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Legacy update log for the iliotibial band syndrome tutorial

This is a listing of older updates made to the iliotibial band syndrome tutorial. They are provided for historical interest only, a “paper trail” demonstrating how the document has been maintained. Newer updates are listed in the tutorial itself.

2015Expanded: Added several items that might cause diagnostic confusion. [Section: Other possible diagnoses and sources of diagnostic confusion.]

2015New item: Added IT band plungering. No really! If it’s stuck, suck it! [Section: Brief debunkery of several therapies that you should be particularly skeptical of.]

2014New item: A brief but very well-researched review of platelet-rich plasma injection. [Section: Brief debunkery of several therapies that you should be particularly skeptical of.]

2014Updated: Added good news story from a reader about a case with a cyst, and improved the information about cysts at the same time. [Section: Should you get an MRI?]

2014Major update: The first complete professional editing of this book has now been completed. Although the difference will not be obvious to most readers, several hundred improvements and corrections were made, and it is definitely a smoother read.

2013Science update: Added a bad-news citation. Sorry about that. [Section: Soft knee straps (and/or Kinesio Taping) are worth a shot.]

2013New case study: Added a fascinating and extreme example of the effect of running style from a case study of an ultra-runner. [Section: Why does IT band pain gets so nasty so fast? A vicious cycle related to running pace.]

2013Science update: A particularly “good news” science update about how running is, counterintuitively, actually pretty good for joints — not hard on them. [Section: “Maybe you’re just not built for running”.]

2013Update: A new introduction for the chapter about the trend of anti-running “science.” [Section: “Maybe you’re just not built for running”.]

2013Updated: Added more detail and a couple examples. [Section: When ITBS isn’t a repetitive strain injury.]

2013Minor update: Minor but nice: a really good new quote adds some entertaining and genuinely fascinating perspective to this section. [Section: “Maybe you’re just not built for running”.]

2013Minor update: Upgraded risk and safety information about Voltaren Gel. [Section: Ibuprofen and friends: non-steroidal anti-inflammatory drugs (NSAIDs), especially Voltaren® Gel.]

2013Product upgrade: Audiobook version now available. See the announcement for more information.

2012Minor update: Added some fun stuff and context about IT band anatomy. [Section: So is it a tendon or what? IT bands are special.]

2012Expanded: Added much more detailed self-help information for trigger points. [Section: Trigger point therapy for your hips, glutes, quads, and calves.]

2012Science update: Weak but interesting new evidence on natural running and injury prevention. [Section: Should you run naked? On faddish running styles and running shoes (or the lack thereof).]

2012Science update: Added evidence from the first foam rolling research ever done. [Section: IT band massage, foam rollers, and Graston Technique® — a big fat waste of time and/or money.]

2012Major update: Numerous significant clarifications, revisions, and new references, and a generally stronger recommendation. [Section: Deep transverse friction massage.]

2012Rewritten: Now about four times more detailed than before and much more strongly focused on the positive, what my final recommendations are, and how to “put it all together.” [Section: Now what?: An action-oriented summary of recommendations.]

2012Nice upgrade: After years of procrastination, I have finally created a video demonstration of a tricky ITBS stretch! About time! [Section: Some stretching hope: a better iliotibial stretch?]

2012New section: New standard section I’m introducing to most of the tutorials to “manage expectations.” Too many readers assume there’s going to be a specific miracle treatment plan. [Section: So what’s the plan?]

2012New diagram: Nice new diagram, “Key locations for massage treatment of ITBS.” [Section: Trigger point therapy for your hips, glutes, quads, and calves.]

2012Minor update: Very simple swimming tip added. Hat tip to reader Eric C. [Section: The fear of rest, and relative resting: how to maintain fitness while protecting your knees.]

2012Major update: Rewritten and expanded, much clearer and more detailed. Not much new science, though — ITBS+orthotics science is pretty scarce! [Section: Orthotics for IT band syndrome: a worthwhile long shot.]

