Daily Mobility Exercises by Dr. Kelly Starrett › Forums › Knee › Persistent IT band problem – now in both knees

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    • 05/04/2014 at 8:27 am #70923
      AvatarJW Blish
      Participant

      Hi there. I’m pretty new to Mobility WOD and I’m hoping you guys might be able to help with some advice for a pretty bad IT band injury.

      I used to be a keen runner and hiker but now I struggle with normal walking. I’ve had pain on the outside of my right knee for the past six months ever since I went on a hiking trip. I saw a physio for three months and thought I was getting better so I tried a short run but the pain returned and is worse than ever now. It hurts just to walk around the house and now the outside of my left knee is hurting too.

      I have a routine of stretches that I do each day – hamstrings, calves, hip flexors, quads and piriformis. I also foam roll which is excruciatingly painful. I seem to have a trigger point half way down the outside of my right leg. I was also doing exercises each day: planks, side planks, bird dogs, hip hikes, lying lateral leg raises, clamshells, pistol squats and glute bridges although the last two made my knee pain worse. I’m now seeing a new physio who tells me I’m doing too much and says I should just do hip hikes every other day. He also couldn’t find anything particularly wrong with my biomechanics apart from my pelvis rotating slightly on one side. I’ve also started seeing a chiropractor in the hope of fixing this.

      I wear orthotics all the time but I don’t know if they help. I do a lot of sitting due to the nature of my job and I have very tight hip flexors, psoas, quads and calves. My right hip is also very stiff and clunky. My IT band doesn’t feel particularly tight though.

      Can anyone point me in the direction of some exercises that could help? I feel that the physios I’m seeing here in the UK have outdated ideas that don’t work. They keep telling me to stretch the IT band (although I understand it can’t be stretched) and to ice my knee but I see that Kelly advises against this. I am interested in the idea of voodoo floss but don’t know where I should be flossing. I do hope someone can help as this injury has completely changed my life and I’m getting very depressed. Thanks.

    • 05/04/2014 at 11:18 am #74581
      AvatarNathan Richer
      Participant

      wow a lot here! first, i would buy the book Becoming a Supple Leopard. it is a great read and will change some thinking about how you will recover.  Kstarr is coming out with a book for runners soon so look for that.

      starting out can be overwhelming.  i wrote a blog post about it here as a suggestion: http://www.dshen.com/blogs/training/archives/mobilitywod_quick_start_guide.html
      i would stock up on the bands, and massage tools like Supernova, lacrosse balls, etc.
      re: videos on running – i would watch these, since you are runner:

      this may be very relevant to you:

      Knee pain on stairs and hills

      there is a lot to work on. i would go through these videos and try some of the smashes and mobilizations. don’t overwhelm yourself trying to do everything at once.  work on a few things instead. sometimes you will find that the other things correct themselves out because everything is related.

      i would however take a break from running for now.

      regarding orthotics – the feet are very important and we’ve destroyed them in a number of ways, especially for women who wear high heels and those thin pointy shoes.  i would not graduate to running without them just yet, but i would work towards not needing them.  to that end, i would recommend walking around in barefeet around the house whenever possible, and finding shoes with wider toe boxes to give your toes room to spread out.  i’m not sure if you can get these in the UK: Correct Toes: https://correcttoes.com/correct-toes but they are amazing and work great. you can wear them during the day or all night or both.

      fixing foot mechanics and function is one part of the solution. the others are all upstream.

      i suspect that your sitting all day has shut off your glutes, which is a contributor to your problems.  your glutes help maintain the arch way down below at your feet. if they are off, your feet will collapse on the arch and hence the need for orthotics.

      one small point to look at re: glute bridges and pistol squats. does your knee move inward when you do them? you should be having a bit of external rotation in them, meaning the knee is biased slightly outward. this protects the structures around the knee.  if your need starts drifting inward, this puts a lot of stress there and can inevitably cause pain and injury.

      try this and report back!
    • 05/04/2014 at 2:14 pm #74582
      AvatarJW Blish
      Participant

      Thank you David – this is all really helpful. I didn’t know where to start before but this has given me some good pointers.

      The knee pain on stairs is very relevant to me. I think there’s something awkward about the way that I move. I think my femurs rotate inwards which is why I think the pistol squats and glute bridges cause me problems.

      Re the orthotics, I have very high arches. I tried running shoes for pronation and they helped initially. I definitely have weak glutes and hips too but I thought I would have seen an improvement after doing the strengthening exercises for over a month. Anyway, thanks again and I’ll see how I get on with all this.

