IT Band ideas

[Catrin]

My IT band is very cranky right now, and I am looking to expand my toolbox of IT band stretches. I am foam rolling religiously and also doing hip/quad/hamstring stretches. Are there other way to directly work with the IT Band outside of foam rolling? It doesn't feel bad today, but there is still some numbness in it from yesterday and, of course, my knee is cranky in the same place it always is with my IT band acts up.

[Irulan]

What stretches are you doing?

[Catrin]

What stretches are you doing?

I don't know the names so I will describe them:

IT Band: Foam Rolling
IT Band: Lying flat on the ground, extend one arm straight out on the ground perpendicular to the body. Bend the leg on that side and with the opposite hand draw the knee up and across the body which gives a nice IT Band stretch.

Hip: Standing - cross one foot in front of the other and lean forward while pushing the hip out that is opposite of the foot that crossed in front of the other

Hip/Hamstring: (I think): Tailor stretch (either standing or lying on the ground)
Hamstring: usual straight leg stretch with the leg elevated

Quad: Standing on one foot and drawing/pulling one foot back to my glute while keeping the leg/knee vertical.

It didn't help that I went a few days without my prescription anti-inflammatory which is probably part of this as well - I am back on it. I was doing SO well that I thought I could go without it. Meh.

[Aromig]

Have you tried a rumble roller? I hit a point where the normal foam roller just didn't do enough - but the rumble roller helped. It's the same rolling technique.

[Catrin]

Have you tried a rumble roller? I hit a point where the normal foam roller just didn't do enough - but the rumble roller helped. It's the same rolling technique.

Not heard of this (http://www.rumbleroller.com/) before. I am trying not to buy anything new but will keep this in mind. Thanks! It looks like it could be brutal....errr...effective! I do need to get a couple lacrosse balls for T-Spine mobility exercises and will see who might carry this locally.

[OakLeaf]

You're already doing all the hip strengthening exercises - focusing especially on the TFL, glute medius, and adductors?

[Catrin]

You're already doing all the hip strengthening exercises - focusing especially on the TFL, glute medius, and adductors?

What is the TFL? My trainer has me doing a series of corrective exercises that focus, in part, on my glutes and adductors. After my recent physical assessment he moved me from easier correctives to more advanced/robust versions. He may have me focusing on the TFL as well, but I am unsure what that is...

Edited: I looked it up :) It looks like one of my usual post-ride stretches are for the TFL, but I found some a couple of other TFL exercises here (http://www.livestrong.com/article/343895-tensor-fasciae-latae-muscle-stretches/?utm_source=RELARTICLES_R1) though I will see if I can find something other than just a text description.

My IT Band has calmed, and my knee feels better than it has in over a week, but I still have odd sensations up where it connects at the hip. I did some mobility exercises this afternoon that focus on the hips and that seems to have been beneficial. The TFL diagram makes it appear to be located right where I still have some numbness and odd sensations. I will see what other exercises I can find for the TFL that I can add to the mix.

I think I was dehydrated during my ride yesterday, and that probably didn't help, though I probably can't blame this on not drinking enough. I didn't get around to emptying my hydration pack until today and it doesn't look like the water level went down at all during that hilly, chilly 28 miles... I do have a problem remembering to drink in cooler temps.

[OakLeaf]

It's the little hip flexor/abductor/internal rotator that feeds into the proximal anterior ITB. I think in most people it's more likely to be inflexible than it is weak, since it's a primary walking muscle, but besides making sure to hit it with the foam roller, you'll want to balance internal vs. external rotation, and abduction vs. adduction.

[Catrin]

It's the little hip flexor/abductor/internal rotator that feeds into the proximal anterior ITB. I think in most people it's more likely to be inflexible than it is weak, since it's a primary walking muscle, but besides making sure to hit it with the foam roller, you'll want to balance internal vs. external rotation, and abduction vs. adduction.

This makes sense, and all of my correctives are addressing flexibility/mobility issues. And, of course, it is indeed THAT leg that had all of the over-use injuries a couple of years back... We do have a PVC pipe at my gym wrapped in tape when we need to roll with something more...aggressive than foam. I will hit it before my group training session tomorrow morning. I am very glad my knee responded to the hip mobility work I did this afternoon. I knew it was really from the IT Band, but that just confirmed it for me.

[bluebug32]

If you're taking an anti-inflammatory, that can slow down healing time, as the body needs some inflammation in order to heal. I don't know how much or how often you're foam rolling, but if you're doing it too long if your body's not used to it or applying too much pressure too soon, you can actually inflame the IT band. You want to roll slowly, pausing and sinking into the sore places.

I had chronic ITB problems that were ultimately attributed to a poorly fitting bike. A combination of bike fit, acupuncture and massage ultimately cleared it up. In the short term, I would try ice and rest or at least backing off on the time/intensity of your workouts.

