Every serious runner dreads hearing that hip or knee pain requires a long break from running to improve. Iliotibial band syndrome (ITBS) is one of several causes of athletic knee pain, loosely referred to as runner’s knee.
The IT band or tract is a band of connective tissue that runs from your hip down the outside of your thigh to just below your knee. During running and other knee-bending activities, the IT band stabilizes your hip and knee. Repeated rubbing of the band over the femur’s upper edge just below the knee thickens the lower end of the band, producing inflammation and pain.
You can reduce the risk of developing ITBS by stretching before running and practicing adequate warm-ups and cool-downs.
If it’s too late for you to avoid the condition, anti-inflammatory drugs such as ibuprofen and naproxen can reduce the inflammation and the pain. Massage, even self-massage, and stretches help the IT band relax and ease your discomfort. Here are four effective techniques:
1. To relax the client’s IT band when I am giving a massage, I hold the knee with one hand while I place the palm of the other hand flat against the outer leg just above the knee. My hand glides slowly up the outer thigh. I repeat this slow glide several times with increasingly deep pressure. Often the IT band has a trigger point or a spot that is tender almost halfway up, which I press with my thumb or a massage tool for several seconds to encourage it to relax.
2. Many runners use a foam roller, which you can buy for less than $20 in a running store or online, for self-massage. Lie on the floor with your injured thigh across the roller and use your arms to roll yourself across the roller, avoiding the bones of knee and hip, for one minute. Rest for a minute, and repeat three times. If the pressure is too intense, reduce the weight on the injured thigh by placing the opposite foot on the floor.
3. The only equipment necessary for another self-massage technique is an armless chair, such as a kitchen chair, on which to sit. To work on your right IT band, place the palms of your hands on both sides of your right knee. Keep your left hand parallel to your right to stabilize your knee throughout the massage.
First rub briskly from the knee up to your hip to warm up the tissue, repeating three times.
Second, place the palm of your right hand flat against your knee and glide the hand slowly up to your hip. A small amount of body lotion or oil on your hand will improve the glide. Repeat five times, increasing the pressure of your hand against your thigh.
Third, make a fist with your right hand and repeat the slow gliding motion from knee to hip with your fist five times, pressing deeply, still keeping the left hand parallel to the right. If you find a tender point along the IT band as you do this, pause, apply pressure at the point, and hold for 10 seconds. Then continue dragging your fist up to your hip.
Fourth, dig the knuckles of your fist to dig into the IT band just above the knee and wiggle your fist. Repeat up to your hip.
Conclude by repeating the brisk rub that started the self-massage, then repeat the full routine on the left leg. Practice this self-massage at least a few times a week.
Are any of these techniques comfortable? Probably not. Are they effective? Oh, yeah.
YouTube has many videos on self-massage, foam rollers and stretches for ITBS relief. Search for “self-massage IT” to find additional techniques that work for you.
The wide-ranging therapeutic benefits of massage help many people function better:
Let’s take a look at how these benefits are achieved. As the massage therapist strokes, kneads, stretches and rubs, tight or partially contracted muscle fibers relax to their normal resting position. Muscles perform their functions better and pain subsides without medication or with less medication.
The massage therapist also manipulates soft tissue and joints to increase your range of motion (ROM), that is, how much movement you have in a joint. Regular massage enables an athlete to improve his golf swing or softball throw as a result of better ROM. If you aren’t an athlete, better ROM means being able to reach the cereal box on the top pantry shelf.
In addition, massage enables you to recover more quickly from injury or infection. Your body produces more white blood cells during massage, speeding healing and fighting infection. The massage also increases your body’s circulation, delivering more nutrients to tissues and promoting healing.
Several studies by the Touch Research Institute at the University of Miami Medical School have focused on changes massage causes in the balance of dopamine, serotonin and endorphins in the blood. The changed balance encourages the production of natural killer cells, which fight pathogens. The balance also affects mood and emotions.
A brief massage – for example, a 15-minute chair massage – increases levels of dopamine, epinephrine and norepinephrine, thus encouraging alertness, focus and attentiveness. Many companies offer chair massage to employees occasionally or on a regular schedule because of this. The employees appreciate how the brief massage relieves aches and pains.
A longer massage raises the level of serotonin, which subdues anxiety and stress, creates pleasurable sensations and promotes feelings of satiety. It reduces irritability and has a calming, comforting effect. It also helps control hunger and cravings.
The level of endorphins, which alleviate pain, also rises with massage. Conversely, massage lowers the level of cortisol, a stress hormone that is involved in stress-related diseases, suppressed immunity, inappropriate inflammatory responses and sleep disturbances .
Massage isn’t simply about pampering yourself; its therapeutic aspects enable your body to function better. The fact that is feels really, really good is a wonderful bonus.
If you have or live with someone who has irritable bowel syndrome (IBS), you already know that chronic abdominal pain, frequent constipation or diarrhea, fatigue, and bloating diminish your quality of life. You may be absent from school or work often and also might avoid social events because of pain and embarrassment.
No one knows what causes IBS. There is no identifiable underlying infection or pathology associated with IBS. Sometimes it develops after an acute intestinal infection, but not always. Most IBS patients are female. Some people with the condition have food intolerances. Stress and depression seem to be connected to IBS, perhaps because of a combination of a predisposition to the condition and the stress-coping mechanism of these patients.
The physician treating IBS may prescribe medications – laxatives, stool softeners and anti-diarrheals – that have unwanted side effects. Treatment recommendations include increasing fiber in the diet and trying to determine if specific foods exacerbate the condition.
Patients also are encouraged to learn new ways to reduce stress and fight depression. The Mayo Clinic web site recommends several methods for encouraging patients to relax, including massage. A primary benefit of massage for anyone, with or without IBS, is that it decreases the level of tension, anxiety and stress. Managing stress is part of managing IBS.
During massage, an endorphin called serotonin, a natural anti-stress weapon, is released into the body, producing both physical and emotional relaxation. In addition to producing a general feeling of well-being, seratonin increases gut motility, a technical term for waste moving forward through the intestine. Abdominal massage, using light pressure strokes in a clockwise direction, also encourages motility. Increased gut motility means less constipation, less bloating and less abdominal pain.
In a study in Sweden a couple of years ago, a group of patients with severe constipation was treated for eight weeks with laxatives only, and another group was treated with laxatives and abdominal massage. The group that received massage had significantly less severe gastrointestinal symptoms, constipation and abdominal pain throughout the study and at the conclusion. One favorable study isn’t scientific proof, but it certainly suggests that massage is beneficial in treating this set of symptoms.
To summarize, regular massage makes the person with IBS more comfortable and improves bowel function without the potential side effects of strong medications.
Yoga, hypnosis, relaxation therapy and even acupuncture also can provide benefits to IBS patients. So can such herbal remedies as peppermint and turmeric. Enteric coated peppermint oil capsules are helpful especially in mild cases of IBS, although the safety for use during pregnancy has not been established. Probiotics, often found in yogurt, can help ease IBS symptoms.
Massage and all the methods mentioned here are helpful in managing the symptoms of IBS, but don’t replace medication or a physician’s care. They are only part of a treatment plan.