sports & wellness blog

IT Band Syndrome

Posted on January 21, 2012 by bobby.horn

The iliotibial band (ITB) is a long tendon on the outside of the leg. It travels from the bottom of your hip to the kneecap. It connects 3 muscles in the hip and creates hip and knee movement that is important for running, walking, squatting, and negotiating elevations.  These muscles also work to stabilize the pelvis.

ITB syndrome can be caused by numerous activities including running and cycling. Too much rubbing of the ITB on bony prominences of the hip and knee can cause irritation.   Also, downhill running, a poorly fit bicycle, and running high mileage can alter mechanics of the ankle, knee, and hip, thus creating irritation of the ITB. Weakness of hamstrings, hip muscles, and core muscles can also contribute to ITB syndrome. Someone may have other anatomic factors working against them that can cause ITB syndrome. Common symptoms that are associated with ITB syndrome are tenderness along the outside of the knee, both above and below the knee, and possible “snapping” along the outside of the knee when bending and straightening the knee.

The first thing to do is to get rid of the inflammation at the site of the ITB that is irritated. Ice is a great way to combat this initially. Ice for 10-15 minutes at a time and try to get ice on the area at least twice per day. Activity modification or avoiding any activity that makes the irritation worse will also help you get back to your activities in a pain-free manner efficiently.

To reduce any restrictions in the ITB, stretching is paramount. The ITB is a tough band of tissue to stretch, so using a foam roller is very helpful to stretch out the entire band. Also stretching the gluteals, quadriceps, hamstrings, and calf muscles will help to get rid of any restrictions that are contributing to the ITB tightness and irritation. Stretching should be held for 30-60 seconds and done 3-5 times per day.

Please call Strive if you’re having these symptoms or symptoms similar to these and have one of our physical therapists help you out with exercises and a possible treatment plan.

 

 

**ITB syndrome can be the Achilles heel of a runner or biker.   Many athletes tend to try and work through minor injuries, but more often than not an ITB issue will eventually end up shutting you down for some period of time, due to the debilitating pain associated with it.  If you listen to your body and get serious about treatment as soon as your symptoms develop, the likelihood of being shut down for an extended time will decrease.  Any pain in the knee should be evaluated by a health care professional.  The key is to get a proper diagnosis and identify any risk factors that could have contributed to your problem.  The sooner you do this, the sooner you can back on track with your training regimen!

Katie Gollotto, DO

Board Certified Sports Medicine, PM&R

Reconstructive Orthopedics

 

**Dr. Katie Gollotto, sports medicine physician with Reconstructive Orthopedics, will be providing her input on the topics discussed on this blog based on her extensive experience in treating athletes.   Please consult a medical professional at all times as conditions and treatments may vary.  The information provided should not be construed as medical advice.

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The NBA Can Learn From The NFL

Posted on December 14, 2011 by Chris Keating

The recent agreement from the NBA and Players Association means professional basketball will begin on Christmas Day. For most of us, this means we will once again see our favorite stars on the court in what was once thought to be a lost season. However, for the small few who follow injury trends, this will be another test on Achilles Tendonitis and its causes.

The Achilles tendon is the medical term for the calf attachment of three muscles (Gastrocnemius, Soleus and Plantaris). When activated, this muscle attachment site carries through it an incredible force. The game of basketball puts this tendon to the test with jumping, sprinting, jogging and pushing.

The NFL recently ended a lock-out, and as a result, saw a dramatic increase in Achilles injuries, as noted in the Journal of Orthopedic and Sports Physical Therapy in an October article by Greg Myer. In a November Wall Street Journal article, Katherine Hobson explored the issue of Achilles injuries and the lessons learned from the NFL came up with Ralph Reiff, executive director and athletic trainer at St. Vincent Sports Performance in Indianapolis. Mr. Reiff believes, as both I and Dr. Myer  do, that an Achilles injury can come from rapid onset of training without proper conditioning and strengthening. Even just overdoing one training session can lead to Achilles pain. Despite this strong support, Will Carroll, of SportsIllustrated.com wrote on November 29 he does not believe the NFL Achilles injuries spike will be duplicated in NBA players. Only time will tell which side of the argument will turn out to be correct. This year has been an ideal sample for those interested in this injury, as well as those who have suffered from it. The recent increase in Achilles tendonitis in this high-end population will give physical therapists, sports medicine doctors and orthopaedic surgeons a chance to review the current treatments for Achilles tendonitis.

The current best practices appear to be the following:

-         Eccentric Loading* and strengthening (*more to come in future posts)

-         ART or Graston Technique to breakdown adhesions & promote proper healing

-         Proper conditioning and progression of forces when resuming training

In addition this topic having a sports rehabilitation flavor to it, it should also be of interest for those of you who play fantasy basketball. Make sure to do your research and draft players who have been training and staying fit. The last thing your fantasy team needs is to lose a top pick! Enjoy the season, and keep an eye out for whether or not Achilles injuries will pile up. Who do you think will be first to go down?

