Iliotibial Band Friction Syndrome

Familiar to many runners, this fibrous band runs along the outside, or lateral, portion of the thigh. It is plays a role in hip and knee stability and commonly becomes overstretched and tightens with runners who over train or increase their intensity (distance or speed) too quickly. However, knowledge of this band and the issues it causes is not common knowledge. Unfortunately, runners are not the only group who suffer from IT band issues. Many people, who are not runners, can also experience this same condition. I have personally it in seen bikers, soccer players, triathletes, even the sedentary population.

Anatomy

The question is: What causes this?

Well in order to answer this question lets do a quick anatomy lesson. The IT band arises from a muscle in the glutes called the TFL, or tensor fasciae latae, which plays a role in abduction of the hip (in lay terms, allows the leg to rise up to the side). From there, the IT band runs down the leg and crosses the knee joint. As it passes across the knee joint, it becomes more fibrous, and when it becomes taut it creates friction over the lateral femoral epicondyle (or the bony prominence just above the knee joint).

Etiology

So how does this happen?

This arises from a fundamental weakness, of the core and gluteal musculature. Allowing the hip to deviate laterally, lengthening and pulling the IT band taut. Weakness in the gluts usually arises from fatigue, especially for athletes. Overtime the adductors, the muscles on the inside of the leg, become tightened, further pulling the IT band taught, which ultimately aides in the acceleration of the syndrome. This overcompensation can also cause changes in the biomechanics of the ankle, causing a syndrome called over pronation (walking on the inside of the foot), which has its own host of issues. Now, after this quick anatomy lesson, you can easily see, that it’s like a house of cards, once one card is pulled out the rest topple over.

Treatment/Prevention

Typically, if treated soon after the symptoms arise, IT band can resolve with little residual complication. However, if left untreated (which happens more frequently than it should) the condition becomes chronic and not only does the outcome become less favorable but the treatment becomes more complicated and drawn out. Since the IT band works in concert with the ACL for proper knee biomechanics, and blends some of its fibers with lateral meniscus, it can lead to more serious conditions, besides just the biomechanical changes. Examples include; ACL sprains, meniscal irritation, chondromalacia patella, patellafemoral tracking disorder, and even early degeneration of the knee joint itself. So, needless to say, this should be treated early and with gusto, to ensure that none of the above develops.

Treatment consists of soft tissue therapies like ART, Graston, Kineseotaping and PNF (description of these therapies can be found on this blog in the archives) stretching to most muscles of the lower extremity. Extensive rehab of the lower extremity and core musculature is key, as well as maintaining proper spinal and extremity joint motion with manipulative therapy. Like I mentioned earlier, if treated early, care is less complicated and can resolve quickly but as the length of the condition increases so does the level of complication and length of care. It is always best to seek care earlier on and get evaluated for early signs of IT band issues. Prevention is key!

If you have any further questions or think you need to be evaluated please contact us at Executive Express Chiropractic by phone 415-392-2225 or email me @ drstephens@executiveexpresschiro.com

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A new Challenge everyday.  Save it to your computer and make no Excuses!  GET IT DONE! 
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Your body needs healthy fats to survive.  Fats provide a concentrated energy source making you feel full longer.  They are important for building cell membranes and various hormones.   Fats are important for the absorption of fat soluble vitamins (A, D, E, and K).  But fats can be confusing for many.  Which fats or oils are good for you, which ones should be avoided, and which ones are best to cook with?

When choosing oils, cold pressed versus heat-processed is important.  When oils are processed by heat, seeds are heated to high temperatures and pressed to expel oil.  Then, the oil is degummed, removing valuable nutrients.  Then the oil is heated again to remove the rancid odor and yellow color leaving a clear oil, void of nutrients and full of free radicals.

When it comes to cooking, you must take into account the smoke point of the oil you are using.  Some oils such as olive oil, have a low smoke point and should not be used to cook with at high temperatures.  The smoke point is the point where the oil begins to break down and become rancid, releasing free radicals that damage the liver.  Some great oils to cook with are rice bran oil (never tried it!), grapeseed oil, macadamia nut oil, butter, ghee butter, and coconut oil.  Some oils that have a lower smoke point and aren’t as great to cook with include corn oil, soy oil, safflower oil, and canola oil.

