What is IT band syndrome?

The first question to answer is what is the IT band? IT band stands for Iliotibial band which is a large sheet of thick fibers that connect the hip to the knee on the outside of the leg. Various muscles and other kinds of soft tissues connect to the IT band. IT band syndrome is an overuse injury common in runners and cyclists. The distal (bottom) portion of the thick band crosses over the lateral epicondyle (outside bony part) of the knee. As the knee bends and straightens that portion crosses over the lateral epicondyle which can cause irritation and/or a popping sound.

How do I prevent IT band syndrome?

Athletes can help prevent IT band syndrome from occurring. Proper mechanics should always be used while exercising regardless of the intensity. It is important that our muscles and joints are used the way that they were designed to be used. Incorporating a dynamic warm up and cool down decreased the rate of injury. This allows blood flow to the muscles while stretching the muscles. IT band syndrome can be an effect of tightness of one or more of the muscles that attach to the IT band. Also, a number of soft tissue techniques could be used including ART (active release technique) and Guasha (a scraping technique). Most soft tissue techniques have the same end goal with different approaches. People react different to different techniques.

How do I treat IT band syndrome?

There are many treatments for IT band syndrome ranging from conservative care or surgery. It is common practice to begin with conservative care, working of proper mechanics, soft tissue techniques, and stretching. From there if no results are found then the injury would be re-evaluated and the case would progress from that point.

 
 
Athletes don't always look like this...
Most athletes look more like this...
Changing the way we, as a society, look at exercises, influences our goals and overall outcomes. If the end goal of exercise is to get bigger and stronger, then lifting at the gym in the traditional sense fits. However, if the end goal is to run faster, throw harder, or jump higher, incorporating a functional approach may be more beneficial.  Our life is lived through functional movement; therefore we should train through functional movement to reflect out activities. The Grey Institute is centered on the philosophy of Applied Functional Science (AFS) which is a functional based approach to exercise and rehab treatment. Using AFS allowed providers to retrain the body to function the way it was designed. Functional training combined with traditional training optimizes our level of performance. But as always proper mechanics is the most important in any type of training.

Using the link below will direct you to an article that explains deeper the “Principles of Lifting” by Logan Schwartz FAFS.

https://www.grayinstitute.com/articles.aspx?Article=5
 
 
Picture
When: Friday, April 25th, 6:30-8:30pm
Where: Authentic Birth Center and Wellness Collective
530 N 108th Place
Wauwatosa, WI 53226

Why: Dr. Miller wants to help you learn how to maintain your most important resource: your body!  This will be an excellent opportunity to discover how fulfilling it can be to play an active role in your personal wellness. The evening will be filled with information about basic body mechanics, common malfunctions, treatment and maintenance care.  There will even be a hands on portion, to practice and perfect the exercise techniques!

    Not only will you have access to live instructions, but the tools for the exercises will be available! Tool kits will be available for pre-order, for $40 dollars.  This includes a high density foam roller, LaCrosse ball, and the $5 admission for the evening.   Dr. Miller will show everyone, step-by-step, proper technique for the maintenance exercises. Then you can practice in the hands on portion of the evening.

Don't let aches and pains get in the way of your summer! This is an excellent event for athletes, new parents, or those simply looking to understand their body, a little better.  Anyone can benefit from this series! If you know anyone who would benefit from this series remember:
The greatest compliment we can receive, is your referral to a friend or loved one.

Cost of attendance will be an appreciated donation of $5.00

Please contact our office for additional information and registration!
phone: 262.366.3655
email: staff@millerswc.com


 
 
This spring, Dr. Miller is determined to give up her sweet, sugary snacks! Breaking bad habits can be difficult, but she knows that strength comes in numbers. She wants to challenge YOU to make a healthy living pledge, in her Spring Fling Challenge!

HERE'S HOW IT WORKS: 

1. Post your pledge on our wall,  in a comment on our blog posts, or @drtmiller on Twitter. It can be any healthy living goal you choose - whether you'd like to shed a few extra pounds, exercise more or simply eat healthier!

2. Inspire and be inspired by everyone who has made a pledge to live healthier! Beginning February 1st, 2014 post a picture to our wall (or @drtmiller on Twitter) and show everyone that you're going the extra mile, a few steps at a time, to become a happier and healthier YOU! 

3. Who doesn't love a little friendly competition? Every pledge post and every picture, will be entered at the end of the month, for a drawing to win some fabulous prizes! There is no limit to the number of posts per day. Winners will be announced on March 1st, 2014. 

Why wait, when it comes to your health? Post your pledge today and make 2014 your happiest and healthiest year yet!

...Stay tuned for more updates!
 
 
Please join us for a Charity Event benefiting The Repairers of the Breach.

