Saturday, August 24, 2013

Iliotibial Band Syndrome or ITBS #physicaltherapypost

Hey fellow athletes and runners! I'm here :)

As I've mentioned before in previous posts, my summer has been so busy! With two active boys we are non-stop when we aren't working. When I get my down-time I go to bed. But, I have some time this morning to put up this post finally!!

I had a lot of interest from my fellow SPAs on running injury posts and how to rehab them. So, I'm starting here with ITBS.

I'm stating with the purpose and causes and then showing you how to prevent and treat it. If you just want to know how to prevent and treat scroll past the first four pictures.  :)

The IT Band is a thick fascia that goes from the hip to the knee on the lateral aspect of each of our legs.

The purpose of the ITB is to contribute to lateral stabilization of the knee. It acts like another ligament on the outside of the joint, adding support during any weight-bearing activities.

ITBS is a common injury seen with runners, however cyclists and hikers can have this issue too.

A lot of times it will crop up when the person starts to increase the activity level without making it a gradual process.

However, there are other anatomical differences that can cause this to happen to, such as having a leg length discrepancy, over-pronating while you are running/walking (putting your weight through the instep of your foot for a longer period than you should), or if your knees are in an increased genu varum position (bow-legged) which would put a strain on the ITB.

This shows a leg length discrepancy, where the 
bones in the lower left leg are longer than the right.

This shows how the different angles of our femur, coming
from our hip can affect the angle of our knees.
Genu varum can cause ITBS, but so can't Genu Valgum.
Genu Valgum puts our feet in an over-pronated position.

This shows over-pronation.

That was a very basic over-view of the anatomical anomalies that can cause ITBS.

So you have ITBS? How you treat it is very similar to how you would prevent it. 

  •  Make sure your shoes aren't worn out.
  • Do you have any of the above anomalies? Check with your doctor to see if you need special inserts in your shoes.
  • Change your running surfaces up. Don't always run on the tar!
  • If the road you run on is graded, switch up the sides you are running on. Having that angle can really tweak your knee.
  • Make sure you warm up before you start and stretch at the end.
  • Strengthen!!

Now, if you have dealt with the above and you are currently dealing with ITBS, there are a few specific things you can do to promote the healing process.

  1. Reduce your mileage. I know, not what you want to do. But, if you want to run pain-free for many more years it is worth it to ease up a little.
  2. Cross-training is great. You work your muscles in a different way and you are still staying fit. Try swimming, pool running or rowing.
  3. Ice or heat the area. If you have been dealing with this issue for more than a couple weeks, heat will actually be better for the inflammation process. Use for 15 minutes at a time while resting your legs.
  4. Stretch the ITB and the side of your hip. You can do basic stretches and you can stretch through foam rolling.
A and B are the same stretch and C is getting more into a side/hip 
stretch. In each picture she is stretching the left side. 
Hold stretch A/B for 30 seconds and repeat three times. Do the same
with C. You can do this 2-3 x day.

The lateral part of your leg is resting with almost your full body
weight pressing down through. You use your arms and top leg as
leverage to roll yourself up and down the foam roller. Roll up and 
down 5 or 6 times and then take a break. Do 3 sets of this twice a day.
Finally, doing some massage to the ITB will help as well. Do self-massage or have someone do it for you. 

If you feel like you would benefit more from a professional helping you through this, then you should see your PCP so they can refer you on to a physical therapist. 

If all else fails and orthopedic doctor can do a release to the ITB, which is a surgical procedure. But....
let's hope it doesn't come to that!

Hope this helps!

Have you ever had ITBS or do you have it now?

What other athletic injuries would you like me to post about?


Saturday, August 3, 2013

Island Boost Giveaway Winner!

The Island Boost Giveaway Winner is......

Kayla Moothart!!

I used the True Random Number Generator below to pick out the winner :)

Please email me at with your address so I can mail you your winnings!

Thanks :)

Friday, August 2, 2013

Strengthening Other Parts of our Bodies is Essential #physicaltherapypost

Lately I have been seeing a lot of patients with shoulder issues - especially impingement. If left untreated this often leads to a tear of the rotator cuff. Continued improper movement of the glenohumeral joint (the ball and socket) because the scapula isn't mobilized can cause this. This tends to be very prevalent in the mid 40s to mid 50s age group. However, anyone can have this happen.

Signs of impingment are weakness in the rotator cuff, pain around the shoulder, possibly shooting pain down your upper arm, and limited range of motion when lifting the arm at your side and trying to reach behind your back.

When we lift our arm in the air our shoulder blade should rotate slightly to allow for full range of motion.
When the shoulder blade becomes bound down and isn't rotating this can cause a lot of pain in the shoulder. Many people don't realize it has to do more with the strength and flexibility in the rotator cuff AS WELL AS the posterior shoulder muscles.

Included are these muscles:

1) Rhomboids

2) Deltoids

3) Trapezius

4) Levator Scapula

5) Serratus Anterior

6) Latissimus Dorsi

A lot of people work their biceps, tricpes, lats, pecs, rhomboids & delts. You are indirectly still working the other muscles I listed, however there are specific ways to work those and isolate them as well. I will show you exercises for each of the 6 muscles I listed above as well as some specific exercises to help mobilize the scapula.

Working the Rhomboids, Delts, Trapezius & Lev. Scapula:

This targets mainly the rhomboids, however you do work 
the posterior deltoid and mid-trapezius as well.

These are called Ys, Ts, Ws & Ls as the picture states.
These exercises can be done on an incline bench like she is using
or lying on a bed - which makes it harder or on a stability ball.
These get the trapezius, rhomboids, posterior delts and rotator cuff. 
Use weights for added benefit.

This gets the superior deltoid and levator scapula.

Working the Serratus Anterior:
 This is a push up with a plus. As you come up you push a 
little extra which makes your back round up. You have just
jutted your shoulders forward to create this.

Another way to work the serratus anterior muscle.
Keep your elbows straight and push your shoulder
up towards the ceiling. You can also do this with both
arms at the same time.)

Working the Lats:

Pull-ups and Lat Pull Downs are great ways to
work this muscle. Pull ups work may muscles,
where as the pull down targets the lats and shoulder

Now for some exercises to target scapular mobility and stability:

Wall Angels
Doing this with the elbows bent and trying to keep
them back against the wall is a better way to 
start this exercise.

Internal Rotation
Use a theraband or some type of resistance band.
Pull in towards your stomach keeping your upper
arm close to your body.

External Rotation
Pull out, away from your stomach, making sure to still keep your upper arm close to your body.

**For all my younger readers: Strengthen your rotator cuff now, and keep your shoulders strong so that you may prevent a tear later on in life.**

I plan on doing more physical therapy related posts in the future. One every other week on different injuries or just ways to strengthen different areas. Hope this was interesting for you all. 

Have you ever had a problem with your rotator cuff or shoulder in general?