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recovery from IT band pain? JMT in 1 week...
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d c
(dc) - M
IT band pain? JMT in 1 week... on 08/13/2013 20:55:44 MDT Print View

A few months ago I developed IT band pain. Orthopedic surgeon says my knees are fine, I just have an overuse issue. After 3 months of PT its better but can still be painful. Because I've been training for the JMT, I've not taken the time off that I should.

I'm scheduled to do the JMT in a week, solo, and I'm beginning to wonder if this is a smart idea! I've done it 3 times already - at ages 20, 50, and last summer when I turned 60. I've never had knee issues before so I have no experience for how this is going to play itself out.

My training hike after work today - 6 miles/2000' gain - just felt awful. Last summer I started with plantar faciiitis and was able to walk through it and was ok. I don't think an IT band issue gets better when you do 18 mile/4000' days??

I see the PT again tomorrow to get his thoughts. I wonder if others here have had IT band issues and have experience with trying to hike through it.

Edited by dc on 08/13/2013 21:02:09 MDT.

Dan Durston
(dandydan) - M

Locale: Cascadia
IT Band on 08/13/2013 21:11:09 MDT Print View

Back in the 2012 Bob Marshall Wilderness Open I hiked through a lot of IT band pain. I could hardly bend my leg on day 2 and hobbled 24 miles in 16hrs. The next day after some rest and quite a bit of ibuprofen, I grinded thru 43 miles in 21 hrs with moderate to high pain to finish. After that event my knee was sore for about a month - probably not a great idea to push it anywhere near this far. It's quite short sighted.

You want to catch IT band problems early in the day, because inflammation makes the rubbing worse and it quickly spirals out of control. I do some stretches before long days to loosen up my IT bands, and if I feel inflammation starting I pop an Aleve, which relaxes my muscles and IT band so I avoid the painful inflammation. If you do start to get significant pain and you want to keep going on a longer journey, I'd recommend stopping for a few hours or the day to let things settle down and get some stretching and maybe muscle relaxants in. It's something I'm still figuring out though, so don't put too much stock in my opinion.

Edited by dandydan on 08/13/2013 21:14:10 MDT.

d c
(dc) - M
IT band pain on 08/13/2013 21:19:12 MDT Print View

Whoa Dan, that sounds intense... All long distance hikers have a high tolerance for suffering, but at this point, at age 61 and a solo hike, I'm starting to think it might be foolish for me to go this summer.

I've been stretching 2 full hours each day, plus PT 2x a week. My problem is I've not stopped training. If I stopped I wouldn't be in shape for the hike, if I continued I risked not healing up - it was a gamble and I decided to keep training/hiking.

Greg Mihalik
(greg23) - M

Locale: Colorado
Re: IT band pain on 08/13/2013 21:23:24 MDT Print View

"I've been stretching 2 full hours each day..."

Using a roller?

d c
(dc) - M
using a roller on 08/13/2013 21:24:52 MDT Print View

yes, lots and lots of roller time.

Greg Mihalik
(greg23) - M

Locale: Colorado
Re: using a roller on 08/13/2013 21:25:47 MDT Print View

+1 !

Randy Martin
(randalmartin) - F

Locale: Colorado
Agree on the Roller on 08/13/2013 21:46:36 MDT Print View

Foam Roller is definitely good advice. The bad news is that regardless of what you do, I don't think you are going to get your IT band in condition fast enough for your planned JMT in a week.

I suffered through this issue a few years ago and found that the best long term solution was significant strengthening of my legs (Squats, Lunges, Plyometrics etc..).

Mike W
(rcmike) - MLife

Locale: California
options on 08/13/2013 23:29:40 MDT Print View

"My training hike after work today - 6 miles/2000' gain - just felt awful. Last summer I started with plantar faciiitis and was able to walk through it and was ok. I don't think an IT band issue gets better when you do 18 mile/4000' days??"

Only YOU will be able to tell how well you think your body will feel for the hike. Keep rolling out your IT band. I like the Trigger Point roller (The Grid) because it is more rigid than a foam roller. Add ice baths to your treatment or use ice cups (freeze water in a a dixie cup). One more thing to try is compression shorts.

Edited by rcmike on 08/14/2013 11:29:16 MDT.

David Chenault
(DaveC) - BPL Staff - F

Locale: Crown of the Continent
JMT and IT band issues on 08/14/2013 09:50:33 MDT Print View

OP, I think you already know hiking the JMT is a bad idea, and are looking for confirmation. So here it is: you may be able to grunt it out with some suffering and vitamin I, but you'll pay the price for months after. It sounds like your issues are advanced enough that you might have to bail. IMO, not worth the gamble.

