Illiotibial/knee pain

[tatakai]

I've ran and hiked for years; at my peak probably 30 miles a week plus long walks with the pup along with muay thai off and on and nary a problem.

I thru hiked the Appalachain Trail last year (Northbound) and in the middle of Virginia it started to flare up - that familiar pain on the outside of my left knee. Always when going down hill, nothing going up. I wore thickly cushioned trail runners (Altra Olympus') the whole way, and have had a runner tell me too much cushion can cause "runners knee," but that could be a totally different thing.

I've had lots of people suggest various stretching regimens, foam rolling, and various exercises but these are anecdotal sources at best. I've gotten so far post hike from inactivity. I think I could probably start jogging again now, but will probably try biking instead.

Aside from this, do you guys and gals have any insight? I've been working on my stride and using more hip/glute which seems to maybe help?

 

[Dream Evil]

I just recently mentioned this in another thread...

I had IT band pain for about 2 years, and I (stupidly) just ignored it and kept pushing through it. Finally it got to a point where I knew I needed to address it. I started looking into it, and the common theme that kept coming up in my research is that many knee problems aren't "knee" problems at all - they're caused by a lack of hip mobility.

I began doing side leg raises before every workout. Immediately I came to realize how weak I was in that position.... I could barely manage 10 reps without a rest. I kept at it, and my rep count increased significantly over the next few weeks. And in that same time frame, my pain disappeared.

Now I begin every workout with a few minutes of hip mobility exercises, and I've not had any IT band issues since.

 

[SMillard]

I just recently mentioned this in another thread...

I had IT band pain for about 2 years, and I (stupidly) just ignored it and kept pushing through it. Finally it got to a point where I knew I needed to address it. I started looking into it, and the common theme that kept coming up in my research is that many knee problems aren't "knee" problems at all - they're caused by a lack of hip mobility.

I began doing side leg raises before every workout. Immediately I came to realize how weak I was in that position.... I could barely manage 10 reps without a rest. I kept at it, and my rep count increased significantly over the next few weeks. And in that same time frame, my pain disappeared.

Now I begin every workout with a few minutes of hip mobility exercises, and I've not had any IT band issues since.

This pretty much covers what I was going to say. The foam roller helped a little too, but the stretching and strengthening the hips really is what did it. As you get older doing the warm ups becomes more crucial.

 

[MisterHappy]

Agree 100% with the above and will throw in that some of my issues were not as much hip mobility but rather pelvic alignment as my pelvic ligaments are pretty much useless so I am prone to movement of the pelvis independently on each side. (In a bad out of whack sort of way) A good PT can diagnose and help get things straightened if need be. Rolling did help alleviate the issue on a temporary basis and now I do it more so for ongoing maintenance.

 

[nhbfan8080]

I've ran and hiked for years; at my peak probably 30 miles a week plus long walks with the pup along with muay thai off and on and nary a problem.

I thru hiked the Appalachain Trail last year (Northbound) and in the middle of Virginia it started to flare up - that familiar pain on the outside of my left knee. Always when going down hill, nothing going up. I wore thickly cushioned trail runners (Altra Olympus') the whole way, and have had a runner tell me too much cushion can cause "runners knee," but that could be a totally different thing.

I've had lots of people suggest various stretching regimens, foam rolling, and various exercises but these are anecdotal sources at best. I've gotten so far post hike from inactivity. I think I could probably start jogging again now, but will probably try biking instead.

Aside from this, do you guys and gals have any insight? I've been working on my stride and using more hip/glute which seems to maybe help?

I'm not a very experienced runner but I think all the common remedies like foam rolling, hip exercises are secondary to maintaining proper core/hip stability with proper neuromuscular 'connection'. The muscles can be adequately strong from heavy squats and MA traning but a person can still fail to achieve good stability during an activity like running without that mind - muscle link.

Running downhill causes most of the damage and most runners feel it more going downhill. Trail running carrying a pack is probably harder on the joints as well. Road camber + going downhill causes ILTB to flare up abit if I don't switch sides regularly.

 

[drbolony]

What really helped me was the 3rd exercise from Defrancos limber 11. Mines severe enough to grow a golf ball sized lump on the affected knee. Haven't had a flare up since I really started focusing on this.

Glute tightness caused mine, that coupled with some it band foam rolls would be my suggestion.

 

[tatakai]

I just recently mentioned this in another thread...

