Monthly archives

August 2008

Healing IT Band Syndrome

Iliotibial Band
Iliotibial Band

Iliotibial band syndrome (ITBS) can be described as outside (lateral) knee pain that is made worse by any lower limb activities, most notably running and cycling.  The incidence of this injury is on the rise in my practice, but research also shows that ITBS is the most common running injury in the lateral knee, with an incidence of 1.6-12%. In cycling, ITBS may account for up to 15-24% of all overuse injuries.

It is thought that ITBS is an overuse injury in which the portion of the iliotibial band which runs over the outside knee rubs over the femoral bone with repetitive knee bending and straightening. This results accumulated tissue damage and irritation of the ITB. Specifically with running, as each leg comes forward before heel strike, the tensor fascia latae (TFL) and gluteus maximus/medius are contracting to slow down the leg, which can result in a large amount of tissue tension generated in the ITB.

A study published in Manual Therapy systematically reviewed all studies on ITB treatment in order to determine which was the most successful method. What they found is that there is a marked lack of good evidence to support any one given treatment for ITBS. All forms reviewed – ultrasound, friction massage, medication or ice all had very little benefit on the condition.

Part of the reason for this is that different treatments could work for different subsets of people (i.e. older cyclists respond better to one thing, while runners with chronic ITBS respond better to another). This Comox Valley Chiropractor will often see good results with ART (active release therapy) and other such soft tissue therapies, kinesiotaping,  and chiropractic adjustments to restore proper function of the pelvis, hips and back. Of course, one must always look above the problem (pelvis) as well as below the problem (feet) for a source of dysfunction.

So the bottom line of this post? So far, the evidence doesn’t point to one therapy being better than another. So when seeking out treatment, be sure to set an appropriate treatment plan that includes regular re-evaluation with your therapist. If something isn’t working, don’t be afraid to move on and try another modality once you’ve given the first one a good shot.

If you have any questions about ITBS, feel free to contact your Comox Valley Chiropractor for more information.

Kinesiotape – A Great Pain Reliever!

Many of you have been watching the Olympics. If you’ve been watching beach volleyball, you’ve no doubt spotted the peculiar black tape all over the shoulder of one of the American women. This taping method which was developed by a chiropractor, called Kinesiotaping, is very popular amongst trainers and chiropractors especially when working with elite athletes. I’ve been using Kinesiotape in my office for about 6 months now with great results.

From the Kinesiotaping website:

The Kinesio Taping® Method has taken the Rehabilitation and Sports Medicine world by storm. This amazing taping method was developed by Dr. Kenzo Kase over 25 years ago in Japan. Kinesio Taping® has quickly become the gold, or should we say “platinum” standard, for therapeutic rehabilitative taping. The proprietary method of taping uses a uniquely designed and patented tape for treatment of muscular disorders and lymphedema reduction.

The Kinesio Taping® Method involves taping over and around muscles in order to assist and give support or to prevent over-contraction. The first technique gives the practitioner the opportunity to actually give support while maintaining full range of motion. This enables the individual to participate in their normal physical activity with functional assistance. The second technique, which is most commonly used in the acute stage of rehabilitation, helps prevent overuse or over-contraction and helps provide facilitation of lymph flow for an entire 24 hour period.

On a personal note, I have been using Kinesiotape for my knee sprain. When the tape is not applied, I have alot of pain walking, standing for long periods of time, and going from a sitting to a standing position. As soon as the tape is applied over the inside surface of my knee, I get instant relief from pain which enables me to strengthen and heal the injury quicker.

I have used this method on various injuries in my office. Just yesterday, the tape was used to reduce the inflammation of biceps tendonitis, pregnancy-related pelvic pain and shin splints. If you have any questions about how Kinesiotape can help you, feel free to contact your Comox Valley Chiropractor.

Summer Sports = Knee Sprains!

I recently read somewhere that ultimate frisbee has one of the highest injury rates of all sports. Some say it is due to the fast pace and uneven fields, but I suspect it also has something to do with improper warm-up and conditioning. One of the most common injuries is that of knee sprains, which I managed to bestow upon myself last week.

Most ultimate frisbee knee sprains can be divided into two categories: MCL or LCL sprains (medial and lateral collateral ligament) or meniscus/ACL (anterior cruciate ligament) sprains. MCL/LCL are usually less severe (this is what I managed to do to myself) and affect the inside or outside of the knee. Meniscal or ACL sprains are more severe as they affect the overall stability of the knee and often take much more time (and sometimes surgery) to heal.

Thankfully, I have almost unrestricted access to low intensity laser therapy (given that I own the machine), and have been treating the injury daily since it happened. Laser therapy is a great option for injuries such as this, as ligaments are considered a tissue that does not heal as quickly as others (such as skin or muscle). Laser therapy can boost the ligament’s healing rate, and get me back on the field a lot faster.

It is important to remember, however, that after the swelling and pain have reduced the knee needs to be strengthened in order to prevent re-occurrence and get you sport-ready. The most important amongst these exercises is medial (inside) quad strength, as this muscle will begin to weaken immediately upon injury, especially if you are on crutches or limping around.

If you have any questions about knee sprains or rehab, feel free to contact your Comox Valley Chiropractor.