ITB Issues, What Worked for You?

[JTrue]

Ok, still having issues on my left side. Ski touring and cycling seem to contribute to the lateral tightness and resulting pain I feel. I've been in and out of PT trying to search for answers, pretty frustrating. The last time I went the PT said that he doesn't have anything else for me, he's stumped. He did note that I am super strong most places but when he tests glute strength he shouldn't be able to push my leg down as easily as he can. Do I up the weight along with doing slow controlled reps? Functional leg length discrepancy seems to be gone after a lot of posterior and core strengthening. I can manage my symptoms by really firing up my posterior chain, one legged rdls, x-band walks, hamstring curls all seem to minimize the tightness I feel in the it band. But if I stop that routine for a day or so the tightness starts creeping back. It's like I can't hold onto the strength I've been working on. I haven't been lifting heavy, just focusing on good form. My left vmo is noticeably smaller than my right, which might be a contributing factor, but it's hard to strengthen it when squats tend to flare up my symptoms sometimes.

I can do most movements at the gym without flaring the lateral tightness, but squatting is one movement that seems to contribute. I've been trying one legged body weight squats to strengthen the vmo and glute med. I think backcountry skiing utilizes a lot of tfl since your lifting a ski then stepping back, but not engaging your glutes like you would in a normal walking gait. Your ski kind of slides against the snow instead of having a heel strike that causes the glutes to fire. After ski touring when I bend over to unbuckle my boots my TFL and hipflexors are in spasm and want to tense up as I lean forward. Since squatting contributes to my symptoms I'm wondering if there is a noticeable flaw I need to work on that would possibly help me correct the movement patterns that are causing this. I feel like my left glute doesn't fire as well as it should when performing one legged rdls. Also feel like my external hip rotation is limited, can't get deep in to a pigeon pose, feel some adductor/hipflexor muscle tightness near groin as I get down into a deep goblet squat.

Things I've tried:
Mobilization(focusing on quads, hamstrings, glutes, ql, adductors:
Smashing muscles with kettlebell
Foam Rolling
Dry Needling
Lacrosse Ball Triggerpoint
Voodoo Floss
Banded Distraction while stretching
Couch Stretch
Pigeon Pose

Strength:
RDLS(200 lbs, probably would max at 300 but I don't try)
One Legged RDLs(max 60 lbs in opposite hand of stance leg)
One Legged Squats(bodyweight)
Goblet Squats(30lbs kettlebell)
Stir the pot, core exercise
Side Plank
Bird Dogs
Clams
Lateral Sidelying Leg Lift holding exercise ball against the wall
Hamstring Curls
Reverse Crunches
One Legged Bridges
Other stuff I don't remember...

[powtario]

Video no worky.

I have pretty fucked up anatomy due to some rocks on Piccolo 12 years ago.

I squat DL clean and stretch as my main leg strength training, but I also role out, like really role out, my IT, erector spinae and glutes with a dumbbell. Get serious spasming if I don't, fine if I do (knock on wood) but it does hurt like hell everytime.

My SO does a psoas release on me if my flexirs flair up, feels incredible and noticeable difference.http://m.youtube.com/watch?v=Fz9hLfTWzKE

My ex couldn't walk her ITB was so blown up for Nordic training, I think she got some Graston technique stuff done which she said was more painful then anything she had ever experienced before, but it worked. She warmed up about a half hour, lots of oil and then the metal while she was squatting. Done by a track and field Olympic trainer.

Hope that helps.

[JTrue]

Video no worky.

I have pretty fucked up anatomy due to some rocks on Piccolo 12 years ago.

I squat DL clean and stretch as my main leg strength training, but I also role out, like really role out, my IT, erector spinae and glutes with a dumbbell. Get serious spasming if I don't, fine if I do (knock on wood) but it does hurt like hell everytime.

My SO does a psoas release on me if my flexirs flair up, feels incredible and noticeable difference.http://m.youtube.com/watch?v=Fz9hLfTWzKE

My ex couldn't walk her ITB was so blown up for Nordic training, I think she got some Graston technique stuff done which she said was more painful then anything she had ever experienced before, but it worked. She warmed up about a half hour, lots of oil and then the metal while she was squatting. Done by a track and field Olympic trainer.