Trans fats are particularly dangerous because they are bigger particles that your body doesn’t know how to break down as efficiently, leading to clogged arteries.  Trans fats are formed when vegetable oils are hardened to make margarine or shortening.  Trans fats are also found in fried foods and cookies and pastries.  A way to tell if a product has trans fat is to look for words such as hydrogenated or partially hydrogenated on the label. 

Saturated fats are usually hard at room temperature and tend to come from animal sources.  Examples include butter, lard, palm oil, cocoa butter, and coconut oil. 

Coconut oil contains medium-chain fatty acids which are digested more easily than long-chain fatty acids.  Instead of being stored in cells, these fatty acids are sent directly to your liver where they are converted to energy.

Unsaturated fats are usually liquid at room temperature and tend to come from plant sources.  There are monounsaturated and polyunsaturated fats.

Monounsaturated fat sources include olive oil, peanut butter, avocados, macadamia nuts, almonds, walnuts, pecans, cashews, hazelnuts, and canola oil.

Canola oil goes rancid easily and during the processing procedure, is transformed into trans fat. 

Polyunsaturated fats include corn oil, sunflower oil, soybean oil, safflower oil, and cottonseed oil.  Polyunsaturated fats go rancid easily with heat so should not be used for cooking.

Too much polyunsaturated oils in your diet can actually contribute to diseases such as cancer and heart disease.  This is usually due to them being exposed to heat through processing or cooking.

I previously covered omega-3 fatty acids and why they are important for health.  Good sources include fish, green leafy vegetables, wild game, algae, certain seeds and nuts.

Flax seed oil is a great source of omega-3, however it should be kept refrigerated and never heated.  It’s great for things like salad dressings.

Sunflower, corn, soy, safflower, and canola oil are full of omega-6 fats which worsen your omega-3 to omega-6 ratio and lead to inflammation. 

There is a misconception that saturated fats are the worst type of fat.  Really, trans fats are the type that should be avoided.  Trans fats are linked to type 2 diabetes and interfere with insulin receptors while saturated fats do not.  Diabetes was non-existent years ago when humans ate a diet high in saturated fat, but has become an epidemic now that trans fats are a common part of the American diet.  The trick is to get your saturated fats from healthy sources that are not processed and contaminated with trans fats – then saturated fats can be good for you (in moderation of course). 

Heart disease is responsible for at least 40% of deaths in the US.  In the period from 1910 to 1970, animal fat in the diet decreased about 20%, and butter consumption plummeted as well.  However, the percentage of refined vegetable oils, margarine, and shortening has increased about 400% and the consumption of sugar has increased about 60%.  Before we are quick to blame saturated fat for heart disease, we need to look at the bigger picture.

I recommend olive oil, coconut oil, avocados, ghee butter, or grass-fed organic butter as healthy sources of fat.  Always choose cold pressed oils, and keep in mind which fats are appropriate to cook with and which ones are best cold.


By: Dr Christine Arseneau
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K-Tip Fit Radio! 03/19/2012
 
Just a few K-Tips about Life I put together during a long thoughtful run...Have you made a goal for yourself recently??
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The truth about water...
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What is a genetically modified organism, or GMO?  Genetically modified food is made by forcing genes from one species (bacteria, virus, animals, or humans) into the DNA of crops or animals in order to introduce a new trait.  GMOs are usually engineered to withstand herbicides and/or to produce an insecticide.

GM food has no long-term data in humans, but several animal studies have found concerning results.  These studies indicate serious health risks such as infertility, immune problems, accelerated aging, faulty insulin regulation, and changes in the gastrointestinal tract and major organs.

Not only are GMOs potentially dangerous, but they have also not lived up to their initially claimed benefits, such as increasing crop yields, more food production, weed and pest control, and drought-tolerant plants.  Farmers are not able to re-use GMO seeds and must buy seeds every year from biotech companies such as Monsanto, DuPont, and Cargill.   GMO seeds will not feed the world; in fact, they have not increased the yield of a single crop.

