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My ITB issues (running & cycling) were completely nailed by lots of glute work - my physio said that virtually every cyclist coming through her doors had poor glute function, comes from being bent over in the saddle. Glute work: tennis balls are for wimps, you want a big fat hard softball; stretching the front of the hips; bridges; squats; single leg deadlifts; lunges. The last two exercises are particularly good because they challenge you to hold the knee in a straight line in exactly the same way you do when running/cycling. Extremely effective! Do see a physio however, because you need to be sure of what's going on and that you're doing rehab work correctly.
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Thats not good, I had this last year due to running and it was excruciating. Get to the physio and do some stretches.
I didn't get a foam roller but used a bottle full of water(full so it doesn't comrpess) And it did wonders. I also iced after every run. -
sometimes it's not that glutes are underdeveloped it's just that they are not firing. i wouldn't jump into doing squats/lifts or glute exercises before seeing a physio. they are the best people to asses your injury and how to treat it.
self diagnosis and internet anecdotal evidence/treatment can often make things worse. -
Guapo and I are massage therapists in south London if you're up for it. I love doing hip work, I'll kick your glutes asses. Ha! I'm also fine with bartering, so give me a PM and we'll discuss. If you're interested, of course. Also, we'll use heat on the IBT, which you should do before stretching.
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@MrSmyth - I agree absolutely - if in pain, get a sound diagnosis from someone that knows what they're doing before trying to do something about it (other than RICE). That said, it took me three physios to find one that actually knew what they were doing. The first two were only interested in treating the immediate symptoms, bit of ultrasound etc. The third one listened, gave me a full once over, and immediately spotted the root cause being the functional deficiency in the glutes and then didn't just stop when the symptoms went away, but also gave pointers (e.g. the glute work!) to stop in happening again. In this respect it's worth having an idea of what to expect when you visit a physio, because you can then spot the good ones, especially when rehabing sportspeople as opposed to getting folk mobile again.
@scherrit - yes, quite! I've completely come round to the idea cyclists should do at least some weights at least once in their lives, if only to help prevent injuries and expose functional flaws. Would have helped me no end.
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I had ITBS about 5 years ago, caused by suddenly increasing my weekly running distance.
I went to see the doctor at my gym in Mornington Crescent, www.kieser-training.co.uk and he sorted it with a cortisone injection. I changed my workout programme to include the smaller leg muscles, eased off on the running a bit, and it's not been back.
When I'm training for a race now, I only increase my weekly mileage by 10%, seems to work for me.
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This topic has sparked good debate.
I wouldn't spend too much time looking at your Gluteus Minimus. It is not a hugely powerful abductor or internal rotator and in hip flexion it doesn't do much at all. It does however contribute to hip joint stability.
ITB syndrome and anterior knee pain are the most common clinical presentations I see in the Cycle Clinic and have similar contributing factors. It's more common in runners due to the greater lateral loading, ground reaction forces and greater range of knee extension which tightens the ITB.
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what was really odd after being treated and getting back to 'normal' was the changes in my thigh muscles. i had an overdeveloped vastis lateralis which is the outside one and after a few weeks of using footbeds and having straight knee tracking the other two thigh muscles started to get bigger to match the one that had been doing all the work. another one at the top of my thigh (don't know what it's called) magically appeared.
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Too high a saddle leading to excessive knee extension or climbing out of the saddle will have similar effects.
What's your opinion re TFL and Glute Med/Min imbalance ie TFL rolling the ITB over the Lat Epicondyle as TFL overpowers those glutes hence causing that 'friction' type pain?
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What's your opinion re TFL and Glute Med/Min imbalance ie TFL rolling the ITB over the Lat Epicondyle as TFL overpowers those glutes hence causing that 'friction' type pain?
I don't know of any published evidence to suggest that this happens. It is true that many patients compensate for gluteal weakness with increased TFL use but I don't think this would have a significant effect on increasing ITB friction over the lateral epicondyle. Clinically I find a combination of increased ITB flexibility and increased gluteal strength yield excellent outcomes. To compliment this I may target the TFL to reduce it's activity and tension with trigger point treatment such as acupuncture.
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I don't know of any published evidence to suggest that this happens. It is true that many patients compensate for gluteal weakness with increased TFL use but I don't think this would have a significant effect on increasing ITB friction over the lateral epicondyle. Clinically I find a combination of increased ITB flexibility and increased gluteal strength yield excellent outcomes. To compliment this I may target the TFL to reduce it's activity and tension with trigger point treatment such as acupuncture.
There is a bit published but poor quality. My question was poorly put though. What I meant to say was do you treat TFL as well. So ta for that! Have you ever come across ITB and hip pain together bearing in mind the ITB's deeper firbers blend into the lateral aspect of teh hip capsule?
