Pencil Shavings

Thursday, December 21, 2006

ITB Anonymous: Session V

Hi, my name is mis_nomer and I have a problem.

I went to see the sports doctor at National Stadium this week. I was nervous about seeing the doc 'cos I felt like an impostor. After all, I'm not exactly an athlete. But I felt a little better when the person after me was an auntie whose sport was "aerobics". Sports is for everyone; it is just hard to imagine it so.

Anyway, it turns out that my ITB problem may have a biomechanical origin. My left leg is 1 cm longer than my right, and my left knee naturally tilts inwards. This means that every time my foot hits the ground, it rolls inwards and the ITB strains to keep the knee straight. After a while the ITB rubs against the bone and becomes inflamed.

I was a bit appalled to hear about the discrepancy in my leg length, but the nice doctor assured me that a 1-3 cm discrepancy is normal and the only reason I feel pain is because small discrepancies become magnified when you multiply it over in long distances. She thinks that thrice daily stretching will help, followed by short runs (starting 3km, increase 10% per run) in the new year. Hopefully, my body will know how to compensate for the quirks in my leg structure. If the pain comes back, I'll have to consider making an insole.

These are the four ITB stretches she recommended:

For the ITB, this is her preferred stretch. This stretch reaches the hip as well, so if you suffer from hip ITB, this is a good one to do.



This is my preferred stretch. I find it hard to feel the stretch in the one above because I'm fairly flexible and have to lean really low to feel anything at all.



This is another one.



This stretch is good because I can do it while I am sitting at work.



You mustn't forget to stretch your calves and quads too.





I had a lot of questions to ask the doctor and she gamely answered them all.

1. Can I swim the breaststroke? What about cycling?
"Everyone is built differently. Of course the frontcrawl is the best for swimming because the breaststroke shortens the ITB, but if it doesn't bother you, go ahead and do it. In your case, it may be that only running/ walking is the precipitating factor." Whoohoo!

2. What do you think about the Walt Reynolds' ITB Special?
"I can't comment on that because we haven't tested it out."

3. How long must I stretch for?
"Three times daily: morning, afternoon, night; and don't forget to stretch before and after your runs." What! I was thinking along the lines of five minutes before and after my runs!

4. How can I stretch for hip ITB? (on behalf of Smole)
"All of the regular ITB stretches work for hip ITBS. The leaning on the wall stretch is the best. Some athletes use a rubber ball with rubber spikes to rub against the hip ITB. That helps too."

5. Can I buy an insole from the store?
"No. If you have a specific problem like you do, it is very unlikely that a store-bought insole will help. You need one to be custom made. Our podiatrist is a runner and comes in every Friday if stretching does not solve your problem."

6. Is this something that will heal and resolve itself? I want to run for a long time.
"Stretch a lot and if that doesn't work, make a prosthetic." Hmm. Not quite what I was looking for. The doctor said she has the exact same problem as me and hers kicks in at 7km. I wonder if this is going to be a long-term issue if even the sports doc struggles with this...

and these are the questions I didn't get around to asking.
7. Is it possible to stretch too much?
8. Can I do speed training, run on hills, run laps, play squash?
9. What do our athletes at the Asian Games struggle with?
10. Hey doc, nice Treo!

5 comments:

Unknown said...

I'm very happy to find your site. I'm a new runner and in the past month been bothered by ITB in my right knee/leg. This has been very helpful, and even encouraging! Thanks

Anonymous said...

Ditto what mobi said, good info.
I too have suffered from ITB problems for the last 3 years. it has affected the amount i run to the point where i'm no longer an active runner. i love to run and miss it very much. i've been to phys. therapy, chiropractor (not regularly) with no significant, long term results. of course the problem seems to originate in my hip alignment and i get pain in the lower back as much as i do in my itb, which still occurs without exercise. does/did your itb pain have accompanying lower back pain as well? thanks!

mis_nomer said...

Hi Mobi and Anon, thanks for dropping by. I'm glad you find the stuff here useful.

I don't get lower back pain with my ITB pain. I tend to have a persistent lower back ache, but I usually attribute that to bad posture, etc.

There is a hip ITB as well.. does that hurt for you?

Anonymous said...

nah, no hip discomfort. it started w/ hip flexor pain (front, not the side where the itb originates), swiftly moved to itb (on outside of knee) and later to both back and itb. sports trainer at university said itb and lower back often complement each other. they said my hips were misaligned. anyways, i'm giving the reynold's exercise a try. talk to you later.

mis_nomer said...

Hmm. Sounds quite serious.. Frankly the Walt Reynold's exercise didn't do very much for me. But perhaps I just didn't give it enough time to heal up. Strengthening the hip abducters would be good...