Hope that helps.

Thanks, have had Graston and ART as well. Nothing really seems to faze me or release much tension from my muscles. I even bought some needles and have been hitting my quads myself, along with e-stim connected to the needles. I also had rolfing done a couple sessions. Quads seem tight, but PT doesn't think they are overly so, I have great hamstring mobility, but I do feel a lateral pull on my kneecap when I hit some trigger points with the lacrosse ball on my biceps femoris. When I got dry needled she hit one trigger point in the biceps femoris and everytime it spasmed I could feel a lateral pull on my knee cap. I've been sitting on the lacrosse ball and doing self administered ART on the biceps femoris. I have a standing desk at work and at home, but I spend too much time in the same position all day. I definitely tighten up at work.

[bourbonisgood]

If you are doing all that strengthening work and your glut med/glut max/ERs aren't bulletproof...there's a reason for it...lumbosacral dysfunction could be the root (even if you don't have back pain). Do you have symmetrical hip motion, especially IR and ER? Otherwise, a movement dysfunction could be to blame. Have you been screened by a PT who uses the SFMA or FMS systems? I've found this method of treating ITBS very valuable. I always remind my patients that ITB pain is a symptom, not a diagnosis...

[JTrue]

If you are doing all that strengthening work and your glut med/glut max/ERs aren't bulletproof...there's a reason for it...lumbosacral dysfunction could be the root (even if you don't have back pain). Do you have symmetrical hip motion, especially IR and ER? Otherwise, a movement dysfunction could be to blame. Have you been screened by a PT who uses the SFMA or FMS systems? I've found this method of treating ITBS very valuable. I always remind my patients that ITB pain is a symptom, not a diagnosis...

No back pain, everytime PT has checked my back he has commented it looks awesome. Never had any imaging done. Do have tightness I feel in my right SI, unaffected side. When being screened by one PT she noticed on my affected left side I have less external rotation. I feel a muscle tightness in the groin/adductor area when squatting deep. Had my other PT check it out and he said I'm pretty even in both IR and ER. Checked adductor mobility and said I was good there. I can't get deep into a pigeon pose though, so I think that points to tight ERs. I've been working on that as well, slowly.

I'm getting screened by a personal trainer using FMS tomorrow. Not many PTs around here that have been certified that I could find. Maybe I need to search harder. Searching for an answer and doing all this work is frustrating since I'm not seeing results. I love learning, so it's not all bad, but just want to be able to function normally and not feel held back all the time.

[bourbonisgood]

ITB problems can be really frustrating, but it sounds like you are covering all the bases. Keep us posted on the outcome of the FMS screening, I'm curious.

[JTrue]

ITB problems can be really frustrating, but it sounds like you are covering all the bases. Keep us posted on the outcome of the FMS screening, I'm curious.

17 out of 21,

Deep Squat I had some trouble with my feet shoulder width going deep, with my heels up on something I was able to go deeper without any problems. They did notice my right knee tracked in a little, but nothing too bad. I usually squat with a bit of a wider stance, toes pointed out just a bit as seen in the video above. Tested ankle dorsiflexion, started with my toes 6 inches from the wall and could get to 3 inches with my knees, a little less on my right unaffected side.

Hurdle Step Scored a 2 they mentioned I swing my leg out and over the line instead of just stepping over.

Inline Lunge scored a 2, was a little shaky coming down, but not much else to be noted.

Shoulder Mobility scored a 3, surprising since I separated my shoulder a couple years back and didn't rehab all the much, just ROM drills, no real soft tissue mobs

Active Straight Leg Raise scored a 3, good hamstring mobility, not much to note, however I do feel a pulling on my left kneecap when mobilizing the biceps femoris with a lacrosse ball, also felt it when a PT hit a trigger point dry needling, continuing to work on that.

