Breaking Runners Knee : How I defeated Iliotibial band syndrome

I've spent the past year and a half struggling with Iliotibial Band Syndrome (ITBS). It developed soon after I began participating in sprint distance triathlons.

I'd put the blame on a combination of over-training and a very weakly structured stretching routine.

Initially ITBS materialized as severe localized pain to my outer patella.

For more on ITBS check Wikipedia.

For Liability Purposes Please read the following Statement.

I am not a medical professional, nor claim to be. I claim no liability in the event you attempt these techniques and they either do not work for you are seem to worsen your condition. Seek professional medical advice from a doctor or orthopedist prior to any change in physical regiment. The information posted on this blog has been distributed through the blog for "the common good" and to further the exploration of potential solutions for Iliotibial Band Syndrome.

A Short and sweet solution

I recommend the combined use of pilates bands and a foam roller to tackle ITBS. The issue I experienced is related to under-developed hip flexors. My working assumption is that the lack of strength in my hip flexors caused a tightening of my ITB. Since the ITB has an attachment point on the outer patella, this explains the pain.

Technique:

Pilates bands should be tightened around your ankles such that you can execute a "side leg raise".

The side leg raise is the exercise being conducted by the guy in this video. Note, I use the pilates bands should be around my ankles.

I believe that by adding resistance to the side leg raise better strengthens the hip flexors, thus solving a possible underlying issue to ITBS.

The Journey

I started the journey by using an IT strap with RICE.

The IT strap and RICE worked for a couple of weeks but the pain persisted after training. The pain then manifested itself as, what I can only call, "general knee pain".

I could hardly walk up and down stairs. My roomates described the experience of watching me go up and downstairs to that of an 80 year old man that needs a knee replacement surgery.

Something had to be done. I scheduled an appointment with an orthopedist, but it was going to be 3 weeks before the appointment; I returned to the internet.

After typing in a couple of queries that described my pain, all sources strongly recommended using a foam roller to conduct self-myofascial release (SMR). I quickly acquired one. The benefits were instant relief with a gradual return of the pain after, roughly 4 hours.

During my appointment with the orthopedist, I placed my self-diagnosis on the table. The doctor asked some addition questions and did some flexibility tests and confirmed my diagnosis. He gave me a topical cream and some stretches to do. I was told that if this didn't work an MRI would be required next, followed by a cortisone shot, and finally knee surgery.

This seemed like an excessive progression of solutions in an attempt to manage pain. I did what I was told, and it seemed to be ok for a little while. The post-run pain returned. It was at this time that I had decided the attention seemed to be on the knee itself instead of the parts of my body that could also be causing the pain.

Continued SMR with the foam roller took care of the pain during exercise. After a run, the pain would return after 4-5 hours. Additional research into SMR lead me to a series of youtube videos featuring chiropractors. This video was the best of the batch. My use of the foam roller was woefully inappropriate. After modifying the technique, pain relief worked but again, for a couple of hours the pain would return when I was sitting at the office.

For some reason, pain building while sitting lead me to re-examine the problem. Some literature about the "kinetic chain" lead to a conclusion that the problem was really rooted some place else. This entire time, I've been focusing on mitigating symptoms not the underlying cause.

Returning to Wikipedia I examined the Illiotibial tract. Something above the ITB was causing it to tighten and pull on the bones outside of my patella.

Moving my attention upward, it seemed the problem was based up around the hips. Other advice columnists recommended using yoga as an option. After reviewing some of the exercises yoga proponents claimed worked, it looked like improving and strengthening the "core" (hips) was a key component to success.

While examining yoga products at Target, I noticed pilates bands. Instantly, I decided this was the route to take. After using the bands for a week or two, along with SMR, I decided to conduct a "test run". The run consisted of a 9 minute mile pace for 40 minutes. It worked.

I currently enjoy the ability to both run and bike without any type of debilitating knee pain.