Sat. Dec 7, 2013
10 am- 2 pm
3400 S 103rd St #300
Greenfield, WI 53227

Holiday Shopping that supports a great cause!


*Each vendor has agreed to donate a portion of their sales to the cause as well as raffle items. 


*A silent auction with a variety of interests and items all valued greater than $75! 

*Chair massages and gift wrapping for donations!

Would you like to get involved? Here are a few ways you can help:
*Help us spread the word!
*We are still looking for silent auction donations. Any items are appreciated- if the value is less than $75, items will be combined into baskets. 
*Monetary donations will be used to cover any non-donated operational expenses; any funds above operational costs will be contributed directly to Repairers of the Breach. 

SPECIAL THANKS TO OUR CO-SPONSORS:
*Central States Insurance
*www.OnMilwaukee.com
*Melissa M.

Please contact us at:
staff@millerswc.com or 262-366-3655 for more information!
 
 
Several important edits have been made to the last post. Although seemingly small details, it is important that T4/T3 testing for Thyroid include not just total T4 and T3, but rather FREE T4/T3. 

Check out the updated information in the link below!

CHANGING THE FACE OF THYROID DISEASE by Angela Michalski
 
 
I wanted to share this with all of you. Please pass it along to friends and family! This was prepared by a friend who really understands the battle of receiving an accurate diagnosis and the all too-common story of receiving incomplete testing and therefore not a complete picture. 


Read below, or better yet, click the link below for the handout!
thyroid_handout.doc
File Size: 645 kb
File Type: doc
Download File

Did you know:  thyroid disorder may present itself with 300+ symptoms!  

Thyroid disease is often misdiagnosed.

 

The TSH test alone is NOT the gold standard for detecting thyroid disorder.

 

All of these Tests are required to check thyroid function:

§    T4 (Thyroxine)  – Inactive form of thyroid hormone.  T4 is a storage hormone and requires iodine to convert to T3, the usable form of the hormone. 

§    T3 (Triiodothyronine) - Active form of thyroid hormone.  Every cell in our body has receptors for this thyroid hormone.

§    TSH (Thyroid Stimulating Hormone) – Hormone released by the pituitary gland.  Stimulates the thyroid gland to release hormone.  The TSH value rarely correlates to how a patient feels!

§    Reverse T3 (rT3)- The inactive form of T3 that doesn’t get used by the body.  A high rT3 is indicative of inflammation in the body caused by stressors. 

§    Thyroid antibodies (TPO AB, TgAb -TSI for Graves’ Disease)- Presence determines autoimmunity. 

 

Be sure to insist your doctor run ALL of these tests.  If not, find another doctor that will!

 

Other important tests to monitor when diagnosed with thyroid disorder:

§  Iron (4 tests: Ferritin, % Saturation, TIBC and serum (or total) iron)

§  Cortisol salvia test (only) (for adrenal issues)

§  Sex hormones

§  B12 & folate, Vitamin D3 (25-hydroxyvitamin D)

§  Magnesium and Potassium, & Calcium, Sodium, Glucose, etc.

§  MTHFR gene: if you have high levels of mercury, or iron, or B12 and family history of cancer, heart disease or stroke.

 
Prescription hormones:

  • T4-only: Synthroid, Levoxyl, Levothyroxine, etc
  • T3 medications: Armour, Naturethroid, Westhroid-P, etc.
 

T4-only hormones are often prescribed by physicians and often leave patients sick and tired because many people have trouble converting the T4 to T3 or have inflammatory issues in the body and too much gets converted to rT3.  Also, the laboratory reference ranges are too broad and those that know how to treat thyroid disease use a much narrower range.  It is important to find a physician that will treat you based upon your symptoms, not just your lab values!

 

Signs that T4-only meds are NOT working for you include:

Low/high blood pressure, high cholesterol, depression, anxiety, weight issues, lingering fatigue, deficiencies in B12, vitamin D, magnesium, iron. Digestive issues, adrenal and hormone issues, being cold, heart palpitations, PMS, fertility issues, etc.  The list is very long!

 

Did you know:

 The majority of thyroid disorders are due to Hashimoto’s Thyroiditis, an autoimmune ds.

Many don’t know this because their doctors either do not order the antibody test or do not tell them they have autoimmune disease.  BUT, if you have autoimmune disease, it is IMPORTANT to treat the immune system and change your diet (gluten-free at minimum) and lifestyle as well so that you don’t develop additional autoimmune diseases.  Celiac disease & Hashimoto’s are often linked.

 

Did you know:

Fibromyalgia is also contributed to low T3; undertreated or untreated thyroid disease.  Most doctors will say there is no known cause or treatment and that it can only be managed.  They may also say it is an emotional or psychiatric problem! Not true!

