Your ITB Syndrome Experiences

[JtB]

I’ve not been cycling regularly for several months due to lower back and leg pain, and the physiotherapist seems to think I have ITB syndrome. I know there are several people here who have had ITB syndrome and I’d be very interested to get their experiences because this is taking ages to sort itself out.

It all started towards the end of April while I was out walking and not paying attention to where I was stepping when I stumbled into a pothole at the side of the road. Luckily I didn’t fall over because the lovely Mrs JtB caught hold of me but I did twist / pull my lower back.

Initially I had a number of telephone consultations with my surgery’s physiotherapist and he gave me some back strengthening exercises to do which didn’t help. Then about 3 weeks ago I had a “face to face” consultation with the physiotherapist and he gave me a number of exercises and stretches for ITB syndrome.

The pain is on the left side, predominantly in the lower back, round the top of the leg (both the outside and groin area) and down the outside of the leg (to knee level). After getting out of bed in the morning the pain very quickly builds up but it’s difficult to tell which is actual pain and which is radiated pain. The strange thing though is that I take a single Ibuprofen before breakfast and most of the pain has then disappeared by the time I stand up after eating my breakfast. It doesn’t disappear completely but it remains tolerable for most of the day.

When I saw the physiotherapist he also identified a bit of clicking in the hip joint and one of my concerns is that part of the pain might be due to the hip itself, but it’s difficult to tell whether any of the pain actually originates in the groin area or if it’s radiated pain. On the plus side, I don’t have a history of hip pain so I guess it’s probably not due to general wear and tear of the hip joint.

The situation now is that apart from the gentle exercises / stretching prescribed for the ITB syndrome and a bit of gentle walking I’m not really doing any physical exercise. It’s really driving me nuts though because I’ve only just retired and I want to be out enjoying the great outdoors. My concern however is that I don’t want to do anything that aggravates the IT Band, but I’m just not good at “relaxing”.

I’d be very interested to get other people’s experiences on ITB syndrome and whether they can relate to any of the above. Also what did other people do (and avoid) to facilitate their recovery and how long did the recovery take?

Many thanks in advance for any insight.

 

[vickster]

Has the physio actually given you any hands on treatment? Ultrasound, dry needling, massage?
If not, pay for a private sports physio who offers this or could try a sports massage to relieve the tightness.
maybe get a hip X-ray too

Can you swim instead to maintain your fitness? Doing rehab in water is fantastic too

 

[Buck]

My experience of ITB problems has always been on the outer side of my knees and always as a result of walking/hiking whereby descending from hills was excruciating.

My physio advised foam roller work to ‘stretch’ the ITB and relieve the tightness also some general leg stretches and manipulation. This will give you the best improvement rather than post issue medication.

Unfortunately, I am not able to take any NSAIDs such as Ibuprofen so limited to external gels and paracetamol when needed.

I don’t get any issues by cycling which is good!

 

[midlife]

I thought ITB was a knee thing?

 

[Edwardoka]

My experience is similar to that of @Buck - during a flareup, the pain is almost all felt on the outside of the knee, although there is discomfort where the IT band joins the hip if I apply pressure there.

Unlike @Buck, I find that my flareups happen instantly, by riding in too high a gear, I feel something go "pop" and for a few weeks/months I can still ride a bike, but in very limited intensity and duration. 10 miles becomes uncomfortable. By mile 20 I'm in agony.

Do you have any tingling sensations running down your leg or numbness in your feet or toes? Going solely from my own experience, lower back pain on one side going down the leg sounds more like sciatica.

 

[T.M.H.N.E.T]

I thought ITB was a knee thing?

Usually is as it passes directly over the lateral condyle (the bony outside bit) but that can be instigated anywhere from the foot to the hip, where you have instability or tightness in one of both of those areas, the knee joint and the repetitive motion of it, is quite often the weakest point.

No amount of foam rolling etc are going to do much to address it if you're not directly addressing the cause. *I had a serious case of ITB syndrome a few years back, I was counting upwards of 25000 steps per day in work on my watch, and all 25000 of them hurt. Went to A&E believing that I had done serious damage that would show up on xray only to find nothing, yet the issue continued.

I actually needed to see a podiatrist for insoles to be made, which I now copy in my cycling shoes + made a fairly major tweak to my cleat setup (slammed back + lowered saddle height relative)

 

[Buck]

I thought ITB was a knee thing?

your ITB runs the full length of your leg but symptoms tend to be more prevalent around the knee area as the ITB rubs against the bone and the then inflamed ITB rubs against the bone on flexing and this is the vicious circle.