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What a Pain in the Neck …

Posted on September 20, 2011 by Chris Keating

Wake up on the wrong side of the bed with a tweak in your neck? Find yourself rubbing your neck after working at a computer for hours? According to the International Association for the Study of Pain, neck pain affects 14% of the population each year. The work force continues to be drawn to iPads, computers and smartphones. All of these devices bring with them poor posture and increased risk of neck and back pain. How do we avoid or reduce our risk of being in that 14% of people who have a crick in their neck? Here are some thoughts and suggestions to keep you working…and yes, that’s a good thing.
When you neck hurts…look at your butt. How are you sitting? Your neck is depended on your low back for support. If you don’t scoot back in the chair, give yourself low back support (about a three- to four-inch pillow) and bring those hips, shoulders and ears in line, you are in serious need of posture correction. Sometimes just putting a sticky note on your computer monitor to remind you of your posture can be enough to get your spine in line and working at its best.
Neck pain is very common, but the causes of neck pain are difficult to determine. Many structures can send a pain signal and refer pain to different areas making it seem like your arm or hand is bothering you. Orthopedic professionals use a clinical exam to help determine the cause and solution to your pain. Disk herniation is a common “bad guy” in the neck, but is rarely the real cause. Facet joint, facet meniscus, nerves, muscles, tendons and ligaments are a few structures that can cause neck pain. Facet joints are small, highly sensitive structures that are the most likely to lead neck pain due to malalignments. Herniated disks happen, but the amount of ligaments holding it in prevents the disk from truly herniating. An MRI will show protrusions, but an acute flare-up of neck pain will most likely be due to a mechanical alteration in these smaller joints.
Your Strive physical therapist will evaluate your neck using the Mechanical Diagnosis and Treatment method. This is a clinically proven effective manner to identify your problem and immediately begin to address it. Neck pain can limit every aspect of your life, but no matter how severe the pain and how far it travels down your arm, a physical therapist can reduce and abolish your pain and return your life with the knowledge to prevent and treat your neck yourself.
Don’t let that pain linger, get your neck back in order.

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Gait-”gate”: Are you running injury free?

Posted on August 16, 2011 by Chris Keating

“Why do I need to learn to run, I already know how to RUN?” This frustrated question is heard by every physical therapist. At the core, the message makes sense. We all know how to run — but do we run in a way that will keep us running and injury-free? The answer is a categorical: No. If you have read my last post, “‘Till Graston Do Us Part,” you know my wife injured herself while training.  In addition to the physical therapy treatment, she had to alter her gait to avoid re-injuring her posterior tibialis. Your running gait (how you mechanically move your joints and muscles from your toes to your back) is very important. You may not think about footwear or how foot mechanics impact running injuries – but your physical therapist does!Footwear is the cause of, and solution to, many running injuries. Have you heard about the barefoot running craze? Here’s the theory behind it: Due to the increased size in footwear and over-striding, we have put runners at risk for injury (I agree), and we should go back to basics, which means running barefoot (I don’t agree). Running barefoot, or near barefoot, mechanically will work for some, but not all. Your foot needs support. When running, you put 4x the force of your body weight though your foot. If, despite my counsel, you wish to pursue barefoot running, make sure to progress slowly. Your most important takeaway should be to shorten your stride and avoid landing on your heel. Make your mid-foot (the center of your foot) your target landing spot. This, along with a solid strengthening and warm-up program, should decrease your risk of injury.Another question physical therapists frequently hear is, “Why do I get injured running?” Unfortunately, there is no easy answer. Even after you’ve been examined by a physical therapist – who will address your foot mechanics up through your hips — you still have a probability of injury. The truth is running is traumatic to the body. We can prepare ourselves as much as possible, which most of us would admit we don’t (time to ‘fess up: do you stretch daily to protect your joints & muscles?), but running is traumatic. Then why run? Some say the high, others are in it for weight loss. No matter the reason, know as long as you run, all the advantages —  the health benefits, places you’ll see andpeople you’ll meet —  will be well worth the effort,  training and treatment. Why do you run?

 

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Till Graston Do We Part?

Posted on July 25, 2011 by Chris Keating

Perhaps you already know my wife. She was the petite brown-haired woman dashing along during the Scott Coffee Memorial 8K Run this year at Moorestown Day wearing a Strive Physical Therapy t-shirt and racing alongside her loving husband.?Margot and I have been training for a half-marathon. Recently, she came down with a case of posterior tibialis tendonitis – inner calf pain.  While training indoors she decided, unbeknownst to her physical therapist husband, to run hills at a five-plus incline on a treadmill. As a result, her calf pain began – of course, and inconveniently enough, one week before the 8K.Immediately, we began treatment with PRICE (protection-rest-ice-compression-elevation), a common treatment method for any recent injury, and forged ahead to the run.After we crossed the finish line – together, at 43 minutes – we began the treatment needed to fully rehabilitate her injury. Our treatment focused on strengthening and stretching the involved muscles and joint, as well as soft-tissue massage and…(cue scary music)…Graston.Graston is a technique using steel tools to break up scar tissue of improperly-healed structures. This erroneous healing is a common theme as our bodies recover, since healing tends to be quick to protect the injury. The body will form a cast of bone and muscle to help protect itself from future injury, but as a result, lead to a chronic inflammation in the affected area, which requires remodeling through manual therapy and strengthening.Margot and I have been married for almost two years. Little did we know Graston would be the biggest challenge to our wedding vows. Graston is painful. If anyone tells you otherwise, they are lying – run (and run quickly) from them. This treatment is painful, tearful and, yes, full of obscenities.  However, it works and is effective.  After only a few short sessions and a very compliant home exercise program designed to strengthen and improve flexibility and balance, Margot is once again running and getting back to her training regimen.?Injuries happen while training for major life goals. The important thing is to recognize issues and correct them as soon as possible. In Margot’s case, physical therapy attended to her injury and got her back on track. The path to recovery wasn’t smooth (“Ow, ow, ow!”) but we got there together.

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