This month, we are investigating Iliotibial Band Syndrome or more commonly know IT Band Syndrome or ITB Syndrome.

How do you know if you have IT Band Syndrome?

Those with ITB syndrome typically experience pain on the outside of the knee, increased pain with repetitive knee motions, increased pain with walking or running uphill, walking stairs or increased pain at the hip on the outer thigh.

What causes IT Band Syndrome?

The iliotibial band (IT Band or ITB) is an extension of the band (a long tendon) that extends down from a hip muscle called the tensor fascia lata (TFL). Starting at the hip, extending along the side of the thigh and attaching just below the front side of the knee, the ITB has a big impact on both joints.

Those with a lack of flexibility of the TFL/ ITB muscle, bowlegged or people with foot problems may be predisposed to chronic ITB syndrome.

What causes lack of flexibility in the ITB?

There is not a one size fits all answer to this question.  The most common reason for tightness in the ITB is compensation for weak Glute muscles, particularly a muscle called the Gluteus Medius (Glute Med).  The Glute Med can become inactive or weak for a number of reasons; two of the most common are restriction in the hip joint and ankle problems (sprains and weak arches).

When the Glute Med stops firing properly, the TFL will work overtime to pick up the slack and essentially doing a job that is wasn’t designed to do. As with any overused muscle (or person), it becomes irritated. The irritation from repetitive knee flexion and extension causes inflammation and stiffness to occur especially in activities such as running and biking.

How do we treat ITB Syndrome?

Our first job is to get you out of pain and once we accomplished that we need to correct the patterns that brought this problem about.  There are a number of therapies that we utilize to relieve tension in the ITB.  See the following videos for explanations of these therapies.

This video demonstrates using the Fuzion tool on the ITB/TFL

In this video we look at multiple uses of the foam roller including the stretching of the ITB.

This video shows a wall stretch for the TFL/ITB

Our next step is to correct the patterns and muscle imbalances.  There are a number of compensatory patterns that can lead to ITB Syndrome, but we will cover the treatment of the most common which is Glute Med insufficiency.  Glute Med insufficiency will lead to instability in the hips which can be seen below in this video.

When we see hip instability like we do in this video we know that we have Gluteus Medius insufficiency which we can remedy a number of ways.  Our two favorite exercises for this muscle are called “clamshells” and “speed skaters.”   You can see examples of these exercises below.

Because the tight tendon rubs against the thigh bone and pulls tight on the knee, inflammation of this area will lead to pain, which also needs to be addressed.  To reduce the inflammation, it is important to fill your diet with foods that have anti-inflammatory agents.  Here is a recipe that includes a number of anti-inflammatory herbs and spices: Yellow Thai Curry.

Cubital tunnel syndrome (CTS) is the second most common nerve entrapment that happens in the arm, with carpal tunnel syndrome being the most common.  It is commonly known as cell phone elbow because it effects people who spend a lot of time with their elbow flexed.  This is the position that you would hold your cell phone.

CTS is caused by pressure to the ulnar nerve that happens at the cubital tunnel which you can see here to the left.   The Ulnar nerve runs down the middle of your arm from your neck all the way to your fingers.

Symptoms:

The most common symptoms include pain and numbness over the pinky finger and the inside of the ring finger.  Often people will wake up with this sensation because their sleeping with their elbow in a flexed position (bringing your first up to your shoulder).

Treatment:

A thorough diagnostic work up is necessary to determine if the cause of the symptoms is cubital tunnel syndrome (CTS) or possibly a condition that mimics CTS.  If it is determined that CTS is the diagnosis the treatment options vary from conservative to invasive.  The first step is to limit or eliminate the behavior that is perpetuating the problem.  Most often this is a repetitive movement that involves flexion of the elbow.

There are conservative therapies for CTS that don’t require injections or surgery.  A recent study in the Journal of Manipulative and Physiological Therapies showed that patient with mild to moderate symptoms favored well from CTS.

This is a wonderful TED video put on by an MD who was diagnosed with Multiple Sclerosis that left her in a wheel chair.  Through making some minor changes in her life she was able to start walking and even ridding her bike again. She has a powerful message about the health of world.