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£45 quid better?
Trigger-Point-Therapy-Roller-BlackBest £45 I ever spent - Thanks for all advise guys and especially for getting me to pony up the extra for one of these!
After rolling my legs to death im back running like paula radcliffe now!
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In case anyone else in London is looking to get a trigger point roller might be worth looking here:
http://www.shop.balancephysio.com/products/the-grid
Got mine there a while back and cheaper than 45 notes (web says 32.50) and they're based near Clapham North tube.
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There is a bit published but poor quality. My question was poorly put though. What I meant to say was do you treat TFL as well. So ta for that! Have you ever come across ITB and hip pain together bearing in mind the ITB's deeper firbers blend into the lateral aspect of teh hip capsule?
True hip joint pain most commonly presents as groin and medial thigh pain whereas a large number of patients with ITB symptoms will complain of diffuse aching in the buttocks and upper thigh (and sometimes lumbar spine) due to overuse / relative weakness in the lateral hip stabilisers.
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True hip joint pain most commonly presents as groin and medial thigh pain whereas a large number of patients with ITB symptoms will complain of diffuse aching in the buttocks and upper thigh (and sometimes lumbar spine) due to overuse / relative weakness in the lateral hip stabilisers.
Sorry not being clear again. Do you ever see pts with ITB and groin pain (ie true hip pain)?
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In case anyone else in London is looking to get a trigger point roller might be worth looking here:
http://www.shop.balancephysio.com/products/the-grid
Got mine there a while back and cheaper than 45 notes (web says 32.50) and they're based near Clapham North tube.
Actually this is where I got mine!
£32.50 is a bargain and they let me have play with all their trigger point stock before I committed to purchase.
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About
Iliotibial band syndrome
Posted by
fairly sure the cause it tight glutes
I'm ticking all the boxes here
Tight Glutes Revisited
http://www.core3massage.com/blog/?tag=gluteus-minimus
In a previous blog post (October 2008) I wrote about gluteal (butt) tightness. I did not go into the specific muscles involved, but this time I am going to discuss one specific butt muscle – gluteus minimus.
The gluteal muscles are comprised of 3 different muscles: gluteus maximus, gluteus medius, andgluteus minimus. http://www.pilatespatio.com/gluteus_medius_minimus.gif
Gluteus minimus is the smallest and deepest of these muscles, and so harder to get at. It is a strong abductor of the hip – which means that it lifts your leg off to the side, away from your body – as well as a internal rotator of the hip.
My interest in this muscle was recently piqued, thanks to a massage therapist friend of mine with chronic hip tightness. While massaging her over the past year, she has encouraged me to go deep into the lateral hip. She has also done a lot of deep lateral hip work on me, and I found that it really did help my hips feel looser on my runs.
Being more aware of gluteus minimus, I now notice that many of my clients are tight in this area. Tightness in this muscle can reduce the looseness in one’s outer/lateral hip joint. And if the tightness is left untreated, trigger points (TPs) could develop. If TPs form in the gluteus minimus, referred pain could possibly be felt in 1) the more fleshy part of the posterior butt, 2) down the outside of the leg to the outer calf and ankle, or 3) the back of the hamstring into the upper calf.
I can, and will, get in there with my elbow and thumbs to release the tightness. However, another great way to deal with tightness in this area is by self massage with a tennis ball. Lie down on the floor on your side, with the top leg in front of you for stabilization and bottom leg relaxed on the floor. Place the tennis ball under your hip between the edge of your pelvic bone and the top of the femur (check the above link for specific location of this muscle). Release as much of your weight as possible onto the ball, and roll back and forth. If you find a tight spot, just hang out there and try to relax into it.
This area is not as sensitive as the illiotibial band (ITB) below it. You might feel some discomfort, but usually it just feels really good to get in there. The foam roller, used to massage the ITB, doesn’t really get into the gluteus minimus – it is not specific enough to go deep between the bones.
For general flexibility of the area, stretching is also good. Regularly stretching the outer hip http://www.sportsinjuryclinic.net/cybertherapist/stretching/outer_hip_stretch.php feels really good. I love doing this stretch after I run, every day. Another hip stretch I like http://www.sportsinjuryclinic.net/cybertherapist/stretching/standing_outer_hip_stretch.php, is great if you are at work or someplace where you just can’t lie down……like in that coffee shop after your bike ride.
Anybody who is active is going to use gluteus minimus to some degree. I know with my longer runs on uneven ground, I am asking a lot of it. So, keep those hips loose not just because it feels good, but because it could prevent pain in the future.