Trunk Stability Pushup scored a 3, didn't say much about this, other than I scored a 3

Rotary Stability scored a 2, could do the movement when lifting my left hand and leg(affected side) but couldn't remove my right knee and hand from the ground without falling over. Could do the bird dog movement opposite sides just fine, heard everyone has issues with this one. Curious why I could complete the original movement with my left side, but not on my right. Any insight here is appreciated, forgot to ask.

Passed the shoulder impingment test and posterior rocking test. No real asymmetry noted except for the rotary stability. He did check my psoas and I didn't have any tenderness. Noticed my rectus femoris on my affected leg is pretty tight vs unaffected side. Gives me a couple things to look into and work on, but I feel like I've been working on some of this stuff already with all the mobs and strength exercises I've done. I barley started working on some rotational isometric holds Naudi Augilar recommends. Similar to the video below:

[jma233]

I replied to this thread last year when it was active. I don't have classic ITBS but some of my symptoms are very similar. I had back surgery 4 years ago and developed partial denervation in my R GMAX during/following surgery. I now realize that my R GMAX was likely weak for a long time before surgery and I never noticed except for the constant problems with my R knee and foot.

I'm now doing much, much better and my main symptom is tightness in my vastus lateralis (ie. IT band). I don't have that classic pain on the outside of my knee, my pain was more general. When my pain was bad, however, massaging that spot on the outside of my knee always lessened and often eliminated the pain.

What got me to this point was a lot of dry needling the GMAX. Lately, we've been needling the most distal fibers and I see tremendous improvement after each needling session. The theory is that I recovered from the denervation but developed a nasty case of GMAX tendinitis. Being such a pivotal muscle for the pelvis, the nervous system causes a lot of other muscles to spasm when you can't efficently transfer load from your gmax to your femur (that's my theory and I have no evidence).

I also exercise a lot. Keys are walking (I agree with the idea that a heel strike really helps gmax activation), elliptical, and lots of stairs. I should try squats and dead lifts again. Last time I tried, I would shift my weight ever-so-slightly towards my unaffected side and get virtually no benefit from the movement. When walking, the opposite is true: I very slightly shift my hips towards the weak side because it loads the gmax less. Therefore I have to consciously try and stay centered. On the elliptical I'll lean way over towards my unaffected side to increase the load on my weak GMAX. Having needled the distal gmax really helps because I can really feel when I'm loading that tissue now.

There are definitely medical professionals out there that contend that spinal disk problems that result in weakness but not pain are common. That seemed to be the case with me since I only developed leg pain in the final two years before my back surgery and I never had any pain in my back. If you want to read more about this disk-weakness-tendinitis theory I know that Chris Centeno writes about it in his free ebook (he refers to tendinitis as enthesopathies). Also many PTs who are certified McKenzie Practitioners think along these lines.

Good luck to all and please post any success stories, trials/tribulations,.etc.

[bourbonisgood]

There are definitely medical professionals out there that contend that spinal disk problems that result in weakness but not pain are common. That seemed to be the case with me since I only developed leg pain in the final two years before my back surgery and I never had any pain in my back. If you want to read more about this disk-weakness-tendinitis theory I know that Chris Centeno writes about it in his free ebook (he refers to tendinitis as enthesopathies). Also many PTs who are certified McKenzie Practitioners think along these lines.

The discussion should not be limited to disc pathology either IMO. Plenty of young people with healthy discs and no structural nerve root encroachment will have inhibited gluteals (which presents as "weakness") when there is dysfunction at L4/5 and L5/S1 facet joints. Just some food for thought in the ITB discussion...

[jma233]

The discussion should not be limited to disc pathology either IMO. Plenty of young people with healthy discs and no structural nerve root encroachment will have inhibited gluteals (which presents as "weakness") when there is dysfunction at L4/5 and L5/S1 facet joints. Just some food for thought in the ITB discussion...

I did not know that and its very interesting. Know of any references offhand that discuss 'facet joint irritation and guteal inhibition'?

