Cortisone shot for persistent ITBS - any experiences?

Zzippy

N.B. Not seeking medical advice, already under care of very good physio and GP

I've had ITBS for about a year now, undiagnosed initially, had exploratory knee surgery in Feb that found nothing wrong. I've tried long periods of rest, first run back just got pain again after the usual 2-3km. Been doing intensive rehab (strengthening of glutes, adductors, etc, cross-training, core work, foam rolling) with a physio for the last few weeks, tried running last week and the pain is there again, even got it on the bike after 25km on Saturday.

Saw the physio again today and he suggested the next step might be a cortisone injection. I'm really keen to get back running, on the other hand have heard a few scare stories about cortisone. Talked to the physio about it and he was reassuring, but I'd love to hear from anyone who has gone through it for their experience.

So, I'm asking has anyone on here had it for ITBS, and if so, has it helped? Was it worth it? Would be very grateful for any help.

ps I realise cortisone is not a long-term solution, I'll be continuing with the cross-training and rehab work to try to address the root cause.

ger664

Got it twice for an inflamed bursa in the groin area. It with 9 weeks off running sorted me out at the time. I wont be worried about the side effects about the cortisone as it is injected with a local anesthetic and the dose is minimal.

Clearlier

Zzippy wrote: »

N.B. Not seeking medical advice, already under care of very good physio and GP

I've had ITBS for about a year now, undiagnosed initially, had exploratory knee surgery in Feb that found nothing wrong. I've tried long periods of rest, first run back just got pain again after the usual 2-3km. Been doing intensive rehab (strengthening of glutes, adductors, etc, cross-training, core work, foam rolling) with a physio for the last few weeks, tried running last week and the pain is there again, even got it on the bike after 25km on Saturday.

Saw the physio again today and he suggested the next step might be a cortisone injection. I'm really keen to get back running, on the other hand have heard a few scare stories about cortisone. Talked to the physio about it and he was reassuring, but I'd love to hear from anyone who has gone through it for their experience.

So, I'm asking has anyone on here had it for ITBS, and if so, has it helped? Was it worth it? Would be very grateful for any help.

ps I realise cortisone is not a long-term solution, I'll be continuing with the cross-training and rehab work to try to address the root cause.

I know that you say that you're happy with your physio but at this stage it might be time to consider another physio. They really, really should have got to the bottom of it by now.

FWIW, I thought that I had a great physio at one time, at this remove having seen other physios I can tell you that they were pretty poor.

Good luck, ITB can be bloody painful!

Zzippy

Clearlier wrote: »

I know that you say that you're happy with your physio but at this stage it might be time to consider another physio. They really, really should have got to the bottom of it by now.

FWIW, I thought that I had a great physio at one time, at this remove having seen other physios I can tell you that they were pretty poor.

Good luck, ITB can be bloody painful!

This is a new physio, I've been through a couple over the years. He works with a professional sports team also and is extremely highly recommended, my experience so far with him has been far superior to other physios I've seen, so I'm happy with that. I think some ITBs are just stubborn to heal, I seem to have been cursed with a bad one that will take more work...

tunney

I have suffered for ITBS for years. When I say suffered it stopped me running until I found a proper person to treat me.

I still get minor flare ups but they never stop me running more than 2-3 days, ie until I get to see the person to treat the person.

The fact that you had exploratory knee surgery in Feb for ITBS screams CHANGE PHYSIO.

pgmcpq

Exploratory surgery for ITBS. Seems strange - not sure what they would expect to see tbh.

Re cortisone. I have had two shots (not for itbs), but purely as a diagnostic tool - i.e. get an injection at X - if it stops hurting we know the problem is located at X.

My memory is that a once off cortisone shot is unlikely to be much of an issue - though anyone can have a bad reaction to any medication. The real question is what is the expected outcome ? It's not a long term solution ... so how does it help ? I'd be asking more questions.


Not directly on topic but ..... ITBS is a very frustrating injury. The minute you think you have it beaten it flares up again. Took me six months from identification of the injury to getting back to any serious running Once I was able to run at all recovery involved running gently until I felt any discomfort at all - even a twinge. Then STOP. Completely. First few weeks back running probably maxed at two miles a time. So your experience of recovery may be pretty typical. Patience is key. Eventually this distances I covered began to grow quickly.

I did have to change a few things. I had to pay close attention to the surfaces I run on - no running on the side of roads with an slope for drainage, close attention to gait (easy enough to develop bad habits if you've been compensating for the pain), etc.