I had IT band pain for about 2 years, and I (stupidly) just ignored it and kept pushing through it. Finally it got to a point where I knew I needed to address it. I started looking into it, and the common theme that kept coming up in my research is that many knee problems aren't "knee" problems at all - they're caused by a lack of hip mobility.

I began doing side leg raises before every workout. Immediately I came to realize how weak I was in that position.... I could barely manage 10 reps without a rest. I kept at it, and my rep count increased significantly over the next few weeks. And in that same time frame, my pain disappeared.

Now I begin every workout with a few minutes of hip mobility exercises, and I've not had any IT band issues since.

right on, i'll start doing those a few times a day.

i really appreciate all of your responses everyone, sorry it took me so long to get back on here.

does anyone know if shoes may be contributing to the situation? I've been an Altra guy for awhile now; particularly the Olympus, because I'm a big dude and i love the cushion.

Someone told me recently that he used a similarly high cushioned shoe, the Hoka...Challenger, maybe? Anyway he said it made his knee hurt, the cushion was making his leg "work harder" or some such, and by switching to a lower cushioned shoe the pain was gone in two weeks?

Irrelevant to IT band stuff, do you reckon?

 

[miaou]

I just recently mentioned this in another thread...

I had IT band pain for about 2 years, and I (stupidly) just ignored it and kept pushing through it. Finally it got to a point where I knew I needed to address it. I started looking into it, and the common theme that kept coming up in my research is that many knee problems aren't "knee" problems at all - they're caused by a lack of hip mobility.

I began doing side leg raises before every workout. Immediately I came to realize how weak I was in that position.... I could barely manage 10 reps without a rest. I kept at it, and my rep count increased significantly over the next few weeks. And in that same time frame, my pain disappeared.

Now I begin every workout with a few minutes of hip mobility exercises, and I've not had any IT band issues since.

Yep.

Before anything else, make sure you've got the fundamentals covered. Do you have halfway decent mobility? Do you have good glute max/med activation and strength? Do you have good VMO activation/hypertrophy? Are your hip flexors in good shape? Are your running mechanics in order? Is your posture halfway decent? Is your core musculature working properly? Do you have basic levels of general strength? Is your connective tissue tolerance on par with the task at hand? Etc.

If your fundamentals aren't solid, addressing them would be your best bet.

 

[Dream Evil]

I wear normal running shoes for running, but for the last year and a half I've been wearing minimalist shoes for all other training. The pair I have are knockoff Merrells.

Do I like the minimalist thing? I guess. I can't say that I've noticed anything game-changing about it since I moved away from regular cross trainers.

 

[tatakai]

Yep.

Before anything else, make sure you've got the fundamentals covered. Do you have halfway decent mobility? Do you have good glute max/med activation and strength? Do you have good VMO activation/hypertrophy? Are your hip flexors in good shape? Are your running mechanics in order? Is your posture halfway decent? Is your core musculature working properly? Do you have basic levels of general strength? Is your connective tissue tolerance on par with the task at hand? Etc.

If your fundamentals aren't solid, addressing them would be your best bet.

well i'm honestly not sure what most of that even means, so lets go ahead and assume not.
I tent to slouch a bit in the posture department and right now I'm out of shape after being lazy the last few months. I'm sure my stride is far from mechanically proper but I'll never be a real runner, I just like staying not fat. I'll be happy so long as I can tackle another Thru hike in a year or two.

As others have said I'm pretty sure its a glute/hip issue, though my girlfriend was convinced it was my calves (I've always had huge calves). She thought they grew noticeably after a few weeks on trail and were oversized compared to the rest of my legs. It sure seems possible, but I reckon it has more to do with under developed hip/glutes than over developed calves.

I've been doing the hip exercises mentioned above and getting aroun 45 minutes on the bike (which feels great on the knee) so I think i'm making progress

 

[Ian Coe]

I'm training for a marathon at the moment and experienced a back ache (/felt thrown out) from a nothing training session.

With training being delayed and a ITB type issue occurring wthiin the last few months during squats, I got a physio involved.
No help with the back baring get some stretches, but his recommendation is biking (10k, 20k time trials) and leg extensions.

Doesn't seem to be a issue (touch wood) for fast hiking at the moment as a result.

 

[Nicholas K]

that sucks man i made a thread asking about my forearm pain but it got deleted....

what the heck ????