2012Minor update: Added a paragraph about elliptical machines. [Section: The fear of rest, and relative resting: how to maintain fitness while protecting your knees.]

2012Minor update: Added an example of surgery gone wrong. [Section: The old surgery: snipping the band.]

2012New section: No notes. Just a new section. [Section: When ITBS isn’t a repetitive strain injury.]

2012Revised: Some modernization and clarifications. Now also discusses the notion of “just rubbing” the hot spot. [Section: Deep transverse friction massage.]

2012Rewritten: Another “like new” rewrite: this section now offers much more detailed resting advice, perspective, and troubleshooting. [Section: The art of rest: the biggest challenge and opportunity for patients who have supposedly “tried everything”.]

2012Rewritten: This section is “like new” and much beefier, and links to an upgraded main contrasting article as well. [Section: Contrast hydrotherapy: exercising tissues with quick temperature changes.]

2012Rewritten: Major changes: new science, new recommendations, more detail, and some explanation of the (very difficult) problem of why anti-inflammatory injections might work despite the fact that IT band syndrome doesn’t involve much inflammation. [Section: Steroid injections: a complicated mix of certain risks and uncertain rewards.]

2012Rewritten: Completely revised to reflect new science and new understanding of the interaction of ice with “inflammation.” [Section: Icing: more is better?]

2012Rewritten: Completely revised to reflect new science and new understanding of the interaction of NSAIDs with “inflammation.” [Section: Ibuprofen and friends: non-steroidal anti-inflammatory drugs (NSAIDs), especially Voltaren® Gel.]

2012Major Update: Expanded and revised summary of treatment options, with emphasis on new and better recommendations about “anti-inflammatory” treatments. [Section: Treatment: What can you do about iliotibial band syndrome?]

2012Updated: Advice on “running through” has changed, with more emphasis on the unknown but plausible risk of permanent damage. [Section: Can you “run through” iliotibial band syndrome?]

2012Major revision: Extensive editing and re-writing concerning the nature of inflammation. The main point of the section remains unchanged, but the section now does a much better job of explaining why ITBS isn’t really inflamed, and why it matters. Although not cited, this update drew heavily on some new scientific papers. [Section: Where’s the fire? The inflammation myth.]

2011Updated: Added new information and some pie charts about the success rate of arthroscopic surgery for ITBS. [Section: The new surgery: excision of tissue from under the IT band.]

2011Minor update: Addressed some common fears about the threat of getting out of shape while resting. [Section: The art of rest: the biggest challenge and opportunity for patients who have supposedly “tried everything”.]

2011Major update: Clearer and more thorough content throughout several sections about the “Nature of the Beast” and “Diagnosis,” especially from the discussion of root causes and onwards. I am producing the audio version of this tutorial, and I am revising and improving content significantly as I go. Information about trigger points was completely re-written, and there’s a whole new section about hip and thigh pain.

2011Updated: Modernization and revision for clarity. [Section: Mobilize and stretch the hip musculature.]

2011New section: Stretching is such a hot topic that I decided to break the discussion up with a new section focused on stretching the IT band itself. It was inspired by important new scientific evidence: researchers have found that IT band stretching is not a very moving experience … [Section: The trouble with stretching the IT band in particular.]

2011Major update: Significant modernization and clarifications. Much better description of why this kind of stretch might be worth trying. [Section: Some stretching hope: a better iliotibial stretch?]

2011New science: Added more anatomical evidence that the IT band is particularly impossible to stretch or even move. [Section: So is it a tendon or what? IT bands are special.]

2011New section: No notes. Just a new section. [Section: Hip and thigh pain: part of the problem, or red herring?]

2011Minor update: Clarifications about the location of IT band syndrome pain. [Section: Are you in the right place? Patellofemoral versus IT band pain.]

2011Updated: Added new research evidence that stretching doesn’t prevent injuries, including (of course) ITBS. [Section: Stretching to prevent or treat IT band syndrome.]