 

[newts]

I have suffered for many years with lower back issues on the SI joints, cycling improved this quite a bit when i started at 50.
After a couple of years i had a bike fit (fitter was an ex pti who understood body mechanics well). He noticed straight away that i had IT band issues, specifically a tight right hip. Seat height raised & setback further, small cleat wedge on right gave me comfort on the bike. IT band strecthing is very important if you want to prevent it becoming a chronic issue (i really ought to be still doing them).

 

[vickster]

I’ve been told the ITB itself is super hard to stretch on your own, get a sports massage therapist to get their fingers dug in if a tight ITB really is the issues (swearing loudly is allowed and expected ). You should be stretching and strengthening every else though, especially lower back, piriformis, hamstrings, hip flexors and glutes

 

[acuna_read]

Lots of interesting stuff on here regarding what physios have said.

Just a quick bit of anatomy, the ITB band runs from the Tensor Fasciae Latae, and to some extent the Gluteus Maximus as well (TFL/ITB anatomy). When looking at stretching the ITB itself stretches very little, regardless if its you doing it or someone else doing it for for/to you, according to this paper it stretches about 0.2% of it's normal length (Stretching of ITB). This is separate to mechanisms for prolonged stretching, think of your ITB to be more like a tendon such as the Achilles.

With regards to imaging, it sounds unlikely you need to get anything done, this is costly and time consuming and with regards to x-rays although minimal is still exposure to radiation that should only be done if necessary. With regards to manual techniques it's been shown often that the best solution to musculo-tendionous problems is for exercise, predominantly strengthening, both for resolving the cause and for pain relief. Manual techniques from a therapist and things such as foam rolling will feel nice initially but doesn't resolve the cause long term, although they can contribute to getting better.

Initially I had a number of telephone consultations with my surgery’s physiotherapist and he gave me some back strengthening exercises to do which didn’t help. Then about 3 weeks ago I had a “face to face” consultation with the physiotherapist and he gave me a number of exercises and stretches for ITB syndrome.

When I saw the physiotherapist he also identified a bit of clicking in the hip joint and one of my concerns is that part of the pain might be due to the hip itself, but it’s difficult to tell whether any of the pain actually originates in the groin area or if it’s radiated pain. On the plus side, I don’t have a history of hip pain so I guess it’s probably not due to general wear and tear of the hip joint.

How often have you been doing the prescribed exercises and how long for, have you been sticking the prescribed amount and duration? If the 'clicking' is new then it is likely related to the recent injury and nothing to be overly concerned about. Clicking or other sounds are also not necessarily connected to wear/deterioration or an issue of any kind so don't be too concerned. The general advice for MSK problems is to keep active as is tolerable as well, reducing intensity and duration as required.

For general health long term look at doing some strengthening exercises regularly, they can be bodyweight at home and be extremely challenging, or perhaps consider getting a kettle bell which can be good for general strength/health particularly with the lower back. Although yours is not low back pain in an of itself and is being driven by the ITB it seems, undertaking something such as the McGill three can be very beneficial long term (https://squatuniversity.com/2018/06/21/the-mcgill-big-3-for-core-stability/), you can stroll down to the 'Mobility First' section to just get to the exercises.

I hope your problems are resolved soon.

 

[JtB]

If anything the pain is worse now than in April, but at last I’ve just had a proper diagnosis and it’s not ITB Syndrome. The results of a CT Scan that I had last week reveal a prolapse disc, so just waiting to hear from the surgeon.

 

[ColinJ]

If anything the pain is worse now than in April, but at last I’ve just had a proper diagnosis and it’s not ITB Syndrome. The results of a CT Scan that I had last week reveal a prolapse disc, so just waiting to hear from the surgeon.

Ouch - good luck!

 

[kingrollo]

If anything the pain is worse now than in April, but at last I’ve just had a proper diagnosis and it’s not ITB Syndrome. The results of a CT Scan that I had last week reveal a prolapse disc, so just waiting to hear from the surgeon.

Surgeon ? - surely you aren't having surgery on a prolapse disk.

I mean I know surgeries exist - but there's a whole host of other options before you start trimming the disc (which won't grow back)

For £10 Id have a read of pain free by peter egoscue.

 

[vickster]

I had surgery to resolve a prolapsed disc when I was 21, it was that or a wheelchair potentially! No real issues 30 years on (other than a big scar, keyhole these days obviously)

But yes, clearly exhaust all other options first, rest and physio as a starter

 

[kingrollo]

I had surgery to resolve a prolapsed disc when I was 21, it was that or a wheelchair potentially! No real issues 30 years on (other than a big scar, keyhole these days obviously)

But yes, clearly exhaust all other options first, rest and physio as a starter

Wow - some decision at 21 - glad it worked out.

Nerve ablation is as far as I have gone.