[Catrin]

Thanks for the rolling tips Bluebug, I am used to doing it and it sounds like I'm doing it properly. The IT Band isn't a chronic issue, I just did something silly a week or so back that caused it to flare. I had bad over-use injuries in that leg two years ago and when I do stupid things one of them flares :( I know what I did to cause it though, and I WON'T be doing that again!

[Catrin]

There is a physical therapist that comes to my gym once a month for a short clinic. This is free to us, and depending on what the issue is, provides a quick evaluation to let us know if we need to focus on more correctives or if PT is on the agenda. I signed up this evening to at least have a professional eye check out the situation just to make certain I am not ignoring something that I will regret. BTDT

He didn't think I need PT, but more correctives added to my list for adduction/abduction, and single-leg squats (and squating in general) to build quad strength to help my knees out. Silly me, I thought my lower body was strong already - but he tells me my favorite leg-press machine is really using hip strength, and that riding is more about muscular endurance than quad strength. It made sense when I thought about it - and I haven't done much climbing this year anyway with my recovery from last falls injury.

So I have my marching orders - it won't be difficult to fit in more correctives into my list...that list is getting a little long! Better than the alternative however, so no complaints.

[Irulan]

All my supposed IT band issues and knee pain went away after about a year of doing the kind of training we've all been talking about. Single leg work really helps all that stuff down there.

[Catrin]

All my supposed IT band issues and knee pain went away after about a year of doing the kind of training we've all been talking about. Single leg work really helps all that stuff down there.

Thanks Irulan, it helps to know that. It was feeling much better this summer - but I think the mtb fall last month had such deep bruising that it brought to light some weaknesses. It is true that where my IT band is sore to the touch just happens to right where I had the worst bruising.

We don't do much single leg work in the group training - at least not since I've been around (not quite 3 months). I can easily add single leg air squats to my usual correctives, the PT gave me a couple of ideas about a goal to work towards regarding how deep to aim for.

[indysteel]

Was the PT named Bryce by chance (tall, trim, bald man)?

[Catrin]

Was the PT named Bryce by chance (tall, trim, bald man)?

Yes it was! Do you know him?

[indysteel]

He's the PT I saw for both my hamstring tendinitis and for my hip/butt/groin issues.

[Catrin]

He's the PT I saw for both my hamstring tendinitis and for my hip/butt/groin issues.

I wondered when you asked if that was him, that is a mark in his favor knowing you've seen him twice.

[indysteel]

I've had good luck with him, minus a few minor issues. He likes to try new things/gizmos here and there and some work better than others. At least once, I had to basically ask him to stop. But I otherwise like him and his office administrator especially since he's pretty one on one. If you ever want a downtown PT, I'd consider him.

[Irulan]

T

We don't do much single leg work in the group training - at least not since I've been around (not quite 3 months). I can easily add single leg air squats to my usual correctives, the PT gave me a couple of ideas about a goal to work towards regarding how deep to aim for.

I always know when it's ski season as we start to do more single leg work than the other parts of the year. Single leg squats, single leg deadlifts and slams, single leg bounding, step up and so on: all of these will help.

[Catrin]

I always know when it's ski season as we start to do more single leg work than the other parts of the year. Single leg squats, single leg deadlifts and slams, single leg bounding, step up and so on: all of these will help.

He got my attention when he told me that neither of my kneecaps are where they are supposed to be...so I will certainly focus on this so I can give my knees the support they need. Now that I think about it, we have done single leg deadlifts with the kettlebell. Irulan and Indy, thanks for your comments!

Since this most recent flare is related to my mtb crash last month, I am going to hold off on trail riding until the hip/knee/leg is calm again. The new tire might decrease the chance of my crashing, but my crash/ride ratio is pretty high (when I am not crashing?) and THAT leg/knee/hip always takes the hit, or at least 99% of the time it does. I hate to back off, especially since I've not yet tried out the new tire, but it seems wise. It is also probable that my past crash/injury rate is causing me to second-guess myself on the trail instead of fully committing - which of course increases the odds of crashing. It is a bad cycle and I am unsure how to break it - but the first goal is to calm down the current flare. Thankfully my group training activities makes my leg/knee feel better, as long as we don't do more than short sprints.

[Catrin]

No WONDER that knee is having problems! Before I started on the single leg squats, one of my trainers at the gym suggested I check out my single leg strength on the leg press and I promptly embarrassed myself...

With both legs I can press close to 3 times my body weight for 6 reps (360 pounds) - this is the leg press that uses plates, no cables. On the Free Motion squat machine (cables) I can squat twice my body weight @ 260 pounds (12 reps). With THAT leg alone? I was able to press only 45 pounds, and I felt that where the quad meets the knee at the upper inside left of the knee. I tried the same 45 pounds with my other leg and it was like I was pressing air. Apparently my left leg has been doing far more than it's share of the work and in a major way...

