ITBS and squats

[RobertFontaine]

I'm just rehabbing some achy it bands. It seems like I've developed a bad case of tight ass; glutes, hips, piriformis. The stretches, ice and massage is clearing it up quickly. Is this common to squatting or a symptom of poor technique?

Is mobility work a necessity/recommended for squatting without injury?

While it's almost certain that the immediate cause of the injury is bad technique. It's kind of tough to maintain good technique when you bomb or succeed on a PR. Do I just suck it up and accept that if I'm going to go after PR's that sometimes I'm going to hurt myself?

How do you try to keep your trainees from tearing up their tendons?

[Mark Rippetoe]

It's rather common to squatting. Since squatting heavy weights is not "natural" in the sense that we didn't evolve with barbells, it makes sense that it might require some additional maintenance on your legs. Lifting PR weights is not perfectly safe; if this is objectionable, maybe you're not going to make a good lifter. My trainees don't usually "tear up" their tendons, but we all hurt occasionally. We do the things you're doing now when this happens.

[startingstrengthad]

Hey Robert, what stretches do you find useful for relieving ITBS? I have recently been afflicted by a bout of it and am having some difficulty stretching adequately.
Thanks!

[nisora33]

Hey Robert, what stretches do you find useful for relieving ITBS? I have recently been afflicted by a bout of it and am having some difficulty stretching adequately.
Thanks!

It has been my experience that no amount of stretching works for iliotibial related pain and tightness. The damn thing is too tough to be stretched. It is more akin to ligament in terms of toughness even though, technically, it's regarded as a tendon, I think.

A massage therapist I went to told me a story about a college friend of hers and his experience with a cadaver and an it-band. She said that he and a classmate tried to reach under the it-band of the cadaver and try to lift it up (don't know why they were doing that), and while struggling to lift it, he let the it-band slip from his fingertips, which cut through his latex glove into his hand (cut it quite deep).

I say this to emphasize the fact that rigorous massage and/or foam-rolling are about the only things I know of that will work for this type of dysfunction and pain.

-Stacey

[Mark Rippetoe]

It has been my experience that foam rolling doesn't work, because you can't hurt yourself nearly as badly as someone else can hurt you. Any of you guys that have had a crazy girlfriend will attest to this.

[nisora33]

It has been my experience that foam rolling doesn't work, because you can't hurt yourself nearly as badly as someone else can hurt you. Any of you guys that have had a crazy girlfriend will attest to this.

No joke, Rip, I can take a lot of pain.

But seriously, I understand what you're saying, that most people just can't inflict enough pain on themselves to see any benefit from the foam rolling. Let me be more specific, though. My last stint with foam rolling produced rather good results. I started with the least dense foam roller, worked up to the highest density over a couple of months, and then I went down to Home Depot and bought a length of PVC pipe once I'd built up a tolerance to that. It worked. Pain diminished, flexibility and function improved.

At each stage, I deliberately inflicted as much white-knuckle pain as I could stand. I'm not kidding, enough to take your breath away. I'd read your comments before about not being able to inflict as much rigorous, bone-grinding pain yourself as the massage therapist can, so I went into the whole process with the mindset "If this doesn't fuckin' hurt, I ain't doing it right."

Just my two cents.

-S.

[RobertFontaine]

... Well you guys are obviously smarter than I am but there are two stretches I've found that seem to help. The two stretches are in the middle surrouned by the rest of what I do to recover from inattention, bad luck, or stubborness.

What I have found after having, golfer's elbow, tennis elbow, screwed up shoulders to the point of not being able to turn the steering wheel without pain, sciatica and a screwed up mouse wrist is that no single modality works by itself. You pretty much need to throw the kitchen sink at it. Tendons are a goddamn pain to rehab.

Notice this is within the context of...
RICE and MEAT

Rest - If it hurts leave it, if it aches exercise carefully
Ice - 3 times a day and after massage, stretching and exercise.
Compression - Tensor bandages at night (it doesn't take much compression to do the trick)
Elevation - leg up when convenient helps but it's mostly a pain in the ass

Just RICE used to get me to no pain but it never got me strong.

MEAT

Mobility - Working the damn thing through it's full range of motion DOES help. It was a key contributor to finally getting through my shoulder tendonitis.

In the case of my IT Bands I have such bad lower body flexibility that mobility work is essentially stretching.

I did a full range of stretching over the last couple of weeks.
back extension, flexion
groin,
quads
hamstrings
calves

... I can say for certain that better mobility in my shoulders has absolutely reduced my reinjury rate. (chronic slouch from a desk job and generally being a slouch). I am told the hockey kids often similar issues, shortening of tendons in shoulders from skating.

... I would guess that same will occur for the IT Bands IF posture issues are a causal factor (tight hips, tight piriformis, tight hams - and I have all of these)

The first stretch I found was the cure to my sciatica (tight piriformis pinching the nerve in my ass)

http://www.youtube.com/watch?v=JbpkAOxro5Q

You can adjust this to emphasize the IT Band pretty effectively.

This is the second which is really a variation of the first
http://www.youtube.com/watch?v=VjMua9UmogA

Exercise: Bill Starr's Advice is exactly the thing and Mark has a sticky for injuries.

Analgesics: I tend to just Ice obsessively, I can eat ibuprophen by the handful and it just doesn't do much for me.

Therapy: The foam roller isn't bad for a day or two but the IT Band is just to deep and tough to get at with it. After a couple of minutes with the foam roller I pull out a 1 inch diameter stick I have from escrima and put some weight into it. With some elbow grease you can get a fairly decent massage with good piece of wood. After that I go to the A535 and thumbs and knuckles to dig in and rub the sore part with and against the grain. (followed by ice and a tensor bandage)

If I manage to get a good massage, I generally give it a day to heal because it usually feels a bit on the bruised side.

If I do ALL of these things then I feel better fairly rapidly although when my shoulders were completely buggered it took me the better part of 4 months to figure out how to heal them (I had tried to work through the pain for the better part of a year).

[AHolts]

re: stretches, I have had limited success with one. I'll try to describe it without being too confusing. While standing in front of a door, or squat-rack (to grip for stability later) cross the effected leg over the other making an upside down "figure 4" with your legs. Then, hold the door-jam/squat rack etc. and sit down and back as if doing a one legged squat. You should feel it where the band attaches at the hips and on the outside of the knee. I hope that makes sense. Additionally, the link below outlines a stretch that I do more regularly - nearly anytime I find myself just standing around.

http://www.rice.edu/~jenky/sports/itband.html

I've found that if I stretch my IT band extensively before I go to sleep, and immediately after I shower in the morning, and then do some leg swings to loosen it before activities (i.e. squatting), it doesn't bother me nearly as much. Hope that's helpful.

[Smudge]

I'm not an expert on ITBS- especially as it relates to squatting- but I've had it for several years (sometimes so bad I couldn't walk) and this is the one stretch I've found most effective at stretching my IT band. I can't find a picture of it anywhere, so if my description makes no sense, let me know & I'll post a picture or video of myself demonstrating it.

Sit on the floor with your knees bent & feet flat on the floor. Place your right leg over your left knee & use it to push your left knee towards the floor. I usually move my leg in & out of the stretch a few times before holding it.

I try to do that 2x a day, along with these stretches and that horrible foam roller thing (or a tennis ball):
http://z.about.com/d/exercise/1/0/r/b/hipflex.jpg
http://www.yogajournal.com/poses/863
http://www.yogajournal.com/poses/2477

I hope this helps!
~Jen