Hurt so good; adventures in foam rolling

Today I bought one of these:

foam rolling

Fifteen inches of neoprene-covered pain-inducing misery. I bought it at the local sports shop and it came with three pressure balls, a poster and a DVD (humorously titled ‘This is How we Roll’).

Why? ITBS. Illiotibial Band Syndrome. If you have to ask what this is, count your blessings.

Several months ago I posted about a knee injury I sustained while doing one of the workouts from The New Rules of Lifting for Abs. Note that I am not implying that this workout is to blame for my injury; I love the book and it’s workouts. Perhaps that day, I loved it a bit too much.

In retrospect, I was lifting too heavy (increasing my load by more than 10% of the previous workout’s load; definitely a no-no). Not sure why, other than some days I feel stronger than I actually am and tend to push myself a bit too hard in the gym (there are worse things, I suppose).

I failed to stabilize my left knee during the up phase of a bench step up. The knee veered inwards; I immediately got down from the step and hobbled towards an ice pack.

Fast forward a month or two. The knee seems to have recovered well. I feel no pain during step class or on the spinning bike. My strength workouts have resumed (although I have not re-introduced step ups to my training; still a little gun shy) and I’m feeling great (note to self, pain and injury are always preceded by a feeling of invincibility…).

I introduce single leg squats to a client and with the second demonstrated rep, feel my left knee give way again. Same inward movement, same lateral pain. Clearly, my recovery was not complete.

This time around I decided to see a physiotherapist right away (well, right after Googling ‘knee pain’ and reading a whole bunch of articles that terrified me into thinking I might never be able to exercise again; don’t ever turn to Google with your health concerns). Might as well find out what kind of injury I’m looking at and get some suggestions as to how to rehab it (other than rest and time, which clearly didn’t work!).

After some questions about the location of the pain (outside edge of knee), the circumstances in which I feel it (during lunges, walking downstairs), a few basic range of motion tests and comparisons between my left and right sides (left side weaker during squats), my physiotherapist diagnosed me with IT band syndrome. Otherwise known as Runner’s Knee.

Paradoxically, I don’t run. I walk, jump, spin and step, but I’m not a runner. How could this be?

While running is the most common way of incurring ITBS, it also happens when athletes progress too quickly in their training (in other words, try to do more or lift heavier than their body is ready for) and cannot properly stabilize their knee under load.

foam rolling

Source: http://www.aafp.org/afp/2005/0415/p1545.html

The IT band is a strong, thick band of fibrous tissue that runs along the outside of the leg. It starts at the hip and runs along the outer thigh and attaches on the outside edge of the shin bone (tibia) just below the knee joint. The band works with the quadriceps (thigh muscles) to provide stability to the outside of the knee joint during movement. IT band syndrome is typically caused by inflammation of the IT band, which in turn, can be caused by muscle tightness or lack of flexibility in the gluteals (buttocks) or quadriceps (thigh).

Tight butt. This is all sounding familiar. Several years ago I went to physio to help resolve some lower back pain. Diagnosis? Tight gluteals and hamstrings. Rx? Stretch ‘em and strengthen my core.

This time round I’ve been advised to step up my glute stretching (including some good old tennis ball rolling; place a tennis or pressure ball between the tight spot on your butt cheek and the wall, draw circles with your butt while pressing into the ball. Ouch!), start foam rolling my IT band to loosen up the fascia (YouTube link) and strengthen the lower quadriceps with single leg half squats.

You’ve probably seen people foam rolling at the gym. It’s one of several techniques referred to as myofascial release. Typically, you lay over top of the roller (which is really just a high density ‘pool noodle’), and use your body weight to administer just the right amount of pressure to the affected body part. Rolling back and forth stimulates relaxation of tight muscles (myo) and connective tissue (fascia) and allowing the antagonistic (or opposing) muscle to properly activate.

The squats aren’t so bad, it’s the myofascial release that’s the killer.

As I roll, I can’t decide whether to swear or cry. It hurts that much.

My physiotherapist says to foam roll both sides once or twice a day until rolling on the injured side only hurts as much as rolling on the uninjured side (both sides hurt like hell, but the right side is a paler shade of hell than the left). It might take a week. It might take a month. The point is to be consistent and persistent in the treatment.

Although we have foam rollers at my gym, I don’t get there every day. So I bought my own self-administered torture device. Looking forward (not) to spending a few minutes with it morning, noon and night for the foreseeable future.

Anticipating the day when using it is just painful, not all out agony.