We have come to the end of the year ready to celebrate and relax with loved ones. In the midst of the hustle and bustle that comes with the season, striving for the Paula Dean’s Christmas dinner, the Pottery Barn home, and Martha Stewart’s gifts puts a great deal of (unnecessary) pressure on us. It is quite easy to lose our sense of self, time, and money, and therefore I’d love to share a few ways to keep balanced (and sane) during the holiday season.

Instead of trying to create elaborate meals on your own while everyone else is cozy by the fire, have guests pitch in a dish of their favorite holiday side that can be easily warmed up. It could be an added bonus to have each person bring copies of their recipe to share.  This cuts down on your time in the kitchen as everyone can share their favorite holiday dish along with nostalgic memories they have associated with it.

Have children in the family that have a ton of things given by extended family? Take a family outing to see the lights in a festive neighborhood, a trip to the zoo, or the children’s museum as their holiday gift.  It will be something they remember long after the games and toys have lost their luster and it can be nice to experience the holidays from a child’s point of view.

Not sure what to give the person that has everything?  Coupons for an outing or donating to their favorite cause in their honor goes a long way.  Or simply writing a heartfelt letter letting them know how much they mean to you can really mean the world to them.

Enjoy exercise as a family!  Build a snowfort (if we get any snow this winter) and make snow angels or the funniest snowman!  Playing outside can help burn off the extra calories we consume during the holidays and just participating in a group activity can lift any spirit.  Also now is a great time to take advantage of later store and mall hours for quick power walking and getting last minute supplies.

Last of all: choose to be joyful! There is a difference between happiness and joy; while happiness comes and goes typically according to circumstances, you can choose to experience joy in any circumstances as you take your focus off of the now and look at how it fits into the big picture. When the ham is overcooked or the shopping lines are long… choose to be joyful! Exercising the facial muscles by smiling triggers ‘feel good’ chemicals in our bodies which in turn actually gives us more to smile about!

As always, let us know if you find other ways to balance your wheel and have a wonderful Holiday!!

In March a few of us from the office will be climbing for air to help raise funds for the American Lung Association. We would enjoy your company if you, too, want to ‘climb’ on board. You can choose to do 1, 2, or 3 sets of thirty-five flights of stairs downtown at the downtown Indiana Square building.

We have joined with a team that is sponsored by Upland Brewery,  but unfortunately I can’t guarantee and free beer samples.   If you would like to join us you can visit our team page here.  If stair climbing is not your thing you can still donate to this worthy cause on the same web page.

Thanks for your support!

Team Compass

We just finished our second annual coat drive for the Hoosier Veterans Assistance Foundation and we collected 55 coats! Thanks to everyone who helped us and help Hoosier Veterans.  Follow this link to find out more about HVAF.

As we gear up for another change of seasons, it is so important to incorporate vitamin D in your daily intake! This recipe is a quick and pretty simple recipe to incorporate vitamins D, K and B12. Signs of vitamin D deficiency include low energy and fatigue, moodiness, bone pain, muscle aches and weakness, frequent colds, asthma (usually in children), or lack of exposure to sunlight (Hello, Indiana winter!). The food naturally highest in vitamin D is salmon, very good sources include sardines, shrimp, and vitamin-D fortified milk, and good sources include cod and eggs.

Ingredients:

• 1 medium onion, sliced
• 1 Tbs coconut oil
• 1 Tbs minced fresh ginger
• 3 medium cloves garlic, chopped
• 1 ½ cups fresh sliced shiitake mushrooms
• 1 ½ cup broccoli
• 1 bunch asparagus, cut in 2″ lengths
• 1/4 cup fresh lemon juice
• 2 Tbs Bragg liquid aminos (healthy, protein filled soy sauce substitute)
• 2 Tbs mirin wine, dry sherry, or sweet marsala
• 1 pinch red pepper flakes
• 3/4 lb cod fillet cut into 1 square inch pieces
• 8 large scallops
• 8 large shrimp, peeled and deveined
• 1 cup cherry tomatoes, quatered
• 1/4 cup chopped fresh cilantro

Directions

• Slice onion. Chop garlic and let sit for 5-10 minutes (Cutting garlic ruptures its cells and as the elements from the different cells mix, a powerful compound called allicin is formed. Allicin adds ups the value of garlic’s health-promoting benefits!! The more finely the garlic is chopped, the more alliicin is produced. And letting garlic rest for 5 minutes gives the allicin time to form.)
• Heat coconut oil at medium heat in a wok or large skillet. Add onion once oil reaches the liquid state for 2 minutes. Add ginger, garlic, mushrooms, broccoli, and asparagus. Stir-fry for another 3 minutes, stirring regularly.
• Add lemon juice, Bragg liquid aminos, wine, red pepper flakes, cod, scallops, and shrimp and stir to mix well. Cover and simmer for just about 5 minutes stirring occasionally.
• Remove from heat and toss in tomatoes and cilantro.