[kingdom-tele]

17 out of 21,

Deep Squat I had some trouble with my feet shoulder width going deep, with my heels up on something I was able to go deeper without any problems. They did notice my right knee tracked in a little, but nothing too bad. I usually squat with a bit of a wider stance, toes pointed out just a bit as seen in the video above. Tested ankle dorsiflexion, started with my toes 6 inches from the wall and could get to 3 inches with my knees, a little less on my right unaffected side.

Hurdle Step Scored a 2 they mentioned I swing my leg out and over the line instead of just stepping over.

Inline Lunge scored a 2, was a little shaky coming down, but not much else to be noted.

Shoulder Mobility scored a 3, surprising since I separated my shoulder a couple years back and didn't rehab all the much, just ROM drills, no real soft tissue mobs

Active Straight Leg Raise scored a 3, good hamstring mobility, not much to note, however I do feel a pulling on my left kneecap when mobilizing the biceps femoris with a lacrosse ball, also felt it when a PT hit a trigger point dry needling, continuing to work on that.

Trunk Stability Pushup scored a 3, didn't say much about this, other than I scored a 3

Rotary Stability scored a 2, could do the movement when lifting my left hand and leg(affected side) but couldn't remove my right knee and hand from the ground without falling over. Could do the bird dog movement opposite sides just fine, heard everyone has issues with this one. Curious why I could complete the original movement with my left side, but not on my right. Any insight here is appreciated, forgot to ask.

Passed the shoulder impingment test and posterior rocking test. No real asymmetry noted except for the rotary stability. He did check my psoas and I didn't have any tenderness. Noticed my rectus femoris on my affected leg is pretty tight vs unaffected side. Gives me a couple things to look into and work on, but I feel like I've been working on some of this stuff already with all the mobs and strength exercises I've done. I barley started working on some rotational isometric holds Naudi Augilar recommends. Similar to the video below:

Because your brain/CNS has developed preferences. Asymmetry is necessary, knowing how you are asymmetrical is more important than chasing the elusive "symmetrical" pattern. Until your CNS has a reason to not rely on the BF it will remain tight, no matter how many needles you jab in it. Not saying not to, but do some movement before you get stuck and then after so you have a quality/sensory profile to file away. To much noise with all this caveman movement to feel. If your attached to Gray's stuff, how's your rolling pattern, dial in your basics, flexor and extensor neuromuscular control. Yo have to know how to shut of while still performing dynamic movement.

[JTrue]

Thanks for all the replies. I'm not married to any system, just searching for anything that will help point me in the right direction. Some of the asymmetries I've been working are the functional leg length discrepancy and getting myself out of APT, even though it's not bad. The fact that when I hit my posterior chain hard my symptoms get better seems to point the fact that my quad dominance and hip flexor dysfunction is playing a roll in keeping me in a position that seems to inhibit the glutes. I feel like hip hinging exercises have helped me the most so I'm going to try a couple more variations. I've been doing a shitload of one legged rdls, doing maintenance on my unaffected side and adding a couple additional sets to the side that seems weaker. Doing slow and controlled reps seem to help the most. I feel a good stretch in my hamstrings and feel the glutes start to really work after a couple reps. I've also noticed my balance while focusing on something else isn't all that great so I've ordered a balance pad to work on some one legged proprioception exercises.

[bourbonisgood]

Thanks for all the replies. I'm not married to any system, just searching for anything that will help point me in the right direction. Some of the asymmetries I've been working are the functional leg length discrepancy and getting myself out of APT, even though it's not bad. The fact that when I hit my posterior chain hard my symptoms get better seems to point the fact that my quad dominance and hip flexor dysfunction is playing a roll in keeping me in a position that seems to inhibit the glutes. I feel like hip hinging exercises have helped me the most so I'm going to try a couple more variations. I've been doing a shitload of one legged rdls, doing maintenance on my unaffected side and adding a couple additional sets to the side that seems weaker. Doing slow and controlled reps seem to help the most. I feel a good stretch in my hamstrings and feel the glutes start to really work after a couple reps. I've also noticed my balance while focusing on something else isn't all that great so I've ordered a balance pad to work on some one legged proprioception exercises.