2011New video: Section now includes a new video, summarizing myths and treatment mistakes. [Section: Bogus ideas about and bad treatments: IT Band syndrome myths are common.]

2011Minor update: Added reference to Kong et al, about the effect of shoe wear. [Section: Hitting the road: shoes, surfaces, impact, and the spring in your step.]

2011Minor update: Added a reference about the poor overall quality of online information about common injuries. See Starman. [Section: Introduction.]

2011Rewritten: Evidence about the real but surprisingly weak connection between impact forces and injury from Zadpoor et al has prompted a bunch of revision and new recommendations for runners. [Section: Hitting the road: shoes, surfaces, impact, and the spring in your step.]

2011Major update: Major improvements to the table of contents, and the display of information about updates like this one. Sections now have numbers for easier reference and bookmarking. The structure of the document has really been cleaned up in general, making it significantly easier for me to update the tutorial — which will translate into more good content for readers. Care for more detail? Really? Here’s the full announcement.

2011New section: No notes. Just a new section. [Section: Mis-treatment horror story: intense massage on an obviously inflamed thigh.]

2011New section: Finally, long overdue, a new section on this topic. [Section: Should you run naked? On faddish running styles and running shoes (or the lack thereof).]

2011Important new info: Where’s the fire? Recently I published a major new article about repetitive strain injuries, in which I explain that these injuries are rarely actually inflamed. Instead of being “on fire,” excessively stressed tissues tend to break down without inflammation — a kind of rot. For the full scoop on inflammation and repetitive strain injuries, see: Repetitive Strain Injuries Tutorial: Five surprising and important facts about repetitive strain injuries like carpal tunnel syndrome, tendinitis, or iliotibial band syndrome.

2010New section: New short section for both this book and the patellofemoral pain book covering potentially confusing alternative diagnoses, such as politeal artery entrapment syndrome (PAES). [Section: Other possible diagnoses and sources of diagnostic confusion.]

2010Overhauled: Rewrote section to accommodate some new science. The new evidence is interesting, but not particularly illuminating: it mostly just emphasizes how we really (still) don’t know if IT band tightness is actually a problem. [Section: Like a rock in your shoe: the mechanism of irritation and the red herring of tightness.]

2010New cover: At last! E-book finally has a “cover.”

2010Minor update: Updated the nutraceuticals item with information about a new study of glucosamine for knee pain. [Section: Brief debunkery of several therapies that you should be particularly skeptical of.]

2010New section: One of several new/revised sections based on the implications of a new surgical technique (see Michels et al). [Section: The new surgery: excision of tissue from under the IT band.]

2010Major update: One of several new/revised sections based on the implications of a new surgical technique (see Michels et al). [Section: The old surgery: snipping the band.]

2010New section: One of several new/revised sections based on the implications of a new surgical technique (see Michels et al). [Section: The bursitis possibility.]

2010Major update: One of several new/revised sections based on the implications of a new surgical technique (see Michels et al). [Section: A new surgery works without loosening anything tight.]

2010Major update: One of several new/revised sections based on the implications of a new surgical technique (see Michels et al). [Section: What’s actually irritated? Not the IT band ….]

2009Two massage sections significantly revised and expanded: IT band massage, foam rollers, and Graston Technique® and .

2009Substantive update today, a whole new section,

2009Wow, that’s probably the longest I’ve gone without updating this tutorial! (I was quite preoccupied with upgrading the neck pain tutorial over the summer.) However, better late than never, a solid update: although brief in terms of wordage, I’ve just revised to include Voltaren® Gel, an excellent treatment option for ITBS that only recently got into my radar. This update it is a freebie: you can read all about it in a free article as well as here in the tutorial.

2009New section: “.” Also did a little minor re-organizing of some content.