    • 05/04/2014 at 9:46 pm #74584
      AvatarNathan Richer
      Participant

      Keep in mind that movement patterns don’t translate. So you training some of your muscles for strength is good for their strength, but does not necessarily mean they will activate in movement patterns. So if you do glute strengthening, that is good but they may not turn on when you want them to. There are exercises to do glute strengthening and activation AND in the movement patterns you desire.  For that kind of work, you’d probably need to find a good PT schooled in today’s rehab methods.  but let’s see how you do with these videos first!

    • 05/04/2014 at 10:59 pm #74585
      AvatarDeven Williams
      Participant

      I was a pretty serious cyclist and recently found that part of my knee issues were a result of being really lateral quad-centric and had very poor firing of my gluteus/hamstrings and my medial quad was sequencing poorly. All a result of single specific activity.

      While all the rolling/stretching/lacrosse balling/etc. is helping they feel long term results will only come when I get my muscles to fire properly.

    • 05/05/2014 at 4:31 am #74586
      AvatarJW Blish
      Participant

      Thanks again guys. What sort of things should I look for when finding a good physio? I’m on my third now and feel that they all have outdated methods. I’m really interested in the idea of certain muscles not firing properly. How can I find a specialist who would know about this?

    • 05/05/2014 at 5:19 am #74588
      AvatarJW Blish
      Participant

      I agree with you Alec that I think my problem is down to muscles not firing properly. I don’t feel that all the foam rolling etc helps massively. I haven’t run for six months now and have been doing a lot of sitting which I guess doesn’t help. Yet I feel as though the physio exercises I’m doing to try and strengthen my glutes and hips are causing my knee to hurt. It’s all so frustrating.

    • 05/05/2014 at 8:25 am #74589
      AvatarDeven Williams
      Participant

      “…..How can I find a specialist who would know about this?…..”


      I’ve seen 4 plus a sports massage specialist [who was perhaps the most helpful]. The 4 PT……a bit from each but none really inspire confidence. One PT told me squatting below parallel was bad and I wouldn’t find any PT’s that thought Crossfit was a good idea! I understand your struggle and have actually thought about traveling to CFSF for an in person evaluation of my mobility.
    • 05/05/2014 at 8:36 am #74590
      AvatarDeven Williams
      Participant

      FWIW: I’m doing sitting leg extensions while holding a 6″ ball between my knees. [the adductors need to fire before the VMO [so I’m told].] Single straight leg dead lifts with a kettle bell and straight leg dead lifts off a box with a barbell for my gluteus/hamstrings. I’m also doing the work from #272 

      http://www.mobilitywod.com/2011/06/episode-272-tj-murphy-edition-and-hamstring-stiffness/

      I too am super tight in the same areas as you with hamstrings like steel cables. They are improving at a rate that kills me but then again it took 56 years to get them as tight as they are so I shouldn’t expect results overnight.
      Sitting on a lacrosse ball under my hamstrings and hunting around for those evil spots and then flossing/knee extensions 100 time per leg daily really seems to help. Not just extending my leg but really trying to feel the flossing makes a huge difference in the effectiveness.

    • 05/05/2014 at 9:45 am #74591
      AvatarNathan Richer
      Participant

      generally the best way is to get a referral. where in the UK are you? it may be possible to ask around and see who is available.

      otherwise, it can be hard on your own to pick one. I would hate to give you a list of certifications in certain techniques that I am in favor of because that is not a guarantee that someone is good. but it may come to that.
    • 05/05/2014 at 5:24 pm #74593
      AvatarJW Blish
      Participant

      I’m based in Essex, but can travel to London fairly easily. I saw your other post about the Gokhale method. I thought it sounded interesting as I had been considering trying the Alexander Technique and it sounds similar. Would you recommend the Gokhale method?

    • 05/05/2014 at 8:12 pm #74595
      AvatarNathan Richer
      Participant

      I took the class along with my mother. Overall i thought it was pretty excellent. It is geared towards sedentary people but i found the concepts to be useful in athletics. i also didn’t agree with everything that was taught and some things were missing. still i think that many people have made enormous positive change with the class and I can highly recommend it in any event and I think it will be useful.  I think you will get a lot out of the several weeks class.

    • 05/07/2014 at 3:27 am #74607
      AvatarJW Blish
      Participant

      Sounds pretty good. I’ll look into it. Thanks!

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