It sounds like you are addressing all the right things, the exercises you have mentioned are the same ones used in our clinic for people with your sx's. One thing I almost forgot, listen to this podcast if you haven't already: http://www.functionalmovement.com/ar..._about_the_itb. Gray Cook is fast becoming one of the guru's in physical medicine and I really like the way he explains regional interdependence with regard to the ITB. Give it a listen.

As far as your FMS scores go, the deep squat was the one I was guessing you would struggle with based on your previous symptoms. Really work on that dorsiflexion, it may be the easiest deficit to clear up, and has tremendous impact on closed chain LE function. IMO, anybody with less than 10 degrees of DF with the knee extended is a setup for LE pain problems.

[JTrue]

It sounds like you are addressing all the right things, the exercises you have mentioned are the same ones used in our clinic for people with your sx's. One thing I almost forgot, listen to this podcast if you haven't already: http://www.functionalmovement.com/ar..._about_the_itb. Gray Cook is fast becoming one of the guru's in physical medicine and I really like the way he explains regional interdependence with regard to the ITB. Give it a listen.

As far as your FMS scores go, the deep squat was the one I was guessing you would struggle with based on your previous symptoms. Really work on that dorsiflexion, it may be the easiest deficit to clear up, and has tremendous impact on closed chain LE function. IMO, anybody with less than 10 degrees of DF with the knee extended is a setup for LE pain problems.

Yeah, that's one of the things I came up with last night after researching why I could squat fine with heels up vs heels flat. At work I actually have a bowl I put my forefoot on and stretch my gastrocnemius, but seems like I might need to get deeper than what that allows to really increase dorsiflexion. I do notice that I've been having cramps at night in my gastrocnemius after a hard workout, whether that be lifting/skiing. Cycling seems to create cramps after in my adductors. Not sure if that would tell you anything. At one point I was working on adductor strength, but wasn't sure if I was just compensating for a glute med weakness, which I've heard the adductors can do.

[Dantheman]

One thing I noticed with your squat is that your shoulders moved forward before your hips dropped. Hips should drop first and the shoulders should follow in a near vertical plane. I don't know what this may mean in regards to your ITBS (if anything), but something is definitely off with your squat mechanics.

Sorry to hear you are still dealing with this J.

[kingdom-tele]

Thanks for all the replies. I'm not married to any system, just searching for anything that will help point me in the right direction. Some of the asymmetries I've been working are the functional leg length discrepancy and getting myself out of APT, even though it's not bad. The fact that when I hit my posterior chain hard my symptoms get better seems to point the fact that my quad dominance and hip flexor dysfunction is playing a roll in keeping me in a position that seems to inhibit the glutes. I feel like hip hinging exercises have helped me the most so I'm going to try a couple more variations. I've been doing a shitload of one legged rdls, doing maintenance on my unaffected side and adding a couple additional sets to the side that seems weaker. Doing slow and controlled reps seem to help the most. I feel a good stretch in my hamstrings and feel the glutes start to really work after a couple reps. I've also noticed my balance while focusing on something else isn't all that great so I've ordered a balance pad to work on some one legged proprioception exercises.

J, if the leg length discrepancy is functional, what is there to fix? Your gluts are part of your extensor chain, check all of the extensors to help activate them, the nervous system can be stimulated without beating the piss out of the offending region. The relationship between your ankle and hip are critical during closed chain movements, spend some time dialing in how you move over the unaffected leg and compare to the affected leg, there are countless variables that may contribute to dispersing the strain. The FMS has a few variations, but everything you need is happening in your body organization when you use the unaffected leg. Save your money, no need to buy balance pads, etc, close your eyes, its a lot cheaper.

good luck.

[JTrue]

Thanks Dan, haven't been squatting too much since it can flare up my symptoms, thank for the pointers. I have been doing a lot of 1 legged RDLs so I'm wondering if the motion I'm used to of hip hinging is causing me to do that during the squat as well. Definitely something I'll need to pay attention to and cue myself on.

