ITBS - is there any hope?

[physio.smith]

If you know your right overpronates more, whilst landing more supinated and you have no leg length descrepancy then most likely a control problem. Make sure if you have not already that you check hip quadrant for tightness / alterted hip congruency right to left. Obviously as you have identified upping the pace is the likely cause...if your control is lacking at all at the hip you will whip over into pronation quicker and overuse lateral structures, irritating ITB.

Control work
I would ensure that you can do sidelying leg lifts first. Clam position, 90 at hips and knees, feet together, lift upper knee. If can't do this without bringing TFL then try with pilow between knees to put glut. med. into inner range and try this. Obviously you do need to get through range control...but it may help you get started.

If you can't get control in side lying then when you try and gain control with weight going through the limb you will constantly compensate. It may take sometime to regain control...it may also be being hindered if there is some Lx involvement.

Gluts / hams can be done prone with end of plinth tilted down, or standing leaning over plinth...definitely get a friend to help identify if you are kicking in your gluts.

[Sports_Rx]

I find clams really difficult on my affected side but I will persevere. I do them against a wall to stop me cheating

Control work

Gluts / hams can be done prone with end of plinth tilted down, or standing leaning over plinth...definitely get a friend to help identify if you are kicking in your gluts.

These leg lifts - is knee straight (for hams + glutes) or bent to 90 to isolate glutes?

Thanks for your time.

[physio.smith]

If you find clams difficult then pillow may well help, so don't have to go through whole ROM, you can just work on small movements. Think recommended was 10x10sec holds to work low threshold, need to work this area to prevent fatiguing when going on long run. Try not to use wall as this may lead to compensations, I had the same problem and found using a partner really help to get technique right in first place and monitor I was not cheating as I progressed through the exercises.

Gluts / hams...can start with knee flexed to isolate gluts more but aim is to initiate gluts then hams and in functional way...thus do need to do with straight leg at some point. (also make sure not activating lumbar muscles)

Nice exercise to try to see if you can dissociate lumbar from hams....
Sit on edge of plinth (feet flat on floor), use hands in small of back, tilt back and forth to find neutral, (make sure sitting tall) try and straighten your leg slowly and monitor what happens in lumbar area....tendancy is to slump if unable to dissociate.

Good luck, let me know how you get on.

Kinetic Control Courses really good for this sort of control work.

[Sports_Rx]

Just an update on my ITBS. It's still there I have trigger points in lateral hip and randomly down lateral thigh that flare up if I run (still only able to run 2 miles) or do any weight training (squats / lunges). Involved R) leg just feels heavy and tight all the time.

Still doing the glute med strength work - clams and wall presses with bent leg. Stopped the 1-legged squats as legs are strong enough. Still doing VMO work and stretching piriformis and itb. Foam rollering after running.

I've stiff L5 so have been doing prone extensions with pelvis fixed and also standing glide/ extension with PA pressure on L5. Physio recently diagnosed posterior torsion at my SIJ. Rx with MET technique and did unilateral PIVM on R) L5 as that facet joint is stiff.

What on earth next?!