In order for GMO crops to grow, you must use a huge area of just one crop which depletes the soil faster than growing a variety of crops together such as organic farmers do, and yields less crop per area.  

Sure GMO crops can resist Roundup®, but these crops do not control weeds and pests; instead, they have led to the emergence of super weeds and super pests – much like the incorrect use of antibiotics can lead to resistant bacteria.  And these super weeds which are becoming immune to Roundup® can only be killed with higher and higher amounts of chemicals.  The active ingredient in Roundup® – glyphosate – has been shown to cause birth defects and reproductive problems in animals at low concentrations.

The logic is backwards.  We plant huge fields of a single crop which depletes the soil and makes the crops unhealthy so that pests can injure the crop.  Instead of making the soil and plants healthier using organic compost and biodiversity of crops, Monsanto (maker of Agent Orange and other dangerous chemicals) develops Roundup® to kill the weeds.  Since this dangerous chemical will also kill crops, now they come up with GMO strains of crops which can withstand the Roundup® – cha ching!  Instead of fixing the problem, come up with a solution that simply masks the problem and needs another money making intervention to work. 

Biotech companies have patents on GMO seeds and can therefore restrict their use.  Even if a seed naturally drifts over to a non-GMO farm and contaminates it, companies like Monsanto can sue that farmer.  And they have!  Is it really appropriate for large corporations to ‘own’ nature? 

How can you protect yourself from GMO ingredients?  Unfortunately, in the states, unlike Europe, GMO ingredients do not need to be labeled as such.  So if you are not buying certified organic products, there is a good chance you are eating GM products.   You can also look for the Non-GMO project verified seal.  Oh, and remember my post on dangerous dairy products?  Monsanto is also responsible for making genetically engineered bovine growth hormone.  Look for dairy products labeled ‘no rBGH or rBST’ otherwise you are drinking a genetically modified ingredient.  Over 90% of corn, soybeans, canola, and sugar beets grown in the states are genetically modified – so any processed food you eat probably contains at least one of these genetically modified ingredients. 

Read labels and avoid these ingredients.  You can check out NonGMOShoppingGuide.com (there’s even an app for that!) for details on specific products.  Buy whole organic foods and cook from scratch as much as you can to avoid GMOs.

I am a supporter of the “Just Label It” campaign where over 900,000 people have summited written support to the FDA for labeling GM foods.  http://justlabelit.org/about-ge-foods/ge-foods-at-a-glance/    Check them out and sign the petition to the FDA!


By: Dr Christine Arseneau
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Quinoa Power Seed! 

So I get a lot of questions via email, Facebook and Twitter regarding training and nutrition.  Some of them unfortunately I do not get around to answering as my focus is primarily with my one-on-one clients here in Cali.....So I decided to start a podcast (Fit Minute) where I plan to do one every week touching on some unique questions.  If you have a question, I'd love to hear from you...shoot me an email: kendrick@kbodyfitness.com 
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Here it is guys!  A few workout ideas to incorporate in your day to day life.  You'll feel better and you may even tone up a bit by the end of the month.  Stay consistent, feed the mind just healthy, positive stuff, keep the kitchen clean of crappy food and break lots of sweat during your workouts!  You'll see results =) 
Your trainer, Kendrick 
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SuperFoods! 02/28/2012
 
Superfoods are nutrient dense foods found in nature.  Mother Nature has come up with many wonderful foods to choose from.  I chose 7 to tell you a little more about.

The acai berry is not only rich in antioxidants, but also contains omega-3s, fiber, protein, and minerals.  Acai has been found to have 300 times the antioxidants of blueberries.  A diet high in antioxidants is important to ward off the germs that constantly surround you.

Coconut oil contains medium-chain fatty acids which are digested more easily than other saturated fats.  Instead of being stored in cells, these fatty acids are sent directly to your liver where they are converted to energy.  Saturated fats are ideal to cook with because they have a high smoke point.  The smoke point is the point at which the oil begins to break down, causing free radicals to be released.  Not only does coconut oil support healthy metabolic function, but it also has anti-bacterial, anti-viral, and anti-fungal properties.

Goji berries are an excellent source of antioxidants and have more vitamin C than any other fruit.  They also contain vitamins A, B1, B2, B6, and E, as well as protein and trace minerals.

