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Iliotibial Band Syndrome: A Hiker’s Guide

Illiotibial Band Syndrome Leg brace

On my last two section hikes, I experienced a cramping sensation in my left outer thigh on high mileage days. I attributed this to an electrolyte deficiency and brought along some extra salty items to compensate on my last trip. But the pain got worse and has persisted off trail. I’ve been able to control it with Ibuprofen, but I didn’t figure out what was wrong until last night. I have Iliotbial Band Syndrome

The iliotibial band is a fibrous ligament extending from the hip to the knee that can become inflamed when it rubs over the outer bony knuckle of your knee. The main symptom of Iliotibial band syndrome is pain that starts outside of the knee and radiates up the side of the thigh. The pain can be very hard to localize. I also feel a snapping sensation inside my knee when when I extend my leg. This is another a sign of the injury.

Iliotbial Band Syndrome is curable and preventable by strengthening your quadriceps muscles, stretching, and by preventing over-pronation that can occur from worn out boots or boot inserts. If you are already in pain, use anti-inflamatories like Ibuprofen or Mortin for relief. You can also use a compression strap for added knee support, like the one worn by my friend Paul on his left leg in the picture above.

Amazon sells a Pro-Tec Iliotibial Band Compression Strap for about $15. These compression straps are designed to support the iliotibial band while you are hiking and keep it from rubbing against your outer knee. I just bought one.

I could kick myself because I have had a number of similar overuse injuries like Iliotbial Band Syndrome over the past 10 years, including runner’s knee (also called Chondromalacia, Patellofemoral Stress Syndrome) and plantar fasciitis. I’ve kept these in check by riding a stationary bicycle 100 miles a week, wearing Superfeet hiking  boot inserts designed to prevent pronation, and by doing a lot of lower body exercises like lunges, split squads, and step ups to keep my quads and hamstrings strong.

About 6 months ago, I finally got bored with this workout and stopped going to the gym everyday. Bad idea: I was back this morning.

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  1. Sorry to hear you've been having leg-trouble, but I'm glad you've both figured out what it is and the treatment.

    I've found yoga also to be a great addition to the injury-prevention toolkit!

  2. Thanks Chris. I'm an old hatha yogi too. Got up this morning to do some stretching before an early meeting. Did you see the comment I left on your Lisp page? Touretzsky was my instructor at CMU in 1982 and then I coded prof. for about 13 years after that.

  3. Hi Philip – I've just rescued your comment from the spam filter! I'm absolutely loving Lisp, it's like being handed (or, at least, being shown) a scalpal after many years of bashing away with a blunt axe. At the moment, I'm learning Lisp for the joy of learning (although I've noticed very tangible benefits to the C++/C# work I do). I would like though to include it in my work in a more direct manner in future.

    Chapters from Touretzky's book have accompanied me on more than a couple of climbs. His writing is crystal clear – what was he like to study under?

  4. DaveT was cranky guy but he gave wonderful examples that really get to the quick of things. But I only really learned advanced Lisp (and system design) after I left grad school and worked in a bunch of artificial intelligence startups. It is a wonderful language, like scheme, for building deep insights into computational elegance and abstraction. I've even used it's 2 phase evaluation concept to create self-writing macros in Excel for some very sophisticated financial service/trading apps. There is no problem that cannot be solved by adding a level of indirection. Enjoy!

  5. Here's an update – My ITB has gone away. I got back into the gym and started doing a lot of stationary bike and spinning work outs which has really strengthened and toned my medial quadriceps. Wearing the pro-tec strap also helped keep me on the trail this summer. I still bring it with me when I go on trips, since it only weighs 1 oz., but I haven't really needed it for a while. I didn't spend much time on stretching – strengthening was the key for me. YMMV.

  6. Myofascical Self-Massage Therapy with high density foam roller [you can find video examples on youtube].

    I found the foam roller to be a very effecive aid in helping me reducing my ITB problems.

    I was stretching and during leg strengthening exercises as well, but when I added the foam roller to those I saw a dramatic improvement.

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