2009The visual design of the site was upgraded over the past several days. Although this is not an update to the content of this tutorial, it is nevertheless a significant upgrade for all of them — like publishing new editions of books with better typesetting and layout. The new design is even cleaner and reader-friendly; it now looks that good in most web browsers; and pages load as much as 50% faster. Many under-the-hood improvements will make it much easier for me to improve tutorial content. The tutorials are now well-oiled machines of digital publishing goodness, vastly superior to the low-production values of most eBooks.

2009Added an important new evidence from a 2008 paper in American Journal of Sports Medicine showing that strengthening, stretching and coordination exercises are ineffective at preventing iliotibial band syndrome.

2009Added a small new section about Traumeel, a popular but questionable remedy that I often get asked about. See the section, “,” or the free article, Does Arnica Gel Work for Pain?.

2009Corrected some minor abuse of a reference to some research about running speed. A reader pointed out that the study I’d cited (Orchard et al) had not involved any actual experiment related to running speed, as implied by my usage. The researchers I was quoting believed that slower running could be more stressful for the iliotibial band syndrome. They had some good reasons for this belief, but had not actually proven any such thing experimentally. Hat tip to Dan for pointing this out. A reminder to visitors and customers that constructive criticism is always welcome.

2009A small but important cautionary warning added to one of the treatment recommendations. It had previously been presented as a harmless and hopefully helpful stretch, but a reader pointed out that it actually has a risk associated with it — hat tip to Alberto.

2008Minor update. Clarified a small but potentially vital point about the nature of the ITB “fat pad” for a reader who had been thrown off by my original wording. Discovering and correcting this sort of misunderstanding is one the best things about publishing in this format. If an author of a book expresses something in a way that misleads or confuses readers, there’s almost nothing that can be done about it!

Tuesday, November 18, 2008 — Major update! Today during a routine check for new research about ITBS I discovered a fascinating scientific paper about a new kind of surgical approach to ITBS. The new surgery is both an important new treatment option for patients, and an incredibly important proof of a principle about the nature of ITBS. Rather than upsetting any of the ideas in this tutorial (which has been known to happen), this new evidence strongly supports some of the most important ideas that I’ve been presenting here for several years now. So I’m quite excited! This is probably the biggest case I’ve ever had of new evidence really boosting an important point in one of my tutorials. There are now four new or significantly revised sections of the tutorial:

2008A minor update: added reader Franklin Swann’s experience with the benefit of a longer stride to the section, “,” along with a new analogy to help explain that phenomenon.

2008Supplemented the tutorial with a new short article about how Canadian Running Magazine botched their featured story about iliotibial band syndrome, and made a few corrections to the tutorial at the same time.

2008Added a reference to some expert opinion about IT band stretching.

2008Added information about Graston Technique® to the section “.” Also added a reference to Kinesio Taping®, which seems popular right now.

2008Added a new section, This was inspired by some correspondence with a reader who’d been told this by her doctor. It led to some very good ways of explaining some of the core issues in ITBS mis-management.

2008Introduced a new special offer: all IT band pain tutorial customers now receive a second, companion tutorial at no charge, Trigger Points & Myofascial Pain Syndrome This is a really great deal, and a valuable extension to this tutorial. If you missed this bargain and want to be included, just drop me a line and I will happily grandfather you into the deal.

2008Added a to sum up the practical implications of all the detailed scientific information. Also, added some new information to the introduction to make sure that readers understand that there is no miracle cure for ITBS.

2007Added two more chilling mis-diagnosis tales: see “” and “.”

2007Responded to reader questions with some clarifications about “.”

2007Upgraded the section to include new research findings.

2007Added the section Expanded the section, which now includes more reader reports of serious cases, and split part of it off to become an expanded section.

2007Integrated important new ideas inspired by the discovery of research by Devan, mostly in the section “ITBFS — not quite what you (or anyone) thought it was”

2007Added several clarifying details to the description of how to use the

2007Revision history implemented! Sorry I didn’t think of it sooner! Added section to help readers determine the difference between iliotibial band syndrome and patellofemoral syndrome.