Raw cacao contains the most concentrated antioxidants of any food (with an ORAC score of 95,500!).  However, most chocolate is heated during the manufacturing process which ruins many of the nutrients.  To get the full benefit, you must eat raw cacao (which does not taste much like processed chocolate!).  Raw cacao is very high in magnesium, which is a common deficiency, as well as a great source of iron.

Chia seeds are very nutritious.  They contain five times the calcium of milk and more omega-3s than flax or salmon.  Chia seeds are also an excellent source of fiber, trace minerals, and protein.

Raw honey is rich in bee pollen.  Bee pollen is the most complete food found in nature and has more protein than beef.  In addition to containing natural antioxidants, honey contains enzymes, and vitamins and minerals such as calcium, iron, zinc, potassium, phosphorus, magnesium, copper, selenium, chromium and manganese.  Bee pollen is a natural antidote for fighting allergies such as hay fever and may even counteract the signs of aging.  Honey can even be used in the topical treatment of wounds (specifically, raw Manuka honey).

Spirulina is actually classified as cyanobacteria – bacteria that used the sun as an energy source the way plants and algae do.  Spirulina is made up of 70% protein and contains all of the essential amino acids!  Not only is it packed with nutrients, but spirulina also has shown promise in reducing cholesterol and cancer, enhancing the immune system, reducing toxicity from heavy metals, and protecting against radiation.

Remember, the more processed a food, the more it loses its beneficial nutrients.  Eat raw, organic whole foods whenever possible, and try incorporating some of these superfoods into your diet!  What’s your favorite superfood?

By: Dr Christine Arseneau 
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Its completely normal to feel down every once in a while.  Unfortunately, however, there are millions who suffer from more than just a passing bout of the blues.  For those who suffer from depression, it can be debilitating and affect many aspects of life.  The good news is that there are ways to boost your mood.  Diet is one way to achieve this.  Eating meals at regular intervals helps to stabilize moods.  More than that, research has shown that what you eat can have a direct effect on how you feel and even minimize symptoms of depression.  What are some of these foods and how do they help?

            Eating enough carbohydrates (complex and veggies) can help raise serotonin levels.  Serotonin is a chemical found in the brain that has a calming effect.  Lower levels are found in those who suffer from depression.  Carbohydrates have been found to aid the production of this vital compound.  Examples in food include quinoa, brown rice, oatmeal, sweet potatoes and pretty much all the veggies.

            Next on the list are omega-3 fatty acids.  These fatty acids are not produced by our  bodies, but are supplemented through diet.  Studies show the importance of omega-3s in that it can aid greatly in the prevention of heart disease, stroke, cancer and depression.  It is considered 'brain food' and can enhance the effectiveness of depression medications.  Flaxseed, almonds, walnuts, salmon and other types of fish are healthy and delicious sources of omega-3 fatty acids.

            Low levels of the antioxidant vitamin E has been recorded in ones who are depressed.  The deficiency in this vitamin can be helped through taking supplements and also by eating foods like the chick pea.  An easy to prepare food like hummus can help boost your mood and tastes great too!

            Folates are another important nutrient that can help raise serotonin and is good for the overall health and function of the brain and nervous system.  Taking in plenty of folate has been shown to reduce symptoms of depression.  Legumes, spinach and peas are examples of foods that are rich in folate and help fight depression.

            Vitamin B6 is another vitamin that is beneficial to brain function.  It aids in the regulating of mood disorders and depression because it also has a positive effect on serotonin levels.  Foods like turkey, chicken, walnuts, wheat germ, yeast, sunflower seeds and soya beans are great sources of B6. 

            Depression can be treated successfully with good treatment, exercise and healthy foods.  Of course, checking with your healthcare provider is important when deciding on how to help improve your condition.  Reviewing together current treatment and proposed diet plans is beneficial and will help maximize results.  Eating a balanced diet and receiving the nourishment your body requires is sure to help chase those lingering bad moods away.  Some of the more persistent or chronic feelings may take a while, but there is hope.  A happier, better you can start today by eating foods that fight depression.

By: Kendrick Ribeiro

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