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IT Band Friction Syndrome – When Knee Pain Comes From the Hip

 

What is the IT Band?

The iliotibial band (IT band) is a very thick, fibrous band of tissue that runs from the outside of your hip down the outside of your leg and connects on the outside of your knee.  Your glutes, hip abductor and tensor fasciae latae (TFL) muscles all connect into this band.

 

leg image

What is IT Band Friction Syndrome (ITBFS)?

A sudden increase in mileage (over a 5% increase in one week) or excessive downhill running can cause the IT band to rub and create friction on the outside of the knee creating pain.  Since the IT band has fibers that also connects into the outside portion of the kneecap this can also be a source of pain at the front of the knee.

What Causes ITBFS?

Remember Newton’s 3rd Law of motion that “every action has an equal & opposite reaction?”  During running, every time our foot hits the ground with a certain amount of force the same amount of force is also exerted from the ground back up through our foot and into our leg.  If the musculature involved (usually the muscles on the outside of the hip) cannot contend with these increased impact and force requirements, then the body can start to break down and often times this occurs at the knee.  A rapid increase in running distance, downhill running, or running on slanted or graded surfaces (the same side of the road every run) forces the legs to undergo a significant increase in impact and force.

How Do I Fix It?

Decreasing your mileage temporarily until your symptoms subside then increasing more gradually sometimes can help initially.  Increasing your cadence (steps per minute) can help because it decreases the time your foot is on the ground, limiting the returning force the ground can exert back.  There is research data to indicate runners with ITBFS may have weaker hip muscle strength on the affected side.  So strengthening those muscles on the outside of your hip is KEY and is very simple with performing either, or both of the following exercises (to be performed every other day at 3 sets of 10 or 15 reps):

exercises

The following stretches after your run will also be helpful to loosen those tissues & muscles on the outside of your hip holding each stretch for 30-45 seconds, 3 times daily:

stretches

HAPPY RUNNING!

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BRET MAIERS, PT, DPT, OCS

Bret Maiers received his Doctorate degree in physical therapy from Eastern Washington University in 2010.  He is a board certified orthopaedic clinical specialist through the American Physical Therapy Association and is currently the clinic director for Mountain Land Physical Therapy at their Stansbury Park location. In his spare time Bret enjoys running and both watching and playing sports.

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Turning 50 and losing 40 – My journey into Running


by Kathryn Macleod
Turning fifty, is a milestone. For me it was huge. I admit to being quite vain and also to fighting getting older.
I wanted the day to pass without ceremony and attention. A few days after my July 12, 2012 Birthday, I took a trip to Vegas with my husband and another couple.
The celebration was to begin with a shopping expedition. I had this visual image of what I would look like in my special new outfit. I spent far too much money, but purchased what I thought was the perfect outfit.
That evening my husband took some pictures of me. I distinctly remember looking at the pictures and this huge lump came in my throat.
I was not “fat” but I was certainly quite chubby. I actually cried. That same weekend, my husband took a picture of me on my horse. Another weepy moment and another eye opener.
I had to do something. What could I do to change my lifestyle?

 

Las Vegas 2012
Las Vegas July 2012

 

Riding Horse 2012
Riding my horse Winston

 

I have always been an active person. I teach dressage riding professionally (think ballet on horseback), I ride many horses a day, muck stalls, lug hay, and do all sorts of manual labor.
I grew up in Prince Edward Island, Canada and studied Education at a university. I competed with my horses and my riding students at a very competitive level — coaching students to represent Canada in North American competitions.
How did this active person let the pounds just gradually slip on? I had done the diet thing many times…diet down for a vacation south…only to gain it back.
I was hitting middle age and for the first time ever…I was gaining weight on my middle. I weighed 167 pounds.
Social media intervened and so did the era of the “app”. I saw someone post on Facebook about a program called C25k [couch to 5k]. I googled it. Interesting, I thought, perhaps this is what I needed to do?
In August of 2012, I downloaded the “app” on my phone and I created a Facebook page called “Let’s Get Fit c25k”. I convinced several friends to take on the challenge with me.
I then put on whatever running shoes I had and ventured out my door.I did not know it, but my life was about to change.
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Plantar Fasciitis – Prevention, Causes, and Treatment

 

By Zachary Kernan

John had been training for the St. George Marathon for the past 10 weeks and as life will have it, work and family obligations took their toll on his training schedule.   Expense reports had come due and the kids had been sick for the previous 4 days, preventing him from running for the past 3 weeks.  This was going to be John’s second marathon and he’s loosely followed a training program that he found online.  The training guide indicated that his mileage should have been at 38 miles for the week with a tapering schedule anticipated over the next 2 weeks. 

 John was quite nervous about the marathon and was concerned that his training program had not been adequate enough for him to finish the 26.2 mile course.  In an effort to catch up and prove to himself that he’d be able to complete the marathon, John skipped ahead on his training program and completed the current week’s prescribed 38 miles. 

 John was on his long run of 20 miles and at mile 16, began to feel an achiness through the arch of his right foot.  The ache was initially dull and John was able to push through the run as it did not affect his pace.  The next morning, John threw back the covers, stepped onto the ground and experienced a sharp pain through the bottom of the heel and the arch of the foot.  The discomfort slowly dissipated by the time he was walking out the door on his way to work.  After being on his feet for most of the day at work, John felt that aching foot come back to haunt him. 

John is experiencing plantar fasciitis, the most common cause of foot pain in adults and one of the most commonly cited injuries among long distance and marathon runners.   Pain is typically experienced through the arch of the foot or through the bottom of the heel.  Symptoms of plantar fasciitis are typically at their worst with the first few steps in the morning and/or with prolonged standing and walking.

The plantar fascia is a thick piece of tissue connecting the heel to the 5 toes.  Its purpose is to provide stability through the arch of the foot.  There’s a higher incidence of plantar fasciitis in the running population compared to the general population due to the repetitive impact, or microtrauma, of the plantar fascia.  The bones and ligaments of the foot must withstand forces that are equal to 3-4x your normal body weight with running.  This repetitive microtrauma can overload the plantar fascia with faulty biomechanics or with overtraining. Read More….

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The “Achilles Heel” of Distance Running

“Myth” Busters

The warrior Achilles is known as one of the greatest heroes in Greek Mythology.  He was strong, courageous in battle, and nearly invincible everywhere but in his heel.  An arrow shot directly to this area ultimately led to his downfall.  This is where the term “Achilles heel” originates from.

Unlike the warrior Achilles most of us don’t fight in epic battles.  However, if you are out beating the pavement, logging miles, you’ve likely had a dustup or two with your own Achilles.  The Achilles most runners battle with is the Achilles tendon.

The Achilles is the large thick tendon extending down from the calf muscles (gastrocnemius and soleus) and connecting to your heel bone (calcaneus).  The calf muscle is responsible for generating the power you need to push off of your big toe and propel forward as you begin your running stride.  The Achilles tendon is the bridge that helps translate that power into action and is a vital component to an efficient running form.

Achilles tendonitis is typically an over use injury.  This means, like most runners, you don’t listen to your body and back off when your calf is crying uncle.  Other factors that increase the likelihood of this occurring are ramping up your training too fast, having overly tight calf muscles, or the smaller possibility of having a bone spur that is rubbing on the tendon.

Read More….

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