ITB issues/surgery?

[spyrosmom]

The quick back story, I'm a runner. Medium-high mileage, probably 20-40 a week, sometimes 50 or 60. I trained for 3 marathons last year, but only ran 2 as one was cancelled due to weather. I thought the weather was ok to run, but that's another rant. I had a marathon last weekend, so started training at the beginning of the year. Ran through ice, snow, cold, all the fun winter stuff we had this year. Which meant most of time I was on rough, uneven surfaces. My right foot started to hurt, but I ignored it until I couldn't really walk on it. Went to the doc, and had a stress fracture under my right big toe. I was booted for 4 weeks, from mid Feb to mid March. The boot made me uneven, so my right leg was longer than my left, because the bottom was about 1-2 inches thick. I was not able too run, but could walk, and take it of for low impact workouts and weights, and to sit around the house. My leg muscles on both sides were sore for the first few days, adjusting, then I was ok. I did slip and fall on the ice and landed hard on my left knee once during this. It was one of our first warm-ish mornings, and I thought it was water I was walking on. It wasn't.

After the boot came off, I went for a 5 mile run. Everything seemed to be in good working order. i went to run the next day, and as soon as my left leg hit the ground, I had a sharp pain on the outside of my left knee. I thought I could run it off, but made it maybe 3 miles until I couldn't anymore. I walked/limped home, at this point I probably could have forced my knee to bend, but it hurt so much, I couldn't. I showered, iced, and it didn't get any better, so my hunny sent me to the ER. Nothing on the xrays, they wrapped it up, ice, and follow up with the ortho. Later that night, I stood up, heard and felt it pop and it felt so much better, and would move again.

I followed up with the ortho, thinking it was maybe a lateral meniscus tear. I've done the medial meniscus, so I know what they feel like. He was pushing and prodding, and hit a spot on the outside that nearly put me through the roof. Thinking it was the ITB, but wanting to rule out the meniscus, we did an MRI. It was odd, because the pain came out of nowhere, it's never hurt like that, and ITB normally creeps up slowly.

The MRI shows nasty ITB inflammation, patellar tendonosis (duh! I knew that), pretty significant arthritis under my kneecap (duh!), a slighty raggedy lateral meniscus, and a little bit of a fussy biceps tendon. Generally, it's a rest it out condition, but I had a marathon in a few weeks from the visit. So we did a cortisone shot, high dose anti inflammatories, and PT. The drugs and shot didn't work, and PT didn't hurt while I did it, but it still hurt to run after a few miles. I did the marathon, and was good until 6 miles, when it started to hurt. The last 20 miles were awful. If I didn't know what was causing it, I would have pulled out thinking something was seriously wrong.

I went back to the doc on Monday, today is Saturday. The next step to loosen the dang ITB is a surgical release. But we're going to try 1 month of no running, and see if that helps. I can do easy or low impact and I can lift if it doesn't bother me. And my PT exercise at home. Maybe one 3 mile run a week. And then we'll revisit. I'm supposed to start marathon training at the end of June. If it's feeling better,he'll release me to do that, and maybe a second cortisone injection.

A week in, and I'm not feeling much better, but I can walk without a limp! I'm not afraid of surgery. This knee has already been fixed twice. A plica removal and debridement, and a lateral release and medial meniscus tear. Both prior to me starting running. I don't want to do surgery, but something tells me that's where I'm headed. I'm not afraid of it, I just don't want to be lamed up for a month. It's about a 4 week recovery time, but back to work next day, and PT almost immediately, so I wouldn't be immobile. He says it works about 90% of time. From what I've read on the internet, it's not a common surgery, but I'd say 95% of what I've read, everyone would do it again, and was back to running in 4-6 weeks.

I really think that being uneven in the boot messed up my walking gait and that messed up the opposite knee, but what do I know?

Has anyone ever had an ITB release? How did it go? Did it help? Would you do it again?

Thanks!

Nan

 

[RapidBreath]

Have not had ITB surgery, did have a horrible dislocation of the leg / hip. My injury showed up as arm pain because I was trying to compensate. My PT did acupressure release and had me do stretches and use the foam roller. My arm hurt so bad I thought it was broken. Thankfully it wasn't. The pressure point release does hurt but it does work. I don't know if it would work for you.

 

[spyrosmom]

The massage therapist helps, but only for a few days. The PT massage, too. I had an hour lower body massage last week that had tears in my eyes. But it felt so good when she was done.

 

[Soapmaker]

One month is not long enough to heal the ITB. I would give it at least 3 months. I would be very cautious with a surgeon who recommends surgery so quickly. Sometimes drs assume that patients won't do what is needed to heal. I would get a second opinion from somebody who does a lot of this type of surgery. Surgery is permanent.

I've had problems with my left ITB which left me with severe lower back pain. What worked for me is consistently stretching on the half roller before and after runs. When in pain, I would stretch 2 or more times a day. You lie down on your side on the half roller making sure that the entire ITB is in touch with the roller and you apply as much pressure from your body weight as you can handle. You need to sit there for a minute or 2 and work up to few minutes. You can do the same stretch on the roller but it is harder to control. This is like stretching a rubber band along its entire length to keep one part from compensating for another. That happens when you roll on the full roller. I also add glute stretches using a tennis ball after. While trying to heal, I would also rub the ITB during the day to get fluids circulating. It helps bring in nutrient and take out toxin because on its own the ITB doesn't have a blood supply. I would do this in addition to regular PT.

One DVD I would suggest is Mike Boyle's foam rolling. It is available to rent from Kineticflix.

If you have an Ohashiatsu massage therapist in your area, consider trying it. They do a very painful stretch that hits the IT band well. It helps. Hope you feel better soon.