- The client is a 23-year old woman who is a former collegiate long distance runner.
- She began to experience pain in her left Illiotibial (IT) Band in the fall of 2012 while training at college.
- She currently runs two to three times per week, along with cross-training (elliptical and strength training) on opposite days.
- The client describes the IT Band pain as a sudden onset of sharp pain that she feels on the outer portion of her left leg near the knee during her runs.
- The pain is debilitating in nature and forces her to stop running almost immediately.
- Typically the pain comes on at the point of running one to three miles continuously.
- As of October 2013, the client had undergone several months of physical therapy and chiropractic therapy, which helped her to manage the pain but did not resolve the issue.
- Currently, her average mileage per run before the IT Band pain sets in is about 2 miles.
- Her goals in beginning therapeutic bodywork are:
- 1) to be able to run 12 miles in a row consistently without pain
- 2) to reach an average weekly mileage goal of 35 miles.
- The initial postural and range-of-motion assessment reveals a functional leg length difference in which the client’s left leg pulls about a ¼ inch shorter than the right leg.
- Lordodic curvature of the lumbar spine and anterior rotation of the pelvis are noted.
- Anterior hip flexors (particularly the right side illiopsoas), lateral hip rotators (particularly the left side piriformis) and gluteus medius and minimus are found to be tight and produce significant tenderness upon compression.
- A large adhesion is noted in the left IT Band about 1 inch superior to acupressure point GB31.
- The client begins 30-minute treatment sessions one time per week for a course of ten weeks.
- There is a two-week break between the first and second 30-minute treatment, and Sessions 3 through 6 are spaced one week apart.
- Sessions 6, 7, and 8 are spaced two weeks apart.
- Chinese medical massage rolling technique, compression, skin rolling, deep tissue stripping are applied to the IT Band and surrounding tissue at every session.
- Chinese kneading technique and deep tissue compression and frictioning techniques are applied to the gluteus medius, maximus, and minimus and deep lateral hip rotators, and compression is applied to the illiopsoas at every session.
- Acupressure points local to the IT Band: GB30, GB31, and GB34 are sedated with finger pressure for about 1 minute at every session.
- From Session 2 onward, cupping is applied to the adhesion near GB31on the IT Band, above and below this point on the IT Band, at the IT Band/TFL transition region, and to GB34.
- The cups remain stationary for 10-15 minutes at each session.
- Following the second session (first session of cupping), the client reported being able to run six miles before her IT Band pain developed.
- She noted this was the first time in a long time she had been able to run that distance without pain.
- Following Session 4, the client reported that she was able to go on two 4-mile runs within a week without experiencing any IT Band pain and without any symptoms of the IT Band pain onset (8 total miles).
- Following Session 5, the client was able to increase her weekly mileage to two 4.5-mile runs without experiencing any IT Band pain (9 total miles).
- Following Session 6, the client was able to go on two 5-mile runs and one 3-mile run during the first week (13 total miles) and on one 5-mile run during the second week (5 total miles) between sessions without any IT Band pain.
- Following Session 7, the client reports that she was able to go for a 2-mile, a 6-mile, a 5-mile, and a 3-mile during the first week (16 miles) and for two 5-mile runs during the second week between sessions (10 miles).
- As mileage was sustained and increased over 4 weeks without any significant IT Band pain, the client’s IT Band pain appears to be resolving and subsequent therapy sessions will be continued at a spacing of three to four weeks apart, until the client consistently hits her weekly target mileage goals for a period of 6 weeks pain-free.