Thinking I should add some GHRs, Reverse Hypers, and Kettlebell swings to the routine along with continuing some more core work. Probably standing at my desk for 8 hours a day is worse than anything else I do, need to break it up more.

[JTrue]

J, if the leg length discrepancy is functional, what is there to fix? Your gluts are part of your extensor chain, check all of the extensors to help activate them, the nervous system can be stimulated without beating the piss out of the offending region. The relationship between your ankle and hip are critical during closed chain movements, spend some time dialing in how you move over the unaffected leg and compare to the affected leg, there are countless variables that may contribute to dispersing the strain. The FMS has a few variations, but everything you need is happening in your body organization when you use the unaffected leg. Save your money, no need to buy balance pads, etc, close your eyes, its a lot cheaper.

good luck.

Thanks for commenting, always willing to listen and learn. I was under the impression from my PT, that the leg length difference was caused by some sort of muscle imbalance resulting in a pelvic/si joint dysfunction which I could fix through streching/strengthening. He applied a chiropractic adjustment pushing down on my anteriorly rotated pelvis on one side, which seemed to get both sides even. So far when I've gone back my legs have been close to the same length after working on my core and posterior chain. Balance pad is just a cheap ebay airex pad, so I'll be able to use it for more than just balance drills, but yeah I understand spending isn't going to solve my problems. I'll try to focus on how I'm moving on my good side and put it all together.

Started reading through this article, seems like a lot of info that might help me understand how the whole chain works. here

[jma233]

Quick note about e-stim connected to needles. If you stick with the normal 15 minute sessions you're almost surely fine, but any longer than 15 minutes and you're going to get some serious pitting corrosion from the (cathode?). Maybe its the anode, I need to retake HS chemistry. I assume most practitioners who needle know this.

The very best electrodes use a moist sponge and a vacuum pump to attach to skin. You can really crank the amps without skin irritation.

[jma233]

I should also add that I went for a bike ride today instead of a walk and it really flared up my vastus lateralis tightness and pain. I tried to crack my T-spine and noticed it was really stiff. 10 minutes with my T-spine against the foam roller and it finally cracked and all my symptoms melted away. I haven't felt this good in a long time. Backs are hell.

[JTrue]

I should also add that I went for a bike ride today instead of a walk and it really flared up my vastus lateralis tightness and pain. I tried to crack my T-spine and noticed it was really stiff. 10 minutes with my T-spine against the foam roller and it finally cracked and all my symptoms melted away. I haven't felt this good in a long time. Backs are hell.

Yeah, I go go for less than 15 minutes, it helps in the short term. Mostly using it to release knots and inhibit hip flexors and quads then do some light stretching and strengthening after.

Question jma, does your tightness and pain come on during the activity or after? Sometimes I feel tightness during the activity, but most of the time I feel ok for a couple hours, then things begin to tighten up. Basically all the cardio I'm into uses an unnatural motion, cycling and backcountry skiing. I find walking to be sort of therapeutic, but don't do enough of it.

[jma233]

Yeah, I go go for less than 15 minutes, it helps in the short term. Mostly using it to release knots and inhibit hip flexors and quads then do some light stretching and strengthening after.

Question jma, does your tightness and pain come on during the activity or after? Sometimes I feel tightness during the activity, but most of the time I feel ok for a couple hours, then things begin to tighten up. Basically all the cardio I'm into uses an unnatural motion, cycling and backcountry skiing. I find walking to be sort of therapeutic, but don't do enough of it.

If something flares me up its usually a couple hours afterwards that it happens. The bike flare-up occurred while I was riding though. I think I might be listing a nice bike on craigslist soon.

[kingdom-tele]

Thanks for commenting, always willing to listen and learn. I was under the impression from my PT, that the leg length difference was caused by some sort of muscle imbalance resulting in a pelvic/si joint dysfunction which I could fix through streching/strengthening. He applied a chiropractic adjustment pushing down on my anteriorly rotated pelvis on one side, which seemed to get both sides even. So far when I've gone back my legs have been close to the same length after working on my core and posterior chain. Balance pad is just a cheap ebay airex pad, so I'll be able to use it for more than just balance drills, but yeah I understand spending isn't going to solve my problems. I'll try to focus on how I'm moving on my good side and put it all together.