This can be served with a healthy starch such as Quinoa or Brown Basmati Rice; just make sure you plan for enough time to cook it as well. Also, it is really easy to over-cook a stir-fry, so try not to cook it past having a little crunch in the center of the veggies. Let me know how it turns out for you and remember to choose to enjoy cooking!!

The only way to grow is to push yourself beyond your current limits. We want to challenge you and push you physically to be even better than you think you can be. Your mission (should you choose to accept) is to do 100 push-ups… consecutively. If you are like the majority of us, you cant even do 20% of that, but there’s still hope. On November 14^th, we will begin a 6-week training schedule that will land us on being able to do 100 pushups on Christmas day. What a gift to yourself! Not convinced? Read more here. The training seems very doable as it will equate to only 30 minutes per week (3 days each week at about 10 minutes per day). So who’s with us?! The staff here at Compass are excited to try it out and would love to have other participate in the challenge with us!

During the holiday months, it is our culture’s habit to bring the focus on ourselves. There are so many opportunities to give, volunteer, and invest into others lives, yet it is so easy to look past them. I have compiled seven different general ways that we can meet the needs of others through local organizations this holiday season. I would love to get feedback on if you follow through with any of these ideas and how it panned out for you.

Choose to serve others in our community by meeting their basic needs: food, clothing, and shelter. This not only helps the recipients, it can also create a foundation for your kids to begin thinking about others and their needs. This can practically look like a few different things: You can donate blankets, coats, boots, hats and gloves, etc to places such as: Fathers and Families, Outreach Inc, Shepherd Community Center, or Wheeler Mission Ministries. Volunteer at food banks/ food kitchens including: Cathedral Kitchen and Food Pantry, Second Helpings, Indy First Free Methodist Church, or St. Vincent DePaul Food pantry. And volunteer with homeless at: Outreach Inc, Dayspring Center Inc, and Shepherd Community Center.

One Warm Coat – This is the coat drive we (Compass) took part in last winter and are excited to participate again for a second year. We will be accepting gently used coats for all ages and sizes and will additionally reward you with a free 30 minute massage! The coat drive will run from November 1^st to November 30!

Many elderly in nursing homes are lonely, exhausted, and missing time with family. During the holiday seasons, sadness and depression are exacerbated as many are unable to spend that quality time with their family and friends. You can bring love and warmth to seniors in our community by just carving a bit of your time to spend with them. You could pass out flowers with your children, help your kids make crafts to give away, play Bingo or other games, or simply sit and talk with them.

Pets live in warm loving homes, but animals at shelters need love too. Especially during cold seasons, animal shelters need assistance with keeping animals safe from the elements. Families could bring in supplies to animal shelters, spend time with lonely animals, or even foster an animal or two. A few local animal shelters include the Humane Society of Indianapolis, Cat’s Haven Ltd, Lucky Dog Retreat Inc.

Ask others how they are doing. Whether its the person sitting next to you at the bus stop or the person the next cubicle over, it’s so easy to engage in conversation. Everyone loves talking about themselves and what a great time to get to know someone new. A few simple starter questions include: Do you have any Christmas Traditions?  Who will you be spending the holidays with this year? If you could receive anything for Christmas this year, what would it be? If you could give someone anything for Christmas, what would you give?

Snow Removal! If our winter will be close to as intense as our summer was, we will have some cold and wet days this winter! Shoveling snow off a driveway or sidewalk for neighbors is a very practical way for kids to help out during the winter. Depending on their ages, you might even be able to let them go on their own while you prepare some warm treats back at home.

Sharing and giving are two great skills that should be taught to the next generation, but are hard lessons to attain… especially to the point that you are doing it joyfully! Regular evaluation of your possessions can reveal an overabundance of unused things that could be a great gift for others. Whether it is giving away unused clothing, toys, or household items, what a clear way to show your concern for those around you. Places to consider: Toys for Tots, Wheeler Mission Ministries, John P Craine House, and Partners in Housing.