Medical IT band problems - Foam roller technique?

[Dembadon]

Situation:

I'm having issues with the iliotibial band in my left leg, and it is preventing me from running. I've been icing it daily and doing lateral leg raises along with various stretching exercises. I've also just purchased a foam roller (didn't know what the heck they were until now).

Problem:

It hurts really bad when I roll over the band in my left leg -- like, I was almost in tears last night. I've been told this is normal, but I'm skeptical and don't want to injure myself further.

Question:

Has anyone else with IT band issues used the foam roller, and, if so, is it supposed to be this painful?

 

[lisab]

I just got over iliotibial band syndrome...my sympathies! I went through physical therapy - strength training and stretching, basically. But no, I didn't work with the foam rollers, and nothing I did was particularly painful.

I'm skeptical, too, that that much pain is normal.

 

[Physics-Learner]

the it bands are usually one of the more painful areas when people start rolling. the advertised techniques usually show rolling back and forth over a long stretch.

this is not really a good thing to do, especially if we are talking about an area that is sensitive. try rolling back and forth SLOWLY over just 2-3 inches at a time.

the it bands is really the outside of your leg, from the hip to the knee. which could be 15-18 inches or so. so at 2-3 inches at a time, you would end up moving in 6 or so distinct areas.

 

[Physics-Learner]

also, another technique that can be useful is to simply lay motionless on the roller, so that is just applies some pressure to an area.

the normal person is much more apt to feel the same amount of tenderness in both legs, though. the fact that you have much more in your left leg points to some sort of injury.

rolling can be very beneficial if you have compromised tendon tissue (i.e. pulled or yanked on it too hard). tendon tissue is not very elastic. and when muscle tissue is already too tight, it is already constantly putting more pressure on the tendon tissue than it desires. so it does not take much to "over-pull" on it.

without knowing for sure what is wrong with your leg, i can only suggest possibilities.

rolling can be great, but one can over-do it, just as with just about anything else.

 

[Dembadon]

Thanks for the replies. I've been trying to stay optimistic and fend-off depression; not being able to exercise throws off my routine and really kills my mood.

I've been doing minimal work with the foam roller and have kept up with the icing and Ibuprofen. I think I'm just going to make an appointment with a sports medicine physician. All the rolling in the world isn't going to help me if the root of my IT issue turns out to be something other than a tight IT band.

This is one of the most frustrating sports-related injuries I've ever had. Thank you for the tips.

 

[Physics-Learner]

okay. so it is a sports INJURY ?

you might also want to look into physical therapists - but you are on the right track, that of seeking someone who has experience with your problem.

the 2 main things that rolling can accomplish is releasing the tightness of grip that the fascia has on the muscle tissue, thereby allowing the muscle to move more freely.

and to help with compromised tendon tissue. it definitely works. what i have read is that compromised tendon tissue loses its normally well aligned cells. and rolling on it tends to help the tissue realign itself.

but as you said, if these are not the basis of your problem, then rolling won't help fix that basis.

good luck - let us know what you hear.

 

[Dembadon]

okay. so it is a sports INJURY ?

[...]

I'm labeling the ITBS as the sports injury, not that the ITBS is being caused by a separate, sports-related injury. But, yes, I'm going to see if I need PT.

 

[ogen]

Situation:

I'm having issues with the iliotibial band in my left leg, and it is preventing me from running. I've been icing it daily and doing lateral leg raises along with various stretching exercises. I've also just purchased a foam roller (didn't know what the heck they were until now).

Problem:

It hurts really bad when I roll over the band in my left leg -- like, I was almost in tears last night. I've been told this is normal, but I'm skeptical and don't want to injure myself further.

Question:

Has anyone else with IT band issues used the foam roller, and, if so, is it supposed to be this painful?

Hi, I'm going to try to get a feeling for what's going on with you. I do bodywork professionally. I'm not a physical therapist or a chiropractor. I think our work is better for many things and we are more sensitive. PT's work with doctors to help people after they have been basically broken. I take functioning people and help them (make them:) function better. By better I mean with more freedom, more breath, more elasticity and more pleasure. You are welcome to PM me or email me, I suggest the latter. Look at my profile too.

I'd like to know your age and any injuries. I don't know what kind of foam you mean, my foam mattress is nice and soft. I'm not being slick but careful. Let me summarize what I think I know about you. As you read it you will notice some things to add, to round out the picture.

1. The subject is your left leg, esp the IT band. That's the band of fascia from your greater trochanter to your knee area. You don't describe the issue or how it affects your running, but it does.

I can assume that it is tight and or painful.

What you are doing is lateral leg lifts. Seems to me this would strengthen it, ie tighten the band. Since this seems counterproductive to me, perhaps I am missing something.
You are icing it which is a safe way to help with pain. By reducing pain icing can contribute to overdoing it. An interesting way to advance with strength is to limit the extent of your exertion to 70%. I read that in one of the books of Bruce Frantzis.

Re doing "something" to the point of pain and being in tears. DON'T!
Pain is nature's way of telling you "Something's Wrong."
Whoever said, "No Pain, No Gain." was mean. It's harmful.