Started reading through this article, seems like a lot of info that might help me understand how the whole chain works. here

Let first say that all that is fine if it makes you feel better and move better. However, the issue isn't that you can't lie down and look symmetrical, it is that once you move you can not redistribute the effort away from whatever pattern is overloading your leg in a specific region. Call if stretching/strengthening, but it is all just movement and sensation, if a person continues to have the same pain after applying the same methodology of correction that would indicate the experiment is failing. Not to say strengthening isn't important, but if the "fix" is coming from a manip and your not "fixed", than the manip is addressing another part of your system, and by the beauty of our design giving you relief. It doesn't change a thing about how you know to use yourself in the offending movements. Get to know your LPHC, not just through strain related movement, so you can apply that sensory skill to the offending movement. Hopefully all the pelvic work and reps help, but the complexity and abundance at our disposal for moving this skeleton would necessitate looking at the whole body, especially if the persistent work at on local region isn't addressing the issue. Hopefully, it is all moot as you feel better soon J.

[JTrue]

That's the problem I feel like I've been pretty persistent at examining most avenues presented for working on LPHC dysfunction, except maybe focusing a ton of attention on my ankles and back/upper body. Obviously things like RDLs hit the lower back along with the other areas I've been targeting. I've tried some of the McKenzie protocol exercises just to see if it did anything for me, haven't noticed anything. When these issues first started occurring I had weird muscle spasms and twitches in most of the muscles surrounding the hip down my quad, it didn't seem normal, even when taking all the muscle imbalances into account. They slowly went away over time. I'm still wondering if I have some sort of back issue that manifests itself tightening up a group of muscles surrounding the hip and down the left side of my body. I should retract my statement when I said I haven't ever had back pain, I have in my mid back. But it wasn't anything that was debilitating, just a slight pinch here and there, it went away and I didn't even think of having a doc check it out. My PT states every time he looks at my back that it looks awesome during movement. And there are definitely other aspects that don't point to a back issue, but I can't help but not be curious. I agree that the experiment is a failure so far and I need to go down other paths. This started off as a bilateral issue and now it's mostly one side.

The differences I notice between left(affected) and right(unafected) are a slight weakness in the glute med along with having a harder time contracting it. Tightness and knots in the vastus lateralis and rectus femoris on the affected side. Get cramps in both gastrocs and adductors. Working on the gastrocs, just mobilizing my ankle, but not sure what to do about the adductors. They are definitely much weaker than my abductors. Just as a test I got on the adductor/abduction machine and can do the full amount of plates with abductors for more than one rep, can't come close to one rep with adductors.

[jma233]

I hate to say it but it sure sounds like a back issue. I never had any pain in my back either (well, rarely) but it turns out that I had a congenital fracture in my lowest vertebra that screwed up the mechanics of my entire spine. My low back seemed like it moved great, but all the motion was occurring at the damaged vertebra plus T12-L1. Also, my thoracic spine was super stiff, but that's true for a lot of people with no pain. I went to PT school with this screwed up back, got examined by my professors (all us students did) and not one single person noticed anything odd except that my low back couldn't be manipulated (presumably because of my 'extra motion' at the damaged vertebra).

I guess what I'm saying is that despite all the fancy lingo (which I try to avoid unless amongst medical professionals) and the hundreds of billions of $ spent on backs every year, nobody understands them all that well. If you're being treated by someone who claims to have all the answers then run as fast as possible for the exit.

I'm not affiliated with them, but as I mentioned earlier the PT's certified as McKenzie Practitioners are probably better than average at detecting subtle spinal lesions. If you're in a major metro area then its worth it to go to a McKenzie Diplomat. Yeah, stupid name but they have the most training. And the vast majority of folks do really well with conservative treatment of back injuries. A big part of treatment is simply being aware of the motions/positions that aggravate the injury. And plenty of people get one cortisone shot and then never have symptoms ever again.