jul 2007)

it doesn't hurt. it hurt the first day and the pain showed up after like 5 min into the run post injury a few days later. so i got worried and now im off of running for about 2 and half weeks. i can walk, run up stairs, and have normal flexion and extension at the knee.
but this syndrome i heard comes back again and again so it's kind of a depressing thought.


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## Command-Sense-Act 105 (16 Jul 2007)

007, here are some answers that may help:

Iliotibial band friction syndrome (ITBFS as some journals call it) is usually a chronic condition exacerbated by the body's normal physiology, usually which causes an alignment problem that causes the band to become irritated and painful as it rubs back and forth on the outside of the knee joint when the knee is repeatedly flexed.  Recovery really varies a lot between person to person.  Some self-aid methods include icing it after activity and when showering, running hot water, as hot as you can stand, for an extended period on the affected area.  Professional medical treatment may see anti-inflammatories prescribed and the use of ultrasound on the affected area to heat it from inside the body and relax/stretch the tendon.  There are a number of stretches you should also be doing to help yourself as much as you can - do these before and after activity, first thing in the morning and last thing at night, as a minimum.  Info on ITBFS and some good stretches are in here:

http://www.time-to-run.com/injuries/thebig5/itb.htm
http://www.drpribut.com/sports/spgait.html
http://www.ourfootdoctor.com/yourfeet_iliotibial.shtml
http://www.ovphysio.com/injuries/runners.htm
http://www.coolrunning.com/engine/2/2_1/126.shtml

A major ITBFS cause for a lot of people is a mechanical or alignment problem, which, if not corrected, will cause it to recur.  Make sure you have good shoes, not worn out, properly fitted and suited to your foot's arch and your footstrike/walk/stride method.  This is the first step and often the most important, particularly if you have just started running, changed your physical activity level or other aspect of your training.

If you have not had a foot-strike or gait analysis done, get either the military physiotherapists or a reputable shop (Running Room is good) to do one for you to recommend shoes if a change in your footwear is required - even if brand new, the wrong shoes for your pronation pattern and weight distribution will injure you.  If you can, go to the Running Room (10% discount for military) and chat with the folks there - someone may be able to look at the way you run and make some recommendations.  I find the staff there to be usually very knowledgeable, ready to sell you the right shoe, not just the most expensive one.

If you can't run while you are healing, get on the elliptical runner, stationary bike and start swimming.  You should balance these activities with each other anyhow and swimming is a fantastic way to stay whole-body fit, no matter how good a shape you are in.  One method many believe is best to burn fat is the LSD - Long Slow Distance method.  Work at 50-60% of your max heart rate (normally 220 minus your age will give you an approx MHR in beats per minute) for a sustained time of 40+ minutes per session.  However, there are differing opinions out there - http://www.findarticles.com/p/articles/mi_m0846/is_7_24/ai_n13606403.  In either case, sign out a heart rate monitor from PSP or buy one (Polar is the best brand I have found) which will let you make sure you are putting the proper effort into your workouts but not overtraining, and get one of the fitness instructors to work out a program for you.  Do circuit training and calisthenics as well, and jump rope if you can based on your pain tolerance.

Look at this and other sites to learn more about the biomechanics of your legs and feet - http://www.drpribut.com/sports/sportframe.html.  
There are lots of methods out there, but don't injure yourself needlessly.  FYI I am a long-time runner with some fairly serious lower limb issues that cause a lot of pain if I don't take care of them.

I would not buy any shoes from a place like Athlete's World, SportChek or Footlocker, particularly if you are unsure of what you are looking for as the salespeople in these places are usually not very knowledgeable and they deal more in 'fashion' athletic shoes than 'real' runners.

If you are heavier and have an over pronation issues, you need a motion control or stability shoe, if you under-pronate you need cushioning.  A lot of people do not have a neutral gait.  Here are some good resources to read up on pronation/supination:

http://www.thefinalsprint.com/2006/12/foot-type-pronation-and-the-choosing-the-right-shoes/
http://www.runningwarehouse.com/learningcenter/PickShoe.html

I find New Balance to be the best in terms of options, sizes including width differences and a lot of their shoes are stability/motion control.  I have tried Brooks, Adidas, Fila and Mizuno, but sworn by New Balance shoes for more than 10 years now (with Mizuno a close second as a backup pair).  Many New Balance models are particularly suited to heavier runners as well.  Browse through the shoes under "motion control" and "stability" for a look.  

http://www.newbalance.com/productbrowser/product.html?product_type=shoe&gender=Men&sport=Running

Your shoes will break down inside and become worn out even though soles and outsides will look functional - depending on the amount you run, you may get as little as 6 months from a pair.  My knees always let me know when it's time to start thinking about a new pair.  You should try to overlap your shoes - when you get new ones, run in them a little at a time as they may give you blisters or some pain when you are first getting used to them.  If you only run occasionally you will get more life out of them.  It can be expensive, but with running shoes, if you have foot/knee/alignment/pain problems, you get what you pay for - you can run in $20 shoes from Giant Tiger but may pay for it in pain.  