Zzippy

tunney wrote: »

I have suffered for ITBS for years. When I say suffered it stopped me running until I found a proper person to treat me.

I still get minor flare ups but they never stop me running more than 2-3 days, ie until I get to see the person to treat the person.

The fact that you had exploratory knee surgery in Feb for ITBS screams CHANGE PHYSIO.

Just to be clear, the surgery was for undiagnosed knee pain. I probably misdiagnosed myself as having a cartilage problem and pushed for the surgery as I've had 3 previous arthroscopies that sorted problems I had. The surgeon removed a couple of plicas as they might have been causing impingement, but said otherwise the knee was perfect. The current physio is not the guy I was seeing prior to surgery. After surgery I tried running - pain came back. Rested it for several months - pain came back. Rested it again, then pain, that's when I started seeing the current physio.

pgmcpq wrote: »

Exploratory surgery for ITBS. Seems strange - not sure what they would expect to see tbh.

Re cortisone. I have had two shots (not for itbs), but purely as a diagnostic tool - i.e. get an injection at X - if it stops hurting we know the problem is located at X.

My memory is that a once off cortisone shot is unlikely to be much of an issue - though anyone can have a bad reaction to any medication. The real question is what is the expected outcome ? It's not a long term solution ... so how does it help ? I'd be asking more questions.


Not directly on topic but ..... ITBS is a very frustrating injury. The minute you think you have it beaten it flares up again. Took me six months from identification of the injury to getting back to any serious running Once I was able to run at all recovery involved running gently until I felt any discomfort at all - even a twinge. Then STOP. Completely. First few weeks back running probably maxed at two miles a time. So your experience of recovery may be pretty typical. Patience is key. Eventually this distances I covered began to grow quickly.

I did have to change a few things. I had to pay close attention to the surfaces I run on - no running on the side of roads with an slope for drainage, close attention to gait (easy enough to develop bad habits if you've been compensating for the pain), etc.

That's the thing, I do all of those things, pay attention to where I run, have never changed my gait, have always stopped when I got the pain, not tried to compensate or run through it, as to be honest it's too painful.

Thanks for feedback folks. I think I will get the shot as a short-term measure, I have a couple of events I want to do this winter. Plan to keep up the cross-training and rehab work, and see one of the people recommended here to look at gait/imbalances to address it long-term (thanks for recommendations and PMs).

thehamo

Zzippy wrote: »

Just to be clear, the surgery was for undiagnosed knee pain. I probably misdiagnosed myself as having a cartilage problem and pushed for the surgery as I've had 3 previous arthroscopies that sorted problems I had. The surgeon removed a couple of plicas as they might have been causing impingement, but said otherwise the knee was perfect. The current physio is not the guy I was seeing prior to surgery. After surgery I tried running - pain came back. Rested it for several months - pain came back. Rested it again, then pain, that's when I started seeing the current physio.





That's the thing, I do all of those things, pay attention to where I run, have never changed my gait, have always stopped when I got the pain, not tried to compensate or run through it, as to be honest it's too painful.

Thanks for feedback folks. I think I will get the shot as a short-term measure, I have a couple of events I want to do this winter. Plan to keep up the cross-training and rehab work, and see one of the people recommended here to look at gait/imbalances to address it long-term (thanks for recommendations and PMs).

You have to wonder is the diagnosis correctbas well. Lateral knee pain doesnt always equal itbs. Its very much a go to diagnosis but it.could be coming.from somewhere else completely. Get your gait checked, look for someone who practices the Anatomy in motion stuff. Problems can also come from the hamstrings, you have to consider fascial connections which means it can come.from the souleus and gastroc of the calfs. I would echo that if pain hasnt cleared after weeks especially with diligent rehab, another opinion should be sought!

tunney

thehamo wrote: »

You have to wonder is the diagnosis correctbas well. Lateral knee pain doesnt always equal itbs. Its very much a go to diagnosis but it.could be coming.from somewhere else completely. Get your gait checked, look for someone who practices the Anatomy in motion stuff. Problems can also come from the hamstrings, you have to consider fascial connections which means it can come.from the souleus and gastroc of the calfs. I would echo that if pain hasnt cleared after weeks especially with diligent rehab, another opinion should be sought!

Agree I thought my ITB went again last year, was the vastus lateralis in spasm. Almost identical pain