It's time to write off the rest of 2013 from a hiking perspective. Even cycling is probably not a good idea for a month or so. Find a good PT who can help you track down and fix, definitively, whatever issues you have going on. Start swimming, or maybe hit the erg at the gym. Find a good yoga class. Come back strong next spring.

A decade ago I got bad IT syndrome from road running. I never let it rest enough, used vitamin I to do some trips in the face of good advice, and because of this it took the better part of 2 years for things to finally get better. It also took 2 chiros and 3 PTs before I found someone competent enough to tell me what was actually wrong (tight/weak hamstrings) and help me fix it.

Greg Mihalik
(greg23) - M

Locale: Colorado
Re: JMT and IT band issues on 08/14/2013 10:15:57 MDT Print View

" It also took 2 chiros and 3 PTs before I found someone competent enough to tell me what was actually wrong (tight/weak hamstrings) and help me fix it."

So sad and so true.

I was told by 3 docs that surgery was the ONLY solution, and that at 45 it was time to "slow down a bit" and give up cycling.

I saw several PT's who, in retrospect, didn't have a clue.

I finally saw a PT who said essentially - "Hey your X, Y, and Z aren't playing well together. We can fix that with stretching and strengthening"

I had to back off and focus on rehab, but three months later I was back on top again.
And years and years later, I'm still going.

Edited by greg23 on 08/14/2013 12:37:56 MDT.

TJ Christopher
(Compel) - F
+1 and echo on 08/14/2013 12:34:11 MDT Print View

What worked for me was physical therapy, foam roller, and taking time off all the activities that were causing me pain. Which sucked because all athletic activity on my feet caused me pain, even walking up and down stairs.

After a month I started riding a bicycle a lot which is really good workout if you have hills around. Another month and I phased hiking back into my routine, I abandoned running altogether because that was the primary cause and I've seen too many people injure themselves.

It might be a bit cliché, but if something is causing pain you're probably doing damage. For me running and hiking were out but I could ride a bike without making it worse. If you experiment you might find a way to exercise that doesn't hurt the IT band but keeps you in shape.

I think the time off was definitely worth it in my case, if only to get rid of the constant aching. I was only 32 at the time, so age is not the only factor, but being debilitated like that and the thought of doing permanent damage was not an attractive option.

Edited by Compel on 08/14/2013 12:40:27 MDT.

d c
(dc) - M
IT band pain on 08/14/2013 19:31:56 MDT Print View

Thanks for all the comments. Yes, I knew it was a bad idea to continue when I posted, and knew that ultimately I would decide to not go. But man, at 60+ years old its not easy to stay in condition plus I'm running out of summers!

Phillip Asby
(PGAsby) - M

Locale: North Carolina
tough issue on 08/15/2013 09:50:39 MDT Print View

The one problem I've had is IT band related to my running attempts. I've since taken up cycling and while you can get IT band problems cycling it is relatively less frequent and in my case has not caused pain.

In my case lots of stretching and rolling has kept it at bay and I recovered pretty quickly but stopped running immediately and did not run again for 2 weeks (and then only sprints/intervals no more endurance).

the only solution is to keep it limber and reduce the inflammation to let it heal - at this stage it might be a bit risky given you continue to have pain...

Eugene Smith
(Eugeneius) - MLife

Locale: Nuevo Mexico
Re: IT band pain on 08/15/2013 10:42:29 MDT Print View

Man, I feel for you. ITBS is a bitch, plain and simple. What you have sounds chronic and not likely to dissipate any time soon. I would stay far away from Ibuprofen. all it does is mask symptoms and increases your chances of reinjury. You mentioned your daily hike consists of a climb. Perhaps you're putting too much strain on your glute muscles? Have you tried hiking on flatter surfaces to see if the pain alleviates? Mixing it up may help.

I have friends that have IT band flare ups mid run and disappear a few miles later never to return. Weird. In my case it was almost a year of battling with IT band pain due to overuse from running. I tried EVERYTHING short of steroid injections. In the end, it was considerable time off from running and cross training that got me back on my feet. For nearly two years I could still feel a "tinge" of tightness and occasional local pain at the side of my knee, but was able to resume running as usual and continue to do so with Increased volume and no pain to speak of. It's been over two years now with no issues.

Everyone's advice above sounds solid and this thread is sounding more like a support group for ITBS recoverers.

- Rest.
- Rolling out that fascia band.
- Stretching (helps some people, but did little for me)
- Cross training. Pick your poison. Whatever keeps your heart ticking strong and doesn't aggravate your IT.
- Footwear. Consider other footwear options if you haven't. Some people have had success making small changes with big results.
- Volume. Perhaps you're doing too much?

Best of luck.