So no single leg squats until I can press my weight with that leg. I've been told this will take some time to strengthen, but I've a plan now, and there are single-leg TRX exercises I can do that doesn't require quite my entire weight. Also focusing on abduction/adduction to make certain everything is good up-stream. It is good to have a plan. I think this leg will probably require special attention in the future, all those over-use injuries 2 years ago left their mark by leaving weaknesses the other leg doesn't have. That is NOT a complaint - I've come so far in the last couple of years, and part of this is the consequences of spending too many decades not moving.

[goldfinch]

I have a weak left leg too. What exercises are you planning on do for it? What are single-leg TRX exercises?

[Catrin]

I can't remember if you go to a gym or not? The first 2 don't require gym equipment, second two can be modified if you don't, Remaining three require access to a leg press machine and a TRX/suspension trainer of some type.

Mountain climbers (I HATE these, but they are great for guads and hips and my lower quad is the problem)
Two-legged air squat, hold it for 1 minute (must be really warmed up)
Split-jump overhead squats - though you can probably get good benefit if you leave out the overhead weight.
Single leg deadlifts with either kettlebell or dumbbell

Single leg presses (10 reps x 2) - haven't decided if it is best to do these before or after my full/regular leg presses

If you have access to a TRX or other suspension trainer (thankfully we do at my gym for no extra cost)

Single leg chest press
Single leg squats depending on how weak that leg/quad is

There are some other TRX exercises that are also good, if you have access to a suspension trainer let me know and I will post them. Of course we need to do these exercises on both sides :)

[Irulan]

There are a lot of things you can do that aren't weight based that will help with stability, knee and strength issues.Single leg step downs are excellent and do not require a lot of strength.

http://youtu.be/ReJJzlp0eeU

[Irulan]

So no single leg squats until I can press my weight with that leg. I've been told this will take some time to strengthen,

You couldn't do this? I'm not talking about adding weights. This is another one to build knee stability etc

http://youtu.be/RoSgmoRAanA

[OakLeaf]

Single leg step downs are excellent and do not require a lot of strength.

If you say so ... The guy in the video is doing them with decent form, but you see how much his leg is quivering after three reps, trying to keep his knee from dropping in. I wish there was narration with the video, to emphasize how important it is to keep your knee from dropping in. That's the point of the whole exercise.

I never do single leg step downs in group class because they require more abductor strength than most of my participants have. I had a LOT of trouble with them when I first began. Start with clams and side leg raises on the floor, progress to side steps and single leg side leg raises with a stretchy band (always remembering to keep your toe and knee turned slightly in when doing side leg work, to make sure your abductors are doing the work and not the quads). I wouldn't recommend single leg step downs until someone already has good strong abductors.

[Irulan]

I didn't spend a whole lot of time looking for the "best" video. All I know is that I had supposed IT band issues for years and after 6 months of doing single leg stability work 10 years of knee pain was gone.

[OakLeaf]

Oh, no, I'm not disputing for a minute the value of single leg stability work. Not only for muscle strengthening, but equally for proprioception and fascia training - if I've been neglecting my single leg calf raises, it only takes one or two sessions to improve my Achilles in a major way.

I'm just saying it DOES take a decent amount of strength and it's not really a good place for a beginner to start.

[Catrin]

I am no worrying about IT band issues here as that appears to have been a red herring - but building lower quad strength in that leg. The PT I saw said the problem with my knee is directly due to not having enough lower quad strength in that leg to properly support a patella that wants to go "walk-about" from time to time. I am already doing clams (on both sides) and side step ups aren't normally a problem (though they hurt when that knee is flaring, like now). My focus right now is to focus on quad strength and adduction/abbduction to provide proper support - I only do these things on days that I don't have a group training session.

Thanks for the video Irulan, I've been expressly told to not do "free standing" single leg squats at this time by both PT and my 2 trainers because it is too easy for the knee to go where it shouldn't go - I've been cleared to do TRX single leg squats, but not free standing. And to do that safely, my leg has to be able to bear my weight. I've tried it a couple of times and...it wasn't pretty.

I was at first resistant to the idea that this was all related to quad strength given my leg press/squat max weight (how can I have a weak quad if I can do...) but they have the degrees and experience to know what they are talking about, and they've helped me improve in so many other ways that I trust their advice.

I agree that single leg stability work is very important, and for more than one thing. I have no problems at all doing such work with my left leg, but with my right? It isn't a pretty sight, but I will incorporate more of this outside of group training as the quad gets stronger.

[Catrin]

Whooo hoooooo! My knee is finally recovered :) All it took was to stay off the bike for 2 weeks... I've been working with it in other ways of course, but apparently even easy spinning with it during that "tweak" was keeping things flared. This is pretty interesting to me considering the wild stuff we do at the gym that doesn't, apparently, bother it - but riding did. Anyway, back to the bike now - whewwwww

Of course, NOW it is time to pull out all of that thermal stuff, but that is, after all, why I have it!