If nothing works, you may be prescribed orthotics, which will help to mechanically align your knees, legs and feet and keep the ITB from rubbing so much and becoming painful. 

As far as being kicked out, you will not be medically released until every effort has been made to fix the problem.  That being said, YOU are a big part of the solution, so you will need to work hard, listen to the docs and help yourself.

How do I know all this?  I've had ITBFS for more than 10 years now, but have managed to control it with proper shoes, stretching, maintaining high activity level, orthotics and knowledge.  It hasn't stopped me from jumping, doing the Petawawa Ironman or other soldierly activities.  You can work to fix it, with some medical help.  The ball is in your court.  Best of luck, hope you can solve your problem soon.

Final note about your post, just some friendly advice:  Punctuation works well.  Use more.  Capitals start sentences and periods end them.  Use the Spell Check button before you post and cut down on the "MSN Speak" - on this board, it's "you" not "u".  Welcome.


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## private_007 (16 Jul 2007)

Thanks for the advice. This is probably the best advice I have heard from weeks of research. By the way, I don't run on pavement or concrete ground at the moment. I play soccer so I usually use my soccer cleats to run on grass around the field. My symptom came because of overuse i believe and not my biomechanics. I have been running for long time but i felt the pain that day because i was outside from 3-10 playing tennis, walking long distances, and then biking and then playing soccer and then biking again. So, I'm just gonna give it a try probably tomorrow night and run for about 5 minutes for self-analysis. If anything feels wrong then I'll go to doctor. If things work out fine then ill try to just cut down on intensity level until i can gradually build it up.

By the way, do you run and if so for how long?


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## Command-Sense-Act 105 (17 Jul 2007)

I thought it was obvious from my post that I ran...

Normal training runs between 6 and 10k, long training runs up to 15k.  Training for the Petawawa Ironman 15-25k.  I've never run a marathon and am not a marathoner, but I do run long distances and carry heavy things.

http://www.army.forces.gc.ca/LF/English/6_1_1.asp?id=800
http://www.youtube.com/watch?v=-LvJdoaA-W4&mode=related&search=
http://forums.psppetawawa.com/forum/messageview.cfm?catid=18&threadid=2911&enterthread=y

If I were you I'd get your biomechanics looked at anyhow.  If ITB flares up after 5 minutes, you've got something wrong that needs to be fixed.  Even if you are a soccer player, your pacing and the body demands between the quick-burst sprinting required for soccer and the extended pounding and flexing from distance running is different.

But hey, what do I know?  I am sure when you explain to your course staff or platoon MCpl that you "don't run on pavement or concrete" he will understand and let you run in grassy locations only...


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## private_007 (18 Jul 2007)

I ran today after doing a 20 minute biking. It's my first day of run after the injury 3 weeks ago, so I only ran 5 minutes and had the ability to run more but I don't want to make the same mistake I made before twice.
I will try to get a good pair of shoes as you suggested so after a few weeks I can run on sidewalk and whatnot but i don't want to flare up another injury before training so i think its crucial that i just keep my endurance level and fitness level at proper and not push myself to the limit here.
My goal at the moment is not to go over 15 minutes of running. This is 'just to b safe'.


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## Command-Sense-Act 105 (18 Jul 2007)

If you can, I'd suggest swimming.  Almost zero stress on knees and legs, keeps your hip flexors limber, your back strong and shoulders and arms used to resistance.  Also helps your cardio and to discipline your breathing.  When I first discovered, the hard and stupid way, that I had ITBFS in 1996, I'd hobble my way over to the pool on my crutches and get into the water - it worked.


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## private_007 (18 Jul 2007)

I'll keep the suggestion in mind. If you have any and i mean ANY other suggestions for me that might help me get through basic military qualification and other training to come i would really appreciate it. Any kind of workout routine that doesn't involve weights. I usually do bodyweight exercises. Any kind of suggestion not just related to workout, but anything would be great.
Thanks a lot of taking the time to help me out.


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## Command-Sense-Act 105 (18 Jul 2007)

A selection of info:

http://www.brianmac.co.uk/circuit.htm
http://www.sport-fitness-advisor.com/circuittraining.html
http://www.cmcrossroads.com/bradapp/docs/rec/stretching/
http://www.building-muscle101.com/weight-lifting-routines.html
http://www.crossfit.com/
http://www.t-nation.com/findArticle.do?article=04-046-training
http://www.pponline.co.uk/encyc/plyometric-exercise.htm
http://www.gymjones.com/knowledge.php?id=35



More ITB stretches - http://www.nismat.org/ptcor/itb_stretch/

Google can be your friend.


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## TCBF (18 Jul 2007)

Command-Sense-Act 105 said:
			
		

> If you can, I'd suggest swimming.  Almost zero stress on knees and legs, keeps your hip flexors limber, your back strong and shoulders and arms used to resistance.  Also helps your cardio and to discipline your breathing.  When I first discovered, the hard and stupid way, that I had ITBFS in 1996, I'd hobble my way over to the pool on my crutches and get into the water - it worked.



- I sure wish I had access to this in Zgon in the summer of 2000.  Your posts are the best "Concentration Of Force" against ITBS I have seen yet.  I thank you for your time and effort.


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