References:  

§   Stop the Thyroid Madness (website and book, author Janine Bowthorpe)

§   Why do I still Have Thyroid Symptoms? Datis Kharrazian

§   www.thyroidchange.org

 

Prepared by: Angela Michalski, amichalski4@wi.rr.com



 
 
Written by Susan Voss. Edited by Dr. Therese Miller, DC.

What is it and why does it happen? 

Iliotibial Band Syndrome is due to inflammation of the iliotibial band, a thick band of fibrous tissue that runs down the outside of the leg. The IT band begins at the hip (iliac crest) and extends to the outer side of the lower leg (fibula) just below the knee joint.  The band functions in coordination with several of the thigh and hip muscles to provide stability to the outside of the knee joint, which is where the irritation usually occurs.  Irritation can also occur at the hip or cause hip "bursitis" as well. 
 
Iliotibial band syndrome is an overuse injury most common in runners and bicyclists.  Runners can develop ITBS when making mistakes in their training or with poor mechanics.  Roads are banked to allow for  water runoff.  If a runner always runs on the same side of the road, it produces the same effect on the body as having a leg-length discrepancy. Running too many hills can also inflame the IT band.  Bicyclists may develop ITBS if they have improper posture on their bike and most commonly if they "toe in" when they pedal.  This increases the angle of the IT band as it crosses the knee, increasing the risk of inflammation.
 
What are the symptoms of ITBS? 

Pain on the outer side of the knee is the most common symptom but pain on the outside of the hip is also common.  There may initially be a sensation of stinging or needle-like pricks that are most often ignored. Some people may feel a snapping or notice a popping sound at the knee, and there may be some swelling.  Occasionally the pain may radiate along the IT band on outer side of the thigh between the knee and
hip.
 
How is ITBS treated? 

Initial treatment for ITBS includes rest, ice cup, compression and elevation; in addition to determining the underlying cause of the irritation. Depending on each individual case, any number of techniques may be helpful including ART, Graston, Kinesiotape, Trigger Point Dry Needling, Class IV Cold Laser Therapy, or many others.  Anti-inflammatory ointments can help to reduce inflammation.  
 
After the acute phase has subsided, focus should be on correcting muscle imbalances or improper mechanics which caused the inflammation to begin  with; this is different in each case. Treatment may include flexibility, stretching, and mobility or strengthening as well as gait retraining, bike adjustments or addressing other movement patterns. 
  
An important step in recovery is to evaluate the underlying cause of the problem. ITBS often becomes a chronic concern because steps are never taken to change and address why the irritation and inflammation actually occurs. 

Finally, patience is required for optimal results in healing ITBS. Whether it is waiting for mechanics changes to develop or simply returning to activity too soon-these common mistakes delay healing.  Listen to your body so you can return to and enjoy the sport you love!
 
 
Did you see our article posted January 30th:

"The Location of Pain isn't Always the Problem."

Be sure to read further on an analogy about how compensations can lead to much larger problems!
 
 
If there is a medical emergency, obviously an ambulance is called and the athlete is taken to the hospital for further evaluation and treatment. Concussions can cause emergenecy situations immediately after the injury or even hours later, and it is very important to recognize these signs and get the athlete the appropriate medical attention quickly.


There is significant debate in treatment options for non-emergency treatments. The one item that is agreed upon is rest. Rest may include lack of participation in sports, or in severe cases may even involve using earphones to control noise, dark rooms to reduce eye strain and rest from mental activities such as studying or working.

One up and coming technique is Active Release Technique or A.R.T. This specific soft-tissue based technique can help increase blood flow and oxygenation to the area treated as well as reduce spasm, tightness and even scar tissue. The premise behind this technique and concussion is several nerves exiting the spine in the neck have a direct connection to the dura (the fibrous covering around the brain). By reducing any compression or irritation on these nerves as well as increasing circulation and nutrients, athletes may be given a chance at faster healing and fewer lasting symptoms. While there are no published research articles currently on this topic, there are multiple case studies as well as anecdotal reports of improvement in symptoms that are awaiting publication.

Chiropractic Manipulation or Adjusting is another method that may have merit in treating concussion. Again, further research is needed in this area. Manipulation is used to help control or alter the nervous system, which is obviously affected by concussion.  Although there are reasons adjusting is contraindicated, the examination both pre-season as well as post-concussion would determine if manipulation is safe to perform. Manipulation can then be used as a very safe and effective way to calm down the overstimulated nervous system and speed up healing of the central nervous system from a concussion. Most adjusting would address the upper cervical spine where the nerves exiting the spine are directly connected to the dura and where some very important neurological structures rest just in front of the spine, and are therefore easily stimulated.

Stay tuned for another article specifically following the treatment of a young athlete and his treatment for concussion.