Here's an interesting fact to back up what I am talking about. You "know" that yo have to push yourself and run and breath hard to improve you cardio-vascular ability. Rather that's your belief. And "believe" is what we do when we hold an opinion regardless of observations, aka facts, as far as we know them. Qi Gung (aka chi gong and similar to tai chi) builds cardio-vascular capability without heavy breathing or fast motion.

Things that test our thinking make us more flexible and observant. The willow survives the storm that breaks the eucalytus.

Re the roller, I'd like to know if you were "rubbing" it with the long axis of the femur (with the grain of the band) or "cross grain", the short way. Were you doing it fast or slow? How big an area of the roller was being pressed, how much pressure? But that's mostly for my curiosity and interest.

I can tell to what depth I am touching tissue. I can do the hair, outer skin, deeper layer, fat, lower, muscle and at a certain pressure, I am touching fascia. Fascia has a wonderful and peculiar property we call "gel to sol". You can get an idea of it by playing with a mixture of cornstarch and water. If you hit it it is hard. If you make it into a ball you can throw it and catch it. If you hold it in your loose fingers and watch it slowly move it will melt and drip down between your fingers.

I can press your tissue slowly so that it softens and melts. Earlier practioners of structural integration (the Rolf Method as it's also called) pushed hard and the tissue resisted and rolfwork had a reputation of hurting. And hurt it did. I called it terror, in my experience.

I work more slowly, more softly and I call out your sensitivity so that you cooperate and work with me to soften and change. I've heard someone say that "you can't work too deep, you can only work too fast." That thought inspires and empowers me and what I do.

I think that this is enough for now. I hope we will communicate more. Peace out.

 

[bobze]

You should see a physical therapist or doctor who specializes in sports medicine (as this is a common sports injury and they deal with it a lot).

The IT band or tract is a specialization of the fascia lata and is very fibrous. You can get small tears in it that can be exacerbated by the tensor fascia lata, a small muscle along the superior side (near your hip), that keeps the IT tract tight--Which can make the pain worse.

What you shouldn't do is seek medical advice online!

 

[Yanick]

First and foremost listen to bobze and go see someone qualified in the field. Don't let a bunch of screen names tell you what is wrong with you over the internet without ever having seen you in person or done any sort of assessment. As bobze has eluded to these problems do not necessarily arise because of you IT band itself, instead it could be a hip or ankle problem that translates into IT band pain. There is no way anyone on here can tell you what is appropriate for you without a proper assessment of gait, mobility/stability of you joints so on and so forth.

In the meantime, foam rolling should not be extremely painful. Mild discomfort is the worst that you should feel if rolling a very tender area.

When rolling your IT band the leg that is supporting you should be flat on the floor (the leg that is not being rolled) and you use that leg to vary the amount of pressure on the tissue. Do not just plop down on the thing and start rolling, you can hurt yourself if you don't know what your doing. Gentle is best, especially since foam rolling is just a crappy DIY substitute for a proper clinical massage. I have a friend who is a Strength and Conditioning Specialist and LMT and works side by side with Osteopaths and PT's and really works wonders with sports injuries. If you want to PM me I can ask him for some recommendations of good practitioners in your area (no guarantees but you never know). The field is, unfortunately, saturated with quacks and hacks and most people have bad experiences with these types of injuries and live their lives' in pain, when it is not always necessary to suffer.

Hope you feel better.

 

[nismaratwork]

One thing to be very careful about, is that you can overwork an area and cause flaccidity in the muscle, which is an injury in and of itself.

Bobze is right, if your qualified PT or MD is on this, keep it up, but this is not something to chat about online. If you have insurance, they will cover at least SOME visits to a PT, and you sound like you need it.

You NEVER want to cause that kind of pain... on a scale of 1-10, try never to go past a 6... with 4 being optimal. Anything more, except in special circumstances with a clinician in charge, is needless.

 

[physiofixme]

Ogen in response to your query about lateral leg raises strengthening your itb - it's actually gluteus medius that you are working. This is important as gluteus medius is usually weak in people with ITBS. There is an imbalance between it and TFL. TFL is usually overworked putting extra stress on ITB. One way of reducing the amount of work done by TFL is by strengthening Gluteus medius - in particular the posterior fibres. The leg raises though do need to be specific and probably start with an exercise we call clams. (hopefully I've managed to attach a photo)

In this exercise it's important that the hips and pelvis don't move or roll back. You can add resistance by tying a loop of exercise resistance band around your legs just above your knees. The top knee slowly lifts up off the bottom knee. Repeat.

As for the foam roller - persevere! It will get less sore as the ITB loosens!

 

[Physics-Learner]

at this point, we simply don't know if the situation is itb tightness or not.

i don't think it is the major basis of the problem, though. if it were, i think it would be more logical that both legs would be equal. the op has a lot more pain in the left leg.

now, the tightness can help to cause a pulled tendon, which would then be much more painful.

the op needs to actually see someone with some experience in that regard, to better give an opinion. and possibly get more than one opinion.

 

[physiofixme]

Quite common to get it one leg only. See it all the time. But yes - get a proper diagnosis!