Tuesday, April 17, 2012

The Best IT Band Stretch Ever

I met Meb Keflezighi again at the Boston Marathon Expo last week and he signed this appropriate photo for me:

I am still looking for ways to recover my stride and it has been a good week for ideas. Last Wednesday, I started up some new physical therapy. I am going with a new PT who works at the same hospital that I had my surgery at as well as the same office with the physiatrist who did the trigger point injections. At the initial appointment, he gave me three stretches or exercises for my hips and IT band.  I was also told not to run. 

The first exercise he gave me is the standard leg lift to strengthen my glutes. My cues are to keep the leg straight and to tighten the core. When I thought it was straight I was bending the knee a bit . I lift the leg up and slightly back from a side lying position. I do 3 sets of 10 multiple times a day. Next he gave me an IT band stretch. I found a video of that one online (see below). I do 3 sets of 30-45 seconds. Finally he gave me a figure 4 stretch. I lie on my stomach, keep me knees on the floor and lift my left lower leg 90 degrees from the floor so mu foot is pointed to the ceiling. I can move the knee out to the side a bit and then let the foot drop over the other leg. I can do this with a light ankle weight holding it down for 3 sets of 30 seconds and then I can lift the leg up and down 10 times for some mobility. All of these target tight muscles around my hip. They feel good. I feel the IT Band stretch over the outer side of my knee area.

 The figure 4 stretch, when done by the PT pushing down on my femur and pulling the leg down really gets into the tight hip muscles. It reminds me of  a PT that found this stretch for me over 10 years ago when I went from running a 25 mile workout in a new pair of Nike Shox (never wear that shoe) to not being able to run more than 1/4 mile without my left hip locking up and forcing me to stop killing my fall marathon plans that year. It was the first time I "felt" something wrong with my hip. She was a young PT who also said of me, "You were so born to run and so not born to run." She had every PT in her office try to figure me out, but none could. After many appointments she kept doing some research and found this stretch for tight hip capsule. I remember going out to run for the first time in a couple weeks after the appointment with a working hip and actually feeling the most balanced as a runner that I have ever felt. That is still one of my most favorite runs of all time as everything just felt right for the first time in a long time and my hip was no longer tight. I guess it unstuck my hip through positioning. The new PT does a similar stretch and mobilization, but after my surgery on the hip he really does it at about 1/2 the angle and force as it was done by the PT years ago.

I could not find a video of the figure 4 stretch, but I found a video of the IT Band stretch. The video is called, "The World's Best IT Band Stretch."

But wait! I found the video on this site on this blog post by Brian Reddy at B-Ready. He uses it as part of a post on stretches for the IT Band. Brian that goes into detail that I have not seen anyone else do where he explains what tight and weak muscles do up and down the leg and how the imbalances may look like the leg has femoral anteversion and tibial torsion. Whoa, he is describing my left leg. He talks about how all these muscles insert into the IT Band-which is not a muscle! So he mentions a tight TFL-that is me and a loose glute medius-me too! The tight TFL can cause internal rotation of the tibia-me here! The IT Band also has connections to the muscles in the lower leg. Yeah, I have been wondering about the anterior tibialis and Peroneus Longus. What? These muscles can create rotational problems like external tibial torsion. That is definitely me He is the first person to show me how all the muscles on my left side may be caused by muscular imbalances and how they all impact each other. And the connection is the IT Band. There is a lot more in his article and I am still working on it to understand it all, so if this interests you, please read it here: The best damn IT band stretch ever. By the way, the stretch he advocates is not the stretch I am doing, but something completely different and he explains why. So you wiill want to go and see what he says is the best IT band stretch. Brian has also been kind enough to answer some of my questions and give me direction which are in the comments on his blog post.

Tomorrow I go see the PT for the first follow-up visit and I also go see my hip surgeon for an evaluation. I have not seen him since minutes before the surgery last July, so I will be happy to thank him for the good work he did on my hip, but I hope he can answer a few questions about what is happening further down the chain for the last thing I want to do is mess up the hip again due to my poor biomechanics.

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